Influence of humeral lengthening on clinical outcomes in reverse shoulder arthroplasty.

Background: Deltoid tensioning secondary to humeral lengthening after reverse shoulder arthroplasty (RSA) is commonly theorized to be crucial to improving range of motion (ROM) but may predispose patients to acromial/scapular spine fractures and neurologic injury. Clinical evidence linking patient outcomes to humeral lengthening is limited. This study assesses the relationship between humeral lengthening and clinical outcomes after RSA.

Clinical outcomes related to glenosphere overhang in reverse shoulder arthroplasty using a lateralized humeral design.

Background: Previous studies have demonstrated that decreased impingement-free range of motion (ROM) can adversely influence clinical outcomes following reverse shoulder arthroplasty (RSA). Inferior placement of the glenosphere is thought to minimize impingement and its associated sequelae. This study evaluated the relationship between inferior overhang of the glenosphere and clinical outcomes in patients undergoing primary RSA using a lateralized humeral implant design.

Rate of improvement in shoulder strength after anatomic and reverse total shoulder arthroplasty.

Background: The rate at which patients regain shoulder strength after anatomic and reverse total shoulder arthroplasty (TSA) is unknown. In this study, we aimed to quantify differences in the timeline during which patients gained shoulder strength after primary anatomic and reverse TSA.

Methods: We retrospectively reviewed prospectively collected data from 374 shoulders after primary anatomic TSA (aTSA) and 601 shoulders after primary reverse TSA (rTSA).

Association Between Preoperative Shoulder Strength and Clinical Outcomes After Primary Reverse Total Shoulder Arthroplasty.

Introduction: We aimed to determine whether preoperative shoulder strength predicts postoperative values and improvement in strength, range of motion (ROM), and outcome scores after primary reverse total shoulder arthroplasty (rTSA).

Methods: We retrospectively reviewed 264 shoulders with a minimum of 2-year follow-up after primary rTSA. Preoperative external rotation (ER) strength, supraspinatus strength, and abduction strength were analyzed to establish their correlation with postoperative values and improvement in strength, ROM, and outcome scores (Constant score, American Shoulder and Elbow Surgeons Shoulder score, Shoulder Pain and Disability Index, Simple Shoulder Test, and the University of California, Los Angeles score).

Preoperative shoulder strength is associated with postoperative primary anatomic total shoulder arthroplasty outcomes and improvement.

Background: Although numerous preoperative factors that influence postoperative outcomes after anatomic total shoulder arthroplasty (aTSA) have been identified, preoperative shoulder strength has not been studied. The purpose of this study was to determine whether preoperative shoulder strength is predictive of postoperative outcomes and improvement after primary aTSA.

Methods: We conducted a retrospective review of prospectively collected data from 160 shoulders with minimum 2-year follow-up after primary aTSA.

Differential outcomes of venous and arterial tissue engineered vascular grafts highlight the importance of coupling long-term implantation studies with computational modeling.

Electrospinning is commonly used to generate polymeric scaffolds for tissue engineering. Using this approach, we developed a small-diameter tissue engineered vascular graft (TEVG) composed of poly-ε-caprolactone-co-l-lactic acid (PCLA) fibers and longitudinally assessed its performance within both the venous and arterial circulations of immunodeficient (SCID/bg) mice. Based on in vitro analysis demonstrating complete loss of graft strength by 12 weeks, we evaluated neovessel formation in vivo over 6-, 12- and 24-week periods.

Factors Associated with the Transfer of Pediatric Patients with Supracondylar Humerus Fractures to a Level I Pediatric Trauma Center.

Objective: To compare the characteristics of pediatric patients with supracondylar humerus fractures transferred to a level I pediatric trauma center to those who presented directly to our institution.

Methods: Retrospective chart review of patients with a supracondylar humerus fracture during a 42-month period (2008-2011) at a major level I pediatric trauma center were reviewed. Of 195 patients, 37 were transferred from outside hospitals.

Comparison of the biological equivalence of two methods for isolating bone marrow mononuclear cells for fabricating tissue-engineered vascular grafts.

Our approach for fabricating tissue-engineered vascular grafts (TEVG), applied in the surgical management of congenital heart disease, is accomplished by seeding isolated bone marrow-derived mononuclear cells (BM-MNCs) onto biodegradable scaffolds. The current method used for isolation of BM-MNCs is density centrifugation in Ficoll. This is a time-consuming, labor-intensive, and operator-dependent method.

In vivo applications of electrospun tissue-engineered vascular grafts: a review.

There is great clinical demand for synthetic vascular grafts with improved long-term efficacy. The ideal vascular conduit is easily implanted, nonthrombogenic, biocompatible, resists aneurysmal dilatation, and ultimately degrades or is assimilated as the patient remodels the graft into tissue resembling native vessel. The field of vascular tissue engineering offers an opportunity to design the ideal synthetic graft, and researchers have evaluated a variety of methods and materials for use in graft construction.

Characterization of evolving biomechanical properties of tissue engineered vascular grafts in the arterial circulation.

We used a murine model to assess the evolving biomechanical properties of tissue engineered vascular grafts (TEVGs) implanted in the arterial circulation. The initial polymeric tubular scaffold was fabricated from poly(lactic acid)(PLA) and coated with a 50:50 copolymer of poly(caprolactone) and poly(lactic acid)(P[PC/LA]). Following seeding with syngeneic bone marrow derived mononuclear cells, TEVGs (n=50) were implanted as aortic interposition grafts in wild-type mice and monitored serially using ultrasound.

Current advances in the translation of vascular tissue engineering to the treatment of pediatric congenital heart disease.

Tissue-engineered vascular grafts (TEVGs) hold great promise for the improvement of outcomes in pediatric patients with congenital cardiac anomalies. Currently used synthetic grafts have several limitations, including thrombogenicity, increased risk of infection, and lack of growth potential. The first pilot clinical trial of TEVGs demonstrated the feasibility of this new technology and revealed an excellent safety profile.