Machine Learning Can Predict Level of Improvement in Shoulder Arthroplasty.

Unlabelled: The ability to accurately predict postoperative outcomes is of considerable interest in the field of orthopaedic surgery. Machine learning has been used as a form of predictive modeling in multiple health-care settings. The purpose of the current study was to determine whether machine learning algorithms using preoperative data can predict improvement in American Shoulder and Elbow Surgeons (ASES) scores for patients with glenohumeral osteoarthritis (OA) at a minimum of 2 years after shoulder arthroplasty.

Do preoperative radiographs help predict intraoperative challenges in revision surgery after previous shoulder hemiarthroplasty?

Background: This study compares preoperative radiographic evaluation with intraoperative video and explant data in patients undergoing revision of a hemiarthroplasty.

Methods: From 2004 to 2017, 182 shoulder hemiarthroplasties underwent revision to reverse shoulder arthroplasty for symptomatic failure. Preoperative radiographs were evaluated for stem fixation, stability, and glenohumeral registry.

Is there a relationship between preoperative diagnosis and clinical outcomes in reverse shoulder arthroplasty? An experience in 699 shoulders.

Background: The influence of diagnosis on outcomes after reverse shoulder arthroplasty (RSA) is not completely understood. The purpose of this study was to compare clinical outcomes of different pathologies.

Methods: A total of 699 RSAs were performed for the following diagnoses: (1) rotator cuff tear arthropathy (RCA), (2) massive cuff tear (MCT) with osteoarthritis (OA), (3) MCT without OA, (4) OA, (5) acute proximal humeral fracture, (6) malunion, (7) nonunion, and (8) inflammatory arthropathy.

Improving preoperative planning of revision surgery after previous anatomic total shoulder arthroplasty.

Background: The purpose of this study was to compare preoperative radiographic evaluation with intraoperative video and explant analysis in patients undergoing revision of a previous anatomic total shoulder arthroplasty (TSA).

Methods: We evaluated the preoperative radiographs of 165 revisions of failed TSAs for component loosening and glenohumeral registry (ie, the spatial relationship of the glenoid component and the prosthetic humeral head). Seventy-nine intraoperative videos were evaluated for component stability, rotator cuff (RC) integrity, synovitis, and glenoid bone loss.

Clinical outcomes following reverse shoulder arthroplasty-allograft composite for revision of failed arthroplasty associated with proximal humeral bone deficiency: 2- to 15-year follow-up.

Background: Patients with pain and disability due to a prior failed shoulder arthroplasty with associated proximal humeral bone loss have limited reconstruction options. Our purpose was to report the results of a large cohort of patients treated with a reverse shoulder allograft-prosthetic composite (APC).

Methods: Between 2002 and 2012, a total of 73 patients were treated with a reverse shoulder APC and had adequate follow-up.

Humeral Bone Loss in Revision Shoulder Arthroplasty.

Revision shoulder arthroplasty is becoming more prevalent as the rate of primary shoulder arthroplasty in the US continues to increase. The management of proximal humeral bone loss in the revision setting presents a difficult problem without a clear solution. Different preoperative diagnoses often lead to distinctly different patterns of bone loss.

Survival of the pegged glenoid component in shoulder arthroplasty: part II.

Background: Loosening of the glenoid component is a primary reason for failure of an anatomic shoulder arthroplasty. Pegged glenoids were designed in an effort to outperform keeled components. This study evaluated the midterm clinical and radiographic survival of a single implant design with implantation of an in-line pegged glenoid component and identified risk factors for radiographic loosening and clinical failure.

Factors Associated With 20-Year Cumulative Risk of Infection After Aseptic Index Revision Total Knee Arthroplasty.

Background: The purpose of this study was to calculate the cumulative risk of periprosthetic joint infection (PJI) after aseptic index knee revisions and to identify the surgical, perioperative, and medical comorbidity risk factors associated with deep infection.

Methods: We retrospectively reviewed 1802 aseptic index revision total knee arthroplasties performed at our institution from 1970 to 2000. From this cohort, there were 60 reoperations performed for deep infection.