Debridement Technique for Single-Stage Revision Shoulder Arthroplasty.

Background: The incidence of revision shoulder arthroplasty continues to rise, and infection is a common indication for revision surgery. Treatment of periprosthetic joint infection (PJI) in the shoulder remains a controversial topic, with the literature reporting varying methodologies, including the use of debridement and implant retention, single-stage and 2-stage surgeries, antibiotic spacers, and resection arthroplasty. Single-stage revision has been shown to have a low rate of recurrent infection, making it more favorable because it precludes the morbidity of a 2-stage operation.

Development, Evolution, and Outcomes of More Anatomical Reverse Shoulder Arthroplasty.

Reverse shoulder arthroplasty (RSA) has become a widely used procedure since its introduction in the 1980s, and is currently used to treat a wider range of conditions than its original indication. The original Grammont-style RSA revolutionized shoulder arthroplasty but had several limitations, including scapular notching and reduced rotational motion. This review discusses the evolution of RSA design, particularly the development of a lateralized center of rotation constructs, which aims to improve all the disadvantages associated with the Grammont-style design and more closely reproduce the native anatomy in order to improve patient outcomes in an expanded context of pathologies.

Revision for humeral stem loosening: a systematic review.

Introduction: Humeral loosening (HL) is an uncommon indication for revision shoulder arthroplasty. This systematic review describes patient characteristics (prosthetic type removed, reimplanted, and septic vs. aseptic loosening status), re-revision rate, and outcomes following revision surgery for a loose humeral stem.

Optimizing Muscle-Tendon Lengths in Reverse Total Shoulder Arthroplasty: Evaluation of Surgical and Implant-Design-Related Parameters.

Background: Optimizing the function of muscles that cross the glenohumeral articulation in reverse total shoulder arthroplasty (RTSA) is controversial. The current study used a geometric model of the shoulder to systematically examine surgical placement and implant-design parameters to determine which RTSA configuration most closely reproduces native muscle-tendon lengths of the deltoid and rotator cuff.

Methods: A geometric model of the glenohumeral joint was developed and adjusted to represent small, medium, and large shoulders.

Common Factors in Shoulder and Hip Arthroplasty Implant Failures: A Historical Review.

In this era of subspecialty care in orthopedics, iterations of implant design can occur in a silo which then precludes gaining knowledge from failures of implant design that may have occurred in different subspecialties. This literature review describes the history of failures in hip and shoulder arthroplasties with the purpose of identifying similar factors that led to previous implant failures. A review of the literature was performed by two reviewers assessing articles that described failed hip and shoulder arthroplasty systems over time.

Do preoperative scapular fractures affect long-term outcomes after reverse shoulder arthroplasty?

Background: Postoperative scapular stress fractures (SSFs) are a formidable problem after reverse shoulder arthroplasty (RSA). Less is known about patients who have these fractures preoperatively. The primary aim of this study was to examine postoperative satisfaction in patients undergoing primary RSA who have preoperative SSF and compared to a matched cohort without preoperative fracture.

Maximizing Implant Stability in the Face of Glenoid Bone Stock Deficiency.

As the incidence of shoulder arthroplasty continues to rise, encountering significant glenoid bone loss in the primary and revision setting is becoming a common occurrence. To effectively treat these difficult scenarios, surgeons must understand the common patterns of glenoid bone loss and be aware of the various techniques available for treatment. Understanding bone loss requires careful pre-operative evaluation with appropriate imaging and pre-operative planning software.

Glenoid-based reference system to differentiate shoulder pathologies on plain radiographs.

Background: Shoulder radiographs are used for evaluation and the planning of treatment of various pathologies. Making a diagnosis of these pathologies on plain radiographs occurs by recognizing the relationship of the humeral head on the registry of the glenoid. Quantification of these changes in registry does not currently exist.

How to avoid baseplate failure: the effect of compression and reverse shoulder arthroplasty baseplate design on implant stability.

Background: Failure to achieve fixation of the glenoid baseplate will lead to clinical failure. The fixation of the baseplate to the scapula must be able to withstand sufficient shear forces to allow bony ingrowth. The importance of compression to neutralize the forces at the baseplate-bone interface has been assumed to be critical in limiting excessive micromotion.

Impact of reverse shoulder arthroplasty design and patient shoulder size on moment arms and muscle fiber lengths in shoulder abductors.

Background: Reverse shoulder arthroplasty (RSA) increases the moment arm of the deltoid; however, there is limited knowledge on the accompanying changes in muscle architecture that play a role in muscle force production. The purpose of this study was to use a geometric shoulder model to evaluate the anterior deltoid, middle deltoid, and supraspinatus regarding (1) the differences in moment arms and muscle-tendon lengths in small, medium, and large native shoulders and (2) the impact of 3 RSA designs on moment arms, muscle fiber lengths, and force-length (F-L) curves.

Methods: A geometric model of the native glenohumeral joint was developed, validated, and adjusted to represent small, medium, and large shoulders.

Academic productivity metrics correlate positively with industry funding amongst orthopedic shoulder and elbow surgeons.

Background: Research efforts can produce practice-changing results with widespread implications for patient care. While critical to the advancement of the field, such efforts do not often provide direct compensation. However, a researcher's academic productivity may facilitate industry relationships, either as the impetus for the affiliation or a result of collaboration.

Interpositional scaffold anchor rotator cuff footprint tear repair: excellent survival, healing, and early outcomes.

Purpose: Shoulder function limitation duration after a full-thickness rotator cuff tendon (RCT) tear may influence post-repair healing and outcomes. A suture anchor was developed to improve footprint repair fixation and healing through biological fluid delivery and scaffold augmentation. The primary multicenter study objective was to evaluate RCT repair failure rate based on 6-month MRI examination, and device survival at 1-year follow-up.

Revision for instability following reverse total shoulder arthroplasty: outcomes and risk factors for failure.

Background: Revision of unstable reverse shoulder arthroplasty (RSA) is significantly challenging, with recurrence rates ranging from 20% to 40%. The purpose of this study was to identify factors associated with recurrent instability. The factors studied included (1) indication for revision RSA (failed primary RSA vs.

Humeral loosening in reverse shoulder arthroplasty: an analysis of 2,342 cases.

Introduction: Humeral loosening is a rare complication in reverse shoulder arthroplasty (RSA) representing approximately 1% of total complications. The purpose of this study is to identify patients who underwent RSA and were revised because of loosening of the humeral component, identify patients who are at increased risk, and report on their surgical outcomes.

Materials And Methods: A retrospective review of all patients who received a primary RSA or revision RSA (rRSA) by a single surgeon from 2002-2021 identified a total of 1591 primary RSA and 751 rRSA procedures.

Three-Dimensional Scapular Border Method for Glenoid Version Measurements.

Unlabelled: Variations among methods to measure glenoid version have created uncertainty regarding which method provides the most consistent measurements of morphology. Greater deformity may also make accurate depiction of the native morphology more challenging. This study examined 4 current methods (Friedman, corrected Friedman, Ganapathi-Iannotti, and Matsumura) and an experimental scapular border-derived coordinate system method, to compare measurement inconsistencies between methods and reference systems and assess the impact of glenoid deformity on measured glenoid version.

Academic Productivity in Orthopaedic Traumatology Correlates Positively With Industry Compensation.

Objective: To determine the association between academic productivity and industry compensation among Orthopaedic Traumatologists.

Design: Retrospective cohort study.

Setting: Review of the Centers for Medicaid and Medicare Services Open Payments program from 2016 to 2020.

Outcomes of femoral head allograft for the management of glenoid bone defects in revision reverse shoulder arthroplasty: a case-controlled study.

Background: Revision shoulder arthroplasty often requires management of glenoid bone defects. Options include using allograft, harvesting iliac crest autograft, or using augmented metal components. The purpose of this study is to report outcomes of revision shoulder arthroplasty requiring management of glenoid bone defects with femoral head allograft in a large cohort of patients using a single reverse shoulder implant system and compare them to a matched cohort based on the indication for surgery.

The Association Between Orthopaedic Surgeon Academic Productivity Metrics and Compensation from Medical Industry.

Introduction: Academic research has value well beyond personal financial gain. However, these endeavors do require a notable amount of time and opportunity cost. Academic productivity may raise a researcher's profile within the field, increasing the likelihood for interactions with the medical industry and possibly cultivating relationships with future monetary significance.

My Reverse Has Failed: Top Five Complications and How to Manage Them.

Reverse total shoulder arthroplasty implantation has increased dramatically over the past 4 decades since it was first introduced in France in 1985. It has greatly improved the ability to treat patients with cuff tear arthropathy, proximal humeral fractures, and osteoarthritis with severe bone loss. However, with the increased implementation of reverse total shoulder arthroplasty, there has been a corresponding rise in complications.