Component Mix-Match for Anatomic Total Shoulder Arthroplasty Revision: A Case Report.

Although mixing and matching components is a common, safe, and well-documented practice in hip revision surgery, our extensive search indicates that it has not been previously reported for shoulder arthroplasty. This case report presents the use of mixed implants in shoulder revision surgery to reduce morbidity and address flaws in the initial implant design. We describe a case of a patient with multiple epiphyseal dysplasia who was treated for osteoarthritis in his left shoulder with an anatomic shoulder replacement in 2014.

Supporting Regional Upper Limb Arthroplasty: The Impact of Establishing an Upper Limb Orthopaedic Network.

Background And Objectives: The management of complex upper limb arthroplasty has received national guidelines supporting the use of a regional network. An upper limb network was established for both elbow and shoulder arthroplasty. This study evaluates the impact of establishing this network over a 5-year period.

Medium-Term Clinical and Radiographic Results of an All-Polyethylene, Pegged, Bone-Ingrowth Glenoid Component: A Concise Follow-up of a Previous Report.

Abstract: We previously reported the mean 4-year outcomes of anatomic total shoulder replacement using an all-polyethylene, pegged, hybrid-fixation (bone ingrowth and cement) glenoid component. In the present study, we report on that patient cohort after another 4 years of follow-up (mean, 101 months; range, 77 to 146 months). At that time, the median American Shoulder and Elbow Surgeons (ASES) score was 92 points (interquartile range [IQR], 81.

Clinical and Radiographic Results of an All-Polyethylene Pegged Bone-Ingrowth Glenoid Component.

Background: Loosening of the glenoid component continues to be the main cause of medium and long-term failure of shoulder replacements. The purpose of this study was to evaluate the early clinical and radiographic results following use of an all-polyethylene pegged glenoid component designed for hybrid (biological and cement) fixation.

Methods: Eighty-three shoulders in 77 patients (mean age, 68.

Use of a Bone Graft Drill Harvester to Create the Fenestration During Arthroscopic Ulnohumeral Arthroplasty.

The Outerbridge-Kashiwagi procedure, or ulnohumeral arthroplasty, was described in 1978 as a method of treating elbow arthritis by creating a fenestration in the olecranon fossa. This fenestration diminishes the likelihood of recurrent spurs in the olecranon fossa and coronoid fossa, without loss of structural bony strength. Arthroscopic techniques have now been developed to perform this procedure.

Cost of infection after surgery for intracapsular fracture of the femoral neck.

Introduction: We investigated the financial and human costs of postoperative infection for intracapsular fracture of the femoral neck at a district general hospital in the UK.

Methods: Data on postoperative infections after surgical treatment for intracapsular fracture of the femoral neck were collected prospectively from June 2005 to April 2009. Infected patients were pairwise-matched (1:2 ratio) with a non-infected group of patients from a database on hip fractures.

Four-dimensional computed tomography scans facilitate preoperative planning in snapping scapula syndrome.

Hypothesis: Because a 4-dimensional CT scan (4D CT) is able to provide a moving 3-dimensional (3D) image in real time in patients with snapping scapula syndrome, a 4D CT scan should be able to demonstrate bony impingement of the scapula on the posterior thorax. This study was performed to determine if 4D CT scans aid the clinician in defining the size and location of the scapular bone causing impingement in patients with snapping scapula syndrome.

Materials And Methods: Between October 2009 and August 2013, 12 patients (median age, 26.

The use of four-dimensional computed tomography to diagnose costoclavicular impingement causing thoracic outlet syndrome.

Thoracic outlet syndrome is caused by compression of the neurovascular structures crossing the interscalene triangle, costoclavicular space or retropectoralis minor space. The costoclavicular space is the most frequent site of arterial compression and is mainly a result of anatomical variations and masses occupying the costoclavicular space causing a compression effect on the vascular or neural structures within it. We present a case of thoracic outlet syndrome caused by dynamic impingement of the clavicle and the second rib diagnosed by four-dimensional computed tomography scanning.

Synovial chondromatosis affecting a digital proximal interphalangeal joint.

We present a case of synovial chondromatosis affecting the interphalangeal joint where the disease did not clearly manifest itself on pre-operative radiographs. Although rare, surgeons should consider articular synovial chondromatosis as a differential for pain and stiffness in any joint, even those of the hand.

Arthroscopic radial head excision in managing elbow trauma.

Purpose: This study describes a case series of 15 patients with radial head fractures who underwent radial head excision using an arthroscopic technique.

Methods: Over a four year period, 15 patients (average age 49.6 years) who had sustained a radial head or radial neck fracture underwent an arthroscopic excision of the radial head.

Novel assessment of the sternoclavicular joint with computed tomography for planning interventional approach.

Objectives: To describe the plane of the sternoclavicular joint (SCJ) to aid planning of instrument orientation during invasive procedures.

Methods: Computed tomography (CT) images of 80 consecutive patients aged 25 to 40 years with appropriate chest imaging series were retrospectively reviewed. Patients with a previous median sternotomy, fused manubriosternal joint or fracture were excluded.

Conservative management of Dieterich disease: case report.

Dieterich disease is characterized by avascular necrosis of the metacarpal head. The recent literature has described surgical management of this condition relatively soon after its presentation. We present a case treated conservatively with a satisfactory outcome at 28 months.

Evaluation of ultrasound-guided diagnostic local anaesthetic hip joint injection for osteoarthritis.

Purpose: The diagnosis of hip osteoarthritis is often complicated by co-existing pathology in the knee and spine, and mismatch between clinical and radiological signs. Temporary pain relief from a local anaesthetic injection into the hip joint has been reported to help localise symptoms, reducing the risk of unnecessary surgery being performed. We hypothesize that good surgical outcome is predicted by good analgesia following diagnostic injection, and that alternative pathology is present when there is no response to injection.

Oxford unicompartmental knee arthroplasty: medial pain and functional outcome in the medium term.

Background: In our experience results of the Oxford unicompartmental knee replacement have not been as good as had been expected. A common post operative complaint is of persistent medial knee discomfort, it is not clear why this phenomenon occurs and we have attempted to address this in our study.

Methods: 48 patients were retrospectively identified at a mean of 4.