[Shoulder periprosthetic infections-what to do? : Diagnosis and treatment].

Treatment of an infected shoulder prosthesis differs significantly from other joint infections because of the unique microbiome, dominated by Cutibacterium acnes. The cause of an infection, its time of onset, the bacterial spectrum and comorbidities have to be considered for evaluation and treatment. The diagnostic workup is sometimes complex, and the recognition of a chronic and low-grade infection is often difficult because typical clinical and laboratory markers may be normal.

[Conversion of anatomic to reverse shoulder arthroplasty : Does it make sense?].

We can observe increasing numbers for the implantation of shoulder endoprostheses in developed industrial countries. This is accompanied by a certain number of revision surgeries. The conversion to reverse arthroplasty systems is by far the most common revision procedure.

Comparison of the antimicrobial efficacy of povidone-iodine-alcohol versus chlorhexidine-alcohol for surgical skin preparation on the aerobic and anaerobic skin flora of the shoulder region.

Background: Cutibacterium acnes is part of the anaerobic skin microbiome and resides in deeper skin layers. The organism is an agent of surgical site infections (SSI) in shoulder surgery. We hypothesized that prolonged skin preparation with an agent that penetrates deeply into the skin would be beneficial.

The implications of the glenoid angles and rotator cuff status in patients with osteoarthritis undergoing shoulder arthroplasty.

Background: The success of shoulder arthroplasty, both reverse and anatomical, depends on correcting the underlying glenoid deformity especially in patients with an osteoarthritis. We hypothesized that the distribution of glenoid version and especially inclination are underestimated in the shoulder arthritis population, and also that superior glenoid inclination can be detected through 3-dimensional (3D) software program of computed tomography (CT) to a greater proportion in patients with rotator cuff insufficiency, but also in patients with osteoarthritis with an intact rotator cuff. Because of the influence of rotator cuff imbalance on secondary glenoid wear the values of the critical shoulder angle (CSA) and the fatty infiltration of the rotator cuff are further analyzed.

Cutibacterium acnes is an intracellular and intra-articular commensal of the human shoulder joint.

Background: Cutibacterium acnes (C acnes) is a mysterious member of the shoulder microbiome and is associated with chronic postoperative complications and low-grade infections. Nevertheless, it is unclear whether it represents a contaminant or whether it accounts for true infections. Because it can persist intracellularly in macrophages at several body sites, it might in fact be an intra-articular commensal of the shoulder joint.

Degenerative rotator cuff tears are associated with a low Omega-3 Index.

Background: The etiology of degenerative rotator cuff tears is multifactorial but chronic inflammation plays an important role in the pathogenesis. Some polyunsaturated fatty acids (PUFA) can modulate inflammation and marine n-3 (Omega-3) PUFA have anti-inflammatory effects. We hypothesized that the Omega-3 Index is lower in patients with degenerative rotator cuff tears when compared to controls without rotator cuff tendinopathy.

The influence of three-dimensional planning on decision-making in total shoulder arthroplasty.

Background: Long-term results and complication rates in shoulder arthroplasty are related to implant positioning. Current literature reports increased precision in glenoid component positioning using 3-dimensional (3D) computed tomography (CT) planning tools. This study evaluated the accuracy of glenoid version and inclination measurements using 2D CT scans compared with a validated 3D software program and its influence on decision making on implant selection.

Radiolucency in stemless shoulder arthroplasty is associated with an imaging phenomenon.

Stemless humeral implants show comparable midterm clinical results compared to stemmed components. Recently, radiolucencies around the metaphyseal seating of humeral stemless implants were reported on postoperative radiographs. It is controversial whether they are attributable to bone resorption.

Long-term analysis of revision reverse shoulder arthroplasty using cemented long stems.

Background: Revision of failed shoulder arthroplasty is often associated with poor results and a high rate of complications. Significant humeral bone loss after removal of long stems poses a considerable surgical challenge. Therefore, the aim of our study was the evaluation of the clinical and radiologic outcome of cemented long-stem humeral components in revision reverse shoulder arthroplasty with a minimum 5 years' follow-up.

Propionibacterium acnes in shoulder surgery: is loss of hair protective for infection?

Background: Propionibacterium acnes (P acnes) has been linked to chronic infections in shoulder surgery. It was recently observed during first-time shoulder surgery in healthy patients at a rate between 36% and 56%. Male gender and the anterolateral approach were reported risk factors.

Propionibacterium acnes in shoulder surgery: true infection, contamination, or commensal of the deep tissue?

Background: Propionibacterium acnes has been linked to chronic infections in shoulder surgery. Whether the bacterium is a contaminant or commensal of the deep tissue is unclear. We aimed to assess P.

C1 fracture in a patient with a congenital cleft in the posterior arch: report on a failed conservative treatment.

Unstable burst fractures of the atlas require sufficient immobilisation either with an external device or by surgical fusion. In patients with pre-existing congenital atlantal defects the decision whether to recommend non-operative or operative therapy is difficult. Treatment options are controversially discussed and standardised guidelines are not available.

Kinetics of crimp and slope grip in rock climbing.

The aim was to investigate differences of the kinetics of the crimp and the slope grip used in rock climbing. Nine cadaver fingers were prepared and fixated with the proximal phalanx in a frame. The superficial (FDS) and deep (FDP) flexor tendons were loaded selectively and together with 40 N in the crimp grip (PIP joint flexed 90°/DIP joint hyperextended) and the slope grip position (<25° flexed/50° flexed respectively).

Novel measurement technique of the tibial slope on conventional MRI.

Unlabelled: The posterior inclination of the tibial plateau, which is referred to as posterior tibial slope, is determined routinely on lateral radiographs. However, radiographically, it is not always possible to reliably recognize the lateral plateau, making a separate assessment of the medial and lateral plateaus difficult. We propose a technique to measure the plateaus separately by defining a tibial longitudinal axis on a conventional MRI.