Glenoid lateralization and subscapularis repair are independent predictive factors of improved internal rotation after reverse shoulder arthroplasty.

Purpose: Reverse shoulder arthroplasty (RSA) has shown improvement in clinical outcomes for various conditions, although some authors expressed concern about the restoration of active internal rotation (AIR). The current study assesses preoperative and intraoperative predictive factors of AIR in patients having a Grammont-style RSA with a minimum five year follow-up.

Methods: We conducted a retrospective multicentric study, including patients operated on with a 155° Grammont-style RSA for cuff-related pathology or primary osteoarthritis with posterior subluxation or an associated cuff tear.

Midterm results of pyrocarbon interposition shoulder arthroplasty: good outcomes after posttraumatic osteonecrosis without malunion of the tuberosities.

Background: In vitro data demonstrate the potential benefits of the pyrocarbon as a bearing material against cartilage or bone. And pyrocarbon-free interposition arthroplasty has been used with positive outcomes for over 10 years for hand and wrist joint replacements. This study reports the midterm results of a Pyrocarbon Interposition Shoulder Arthroplasty (PISA) in primary and secondary glenohumeral osteoarthritis and in avascular osteonecrosis.

Clinical and Radiological Results of Hemiarthroplasty and Total Shoulder Arthroplasty for Primary Avascular Necrosis of the Humeral Head in Patients Less Than 60 Years Old.

Background: Total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) have shown good clinical outcomes in primary avascular necrosis of the humeral head (PANHH) both in short and long terms. The purpose of this study was to assess the complications, the clinical and radiological outcomes of shoulder arthroplasty in young patients with PANHH.

Methods: One hundred and twenty-seven patients aged under 60 years old and suffering from PANHH were operated with arthroplasty.

Reverse shoulder arthroplasty in rheumatoid arthritis: survival and outcomes.

Background: Despite its potential biomechanical advantages, reverse shoulder arthroplasty (RSA) is still considered to be particularly high risk in rheumatoid patients who are osteoporotic and immunodeficient. Our purpose was to report prosthesis survival, complications, and outcomes of RSA in patients with rheumatoid arthritis (RA) at minimum 5-year follow-up.

Methods: We conducted a retrospective multicenter study including 65 consecutive primary RSAs performed in 59 patients with RA between 1991 and 2010.

Internal impingement of the shoulder in overhead athletes: Retrospective multicentre study in 135 arthroscopically-treated patients.

Background: Internal impingement of the shoulder (IIS) is the leading cause of chronic shoulder pain in overhead throwing athletes. No consensus exists about which techniques are optimal when surgery is in order. The available studies are limited by small sample sizes and short follow-ups.

Internal impingement of the shoulder: An international survey of 261 orthopaedic surgeons.

Background: Internal impingement of the shoulder (IIS) is a specific disorder of young overhead-throwing athletes that was first described in 1991. The many non-operative and surgical treatments suggested to date have produced mixed outcomes. The objective of this study was to compare the practices of surgeons in France versus other countries regarding the diagnosis and treatment of IIS.

Is posterosuperior contact a normal occurrence in the shoulder?

Unlabelled: Posterosuperior (or internal) impingement at the shoulder is defined as contact between the underside of the supraspinatus or infraspinatus tendons with the posterosuperior labrum during extreme external rotation and abduction. In many cases, this contact damages the tendon and causes mirror posterosuperior labrum deterioration. The primary aim of this study was to define whether this contact occurs normally in patients who do not have a rotator cuff tear.

Superior glenoid inclination and glenoid bone loss : Definition, assessment, biomechanical consequences, and surgical options.

Correct anatomical alignment of the glenoid component is of central importance for wear and loosening in shoulder endoprostheses. The aim of this article is to review and clarify the biomechanical and clinical effects of incorrect glenoid inclination in reverse and anatomical joint replacements. Based on the literature and on our own work, statements are made about the following: (1) the glenoid inclination of a normal glenoid, a degenerative glenoid and a glenoid implant, and the consequences if superior inclination is too large, and (2) the surgical technique as well as tips and tricks for correct adjustment of the inclination.

Pyrocarbon interposition shoulder arthroplasty: preliminary results from a prospective multicenter study at 2 years of follow-up.

Background: The concept of free interposition arthroplasty proved successful for small joints of the hand, wrist, and foot, particularly after the use of implants coated with pyrocarbon, which enhanced their tribologic and elastic properties. The present study reports preliminary outcomes of a pyrocarbon-coated interposition shoulder arthroplasty (PISA) implant.

Methods: This was a prospective study of 67 consecutive patients who underwent shoulder PISA at 9 centers.

Metal-backed glenoid implant with polyethylene insert is not a viable long-term therapeutic option.

Background: The aims of this study were to determine the survival of anatomic total shoulder arthroplasty with uncemented metal-backed (MB) glenoid components with a polyethylene (PE) insert in primary osteoarthritis, to assess the reasons for revision surgery, and to identify patients and diagnostic factors that influence failure rates.

Methods: Between 1994 and 1999, 165 patients (mean age, 68 years) with primary osteoarthritis were treated with anatomic total shoulder arthroplasty using an uncemented MB/PE glenoid component. Outcomes were assessed both clinically and radiologically with a minimum of 2 years of follow-up.

Three-dimensional assessment of the dimensions of the osteoarthritic glenoid.

Osteoarthritis results in changes in the dimensions of the glenoid. This study aimed to assess the size and radius of curvature of arthritic glenoids. A total of 145 CT scans were analysed, performed as part of routine pre-operative assessment before total shoulder replacement in 91 women and 54 men.

Three-dimensional measurement method of arthritic glenoid cavity morphology: feasibility and reproducibility.

Introduction: Glenoid component loosening is the main complication of total shoulder arthroplasty. Better knowledge of the arthritic glenoid cavity anatomy can help in developing new implants and techniques. The goal of this study was to describe and validate the reproducibility of a CT scan-based, 3D measurement method used to describe various parameters characterizing arthritic glenoid cavity morphology.

Surgical technique arthroscopic posterior glenoidplasty for posterosuperior glenoid impingement in throwing athletes.

Background: Posterosuperior glenoid impingement (PSGI) is the repetitive impaction of the supraspinatus tendon insertion on the posterosuperior glenoid rim in abduction and external rotation. While we presume the pain is mainly caused by mechanical impingement, this explanation is controversial. If nonoperative treatment fails, arthroscopic débridement of tendinous and labral lesions has been proposed but reportedly does not allow a high rate of return to sports.

Glenoid loosening and failure in anatomical total shoulder arthroplasty: is revision with a reverse shoulder arthroplasty a reliable option?

Introduction: Our purpose was to evaluate if, in case of aseptic glenoid loosening and failure in anatomical total shoulder arthroplasty (TSA), revision by a reverse shoulder arthroplasty (RSA) is a reliable therapeutic option.

Methods: Retrospective multicenter cohort study of 37 consecutive anatomical TSA revised by RSA for aseptic glenoid loosening or failure. The decision to implant a RSA was related to the presence of associated complications: rotator cuff tears (n = 24), subscapularis insufficiency (n = 29), prosthetic instability (n = 13), and glenoid bone deficiency (n = 37).

Pain management in the rehabilitation of stiff shoulder: prospective multicenter comparative study of 193 cases.

Introduction: The present study investigated the impact of respecting pain threshold on clinical recovery in stiff shoulder.

Patients And Methods: A prospective multicenter comparative study followed up 193 cases of shoulder stiffness for a mean 12-month period (range, 8-31 months) after four different treatment protocols: (1) conventional sub-pain-threshold rehabilitation (58 cases); (2) self-rehabilitation exceeding the pain threshold (59 cases); (3) supervised suprathreshold rehabilitation (31 cases); and (4) capsulotomy with sub-threshold rehabilitation (45 cases). Follow-up was daily for the first 6 weeks then weekly for the next 6; each session included assessment of the painfulness, feasibility and duration of each rehabilitation and self-rehabilitation exercise and of pain status, disability and psychological status.

Management of the stiff shoulder. A prospective multicenter comparative study of the six main techniques in use: 235 cases.

Introduction: Stiffness in the shoulder is a frequent symptom associated with a number of clinical entities whose management remains inadequately defined.

Patients And Methods: This prospective study of 235 cases of stiffness in the shoulder compared six therapeutic techniques with a mean follow-up of 13 months (range, 3-28 months) (T1: 58 cases, conventional rehabilitation under the pain threshold, T2: 59 cases, self-rehabilitation over the pain threshold, T3: 31 cases, T2 + supervision, T4: 11 cases, T1 + capsular distension, T5: 31 cases, T1 + locoregional anesthesia, T6: 45 cases, T1 + T5 + capsulotomy). The therapeutic power of each technique and its impact on the result were assessed at each self-rehabilitation and rehabilitation session during the first 6 weeks and then at 3 months, 6 months, and at the final revision depending on subjective criteria (pain, discomfort, and morale) and objective criteria (Constant score, goniometric measurements).

Comparison and critical evaluation of rehabilitation and home-based exercises for treating shoulder stiffness: prospective, multicenter study with 148 cases.

Introduction: The goal of this study was to evaluate the effectiveness of individual exercises performed as classic rehabilitation or a home program on the clinical progression of patients with shoulder stiffness. Based on this information, the secondary goal was to develop a new rehabilitation protocol.

Patients And Methods: This prospective, comparative series included 148 cases of shoulder stiffness.

Scapular notching in reverse shoulder arthroplasties: the influence of glenometaphyseal angle.

Unlabelled: Solutions described to limit the risk of scapular notching mainly concern the glenoid. Our hypothesis is that this risk also depends upon the glenoid-humeral relationship when the arm is resting along the body.

Patient And Methods: This is a retrospective study of a continuous series of 85 reverse shoulder arthroplasties; 62 of these fulfilled inclusion criteria.

Reverse prostheses in arthropathies with cuff tear: are survivorship and function maintained over time?

Background: The use of reverse shoulder arthroplasty has considerably increased since first introduced in 1985. Despite demonstrating early improvement of function and pain, there is limited information regarding the durability and longer-term outcomes of this prosthesis.

Questions/purposes: We determined complication rates, functional scores over time, survivorship, and whether radiographs would develop signs of loosening.

Scapular notching in reverse shoulder arthroplasty: is it important to avoid it and how?

Background: Scapular notching, erosion of the scapular neck related to impingement by the medial rim of the humeral cup during adduction, is a radiographic sign specific to reverse shoulder arthroplasty (RSA). Its clinical and radiological consequences remain unclear.

Questions/purposes: Therefore, we: (1) determined the incidence of notching in a large series, (2) described the natural history of notching, (3) determined whether notching is related to functional scores or (4) radiographic signs of failure, and (5) identified factors related to notch development.

Scapular notching in reverse shoulder arthroplasty.

The causes and consequences of scapular notching after reverse shoulder arthroplasty (RSA) were investigated in 326 consecutive patients (337 shoulders) undergoing RSA between 1991 and 2003. Patients underwent 269 (80%) primary RSAs and 68 revisions of unconstrained shoulder prosthesis. At last follow-up (average, 47 months; range, 24-120 months) 62% had scapular notching.

Prosthetic replacement in the treatment of osteoarthritis of the shoulder: early results of 268 cases.

Two hundred sixty-eight anatomically designed shoulder arthroplasties for primary osteoarthritis were reviewed at a mean follow-up of 30 months. The Constant score adjusted for age and sex was 38% preoperatively and 97% at follow-up. Good or excellent results were observed in 77% of patients, and 94% were satisfied or very satisfied.

[Arthroscopic debridement of full-thickness tears of the rotator cuff: a retrospective multicenter study of 283 cases with 3-year follow-up].

Purpose Of The Study: The purpose of this study was to assess clinical and radiological course of full-thickness rotator cuff tears treated by arthroscopic debridement and to discuss surgical indications according to patient demands and anatomical lesions.

Material And Methods: This retrospective and multicentric study included patients with a minimal 3 years follow-up. The coronal extent of the supraspinatus tear was described as distal, intermediate or retracted.