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Factors associated with patient satisfaction after arthroscopic rotator cuff repair: do they differ by age? 关节镜下肩袖修复术后患者满意度的相关因素:是否因年龄而异?
IF 1.8 Q2 ORTHOPEDICS Pub Date : 2024-09-01 Epub Date: 2024-08-07 DOI: 10.5397/cise.2024.00283
Jung-Han Kim, Soo-Hwan Jung, Dae-Hyun Park, Yong-Uk Kwon, Hyo-Young Lee

Background: Several studies have investigated factors affecting patient satisfaction after arthroscopic rotator cuff repair (ARCR); however, it is unknown if these factors vary according to age. Therefore, this study aimed to evaluate the factors associated with satisfaction of ARCR in individuals 70 years and older versus younger patients.

Methods: Among 319 consecutive patients who underwent ARCR, 173 were included. Patients were divided into an old age group (≥70 years) and a young age group (<70 years), and the two age groups were further divided into satisfied and unsatisfied subgroups. Patient satisfaction was evaluated at the final follow-up visit using a binary question (yes or no). Clinical outcomes were assessed preoperatively and at the final follow-up.

Results: Satisfaction rates in the older and younger age groups were 75.41% and 79.47%, respectively. Mean changes in Constant and American Shoulder and Elbow Surgeons scores were significantly different between the satisfied and unsatisfied subgroups (P=0.031 and P=0.012, respectively) in the young patients. In the old patients, there was a significant difference in the mean change in depression subscale of the Hospital Anxiety and Depression Scale (P=0.031) and anxiety subscale of the Hospital Anxiety and Depression Scale (P=0.044) scores between the satisfied and unsatisfied subgroups.

Conclusions: Factors affecting patient satisfaction after ARCR differed according to age. Psychological improvement was more important to elderly patients, whereas restoration of function was more important to younger patients. Pain relief was important for both age groups. Level of evidence: III.

背景:有几项研究调查了影响关节镜下肩袖修复术(ARCR)后患者满意度的因素,但这些因素是否随年龄而变化尚不清楚。因此,本研究旨在评估 70 岁及以上患者与年轻患者对 ARCR 满意度的相关因素:在连续接受 ARCR 的 319 名患者中,纳入了 173 人。患者被分为老年组(≥70 岁)和年轻组(结果:老年组和年轻组患者的满意度均高于老年组):老年组和年轻组的满意率分别为 75.41% 和 79.47%。在年轻患者中,满意亚组和不满意亚组的常量和美国肩肘外科医生评分的平均变化有显著差异(分别为 P=0.031 和 P=0.012)。在老年患者中,医院焦虑抑郁量表抑郁分量表(P=0.031)和医院焦虑抑郁量表焦虑分量表(P=0.044)评分的平均变化在满意和不满意亚组之间存在显著差异:ARCR术后影响患者满意度的因素因年龄而异。心理改善对老年患者更为重要,而恢复功能对年轻患者更为重要。疼痛缓解对两个年龄组的患者都很重要。证据等级:III.
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引用次数: 0
Arthroscopic matched osteoplasty of the radial head for painful radiocapitellar osteoarthritis: surgical technique and case series. 关节镜下桡骨头匹配骨成形术治疗放射髌骨关节炎疼痛:手术技术和病例系列。
IF 1.8 Q2 ORTHOPEDICS Pub Date : 2024-09-01 Epub Date: 2024-07-30 DOI: 10.5397/cise.2024.00073
Dani Rotman, Adam C Watts

Background: Radiocapitellar arthritis can cause pain, loss of motion, and impaired elbow function. Current surgical treatment options are limited. We have developed an original and simple surgical technique to address this, called arthroscopic matched osteoplasty of the radial head (AMOR). In AMOR, the radial head is partially resected and recontoured to match the capitellum and decompress the degenerate radiocapitellar articulation while preserving the ulnohumeral articulation where the cartilage is usually well preserved.

Methods: Indications and the surgical technique of the AMOR procedure are described. A retrospective observational service evaluation study was conducted from electronic patient records. Collected clinical outcomes included range of motion, pain level, subjective functional score, and general satisfaction with the results of the procedure. The radiographic outcome was radiocapitellar joint space.

Results: Between 2017 and 2021, eight consecutive patients underwent AMOR as part of an arthroscopic osteocapsular arthroplasty procedure. Radiographically, the mean radiocapitellar joint space improved from an average of 1.7 mm to 4.6 mm. Clinically, the mean pain score decreased from 8/10 to 3/10. Six of the eight patients (75%) were satisfied with their results. In two cases, initial improvement following surgery lasted less than 1 year, and one of these patients underwent total elbow arthroplasty for painful ulnohumeral osteoarthritis. There were no complications of surgery recorded.

Conclusions: AMOR is a safe treatment option for painful radiocapitellar osteoarthritis and can be incorporated as an "add-on" procedure by surgeons performing elbow osteocapsular arthroplasty in cases with a positive grip and grind test and radiographic evidence of radiocapitellar OA. Level of evidence: IV.

背景:桡骨髌关节炎会导致疼痛、活动障碍和肘关节功能受损。目前的手术治疗方案有限。针对这一问题,我们开发了一种新颖而简单的手术技术,即桡骨头关节镜匹配骨成形术(AMOR)。在 AMOR 中,桡骨头被部分切除并重新塑形,以与髌骨相匹配,并对退化的桡骨髌骨关节进行减压,同时保留尺桡关节,因为尺桡关节的软骨通常保存完好:方法:介绍了AMOR手术的适应症和手术技巧。根据电子病历开展了一项回顾性观察服务评估研究。收集的临床结果包括活动范围、疼痛程度、主观功能评分以及对手术结果的总体满意度。影像学结果为髌骨关节间隙:2017年至2021年间,连续有8名患者接受了AMOR手术,作为关节镜下骨帽关节成形术的一部分。从影像学上看,平均桡髌关节间隙从平均 1.7 毫米改善到 4.6 毫米。临床上,平均疼痛评分从 8/10降至 3/10。八名患者中有六名(75%)对手术效果表示满意。有两名患者术后的初步改善持续时间不到一年,其中一名患者因疼痛性尺肱骨关节炎接受了全肘关节置换术。没有手术并发症的记录:结论:AMOR是一种治疗放射性髌骨关节炎疼痛的安全方法,可作为肘关节骨关节置换术的 "附加 "手术。证据等级:IV级。
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引用次数: 0
Comparison of clinical outcomes of anterior combined latissimus dorsi and teres major tendon transfer for anterior superior irreparable rotator cuff tear between young and elderly patients. 年轻和老年患者前方背阔肌和大圆肌腱联合转移治疗前上不可修复肩袖撕裂的临床疗效比较。
IF 1.8 Q2 ORTHOPEDICS Pub Date : 2024-09-01 Epub Date: 2024-08-06 DOI: 10.5397/cise.2024.00248
Chang Hee Baek, Bo Taek Kim, Jung Gon Kim, Seung Jin Kim

Background: Anterior combined latissimus dorsi and teres major (aLDTM) tendon transfer has shown promise as a treatment for anterior superior irreparable rotator cuff tears (ASIRCTs). Our study aimed to compare aLDTM clinical outcomes for ASIRCTs between young and elderly patients.

Methods: This retrospective study reviewed data from patients who underwent aLDTM tendon transfer for ASIRCTs with minimum 2-year follow-up. Clinical evaluations included visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE), active range of motion (aROM), strength, and complications. Radiologic assessments included acromiohumeral distance, Hamada classification, and integrity of transferred tendon. Patients were divided into group total (all ages), group old (≥70 years), and group young (≤60 years).

Results: A total of 123 patients were enrolled with 39 in group young (mean age, 56.6±4.9 years) and 27 in group old (mean age, 73.6±2.3 years). Postoperatively, both groups showed significant improvements in VAS, ASES, and SANE scores and improved aROM for forward elevation, abduction, and internal rotation. No significant differences in clinical coutcomes were noted between the groups. Furthermore, similar rates of complications, including retears and postoperative infections, were observed across all three groups.

Conclusions: Our study highlights the effectiveness of aLDTM transfer for ASIRCTs with minimal glenohumeral arthritis, demonstrating similar outcomes in both group young and group old patients. Moreover, patients in these distinct age groups showed comparable clinical results when compared to group total. Level of evidence: III.

背景:前联合背阔肌和大圆肌腱(aLDTM)转移作为一种治疗前上不可修复肩袖撕裂(ASIRCTs)的方法,已显示出良好的前景。我们的研究旨在比较年轻患者和老年患者的 aLDTM 治疗 ASIRCT 的临床效果:这项回顾性研究回顾了因 ASIRCT 而接受 aLDTM 肌腱转移术的患者的数据。排除标准为无法进行评估:共有 123 例患者入组,其中年轻组 39 例(平均年龄为 56.6±4.9 岁),老年组 27 例(平均年龄为 73.6±2.3 岁)。术后,两组患者的 VAS、ASES 和 SANE 评分均有明显改善,前倾、外展和内旋的 aROM 均有改善。两组间无明显差异。两组之间的力量增量无明显差异。与所有组别相比,年轻组和年长组在 VAS、ASES 和 SANE 评分以及 aROM 和放射学评估方面的结果相当。此外,三组患者的并发症发生率相似,包括再次撕裂和术后感染:我们的研究强调了在盂肱关节炎程度较轻的 ASIRCT 中采用 aLDTM 转移术的有效性,在年轻组和年长组患者中均显示出相似的疗效。此外,与全组相比,这些不同年龄组患者的临床效果相当。证据等级:III.
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引用次数: 0
Improving arthroscopic subscapularis repair: the essential role of surgical anatomical landmarks. 改进关节镜下肩胛下肌修复术:手术解剖标志的重要作用。
IF 1.8 Q2 ORTHOPEDICS Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI: 10.5397/cise.2024.00577
Sung Il Wang
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引用次数: 0
Persistent lateral elbow pain from overlooked posterolateral impingement of the elbow: a literature review and guidance for treatment. 被忽视的肘关节后外侧撞击引起的持续性肘外侧疼痛:文献综述和治疗指南。
IF 1.8 Q2 ORTHOPEDICS Pub Date : 2024-08-07 DOI: 10.5397/cise.2023.01081
Gur-Aziz Singh Sidhu, Niyam Amanullah, Harjot Kaur, Saphalya Pattnaik, Neil Ashwood, Andrew Peter Dekker, Harpal Singh Selhi

Posterolateral impingement is sometimes diagnosed as a cause of refractory elbow pain, often after other treatments have been tried for common conditions such as lateral epicondylitis (tennis elbow) or subtly different conditions common in throwing athletes, such as valgus extension overload syndrome. Arthroscopic surgical treatment is effective when targeting abnormal anatomy such as plical folds. Partial excision of the olecranon must be undertaken with caution because it can lead to instability. This systematic review of the current literature uses a narrative synthesis to identify anatomical morphological variations of the olecranon, humeral and capitellar geometry, and overloading of the lateral part of the elbow as causative factors for this condition and discusses how arthroscopic techniques can resolve symptoms. Further understanding of the static and dynamic anatomy of the lateral part of the elbow will help to develop future treatment and preventive strategies.

后外侧撞击有时被诊断为难治性肘部疼痛的原因,通常是在尝试过其他治疗方法后出现的常见疾病,如外侧上髁炎(网球肘)或投掷运动员常见的微妙不同的疾病,如外翻伸展超负荷综合征。关节镜手术治疗在针对异常解剖结构(如犁状皱褶)时非常有效。对肩胛骨进行部分切除时必须谨慎,因为这可能会导致不稳定。这篇对当前文献的系统性综述采用叙述性综合的方式,将肩胛骨的解剖形态变化、肱骨和髌骨的几何形状以及肘外侧部分的过度负荷确定为该病症的致病因素,并讨论了关节镜技术如何解决症状。进一步了解肘外侧的静态和动态解剖结构将有助于制定未来的治疗和预防策略。
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引用次数: 0
The role of vitamin D in shoulder health: a comprehensive review of its impact on rotator cuff tears and surgical results. 维生素 D 在肩部健康中的作用:全面回顾维生素 D 对肩袖撕裂和手术效果的影响。
IF 1.8 Q2 ORTHOPEDICS Pub Date : 2024-07-30 DOI: 10.5397/cise.2024.00220
Mohammad Daher, Oscar Covarrubias, Ryan Lopez, Peter Boufadel, Maria Catherine Rita Hachem, Ziad Zalaquett, Mohamad Y Fares, Joseph A Abboud

Vitamin D deficiency is highly prevalent in the general population and is associated with various chronic health conditions. In addition to its role in bone mineralization, Vitamin D has various physiological effects that may impact the pathogenesis of shoulder pathologies. Vitamin D deficiency may also affect outcomes after shoulder surgeries, such as rotator cuff repair and total shoulder arthroplasty. Vitamin D plays a role in tissue healing, bone growth, and maintenance of homeostasis in skeletal muscle cells. Vitamin D also has anti-inflammatory effects that are important to rotator cuff health. Vitamin D deficiency is highly prevalent in patients with rotator cuff tears, suggesting its role as a potential risk factor. Vitamin D deficiency has been associated with decreased preoperative shoulder strength as well as increased re-tear rates, postoperative stiffness, and the need for revision surgery in patients who underwent rotator cuff repair. Studies have also demonstrated a potential association between vitamin D deficiency and increased risk of revision after total shoulder arthroplasty. Further research is necessary to elucidate the direct role of vitamin D in the pathogenesis of rotator cuff tears and its impact on clinical outcomes after rotator cuff surgery and total shoulder arthroplasty.

维生素 D 缺乏症在普通人群中非常普遍,并与各种慢性疾病相关。除了在骨矿化中的作用外,维生素 D 还具有各种生理效应,可能会影响肩部病变的发病机制。缺乏维生素 D 还可能影响肩部手术(如肩袖修复术和全肩关节置换术)后的效果。维生素 D 在组织愈合、骨骼生长和维持骨骼肌细胞平衡方面发挥着作用。维生素 D 还具有抗炎作用,对肩袖健康非常重要。肩袖撕裂患者普遍缺乏维生素 D,这表明维生素 D 是一个潜在的风险因素。维生素 D 缺乏与肩袖修复患者术前肩部力量下降、再次撕裂率增加、术后僵硬以及需要进行翻修手术有关。研究还表明,维生素 D 缺乏与全肩关节置换术后翻修风险增加之间存在潜在联系。要阐明维生素 D 在肩袖撕裂发病机制中的直接作用及其对肩袖手术和全肩关节置换术后临床效果的影响,还需要进一步的研究。
{"title":"The role of vitamin D in shoulder health: a comprehensive review of its impact on rotator cuff tears and surgical results.","authors":"Mohammad Daher, Oscar Covarrubias, Ryan Lopez, Peter Boufadel, Maria Catherine Rita Hachem, Ziad Zalaquett, Mohamad Y Fares, Joseph A Abboud","doi":"10.5397/cise.2024.00220","DOIUrl":"https://doi.org/10.5397/cise.2024.00220","url":null,"abstract":"<p><p>Vitamin D deficiency is highly prevalent in the general population and is associated with various chronic health conditions. In addition to its role in bone mineralization, Vitamin D has various physiological effects that may impact the pathogenesis of shoulder pathologies. Vitamin D deficiency may also affect outcomes after shoulder surgeries, such as rotator cuff repair and total shoulder arthroplasty. Vitamin D plays a role in tissue healing, bone growth, and maintenance of homeostasis in skeletal muscle cells. Vitamin D also has anti-inflammatory effects that are important to rotator cuff health. Vitamin D deficiency is highly prevalent in patients with rotator cuff tears, suggesting its role as a potential risk factor. Vitamin D deficiency has been associated with decreased preoperative shoulder strength as well as increased re-tear rates, postoperative stiffness, and the need for revision surgery in patients who underwent rotator cuff repair. Studies have also demonstrated a potential association between vitamin D deficiency and increased risk of revision after total shoulder arthroplasty. Further research is necessary to elucidate the direct role of vitamin D in the pathogenesis of rotator cuff tears and its impact on clinical outcomes after rotator cuff surgery and total shoulder arthroplasty.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors associated with long head of the biceps tendon tear severity and predictive insights for grade II tears in rotator cuff surgery. 肱二头肌长头肌腱撕裂严重程度的相关因素以及肩袖手术中 II 级撕裂的预测性见解。
Pub Date : 2024-06-01 Epub Date: 2024-04-22 DOI: 10.5397/cise.2023.01053
Dong-Hyun Lee, Gyu-Min Lee, Hyung Bin Park

Background: In rotator cuff repair, the long head of the biceps tendon (LHB) is commonly used as graft material. However, factors influencing LHB tear severity are poorly understood, and predicting grade II LHB tears is challenging. This study aimed to identify these factors preoperatively.

Methods: The demographics, medical parameters, and pain severity of 750 patients who underwent arthroscopic surgery from January 2010 to February 2021 were evaluated to determine the factors associated with LHB tear severity and grade II tears. Both overall and largeto-massive rotator cuff tear (RCT) cohorts underwent ordinal and binary logistic regression analyses. Predictive accuracy for grade II LHB tears was determined using the area under the receiver operating characteristic curve (AUC).

Results: In the overall cohort, high-sensitivity C-reactive protein (hs-CRP) >1 mg/L (P<0.001), subscapularis tear (P<0.001), hypothyroidism (P=0.031), and the tangent sign (P=0.003) were significantly associated with LHB tear severity, and hs-CRP>1 mg/L, subscapularis tear, and Patte retraction degree were significantly associated with grade II LHB tears (P<0.001). In the large-to-massive RCT cohort, hs-CRP>1 mg/L, hypertension, and age ≥50 years (P<0.05) were significantly associated with LHB tear severity, and hs-CRP>1 mg/L (P<0.001) and hypertension (P=0.026) were significantly associated with grade II LHB tears. In both cohorts, hs-CRP >1 mg/L demonstrated good predictive accuracy for grade II LHB tears (AUCs: 0.72 and 0.70).

Conclusions: Serum hs-CRP >1 mg/L is associated with LHB tear severity and serves as a reliable predictor of grade II LHB tears, facilitating preoperative assessment of the LHB as potential graft material in arthroscopic rotator cuff repair. Level of evidence: III.

背景:在肩袖修复中,肱二头肌长头肌腱(LHB)是一种常见的移植材料。然而,人们对与 LHB 撕裂严重程度相关的因素知之甚少,而且很难预测 II 级 LHB 撕裂。本研究旨在手术前确定这些因素:评估了2010年1月至2021年2月期间接受关节镜手术的750名患者的人口统计学特征、医疗参数和疼痛严重程度,以确定与LHB撕裂严重程度和II级LHB撕裂相关的因素。研究人员使用序数和二元逻辑回归分析法对总体研究人群和大到重度肩袖撕裂(RCT)人群进行了分析。使用接收者操作特征曲线下面积(AUC)曲线确定了II级LHB撕裂的预测准确性:在总体队列中,高敏C反应蛋白(hs-CRP)>1 mg/L、肩胛下撕裂、甲状腺机能减退和切线征(P≤0.031)与LHB撕裂严重程度显著相关,而hs-CRP>1 mg/L、肩胛下撕裂和Patte回缩程度与II级LHB撕裂显著相关(P1 mg/L、高血压和年龄≥50岁(P≤0.034)与LHB撕裂严重程度明显相关,hs-CRP>1 mg/L和高血压与II级LHB撕裂明显相关(P≤0.026)。在两个队列中,hs-CRP>1 mg/L对II级LHB撕裂具有良好的预测准确性(AUC:0.72和0.70):结论:血清 hs-CRP >1 mg/L 与 LHB 撕裂严重程度相关,是预测 II 级 LHB 撕裂的可靠指标,有助于术前评估 LHB 作为关节镜下肩袖修复的潜在移植物材料。
{"title":"Factors associated with long head of the biceps tendon tear severity and predictive insights for grade II tears in rotator cuff surgery.","authors":"Dong-Hyun Lee, Gyu-Min Lee, Hyung Bin Park","doi":"10.5397/cise.2023.01053","DOIUrl":"10.5397/cise.2023.01053","url":null,"abstract":"<p><strong>Background: </strong>In rotator cuff repair, the long head of the biceps tendon (LHB) is commonly used as graft material. However, factors influencing LHB tear severity are poorly understood, and predicting grade II LHB tears is challenging. This study aimed to identify these factors preoperatively.</p><p><strong>Methods: </strong>The demographics, medical parameters, and pain severity of 750 patients who underwent arthroscopic surgery from January 2010 to February 2021 were evaluated to determine the factors associated with LHB tear severity and grade II tears. Both overall and largeto-massive rotator cuff tear (RCT) cohorts underwent ordinal and binary logistic regression analyses. Predictive accuracy for grade II LHB tears was determined using the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>In the overall cohort, high-sensitivity C-reactive protein (hs-CRP) >1 mg/L (P<0.001), subscapularis tear (P<0.001), hypothyroidism (P=0.031), and the tangent sign (P=0.003) were significantly associated with LHB tear severity, and hs-CRP>1 mg/L, subscapularis tear, and Patte retraction degree were significantly associated with grade II LHB tears (P<0.001). In the large-to-massive RCT cohort, hs-CRP>1 mg/L, hypertension, and age ≥50 years (P<0.05) were significantly associated with LHB tear severity, and hs-CRP>1 mg/L (P<0.001) and hypertension (P=0.026) were significantly associated with grade II LHB tears. In both cohorts, hs-CRP >1 mg/L demonstrated good predictive accuracy for grade II LHB tears (AUCs: 0.72 and 0.70).</p><p><strong>Conclusions: </strong>Serum hs-CRP >1 mg/L is associated with LHB tear severity and serves as a reliable predictor of grade II LHB tears, facilitating preoperative assessment of the LHB as potential graft material in arthroscopic rotator cuff repair. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does the polarity of radial head arthroplasty affect functional outcomes? A systematic review and meta-analysis. 桡骨头关节置换术的极性是否会影响功能结果?
Pub Date : 2024-06-01 Epub Date: 2024-04-30 DOI: 10.5397/cise.2023.01088
Kofi Agyeman, Arya Minaie, Seth D Dodds

Background: Radial head arthroplasty allows a high degree of customizability, and implant polarity has emerged as an important variable. The purpose of this meta-analysis was to evaluate differences in functional and clinical outcomes between patients receiving monopolar and bipolar radial head prosthetic implants.

Methods: A systematic review and meta-analysis were employed, and 65 articles were identified in three databases. Twelve articles contained non-English or insufficient text and were consequently excluded, and 20 others did not contain sufficient data or follow-up. The remaining 33 articles were qualitatively and quantitatively reviewed.

Results: In total, 33 populations were identified, with 809 unduplicated patients: 565 with monopolar and 244 with bipolar implants. In these respective patients, the mean follow-up was 40.2 and 56.9 months. Average Mayo Elbow Performance Score were 86.7 and 87.4 (P=0.80), respectively; average Disability of the Arm, Shoulder, and Hand scores were 17.9 and 14.7 (P=0.47), and average final flexion/extension arcs were 119.4° and 118.7° (P=0.48). Revision rates were 4.07% and 6.56%, while complication rates were 19.65% and 20.08% in the respective monopolar and bipolar patients. These increased relative risks associated with bipolar implants were not significant.

Conclusions: Radial head implant polarity does not appear to affect functional outcomes. While bipolar prosthetic design may increase the risks of revision and complications, the increases were not significant. Level of evidence: IV.

背景:桡骨头关节成形术具有高度定制性,植入物的极性已成为一个重要变量。本荟萃分析旨在评估接受单极和双极桡骨头假体植入物的患者在功能和临床效果方面的差异:方法:采用系统综述和荟萃分析的方法,在三个数据库中找到了 65 篇文章。其中12篇文章因非英文或文本不足而被排除,另外20篇文章因数据或随访不足而被排除。对其余 33 篇文章进行了定性和定量审查:结果:总共确定了 33 个人群,809 名不重复的患者:其中 565 人使用单极种植体,244 人使用双极种植体。这些患者的平均随访时间分别为 40.2 个月和 56.9 个月。梅奥肘关节功能评分平均值分别为86.7和87.4(P=0.80);手臂、肩部和手部残疾评分平均值分别为17.9和14.7(P=0.47),最终屈伸弧度平均值分别为119.4°和118.7°(P=0.48)。单极和双极患者的翻修率分别为 4.07% 和 6.56%,并发症发生率分别为 19.65% 和 20.08%。双极种植体增加的相对风险并不显著:结论:桡骨头植入物的极性似乎不会影响功能性结果。虽然双极假体设计可能会增加翻修和并发症的风险,但增加的风险并不显著。
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引用次数: 0
Arthroscopic treatment of chronic calcific tendinitis with intraosseous migration: a case report. 关节镜治疗伴有骨内移位的慢性钙化性腱鞘炎:病例报告。
Pub Date : 2024-06-01 Epub Date: 2024-01-29 DOI: 10.5397/cise.2023.00654
Jung Uk Kim, Pei Wei Wang

We present a case of calcific tendinitis in the shoulder, where calcifications were observed within both the tendon and the adjacent bone. At the time of acute onset, radiographs (including a plain radiograph) and magnetic resonance imaging revealed calcific tendinitis with intraosseous migration. The patient's symptoms did not improve after 5 months of conservative treatment. The patient underwent arthroscopic debridement of the calcific deposits, and the defect was repaired using the double-row repair technique. The patient's symptoms improved 3 months after arthroscopic treatment. We share our unusual experience with arthroscopic debridement in the treatment of chronic calcific tendinitis with intraosseous migration.

我们介绍了一例肩部钙化性肌腱炎病例,该病例的肌腱和邻近骨骼均出现钙化。急性发病时,X 光片(包括普通 X 光片)和磁共振成像显示钙化性肌腱炎伴有骨内移位。经过 5 个月的保守治疗,患者的症状没有改善。患者在关节镜下清除了钙化沉积物,并使用双排修复技术修复了缺损。关节镜治疗 3 个月后,患者的症状有所改善。我们与大家分享关节镜清创术治疗伴有骨内移位的慢性钙化性腱鞘炎的独特经验。
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引用次数: 0
Reverse total shoulder replacement for patients with "weight-bearing" shoulders. 为 "负重 "肩部患者提供反向全肩关节置换术。
Pub Date : 2024-06-01 Epub Date: 2024-03-13 DOI: 10.5397/cise.2023.00535
Ofer Levy, Georgios Arealis, Oren Tsvieli, Paolo Consigliere, Omri Lubovsky

Background: Reverse total shoulder arthroplasty (rTSA) has gained popularity in recent years and is indicated for a wide variety of shoulder pathologies. However, use of rTSA in patients with "weight-bearing" shoulders that support wheelchair use or crutches has higher risk. The aim of this study was to assess the results of rTSA in such patients.

Methods: Between 2005 and 2014, 24 patients (30 shoulders) with weight-bearing shoulders were treated with rTSA at our unit. Patients had cuff arthropathy (n=21), rheumatoid arthritis (n=3), osteoarthritis (n=1), acute fracture (n=3), or fracture sequela (n=2). Postoperatively, patients were advised not to push themselves up and out of their wheelchair for 6 weeks. This study was performed in 2016, and 21 patients (27 shoulders) were available for a mean follow-up of 5.6 years (range, 2-10 years). The mean age at surgery was 78 years (range, 54-90 years).

Results: Constant-Murley score improved from 9.4 preoperatively to 59.8 at the final follow-up (P=0.001). Pain score improved from 2/15 to 13.8/15 (P=0.001). Patient satisfaction (Subjective Shoulder Value) improved from 0.6/10 to 8.7/10 (P=0.001). Significant improvement in mean range of motion from 46° to 130° of elevation, 14° to 35° of external rotation, and 29° to 78° internal rotation was recorded (P=0.001). Final mean Activities of Daily Living External and Internal Rotation was 32.4/36. Only three patients showed Sirveaux-Nerot grade-1 (10%) glenoid notching and three grade 2 (10%).

Conclusions: rTSA can be used for treatment of patients with weight-bearing shoulders. Such patients reported pain free movement, resumed daily activities, and high satisfaction rates. Level of evidence: IV.

背景:反向全肩关节置换术(rTSA)近年来越来越受欢迎,适用于多种肩部病变。然而,对于肩部 "负重"、需要使用轮椅或拐杖的患者来说,使用反向全肩关节置换术的风险较高。本研究旨在评估 rTSA 在此类患者中的应用效果:2005年至2014年期间,我院对24名肩部负重患者(30个肩部)进行了rTSA治疗。患者患有袖带关节病(21 例)、类风湿性关节炎(3 例)、骨关节炎(1 例)、急性骨折(3 例)或骨折后遗症(2 例)。术后,建议患者在 6 周内不要将自己推出轮椅。研究手术于2016年进行,21名患者(27个肩部)接受了平均5.6年(2-10年)的随访。手术当天的平均年龄为78岁(54-90岁)。Constant-Murley评分从术前的9.4(范围:2-26)提高到最终随访时的59.8(范围:29-80)(P=0.001):结果:疼痛从 2/15(范围 0-8)改善到 13.8/15(范围 9-15)(P=0.001)。最后随访时,患者满意度(肩部主观值)从 0.6/10 提高到 8.7/10(P=0.001)。记录显示,患者的平均活动范围明显改善,抬高从46°增加到130°,外旋从13°增加到35°,内旋从29°增加到78°(P=0.001)。日常生活活动外旋和内旋的最终平均值为 32.4/36(范围为 16-36)。有三名患者出现 Sirveaux-Nerot 1 级(10%)盂兰切迹,三名患者出现 2 级(10%)盂兰切迹。结论:rTSA 可用于肩部负重患者的治疗,此类患者可无痛活动,恢复日常活动,满意度高。
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引用次数: 0
期刊
Clinics in Shoulder and Elbow
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