Background: Classification systems are only useful if there is agreement among observers. The purpose of this study is to introduce a simple and clinically applicable classification system - The Copenhagen Classification System for Distal Humeral Fractures (CCDHF) and to compare the interobserver and intraobserver agreement for this classification with the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association (AO/OTA), and the Sheffield classification systems. The primary objective of the new classification system is to distinguish fractures that may not be suitable for open reduction and internal fixation, necessitating treatment options such as elbow hemiarthroplasty or total elbow arthroplasty (TEA).
View Article and Find Full Text PDFBackground And Purpose: There is controversy regarding the results of stemmed and stemless total shoulder arthroplasty (TSA) used for osteoarthritis. Therefore, we aimed to compare revision rates of stemmed and stemless TSA and to examine the impact of metal-backed glenoid components.
Methods: We included all patients reported to the Danish Shoulder Arthroplasty Register from January 1, 2012 to December 31, 2022 with an anatomical TSA used for osteoarthritis.
Background: The stemmed anatomic total shoulder arthroplasty is the gold standard in the treatment of glenohumeral osteoarthritis. However, the use of stemless total shoulder arthroplasties has increased in recent years. The number of revision procedures are relatively low, and therefore it has been recommended that national joint replacement registries should collaborate when comparing revision rates.
View Article and Find Full Text PDFBackground: The minimal clinically important difference (MCID) is defined as the smallest meaningful change in a health domain that a patient would identify as important. Thus, an improvement that exceeds the MCID can be used to define a successful treatment for the individual patient.
Aim: To quantify the rate of clinical improvement following anatomical total shoulder arthroplasty for glenohumeral osteoarthritis.
Background: Adult distal humeral fractures (DHF) comprise 2%-5% of all fractures and 30% of all elbow fractures. Treatment of DHF may be technically demanding due to fracture complexity and proximity of neurovascular structures. Open reduction and internal fixation (ORIF) are often the treatment of choice, but arthroplasty is considered in case of severe comminution or in elderly patients with poor bone quality.
View Article and Find Full Text PDFBackground: Hemiarthroplasty for acute proximal humeral fractures gives disappointing results, often due to rotator cuff insufficiency. Better tuberosity fixation might improve results. Therefore, the aim of this study was to: 1) report the outcome of a stemmed hemiarthroplasty with a common platform system and a modular suture collar; 2) compare the outcome with that of a standard stemmed hemiarthroplasty; 3) report the feasibility of revision arthroplasty with retention of the stem; and 4) to evaluate the association between tuberosity healing and functional outcome.
View Article and Find Full Text PDFA 47-year-old woman developed anterior interosseus nerve (AIN) syndrome after subacromial decompression and acromioclavicular joint resection. The operation was performed in the beach chair position and under general anaesthesia without the application of an interscalene block. Two weeks later, the patient presented with paresis of the distal interphalangeal joint of the second finger.
View Article and Find Full Text PDFBackground: Open reduction and internal fixation (ORIF) is the standard treatment for multifragmentary intra-articular distal humeral fractures. Fractures not amenable by ORIF are treated with total elbow arthroplasty (TEA). In recent years, elbow hemiarthroplasty (EHA) has been used as an alternative to TEA, as weight bearing restrictions and risk of component loosening are lower.
View Article and Find Full Text PDFBackground: Previous studies have indicated an increased risk of periprosthetic joint infection (PJI) in patients treated with reverse shoulder arthroplasty (RSA) compared with patients treated with anatomic total shoulder arthroplasty. The reason for this is unclear but may be related to a high prevalence of previous rotator cuff repair in patients who are treated with RSA. The purpose of this study was to determine previous non-arthroplasty surgery as a risk factor for revision owing to PJI after RSA for cuff tear arthropathy, massive irreparable rotator cuff tears, or osteoarthritis.
View Article and Find Full Text PDFBackground: Inferior scapular notching is a complication unique to reverse shoulder arthroplasty. The most efficient technique to avoid inferior scapular notching has been reported to be lateralization of the glenoid offset. This study aims to compare radiological and functional outcomes of the DELTA Xtend® Reverse Shoulder System Lateralized Glenosphere Line Extension (intervention group) with the Standard DELTA Xtend® Reverse Shoulder System (control group).
View Article and Find Full Text PDFBackground And Purpose: Although most patients have good outcomes after shoulder arthroplasty for osteoarthritis, certain risk factors may lead to disappointing outcomes. We assessed risk factors for a worse outcome after anatomical shoulder arthroplasty for osteoarthritis. Our hypothesis was that previous surgery for instability would be a risk factor for a worse outcome independent of age, sex, and arthroplasty type.
View Article and Find Full Text PDFBackground: The use of the reverse shoulder arthroplasty (RSA) for cuff tear arthropathy (CTA) has increased within the last decades, but there is still limited information about the long-term outcome and how it performs in comparison with hemiarthroplasty (HA). The aim of this study was to compare the long-term patient-reported outcomes of RSA and HA for CTA.
Methods: We included all patients with CTA, who according to the Danish Shoulder Arthroplasty Registry, underwent either HA or RSA between 2006 and 2010.
Introduction: The incidence of olecranon fractures is growing in the elderly population. The traditional operative approach is giving way among the elderly to conservative treatment, which seems to provide a comparable functional outcome with a lower complication burden. However, there is still a lack of reliable evidence to support this shift.
View Article and Find Full Text PDFBackground: The minimal clinically important difference (MCID) is an important instrument in the interpretation of changes in patient-reported outcome measures (PROM). To our knowledge, no MCID of the Western Ontario Osteoarthritis of the Shoulder Index (WOOS) score has ever been reported and no studies have reported an MCID for the Oxford Shoulder Score (OSS) based on patients with glenohumeral osteoarthritis, treated with an anatomical total shoulder arthroplasty (aTSA). The aim of this study was to determine MCID for WOOS and OSS in a cohort of patients with glenohumeral osteoarthritis treated with an aTSA.
View Article and Find Full Text PDFBackground: The purpose of this study was to report the functional outcomes and complications after open reduction and internal fixation (ORIF) for Arbeitsgemeinschaft für Osteosynthesefragen (AO)/Orthopaedic Trauma Association (OTA) type 13-C2 and -C3 acute distal humeral fractures with minimum 2-year follow-up. Our hypothesis was that ORIF would provide functional outcomes that are comparable to those of total elbow arthroplasty and elbow hemiarthroplasty reported in the literature.
Materials And Methods: During a 6-year period, 23 patients aged > 45 years were treated with double plating for AO/OTA type 13-C2 or -C3 fractures.
Aims: There is no consensus on the treatment of proximal humeral fractures. Hemiarthroplasty has been widely used in patients when non-surgical treatment is not possible. There is, despite extensive use, limited information about the long-term outcome.
View Article and Find Full Text PDFTraumatic ruptures of the subscapularis tendon in children are rare and often missed. In this case report, a 70 kg person landed on a 13-year-old boy with his arm abducted and rotated, causing pain and restricted motion. An MRI showed a total rupture of the subscapularis with avulsion of the minor tubercle and subluxation of the biceps tendon.
View Article and Find Full Text PDFOsteoarthritis of the shoulder is common in elderly, and arthroplasty surgery is increasing in Denmark. This review summarises the current knowledge. Results are good, and revision rates are low at ten years.
View Article and Find Full Text PDFBackground: Glenohumeral osteoarthritis can, in the most severe cases, require surgery with insertion of a shoulder arthroplasty. A design with a stem in the humeral bone canal is currently regarded as the standard treatment option in patients who have an intact rotator cuff function, but complications related to the stem including humeral fractures can have devastating consequences. By using a stemless humeral component, stem-related complications can be reduced.
View Article and Find Full Text PDFBackground: Intraarticular distal humeral fractures of AO/OTA type 13 C2 and C3 pose a surgical challenge despite the evolution of surgical implants and techniques. Open reduction and internal fixation (ORIF) is often preferred as the first choice of treatment, but the results vary and are sometimes disappointing. Total elbow arthroplasty (TEA) has been widely used for fractures that are not amenable to ORIF in elderly patients, but the mechanical complications remain a challenge, especially in active patients.
View Article and Find Full Text PDFBackground: Reverse shoulder arthroplasty has been proven to improve function in shoulders with cuff-tear arthropathy, but existing studies are primarily single-center studies with a small number of patients, which limits their ability to identify patients who have an increased risk of revision or a worse functional outcome.
Questions/purposes: (1) What is the estimated 10-year cumulative revision rate after reverse shoulder arthroplasty for cuff-tear arthropathy, and what factors are associated with the risk of revision? (2) What is the patient-reported outcome 1 year after surgery, and what factors are associated with a worse patient-reported outcome?
Methods: We included all patients treated with reverse shoulder arthroplasty for cuff-tear arthropathy reported in the Danish Shoulder Arthroplasty Registry from 2006 to 2015. During the study period, the completeness of reporting was 93% for both primary and revision arthroplasties.
Acta Orthop
October 2019
Background and purpose - Osteoarthritis has become the most common indication for shoulder arthroplasty in Denmark, and the treatment strategies have changed towards the use of anatomical total shoulder arthroplasty and reverse shoulder arthroplasty. We investigated whether changes in the use of arthroplasty types have changed the overall patient-reported outcome from 2006 to 2015. Patients and methods - We included 2,867 shoulder arthroplasties performed for osteoarthritis between 2006 and 2015 and reported to the Danish Shoulder Arthroplasty Registry.
View Article and Find Full Text PDFBackground and purpose - The revision rate of stemmed hemiarthroplasty (SHA) for acute proximal humeral fractures is low, but does not necessarily reflect the functional outcome. We report the revision rate of SHA for acute proximal humeral fractures and the proportion of arthroplasties that are not revised despite low functional outcome scores. Patients and methods - The Danish Shoulder Arthroplasty Registry was used to identify all patients with a proximal humeral fracture that was treated with a SHA between January 1, 2006 and December 31, 2015.
View Article and Find Full Text PDFBackground and purpose - Reverse shoulder arthroplasty (RSA) has become the treatment of choice for cuff-tear arthropathy. There are, however, concerns about the longevity and the outcome of an eventual revision procedure. Thus, resurfacing hemiarthroplasty (RHA) with extended articular surface has been suggested for younger patients.
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