scholarly journals Effect of Tranexamic Acid on Hematologic Values and Blood Loss in Reverse Total Shoulder Arthroplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Sae Hoon Kim ◽  
Whan Ik Jung ◽  
Young Jun Kim ◽  
Do Hyeon Hwang ◽  
Young Eun Choi
Keyword(s):  
Side Effects ◽  
Tranexamic Acid ◽  
Total Shoulder Arthroplasty ◽  
Asian Population ◽  
Single Intravenous Dose ◽  
Cuff Tear Arthropathy ◽  
Cuff Tear ◽  
Hematologic Change ◽  
Reverse Total Shoulder ◽  
Medical Side

Purpose. Use of tranexamic acid (TXA) in the setting of arthroplasty of the lower extremity has been previously described. The aim of this study was to evaluate the benefit of a single dose of TXA (500 mg vial) administered intravenously just prior to RTSA in an Asian population. Methods. The records of 48 patients (no TXA, n=24, versus TXA, n=24) that underwent RTSA for cuff tear arthropathy were retrospectively reviewed. All patients had a Hemovac drain positioned for 2 days after surgery. Hemoglobin (Hb) and hematocrit (Hct) were checked on postoperative day 2 and compared with preoperative levels. Results. Hematologic change on postoperative day 2 as determined by Hb level after surgery was statistically lower in the TXA group (2.8±0.8 versus 2.1±0.8 (mg/dL), P=0.006). Mean fall in Hct level was also significantly less in the TXA group (8.0±2.5 versus 6.1±2.6 (L/L), P=0.012). Total Hemovac drainage tended to be lower in the TXA group (263.4±129.3 versus 203.5±84.2 (ml), P=0.064). TXA was found to have no noticeable side effects. Conclusion. The use of a single intravenous dose of TXA immediately prior to RTSA reduces hematologic deterioration postoperatively and the amount of Hemovac drainage. TXA could avoid unnecessary transfusion and its associated medical side effects and cost.

scholarly journals Reverse Total Shoulder Arthroplasty as Treatment for Rotator Cuff-Tear Arthropathy and Shoulder Dislocations in an Elderly Male with Parkinson’s Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
John G. Skedros ◽  
James S. Smith ◽  
Tanner D. Langston ◽  
Micheal G. Adondakis
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Reverse Total Shoulder Arthroplasty ◽  
Cuff Tear Arthropathy ◽  
Cuff Tear ◽  
Reverse Total Shoulder

We report the case of a 70-year-old male with Parkinson’s disease (PD) and recurrent traumatic left shoulder dislocations. This case is rare because (1) he had a massive irreparable rotator cuff tear and end-stage arthritis (i.e., rotator cuff-tear arthropathy) of the same shoulder and (2) his shoulder was ultimately reconstructed with a reverse total shoulder arthroplasty (RTSA). His first dislocation occurred after a fall. Recurrent shoulder dislocations occurred despite successful closed reduction and physical therapy. Initial surgical treatment included an open capsular-labral reconstruction; RTSA was not an ideal option because of the presumed risk of failure from PD-related dyskinesias. However, the capsular-labral reconstruction failed after he lost balance and stumbled but did not fall. A RTSA was then done which restored the patient’s shoulder stability and greatly improved his pain. At final follow-up two years later, he reported pain relief and improved function. This was partially attributed to the fact that he had moved to an assisted living center. He also began using an electric wheelchair one year after the RTSA. We report this case because of the unusual set of conditions and circumstances, namely, the implantation of a RTSA in a patient with PD and shoulder instability.

scholarly journals Bilateral acromial stress fractures in a patient with a massive rotator cuff tear

2020 ◽  
Author(s):  
Du-Han Kim ◽  
Sang-Soo Na ◽  
Chung-Sin Baek ◽  
Chul-Hyun Cho
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Total Shoulder Arthroplasty ◽  
Stress Fractures ◽  
Cuff Tear Arthropathy ◽  
Posterior Angle ◽  
Massive Rotator Cuff Tear ◽  
Cuff Tear ◽  
Scapular Spine ◽  
Reverse Total Shoulder

Stress fractures of the acromion and scapular spine are well-known complications following reverse total shoulder arthroplasty. However, these fractures in patients with massive rotator cuff tear or cuff tear arthropathy are extremely rare, and the pathogenesis, clinical features, diagnosis, and treatment of these fractures are poorly understood. We report a case of bilateral stress fracture of the posterior angle of the acromion in a patient with massive rotator cuff tear and discuss the pathogenesis, clinical manifestation, and treatment with a review of the literature.

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