Better Radiographic Reduction and Lower Complication Rates With Combined Coracoclavicular and Acromioclavicular Ligament Reconstruction Than With Isolated Coracoclavicular Reconstruction.

Purpose: To determine whether combined acromioclavicular (AC) ligament reconstruction and coracoclavicular (CC) ligament reconstruction without bone tunnels would improve radiographic reduction maintenance and complication rates for type III to V AC dislocations.

Methods: This single-institution retrospective study analyzed all patients who underwent a hybrid synthetic/graft wrap CC reconstruction without tunnels with additional AC reconstruction/repair from January 2013 to August 2019. This 26-patient cohort was compared with a 1:1 sex- and age-matched control group who underwent CC reconstruction without AC reconstruction.

The relationship of bilateral shoulder arthroplasty timing and postoperative complications.

Background: Though several case series have described bilateral shoulder arthroplasty results with range of motion, patient-reported outcomes, and complications, little guidance exists regarding the optimal interval timing between surgeries.

Methods: All patients from 2 insurance databases who underwent staged bilateral shoulder arthroplasty between 2005 and 2016 were identified. These patients were then stratified by elapsed time between surgeries into 4 study groups: (1) less than 3 months, (2) 3-6 months, (3) 6-9 months, and (4) 9-12 months.

Bundled Payment Plans Are Associated With Notable Cost Savings for Ambulatory Outpatient Total Shoulder Arthroplasty.

Introduction: Bundling of services, typically into a 90-day episode of care, is intended to facilitate cost reduction. The purpose of this study was to determine the impact of a private insurance bundling program on the costs of outpatient total shoulder arthroplasty (TSA) at a freestanding ambulatory surgery center.

Methods: A cost minimization analysis was done of patients who had anatomic TSA by a single surgeon at a single freestanding ambulatory surgery center, including line-by-line comparisons of demographic and comorbidity factors for all patients treated within the 90-day episode of care.

Safety and Cost-Effectiveness of Outpatient Unicompartmental Knee Arthroplasty in the Ambulatory Surgery Center: A Matched Cohort Study.

Using an age- and comorbidity-matched cohort, we compared patients who underwent unicompartmental knee arthroplasty in an ambulatory surgery center with those who underwent the procedure in a traditional hospital inpatient setting. Postoperatively, the ambulatory surgery center cohort had fewer major complications than the inpatient cohort. No ambulatory surgery center patients required acute hospital admission and none had major complications.

The effect of current and former tobacco use on outcomes after primary reverse total shoulder arthroplasty.

Background: The purpose of this study was to determine the influence of current and former tobacco use on minimum 2-year clinical and radiographic outcomes after reverse total shoulder arthroplasty (RTSA).

Methods: Review of primary RTSA patient data identified 186 patients with at least 2 years of follow-up. Patients were classified as nonsmokers (76 patients), former smokers (89 patients), or current smokers (21 patients).

Younger patients report similar activity levels to older patients after reverse total shoulder arthroplasty.

Background: Younger patients who have undergone reverse total shoulder arthroplasty (RTSA) are believed to have higher activity levels that place higher stresses across the prosthesis, increasing the risk of failure, but there is little information to support or refute this supposition. The purposes of this study were to define the patient-reported activity levels of patients younger than 65 years and older than 65 years who underwent RTSA and to evaluate any differences between the groups.

Methods: Forty-six patients who underwent primary RTSA answered a questionnaire regarding their activity levels.