Delta Xtend reverse shoulder arthroplasty - Results at a minimum of five years.

Background: Reverse shoulder arthroplasty provides predictable pain relief and improvements in function, but concerns remain regarding complication rates and there is little long-term outcome data. The aim of this study was to review the clinical and radiographic outcomes of the Delta Xtend reverse shoulder arthroplasty at a minimum of five years.

Methods: Ninety-six Delta Xtend reverse shoulder arthroplasty procedures were performed in 93 patients.

Arthroscopic rotator cuff repair: magnetic resonance arthrogram assessment of tendon healing.

Background: Many poor outcomes after arthroscopic rotator cuff (RC) repair relate to failure of tendon healing. The purposes of this study were to provide a better understanding of the magnetic resonance arthrography (MRA) characteristics of the RC tendon repair site after arthroscopic RC repair and to examine how these findings influence patient-reported outcome measures (PROMs) and the presence of persistent symptoms.

Methods: We reviewed 48 shoulders (13 female and 35 male patients; average age, 53.

Neurologic complications of shoulder joint replacement.

Background: Little attention has been given to neurologic complications after shoulder joint replacement (SJR). Previously thought to occur infrequently, it is likely that many are not clinically recognized, and they can result in postoperative morbidity and impair the patient's recovery. The purpose of this study was to document the prevalence of nerve complications after SJR, to identify the nerves involved, and to define patient outcomes.

Reverse shoulder arthroplasty compared with hemiarthroplasty in the treatment of acute proximal humeral fractures.

Background: Complex proximal humeral fractures may require prosthetic replacement of the humeral head. Surgical options include reverse shoulder arthroplasty (RSA) and shoulder hemiarthroplasty; however, the optimal technique remains controversial. The goal of this study was to compare functional outcomes and revision rates of RSA with hemiarthroplasty in patients with acute proximal humeral fractures.

The superomedial bare area of the costal scapula surface: a possible cause of snapping scapula syndrome.

Purpose: Scapulothoracic bursitis is a painful condition of the scapulothoracic articulation, which may be caused by various pathological anatomical associations. We have arthroscopically observed a constant bare area of bone on the costal scapula surface in patients with scapulothoracic bursitis, contradictory to traditional anatomical reports of scapular muscle relations. We undertook a cadaveric study to further define this anatomical feature.

Radial head reconstruction versus replacement in the treatment of terrible triad injuries of the elbow.

Introduction: Dislocation of the elbow with associated fractures of the radial head and the coronoid process of the ulna have been referred to as the terrible triad of the elbow because of the difficulties in treating this injury and the poor outcomes.

Materials And Methods: There were 23 patients (24 elbows) available for evaluation with this injury during a 7-year period at Auckland City Hospital.

Results: There were 11 women and 12 men with an average age of 43.

Functional outcomes of reverse shoulder arthroplasty compared with hemiarthroplasty for acute proximal humeral fractures.

Background: Complex acute proximal humeral fractures may require prosthetic replacement of the proximal humerus. Reverse shoulder arthroplasty (RSA) has been suggested as an alternative to hemiarthroplasty in the management of such fractures. This study compared the functional outcomes of RSA with hemiarthroplasty in patients with acute proximal humeral fractures.

Catheter orifice configuration influences the effectiveness of continuous peripheral nerve blockade.

Background And Objectives: We investigated perineural catheter threading distance and orifice configuration during continuous interscalene analgesia.

Methods: One hundred fifty-three patients receiving an anterolateral interscalene catheter (catheter needle and nerve/plexus in a similar alignment) for elective shoulder surgery were randomized to 1 of 3 groups: following out-of-plane ultrasound confirmation of the needle tip immediately lateral to the C5/6 roots, a nonstimulating catheter was blindly advanced 0.5 cm (end-hole; n = 50), 2.

Posterior versus anterolateral approach interscalene catheter placement: a prospective randomized trial.

Background And Objectives: Two distinctly different approaches to interscalene catheter placement have been in common use for close to a decade. This prospective randomized study tested the hypothesis that interscalene catheters placed using the posterior approach would provide a more effective analgesia after shoulder surgery compared with catheters placed using the anterolateral approach.

Methods: A total of 110 patients presenting for elective shoulder surgery were randomly assigned to receive an ultrasound-guided posterior (n=54) or anterolateral (n=56) interscalene catheter with 20 mL of ropivacaine 0.

Analgesic effectiveness of a continuous versus single-injection interscalene block for minor arthroscopic shoulder surgery.

Background And Objectives: The utility of continuous perineural infusions for lesser painful shoulder procedures is not well established. We hypothesized that the addition of a continuous interscalene ropivacaine infusion to a single-injection interscalene block would improve analgesia after minor arthroscopic shoulder surgery.

Methods: An ultrasound-guided interscalene catheter targeting the C5-C6 roots/superior trunk was placed preoperatively in patients undergoing arthroscopic subacromial decompression, excision lateral clavicle, or stabilization.

A prospective randomized comparison of ultrasound guidance versus neurostimulation for interscalene catheter placement.

Background And Objectives: Ultrasound (US) imaging facilitates catheter placement adjacent to the most appropriate elements of the brachial plexus, which for shoulder surgery are the C5YC6 roots or superior trunk. Therefore, it was investigated whether such placement would improve catheter effectiveness compared to placement with traditional techniques.

Methods: Needles introduced for catheter insertion were prospectively randomized to either US guidance immediately lateral to the C5-C6 roots/superior middle trunks (n = 43) or neurostimulation (NS) guidance to an appropriate motor response at less than 0.

A prospective randomized comparison of ultrasound and neurostimulation as needle end points for interscalene catheter placement.

Background: In this prospective, randomized study, we tested the hypothesis that interscalene catheters placed for shoulder surgery using an ultrasound needle end point provide postoperative analgesia similar in quality to those placed using a neurostimulation needle end point. Secondary end points included needle time under the skin, procedure-related pain, and the incidence of early neurological complications.

Methods: Patients presenting for shoulder surgery were recruited.

The SMR reverse shoulder prosthesis in the treatment of cuff-deficient shoulder conditions.

Background: Reverse total shoulder arthroplasty (RSA) is a relatively recent concept that provides further options in the management of cuff-deficient shoulder disorders. While early results utilizing the Delta III prosthesis (DePuy, Warsaw, IN) have been promising, there is limited data in the literature on outcomes utilizing differing prosthetic designs. We report on the outcomes of Reverse total shoulder arthroplasty (RSA) utilizing a previously unreported prosthesis, the SMR Modular Shoulder System (Systema Multiplana Randelli, Lima-LTO, Italy).

Successful continuous interscalene analgesia for ambulatory shoulder surgery in a private practice setting.

Background And Objectives: Large prospective studies evaluating continuous interscalene block for shoulder surgery have thus far been limited to inpatient and university teaching practices. Shoulder surgery is increasingly being performed on an outpatient basis. The aim of this case series was to prospectively evaluate a large series of interscalene catheters for ambulatory shoulder surgery in a private practice setting.

The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears.

Background: The impact of a recurrent defect on the outcome after rotator cuff repair has been controversial. The purpose of this study was to evaluate the functional and anatomic results after arthroscopic repair of large and massive rotator cuff tears with use of ultrasound as an imaging modality to determine the postoperative integrity of the repair.

Methods: Eighteen patients who had complete arthroscopic repair of a tear measuring >2 cm in the transverse dimension were evaluated at a minimum of twelve months after surgery and again at two years after surgery.

Do the genes that cause otosclerosis reduce susceptibility to otitis media?

Hypothesis: The genetic factors that cause otosclerosis reduce susceptibility to otitis media.

Background: Susceptibility to some infectious diseases is modulated by host genetic factors. Genes that reduce the morbidity and mortality of infectious diseases may confer a selective advantage and achieve high-frequency in at-risk populations.

The posterior branch of the axillary nerve: an anatomic study.

Background: Surgery on the posterior aspect of the shoulder has become accepted practice for a number of pathological conditions affecting the scapula and the glenohumeral joint. Despite this trend, the anatomy of the posterior branch of the axillary nerve has not been well characterized. The purpose of the present study was to determine the innervation pattern and surgical relationships of the posterior branch of the axillary nerve.

Arthroscopic treatment of post-traumatic elbow contracture.

The purpose of this study was to evaluate range of motion and patient-reported outcome after complete arthroscopic release of post-traumatic elbow contracture. Fourteen consecutive patients who underwent elbow arthroscopy and capsular release were reviewed retrospectively at a minimum follow-up of 1 year. Pain and range of motion were measured.

Elbow instability: treatment strategies and emerging concepts.

Elbow stability relies on a complex interaction between the bony articulations of the elbow joint, the capsuloligamentous structures, and dynamic muscle restraints. Understanding the functional anatomy of the elbow and the relative contribution of the various elements to elbow stability is important in developing a strategy for diagnosis and management. Elbow instability presents a spectrum from minor subluxation to dislocation.