Publications by authors named "Joseph King"

Background: A variety of clinically important benchmarks of success (CIBS) have been defined for total shoulder arthroplasty (TSA) to quantify success. However, it is unclear how the preoperative status of the patient influences their likelihood of achieving each CIBS.

Questions/purposes: (1) What proportion of patients achieve commonly used CIBS after TSA? (2) Is there a relationship between a patients' preoperative function and their probability of achieving different CIBS? (3) Does there exist preoperative ranges for each outcome measure that are associated with greater achievement of CIBS?

Methods: We retrospectively queried a multicenter shoulder arthroplasty database for primary anatomic TSA (aTSA) and reverse TSA (rTSA).

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  • The study investigates thalamic nuclei changes in females with anorexia nervosa (AN) compared to healthy controls, revealing reduced volumes in most thalamic nuclei.
  • Significant associations were found between thalamic alterations, body mass index (BMI), and leptin levels, indicating leptin's role in these changes.
  • The findings highlight the thalamus as a crucial area for understanding AN and suggest exploring leptin treatment as a potential intervention.
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Background: The Latarjet procedure is considered the gold standard for treating patients with anterior shoulder instability in the presence of critical glenoid bone loss. Proponents of the Latarjet contend that its efficacy is in-part attributable to the "sling effect" of the conjoint tendon; however, recent studies have demonstrated similar restoration of anterior stability in patients undergoing free bone block (FBB) procedures. The purpose of this systematic review was to evaluate the biomechanical and clinical evidence for the sling effect.

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Background: Reverse shoulder arthroplasty (RSA) is increasingly used in the treatment of displaced proximal humerus fractures (PHFs) with reliable clinical improvement. However, the preferred techniques for humeral stem fixation are varied and may be influenced by patient and injury characteristics, including bone quality and fracture pattern. This systematic review and meta-analysis sought to determine the effect of humeral component cementing and bone grafting on tuberosity healing rates and functional outcomes after RSA for PHFs.

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Introduction: Previous research has determined that objective and subjective internal rotation (IR) may be discordant. The purpose of this study was to identify predictors of patient-reported ability to perform IR-dependent activities of daily living (IRADLs) and favorable patient satisfaction after reverse shoulder arthroplasty (RSA) despite the loss of objective IR.

Methods: A single, institutional, shoulder arthroplasty database was queried for patients undergoing primary RSA with a minimum 2-year follow-up.

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Objective: The purpose of this study was to evaluate the clinical outcomes in patients who underwent bilateral total shoulder arthroplasty (TSA) at a single institution. Secondarily, we evaluated the influence of the time interval between successive TSAs on clinical outcomes of the second TSA.

Methods: A single-institution shoulder arthroplasty database was reviewed for patients undergoing bilateral primary anatomic TSA (aTSA) or reverse TSA (rTSA) between 2000 and 2022.

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Purpose: Although the hematologic benefits of tranexamic acid (TXA) have been thoroughly evaluated, an additional value demonstrated in knee arthroplasty and rotator cuff repair is improved early postoperative range of motion (ROM). This study aims to evaluate whether TXA given during total shoulder arthroplasty (TSA) confers improved early postoperative ROM or pain.

Methods: We did retrospective review of 653 TSAs (223 anatomic TSA [aTSA] and 430 reverse TSA [rTSA]) performed in 596 patients at a single institution from 2007 to 2022.

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Background: Pain-relief plays a major deterministic role when assessing postoperative patient satisfaction; however, whether anatomic total shoulder arthroplasty (aTSA) or reverse total shoulder arthroplasty (rTSA) provides the most durable pain-relief has not been studied. The purpose of this study was to evaluate the durability of pain-relief after aTSA compared to rTSA in patients undergoing surgery for rotator cuff-intact glenohumeral osteoarthritis (RCI-GHOA).

Methods: A retrospective review of a multicenter shoulder arthroplasty database (Exactech Equinoxe) was performed.

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  • A study compared the clinical outcomes of lateralized reverse shoulder arthroplasty (RSA) and RSA with latissimus dorsi transfer (LDT) in patients with poor preoperative external rotation (ER).
  • The analysis showed that lateralized RSA alone led to better postoperative ER and Constant scores while having fewer complications compared to RSA with LDT.
  • Both procedures are effective for restoring ER, but lateralized RSA is preferred due to its lower risk of nerve injuries and dislocations, although LDT may still be suitable for select patients with severe ER loss.
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Background: As no consensus exists on the optimal postoperative rehabilitation protocol in terrible triad injuries, we sought to characterize the reported protocols and relate them to postoperative range of motion (ROM) measures and Mayo Elbow Performance Score (MEPS).

Methods: A systematic review was performed by searching PubMed/MEDLINE, Embase, Web of Science, and Cochrane databases to identify articles on the operative treatment of terrible triad injuries reporting postoperative rehabilitation protocols were included. Included studies were descriptively summarized.

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Background: This study sought to characterize the tipping point values (the functional scores that patients deem dysfunctional enough to warrant surgery) for patients undergoing first revision reverse total shoulder arthroplasty (rTSA).

Methods: This study was a retrospective review of a prospectively collected single-institution database of patients undergoing first revision rTSA between August 2015 and December 2019. Tipping point evaluation utilized preoperative scores including the American Shoulder and Elbow Surgeons (ASES), raw and normalized Constant, Shoulder Pain and Disability Index (SPADI), Simple Shoulder Test (SST), and University of California-Los Angeles (UCLA) scores, and active range of motion including abduction, forward elevation (FE), external rotation (ER), and internal rotation score (IR) prior to elective revision rTSA.

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Background: Improper sizing of the humeral head component in anatomic total shoulder arthroplasty (ATSA) can overstuff the joint, potentially compromising outcomes. The purpose of this study was to validate a novel method of evaluating glenohumeral joint overstuffing in which superoinferior and mediolateral overstuffing can be evaluated independently relative to the native humeral anatomy.

Methods: We identified 25 patients who underwent ATSA and the best Grashey radiograph taken within 1 year of follow-up was assessed using our proposed technique.

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  • * A total of 2.1% of patients (n=138) experienced dislocations, primarily within the first 90 days post-surgery, with different treatment approaches for dislocation including closed reduction, open reduction, revision arthroplasty, or benign neglect.
  • * Among those treated with closed reduction, only 31% were successfully resolved without further intervention, while many either required revision surgery or experienced recurrent dislocations, highlighting the complexity of managing these postoperative complications.
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  • Patients undergoing total shoulder arthroplasty (aTSA and rTSA) often face challenges in regaining overhead range of motion (ROM) after surgery, especially if they had stiff shoulders before the operation.
  • The study hypothesized that patients with stiff shoulders (passive external rotation ≤0°) would recover more slowly in ROM after surgery, compared to those with non-stiff shoulders (passive external rotation >0°).
  • Results showed that non-stiff aTSA and rTSA patients regained various motion types faster than their stiff counterparts, although non-stiff rTSA patients took longer to regain internal rotation compared to stiff rTSA patients.
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  • The study compared functional outcomes and survival rates in non-smokers, former smokers, and current smokers who underwent anatomical total shoulder arthroplasty (aTSA).
  • It analyzed data from 428 patients, noting that non-smokers had significantly better functional scores, strength, and range of motion compared to both former and current smokers.
  • The results indicate that smoking negatively impacts recovery and revision-free survival after shoulder surgery, with non-smokers experiencing the best outcomes.
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Background: The increasing incidence of reverse total shoulder arthroplasties (RTSA) has led to an increase in revision surgery. We aimed to compare patients undergoing re-revision RTSA to a matched cohort undergoing first-revision RTSA.

Methods: A retrospective review of all revision RTSAs was performed at a single institution.

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  • Cranial nerve palsies, although rare, can indicate the presence of intracranial aneurysms, and this study aimed to evaluate recovery rates and factors influencing improvement after flow diversion treatment.
  • A meta-analysis combined data from 13 studies and institutional findings, showing a 71% overall improvement in cranial nerve palsies post-treatment, with lower recovery rates specifically for CN II deficits.
  • Improved outcomes were linked to quicker interventions and successful aneurysm occlusion, suggesting that timely treatment significantly enhances recovery prospects in affected patients.
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Background: Proximal humerus fractures (PHFs) are relatively common, although optimal rehabilitation is unknown. This review aims to characterize the published rehabilitation regimens utilized for PHFs.

Methods: A systematic review was performed per PRISMA guidelines, utilizing PubMed/MEDLINE, Embase, and Cochrane.

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  • The study analyzed how smoking status (current, former, non-smokers) affects pain, function, and complications in patients undergoing reverse total shoulder arthroplasty (rTSA).
  • A total of 676 patients were included, and results showed that current smokers had worse functional outcomes compared to former smokers and non-smokers after 2-4 years.
  • However, there were no significant differences in complication rates or the need for revision surgery between the different smoking cohorts.
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  • * Researchers reviewed data on 1,148 shoulder surgeries, correlating Area Deprivation Index (ADI) scores from zip codes with patients' functional outcomes before and after surgery.
  • * Results indicated a weak negative correlation between higher ADI (representing greater area deprivation) and poorer preoperative and postoperative function; however, there was no significant difference in outcome achievement among socioeconomic groups for anatomic TSA.
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Background: This systematic review and meta-analysis sought to compare the clinical outcomes after proximal humerus reconstruction with a reverse allograft-prosthetic composite (APC) versus reverse endoprosthesis.

Methods: Per PRISMA guidelines, we queried PubMed/MEDLINE, Embase, Web of Science, and Cochrane databases to identify articles reporting clinical outcomes of reverse APC or reverse endoprosthesis reconstruction of the proximal humerus for massive bone loss secondary to tumor, fracture, or failed arthroplasty. We compared postoperative range of motion, outcome scores, and the incidence of complications and revision surgery.

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Background: Stilting is a novel technique used in reverse shoulder arthroplasty (RSA) in patients with significant glenoid bone loss. This technique utilizes peripheral locking screws placed behind an unseated portion of the baseplate to transmit forces from the baseplate to the cortical surface of the glenoid, without the need for bone grafting. The stilted screw, once locked, provides a fixed angle point of support for this unseated aspect of a baseplate.

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Purpose: This systematic review and meta-analysis compared clinical outcome measures in patients undergoing reverse shoulder arthroplasty (RSA) for proximal humerus fracture (PHF) with healed versus non-healed greater tuberosity (GT).

Methods: We performed a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines querying PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane for studies that stratified results by the GT healing status. Studies that did not attempt to repair the GT were excluded.

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» Instability and dislocation after reverse shoulder arthroplasty may occur in up to 31% of patients. » Clinical risk factors for instability include younger age, male sex, increased body mass index, preoperative diagnosis of proximal humerus fracture or rotator cuff pathology, history of instability of the native shoulder or after surgery, and a medical history of Parkinson's disease. » Patients with rheumatoid arthritis and decreased proximity to the coracoid may also be at greater risk.

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Effortful tasks are generally experienced as costly, but the value of work varies greatly across individuals and populations. While most mental health conditions are characterized by amotivation and effort avoidance, individuals with anorexia nervosa (AN) persistently engage in effortful behaviors that most people find unrewarding (food restriction, excessive exercise). Current models of AN differentially attribute such extreme weight-control behavior to altered reward responding and exaggerated cognitive control.

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