Aims. Glenoid bone loss can be a challenging problem when revising
a shoulder arthroplasty. Precise pre-operative planning based on
plain radiographs or CT scans is essential. We have investigated
a new radiological classification system to describe the degree
of medialisation of the bony
Aims. Reverse total shoulder arthroplasty (rTSA) can be used in complex cases when the
Aims. We evaluated clinical and radiographic outcomes of total shoulder
arthroplasty (TSA) using the second-generation Trabecular Metal
(TM)
Osteochondral
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
Aims. We report the clinical results of
Introduction. Achieving prosthesis fixation in patients with glenoid defects can be challenging, particularly when the bony defects are large. To that end, this study quantifies the impact of 2 different sizes of large anterior glenoid defects on reverse shoulder
Aims. This study aimed to assess the impact of using the metal-augmented
Introduction. Due to the predictability of outcomes achieved with reverse shoulder arthroplasty (rTSA), rTSA is increasingly being used in patients where
Aims. The aim of this study was to longitudinally compare the clinical and radiological outcomes of anatomical total shoulder arthroplasty (aTSA) up to long-term follow-up, when using cemented keel, cemented peg, and hybrid cage peg
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 glenohumeral joint and deltoid. The purpose of the current study was to report the outcome of patients who had undergone tumour resection that included the scapula. Methods. We reviewed 61 patients (37 male, 24 female; mean age 42 years (SD 19)) who had undergone resection of the scapula. The most common resection was type 2 (n = 34) according to the Tikhoff-Linberg classification, or type S1A (n = 35) on the Enneking classification. Results. The ten-year disease-specific survival was 76%. High tumour grade (hazard ratio (HR) 4.27; p = 0.016) and a total resection of the scapula (HR 3.84; p = 0.015) were associated with worse survival. The ten-year metastasis-free and local recurrence-free survivals were 82% and 86%, respectively. Total scapular resection (HR 6.29; p = 0.004) was associated with metastatic disease and positive margins were associated with local recurrence (HR 12.86; p = 0.001). At final follow-up, the mean shoulder forward elevation and external rotation were 79° (SD 62°) and 27° (SD 25°), respectively. The most recent functional outcomes evaluated included the mean Musculoskeletal Tumor Society Score (76% (SD 17%)), the American Shoulder and Elbow Score (73% (SD 20%)), and the Simple Shoulder Test (7 (SD 3)). Preservation of the
Knowledge of the premorbid
Aims. Rates of reverse total shoulder arthroplasty (rTSA) continue to grow. Glenoid bone loss and deformity remains a technical challenge to the surgeon and may reduce improvements in patients’ outcomes. However, there is no consensus as to the optimal surgical technique to best reconstruct these patients’ anatomy. This review aims to compare the outcomes of glenoid bone grafting versus augmented
Purpose: The causes of
Purpose of the study: Posterior
Aims. Reverse total shoulder arthroplasty (RTSA) using trabecular metal (TM)-backed
Aims. The use and variety of stemless humeral components in anatomical total shoulder arthroplasty (TSA) have proliferated since their advent in 2004. Early outcomes are reassuring but independent mid-term results are scarce. This independent study reports a consecutive series of 143 Eclipse stemless shoulder prostheses with a minimum five-year (5 to 10) follow-up. Methods. Outcomes of 143 procedures undertaken for all indications in 131 patients were reviewed, with subset analysis of those for osteoarthritis (OA) (n = 99). The primary outcome was the Oxford Shoulder Score (OSS) at a minimum of five years. Secondary outcomes were ranges of motion and radiological analysis of humeral radiolucency, rotator cuff failure, and
Aims. Accurate measurement of the
Aims. The Walch Type C dysplastic
Aims. Existing literature indicates that inferiorly inclined
Abstract. Aim. Excessive
This paper presents an ongoing review of the use of a wedge-shaped porous metal augments in the shoulder to address
Ideberg-Goss type VI/AO F2(4)
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)
Summary Statement. In this study, excellent positioning of custom-made
Aims. The aim of this study was to report the outcomes of different treatment options for
Reverse shoulder arthroplasty (RSA) is commonly used to treat patients with rotator cuff tear arthropathy. Loosening of the
This study examined the regional variations of cortical and cancellous bone density present in superiorly eroded
Patients receiving reverse total shoulder arthroplasty (RTSA) often have osseous erosions because of glenohumeral arthritis, leading to increased surgical complexity.
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 glenohumeral loads in a dynamic model; Gene expression in
Aims. To systematically review the predominant complication rates and changes to patient-reported outcome measures (PROMs) following osteochondral allograft (OCA) transplantation for shoulder instability. Methods. This systematic review, following PRISMA guidelines and registered in PROSPERO, involved a comprehensive literature search using PubMed, Embase, Web of Science, and Scopus. Key search terms included “allograft”, “shoulder”, “humerus”, and “glenoid”. The review encompassed 37 studies with 456 patients, focusing on primary outcomes like failure rates and secondary outcomes such as PROMs and functional test results. Results. A meta-analysis of primary outcomes across 17 studies revealed a dislocation rate of 5.1% and an increase in reoperation rates from 9.3% to 13.7% post-publication bias adjustment. There was also a noted rise in conversion to total shoulder arthroplasty and incidence of osteoarthritis/osteonecrosis over longer follow-up periods. Patient-reported outcomes and functional tests generally showed improvement, albeit with notable variability across studies. A concerning observation was the consistent presence of allograft resorption, with rates ranging from 33% to 80%. Comparative studies highlighted similar efficacy between distal tibial allografts and Latarjet procedures in most respects, with some differences in specific tests. Conclusion. OCA transplantation presents a promising treatment option for shoulder instability, effectively addressing both
In an effort to address the relatively high rate of
Aims. Patient-specific
Background. Rotator cuff atrophy evaluated with computed tomography scans has been associated with asymmetric
Aims. We present our experience of using a metal-backed prosthesis and autologous bone graft to treat gross
Aims. Patients with recurrent anterior dislocation of the shoulder commonly have an anterior osseous defect of the
Osteoarthritis results in changes in the dimensions
of the
BACKGROUND. Stability of the
Our aim was to determine the most repeatable three-dimensional measurement of
Aims. Our aim was to investigate the outcomes of patients with a displaced
fracture of the
We have investigated the mid-term outcome of total shoulder replacement using a keeled cemented
Pre-operative 3D
Introduction. The clinical impact of radiolucent
Introduction.
Objectives: The aim of this study was to quantify bone microarchitecture within the
The aim of this study was to compare a third-generation
cementing procedure for
Combined
Introduction. Aseptic
Background. Malposition of the
INTRODUCTION. 3D preoperative planning software for anatomic and reverse total shoulder arthroplasty (ATSA and RTSA) provides additional insight for surgeons regarding implant selection and placement. Interestingly, the advent of such software has brought previously unconsidered questions to light on the optimal way to plan a case. In this study, a survey of shoulder specialists from the American Shoulder and Elbow Society (ASES) was conducted to examine thought patterns in current
Total shoulder arthroplasty (TSA) is an excellent surgical solution for patients with shoulder arthritis, providing good to excellent results in the vast majority of patients. Complications are rare, however, when they occur, can be devastating for both the patient and surgeon. An increasingly recognised complication of TSA is
BACKGROUND. Abnormal
Glenoid bone grafting in reverse total shoulder arthroplasty (RTSA) has emerged as an effective method of restoring bone stock in the presence of complex glenoid bone loss, yet there is limited published evidence on efficacy. The aim of this study was to conduct an analysis of clinical and radiographic outcomes associated with glenoid bone grafting in primary RTSA. Patients who underwent a primary RTSA with glenoid bone grafting were retrospectively identified from the databases of two senior shoulder surgeons. Inclusion criteria included minimum of 12 months clinical and/or radiographical follow up. Patients underwent preoperative clinical and radiographic assessment. Graft characteristics (source, type, preparation), range of movement (ROM), patient-reported outcome measures (Oxford Shoulder Scores [OSS]), and complications were recorded. Radiographic imaging was used to analyse implant stability, graft incorporation, and notching by two independent reviewers. Between 2013 and 2021, a total of 53 primary RTSA procedures (48 patients) with glenoid bone grafting were identified. Humeral head autograft was used in 51 (96%) of cases. Femoral head allograft was utilised in two cases. Depending on the morphology of glenoid bone loss, a combination of structural (corticocancellous) and non-structural (cancellous) grafts were used to restore
Aim. We present the medium-term clinical results of a reverse total
shoulder arthroplasty with a trabecular metal
Total shoulder replacement is a successful procedure for degenerative or some inflammatory diseases of the shoulder. However, fixation of the
Introduction. Varying degrees of posterior glenoid bone loss occurs in patients with end stage osteoarthritis and can result in increased
Introduction. The Walch Type B2
Background. Use of a baseplate with a smaller diameter in reverse shoulder arthroplasty has been recommended, especially in patients with a small
INTRODUCTION. Reverse shoulder arthroplasty (RSA) provides an effective alternative to anatomic shoulder replacements for individuals with cuff tear arthropathy, but certain osteoarthritic
Introduction. Varying degrees of posterior glenoid bone loss occurs in patients with end stage osteoarthritis and can result in increased
Accurate
The purpose of this study is to report the clinical and radiological outcomes of patients undergoing primary or revision reverse total shoulder arthroplasty using custom 3D printed components to manage severe glenoid bone loss with a minimum of 2-year follow-up. After ethical approval (reference: 17/YH/0318), patients were identified and invited to participate in this observational study. Inclusion criteria included: 1) severe glenoid bone loss necessitating the need for custom implants; 2) patients with definitive
Background. Accurate placement of the
Background. Massive rotator cuff tears and consequent cuff-deficient arthritis (CTA) of the shoulder can cause severe shoulder dysfunction in the elderly. Reverse total shoulder arthroplasty (RTSA) has been widely used for treatment of CTA in all over the world since its introduction in the 90's. In Japan, however, we have just started to clinically use RTSA from April 2014. In addition, we have only one choice of the implants (Aequalis Reverse, Tornier) currently, and only one size of the base-plate of the
Introduction. Posterior
INTRODUCTION. 3D preoperative planning software for anatomic total shoulder arthroplasty (ATSA) provides surgeons with increased ability to visualize complex joint relationships and deformities. Interestingly, the advent of such software has seemed to create less of a consensus on the optimal way to plan an ATSA rather than more. In this study, a survey of shoulder specialists from the American Shoulder and Elbow Society (ASES) was conducted to examine thought patterns in current ATSA implant selection and placement. METHODS. 172 ASES members completed an 18-question survey on their thought process for how they select and place an ATSA
We report the long-term clinical and radiological outcomes of the Aequalis total shoulder replacement with a cemented all-polyethylene flat-back keeled
Introduction. Posterior
Anatomic and accurate placement of components is a primary goal in all arthroplasty procedures. Unique to total shoulder arthroplasty, challenging
Common post-operative problems in shoulder arthroplasty such as
Background.
Experience has demonstrated in the hip and knee, related to total joint replacement arthroplasty, polymethyl methacrylate cement fixation can provide problems in terms of loosening, fragmentation, particulate wear and ultimate failure. These same problems have been recognised in total shoulder arthroplasty related to cement fixation of the
Cement fixation of the
The composition and morphology of the
Background. Virtual planning of shoulder arthroplasty has gained recent popularity. Combined with patients specific instrumentation, several systems have been developed that allow the surgeon to accurately appreciate and correct
In a prospective study between 2000 and 2005, 22 patients with primary osteoarthritis of the shoulder had a total shoulder arthroplasty with a standard five-pegged
Purpose:. The optimal degree of conformity between the
The incidence of loosening of a cemented
The purpose of the study was to describe the normal anatomy of
Purpose:.
Introduction: Fractures of the scapula are rare injuries. When they do occur, they are usually caused by high-energy trauma and some of the patients may have significant associated injuries. Most fractures are minimally displaced and amenable to nonsurgical treatment. Open reduction and internal fixation of intra-articular fractures are considered if there is a glenohumeral sub-luxation secondary to fracture or if there is an intra-articular displacement greater than 5 mm. Patients and Methods: This study consisted of 33 Pts from Israel and Macedonia (28 M, 5F, 18–74 year old, mean 43.5Y) followed for 2–5 years (mean 3.5Y). Fractures were classified according to Idelberg following analysis of plain radiographs and computerized radiographs. 26 patients had undisplaced or minimally displaced fractures of the
The incidence of total shoulder arthroplasty continues to increase. The most common reason for failure of a total shoulder arthroplasty is the
Introduction:. Subchondral bone density (SBD) distribution is an important parameter regarding that may be important when considering implant stability. This parameter is a reflection of the loading experienced by the joint throughout the lifetime and may be useful in pre-surgical planning and implant design. Clinically, the question of the
Aims. Radiostereometric analysis (RSA) allows an extremely accurate
measurement of early micromotion of components following arthroplasty. . Patients and Methods. In this study, RSA was used to measure the migration of 11 partially
cemented fluted pegged
Background:.
Introduction. Hypoplasia of the
Assessing
Introduction: Concern remains in loosening of
Introduction. Augmented
The Latarjet procedure utilises the coracoid as a vascularised bone autograft to augment the
Radiolucent lines in total shoulder arthroplasty around the
INTRODUCTION. The advent of CT based 3D preoperative planning software for reverse total shoulder arthroplasty (RTSA) provides surgeons with more data than ever before to prepare for a case. Interestingly, as the usage of such software has increased, further questions have appeared over the optimal way to plan and place a
The purpose of the study was to describe the normal anatomy of
Background. Radiological and clinical results of total shoulder arthroplasty are dependent upon ability to accurately measure and correct
The shape of the