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Journal of shoulder and elbow arthroplasty最新文献

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Deltopectoral Approach Deltopectoral方法
Pub Date : 2020-01-01 DOI: 10.1007/978-3-030-19285-3_3
Bujar Shabani, Dafina Bytyqi, R. Ballis
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引用次数: 2
Complications of Reverse Total Shoulder Arthroplasty 反向全肩关节置换术的并发症
Pub Date : 2020-01-01 DOI: 10.1007/978-3-030-19285-3_20
A. Bitzer, Ronak N. Kotian, Jorge L Rojas, E. McFarland
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引用次数: 0
Shoulder Arthroplasty: The Shoulder Club Guide 肩关节成形术:肩关节棒指南
Pub Date : 2020-01-01 DOI: 10.1007/978-3-030-19285-3
M. Lungren, M. R. Evans, G. Huri, F. Familiari, Y. Moon, M. Doral
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引用次数: 1
Acromioclavicular Joint Injuries 肩锁关节损伤
Pub Date : 2020-01-01 DOI: 10.1007/978-3-030-19285-3_19
O. Bilge, N. Karalezlİ, G. Huri, M. Doral
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引用次数: 0
Elbow Arthroplasty: Current Techniques and Complications 肘关节置换术:当前技术和并发症
Pub Date : 2020-01-01 DOI: 10.1007/978-3-030-14455-5
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引用次数: 1
Rehabilitation Following Shoulder Arthroplasty 肩关节置换术后的康复
Pub Date : 2020-01-01 DOI: 10.1007/978-3-030-19285-3_10
G. Lullini, G. Muccioli, G. Ravazzolo, S. Zaffagnini
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引用次数: 0
Stemless RTSA
Pub Date : 2020-01-01 DOI: 10.1007/978-3-030-19285-3_12
C. Witney-Lagen, P. Consigliere, L. Natera, Ofer Levy
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引用次数: 0
Reverse Shoulder Arthroplasty for B2 Glenoid Deformity. B2型肩关节畸形的反向肩关节置换术。
Pub Date : 2019-12-30 eCollection Date: 2019-01-01 DOI: 10.1177/2471549219897661
Andrew M Holt, Thomas W Throckmorton

In shoulder osteoarthritis, the B2 glenoid presents challenges in treatment because of the excessive retroversion and posterior deficiency of the glenoid. Correction of retroversion and maintenance of a stable joint line with well-fixed implants are essential for the successful treatment of this deformity with arthroplasty. Reverse shoulder arthroplasty offers several key advantages in achieving this goal, including favorable biomechanics, a well-fixed baseplate, and proven success in other applications. Techniques such as eccentric reaming, bone grafting, and baseplate augmentation allow surgeons to tailor treatment to the patient's altered anatomy. Eccentric reaming is favored for correction of small defects or mild version anomalies. Current trends favor bone grafting for larger corrections, though augmented components have shown early promise with the potential for expanded use. With overall promising results reported in the literature, reverse shoulder arthroplasty is a useful tool for treating older patients with B2 glenoid deformities.

在肩关节骨性关节炎中,由于肩关节过度后倾和后部缺陷,B2肩关节盂在治疗中提出了挑战。用固定良好的假体矫正后倾和维持关节线的稳定是成功治疗关节置换术的关键。在实现这一目标的过程中,反向肩关节置换术有几个关键的优势,包括良好的生物力学性能、固定良好的底板以及在其他应用中的成功。诸如偏心扩孔、植骨和基板增强等技术使外科医生能够根据患者解剖结构的改变来定制治疗方案。偏心扩孔适用于小缺陷或轻度畸形的矫正。目前的趋势倾向于骨移植进行更大的矫正,尽管增强组件已经显示出扩大使用潜力的早期前景。根据文献报道的总体结果,反向肩关节置换术是治疗老年B2型肩关节畸形患者的有效工具。
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引用次数: 8
A Point-Based Model to Predict Absolute Risk of Revision in Anatomic Shoulder Arthroplasty. 基于点的模型预测解剖肩关节置换术翻修绝对风险。
Pub Date : 2019-10-21 eCollection Date: 2019-01-01 DOI: 10.1177/2471549219883446
Peter Lc Lapner, Meaghan D Rollins, Meltem G Tuna, Caleb Netting, Anan Bader Eddeen, Carl van Walraven

Background: Total shoulder arthroplasty (TSA) has demonstrated good long-term survivorship but early implant failure can occur. This study identified factors associated with shoulder arthroplasty revision and constructed a risk score for revision surgery following shoulder arthroplasty.

Methods: A validated algorithm was used to identify all patients who underwent anatomic TSA between 2002 and 2012 using population-based data. Demographic variables included shoulder implant type, age and sex, Charlson comorbidity score, income quintile, diagnosis, and surgeon arthroplasty volume. The associations of covariates with time to revision were measured while treating death as a competing risk and were expressed in the Shoulder Arthroplasty Revision Risk Score (SARRS).

Results: During the study period, 4079 patients underwent TSA. Revision risk decreased in a nonlinear fashion as patients aged and in the absence of osteoarthritis with no influence from surgery type or other covariables. The SARRS ranged from -21 points (5-year revision risk 0.75%) to 30 points (risk 11.4%). Score discrimination was relatively weak 0.55 (95% confidence interval: 0.530.61) but calibration was very good with a test statistic of 5.77 (df = 8, P = .762).

Discussion: The SARRS model accurately predicted the 5-year revision risk in patients undergoing TSA. Validation studies are required before this score can be used clinically to predict revision risk. Further study is needed to determine if the addition of detailed clinical data including functional outcome measures and the severity of glenohumeral arthrosis increases the model's discrimination.

背景:全肩关节置换术(TSA)显示出良好的长期生存率,但早期植入物可能发生失败。本研究确定了与肩关节置换术翻修相关的因素,并构建了肩关节置换术后翻修手术的风险评分。方法:采用一种经过验证的算法,使用基于人群的数据识别2002年至2012年间接受解剖性TSA的所有患者。人口统计学变量包括肩关节植入物类型、年龄和性别、Charlson合并症评分、收入五分位数、诊断和外科医生关节置换术量。在将死亡视为竞争风险并在肩关节置换术翻修风险评分(SARRS)中表达时,测量协变量与翻修时间的关联。结果:在研究期间,4079例患者接受了TSA。翻修风险随患者年龄增长和无骨关节炎呈非线性降低,不受手术类型或其他协变量的影响。SARRS范围从-21分(5年修订风险0.75%)到30分(风险11.4%)。评分判别性相对较弱,为0.55(95%可信区间:0.530.61),但校准非常好,检验统计量为5.77 (df = 8, P = .762)。讨论:SARRS模型准确预测了TSA患者的5年翻修风险。在此评分用于临床预测翻修风险之前,需要进行验证研究。需要进一步的研究来确定加入详细的临床数据,包括功能结果测量和盂肱关节的严重程度是否会增加模型的辨别能力。
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引用次数: 0
Shoulder Arthroplasty for Posttraumatic Arthritis Is Associated With Increased Transfusions and Longer Operative Times 创伤后关节炎肩关节置换术与输血量增加和手术时间延长有关
Pub Date : 2019-10-01 DOI: 10.1177/2471549219882133
Tyler A. Luthringer, Benjamin S. Kester, Oluwadamilola Kolade, M. Virk, M. Alaia, K. Campbell
Introduction: Posttraumatic arthritis (PTA) is a common sequela of proximal humerus fractures that is commonly managed with anatomic or reverse total shoulder arthroplasty (TSA). TSA for PTA is more challenging than that performed for primary osteoarthritis and frequently leads to worse patient outcomes. CPT uniformly classifies all cases of primary TSA, irrespective of procedural complexity and resource utilization. This study analyzes intraoperative differences and 30-day outcomes for anatomic and reverse TSA performed in the posttraumatic shoulder. Methods: Patients undergoing TSA from 2008 to 2015 were selected from the National Surgical Quality Improvement Program database and stratified according to concurrent procedures and administrative codes indicating posttraumatic diagnoses. Perioperative parameters and 30-day complications were recorded; multivariate analyses were performed to determine whether PTA was a risk factor for poor outcomes. Results: A total of 8508 primary and 243 posttraumatic TSAs were identified. Posttraumatic TSA patients were slightly younger (P = .003), more likely to be female (P < .001), smokers (P = .029), and diabetic (P = .003). Diagnosis of PTA was an independent risk factor for prolonged operative times ≥160 minutes (≥1 standard deviation above the mean, P = .003; odds ratio [OR]: 1.718; 95% confidence interval [CI]: 1.204–2.449) and increased bleeding requiring transfusion (P < .001; OR: 2.719; 95% CI: 1.607–4.600). Although posttraumatic TSA had a tendency for longer hospital admissions, 30-day readmissions were not significantly different between cohorts. Conclusions: Compared with primary osteoarthritis, a preoperative diagnosis of PTA is an independent risk factor for prolonged operative times and postoperative transfusion in anatomic or reverse TSA patients; such patients may be less than optimal candidates for same-day discharges or outpatient shoulder arthroplasty.
简介:创伤后关节炎(PTA)是肱骨近端骨折的常见后遗症,通常采用解剖或反向全肩关节置换术(TSA)治疗。PTA的TSA比原发性骨关节炎的TSA更具挑战性,往往导致患者预后更差。CPT将所有原发性TSA病例统一分类,而不考虑程序复杂性和资源利用率。本研究分析了创伤后肩关节解剖和反向TSA的术中差异和30天的结果。方法:从国家外科质量改进计划数据库中选择2008 - 2015年接受TSA的患者,并根据并发程序和创伤后诊断的行政代码进行分层。记录围手术期参数及30 d并发症;进行多变量分析以确定PTA是否是不良预后的危险因素。结果:共发现原发性tsa 8508例,创伤后tsa 243例。创伤后TSA患者年龄稍轻(P = 0.003),多为女性(P < 0.001)、吸烟者(P = 0.029)和糖尿病患者(P = 0.003)。PTA诊断是延长手术时间≥160分钟的独立危险因素(高于平均值≥1个标准差,P = 0.003;优势比[OR]: 1.718;95%可信区间[CI]: 1.204-2.449)和需要输血的出血量增加(P < 0.001;OR: 2.719;95% ci: 1.607-4.600)。虽然创伤后TSA倾向于住院时间更长,但30天的再入院在队列之间没有显着差异。结论:与原发性骨关节炎相比,PTA术前诊断是解剖或逆向TSA患者手术时间延长和术后输血的独立危险因素;这类患者可能不是当天出院或门诊肩关节置换术的最佳人选。
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引用次数: 1
期刊
Journal of shoulder and elbow arthroplasty
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