Enlarged transacromial superior approach with reverse shoulder arthroplasty for fractures.

The authors describe a step-by-step technique for reverse total shoulder arthroplasty using arthrotomy via the enlarged transacromial superior approach. This technique seems ideal for reinsertion of the tuberosities and to ensure adequate postoperative tensional balance of the infraspinatus and the subscapularis, which is critical for the rotator cuffs to function properly and to achieve optimal arthroplasty stability. Reviewing these different steps helps understanding each rotator cuff individual component's contribution to achieve optimal arthroplasty stability and external rotation with a reverse shoulder arthroplasty.

Septic arthritis of the hip in adults with sickle cell anemia.

Although the presence of osteonecrotic bone is known to make joints more prone to infection, acute septic joint in hip osteonecrosis has not frequently been reported in adults with sickle cell disease. The clinical features at the time of admission, imaging findings suggesting the diagnosis, modes of treatment and sequelae of septic arthritis of twenty-four hip joints with osteonecrosis in patients with sickle cell disease were studied retrospectively over a 25-years period. This study evaluated also the complications, the efficiency and the risk of total hip arthroplasty in these patients.

High dislocation cumulative risk in THA versus hemiarthroplasty for fractures.

Background: Although not all elderly patients with femoral neck fractures are candidates for THA, active, mentally competent, independent patients achieve the most durable functional scores with THA compared with hemiarthroplasty. However, a relatively high frequency of early or late dislocation could reduce the potential benefits with THA.

Questions/purposes: We asked whether the incidence of first-time, recurrent dislocation, and revision differed in patients with hip fractures having THA or hemiarthroplasty.