A review of the literature on elbow replacement found no consistency in the clinical outcome measures which are used to assess the effectiveness of interventions. The aim of this study was to define core outcome domains for elbow replacement. A real-time Delphi survey was conducted over four weeks using outcomes from a scoping review of 362 studies on elbow replacement published between January 1990 and February 2021. A total of 583 outcome descriptors were rationalized to 139 unique outcomes. The survey consisted of 139 outcomes divided into 18 domains. The readability and clarity of the survey was determined by an advisory group including a patient representative. Participants were able to view aggregated responses from other participants in real time and to revisit their responses as many times as they wished during the study period. Participants were able to propose additional items for inclusion. A Patient and Public Inclusion and Engagement (PPIE) panel considered the consensus findings.Aims
Methods
Rotator cuff disease (RCD) can considerably decrease quality of life. Here, we investigated whether health-related quality of life (HRQoL) influences the need for surgery in patients with RCD. We performed an analysis of 417 patients with symptomatic RCD who were recruited from two hospitals between June 2008 and December 2014 to be randomized to receive non-surgical or surgical treatment. After a three-month rehabilitation period, 36-Item Short-Form Health Survey questionnaire (SF-36), shoulder pain (visual analogue scale (VAS)), and shoulder function (Constant-Murley score) data were available from 191 still-symptomatic patients who were eligible for surgery. A control group was formed from 87 excluded patients who were no longer eligible for surgery due to relief of symptoms.Aims
Methods
To achieve expert clinical consensus in the delivery of hydrodilatation for the treatment of primary frozen shoulder to inform clinical practice and the design of an intervention for evaluation. We conducted a two-stage, electronic questionnaire-based, modified Delphi survey of shoulder experts in the UK NHS. Round one required positive, negative, or neutral ratings about hydrodilatation. In round two, each participant was reminded of their round one responses and the modal (or ‘group’) response from all participants. This allowed participants to modify their responses in round two. We proposed respectively mandating or encouraging elements of hydrodilatation with 100% and 90% positive consensus, and respectively disallowing or discouraging with 90% and 80% negative consensus. Other elements would be optional.Aims
Methods
The purpose of this study was to assess the prevalence of depression and anxiety symptoms in patients undergoing shoulder surgery using the National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS) Depression and Anxiety computer adaptive tests, and to determine the factors associated with more severe symptoms. Additionally, we sought to determine whether PROMIS Depression and Anxiety were associated with functional outcomes after shoulder surgery. This was a retrospective analysis of 293 patients from an urban population who underwent elective shoulder surgery from 2015 to 2018. Survey questionnaires included preoperative and two-year postoperative data. Bivariate analysis was used to identify associations and multivariable analysis was used to control for confounding variables.Aims
Methods
Acute distal biceps tendon repair reduces fatigue-related pain and minimizes loss of supination of the forearm and strength of flexion of the elbow. We report the short- and long-term outcome following repair using fixation with a cortical button techqniue. Between October 2010 and July 2018, 102 patients with a mean age of 43 years (19 to 67), including 101 males, underwent distal biceps tendon repair less than six weeks after the injury, using cortical button fixation. The primary short-term outcome measure was the rate of complications. The primary long-term outcome measure was the abbreviated Disabilities of the Arm, Shoulder and Hand (QuickDASH) score. Secondary outcomes included the Oxford Elbow Score (OES), EuroQol five-dimension three-level score (EQ-5D-3L), satisfaction, and return to function.Aims
Methods
The purpose of this study was to identify the changes in untreated long head of the biceps brachii tendon (LHBT) after a rotator cuff tear and to evaluate the factors related to the changes. A cohort of 162 patients who underwent isolated supraspinatus with the preservation of LHBT was enrolled and evaluated. The cross-sectional area (CSA) of the LHBT on MRI was measured in the bicipital groove, and preoperative to postoperative difference was calculated at least 12 months postoperatively. Second, postoperative changes in the LHBT including intratendinous signal change, rupture, dislocation, or superior labral lesions were evaluated with seeking of factors that were correlated with the changes or newly developed lesions after rotator cuff repair.Aims
Methods
Aims. Improvements in the evaluation of outcomes following peripheral nerve injury are needed. Recent studies have identified muscle
The aim of this study was to report the outcomes of different treatment options for glenoid loosening following reverse shoulder arthroplasty (RSA) at a minimum follow-up of two years. We retrospectively studied the records of 79 patients (19 men, 60 women; 84 shoulders) aged 70.4 years (21 to 87) treated for aseptic loosening of the glenosphere following RSA. Clinical evaluation included pre- and post-treatment active anterior elevation (AAE), external rotation, and Constant score.Aims
Patients and Methods
Aims . Few studies have evaluated the relationship between patients’
pre-operative expectations and the outcome of orthopaedic procedures.
Our aim was to determine the effect of expectations on the outcome
after primary anatomical total shoulder arthroplasty (TSA). We hypothesised
that patients with greater expectations would have better outcomes. . Patients and Methods. Patients undergoing primary anatomical TSA completed the Hospital
for Special Surgery’s Shoulder Expectations Survey pre-operatively.
The American Shoulder and Elbow Surgeons (ASES), Shoulder Activity
Scale (SAS), Short-Form-36 (SF-36), and visual analogue scale (VAS)
for pain,
Improvements in the evaluation of outcome after nerve transfers
are required. The assessment of force using the Medical Research
Council (MRC) grades (0 to 5) is not suitable for this purpose.
A ceiling effect is encountered within MRC grade 4/5 rendering this
tool insensitive. Our aim was to show how the strength of flexion
of the elbow could be assessed in patients who have undergone a
re-innervation procedure using a continuous measurement scale. A total of 26 patients, 23 men and three women, with a mean age
of 37.3 years (16 to 66), at the time of presentation, attended
for review from a cohort of 52 patients who had undergone surgery
to restore flexion of the elbow after a brachial plexus injury and
were included in this retrospective study. The mean follow-up after
nerve transfer was 56 months (28 to 101, standard deviation (Aims
Methods
Depression can significantly affect quality of life and is associated
with higher rates of medical comorbidities and increased mortality
following surgery. Although depression has been linked to poorer
outcomes following orthopaedic trauma, total joint arthroplasty
and spinal surgery, we wished to examine the impact of depression
in elective total shoulder arthroplasty (TSA) as this has not been
previously explored. The United States Nationwide Inpatient Sample (NIS) was used
to identify patients undergoing elective TSA over a ten-year period.
Between 2002 and 2012, 224 060 patients underwent elective TSA.Aims
Patients and Methods
The eccentric glenosphere was principally introduced into reverse
shoulder arthroplasty to reduce the incidence of scapular notching.
There is only limited information about the influence of its design
on deltoid power and joint reaction forces. The aim of our study was to investigate how the diameter and
eccentricity of the glenosphere affect the biomechanics of the deltoid
and the resultant joint reaction forces. Different sizes of glenosphere and eccentricity were serially
tested in ten cadaveric shoulders using a custom shoulder movement
simulator.Aims
Methods
If a modular convertible total shoulder system
is used as a primary implant for an anatomical total shoulder arthroplasty,
failure of the prosthesis or the rotator cuff can be addressed by
converting it to a reverse shoulder arthroplasty (RSA), with retention
of the humeral stem and glenoid baseplate. This has the potential
to reduce morbidity and improve the results. . In a retrospective study of 14 patients (15 shoulders) with a
mean age of 70 years (47 to 83) we reviewed the clinical and radiological
outcome of converting an anatomical shoulder arthroplasty (ASA)
to a RSA using a convertible prosthetic system (SMR system, Lima,
San Daniele, Italy). . The mean operating time was 64 minutes (45 to 75). All humeral
stems and glenoid baseplates were found to be well-fixed and could
be retained. There were no intra-operative or early post-operative
complications and no post-operative infection. The mean follow-up was 43 months (21 to 83), by which time the
mean visual analogue scale for pain had decreased from 8 pre-operatively
to 1, the mean American Shoulder and Elbow Surgeons Score from 12
to 76, the mean Oxford shoulder score from 3 to 39, the mean Western
Ontario Osteoarthritis of the Shoulder Score from 1618 to 418 and
the mean Subjective shoulder value from 15 to 61. On radiological review, one patient had a lucency around the
humeral stem, two had stress shielding. There were no
