Aims. The
Analyzing shoulder kinematics is challenging as the shoulder is comprised of a complex group of multiple highly mobile joints. Unlike at the elbow or knee which has a primary flexion/extension axis, both primary shoulder joints (glenohumeral and scapulothoracic) have a large range of motion (ROM) in all three directions. As such, there are six degrees of freedom (DoF) in the shoulder joints (three translations and three rotations), and all these parameters need to be defined to fully describe shoulder motion. Despite the importance of
A fracture of the tuberosity is associated with 16% of anterior
Knowledge of the premorbid glenoid shape and the morphological changes the bone undergoes in patients with
Massive irreparable rotator cuff tears often lead to superior migration of the humeral head, which can markedly impair
We studied retrospectively a consecutive series of 547 shoulders in 529 patients undergoing operation for instability. In 41, the cause of instability was considered to be lateral avulsion of the capsule, including the inferior
The natural history of primary anterior dislocation
of the
Introduction. For anatomical reconstruction in shoulder arthroplasty, it is important to understand normal
Aims. Frozen shoulder is a common, painful condition that results in impairment of function. Corticosteroid injections are commonly used for frozen shoulder and can be given as
We report our experience with
Aims: Although the
Background. Rotator cuff atrophy evaluated with computed tomography scans has been associated with asymmetric glenoid wear and humeral head subluxation in
The aim of this study was to determine if the extent of the glenoid and humeral bone loss affects the rate of recurrent instability and the functional outcome following the Latarjet procedure. 161 patients underwent open Latarjet procedure during the period 2006–2015 (Mean age 30.0 years, 150t (93.2%) Male, 118 (73.3%) primary procedure). Functional outcome was measured using the Western Ontario Shoulder Instability Index (WOSI) and Quick Disabilities of the Arm, Shoulder and Hand (QuickDash) score at a mean of 4.7 years post-operatively. All patients underwent computed tomographic (CT) imaging pre-operatively. Using three-dimensional reconstruction, the glenoid bone loss, Hill-Sachs lesion and ‘Glenoid Track’ status was recorded. Radiographically-confirmed redislocation was rare (1.2%), but 18.5% (n=23/124) reported ongoing subjective shoulder instability. Fifty-two shoulders (32.3%) were classified as “Off-Track”. The median Quick DASH and WOSI scores were 2.27 (IQR 9.09; range 0–70.45) and 272.0 (IQR 546.5; range 0–2003), respectively. There were no significant differences observed between overall Quick DASH scores or WOSI scores for either On-Track or Off-Track groups (p=0.7 and 0.73, respectively). Subjective instability was not influenced by the degree of glenoid bone loss (p=0.82), the overall size of the Hill-Sachs lesion (p=0.80), or the presence of an ‘Off-Track’ lesion (p=0.84). Functional outcome and recurrent instability following the Latarjet procedure do not appear to be influenced by the extent of
The natural history of primary anterior
Introduction and Objective. Only few studies have investigated the outcome of exercises in patients with
Cementless surface replacement arthroplasty (CSRA) is an established treatment for
Purpose: Study experimental instability by ligament section leaving intact all the periarticular elements. Material and methods: Sixteen fresh cadaver shoulders were studied. Dissection was achieved via an axillary approach isolating the ligaments without muscle section. Instability was classified in five stages: 0) stable, 1) drawer and sulcus, 2) subluxation: the head crossed the glenoid border but remained in the plane of the glenoid, 3) reversible dislocation: the head was dislocated by returned spontaneously into place when the arm was left to hang along the body, 4) permanent dislocation. The ligaments were sectioned in the following order: 1) betrween 7h and 5h, 2) between 5h and 2h, 3) between 1h and 11h. Instability was tested with usual manœuvres: drawer, sulcus, hyperabduction test, provoked dislocation in elevation and maximal external rotation, downward pressure in the axis of the humerus. Results: Dissection of the ligaments produced class 1 instability in 0% of the shoulders, Section between 7h and 5h (anterior part of the inferior
Introduction The complex movement of scapula is significant for the support of the arm and the stability of the shoulder joint. Recent investigations showed an adaptation in scapula rhythm after total shoulder replacement with a big variability within subjects. The latter can change the loading pattern in the
Purpose: Arthroscopic treatment of calcified tendinopathy is classically performed in two times: exploration of the
This study compared the effect of a computer-assisted and a traditional surgical technique on the kinematics of the
Purpose:. The optimal degree of conformity between the glenoid and humeral components in cemented total shoulder arthroplasty (TSA) has not been established. Glenoid component stability is thought to be at risk due to the “rocking-horse” phenomenom, which, can lead to increased micromotion and loosening in response to humeral head edge loading. The goal of this biomechanical study is to investigate the influence of
Surgical treatment for traumatic, anterior glenohumeral instability requires repair of the anterior band of the inferior
Introduction and purpose: Neuropathy associated with syringomyelia is a relatively rare entity that predominantly affects the
Purpose. There is minimal information on outcome of
Aim: To study the morphology of the anterior cap-suloligamentous structures of the
We have compared the functional outcome after
Summary. Analysis of existing data of patients who had undergone debridement procedure for osteoarthritis (OA) of
Introduction. Augmented glenoid implants provide a new avenue to correct glenoid bone loss and can possibly reconcile current prosthetic failures and improve long-term performance. Biomechanical implant studies have suggested benefits from augmented glenoid components but limited evidence exists on optimal design of these augmented glenoid components. The aim of this study was to use integrated kinematic finite element analysis (FEA) model to evaluate the optimal augmented glenoid design based on biomechanical performance in extreme conditions for failure. Materials and Methods. Computer aided design software (CAD) models of two different commercially available augmented glenoid designs - wedge (Equinox®, Exactech, Inc.) and step (Steptech®, Depuy Synthes) were created per precise manufacturer's dimensions and sizes of the implants. Using FE modeling, these implants were virtually implanted to correct 20° of glenoid retroversion. Two
Background:. Currently, there are a variety of different reverse shoulder implant designs but few anatomic studies to support the optimal selection of prosthetic size. This study analyzed the
Background. A challenge to obtaining proper glenoid placement in total shoulder arthroplasty is eccentric posterior bone loss and associated glenoid retroversion. This bone loss can lead to poor stability and perforation of the glenoid during arthroplasty. The purpose of this study was to evaluate the three dimensional morphology of the glenoid with associated bone loss for a spectrum of osteoarthritis patients using 3-D computed tomography imaging and simulation software. Methods. This study included 29 patients with advanced
Our aim in this prospective study was to evaluate the outcome of total shoulder replacement in the treatment of young and middle-aged active patients with primary
Introduction: The Spaso technique for reduction of
Introduction. Resurfacing of the
Introduction. The treatment of
Aim. Biomechanical models of the shoulder have been used to measure forces and
Introduction. The reliability of currently available proximal humeral fracture classi?cation systems has been shown to be poor, giving rise to the question whether a more objective measure entails improved predictability of surgical outcome. This study aims to apply a novel software system to predict the functional range of motion of the
We report the use of the reverse shoulder prosthesis in the revision of a failed shoulder hemiarthroplasty in 19 shoulders in 18 patients (7 men, 11 women) with severe pain and loss of function. The primary procedure had been undertaken for
Fourteen cases of hemiarthroplasty for four-part fractures of the proximal humerus were reviewed. Pain relief was satisfactory, but function was limited, mainly due to loss of
Whereas a general trend in the management of obstetric brachial plexus injuries has been nerve reconstruction in patients without spontaneous recovery of biceps function by three to six months of age, many recent studies suggest this may be unnecessary. In this study, the severity of
This study was conducted to determine the effect of passive and active muscle loading on humeral head translation during
Purpose: We hypothesized that
Background. Acute anterior dislocation of the
Aim: To study the contribution of humeral avulsion of the
Examination was made of 486 skeletons of subjects over the age of 60 years to study patterns of degenerative change in the
Introduction. Reverse total shoulder arthroplasty (RTSA) is a commonly performed operation for a variety of pathologies. Despite excellent short-term outcomes, complications are commonly encountered. Recurrent instability occurs in up to 31% of cases, often due to components placed with too little tension. Acromial stress fractures can occur in up to 7% of cases, often due to components placed in too much tension. Despite these concerns, there is little evidence evaluating the intraoperative tension and
Background: The Inferior
Purpose: The glenoid status is a crucial aspect of planning for shoulder replacements. This study revisits the classification proposed by Walch et al and discusses its value to orthopedic surgeons in terms of reproducibility and reliability. Method: Three evaluators viewed one hundred-sixteen (116) shoulder CT-scans with primary
We hypothesised that a large acromial cover with
an upwardly tilted glenoid fossa would be associated with degenerative
rotator cuff tears (RCTs), and conversely, that a short acromion
with an inferiorly inclined glenoid would be associated with glenohumeral
osteoarthritis (OA). This hypothesis was tested using a new radiological parameter,
the critical shoulder angle (CSA), which combines the measurements
of inclination of the glenoid and the lateral extension of the acromion
(the acromion index). The CSA was measured on standardised radiographs of three groups:
1) a control group of 94 asymptomatic shoulders with normal rotator
cuffs and no OA; 2) a group of 102 shoulders with MRI-documented
full-thickness RCTs without OA; and 3) a group of 102 shoulders
with primary OA and no RCTs noted during total shoulder replacement.
The mean CSA was 33.1° (26.8° to 38.6°) in the control group, 38.0°
(29.5° to 43.5°) in the RCT group and 28.1° (18.6° to 35.8°) in
the OA group. Of patients with a CSA >
35°, 84% were in the RCT
group and of those with a CSA <
30°, 93% were in the OA group. We therefore concluded that primary
Aims: The complications and functional long time results after
Introduction. Advanced medical imaging techniques have allowed the understanding of the patterns of relative bone motions at human joints. 1. However, poor imaging contrasts of soft tissues have not allowed the full understanding of various
We studied the position and rotational changes associated with elevation of the
Purpose: Functional outcome after shoulder arthrodesis was evaluated to assess indications for the treatment of posttraumatic partial and total brachial plexus paralysis in adults. Material and methods: Twenty-seven patients who underwent
Purpose: 2 orthopaedic surgeons identified 18 patients who developed
Aims: Aim of this study was to asses the
To investigate the significance of a cluster of cases of
We have studied 105 patients with 107 acute, primary, dislocations of the
Purpose of the study:
Synovitis in the subacromial bursa (SAB) and the gle-nohumeral joint (GHJ) is often seen in rotator cuff diseases. In order to clarify its significance, following studies were conducted. The mRNA expression levels of IL-1B, sIL-1ra and icIL-1ra and the amount of substance P in the SAB synovium were correlated with the degree of shoulder pain. The cytokine-mRNAs in the GHJ synovium expressed more significantly in full-thickness tears (perforating tears) than in non-perforating tears. Biochemical markers (MMP-1, MMP-3) in the GHJ fluid were significantly higher in massive cuff tears than in smaller tears. These findings suggest the possibility that SAB and GHJ synovitis in rotator cuff diseases are associated with shoulder pain and the development of
Treatment of OA of the shoulder in young and active patients remains a problem. Present treatment options are debridement, microfracturing, arthrodesis or shoulder replacement. We report the preliminary results of soft-tissue interposition arthroplasty with an acellular allograft skin-derived collagen matrix (Graft Jacket®, Wright Medical). Between July and December 2003 five men and one woman with severe
Purpose: Determine the ideal form of subacromial decompression. Method: Six cadaveric shoulders with intact rotator cuffs (RTC) underwent “smooth &
move (SM),” limited acromioplasty with coracoacromial ligament (CAL) preservation, and CAL resection.
Total shoulder arthroplasty has gone through several generations, as instruments and implant designs have given surgeons both more options in the alignment of the components and more guidance in the best choices to make. However, while the measurement of alignment has become more sophisticated, the importance of particular aspects of alignment to actual patient comfort and function has been less completely characterised. Overstuffing of the joint and proud humeral heads have been most associated with clinical failure. The efforts to avoid this can be divided into two camps: 1.) The anatomic school, who believe an experienced surgeon can divine the correct anatomy that existed before the distortions of arthritis began, and that the surgeon should make free-hand cuts and alignments to restore the normal anatomy. 2.) The cutting-guide school, who believe that average versions and positions avoid error and that soft-tissue balancing requires occasional deviations from “normal” anatomy. Reverse total shoulder replacement in contrast is a semi-constrained implant, with built-in “internal impingement” at the extremes of motion, which can cause notching and/or instability (levering out). Initial European experience favored placing the humeral component in 0 degrees, but most surgeons have gravitated toward 15–20 degrees of retroversion to allow easy conversion from/to a hemiarthroplasty as needed. Increased retroversion may block internal rotation, and increased anteversion limits external rotation.
In a cadaveric study, the anterior shoulder capsule indicated the presence of the middle (MGHL) and inferior (IGHL)
Inherent disadvantages of reverse shoulder arthroplasty
designs based on the Grammont concept have raised a renewed interest
in less-medialised designs and techniques. The aim of this study
was to evaluate the outcome of reverse shoulder arthroplasty (RSA)
with the fully-constrained, less-medialised, Bayley–Walker prosthesis performed
for the treatment of rotator-cuff-deficient shoulders with glenohumeral
arthritis. A total of 97 arthroplasties in 92 patients (53 women
and 44 men, mean age 67 years (standard deviation ( The Bayley–Walker prosthesis provides reliable pain relief and
reasonable functional improvement for patients with symptomatic
cuff-deficient shoulders. Compared with other designs of RSA, it
offers a modest improvement in forward elevation, but restores external
rotation to some extent and prevents scapular notching. A longer
follow-up is required to assess the survival of the prosthesis and
the clinical performance over time. Cite this article:
Total shoulder arthroplasty has gone through several generations, as instruments and implant designs have given surgeons both more options in the alignment of the components and more guidance in the best choices to make. However, while the measurement of alignment has become more sophisticated, the importance of particular aspects of alignment to actual patient comfort and function has been less completely characterised. Overstuffing of the joint and proud humeral heads have been most associated with clinical failure. The efforts to avoid this can be divided into two camps: The anatomic school, who believe an experienced surgeon can divine the correct anatomy that existed before the distortions of arthritis began, and that the surgeon should make free-hand cuts and alignments to restore the normal anatomy. The cutting-guide school, who believe that average versions and positions avoid error and that soft-tissue balancing requires occasional deviations from “normal” anatomy.
Promising medium-term results from total shoulder arthroplasty
(TSA) have been reported for the treatment of primary osteoarthritis
in young and middle-aged patients. The aim of this study was to
evaluate the long-term functional and radiological outcome of TSA
in the middle-aged patient. The data of all patients from the previous medium-term study
were available. At a mean follow-up of 13 years (8 to 17), we reviewed
21 patients (12 men, nine women, 21 shoulders) with a mean age of
55 years (37 to 60). The Constant-Murley score (CS) with its subgroups
and subjective satisfaction were measured. Radiological signs of implant
loosening were analysed.Aims
Patients and Methods
Total shoulder arthroplasty has gone through several generations as instruments and implant designs have given surgeons both more options in the alignment of the components and more guidance in the best choices to make. However, while the measurement of alignment has become more sophisticated, the importance of particular aspects of alignment to actual patient comfort and function has been less completely characterised. Overstuffing of the joint and proud humeral heads have been most associated with clinical failure. The efforts to avoid this can be divided into two camps:
The anatomic school, who believe an experienced surgeon can divine the correct anatomy that existed before the distortions of arthritis began, and that the surgeon should make free-hand cuts and alignments to restore the normal anatomy The cutting-guide school, who believe that average versions and positions avoid error and that soft-tissue balancing requires occasional deviations from “normal” anatomy.
Total shoulder arthroplasty is technically demanding in regards to implantation of the glenoid component, especially in the setting of increased glenoid deformity and posterior glenoid wear. Augmented glenoid implants are an important and innovative option; however, there is little evidence accessible to surgeons to guide in the selection of the appropriate size augmented glenoid. Solid computer models of a commercially available augmented glenoid components (+3, +5, +7) contained within the software allowed for placement of the best fit glenoid component within the 3D reconstruct of each patient's scapula. Peg perforation, amount of bone reamed and amount of medialization were recorded for each augment size.Background
Methods
One hundred and fifty asymptomatic shoulders in 75 schoolchildren were studied. The shoulders were tested for instability and a hyperextensometer was used to assess joint laxity. Signs of instability were found in 57% of the shoulders in boys and 48% in girls; the commonest sign was a positive posterior drawer test which was found in 63 shoulders. A positive sulcus sign was found in 17 shoulders and 17 subjects had signs of multidirectional instability. General joint laxity was not a feature of subjects whose shoulders had positive instability signs.
There is no consensus on which glenoid plane should be used in total shoulder arthroplasty. Nevertheless, anatomical reconstruction of this plane is imperative for the success of a total shoulder arthroplasty. Three-dimensional reconstruction CT-scans were performed on 152 healthy shoulders. Four different glenoid planes, each determined by three surgical accessible bony reference points, are determined. The first two are triangular planes, defined by the most anterior and posterior point of the glenoid and respectively the most inferior point for the Saller's Inferior plane and the most superior point for the Saller's Superior plane. The third plane is formed by the best fitting circle of the superior tubercle and the most anterior and posterior point at the distal third of the glenoid (Circular Max). The fourth plane is formed by the best fitting circle of three points at the rim of the inferior quadrants of the glenoid (Circular Inferior). We hypothesized that the plane with normally distributed parameters, narrowest variability and best reproducibility would be the most suitable surgical glenoid plane.Background
Methods
We reviewed 80 shoulders (77 patients) at a mean follow-up of 44 months after insertion of a Grammont inverted shoulder prosthesis. Three implants had failed and had been revised. The mean Constant score had increased from 22.6 points pre-operatively to 65.6 points at review. In 96% of these shoulders there was no or only minimal pain. The mean active forward elevation increased from 73° to 138°. The integrity of teres minor is essential for the recovery of external rotation and significantly influenced the Constant score. Five cases of aseptic loosening of the glenoid and seven of dissociation of the glenoid component were noted. This study confirms the promising early results obtained with the inverted prosthesis in the treatment of a cuff-tear arthropathy. It should be considered in the treatment of osteoarthritis with a massive tear of the cuff but should be reserved for elderly patients.
To compare the effectiveness of immediate open anterior capsulolabral reconstruction (ACLR) with conventional treatment in young military personnel who had sustained a first-time traumatic shoulder dislocation, we carried out a prospective non-randomised study of 34 recruit and active-duty servicemen (average, 20 years). All patients met the following criteria: 1) an acute first- time traumatic anterior dislocation, 2) no history of impingement or occult subluxation, 3) the dislocation required a manual reduction, and 4) no concomitant fracture or neurological injury. Group 1 (16 patients) were immobilised in a sling for 6 weeks followed by an intensive rehabilitation programme. Group 2 (18 patients) underwent open ACLR within 10 days of dislocation followed by the same rehabilitation protocol as Group 1. The average follow-up was 36 months; all patients were available for review. Twelve (75%) non-operatively treated patients developed recurrent instability all of whom required subsequent open repair. In the surgical repair group, there were no cases of recurrent instability. Early open repair (ACLR) significantly reduces the incidence of recurrent instability in young military personnel who sustain an acute initial anterior shoulder dislocation.
The research question was: can Arthroscopic or open biopsies were obtained, with informed consent and institution-approved review protocol, from patients undergoing total shoulder replacement or orthopaedic interventions for end-stage rotator cuff deficiency or arthropathy. Chondrocytes were isolated from eight biopsies and cells cultured over 4-weeks. In the first week post-digestion, validation studies showed cell counts varying from 30 000 to 400 000 (mean 126 666) and viability ranging from 30% to 100% (mean 75.2%). No primary culture failures were observed. One of the eight had an unexplained lower cell count and viability. Viability exceeded 80% in six of the eight cultures (75%). Alcian Blue stains and flow cytometry (Facscan) confirmed stable cultures with matrix formation. Aggrecan studies are in progress. The fact that
Aims. Both anatomical and reverse total shoulder arthroplasty (aTSA and rTSA) provide functional improvements. A reported benefit of aTSA is better range of motion (ROM). However, it is not clear which procedure provides better outcomes in patients with limited foward elevation (FE). The aim of this study was to compare the outcome of aTSA and rTSA in patients with
Anatomically specific fixation devices have become mainstream, yet there are anatomical regions and clinical conditions where no pre-contoured plates are available, such as for
Magnetic resonance imaging (MRI) is the gold standard for the diagnosis of the pathologies affecting the
The October 2023 Shoulder & Elbow Roundup. 360. looks at: Arthroscopic capsular shift surgery in patients with atraumatic shoulder joint instability: a randomized, placebo-controlled trial; Superior capsular reconstruction partially restores native
Aims. Shoulder arthroplasty is effective in the management of end-stage
Aims. The scapula is a rare site for a primary bone tumour. Only a small number of series have studied patient outcomes after treatment. Previous studies have shown a high rate of recurrence, with functional outcomes determined by the preservation of the
Reverse Total shoulder arthroplasty (RTSA) was initially introduced to treat rotator cuff arthropathy. With proven successful long-term outcomes, it has gained a noteworthy surge in popularity with its indications consequently being extended to treating various traumatic
Aims. The aim of this study was to determine whether there is a correlation between the grade of humeral osteoarthritis (OA) and the severity of glenoid morphology according to Walch. We hypothesized that there would be a correlation. Methods. Overal, 143 shoulders in 135 patients (73 females, 62 males) undergoing shoulder arthroplasty surgery for primary
Aims. Corticosteroid injections are often used to manage
Aims. Controversy about the use of an anatomical total shoulder arthroplasty
(aTSA) in young arthritic patients relates to which is the ideal
form of fixation for the glenoid component: cemented or cementless.
This study aimed to evaluate implant survival of aTSA when used
in patients aged < 60 years with primary
Aims. Ultrasound (US)-guided injections are widely used in patients with conditions of the shoulder in order to improve their accuracy. However, the clinical efficacy of US-guided injections compared with blind injections remains controversial. The aim of this study was to compare the accuracy and efficacy of US-guided compared with blind corticosteroid injections into the
Aims. To report early (two-year) postoperative findings from a randomized controlled trial (RCT) investigating disease-specific quality of life (QOL), clinical, patient-reported, and radiological outcomes in patients undergoing a total shoulder arthroplasty (TSA) with a second-generation uncemented trabecular metal (TM) glenoid versus a cemented polyethylene glenoid (POLY) component. Methods. Five fellowship-trained surgeons from three centres participated. Patients aged between 18 and 79 years with a primary diagnosis of
Abstract. Objective. Radial to axillary nerve and spinal accessory (XI) to suprascapular nerve (SSN) transfers are standard procedures to restore function after C5 brachial plexus dysfunction. The anterior approach to the SSN may miss concomitant pathology at the suprascapular notch and sacrifices lateral trapezius function, resulting in poor restoration of shoulder external rotation. A posterior approach allows decompression and visualisation of the SSN at the notch and distal coaptation of the medial XI branch. The medial triceps has a double fascicle structure that may be coapted to both the anterior and posterior division of the axillary nerve, whilst preserving the stabilising effect of the long head of triceps at the
In reverse shoulder arthroplasty (RSA), a high complication rate is noted in the international literature (24.7%), and limited local literature is available. The complications in our developing health system, with high HIV, tuberculosis and metabolic syndrome prevalence may be different from that in developed health systems where the literature largely emanates from. The aim of this study is to describe the complications and complication rate following RSA in a South African cohort. An analytical, cross-sectional study was done where all patients’ who received RSA over an 11 year period at a tertiary hospital were evaluated. One-hundred-and-twenty-six primary RSA patients met the inclusion criteria and a detailed retrospective evaluation of their demographics, clinical variables and complication associated with their shoulder arthroplasty were assessed. All fracture, revision and tumour resection arthroplasties were excluded, and a minimum of 6 months follow up was required. A primary RSA complication rate of 19.0% (24/126) was noted, with the most complications occurring after 90 days at 54.2% (13/24). Instability was the predominant delayed complication at 61.5% (8/13) and sepsis being the most common in the early days at 45.5% (5/11). Haematoma formation, hardware failure and axillary nerve injury were also noted at 4.2% each (1/24). Keeping in mind the immense difference in socioeconomical status and patient demographics in a third world country the RSA complication rate in this study correlates with the known international consensus. This also proves that RSA is still a suitable option for rotator cuff arthropathy and
Aim. Clavicular osteotomy was described as an adjunct to deltopectoral approach for improved exposure of the
The musculoskeletal (MSK) profiles of water polo players and other overhead athletes has been shown to relate to injury and throwing performance (TP). There have been no robust studies conducted on the MSK profiles and the variables affecting TP amongst female, adolescent, elite water polo players. A prospective quantitative cohort design was conducted amongst eighty-three female adolescent, elite water polo players (range 14–19 years). All participants filled out the Kerlan-Jobe Orthopaedic Clinic questionnaire, followed by a battery of screening tests aimed to identify possible MSK factors affecting TP. Pain provocation tests, range of motion (ROM), upward scapula rotation (USR), strength and pectoralis minor length measurements were all included. Participants also performed throwing speed (TS) and throwing accuracy (TA) tests. All the data collected were grouped together and analysed using SPSS 28.0. The condition for statistical significance was set as p <0.05. Multi-collinearity was tested for among variables to find out inter-variable correlations. Finally, a multiple regression analysis was performed. The mean KJOC score was 82.55 ± 14.96. 26.5% tested positive for at least one of the impingement tests. The MSK profile revealed decreased internal rotation ROM, increased external rotation ROM, a downwardly rotated scapula, weak external rotators, weak serratus anterior strength, strong lower trapezius and gluteus medius strength and a shorter pectoralis minor length all on the dominant side. Age, pectoralis minor length, upper trapezius and serratus anterior strength as well as upward scapula rotation were all positively correlated with TS, while sitting height, upper trapezius and serratus anterior strength and
To analyse bone stresses in humerus-megaprosthesis construct in response to axial loading under varying implant lengths in proximal humeral replacement following tumour excision. CT scans of 10 cadaveric humeri were processed in 3D Slicer to obtain three-dimensional (3D) models of the cortical and cancellous bone. Megaprostheses of varying body lengths (L) were modelled in FreeCAD to obtain the 3D geometry. Four FE models: group A consisting of intact bone; groups B (L=40mm), C (L=100mm) and D (L=120mm) comprising of humerus-megaprosthesis constructs were created. Isotropic linear elastic behaviour was assigned for all materials. A tensile load of 200N was applied to the elbow joint surface with the
Aim. Deadspace is the tissue and bony defect in a surgical wound after closure. This space is presumably poorly perfused favouring bacterial proliferation and biofilm formation. In arthroplasty surgery, an obligate deadspace surrounding the prosthesis is introduced and deadspace management, in combination with obtaining therapeutic prophylactic antibiotic concentrations, is important for limiting the risk of acquiring a periprosthetic joint infection (PJI). This study aimed to investigate cefuroxime distribution to an orthopaedic surgical deadspace in comparison with plasma and bone concentrations during two dosing intervals (8 h × 2). Method. In a setup imitating shoulder arthroplasty surgery, but without insertion of a prosthesis, microdialysis catheters were placed for cefuroxime sampling in a deadspace in the
Patients receiving reverse total shoulder arthroplasty (RTSA) often have osseous erosions because of
Shoulder arthroplasty is effective at restoring function and relieving pain in patients suffering from