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.

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.

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.

The use of the reverse shoulder arthroplasty for treatment of failed total shoulder arthroplasty.

Background: This study evaluated the outcomes of patients with failed total shoulder arthroplasty (TSA) who were treated with conversion to reverse shoulder arthroplasty (RSA).

Materials And Methods: We performed a retrospective case series of 24 consecutive patients with failed TSA who were treated with conversion to RSA. Twenty-two patients (16 women, 6 men) had a minimum 2-year clinical and radiographic follow-up.

Proximal humeral malunion treated with reverse shoulder arthroplasty.

Background: The purpose of this study was to determine the outcomes of patients with proximal humeral malunions treated with reverse shoulder arthroplasty (RSA).

Materials And Methods: Sixteen patients were treated with RSA for sequelae of a proximal humeral fracture with a malunion. Clinical outcomes (American Shoulder and Elbow Surgeons [ASES] score, Simple Shoulder Test, visual analog scale [VAS] score for pain and function, range of motion, and patient satisfaction) and radiographs were evaluated at a minimum follow-up of 2 years.

Effects of tilt and glenosphere eccentricity on baseplate/bone interface forces in a computational model, validated by a mechanical model, of reverse shoulder arthroplasty.

Hypothesis/background: Reverse shoulder arthroplasty is being used with greater frequency for patients with severe rotator cuff deficiency. There are several commercially available reverse shoulder devices, each with different glenosphere options. The purpose of this study was to determine: (1) forces at the baseplate-bone interface in glenospheres with centers of rotation located concentrically and eccentrically to the center of the baseplate; and (2) if baseplate-bone forces can be optimized by altering tilt of the baseplate.

Reverse shoulder arthroplasty for the treatment of irreparable rotator cuff tear without glenohumeral arthritis.

Background: The purpose of the present study was to evaluate the indications for, and outcomes of, reverse shoulder arthroplasty in patients with massive rotator cuff tears but without glenohumeral arthritis.

Methods: From December 1998 to December 2006, sixty-nine patients (seventy-two shoulders) were managed with reverse shoulder arthroplasty for the treatment of irreparable rotator cuff dysfunction without glenohumeral arthritis. The indications for reverse shoulder arthroplasty were persistent shoulder pain and dysfunction despite a minimum of six months of nonoperative treatment, the presence of at least a two-tendon tear, and Hamada stage-1, 2, or 3 changes in a patient for whom a non-arthroplasty option did not exist.

Effects of acquired glenoid bone defects on surgical technique and clinical outcomes in reverse shoulder arthroplasty.

Background: Reverse total shoulder arthroplasty is the accepted method of treatment for selected shoulder disorders. The purpose of this study was to compare primary reverse shoulder arthroplasty surgical techniques as well as clinical and radiographic outcomes in patients with acquired glenoid bone defects and in those with normal glenoid morphology.

Methods: Preoperative three-dimensional computed tomography scans were performed on 216 shoulders in 211 patients undergoing primary reverse shoulder arthroplasty between 2004 and 2007.

Reverse shoulder arthroplasty in patients with rheumatoid arthritis.

Background: The purpose of this study was to describe the pathoanatomy of patients diagnosed with rheumatoid arthritis and rotator cuff deficiency and report their outcomes following reverse shoulder arthroplasty.

Methods: Twenty-one shoulders were evaluated prospectively. Nine had no prior surgery, 9 had a failed rotator cuff repair, and 3 had a failed arthroplasty.

Is a formal physical therapy program necessary after total shoulder arthroplasty for osteoarthritis?

Hypothesis: A retrospective analysis was conducted of 2 consecutive groups of patients undergoing total shoulder arthroplasty (TSA) for primary osteoarthritis. One group was treated with formal physical therapy (PT), and one group was treated with home-based, physician-guided PT. We hypothesized that patients with a formal postoperative PT protocol would have significantly better postoperative clinical outcomes than patients with no formal PT.

Glenoid morphology in reverse shoulder arthroplasty: classification and surgical implications.

Background: A great challenge in reverse shoulder arthroplasty is the wide variation in glenoid morphology that adds uncertainties in glenoid component placement. The purpose of this study was to classify glenoid morphology and examining its effect on possible glenoid component fixation.

Materials And Methods: The morphology of 216 glenoids was classified into normal and abnormal with subgroups defined by erosion sites.

Pyrolytic carbon endoprosthetic replacement for osteonecrosis and femoral fracture of the hip: a pilot study.

Unlabelled: Hemiarthroplasty in young patients has the potential for eliminating bearing wear, but has the disadvantage of cartilage wear. Low-temperature isotropic (LTI) pyrolytic carbon reportedly reduces cartilage wear in canine hemiarthroplasties. We therefore initiated a study in humans when it was released for human use.

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).

Revision arthroplasty with use of a reverse shoulder prosthesis-allograft composite.

Background: Patients with disabling pain and loss of shoulder function with associated proximal humeral bone loss following shoulder arthroplasty have limited reliable treatment options. Our objective was to report the results, obtained as part of a prospective outcomes study, of the use of a reverse shoulder prosthesis-allograft composite in these patients.

Methods: Between 2002 and 2005, 353 patients treated with a reverse shoulder prosthesis were enrolled in a prospective cohort study.

Range of impingement-free abduction and adduction deficit after reverse shoulder arthroplasty. Hierarchy of surgical and implant-design-related factors.

Background: Evaluations of functional outcomes of reverse shoulder arthroplasty have revealed variable improvements in the range of motion and high rates of scapular notching. The purpose of this study was to systematically examine the impact of surgical factors (location of the glenosphere on the glenoid and tilt angle of the glenosphere on the glenoid) and implant-related factors (implant size, center-of-rotation offset, and humeral neck-shaft angle) on impingement-free abduction motion.

Methods: A computer model was developed to virtually simulate abduction/adduction motion and its dependence on five surgical and implant-related factors.

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.

In vitro and finite element analysis of glenoid bone/baseplate interaction in the reverse shoulder design.

We developed biomechanical and finite element models, using high-strength polyurethane foam blocks, to represent the glenoid bone/baseplate junction to determine if increasing the distance between the glenoid bone and the center of rotation of the glenosphere increases baseplate motion during static loading in the reverse shoulder design. Although there was a general trend toward increased baseplate motion with increasing distance from the glenoid to the center of rotation, in vitro mechanical testing revealed no significant difference between the 7 glenosphere types tested, with average baseplate motion during 1000 load cycles ranging from 90 mum to 120 mum. Results from the finite element analysis strongly correlated with the in vitro mechanical testing.

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.