Medialized vs. Lateralized Reverse Total Shoulder Arthroplasty for Proximal Humerus Fractures: A Systematic Review and Meta-Analysis.

Background: Reverse shoulder arthroplasty (RSA) is increasingly used in the treatment of proximal humerus fractures (PHFs) with reliable clinical improvement. Lateralized RSA implants have conferred superior outcomes compared with the original Grammont design in patients with nontraumatic indications. However, in the setting of a PHF, lateralized components can place increased tension across the tuberosity fracture site and potentially compromise tuberosity healing and outcomes.

Does the Relationship Between Preoperative Function and Achievement of Clinically Important Benchmarks of Success After Total Shoulder Arthroplasty Depend on Outcome Assessment Design?

Background: A variety of clinically important benchmarks of success (CIBS) have been defined for total shoulder arthroplasty (TSA) to quantify success. However, it is unclear how the preoperative status of the patient influences their likelihood of achieving each CIBS.

Questions/purposes: (1) What proportion of patients achieve commonly used CIBS after TSA? (2) Is there a relationship between a patients' preoperative function and their probability of achieving different CIBS? (3) Does there exist preoperative ranges for each outcome measure that are associated with greater achievement of CIBS?

Methods: We retrospectively queried a multicenter shoulder arthroplasty database for primary anatomic TSA (aTSA) and reverse TSA (rTSA).

Is The "Sling Effect" of the Conjoint Tendon in Latarjet Procedures Real? A Systematic Review and Descriptive Synthesis of Controlled Laboratory and Comparative Clinical Studies.

Background: The Latarjet procedure is considered the gold standard for treating patients with anterior shoulder instability in the presence of critical glenoid bone loss. Proponents of the Latarjet contend that its efficacy is in-part attributable to the "sling effect" of the conjoint tendon; however, recent studies have demonstrated similar restoration of anterior stability in patients undergoing free bone block (FBB) procedures. The purpose of this systematic review was to evaluate the biomechanical and clinical evidence for the sling effect.

Influence of Humeral Component Cement and Bone Grafting on Greater Tuberosity Healing and Functional Outcomes After Reverse Shoulder Arthroplasty for Proximal Humerus Fractures: A Systematic Review and Meta-Analysis.

Background: Reverse shoulder arthroplasty (RSA) is increasingly used in the treatment of displaced proximal humerus fractures (PHFs) with reliable clinical improvement. However, the preferred techniques for humeral stem fixation are varied and may be influenced by patient and injury characteristics, including bone quality and fracture pattern. This systematic review and meta-analysis sought to determine the effect of humeral component cementing and bone grafting on tuberosity healing rates and functional outcomes after RSA for PHFs.

Predictors of Internal Rotation-Dependent Activities of Daily Living Performance and Favorable Satisfaction Despite Loss of Objective Internal Rotation After Reverse Shoulder Arthroplasty.

Introduction: Previous research has determined that objective and subjective internal rotation (IR) may be discordant. The purpose of this study was to identify predictors of patient-reported ability to perform IR-dependent activities of daily living (IRADLs) and favorable patient satisfaction after reverse shoulder arthroplasty (RSA) despite the loss of objective IR.

Methods: A single, institutional, shoulder arthroplasty database was queried for patients undergoing primary RSA with a minimum 2-year follow-up.