The reverse shoulder prosthesis reverses the relationship between the scapular and humeral component, resulting in a mechanical advantage as the deltoid muscle is able to compensate for the rotator cuff deficiency. Based on this mechanical advantage, the reverse shoulder prosthesis has become an accepted alternative for the treatment of complex proximal humeral fractures. The purpose of this article is to discuss technical considerations related to stability in the use of the reverse shoulder prosthesis in acute shoulder fractures, based on clinical experience.
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J Shoulder Elbow Surg
December 2024
Department of Orthopaedic Surgery, Konkuk University Medical Center, Seoul, Korea.
Background: Muscle atrophy after the rupture of a rotator cuff (RC) tendon is a major factor that increases the risk of secondary complications and re-rupture. Metformin, a type 2 diabetes treatment, can be used to modulate intracellular signaling pathways that promote muscle growth. This study aimed to verify whether systemic metformin administration could prevent supraspinatus (SS) atrophy after RC rupture in a rat model.
View Article and Find Full Text PDFEur J Orthop Surg Traumatol
December 2024
Department of Orthopaedic Surgery, Royal North Shore Hospital, St Leonards, Australia.
Background: Proximal humerus fractures (PHF) are common with approximately 30% requiring surgical intervention. This ranges from open reduction internal fixation (ORIF) to shoulder arthroplasty (including hemiarthroplasty, total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA)). The aim of this study was to assess trends in operative interventions for PHF in an Australian population.
View Article and Find Full Text PDFJ Imaging
December 2024
Department of Orthopedic Research, Arthrex, 81249 Munich, Germany.
Objective: This study evaluated the effect of three-dimensional (3D) volumetric humeral canal fill ratios (VFR) of reverse shoulder arthroplasty (RSA) short and standard stems on biomechanical stability and bone deformations in the proximal humerus.
Methods: Forty cadaveric shoulder specimens were analyzed in a clinical computed tomography (CT) scanner allowing for segmentation of the humeral canal to calculate volumetric measures which were verified postoperatively with plain radiographs. Virtual implant positioning allowed for group assignment (VFR < 0.
J Shoulder Elbow Surg
December 2024
Department of Orthopaedic Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA. Electronic address:
Introduction: Higher perioperative opioid use has been associated with an increase in periprosthetic joint infection, thromboembolic complications, respiratory events, gastrointestinal complications, cost, and length of stay following hip and knee arthroplasty. Limited data exists regarding the relationship between the postoperative opioid dose and complication rates following primary total shoulder arthroplasty (TSA). The purpose of this study is to investigate the relationship between perioperative opioid consumption and postoperative complications following TSA.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
December 2024
Shoulder and Elbow Division, Sports Medicine Institute, Hospital for Special Surgery, New York, NY, USA.
Background: Patients undergoing reverse shoulder arthroplasty (RSA) for rotator cuff arthropathy may present with an external rotation (ER) lag due to posterior rotator cuff insufficiency. As a result, the addition of a latissimus dorsi (LD) tendon transfer in combination with RSA has become increasingly utilized. Initial descriptions of LD tendon transfer involved rerouting of the LD tendon posterior to the long head of the triceps tendon.
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