The medium- and long-term outcome of total shoulder arthroplasty for primary glenohumeral osteoarthritis in middle-aged patients

2017 ◽  
Vol 99-B (7) ◽  
pp. 939-943 ◽  
Author(s):  
B. Sowa ◽  
M. Bochenek ◽  
M. Bülhoff ◽  
F. Zeifang ◽  
M. Loew ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Middle Aged ◽  
Aged Patients ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Glenohumeral Osteoarthritis

scholarly journals Clinical Course, Serologic Response, and Long-Term Outcome in Elderly Patients with Early Lyme Borreliosis

2018 ◽  
Vol 7 (12) ◽  
pp. 506 ◽  
Author(s):  
Katarina Boršič ◽  
Rok Blagus ◽  
Tjaša Cerar ◽  
Franc Strle ◽  
Daša Stupica
Keyword(s):  
Lyme Borreliosis ◽  
Older Patients ◽  
Erythema Migrans ◽  
Middle Aged ◽  
Patient Age ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Incomplete Response ◽  
Patient Âgé

Infected elderly people often present with signs and symptoms that differ from those in younger adults, but data on the association between patient age and presentation of early Lyme borreliosis (LB) are limited. In this study, the association between patient age (18–44 years, young vs. 45–64 years, middle-aged vs. ≥ 65 years, elderly) and disease course, microbiologic characteristics, and the long-term outcome of treatment was investigated prospectively in 1220 adult patients with early LB manifesting as erythema migrans (EM) at a single-center university hospital. Patients were assessed at enrolment and followed-up for 12 months. Age was associated with comorbidities, previous LB, presenting with multiple EM, and seropositivity to borreliae at enrolment. The time to resolution of EM after starting antibiotic treatment was longer in older patients. At 12 months, 59/989 (6.0%) patients showed incomplete response. The odds for incomplete response decreased with time from enrolment (odds ratio (OR) of 0.49, 0.50, and 0.48 for 2-month vs. 14-days, 6-month vs. 2-month, and 12-month vs. 6-month follow-up visits, respectively), but were higher with advancing age (OR 1.57 for middle-aged vs. young, and 1.95 for elderly vs. young), in women (OR 1.41, 95% confidence interval (CI) 1.01–1.96), in patients who reported LB-associated constitutional symptoms at enrolment (OR 7.69, 95% CI 5.39–10.97), and in those who presented with disseminated disease (OR 1.65, 95% CI 1.09–2.51). The long-term outcome of EM was excellent in patients of all age groups. However, older patients had slower resolution of EM and higher odds for an unfavorable outcome of treatment (OR 1.57, 95% CI 1.05–2.34 for middle-aged vs. young; and OR 1.95, 95% CI 1.14–3.32 for elderly vs. young), manifested predominantly as post-LB symptoms. The presence of LB-associated constitutional symptoms at enrolment was the strongest predictor of incomplete response.

One-year community-based education program for hypercholesterolemia in middle-aged Japanese: a long-term outcome at 8-year follow-up

2002 ◽  
Vol 164 (1) ◽  
pp. 195-202 ◽  
Author(s):  
Hiroyasu Iso ◽  
Hironori Imano ◽  
Yuko Nakagawa ◽  
Masahiko Kiyama ◽  
Akihiko Kitamura ◽  
...  
Keyword(s):  
Education Program ◽  
Middle Aged ◽  
Community Based ◽  
Term Outcome ◽  
Community Based Education ◽  
Long Term Outcome ◽  
One Year

scholarly journals EARLY AND LONG-TERM OUTCOME OF SURGICAL RESECTION FOR GASTRIC CARCINOMA IN AGED PATIENTS

1991 ◽  
Vol 52 (6) ◽  
pp. 1225-1230
Author(s):  
Eiji KANEHIRA ◽  
Yukimitsu KAWAURA ◽  
Yasuhiko OHTA ◽  
Ichirou NAKANO
Keyword(s):  
Gastric Carcinoma ◽  
Surgical Resection ◽  
Aged Patients ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals TOTAL SHOULDER ARTHROPLASTY, AN OVERVIEW, INDICATINS AND PROSTHETIC OPTIONS

2020 ◽  
Vol 73 (9) ◽  
pp. 1870-1873
Author(s):  
Mateusz Wicha ◽  
Agnieszka Tomczyk-Warunek ◽  
Jaromir Jarecki ◽  
Anna Dubiel
Keyword(s):  
Shoulder Arthroplasty ◽  
Humeral Head ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Shoulder Function ◽  
Long Term Result ◽  
Glenohumeral Osteoarthritis ◽  
Hip Arthroplasties ◽  
Reverse Total Shoulder

Shoulder arthroplasty (SA) has improved significantly over the last twenty years. It offers the effective treatment for patients with severe shoulder dysfunctions. The indications for this procedure have recently expanded tremendously. However, the most common are glenohumeral osteoarthritis, inflammatory shoulder arthropathies, rotator cuff-tear arthropathy, complex fractures of the proximal humerus and osteonecrosis of a humeral head. There is range of the procedures, such as resurfacing of humeral head, anatomic total shoulder arthroplasty, hemiarthroplasty and reverse shoulder arthroplasty. All of them could significantly improve patients quality of life. The outcomes of the shoulder arthroplasty are very satisfying in terms of pain relief and considerable improvements in shoulder function as well as in motion. However, this procedure is not so popular as knee or hip arthroplasties. The reasons for this phenomenon are not clear. The complication rate is considerably low. The most common are periprosthetic fractures, infections, implant loosening and instability. The reasonable solution is a conversion to reverse total shoulder arthroplasty. The survivorship of the prosthesis is up to 12 years, which is acceptable by patients. Long term result are still not clear. Surgeons performing SA opt for deltopectoral approach which provides good exposure of the joint also for revisions. The aim: To summarize knowledge about SA based on current literature.

scholarly journals Shoulder arthroplasty in dwarfism: A case report of pseudoachondroplasia with 17-year follow-up

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Gregory Gasbarro ◽  
Joseph W. Galvin ◽  
Alexander Prete ◽  
Ameen Barghi ◽  
Aisha Obeidallah ◽  
...  
Keyword(s):  
Case Report ◽  
Shoulder Arthroplasty ◽  
Preoperative Planning ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Shoulder Hemiarthroplasty ◽  
Long Term Outcome ◽  
Glenoid Dysplasia

The purpose of this case report is to report the long-term outcome following shoulder hemiarthroplasty in a patient with dwarfism. A 60-year old female with pseudoachondroplasia dwarfism presented 17 years post-operative with a Subjective Shoulder Value of 90% and minimal pain. Custom designed implants were critical for surgical success. Preoperative planning with a CT scan was important in assessing glenoid dysplasia and determining the feasibility of glenoid resurfacing. The emergence of 3D CT virtual preoperative planning tools can further assist in the recognition of deformity to determine if custom designed implants are needed. Shoulder arthroplasty in dwarfism can lead to excellent long-term outcomes.

scholarly journals Survivorship and Patient-Reported Outcomes After Comprehensive Arthroscopic Management of Glenohumeral Osteoarthritis: Minimum 10-Year Follow-up

2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0021
Author(s):  
Justin Arner ◽  
Bryant Elrick ◽  
Philip Nolte ◽  
Marilee Horan ◽  
Peter Millett ◽  
...  
Keyword(s):  
Risk Factors ◽  
Shoulder Arthroplasty ◽  
Patient Reported Outcomes ◽  
Total Shoulder Arthroplasty ◽  
Arthroscopic Management ◽  
Kaplan Meier ◽  
Patient Reported ◽  
Glenohumeral Osteoarthritis

Objectives: Glenohumeral osteoarthritis (GHOA) remains a common cause of shoulder pain, loss of shoulder range of motion, and upper extremity dysfunction. Few long-term outcome studies exist evaluating glenohumeral osteoarthritis (GHOA) treatment with arthroscopic management. The purpose of this study was to determine outcomes, risk factors for failure, and survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA at minimum 10-year follow-up. It was hypothesized that while some patients would progress to total shoulder arthroplasty (TSA), the majority of patients would demonstrate sustained improvement in patient-reported outcomes and satisfaction without conversion to TSA at long term follow-up. Methods: The CAM procedure was performed on a consecutive series of patients with advanced GHOA who opted for joint preservation surgery that otherwise met criteria for total shoulder arthroplasty (TSA). At minimum 10-year follow-up, pre- and post-operative outcome measures collected included the American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH), Short Form–12 (SF-12) Physical Component Summary (PCS), visual analog scale for pain, and satisfaction scores. Kaplan-Meier survivorship analysis was performed with failure defined as progression to arthroplasty. Results: Thirty-eight CAM procedures were performed with 10-year minimum follow-up (range, 10-14 years) with a mean age of 53 years (range, 27-68) at time of surgery. Kaplan Meier survivorship curve showing 75.3% CAM survivorship (Comprehensive Arthroscopic Management) for glenohumeral arthritis at 5 years and 63.2% at 10 years in Figure 1. Those who progressed to arthroplasty did so at a mean of 4.7 years (range, 0.8-9.6 years). For those who did not undergo arthroplasty, ASES scores significantly improved post-operatively at both 5 and 10 years (63.3-89.6, p<0.001; 63.3-80.6, p=.007) (Table 1). CAM failure was associated with severe pre-operative humeral head incongruity in 93.8% of failures compared to 50.0.% of patients who did not go onto arthroplasty (p= 0.008). Median satisfaction was 7.5 out of 10. Conclusions: Significant improvement in patient reported outcomes were sustained at minimum 10-year follow-up in young patients with GHOA who underwent a CAM procedure. Survivorship rate at minimum 10-year follow-up was 63.2%. Humeral head flattening and severe joint incongruity were risk factors for CAM failure. The CAM procedure is an effective joint preserving treatment for GHOA in appropriately selected patients with sustained positive outcomes at 10 years. [Table: see text]

scholarly journals The clinical outcome of the different HemiCAP and UniCAP knee implants: A systematic and comprehensive review

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Michael-Alexander Malahias ◽  
Dimitrios Chytas ◽  
Fritz Thorey
Keyword(s):  
Systematic Reviews ◽  
Cartilage Defects ◽  
Failure Rates ◽  
Middle Aged ◽  
Aged Patients ◽  
Term Outcome ◽  
Number Of Patients ◽  
Pubmed Database

The focal metallic cartilage resurfacing is a surgical method that offers an appropriate step between the biological techniques and arthroplasty in middle-aged patients with full-thickness cartilage defects. The advantages of this technique are that it addresses the defect, respects healthy tissues and provides stability and contoured surface similar to a full arthroplasty. A systematic review was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers (MM and DC) independently conducted the search using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews (CDSR). These databases were searched for the terms hemicap knee implant and unicap knee implant and knee focal metallic implant. From the initial 21 studies that were evaluated, 10 were eligible for analysis. Considering both the HemiCAP focal implant and the HemiCap® Wave patellofemoral prosthesis, we found a lack of mid- to long-term clinical outcomes in well-designed prospective clinical studies. No Level I or II studies were found, while the limited number of patients who were included undermines the overall clinical results of these studies. The progression of osteoarthritis, the persisting pain and the subsequent high revision or failure rates in the limited available studies with long-term follow-up, seem to be the major drawbacks of these partial resurfacing techniques. Utilization of partial resurfacing for femoral or patellofemoral compartments results in good short-term outcome for middle-aged patients as a step between biological technique and total knee arthroplasty. The surgeon should be cognizant and also notify the patient of the high failure rates that are reported in the literature in mid- to longterm follow-up and ultimately, the decision to perform partial resurfacing should be taken by both the patient and the orthopedic surgeon.

scholarly journals Long-Term Outcome of Rockwood Capsular Shift for Recurrent Shoulder Dislocation

2016 ◽  
Vol 24 (3) ◽  
pp. 392-397 ◽  
Author(s):  
Luigi Murena ◽  
Nicola Guindani ◽  
Stefano Turino ◽  
Federico A Grassi ◽  
Paolo Cherubino
Keyword(s):  
Shoulder Dislocation ◽  
Recurrent Dislocation ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Capsular Shift ◽  
Shoulder Range Of Motion ◽  
Recurrent Shoulder Dislocation ◽  
Glenohumeral Osteoarthritis

Purpose To review the long-term outcome of Rockwood capsular shift for recurrent shoulder dislocation secondary to trauma. Methods Records of 30 males and 4 females who underwent Rockwood capsular shift for recurrent (≥2 episodes) anterior shoulder dislocation were reviewed. An additional Bankart repair with different techniques was performed in 24 of the patients by 2 different surgeons. The outcome was assessed using the Western Ontario Shoulder Instability Index (WOSI) and the Western Ontario Osteoarthritis of the Shoulder (WOOS) index questionnaires, the modified Rowe score, and the Constant-Murley score. Shoulder range of motion (ROM) was measured. Degenerative joint changes were evaluated on radiographs. Results During a mean follow-up of 13 (range, 10–16) years, 6 (18%) patients had a mean of 1.2 recurrent dislocations. Four of the patients reported a traumatic event during recurrent dislocation. Of the 6 patients, 3 had undergone a Bankart lesion repair. Better Rowe and adjusted Constant scores were associated with lower age at first dislocation, at the index surgical procedure, and at follow-up. Four patients developed glenohumeral osteoarthritis: 2 were mild or moderate and 2 were severe and symptomatic. Glenohumeral osteoarthritis was associated with follow-up duration (p=0.03) and poorer Rowe score (p=0.012), adjusted Constant score (p=0.001), and WOOS score (p=0.006). Conclusion Rockwood capsular shift can preserve shoulder ROM, with rates of recurrent dislocation and degenerative joint changes comparable with other techniques.

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