The Effect of Reverse Shoulder Arthroplasty Design and Surgical Indications on Deltoid and Rotator Cuff Muscle Length.

Background: Advancements in surgical planning, technique, and prosthesis design have improved adaptation to patient anatomy in reverse total shoulder arthroplasty (rTSA). Postoperative changes in deltoid and rotator cuff muscle length are important and may vary based on preoperative indications and prosthesis selection. The purpose of this study is to demonstrate the changes in deltoid and rotator cuff muscle length for planned rTSA using the spectrum of prosthesis configurations in both GHOA and RCA.

Modular baseplate augmentation: a simple and effective method for addressing eccentric glenoid wear.

Background: Augmented baseplates can be effective at addressing eccentric glenoid wear in reverse total shoulder arthroplasty. However, these implants often come in a limited number of predetermined shapes that require additional reaming to ensure adequate glenoid seating. This typically involves complex instrumentation and can have a negative impact on implant stability.

Anatomic shoulder arthroplasty with high side reaming versus reverse shoulder arthroplasty for eccentric glenoid wear patterns with an intact rotator cuff: comparing early versus midterm outcomes with minimum 7 years of follow-up.

Background: Eccentric glenoid bone loss patterns (B- and C-type glenoid) pose a difficult challenge when performing shoulder arthroplasty. Anatomic total shoulder arthroplasty with preferential high-side reaming (ATSA + HSR) has been an accepted method to treat this problem. Reverse shoulder arthroplasty (RSA) has become an alternative method to manage these cases with eccentric glenoid wear.

Consensus statement on the treatment of massive irreparable rotator cuff tears: a Delphi approach by the Neer Circle of the American Shoulder and Elbow Surgeons.

Background: Management of massive irreparable rotator cuff tears (MIRCTs) remains controversial owing to variability in patient features and outcomes contributing to a lack of unanimity in treatment recommendations. The purpose of this study was to implement the Delphi process using experts from the Neer Circle of the American Shoulder and Elbow Surgeons to determine areas of consensus regarding treatment options for a variety of MIRCTs.

Methods: A panel of 120 shoulder surgeons were sent a survey regarding MIRCT treatments including arthroscopic débridement and partial cuff repair, graft augmentation, reverse shoulder arthroplasty (RSA), superior capsular reconstruction (SCR), and tendon transfer.

Randomized prospective evaluation of the use of tranexamic acid and effects on blood loss for proximal humeral fracture surgery.

Background: Tranexamic acid (TXA) is an antifibrinolytic agent that has been used to reduce blood loss in orthopedic surgery. It has been shown to decrease blood loss in upper- and lower-extremity arthroplasty, as well as lower-extremity fracture surgery. The use of TXA for proximal humeral fracture surgery has yet to be evaluated.

Anatomic Total Shoulder Arthroplasty Versus Reverse Total Shoulder Arthroplasty for Post-Capsulorrhaphy Arthropathy.

Post-capsulorrhaphy arthropathy is a long-term sequela that can develop after open anterior stabilization surgeries, which have historically been performed. The purpose of this study was to compare anatomic total shoulder arthroplasty (ATSA) with reverse total shoulder arthroplasty (RTSA) for the treatment of post-capsulorrhaphy arthropathy. There were 19 patients in the ATSA cohort and 20 in the RTSA cohort.

Reverse Shoulder Arthroplasty in the Weight-Bearing Versus Non-Weight-Bearing Shoulder: Mid-term Outcomes With Minimum 5-Year Follow-up.

This retrospective review evaluated the mid-term outcomes of cemented reverse shoulder arthroplasty in patients who use the shoulder for weight bearing (WB) vs non-weight-bearing (NWB) patients. Twenty-five shoulders of 21 patients who used their upper extremity for WB (WB group) were treated with cemented reverse shoulder arthroplasty and followed for a minimum of 5 years postoperatively (average, 73 months). Seventy-five consecutive shoulders of 72 patients who were NWB (NWB group) were treated and matched for duration of follow-up (average, 72 months) to serve as a control group.

Total shoulder arthroplasty with minimum 5-year follow-up: does the presence of subchondral cysts in the glenoid increase risk of failure?

Background: This study evaluated the effect of cystic changes in the glenoid on postoperative outcomes and implant survival after total shoulder arthroplasty (TSA).

Materials And Methods: From 2004 to 2012, 75 patients underwent TSA for primary osteoarthritis with minimum 5-year follow-up. Preoperative 3-dimensional models based on computed tomography imaging were created for all patients.

Classification of instability after reverse shoulder arthroplasty guides surgical management and outcomes.

Background: Revision of unstable reverse shoulder arthroplasty (RSA) remains a significant challenge. The purpose of this study was to determine the reliability of a new treatment-guiding classification for instability after RSA, to describe the clinical outcomes of patients stabilized operatively, and to identify those with higher risk of recurrence.

Methods: All patients undergoing revision for instability after RSA were identified at our institution.

Reverse Shoulder Arthroplasty for the Treatment of Rotator Cuff Deficiency: A Concise Follow-up, at a Minimum of 10 Years, of Previous Reports.

Unlabelled: We previously evaluated 94 patients (96 shoulders) who underwent reverse shoulder arthroplasty using a central compressive screw with 5.0-mm peripheral locking screws for baseplate fixation and a center of rotation lateral to the glenoid as treatment for end-stage rotator cuff deficiency. The purpose of this study was to report updated results at a minimum follow-up of 10 years.

Partial rotator cuff repair and biceps tenotomy for the treatment of patients with massive cuff tears and retained overhead elevation: midterm outcomes with a minimum 5 years of follow-up.

Background: A subset of patients with massive irreparable rotator cuff tears present with retained overhead elevation and pain as their primary complaint. Our aim was to evaluate the outcomes of partial arthroscopic rotator cuff repair with biceps tenotomy and to report the failure rate of this procedure for patients with >5 years of follow-up.

Methods: Thirty-four patients underwent partial rotator cuff repair and biceps tenotomy for treatment of a massive rotator cuff tear.

Evaluation of Factors Affecting Acute Postoperative Pain Levels After Arthroscopic Rotator Cuff Repair.

Purpose: To evaluate multiple preoperative and operative factors that may be predictive of and correlate with acute postoperative pain levels after arthroscopic rotator cuff repair.

Methods: One hundred eighty-one patients underwent arthroscopic rotator cuff surgery along with subacromial decompression and met the inclusion criteria for this study. Postoperative visual analog scale (VAS) scores were obtained on postoperative days 1, 7, and 90.

Glenosphere dissociation after reverse shoulder arthroplasty.

Background: Reverse shoulder arthroplasty (RSA) is gaining popularity for the treatment of debilitating shoulder disorders. Despite marked improvements in patient satisfaction and function, the RSA complication rate is high. Glenosphere dissociation has been reported and may result from multiple mechanisms.

Comparison of hemiarthroplasty and reverse shoulder arthroplasty for the treatment of proximal humeral fractures in elderly patients.

Background: Treatment of complex three and four-part proximal humeral fractures with hemiarthroplasty in elderly patients has yielded mixed clinical results. Reverse shoulder arthroplasty has emerged as a treatment option for comminuted proximal humeral fractures for these patients. The purpose of the study was to perform a prospective evaluation of patient outcomes comparing hemiarthroplasty and reverse shoulder arthroplasty for the treatment of comminuted proximal humeral fractures in elderly patients.

Scapular fractures after reverse shoulder arthroplasty: evaluation of risk factors and the reliability of a proposed classification.

Background: The aims were to determine the sensitivity of plain radiographs to detect scapular fractures after reverse shoulder arthroplasty (RSA), to test the reliability of a proposed classification, and to evaluate risk factors.

Materials And Methods: We matched 53 patients with scapular fractures after RSA to 212 control patients. Clinical risk factors were assessed by correlating comorbidities.

Reverse shoulder arthroplasty for the treatment of rotator cuff deficiency: a concise follow-up, at a minimum of five years, of a previous report.

Unlabelled: We previously evaluated ninety-four patients (ninety-six shoulders) who underwent reverse shoulder arthroplasty with use of a central compressive screw along with 5.0-mm peripheral locking screws for baseplate fixation and a center of rotation lateral to the glenoid. The purpose of this study was to report updated results at a minimum follow-up of five years.

Prospective evaluation of postoperative compliance and outcomes after rotator cuff repair in patients with and without workers' compensation claims.

Background: This study prospectively evaluated compliance and outcomes after rotator cuff repair in patients with and without Workers' Compensation claims.

Materials And Methods: From December 2007 to January 2010, 42 consecutive patients with Workers' Compensation claims (Work Comp group), and 50 consecutive patients without a Workers' Compensation claim (non-Work Comp group) underwent arthroscopic rotator cuff repair and were enrolled in this study. Compliance with a postoperative protocol of shoulder immobilization and physical therapy was documented.

Prospective randomized study of arthroscopic rotator cuff repair using an early versus delayed postoperative physical therapy protocol.

Background: This study evaluated patient outcomes and rotator cuff healing after arthroscopic rotator cuff repair using a postoperative physical therapy protocol with early passive motion compared with a delayed protocol that limited early passive motion.

Materials And Methods: The study enrolled 68 patients (average age, 63.2 years) who met inclusion criteria.

Torsional stability of modular and non-modular reverse shoulder humeral components in a proximal humeral bone loss model.

Hypothesis/background: Patients who are treated with reverse shoulder arthroplasty in the setting of proximal humeral bone loss present a technical challenge for humeral component fixation. The purpose of this study was to determine the effect of proximal humeral bone loss on fixation of reverse shoulder humeral implants.

Materials And Methods: Three reverse humeral designs (two modular and one monobloc) were cemented into twenty-four Sawbones humeri prepared to simulate intact and proximal humeral bone loss.

Revision reverse shoulder arthroplasty for glenoid baseplate failure after primary reverse shoulder arthroplasty.

Background: The aim of this study is to document a single surgeon's experience performing revision reverse shoulder arthroplasty after baseplate failure.

Methods: Revision reverse shoulder arthroplasty (RSA) for mechanical failure of the glenoid baseplate after RSA was performed in 14 patients. Clinical and radiographic data were collected preoperatively, prior to baseplate failure, after baseplate failure, and at latest follow-up after revision (average, 33 months).

Reverse shoulder arthroplasty for the treatment of rotator cuff deficiency.

Background: Early designs of reverse shoulder arthroplasty components for the treatment of glenohumeral arthritis associated with severe rotator cuff deficiency in some cases have been associated with mechanical failure. The purpose of this study was to perform a prospective outcomes study of reverse shoulder arthroplasty performed with use of 5.0-mm peripheral locking screws for baseplate fixation and a lateralized center of rotation for the treatment of a rotator cuff deficiency.

Young patients with shoulder chondrolysis following arthroscopic shoulder surgery treated with total shoulder arthroplasty.

Chondrolysis following shoulder arthroscopy is a devastating complication, often seen in young patients. After nonoperative measures have been exhausted, there are few treatment options available that reliably improve pain and function. The purpose of this study is to examine the intra-operative findings, radiographic features, and clinical outcomes of a series of patients with chondrolysis following arthroscopic surgery managed with a total shoulder arthroplasty.

Evaluation of abduction range of motion and avoidance of inferior scapular impingement in a reverse shoulder model.

The purpose of this study was to determine the effects of prosthetic design and surgical technique of reverse shoulder implants on total abduction range of motion and impingement on the inferior scapular neck. Custom implants in three glenosphere diameters (30, 36, and 42 mm), with 3 different centers of rotation offsets (0, +5, and +10 mm), were placed into a Sawbones scapula (Pacific Research Laboratories, Vashon, WA) in 3 different positions: superior, center, and inferior glenoid. Humeral sockets were manufactured with a 130 degrees , 150 degrees , and 170 degrees neck-shaft angle.