Cost-utility analysis of total shoulder arthroplasty: a prospective health economic study using real-world data.

Background: With increasing health care expenditures, knowledge about the benefit and costs of surgical interventions such as total shoulder arthroplasty (TSA) becomes important for orthopedic surgeons, social insurance programs, and health policy decision makers. We examined the impact of TSA on quality of life (QOL), direct medical costs, and productivity losses and evaluated the cost-utility ratio of TSA compared with ongoing nonoperative management using real-world data.

Methods: Patients with shoulder osteoarthritis and/or rotator cuff tear arthropathy indicated for anatomic or reverse TSA were included in this prospective study.

Effects of gait variations on grip force coordination during object transport.

In object transport during unimpeded locomotion, grip force is precisely timed and scaled to the regularly paced sinusoidal inertial force fluctuations. However, it is unknown whether this coupling is due to moment-to-moment predictions of upcoming inertial forces or a longer, generalized time estimate of regularly paced inertial forces generated during the normal gait cycle. Eight subjects transported a grip instrument during five walking conditions, four of which altered the gait cycle.