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Improving visualization in shoulder arthroscopy. 提高肩关节镜的可视性。
Q2 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-02-22 DOI: 10.5397/cise.2022.01291
Emily R McDermott, David J Tennent, Daniel J Song

Arthroscopic shoulder procedures are one of the most common procedures used to restore function through minimally invasive techniques. With the demand for shoulder arthroscopic procedures comes the need for safe, effective, and efficient surgery that maximizes patient outcomes while minimizing complications. Many variables contribute to visualization in shoulder arthroscopy including vascular anatomy, blood pressure control, arthroscopic pump systems, turbulence control, epinephrine, and tranexamic acid. Furthermore, patient positioning can have a dramatic effect on visualization with both the beach chair position and lateral decubitus positioning having various strengths and weaknesses depending on the intended procedure being performed. The purpose of this review is to examine the benefits and complications reported in the literature for improving visualization in shoulder arthroscopy.

关节镜肩关节手术是通过微创技术恢复功能最常用的手术之一。随着对肩关节镜手术的需求,需要安全、有效和高效的手术,以最大限度地提高患者的预后,同时最大限度地减少并发症。肩关节镜下的可视化有很多因素,包括血管解剖、血压控制、关节镜下泵系统、湍流控制、肾上腺素和氨甲环酸。此外,患者的体位会对可视化产生巨大的影响,沙滩椅体位和侧卧体位都有不同的优点和缺点,这取决于所要进行的手术。本综述的目的是研究文献中报道的改善肩关节镜观察的益处和并发症。
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引用次数: 1
Inpatient or outpatient total elbow arthroplasty: a comparison of patient populations and 30-day surgical outcomes from the American College of Surgeons National Surgical Quality Improvement Program. 住院或门诊全肘关节置换术:来自美国外科医师学会国家手术质量改进计划的患者群体和30天手术结果的比较
Q2 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-11-23 DOI: 10.5397/cise.2023.00486
David Momtaz, Farhan Ahmad, Aaron Singh, Emilie Song, Dean Slocum, Abdullah Ghali, Adham Abdelfattah

Background: Total elbow arthroplasty (TEA) is uncommon, but growing in incidence. Traditionally an inpatient operation, a growing number are performed outpatient, consistent with general trends in orthopedic surgery. The aim of this study was to compare TEA outcomes between inpatient and outpatient surgical settings. Secondarily, we sought to identify patient characteristics that predict the operative setting.

Methods: Patient data were collected from the American College of Surgeons National Quality Improvement Program. Preoperative variables, including patient demographics and comorbidities, were recorded, and baseline differences were assessed via multivariate regression to predict operative setting. Multivariate regression was also used to compare postoperative complications within 30 days.

Results: A total of 468 patients, 303 inpatient and 165 outpatient procedures, were identified for inclusion. Hypoalbuminemia (odds ratio [OR], 2.5; P=0.029), history of chronic obstructive pulmonary disorder or pneumonia (OR, 2.4; P=0.029), and diabetes mellitus (OR, 2.5; P=0.001) were significantly associated with inpatient TEA, as were greater odds of any complication (OR, 4.1; P<0.001) or adverse discharge (OR, 4.5; P<0.001) and decreased odds of reoperation (OR, 0.4; P=0.037).

Conclusions: Patients undergoing inpatient TEA are generally more comorbid, and inpatient surgery is associated with greater odds of complications and adverse discharge. However, we found higher rates of reoperation in outpatient TEA. Our findings suggest outpatient TEA is safe, although patients with a higher comorbidity burden may require inpatient surgery. Level of evidence: III.

背景:全肘关节置换术(TEA)并不常见,但发病率正在上升。传统的住院手术,越来越多的在门诊进行,与骨科手术的总体趋势一致。本研究的目的是比较住院和门诊手术的TEA结果。其次,我们试图确定预测手术环境的患者特征。方法:患者资料收集自美国外科医师学会国家质量改进计划。记录术前变量,包括患者人口统计学和合并症,并通过多变量回归评估基线差异,以预测手术环境。采用多因素回归比较术后30天内的并发症。结果:纳入了468例患者,303例住院患者和165例门诊患者。低白蛋白血症(优势比[OR], 2.5;P=0.029)、慢性阻塞性肺疾病(COPD)或肺炎史(or, 2.4;P=0.029),糖尿病(OR, 2.5;P=0.001)与住院患者TEA显著相关,任何并发症的发生率也较高(OR, 4.1;结论:住院TEA患者通常有更多的合并症,住院手术与并发症和不良出院的发生率相关。然而,我们发现门诊TEA的再手术率较高。我们的研究结果表明,尽管合并症负担较高的患者可能需要住院手术,但门诊TEA是安全的。证据水平:III。
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引用次数: 0
Anatomic total shoulder arthroplasty with a nonspherical humeral head and inlay glenoid: 90-day complication profile in the inpatient versus outpatient setting. 解剖全肩关节置换术与非球形肱骨头和嵌体肩关节:住院患者与门诊患者90天并发症概况
Q2 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-11-01 DOI: 10.5397/cise.2023.00479
Andrew D Posner, Michael C Kuna, Jeremy D Carroll, Eric M Perloff, Matthew J Anderson, Ian D Hutchinson, Joseph P Zimmerman

Background: Total shoulder arthroplasty (TSA) with a nonspherical humeral head component and inlay glenoid is a successful bone-preserving treatment for glenohumeral arthritis. This study aimed to describe the 90-day complication profile of TSA with this prosthesis and compare major and minor complication and readmission rates between inpatient- and outpatient-procedure patients.

Methods: A retrospective review was performed of a consecutive cohort of patients undergoing TSA with a nonspherical humeral head and inlay glenoid in the inpatient and outpatient settings by a single surgeon between 2017 and 2022. Age, sex, body mass index, American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), and 90-day complication and readmission rates were compared between inpatient and outpatient groups.

Results: One hundred eighteen TSAs in 111 patients were identified. Mean age was 64.9 years (range, 39-90) and 65% of patients were male. Ninety-four (80%) and 24 (20%) patients underwent outpatient and inpatient procedures, respectively. Four complications (3.4%) were recorded: axillary nerve stretch injury, isolated ipsilateral arm deep venous thrombosis (DVT), ipsilateral arm DVT with pulmonary embolism requiring readmission, and gastrointestinal bleed requiring readmission. There were no reoperations or other complications. Outpatients were younger with lower ASA and CCI scores than inpatients; however, there was no difference in complications (1/24 vs. 3/94, P=1.00) or readmissions (1/24 vs. 1/94, P=0.37) between these two groups.

Conclusions: TSA with a nonspherical humeral head and inlay glenoid can be performed safely in both inpatient and outpatient settings. Rates of early complications and readmissions were low with no difference according to surgical setting. Level of evidence: IV.

背景:全肩关节置换术(TSA)与非球形肱骨头组件和内嵌肩关节是一种成功的保骨治疗肩关节关节炎。本研究旨在描述使用该假体的90天并发症概况,并比较住院和门诊患者的主要和次要并发症和再入院率。方法:回顾性分析2017年至2023年间,由同一名外科医生在住院和门诊接受非球形肱骨头和嵌体肩关节的TSA患者的连续队列。年龄、性别、体重指数、美国麻醉医师协会(ASA)评分、Charlson合并症指数(CCI)、住院组和门诊组90天并发症和再入院率进行比较。结果:111例患者中发现118例tsa。平均年龄64.9岁(39-90岁),65%的患者为男性。94例(80%)和24例(20%)患者分别接受了门诊和住院治疗。记录了4例并发症(3.4%):腋窝神经牵张损伤、孤立的同侧臂深静脉血栓形成(DVT)、同侧臂深静脉血栓合并肺栓塞需要再入院、胃肠道出血需要再入院。没有再手术或其他并发症。门诊患者年龄较轻,ASA和CCI评分低于住院患者;两组患者并发症发生率(1/24 vs 3/94, P=1.00)和再入院率(1/24 vs 1/94, P=0.37)均无差异。结论:非球形肱骨头和内嵌式关节盂的TSA在住院和门诊都是安全的。早期并发症和再入院率低,根据手术设置没有差异。证据等级:四级。
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引用次数: 0
Effect of cigarette smoking on the maintenance of reduction after treatment of acute acromioclavicular joint dislocation with hook plate fixation. 吸烟对钩钢板治疗急性肩锁关节脱位后复位维持的影响。
Q2 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-11-03 DOI: 10.5397/cise.2023.00738
Jee-Hoon Choi, Yong-Min Chun, Tae-Hwan Yoon

Background: The purpose of this study was to determine the association between smoking and clinical outcomes of hook plate fixation for acute acromioclavicular (AC) joint injuries.

Methods: This study retrospectively investigated 82 patients who underwent hook plate fixation for acute AC joint dislocation between March 2014 to June 2022. The patients were grouped by smoking status, with 49 in group N (nonsmokers) and 33 in group S (smokers). Functional scores and active range of motion were compared among the groups at the 1-year follow-up. Coracoclavicular distance (CCD) was measured, and difference with the uninjured side was compared at initial injury and 6 months after implant removal.

Results: No significant differences were observed between the two groups in demographic factors such as age and sex, as well as parameters related to initial injury status, which included time from injury to surgery, the preoperative CCD difference value, and the Rockwood classification. However, the postoperative CCD difference was significantly higher in group S (3.1±2.6 mm) compared to group N (1.7±2.4 mm). Multivariate regression analysis indicated that smoking and the preoperative CCD difference independently contributed to an increase in the postoperative CCD difference. Despite the radiographic differences, the postoperative clinical outcome scores and active range of motion measurements were comparable between the groups.

Conclusions: Smoking had a detrimental impact on ligament healing after hook plate fixation for acute AC joint dislocations. This finding emphasizes the importance of smoking cessation to optimize reduction maintenance after AC joint injury. Level of evidence: III.

背景:本研究的目的是确定吸烟与钩钢板固定治疗急性肩锁关节损伤的临床结果之间的关系。方法:回顾性分析2014年3月至2022年6月82例急性AC关节脱位行钩钢板固定的患者。按吸烟情况分组,N组(不吸烟)49例,S组(吸烟)33例。在1年的随访中比较各组的功能评分和活动范围。测量喙锁骨距离(CCD),比较其与未损伤侧在初始损伤时和移除植入物6个月后的差异。结果:两组患者在年龄、性别等人口统计学因素、损伤至手术时间、术前CCD差值、Rockwood分级等初始损伤状态相关参数均无显著差异。但术后CCD差异S组(3.1±2.6 mm)明显高于N组(1.7±2.4 mm)。多因素回归分析显示,吸烟和术前CCD差异是导致术后CCD差异增加的独立因素。尽管放射学上存在差异,但两组之间的术后临床结果评分和活动范围测量值具有可比性。结论:吸烟对急性AC关节脱位钩钢板固定后韧带愈合有不利影响。这一发现强调了戒烟对于减少交流关节损伤后的维持的重要性。
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引用次数: 0
Radiologic and clinical outcomes of an arthroscopic bridging graft for irreparable rotator cuff tears with a modified MasonAllen stitch using a plantaris tendon autograft: a case series with minimum 2-year outcomes. 关节镜下改良MasonAllen针与自体跖腱移植桥接治疗不可修复的肩袖撕裂的放射学和临床结果:至少2年预后的病例系列
Q2 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-07-18 DOI: 10.5397/cise.2022.01445
Hyun-Gyu Seok, Sam-Guk Park

Background: Surgical management of a massive rotator cuff tear (RCT) is always challenging. This study describes the clinical and radiological outcomes of patients who underwent bridging grafts using a plantaris tendon for an irreparable RCT.

Methods: Thirteen patients with a massive RCT were treated with arthroscopic interposition of a folded plantaris tendon autograft between June 2017 and January 2020. For clinical evaluation, a visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, Constant-Murley score, and range of motion values were collected. For radiographic evaluation, standardized magnetic resonance imaging and ultrasonography were performed to check the integrity of the interposed tendon.

Results: A statistically significant improvement at the final follow-up was evident in scores for the VAS (-3.0, P=0.003), ASES (24.9, P=0.002), D ASH (-20.6, P=0.001), and Constant-Murley values (14.2, P=0.010). In addition, significant improvement was shown in postoperative flexion (17.3°, P=0.026) and external rotation (27.7°, P<0.001). In postoperative radiologic evaluations, the interposed tendons were intact at the last examination in 12 of the 13 patients. No complications related to donor sites were reported.

Conclusions: An arthroscopic bridging graft for irreparable RCTs using a modified Mason-Allen stitch and a plantaris autograft resulted in improved short-term radiological and clinical outcomes. Graft integrity was maintained for up to 2 years in most patients. Level of evidence: IV.

背景:大规模肩袖撕裂(RCT)的手术治疗一直具有挑战性。本研究描述了在不可修复的随机对照试验中使用足底肌腱进行桥接移植的患者的临床和影像学结果。方法:2017年6月至2020年1月期间,对13例大规模随机对照试验患者进行关节镜下自体足底肌腱折叠植入治疗。临床评估采用视觉模拟量表(VAS)、美国肩肘外科医生(ASES)评分、臂、肩和手残疾(DASH)评分、Constant-Murley评分和运动范围值。影像学评估采用标准化磁共振成像和超声检查介入肌腱的完整性。结果:在最终随访时,VAS评分(-3.0,P=0.003)、ASES评分(24.9,P=0.002)、D ASH评分(-20.6,P=0.001)和Constant-Murley值(14.2,P=0.010)均有统计学显著改善。此外,术后屈曲度(17.3°,P=0.026)和外旋度(27.7°)也有显著改善。结论:关节镜下桥接移植物用于不可修复的随机对照试验,使用改良的Mason-Allen针和自体跖骨移植物可改善短期放射学和临床结果。在大多数患者中,移植物的完整性维持了2年。证据等级:四级。
{"title":"Radiologic and clinical outcomes of an arthroscopic bridging graft for irreparable rotator cuff tears with a modified MasonAllen stitch using a plantaris tendon autograft: a case series with minimum 2-year outcomes.","authors":"Hyun-Gyu Seok, Sam-Guk Park","doi":"10.5397/cise.2022.01445","DOIUrl":"10.5397/cise.2022.01445","url":null,"abstract":"<p><strong>Background: </strong>Surgical management of a massive rotator cuff tear (RCT) is always challenging. This study describes the clinical and radiological outcomes of patients who underwent bridging grafts using a plantaris tendon for an irreparable RCT.</p><p><strong>Methods: </strong>Thirteen patients with a massive RCT were treated with arthroscopic interposition of a folded plantaris tendon autograft between June 2017 and January 2020. For clinical evaluation, a visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, Constant-Murley score, and range of motion values were collected. For radiographic evaluation, standardized magnetic resonance imaging and ultrasonography were performed to check the integrity of the interposed tendon.</p><p><strong>Results: </strong>A statistically significant improvement at the final follow-up was evident in scores for the VAS (-3.0, P=0.003), ASES (24.9, P=0.002), D ASH (-20.6, P=0.001), and Constant-Murley values (14.2, P=0.010). In addition, significant improvement was shown in postoperative flexion (17.3°, P=0.026) and external rotation (27.7°, P<0.001). In postoperative radiologic evaluations, the interposed tendons were intact at the last examination in 12 of the 13 patients. No complications related to donor sites were reported.</p><p><strong>Conclusions: </strong>An arthroscopic bridging graft for irreparable RCTs using a modified Mason-Allen stitch and a plantaris autograft resulted in improved short-term radiological and clinical outcomes. Graft integrity was maintained for up to 2 years in most patients. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"406-415"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9964289","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
Arthroscopic Latarjet procedure: current concepts and surgical techniques. 关节镜下Latarjet手术:当前的概念和手术技术。
Q2 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-06-15 DOI: 10.5397/cise.2022.01396
Sang-Jin Shin, Jae Hyung Kim, Jonghyun Ahn

The Latarjet procedure is a surgical procedure that can effectively restore glenohumeral stability, especially in patients with anterior shoulder instability and glenoid bone loss. Many studies have shown comparable clinical outcomes between patients undergoing the arthroscopic Latarjet procedure and those undergoing traditional open methods or other glenohumeral joint stabilization procedures. However, the arthroscopic Latarjet procedure is a challenging technique due to the unfamiliar portal placements, proximity of neurovascular structures, and serious postoperative complications. The arthroscopic Latarjet procedure has not yet been widely applied, and a clear understanding of the anatomical structure and the precise methods is required prior to operation performance. Satisfactory clinical outcomes can be achieved by thorough preoperative planning and proper implant fixation methods.

Latarjet手术是一种可以有效恢复肩关节稳定性的手术方法,特别是对于肩关节前部不稳定和肩关节骨丢失的患者。许多研究表明,接受关节镜下Latarjet手术的患者与接受传统开放方法或其他盂肱关节稳定手术的患者的临床结果相当。然而,由于门静脉位置不熟悉、靠近神经血管结构和严重的术后并发症,关节镜下Latarjet手术是一项具有挑战性的技术。关节镜下Latarjet手术尚未广泛应用,在手术前需要对解剖结构有清晰的了解和精确的方法。通过周密的术前计划和正确的种植体固定方法,可以获得满意的临床结果。
{"title":"Arthroscopic Latarjet procedure: current concepts and surgical techniques.","authors":"Sang-Jin Shin, Jae Hyung Kim, Jonghyun Ahn","doi":"10.5397/cise.2022.01396","DOIUrl":"10.5397/cise.2022.01396","url":null,"abstract":"<p><p>The Latarjet procedure is a surgical procedure that can effectively restore glenohumeral stability, especially in patients with anterior shoulder instability and glenoid bone loss. Many studies have shown comparable clinical outcomes between patients undergoing the arthroscopic Latarjet procedure and those undergoing traditional open methods or other glenohumeral joint stabilization procedures. However, the arthroscopic Latarjet procedure is a challenging technique due to the unfamiliar portal placements, proximity of neurovascular structures, and serious postoperative complications. The arthroscopic Latarjet procedure has not yet been widely applied, and a clear understanding of the anatomical structure and the precise methods is required prior to operation performance. Satisfactory clinical outcomes can be achieved by thorough preoperative planning and proper implant fixation methods.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"445-454"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10134905","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: 1
Superior capsular reconstruction for irreparable rotator cuff tear: a review of current methods. 上囊重建术治疗不可修复的肩袖撕裂:当前方法综述。
Q2 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-11-23 DOI: 10.5397/cise.2023.00514
Seok Won Chung, Dong-Hyun Kim, Hyun Joo Lee, Won Ki Hong, Seung Ho Chung, Jong Pil Yoon

Irreparable massive rotator cuff tears can significantly impact daily life; and these types of tears can be difficult to repair completely, especially in younger patients who are more active and have higher functional requirements. Since its introduction by Mihata and the colleagues, superior capsular reconstruction (SCR) has gained popularity in the treatment of irreparable massive rotator cuff tears and has shown promising short-term results. A variety of studies have focused on the clinical and biomechanical outcomes of this procedure. This article reviews the biomechanics, indications for the surgical procedure, graft options, surgical technique, and rehabilitation from SCR.

不可修复的大面积肩袖撕裂会严重影响日常生活;这些类型的撕裂很难完全修复,特别是对于那些更活跃、对功能有更高要求的年轻患者。自从Mihata和他的同事提出后,上囊重建术(SCR)在治疗不可修复的大面积肩袖撕裂中得到了广泛的应用,并显示出有希望的短期效果。各种各样的研究都集中在该手术的临床和生物力学结果上。本文综述了生物力学、手术适应证、移植物选择、手术技术和SCR的康复。
{"title":"Superior capsular reconstruction for irreparable rotator cuff tear: a review of current methods.","authors":"Seok Won Chung, Dong-Hyun Kim, Hyun Joo Lee, Won Ki Hong, Seung Ho Chung, Jong Pil Yoon","doi":"10.5397/cise.2023.00514","DOIUrl":"10.5397/cise.2023.00514","url":null,"abstract":"<p><p>Irreparable massive rotator cuff tears can significantly impact daily life; and these types of tears can be difficult to repair completely, especially in younger patients who are more active and have higher functional requirements. Since its introduction by Mihata and the colleagues, superior capsular reconstruction (SCR) has gained popularity in the treatment of irreparable massive rotator cuff tears and has shown promising short-term results. A variety of studies have focused on the clinical and biomechanical outcomes of this procedure. This article reviews the biomechanics, indications for the surgical procedure, graft options, surgical technique, and rehabilitation from SCR.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"438-444"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296169","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
Clavicle midshaft fractures should not be considered an easy surgery: reduction and prebending. 锁骨中轴骨折不应被视为简单的手术:还原和预弯。
Q2 ORTHOPEDICS Pub Date : 2023-12-01 DOI: 10.5397/cise.2023.00976
Young-Hoon Jo, Bong Gun Lee
{"title":"Clavicle midshaft fractures should not be considered an easy surgery: reduction and prebending.","authors":"Young-Hoon Jo, Bong Gun Lee","doi":"10.5397/cise.2023.00976","DOIUrl":"10.5397/cise.2023.00976","url":null,"abstract":"","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"26 4","pages":"341-342"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138488559","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
Use of custom glenoid components for reverse total shoulder arthroplasty. 定制肩关节假体在反向全肩关节置换术中的应用。
Q2 ORTHOPEDICS Pub Date : 2023-12-01 Epub Date: 2023-11-14 DOI: 10.5397/cise.2023.00563
Punyawat Apiwatanakul, Prashant Meshram, Andrew B Harris, Joel Bervell, Piotr Łukasiewicz, Ridge Maxson, Matthew J Best, Edward G McFarland

Background: Our purpose was to evaluate a custom reverse total shoulder arthroplasty glenoid baseplate for severe glenoid deficiency, emphasizing the challenges with this approach, including short-term clinical and radiographic outcomes and complications.

Methods: This was a single-institution, retrospective series of 29 patients between January 2017 and December 2022 for whom a custom glenoid component was created for extensive glenoid bone loss. Patients were evaluated preoperatively and at intervals for up to 5 years. All received preoperative physical examinations, plain radiographs, and computed tomography (CT). Intra- and postoperative complications are reported.

Results: Of 29 patients, delays resulted in only undergoing surgery, and in three of those, the implant did not match the glenoid. For those three, the time from CT scan to implantation averaged 7.6 months (range, 6.1-10.7 months), compared with 5.5 months (range, 2-8.6 months) for those whose implants fit. In patients with at least 2-year follow-up (n=9), no failures occurred. Significant improvements were observed in all patient-reported outcome measures in those nine patients (American Shoulder and Elbow Score, P<0.01; Simple Shoulder Test, P=0.02; Single Assessment Numeric Evaluation, P<0.01; Western Ontario Osteoarthritis of the Shoulder Index, P<0.01). Range of motion improved for forward flexion and abduction (P=0.03 for both) and internal rotation up the back (P=0.02). Pain and satisfaction also improved (P<0.01 for both).

Conclusions: Prolonged time (>6 months) from CT scan to device implantation resulted in bone loss that rendered the implants unusable. Satisfactory short-term radiographic and clinical follow-up can be achieved with a well-fitting device. Level of evidence: III.

背景:本研究的目的是评估使用定制的反向肩关节置换盂底钢板治疗严重盂底不足,并强调该方法的挑战,包括短期临床和影像学结果以及短期并发症。方法:这是一个单一机构的回顾性病例系列,包括2017年1月至2022年12月期间的29例患者,他们为广泛的盂骨骨丢失创建了定制的盂骨假体。患者术前和每隔5年进行评估。所有患者术前均接受体格检查、x线平片和计算机断层扫描(CT)。定制的植入物是由制造商的工程师计划和制造的。报告了手术内和术后并发症。结果:在29例患者中,只有25例延迟接受手术,其中3例植入物与关节盂不匹配。对于这三个人来说,从他们的CT扫描到植入平均需要7.6个月(范围,6.1-10.7个月),相比之下,那些植入没有困难的人需要5.5个月(范围,2-8.6个月)。在随访至少2年的患者中(n=9),没有发生失败。在这9名患者中,所有患者报告的预后指标均有显著改善(美国肩肘评分,p)。结论:在本研究中,从CT扫描到植入器械的时间延长(bbb6个月)导致骨丢失,导致植入物无法使用。使用合适的设备,至少2年后可以获得满意的短期放射学和临床随访。
{"title":"Use of custom glenoid components for reverse total shoulder arthroplasty.","authors":"Punyawat Apiwatanakul, Prashant Meshram, Andrew B Harris, Joel Bervell, Piotr Łukasiewicz, Ridge Maxson, Matthew J Best, Edward G McFarland","doi":"10.5397/cise.2023.00563","DOIUrl":"10.5397/cise.2023.00563","url":null,"abstract":"<p><strong>Background: </strong>Our purpose was to evaluate a custom reverse total shoulder arthroplasty glenoid baseplate for severe glenoid deficiency, emphasizing the challenges with this approach, including short-term clinical and radiographic outcomes and complications.</p><p><strong>Methods: </strong>This was a single-institution, retrospective series of 29 patients between January 2017 and December 2022 for whom a custom glenoid component was created for extensive glenoid bone loss. Patients were evaluated preoperatively and at intervals for up to 5 years. All received preoperative physical examinations, plain radiographs, and computed tomography (CT). Intra- and postoperative complications are reported.</p><p><strong>Results: </strong>Of 29 patients, delays resulted in only undergoing surgery, and in three of those, the implant did not match the glenoid. For those three, the time from CT scan to implantation averaged 7.6 months (range, 6.1-10.7 months), compared with 5.5 months (range, 2-8.6 months) for those whose implants fit. In patients with at least 2-year follow-up (n=9), no failures occurred. Significant improvements were observed in all patient-reported outcome measures in those nine patients (American Shoulder and Elbow Score, P<0.01; Simple Shoulder Test, P=0.02; Single Assessment Numeric Evaluation, P<0.01; Western Ontario Osteoarthritis of the Shoulder Index, P<0.01). Range of motion improved for forward flexion and abduction (P=0.03 for both) and internal rotation up the back (P=0.02). Pain and satisfaction also improved (P<0.01 for both).</p><p><strong>Conclusions: </strong>Prolonged time (>6 months) from CT scan to device implantation resulted in bone loss that rendered the implants unusable. Satisfactory short-term radiographic and clinical follow-up can be achieved with a well-fitting device. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"343-350"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92156892","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
Online resources for information on shoulder arthroplasty: an assessment of quality and readability. 关于肩关节置换术信息的在线资源:质量和可读性评估。
Q2 ORTHOPEDICS Pub Date : 2023-09-01 DOI: 10.5397/cise.2023.00290
Mohamad Y Fares, Jaspal Singh, Amar S Vadhera, Jonathan Koa, Peter Boufadel, Joseph A Abboud

Background: Many patients use online resources to educate themselves on surgical procedures and make well-informed healthcare decisions. The aim of our study was to evaluate the quality and readability of online resources exploring shoulder arthroplasty.

Methods: An internet search pertaining to shoulder arthroplasty (partial, anatomic, and reverse) was conducted using the three most popular online search engines. The top 25 results generated from each term in each search engine were included. Webpages were excluded if they were duplicates, advertised by search engines, subpages of other pages, required payments or subscription, or were irrelevant to our scope. Webpages were classified into different source categories. Quality of information was assessed by HONcode certification, Journal of the American Medical Association (JAMA) criteria, and DISCERN benchmark criteria. Webpage readability was assessed using the Flesch reading ease score (FRES).

Results: Our final dataset included 125 web pages. Academic sources were the most common with 45 web pages (36.0%) followed by physician/private practice with 39 web pages (31.2%). The mean JAMA and DISCERN scores for all web pages were 1.96±1.31 and 51.4±10.7, respectively. The total mean FRES score was 44.0±11.0. Only nine web pages (7.2%) were HONcode certified. Websites specified for healthcare professionals had the highest JAMA and DISCERN scores with means of 2.92±0.90 and 57.96±8.91, respectively (P<0.001). HONcode-certified webpages had higher quality and readability scores than other web pages.

Conclusions: Web-based patient resources for shoulder arthroplasty information did not show high-quality scores and easy readability. When presenting medical information, sources should maintain a balance between readability and quality and should seek HONcode certification as it helps establish the reliability and accessibility of the presented information. Level of evidence: IV.

背景:许多患者使用在线资源对外科手术进行自我教育,并做出明智的医疗保健决定。我们研究的目的是评估在线资源探讨肩关节置换术的质量和可读性。方法:使用三种最流行的在线搜索引擎进行有关肩关节置换术(部分,解剖和反向)的互联网搜索。在每个搜索引擎中,每个词产生的前25个结果被包括在内。如果网页是重复的,被搜索引擎做广告的,其他网页的子页面,需要付费或订阅的,或者与我们的范围无关,则将被排除。网页被分为不同的来源类别。信息质量通过HONcode认证、美国医学会杂志(JAMA)标准和DISCERN基准标准进行评估。使用Flesch阅读简易评分(FRES)评估网页的可读性。结果:我们的最终数据集包括125个网页。最常见的是学术来源,有45个网页(36.0%),其次是医生/私人诊所,有39个网页(31.2%)。所有网页的JAMA和DISCERN评分平均值分别为1.96±1.31和51.4±10.7。总平均FRES评分为44.0±11.0。只有9个网页(7.2%)通过了HONcode认证。医疗保健专业人员网站的JAMA和DISCERN评分最高,平均值分别为2.92±0.90和57.96±8.91。(结论:基于网络的肩关节置换术患者资源评分不高,且易读。在提供医疗信息时,来源应在可读性和质量之间保持平衡,并应寻求HONcode认证,因为它有助于建立所提供信息的可靠性和可访问性。证据等级:四级。
{"title":"Online resources for information on shoulder arthroplasty: an assessment of quality and readability.","authors":"Mohamad Y Fares,&nbsp;Jaspal Singh,&nbsp;Amar S Vadhera,&nbsp;Jonathan Koa,&nbsp;Peter Boufadel,&nbsp;Joseph A Abboud","doi":"10.5397/cise.2023.00290","DOIUrl":"https://doi.org/10.5397/cise.2023.00290","url":null,"abstract":"<p><strong>Background: </strong>Many patients use online resources to educate themselves on surgical procedures and make well-informed healthcare decisions. The aim of our study was to evaluate the quality and readability of online resources exploring shoulder arthroplasty.</p><p><strong>Methods: </strong>An internet search pertaining to shoulder arthroplasty (partial, anatomic, and reverse) was conducted using the three most popular online search engines. The top 25 results generated from each term in each search engine were included. Webpages were excluded if they were duplicates, advertised by search engines, subpages of other pages, required payments or subscription, or were irrelevant to our scope. Webpages were classified into different source categories. Quality of information was assessed by HONcode certification, Journal of the American Medical Association (JAMA) criteria, and DISCERN benchmark criteria. Webpage readability was assessed using the Flesch reading ease score (FRES).</p><p><strong>Results: </strong>Our final dataset included 125 web pages. Academic sources were the most common with 45 web pages (36.0%) followed by physician/private practice with 39 web pages (31.2%). The mean JAMA and DISCERN scores for all web pages were 1.96±1.31 and 51.4±10.7, respectively. The total mean FRES score was 44.0±11.0. Only nine web pages (7.2%) were HONcode certified. Websites specified for healthcare professionals had the highest JAMA and DISCERN scores with means of 2.92±0.90 and 57.96±8.91, respectively (P<0.001). HONcode-certified webpages had higher quality and readability scores than other web pages.</p><p><strong>Conclusions: </strong>Web-based patient resources for shoulder arthroplasty information did not show high-quality scores and easy readability. When presenting medical information, sources should maintain a balance between readability and quality and should seek HONcode certification as it helps establish the reliability and accessibility of the presented information. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"26 3","pages":"238-244"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/63/cise-2023-00290.PMC10497924.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10239868","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
期刊
Clinics in Shoulder and Elbow
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