Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Apr 2017
Bilateral reverse total shoulder arthroplasty-functional outcome and activities of daily living.
Reverse total shoulder arthroplasty (rTSA) has gained popularity in recent years, providing good shoulder elevation, yet less predictable rotations. Good rotations are crucial for performance of activities of daily living (ADLs), including personal hygiene. Concerns remain regarding bilateral rTSA over lack of rotations bilaterally and resultant difficulties with ADLs. This study examined the outcome of patients with bilateral rTSA in restoration of function and ADLs. ⋯ Bilateral rTSA results in marked and predictable improvement in all movements, pain relief, and functional outcomes, with high patient satisfaction and high ADLEIR score. All patients were able to perform perineal hygiene after their rTSA. Most patients had no limitation in ADLs and their leisure activities.
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J Shoulder Elbow Surg · Apr 2017
Comparative StudyComparison of reverse total shoulder arthroplasty outcomes with and without subscapularis repair.
Repair of the subscapularis with reverse total shoulder arthroplasty (rTSA) is controversial. The purpose of this study is to quantify rTSA outcomes in patients with and without subscapularis repair to determine if there is any impact on clinical outcomes. ⋯ Significant clinical improvements were observed for both the subscapularis-repaired and non-repaired cohorts, with some statistical differences observed using a variety of outcome measures. Repair of the subscapularis did not lead to inferior clinical outcomes as predicted by biomechanical models. No difference was noted in the complication or scapular notching rates between cohorts. These clinical results show that rTSA using a lateralized humeral prosthesis delivers reliable clinical improvements with a low risk of instability, regardless of subscapularis repair.
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J Shoulder Elbow Surg · Apr 2017
Loss of reduction and complications of coracoclavicular ligament reconstruction with autogenous tendon graft in acute acromioclavicular dislocations.
This study was conducted to report loss of reduction and complications after single-tunnel coracoclavicular (CC) ligament reconstruction with autogenous semitendinosus tendon graft for acute acromioclavicular (AC) joint dislocations. ⋯ In acute AC joint dislocation, single-tunnel CC ligament reconstruction using autogenous tendon graft resulted in loss of reduction rate of 47% and a complication rate of 20%. The development of complications adversely affected clinical outcomes.
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J Shoulder Elbow Surg · Apr 2017
Length of time between surgery and return to sport after ulnar collateral ligament reconstruction in Major League Baseball pitchers does not predict need for revision surgery.
Pitchers who return to sport (RTS) sooner will have a higher risk of revision ulnar collateral ligament reconstruction (UCLR) than those who return later. ⋯ No statistically significant difference existed in the length of time to RTS after UCLR in professional baseball players who required a revision UCLR and those who did not.
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J Shoulder Elbow Surg · Mar 2017
Relative individual workload changes may be a risk factor for rerupture of ulnar collateral ligament reconstruction.
With an increasing number of Major League Baseball (MLB) players undergoing ulnar collateral ligament (UCL) reconstruction, there remains limited literature on appropriate post-reconstruction workload management to limit the risk of reinjury. ⋯ This study's findings suggest that MLB pitchers who require revision UCL reconstruction after returning to play following primary UCL reconstruction pitch at or above their pre-primary UCL reconstruction workload whereas control pitchers who do not require revision pitch significantly less, below their pre-primary UCL reconstruction workload.