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The Bone & Joint Journal
Vol. 106-B, Issue 3 | Pages 268 - 276
1 Mar 2024
Park JH Lee JH Kim DY Kim HG Kim JS Lee SM Kim SC Yoo JC

Aims

This study aimed to assess the impact of using the metal-augmented glenoid baseplate (AGB) on improving clinical and radiological outcomes, as well as reducing complications, in patients with superior glenoid wear undergoing reverse shoulder arthroplasty (RSA).

Methods

From January 2016 to June 2021, out of 235 patients who underwent primary RSA, 24 received a superior-AGB after off-axis reaming (Group A). Subsequently, we conducted propensity score matching in a 1:3 ratio, considering sex, age, follow-up duration, and glenoid wear (superior-inclination and retroversion), and selected 72 well-balanced matched patients who received a standard glenoid baseplate (STB) after eccentric reaming (Group B). Superior-inclination, retroversion, and lateral humeral offset (LHO) were measured to assess preoperative glenoid wear and postoperative correction, as well as to identify any complications. Clinical outcomes were measured at each outpatient visit before and after surgery.


The Bone & Joint Journal
Vol. 98-B, Issue 11 | Pages 1521 - 1525
1 Nov 2016
Su Y Nan G

Aims. Cubitus varus is the most common late complication of a supracondylar fracture of the humerus in children. Correction can be performed using one of a number of techniques of osteotomy but each has disadvantages. We describe a new technique for correcting post-traumatic cubitus varus using a lateral closing wedge isosceles triangular osteotomy. Patients and Methods. A lateral closing wedge isosceles triangular osteotomy was performed in 25 patients (15 male and ten female with a mean age of 9.5 years (6 to 12)) between May 2010 and April 2013. All patients had cubitus varus secondary to malunion of a supracondylar fracture, with good function of the elbow and a full range of movement. The osteotomy lines were marked on the bone with an isosceles triangular template made before surgery, after which the osteotomy was performed leaving the medial cortex intact. Fixation was performed using two lateral 2 mm Kirschner (K)-wires and patients were immobilised in an above-elbow plaster. By six to eight weeks callus was present and the wires and cast were removed. Patients were reviewed at four and six weeks, three, six and 12 months and then every two years until skeletal maturity. Clinical and radiographic outcomes were categorised as excellent, good or poor. Results. A total of 23 patients had an excellent and two had a good outcome at a mean final follow-up of 3.4 years (two to four). The mean post-operative carrying angle in the corrected elbow was 11.7° (7° to 18°). One patient fell, displacing the osteotomy, and needed revision of the fixation. No patient had a nerve injury. Conclusion. A lateral isosceles triangular osteotomy and with K-wire fixation is a practical, effective, reliable, safe and simple method of correcting post-traumatic cubitus varus in children. It has inherent stability and excellent cosmesis without prominence of the lateral condyle. . Cite this article: Bone Joint J 2016;98-B:1521–5


The Bone & Joint Journal
Vol. 103-B, Issue 1 | Pages 123 - 130
1 Jan 2021
Lapner P Pollock JW Laneuville O Uhthoff HK Zhang T Sheikh A McIlquham K Trudel G

Aims

Despite recent advances in arthroscopic rotator cuff repair, re-tear rates remain high. New methods to improve healing rates following rotator cuff repair must be sought. Our primary objective was to determine if adjunctive bone marrow stimulation with channelling five to seven days prior to arthroscopic cuff repair would lead to higher Western Ontario Rotator Cuff (WORC) scores at 24 months postoperatively compared with no channelling.

Methods

A prospective, randomized controlled trial was conducted in patients undergoing arthroscopic rotator cuff repair. Patients were randomized to receive either a percutaneous bone channelling of the rotator cuff footprint or a sham procedure under ultrasound guidance five to seven days prior to index surgery. Outcome measures included the WORC, American Shoulder and Elbow Surgeons (ASES), and Constant scores, strength, ultrasound-determined healing rates, and adverse events.


The Bone & Joint Journal
Vol. 100-B, Issue 3 | Pages 346 - 351
1 Mar 2018
Goodall R Claireaux H Hill J Wilson E Monsell F BOAST 11 Collaborative Tarassoli P

Aims

Supracondylar fractures are the most frequently occurring paediatric fractures about the elbow and may be associated with a neurovascular injury. The British Orthopaedic Association Standards for Trauma 11 (BOAST 11) guidelines describe best practice for supracondylar fracture management. This study aimed to assess whether emergency departments in the United Kingdom adhere to BOAST 11 standard 1: a documented assessment, performed on presentation, must include the status of the radial pulse, digital capillary refill time, and the individual function of the radial, median (including the anterior interosseous), and ulnar nerves.

Materials and Methods

Stage 1: We conducted a multicentre, retrospective audit of adherence to BOAST 11 standard 1. Data were collected from eight hospitals in the United Kingdom. A total of 433 children with Gartland type 2 or 3 supracondylar fractures were eligible for inclusion. A centrally created data collection sheet was used to guide objective analysis of whether BOAST 11 standard 1 was adhered to. Stage 2: We created a quality improvement proforma for use in emergency departments. This was piloted in one of the hospitals used in the primary audit and was re-audited using equivalent methodology. In all, 102 patients presenting between January 2016 and July 2017 were eligible for inclusion in the re-audit.


The Bone & Joint Journal
Vol. 100-B, Issue 3 | Pages 318 - 323
1 Mar 2018
Raiss P Alami G Bruckner T Magosch P Habermeyer P Boileau P Walch G

Aims

The aim of this study was to analyze the results of reverse shoulder arthroplasty (RSA) in patients with type 1 sequelae of a fracture of the proximal humerus in association with rotator cuff deficiency or severe stiffness of the shoulder.

Patients and Methods

A total of 38 patients were included: 28 women and ten men. Their mean age at the time of arthroplasty was 73 years (54 to 91). Before the RSA, 18 patients had been treated with open reduction and internal fixation following a fracture. A total of 22 patients had a rotator cuff tear and 11 had severe stiffness of the shoulder with < 0° of external rotation. The mean follow-up was 4.3 years (1.5 to 10). The Constant score and the range of movement of the shoulder were recorded preoperatively and at final follow-up.

Preoperatively, radiographs in two planes were performed, as well as CT or arthro-CT scans; radiographs were also performed at final follow-up.


The Bone & Joint Journal
Vol. 95-B, Issue 12 | Pages 1595 - 1602
1 Dec 2013
Modi CS Beazley J Zywiel MG Lawrence TM Veillette CJH

The aim of this review is to address controversies in the management of dislocations of the acromioclavicular joint. Current evidence suggests that operative rather than non-operative treatment of Rockwood grade III dislocations results in better cosmetic and radiological results, similar functional outcomes and longer time off work. Early surgery results in better functional and radiological outcomes with a reduced risk of infection and loss of reduction compared with delayed surgery.

Surgical options include acromioclavicular fixation, coracoclavicular fixation and coracoclavicular ligament reconstruction. Although non-controlled studies report promising results for arthroscopic coracoclavicular fixation, there are no comparative studies with open techniques to draw conclusions about the best surgical approach. Non-rigid coracoclavicular fixation with tendon graft or synthetic materials, or rigid acromioclavicular fixation with a hook plate, is preferable to fixation with coracoclavicular screws owing to significant risks of loosening and breakage.

The evidence, although limited, also suggests that anatomical ligament reconstruction with autograft or certain synthetic grafts may have better outcomes than non-anatomical transfer of the coracoacromial ligament. It has been suggested that this is due to better restoration horizontal and vertical stability of the joint.

Despite the large number of recently published studies, there remains a lack of high-quality evidence, making it difficult to draw firm conclusions regarding these controversial issues.

Cite this article: Bone Joint J 2013;95-B:1595–1602.


The Bone & Joint Journal
Vol. 98-B, Issue 8 | Pages 1086 - 1092
1 Aug 2016
de Vos MJ Wagener ML Hannink G van der Pluijm M Verdonschot N Eygendaal D

Aims

Revision total elbow arthroplasty (TEA) is often challenging. The aim of this study was to report on the clinical and radiological results of revision arthroplasty of the elbow with the Latitude TEA.

Patients and Methods

Between 2006 and 2010 we used the Latitude TEA for revision in 18 consecutive elbows (17 patients); mean age 53 years (28 to 80); 14 women. A Kudo TEA was revised in 15 elbows and a Souter-Strathclyde TEA in three.

Stability, range of movement (ROM), visual analogue score (VAS) for pain and functional scores, Elbow Functional Assessment Scale (EFAS), the Functional Rating Index of Broberg and Morrey (FRIBM) and the Modified Andrews’ Elbow Scoring System (MAESS) were assessed pre-operatively and at each post-operative follow-up visit (six, 12 months and biennially thereafter). Radiographs were analysed for loosening, fractures and dislocation. The mean follow-up was 59 months (26 to 89).


The Bone & Joint Journal
Vol. 97-B, Issue 5 | Pages 681 - 688
1 May 2015
Wagener ML de Vos MJ Hannink G van der Pluijm M Verdonschot N Eygendaal D

Unlinked, linked and convertible total elbow arthroplasties (TEAs) are currently available. This study is the first to report the clinical results of the convertible Latitude TEA. This was a retrospective study of a consecutive cohort of 63 patients (69 primary TEAs) with a mean age of 60 years (23 to 87). Between 2006 and 2008 a total of 19 men and 50 women underwent surgery. The mean follow-up was 43 months (8 to 84). The range of movement, function and pain all improved six months post-operatively and either continued to improve slightly or reached a plateau thereafter. The complication rate is similar to that reported for other TEA systems. No loosening was seen. Remarkable is the disengagement of the radial head component in 13 TEAs (31%) with a radial head component implanted.

Implantation of both the linked and the unlinked versions of the Latitude TEA results in improvement of function and decreased pain, and shows high patient satisfaction at mid-term follow-up.

Cite this article: Bone Joint J 2015; 97-B:681–8.