scholarly journals RSA, TSA and PyC hemi-prostheses: comparing indications and clinical outcomes using a second-generation modular short-stem shoulder prosthesis

2020 ◽  
Author(s):  
Benjamin D. Kleim ◽  
Christina Garving ◽  
Ulrich H. Brunner
Keyword(s):  
Internal Rotation ◽  
Second Generation ◽  
Constant Score ◽  
Clinical Results ◽  
Short Stem ◽  
Shoulder Prosthesis ◽  
Porous Coating ◽  
Subscapularis Tendon ◽  
Type B ◽  
Insight Into

Abstract Introduction The goal of this study was to provide an insight into the clinical results after modular short-stem shoulder arthroplasty for various indications. Materials and methods A consecutive cohort study of 76 patients followed up for 23–55 (mean 31.4) months. 23 anatomical (TSA), 32 reverse (RSA) and 21 hemi-prostheses with a pyrocarbon head (PyC), using a modular short stem with proximal porous coating were implanted. Range of motion, pain and Constant score (CS) were recorded. Comparisons of pre- vs postoperative outcomes, between prosthesis types and indications, were made. Results All prosthesis types brought about a significant improvement (p < 0.05) in all measured outcomes. TSA had a significantly higher increase in the CS than PyC and RSA (p = 0.002 and 0.003, respectively). TSA produced superior gains in all ROM compared with RSA (p < 0.02). RSA brought about significantly smaller improvements in internal rotation than TSA and PyC (p = 0.0001 and 0.008, respectively). TSA had greater pain relief than PyC (p = 0.02). TSA with Walch A glenoids seemed to improve more than type B in the CS. PyC patients with Walch B glenoids improved more than Walch A (p = 0.03). When implanted due to Osteoarthritis (OA), PyC had a comparable final outcome to TSA (p = 0.95), although the preoperatively worse TSA patients had a greater improvement in the CS (p = 0.026). The outcome of RSA did not differ between indications, but Walch A glenoids tended to improve more. Conclusions Using a second-generation short-stem shoulder prostheses, TSA achieves the best clinical improvements overall, especially for OA with a Walch A glenoid. Despite refixation of the subscapularis tendon in all cases, RSA has inferior internal rotation than TSA and PyC, suggesting a mechanical limitation. OA, a Walch B glenoid and arthritis caused by instability seem to be ideal indications when considering PyC.

scholarly journals Clinical results and survivorship of the Mathys Affinis Short, Short Stem Total Shoulder Prosthesis

2021 ◽  
Vol 2 (1) ◽  
pp. 58-65
Author(s):  
Timothy James Karssiens ◽  
James Ritchie Gill ◽  
Karadi Hari Sunil Kumar ◽  
Søren Upton Sjolin
Keyword(s):  
Cohort Study ◽  
Rotator Cuff ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Clinical Results ◽  
Short Stem ◽  
Shoulder Prosthesis ◽  
Level Of Evidence ◽  
Survivorship Analysis

Aims The Mathys Affinis Short is the most frequently used stemless total shoulder prosthesis in the UK. The purpose of this prospective cohort study is to report the survivorship, clinical, and radiological outcomes of the first independent series of the Affinis Short prosthesis. Methods From January 2011 to January 2019, a total of 141 Affinis Short prostheses were implanted in 127 patients by a single surgeon. Mean age at time of surgery was 68 (44 to 89). Minimum one year and maximum eight year follow-up (mean 3.7 years) was analyzed using the Oxford Shoulder Score (OSS) at latest follow-up. Kaplan-Meier survivorship analysis was performed with implant revision as the endpoint. Most recently performed radiographs were reviewed for component radiolucent lines (RLLs) and proximal humeral migration. Results Five shoulders underwent revision surgery (3.5%); three for rotator cuff failure, one for infection, and one for component malposition. Survivorship of the implant was 95.4% (95% confidence interval 90.1% to 97.9%) at five and nine years. Mean OSS improved significantly compared to preoperative values from 19.0 (1 to 35) to 43.3 (7 to 48) (p < 0.001). Radiological analysis was undertaken for 99 shoulders. This revealed humeral RLLs in one case (1%), glenoid RLLs in 15 cases (15.2%), and radiological rotator cuff failure in 22 cases (22.2%). Conclusion This prospective cohort study shows encouraging short- to mid-term survivorship and clinical and radiological results for the Mathys Affinis Short, Short Stem Total Shoulder Prosthesis. Level of Evidence: IV Cite this article: Bone Jt Open 2021;2(1):58–65.

Association Between the Postoperative Condition of the Subscapularis Tendon and Clinical Outcomes After Superior Capsular Reconstruction Using Autologous Tensor Fascia Lata in Patients With Pseudoparalytic Shoulder

2020 ◽  
Vol 48 (8) ◽  
pp. 1812-1817
Author(s):  
Kazumasa Takayama ◽  
Shunsuke Yamada ◽  
Yuu Kobori ◽  
Hayao Shiode
Keyword(s):  
Cohort Study ◽  
Clinical Outcomes ◽  
Internal Rotation ◽  
External Rotation ◽  
Clinical Results ◽  
Rank Test ◽  
Subscapularis Tendon ◽  
Level Of Evidence ◽  
Active Flexion ◽  
Superior Capsular Reconstruction

Background: Superior capsular reconstruction (SCR) has been performed for irreparable rotator cuff tear and pseudoparalytic shoulder (PPS); however, poor clinical outcomes have occasionally been reported. Previous studies have shown that the cause of poor clinical results was mainly graft rupture; however, poor clinical outcomes have also been observed in some cases even though the graft was not ruptured. Hypothesis/Purpose: We hypothesized that the subscapularis (SSC) tendon would be an important factor affecting clinical outcomes after SCR. The purpose was to clarify the correlation between the condition of the SSC tendon and clinical outcomes after SCR in patients with PPS. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective cohort study included 27 patients who had undergone SCR for PPS performed by 1 surgeon between June 2014 and July 2017. The 27 patients were divided into 3 groups for evaluation: group A (n = 12), irreparable supraspinatus (SSP) and infraspinatus (ISP) tears but intact SSC tendon; group B (n = 11), irreparable SSP and ISP tears and repairable SSC tear; and group C (n = 4), irreparable SSP, ISP, and SSC tears. We evaluated the preoperative and postoperative ranges of motion (ROMs; active flexion, abduction, external rotation, and internal rotation), the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form score, and graft condition on magnetic resonance imaging at 12 months postoperatively. All data were analyzed using the Mann-Whitney U, Wilcoxon signed-rank test, and Fisher exact tests, and P < .05 was considered significant. Results: Postoperative flexion, abduction, and internal rotation ROMs were significantly lower in group C than in groups A and B (flexion: 70.0° ± 17.8° vs 153.3° ± 14.3° and 154.5° ± 14.3°, P = .003 and P = .003, respectively; abduction: 67.5° ± 15° vs 148.3° ± 22.5° and 140° ± 29.3°, P = .003 and P = .004, respectively; internal rotation: L4 vs Th10 and Th11, P = .005 and P = .008, respectively). All 23 patients in groups A and B were able to recover from PPS; however, no patient recovered from PPS in group C. Conclusion: The present study suggests that the SSC tendon is the important factor for achieving good clinical outcomes after SCR in patients with PPS. When the SSC tendon was irreparable, SCR was not an effective treatment for patients with PPS.

scholarly journals Repair versus shaving of partial-thickness articular-sided tears of the upper subscapularis tendon. A prospective randomized controlled trial

Joints ◽  
2015 ◽  
Vol 03 (03) ◽  
pp. 109-115 ◽  
Author(s):  
Pietro Randelli ◽  
Paolo Arrigoni ◽  
Alberto Aliprandi ◽  
Silvana Sdao ◽  
Vincenza Ragone ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Bone Repair ◽  
Suture Anchor ◽  
Constant Score ◽  
Tendon Healing ◽  
Subscapularis Tendon ◽  
Dash Score ◽  
Partial Thickness ◽  
Significant Difference

Purpose:the purpose of this study was to evaluate whether treating partial-thickness articular-sided tears of the upper subscapularis (SSC) tendon with a dedicated suture anchor would result in an internal rotation strength improvement compared with simple shaving of the SSC tendon and footprint. Methods: twenty-six patients with a limited SSC tendon tear (equal or inferior to the most superior centimeter) in association with a posterosuperior cuff lesion were prospectively randomized to two treatments: repair with a dedicated suture anchor versus shaving of the tendon and footprint. The patients also underwent long head of the biceps (LHB) treatment and posterosuperior cuff tear repair. In each patient the following parameters were measured both preoperatively and at a minimum follow-up of 2.5 years: strength in internal rotation in the bear-hug testing position (using a digital tensiometer), DASH score and Constant scores. MRI assessment of tendon healing was performed at the final follow-up. Results: twenty of the 26 patients (76%) were reviewed after a mean follow-up time of 42 months: 11 patients had undergone SSC tendon repair and nine simple shaving. At final follow-up no significant differences were found between the repaired and shaving group in strength in internal rotation (9.5 ± 3.8 kg versus 10.3±5.4 kg; p=0.7). the DASH score and Constant score also failed to show significant differences between the two groups. Furthermore, no significant difference in SSC tendon healing rate was observed on MRI evaluation. Conclusions: partial-thickness articular-sided tear of the upper SSC tendon in association with a posterosuperior rotator cuff repair and LHB treatment, when limited to the superior centimeter of the SSC tendon, shows a comparable performance in terms of strength in internal rotation either after simple shaving or a tendon-to-bone repair. Level of evidence: Level II, prospective comparative study.

scholarly journals Arthroscopic extended rotator interval release for treating refractory adhesive capsulitis

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901769271 ◽  
Author(s):  
Ming-Jr Tsai ◽  
Wei-Pin Ho ◽  
Chih-Hwa Chen ◽  
Tsai-Hsueh Leu ◽  
Tai-Yuan Chuang
Keyword(s):  
Los Angeles ◽  
Internal Rotation ◽  
Muscle Power ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Case Series ◽  
Clinical Results ◽  
Subscapularis Tendon ◽  
Rotator Interval ◽  
Forward Flexion

Purpose: To present the clinical results of arthroscopic extended rotator interval release with a stretching program for treating refractory adhesive capsulitis. Study design: Case series; level of evidence, 4. Methods: Arthroscopy-assisted extended rotator interval tissue release including anterior capsular was performed in 26 patients with refractory adhesive capsulitis. All rotator interval tissues, except the medial sling of the biceps, were excised and the excursion of the subscapularis tendon was restored and freely mobilized. The preoperative mean passive forward flexion was 101°, whereas external rotation at the side was 10°. Patients were followed for a minimum of 2 years and their visual analog scale for pain, muscle power, range of motion, Constant score, modified American Shoulder and Elbow Surgeons Shoulder Evaluation Form score, and modified University of California at Los Angeles score were recorded. Results: Visual pain scale and the aforementioned clinical scores improved postoperatively. The patients exhibited a significant postoperative difference in forward flexion, external rotation, and internal rotation. Postoperative mean passive forward flexion was 172°, whereas external rotation at the side was 58°. There was no difference in the muscle power postoperatively including abduction, internal rotation, and external rotation. Conclusions: Our study revealed satisfactory subjective and objective clinical results after a 2-year follow-up. Arthroscopy-assisted extended rotator interval release with a stretching program could be an alternative treatment for refractory adhesive capsulitis.

scholarly journals Revisiting an Aspergillus flavus Strain Isolated from an Egyptian Sugarcane Field in 1930

2020 ◽  
Vol 8 (11) ◽  
pp. 1633
Author(s):  
Mohamed F. Abdallah ◽  
Kris Audenaert ◽  
Sarah De Saeger ◽  
Jos Houbraken
Keyword(s):  
Aspergillus Flavus ◽  
Short Communication ◽  
Aflatoxin Contamination ◽  
Type B ◽  
Prevention Strategies ◽  
Sugarcane Field ◽  
Host Pathogen Interaction ◽  
Sugarcane Crop ◽  
Insight Into ◽  
Shed Light

The aflatoxin type B and G producer Aspergillus novoparasiticus was described in 2012 and was firstly reported from sputum, hospital air (Brazil), and soil (Colombia). Later, several survey studies reported the occurrence of this species in different foods and other agricultural commodities from several countries worldwide. This short communication reports on an old fungal strain (CBS 108.30), isolated from Pseudococcus sacchari (grey sugarcane mealybug) from an Egyptian sugarcane field in (or before) 1930. This strain was initially identified as Aspergillus flavus; however, using the latest taxonomy schemes, the strain is, in fact, A. novoparasiticus. These data and previous reports indicate that A. novoparasiticus is strongly associated with sugarcane, and pre-harvest biocontrol approaches with non-toxigenic A. novoparasiticus strains are likely to be more successful than those using non-toxigenic A. flavus strains. Further studies on the association between A. novoparasiticus and Pseudococcus sacchari might shed light on the distribution (and aflatoxin contamination) of this species in sugarcane. Additionally, the interaction between A. novoparasiticus, Pseudococcus sacchari, and sugarcane crop under different scenarios of climate change will be critical in order to get more insight into the host–pathogen interaction and host resistance and propose appropriate prevention strategies to decrease mycotoxin contamination and crop loss due to A. novoparasiticus attack.

Minimum 10 years clinical results of an anatomical short stem with a proximal hydroxyapatite coating

2021 ◽  
pp. 1-10
Author(s):  
Keisuke Uemura ◽  
Hidetoshi Hamada ◽  
Wataru Ando ◽  
Masaki Takao ◽  
Nobuhiko Sugano
Keyword(s):  
Clinical Results ◽  
Hydroxyapatite Coating ◽  
Short Stem

Otitis Media in Infancy: Tympanometric Findings

PEDIATRICS ◽  
1979 ◽  
Vol 63 (3) ◽  
pp. 435-442
Author(s):  
Jessie R. Groothuis ◽  
Sarah H. W. Sell ◽  
Peter F. Wright ◽  
Judith M. Thompson ◽  
William A. Altemeier
Keyword(s):  
Otitis Media ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Normal Pressure ◽  
Pressure Curve ◽  
Type B ◽  
History Of ◽  
Life Type ◽  
Insight Into

Ninety-one normal infants were followed longitudinally for varying periods from November 1975 to April 1977 to assess the correlation between tympanometry and pneumatic otoscopy and to study the pathogenesis of acute and chronic otitis media early in life. Type A (normal) tympanograms correlated with normal otoscopic findings in 92% of instances. Type B tympanograms, indicating reduced drum compliance with a relatively flat pressure curve, were associated with abnormal otoscopic findings in 93% of cases. The A8 (reduced compliance, normal pressure) and C (normal compliance, negative pressure) tympanograms were less consistent predictors of otoscopic findings. The correlation of tympanometric and otoscopic findings were similar in infants above and below 7 months of age. Tympanometry provided some insight into the natural history of otitis in 71 infants followed 12 to 17 months. Infants who failed to develop otitis had type B curves in only one of 240 determinations (0.4%). This pattern did not appear in those who developed acute otitis media (AOM) until the month preceding the first attack; nine of 29 tests (31%) made under these circumstances were type B. When a type B curve appeared in an asymptomatic study infant who had not previously had otitis, AOM developed within a month in nine of ten instances. At the time of diagnosis of first AOM, 87% of tympanograms were type B with the remainder type A8 or C. Sixty-three percent of tympanograms obtained from 25 infants during the six months following first AOM were type B, indicating that abnormal middle ear function was often prolonged. Fifteen of these 25 developed recurrent otitis during follow-up.

GIRD syndrome in male handball and volleyball players: Is the decrease of total range of motion the turning point to pathology?

2021 ◽  
pp. 1-8
Author(s):  
Jonas Schmalzl ◽  
Helen Walter ◽  
Wolfram Rothfischer ◽  
Sören Blaich ◽  
Christian Gerhardt ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
Turning Point ◽  
External Rotation ◽  
Constant Score ◽  
High Rate ◽  
Overhead Athletes ◽  
Glenohumeral Internal Rotation Deficit ◽  
Total Range ◽  
Volleyball Players

BACKGROUND: Adaptations in glenohumeral range of motion may affect overhead athletes and lead to shoulder pathologies. OBJECTIVE: The purpose of this study was to evaluate glenohumeral internal rotation deficit (GIRD) and postero-superior impingement among male handball and volleyball players and the relationship between these pathologies and training level (amateur vs. professional), position (attack vs. no attack), experience (> 5 years vs. < 5 years) and sports. METHODS: Sixty-seven handball players and 67 volleyball players with a mean age of 25 [± 5] years were included. The range of motion including external and internal rotation in 90∘ abduction of the dominant and non-dominant shoulder was measured of each examined athlete. Visual analogue scale, disabilities of the shoulder and hand score, constant score and subjective shoulder value were recorded. The athletes were examined for postero-superior impingement and abduction force was measured with an isokinetic dynamometer. RESULTS: Internal rotation was significantly lower and external rotation was significantly greater in the dominant arm for both sports. 72% presented with GIRD. GIRD was more prevalent in athletes active for > 5 years (odds ratio (OR) 3), in those training > 3 times per week (OR 1.4) and in handball players (OR 2.7). 24% presented with postero-superior impingement. Players active for > 5 years (OR 1.22), professionals (OR 1.14), volleyball players (OR 1.19), offensive players (OR 2.2) and athletes with GIRD > 10∘ (OR 1.5) showed a higher prevalence of postero-superior impingement. CONCLUSION: GIRD is a common phenomenon in handball and volleyball players. Offensive players are frequently suffering from postero-superior impingement. GIRD > 10∘ leads in nearly 75% of the athletes to a decrease of total range of motion and a high rate of postero-superior impingement. Thus, a decreased range of motion seems to be the turning point from adaptation to pathology. Therefore, regular controls of range of motion and countermeasures by means of stretching the posterior shoulder joint should be integrated in the training content.

scholarly journals Total versus hemiarthroplasty for glenohumeral arthritis according to preoperative glenoid erosion

2015 ◽  
Vol 7 (2) ◽  
Author(s):  
Marc-Frederic Pastor ◽  
Melena Kaufmann ◽  
Andre Gettmann ◽  
Mathias Wellmann ◽  
Tomas Smith
Keyword(s):  
Pain Relief ◽  
Clinical Outcome ◽  
Internal Rotation ◽  
Constant Score ◽  
Total Shoulder Arthroplasty ◽  
Short Term ◽  
Simple Shoulder Test ◽  
Lower Pain ◽  
Glenoid Erosion

Clinical studies on primary osteoarthritis have shown better results of total shoulder arthroplasty (TSA) compared to hemiarthroplasty (HA) regarding the function, revision rate and postoperative pain relief. However, a clear recommendation for implantation of TSA or HA, depending on the glenoid type of erosion, does not exist. The aim of the study was to compare the results of TSA and HA with respect to the preoperative glenoid type. In this study, 41 patients were examined retrospectively; among them, 25 patients were treated with stemmed anatomic TSA and 16 with stemmed anatomic HA. The degree of osteoarthritis was determined according to Samilson and the glenoid erosion was classified according to Walch. The clinical outcome of the patients was determined by using the Constant Score (CS) and the Simple Shoulder Test at final follow-up. Patients after TSA demonstrated a significantly improved internal rotation compared to HA patients. Patients with preoperative B1 glenoid showed better pain relief after TSA compared to HA. For patients with preoperative type A2 glenoid a significantly higher CS was found after TSA compared to HA. We were able to show good short-term results after TSA and HA. Our findings suggest a better internal rotation for TSA compared to HA, superior clinical outcome for patients with preoperative A2 glenoid and lower pain level for patients with a preoperative B1 glenoid. However, these results need to be confirmed by further studies.

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