A validated algorithm using current literature to judge the appropriateness of anatomic total shoulder arthroplasty utilizing the RAND/UCLA appropriateness method.

Background: Currently, appropriateness criteria evaluating when to perform total shoulder arthroplasty (TSA) is lacking. In the absence of society guidelines and limited quality evidence, the RAND/University California in Los Angeles (UCLA) method provides a suitable alternative to evaluate appropriateness and assist in clinical decision making. Given the rise in utilization, appropriateness criteria for TSA have the potential to be an extremely powerful tool for improving quality of care and controlling costs.

The modern reverse shoulder arthroplasty and an updated systematic review for each complication: part II.

Background: Globally, reverse shoulder arthroplasty (RSA) has moved away from the Grammont design to modern prosthesis designs. The purpose of this study was to provide a focused, updated systematic review for each of the most common complications of RSA by limiting each search to publications after 2010. In this part II, the following were examined: (1) instability, (2) humerus/glenoid fracture, (3) acromial/scapular spine fractures (AF/SSF), and (4) problems/miscellaneous.

The modern reverse shoulder arthroplasty and an updated systematic review for each complication: part I.

Background: Globally, reverse shoulder arthroplasty (RSA) has moved away from the Grammont design to modern prosthesis designs. The purpose of this 2-part study was to systematically review each of the most common complications of RSA, limiting each search to publications in 2010 or later. In this part (part I), we examined (1) scapular notching (SN), (2) periprosthetic infection (PJI), (3) mechanical failure (glenoid or humeral component), and (4) neurologic injury (NI).

Difficulty in decision making in the treatment of displaced proximal humerus fractures: the effect of uncertainty on surgical outcomes.

Background: Decision making in the management of proximal humerus fractures can be difficult in situations in which the surgeon is uncertain of the ideal treatment.

Methods: Two shoulder surgeons operatively treated 476 proximal humerus fractures from 1998-2014 with open reduction-internal fixation (ORIF), hemiarthroplasty, or reverse shoulder arthroplasty. Operative treatment was stratified by year to determine the evolution of technological influences on treatment over time.

Total shoulder arthroplasty with minimum 5-year follow-up: does the presence of subchondral cysts in the glenoid increase risk of failure?

Background: This study evaluated the effect of cystic changes in the glenoid on postoperative outcomes and implant survival after total shoulder arthroplasty (TSA).

Materials And Methods: From 2004 to 2012, 75 patients underwent TSA for primary osteoarthritis with minimum 5-year follow-up. Preoperative 3-dimensional models based on computed tomography imaging were created for all patients.

Classification of instability after reverse shoulder arthroplasty guides surgical management and outcomes.

Background: Revision of unstable reverse shoulder arthroplasty (RSA) remains a significant challenge. The purpose of this study was to determine the reliability of a new treatment-guiding classification for instability after RSA, to describe the clinical outcomes of patients stabilized operatively, and to identify those with higher risk of recurrence.

Methods: All patients undergoing revision for instability after RSA were identified at our institution.

Outcome of Reverse Shoulder Arthroplasty for Patients With Parkinson's Disease: A Matched Cohort Study.

Parkinson's disease (PD) is a progressive neurologic disorder that affects the musculoskeletal system. Currently, the use of reverse shoulder arthroplasty (RSA) for patients with PD has not been adequately studied. The authors sought to determine if RSA provided similar functional outcomes for patients with PD compared with a matched cohort of patients without PD.

Reverse shoulder arthroplasty in patients younger than 55 years: 2- to 12-year follow-up.

Background: This study reports the outcomes of reverse shoulder arthroplasty (RSA) in patients younger than 55 years with midterm to long-term follow-up.

Methods: Sixty-seven patients (average age, 47.9 years; range, 21-54 years) were identified who underwent RSA with an average 62.

Complex trauma to the shoulder girdle, including the proximal humerus, the clavicle, and the scapula: current concepts in diagnosis and treatment.

Fractures to the shoulder girdle are common injuries in an aging population. Many techniques and theories lie behind the treatment of such injuries. Knowledge and understanding of current concepts for diagnosing and treating proximal humeral, clavicular, and scapular fractures and the theory behind them will help surgeons make informed decisions with regard to patient care.

Arthrodesis for failed total elbow arthroplasty with deep infection.

Background: Elbow arthrodesis is typically reserved as a salvage procedure. Current literature suggests that satisfactory outcomes can be expected if fusion occurs. There is a paucity of literature on outcomes of elbow arthrodesis after failed elbow arthroplasty with deep infection.

What is the effect of postoperative scapular fracture on outcomes of reverse shoulder arthroplasty?

Background: Postoperative scapular fracture is a common complication after reverse shoulder arthroplasty (RSA). The purpose of this study was to determine its effect on RSA patient outcomes.

Methods: A retrospective, case-control study of 25 nonoperatively treated postoperative scapular fractures after RSA were analyzed with a minimum 2-year follow-up from surgery and 1-year follow-up from fracture.

Scapular fractures after reverse shoulder arthroplasty: evaluation of risk factors and the reliability of a proposed classification.

Background: The aims were to determine the sensitivity of plain radiographs to detect scapular fractures after reverse shoulder arthroplasty (RSA), to test the reliability of a proposed classification, and to evaluate risk factors.

Materials And Methods: We matched 53 patients with scapular fractures after RSA to 212 control patients. Clinical risk factors were assessed by correlating comorbidities.

Biomechanical comparison of polyaxial-type locking plates and a fixed-angle locking plate for internal fixation of distal femur fractures.

Objectives: To test the stability to axial loading of 2 new polyaxial locking screw-plate designs and analyze different angles of screw insertion. The noncontact bridging (NCB) polyaxial locking plate (Zimmer) and the POLYAX plate (DePuy) were compared with a fixed-angle less invasive stabilization system (LISS; Synthes).

Methods: Twenty-five synthetic femurs were divided into 5 groups and assigned fixation with the LISS plate (group I), POLYAX plate (groups IIA and IIB), or NCB plate (groups IIIA and IIIB).