Autologous platelet gel and platelet-poor plasma reduce pain with total shoulder arthroplasty.

The recovery of patients undergoing total shoulder arthroplasty (TSA) can be adversely affected by a number of complications. Autologous platelet gel (APG), produced by activating platelet-rich plasma (PRP), has been shown to improve hemostasis and wound healing and reduce infections in some surgical procedures. Activated platelet-poor plasma (PPP) has also been used as a hemostatic agent.

Successful osteosynthesis of an unstable mesoacromion in 6 shoulders: a new technique.

Six patients with impingement syndrome associated with an unstable mesoacromion underwent successful acromial fusion performed with a new technique. Preoperative symptoms included pain from a combination of 3 sources: movement at the mesoacromial cleft, junction of the medial cleft with the distal clavicle, and dynamic impingement of the unstable anterior acromion on the underlying rotator cuff. Two patients reported the onset of pain after a blow to the top of the acromion that supposedly rendered the mesoacromion unstable.

Magnetic resonance imaging for evaluation of failed repairs of the rotator cuff. Relationship to operative findings.

We used magnetic resonance imaging to evaluate thirty shoulders in twenty-nine patients who had unacceptable pain and loss of function after at least one operative procedure for a lesion of the rotator cuff. A preoperative history was recorded and physical and radiographic examinations were performed before magnetic resonance imaging. All patients had a reoperation two to 156 months (average, thirty-two months) after the operation.

The anatomy and potential effects of contracture of the coracohumeral ligament.

In 63 anatomic specimens of the shoulder, the coracohumeral ligament was found to be a clear, well-developed structure in 59 and absent or vestigial in four. The origin of the coracohumeral ligament was consistently found at the base of the coracoid process. The insertion was more variable, between the rotator interval, supraspinatus, and subscapularis.

Experimental evaluation of seven different spinal fracture internal fixation devices using nonfailure stability testing. The load-sharing and unstable-mechanism concepts.

Fracture site immobilization capabilities of seven internal spine fixation systems were experimentally evaluated: Harrington double distraction (plain, supplemented with Edwards sleeves, supplemented with sublaminar wires), Luque rectangle, Kaneda device, transfixed Kaneda device, and Steffee plates. Stability evaluation involved comparing the three-dimensional motion that occurred across an experimentally created L1 slice fracture, and the load resistance of the implants when subjected to axial, flexion, extension, lateral bending, and torsional loads. Each implant was tested on 15 different vertebral segments from 200-250-lb calves.