Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Jan 2018
Tobacco use predicts a more difficult episode of care after anatomic total shoulder arthroplasty.
In the current health care environment, it is becoming increasingly important to recognize risks factors that may affect a patient's postoperative outcome. To determine the potential impact of tobacco as a risk factor, we evaluated postoperative pain, narcotic use, length of stay, reoperations, and complications in the global 90-day episode of care for patients undergoing anatomic total shoulder arthroplasty (TSA) who were current tobacco users, former users, or nonusers. ⋯ Although length of stay, complication rates, hospital readmissions, and reoperation rates were not significantly different, tobacco users reported increased postoperative pain and narcotic use in the global period after TSA. Former tobacco users were found to have a postoperative course similar to that of nonusers, suggesting that discontinuation of tobacco use can improve a patient's episode of care performance after TSA.
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J Shoulder Elbow Surg · Jan 2018
Structural glenoid grafting during primary reverse total shoulder arthroplasty using humeral head autograft.
Large glenoid bone defects in the setting of glenohumeral arthritis can present a challenge to the shoulder arthroplasty surgeon. The results of large structural autografting at the time of reverse total shoulder arthroplasty (RTSA) are relatively unknown. ⋯ RTSA incorporating structural grafting of the glenoid with humeral head autograft results in significant improvements in active forward elevation, pain, and function, with a low complication rate. This technique can reliably be used to achieve correction of large (up to 35°) glenoid defects with a 93% chance of baseplate survival and a 100% chance of graft incorporation in the short-term.
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J Shoulder Elbow Surg · Dec 2017
Comparative StudyBiomechanical comparison of three different plate configurations for comminuted clavicle midshaft fracture fixation.
The aim of this study was to compare the fixation rigidity of anterior, anterosuperior, and superior plates in the treatment of comminuted midshaft clavicle fractures. ⋯ In the surgical treatment of comminuted midshaft clavicle fractures, the fixation strength of anterosuperior plating was greater than that of anterior plating under rotational forces and similar to that of superior plating.
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J Shoulder Elbow Surg · Dec 2017
Randomized Controlled TrialRadiographic and clinical comparison of pegged and keeled glenoid components using modern cementing techniques: midterm results of a prospective randomized study.
Glenoid component loosening remains a significant issue after anatomic shoulder arthroplasty. Pegged glenoid components have shown better lucency rates than keeled components in the short term; however, midterm to long-term results have not fully been determined. We previously reported early outcomes of the current randomized controlled group of patients, with higher glenoid lucency rates in those with a keeled glenoid. The purpose of this study was to evaluate the radiographic and clinical outcomes of these components at minimum 5-year follow-up. ⋯ At an average 7.9-year follow-up, non-ingrowth, all-polyethylene pegged glenoid implants are equivalent to keeled implants with respect to radiolucency, clinical outcomes, and need for revision surgery.
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J Shoulder Elbow Surg · Dec 2017
Epidemiology of proximal humeral fractures: a detailed survey of 711 patients in a metropolitan area.
Literature lacks data concerning several epidemiologic aspects of proximal humeral fractures (PHFs). ⋯ PHFs have a higher prevalence and incidence in females and in older age, respectively; they are more frequent in the winter months. In addition, male fractures are due to different traumatic events than those in females. A correlation between trauma and PHF pattern was evident only for adults. Some fracture patterns are correlated with different ranges of age in all patients.