Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Dec 2019
Construct validation of machine learning in the prediction of short-term postoperative complications following total shoulder arthroplasty.
We aimed to demonstrate that supervised machine learning (ML) models can better predict postoperative complications after total shoulder arthroplasty (TSA) than comorbidity indices. ⋯ With continued validation, intelligent models could calculate patient-specific risk for complications to adjust perioperative care and site of surgery.
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J Shoulder Elbow Surg · Dec 2019
Performance and return to sport following rotator cuff surgery in professional baseball players.
While many injuries to the rotator cuff in professional baseball players can be managed nonoperatively, recovery fails to occur with nonoperative treatment in some players and surgery on the rotator cuff is performed in an attempt to return to sport (RTS). ⋯ Rotator cuff débridement is significantly more common than repair in professional baseball players, with 86% of all rotator cuff surgical procedures reported as débridement. RTS rates following débridement and repair are disappointing, at 50.8% and 33.3%, respectively. For players who do return, performance declines after surgery.
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J Shoulder Elbow Surg · Nov 2019
Development of a clinical risk calculator for prolonged opioid use after shoulder surgery.
Understanding risk factors associated with prolonged opioid use to help mitigate abuse and develop presurgical screening programs to identify at-risk patients is paramount. The purpose of this study was to develop and validate a clinical risk assessment tool to preoperatively predict prolonged opioid use after shoulder surgery. ⋯ We present a preoperative predictive calculator to help identify at-risk patients and quantify their risk of prolonged opioid use after shoulder surgery. This is a valuable clinical decision-making tool to identify patients benefitting from referral to pain management specialists and to possibly reduce the risk of opioid abuse and addiction.
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J Shoulder Elbow Surg · Oct 2019
Opioid use following shoulder stabilization surgery: risk factors for prolonged use.
The purpose of this study was to determine the rate of opioid use before and after shoulder stabilization surgery for instability due to recurrent dislocation and assess patient factors associated with prolonged opioid use postoperatively. ⋯ Patients who were prescribed opioids 1 to 3 months before surgery had the highest risk of prolonged opioid use following surgery. Obesity, tobacco use, and a preoperative diagnosis of fibromyalgia were independently associated with prolonged opioid use following surgery.
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J Shoulder Elbow Surg · Oct 2019
Surgical management of chronic high-grade acromioclavicular joint dislocations: a systematic review.
To date, no gold-standard technique exists for the treatment of chronic acromioclavicular joint (ACJ) instability. We systematically reviewed the clinical results of 3 main categories of ACJ reconstruction for high-grade chronic instability. ⋯ On comparison of the results of 3 different ACJ reconstruction methods, all techniques showed similar complication rates. Among the level II studies, ACJ reconstruction with a tendon graft showed superior results.