Bulletin of the Hospital for Joint Disease (2013)
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Bull Hosp Jt Dis (2013) · Dec 2015
Multicenter Study Comparative StudyPreliminary Results of a Posterior Augmented Glenoid Compared to an all Polyethylene Standard Glenoid in Anatomic Total Shoulder Arthroplasty.
Osteoarthritis of the shoulder often results in significant posterior glenoid wear. The options for treating this have been eccentric glenoid reaming and occasionally bone grafting. More recently reverse total shoulder arthroplasty (rTSA) with or without bone grafting and posterior augmented glenoids (PAGs) has been introduced. The PAG restores the native joint line while reaming a minimal amount of glenoid bone. The purpose of this study is to compare osteoarthritic shoulders with significant posterior glenoid wear treated with anatomic total shoulder arthroplasty (aTSA) using a PAG to shoulders without glenoid wear treated with aTSA using a standard all poly pegged glenoid. ⋯ At a minimum of two-year follow-up, there were no statistical clinical differences between the PAG and NAG groups despite the PAG group being disadvantaged with posterior worn glenoids. There were no revisions in either group. No humeral heads resubluxated posteriorly. The PAG group had a higher incidence of lucent lines. Based on this short-term follow-up, a posterior augmented glenoid is a viable option for the posterior worn osteoarthritic glenoid.
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Bull Hosp Jt Dis (2013) · Dec 2015
Comparative StudyEtiology of Readmissions Following Orthopaedic Procedures and Medical Admissions. A Comparative Analysis.
The Federal Government, the largest payer of health care, considers readmission within 30 days of discharge an indicator of quality of care. Many studies have focused on causes for and strategies to reduce readmissions following medical admissions. However, few studies have focused on the differences between them. We believe that the causes for readmission following orthopaedic surgery are markedly different than those following medical admissions, and therefore, the strategies developed to reduce medical readmissions will not be as effective in reducing readmissions after elective orthopaedic surgery. ⋯ The causes of readmissions following orthopaedic surgery and medical admissions are different. Patients undergoing orthopaedic procedures are readmitted for surgical complications, frequently unrelated to aftercare, and medicine patients are readmitted for reasons related to the index diagnosis. Interventions designed to reduce orthopaedic readmissions must focus on reducing surgical complications, differing from interventions designed to reduce readmissions following medical admissions, which focus on medical diagnoses.
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Bull Hosp Jt Dis (2013) · Dec 2015
The Clinical and Economic Impact of Preoperative Transthoracic Echocardiography in Elderly Patients with Hip Fractures.
The purpose of this study was to evaluate preoperative transthoracic echocardiography (TTE) on cardiac intervention, length of stay (LOS), inpatient mortality, and costs. ⋯ Preoperative TTE in elderly patients with hip fractures resulted in a low cardiac intervention rate. Patients undergoing preoperative TTE prior to surgery had longer times to operation, LOS, and higher hospital costs. The utility of TTE as a preoperative screening tool is limited in the geriatric hip fracture population and does not appear to effect perioperative mortality rates.
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Bull Hosp Jt Dis (2013) · Dec 2015
Correlation Between Clinical Outcomes and Anatomic Reconstruction with Anatomic Total Shoulder Arthroplasty.
Many glenohumeral studies have demonstrated how anatomy varies across the population. Third and fourth generation shoulder prosthesis designs were developed to provide greater modularity and size ranges to better reproduce this anatomy and thus achieve better results in terms of shoulder function. This study quantifies the quality of anatomic reconstruction and compares that to long-term clinical outcomes using one fourth generation platform shoulder system. ⋯ This study confirmed that an improved anatomic reconstruction results in better postoperative clinica outcomes. The fourth generation prosthesis used for this study allows continuous in-situ adjustment of the humeral head orientation through use of the spherical taper on the replicator plate and also a double adjustment of offset through the use of the offset humeral head and offset taper on the replicator plate.
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Bull Hosp Jt Dis (2013) · Dec 2015
Comparative StudyPreliminary Results of a Novel Hybrid Cage Glenoid Compared to an All-Polyethylene Glenoid in Total Shoulder Arthroplasty.
The aim of this study was to evaluate the preliminary outcomes of a hybrid cage glenoid design in comparison to pegged all-polyethylene glenoid components in anatomic total shoulder arthroplasty (aTSA). ⋯ At minimum two-year follow-up, hybrid cage aTSA components show equal clinical outcomes to UHMWPE pegged glenoids. However, the hybrid cage components had significantly fewer radiolucent lines and less intra-operative blood loss. Additional and longer-term clinical and radiographic follow-up is necessary to confirm these promising early results.