Shoulder & Elbow Journal Scan

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Preliminary evaluation of a robotic apparatus for the analysis of passive glenohumeral joint kinematics.

J Orthop Surg Res. 2013;8(1):24

Authors: Rosso C, Müller AM, Entezari V, Dow WA, McKenzie B, Stanton SK, Li D, Cereatti A, Ramappa AJ, Deangelis JP, Nazarian A, Della Croce U

Abstract
BACKGROUND: The shoulder has the greatest range of motion of any joint in the human body. This is due, in part, to the complex interplay between the glenohumeral (GH) joint and the scapulothoracic (ST) articulation. Currently, our ability to study shoulder kinematics is limited, because existing models isolate the GH joint and rely on manual manipulation to create motion, and have low reproducibility. Similarly, most established techniques track shoulder motion discontinuously with limited accuracy.
METHODS: To overcome these problems, we have designed a novel system in which the shoulder girdle is studied intact, incorporating both GH and ST motions. In this system, highly reproducible trajectories are created using a robotic actuator to control the intact shoulder girdle. High-speed cameras are employed to track retroreflective bone markers continuously.

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Interscalene brachial plexus block for arthroscopic shoulder surgery: a systematic review.

J Bone Joint Surg Am. 2013 Jul 17;95(14):1318-24

Authors: Hughes MS, Matava MJ, Wright RW, Brophy RH, Smith MV

PMID: 23864181 [PubMed - in process]

Read more... http://www.ncbi.nlm.nih.gov/pubmed/23864181?dopt=Abstract

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Medial scapular muscle detachment: clinical presentation and surgical treatment.

J Shoulder Elbow Surg. 2013 Jul 15;

Authors: Kibler WB, Sciascia A, Uhl T

Abstract
BACKGROUND: This study describes the clinical presentation and preliminary outcomes in a cohort of patients treated for detachment of the medial scapular stabilizing muscles.
METHODS AND METHODS: The study included 72 patients who underwent reattachment of the lower trapezius and rhomboid muscles. Patients presented with a history of a high level of medial scapular border pain during activity and inability to perform overhead or forward flexion activities. Clinical examination demonstrated palpable tenderness along the medial scapular border, palpable defect along the medial border muscles, scapular dyskinesis, decreased scapular/rotator cuff strength, and modification of symptoms by manual scapular repositioning. Surgical exploration revealed detachment of the lower trapezius muscle or rhomboid muscles, requiring muscle reattachment to the scapula. Clinical outcomes were measured by the American Shoulder and Elbow Surgeons (ASES) self-report form, with comparisons made between the overall scores and subcomponents obtained at initial evaluation, discharge from active care, and postdischarge follow-up.
RESULTS: Time from injury to treatment averaged 52 months, and time from surgery to discharge was 7.4 months. ASES scores significantly improved from initial

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Radial head fractures: indications and outcomes for radial head arthroplasty.

Orthop Clin North Am. 2013 Jul;44(3):425-31

Authors: Fowler JR, Goitz RJ

Abstract
Radial head fractures without associated bony or ligamentous injury can be safely treated with internal fixation, if possible, or arthroplasty if nonreconstructable. However, nonreconstructable radial head fractures in association with elbow dislocation and/or ligamentous injury in the elbow or forearm represent a specific subset of injuries that requires restoration of the radiocapitellar articulation for optimal function. The purpose of this article was to summarize the indications for radial head arthroplasty and discuss the reported outcomes.

PMID: 23827844 [PubMed - in process]

Read more... http://www.ncbi.nlm.nih.gov/pubmed/23827844?dopt=Abstract

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Update on the state of outcome measurement in total elbow arthroplasty research: identifying a need for consensus.

J Bone Joint Surg Am. 2013 Jul 17;95(14):e971-8

Authors: Riedel K, Beaton DE

Abstract
BACKGROUND: There is little consensus for a standard set of metrics to express outcome after total elbow arthroplasty. In order to set the stage for future work toward a core set of measurement tools, our goal was to gather a complete view of the outcomes used in total elbow arthroplasty research, the concepts of their focus, and their quality as measures of the target concept.
METHODS: We reviewed the outcome measures for total elbow arthroplasty presented in the literature from 2004 to 2011 in terms of the instruments used and their concepts of focus. We reviewed the reliability, validity, and responsiveness of the prevailing measurement tools.

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Posterior elbow wounds: soft tissue coverage options and techniques.

Orthop Clin North Am. 2013 Jul;44(3):409-17

Authors: Patel KM, Higgins JP

Abstract
Many options exist for reconstruction of the posterior elbow/olecranon area following wound formation. Careful early wound management is crucial to ensure successful outcomes following reconstruction. Local and regional options are preferred methods for soft tissue coverage in this region. Common flap options include the reversed lateral arm flap, the radial forearm flap, posterior interosseous artery flap, brachioradialis muscle flap, flexor carpi ulnaris flap, and the latissimus flap. The advantages and disadvantages of these flap options are discussed in this review.

PMID: 23827842 [PubMed - in process]

Read more... http://www.ncbi.nlm.nih.gov/pubmed/23827842?dopt=Abstract

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Reverse total shoulder arthroplasty for primary glenohumeral osteoarthritis in patients with a biconcave glenoid.

J Bone Joint Surg Am. 2013 Jul 17;95(14):1297-304

Authors: Mizuno N, Denard PJ, Raiss P, Walch G

Abstract
BACKGROUND: The biconcave glenoid in patients with primary glenohumeral osteoarthritis represents a surgical challenge because of the associated static posterior instability of the humeral head and secondary posterior glenoid erosion. The purpose of the present study was to evaluate the clinical and radiographic results of reverse total shoulder arthroplasty for the treatment of primary osteoarthritis in patients with a biconcave glenoid without rotator cuff insufficiency.

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Reverse shoulder arthroplasty.

Orthop Clin North Am. 2013 Jul;44(3):389-408

Authors: Jarrett CD, Brown BT, Schmidt CC

Abstract
The reverse shoulder arthroplasty is considered to be one of the most significant technological advancements in shoulder reconstructive surgery over the past 30 years. It is able to successfully decrease pain and improve function for patients with rotator cuff-deficient shoulders. The glenoid is transformed into a sphere that articulates with a humeral socket. The current reverse prosthesis shifts the center of rotation more medial and distal, improving the deltoid's mechanical advantage. This design has resulted in successful improvement in both active shoulder elevation and in quality of life.

PMID: 23827841 [PubMed - in process]

Read more... http://www.ncbi.nlm.nih.gov/pubmed/23827841?dopt=Abstract

Related Articles

Clinical and radiographic outcomes of total shoulder arthroplasty with bone graft for osteoarthritis with severe glenoid bone loss.

J Bone Joint Surg Am. 2013 Jul 17;95(14):1290-6

Authors: Sabesan V, Callanan M, Ho J, Iannotti JP

Abstract
BACKGROUND: Glenohumeral osteoarthritis may be associated with severe posterior glenoid bone loss and glenoid retroversion. Treatment with total shoulder arthroplasty and autologous bone graft obtained from the humeral head has been infrequently reported in the peer-reviewed literature.
METHODS: The clinical and radiographic results of primary total shoulder replacement with an all-polyethylene glenoid component and autologous humeral head graft augmentation performed by a single surgeon in thirteen consecutive patients were evaluated.