Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · May 2019
Shoulder arthroplasty after prior anterior stabilization procedures: do reverses have better outcomes?
Few studies have focused on shoulder arthroplasty after anterior stabilization procedures. This study compares the outcomes of total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA) after anterior stabilization surgical procedures. ⋯ RTSA patients had better postoperative improvement in most ROMs and all functional scores; only the ASES score was statistically significant. This study suggests better outcomes with a lower complication rate with RTSA after prior anterior stabilization procedures compared with TSA.
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J Shoulder Elbow Surg · May 2019
Liposomal bupivacaine reduces opiate consumption after rotator cuff repair in a randomized controlled trial.
Arthroscopic rotator cuff repair (ARCR) provides excellent clinical outcomes but is often associated with significant postoperative pain. The use of intraoperative anesthesia in conjunction with multimodal pharmacologic strategies is a widely accepted approach for managing surgical pain and reducing opiate use. The purpose of this study was to determine whether using a combined field and suprascapular nerve block with liposomal bupivacaine (LB) in addition to an interscalene block would provide greater pain relief and a reduction in opiate consumption compared with an interscalene block alone. ⋯ The findings of this study suggest that the addition of LB to multimodal anesthetic protocols significantly reduces the acute perioperative pain experienced following rotator cuff repair and the number of narcotic pills consumed in the first 5 days after ARCR. Furthermore, the findings provide guidelines for postoperative narcotic prescribing to reduce the quantity of opiates prescribed.
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J Shoulder Elbow Surg · Apr 2019
Long-term results after arthroscopic transosseous rotator cuff repair.
The purpose of this study was to evaluate the long-term clinical and radiologic results after arthroscopic transosseous rotator cuff repair (TORCR). ⋯ Arthroscopic TORCR for the treatment of full-thickness rotator cuff tears provided good clinical results 12 to 18 years after surgery. Cuff integrity on follow-up MRI scans had a positive effect on the clinical outcome.
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J Shoulder Elbow Surg · Mar 2019
Meta AnalysisTuberosity healing after reverse shoulder arthroplasty for complex proximal humeral fractures in elderly patients-does it improve outcomes? A systematic review and meta-analysis.
Reverse shoulder arthroplasty (RSA) is being increasingly used for complex, displaced fractures of the proximal humerus in older patients. Anatomic tuberosity healing in RSA has been recognized to restore better shoulder function. We compared the reported clinical and functional outcomes of RSA in proximal humeral fractures with and without tuberosity healing. ⋯ The RSA group with healed greater tuberosity showed better range of motion, especially forward flexion and external rotation and Constant scores, compared with the nonhealed greater tuberosity group. Tuberosity healing may influence overall shoulder function after RSA for proximal humeral fractures in the elderly, and this needs verification with future prospective studies.
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J Shoulder Elbow Surg · Mar 2019
Reverse shoulder arthroplasty for acute fractures in the elderly: is it worth reattaching the tuberosities?
Reverse Shoulder Arthroplasty (RSA) may be indicated in displaced proximal humerus fractures in elderly patients. We hypothesized that tuberosity fixation and healing around the prosthesis would result in better outcomes and patient satisfaction. ⋯ Despite the advanced age of the patients, tuberosity reattachment and use of bone graft results in a high rate of tuberosity healing. Tuberosity reconstruction and healing in reverse shoulder arthroplasty for fractures improves active forward elevation, external rotation, and patient satisfaction.