Shoulder/Elbow News

BOSTON — Patients who underwent arthroscopic shoulder stabilization with knotless anchors had outcomes similar to patients who had traditional knotted anchors, according to a presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting. In addition, investigators found all-suture-based anchors may be correlated with lower redislocation rates.

Published results showed high and equivalent rates of sporting, clinical and radiographic outcomes between patients who underwent hemiarthroplasty with concentric reaming and patients who underwent anatomical total shoulder arthroplasty.

In the past decade, published research has identified an increase in shoulder arthroplasty procedures performed in the United States. Some orthopedic surgeons associate this increase with the approval of reverse total shoulder arthroplasty by the FDA in 2004.

Anatomic TSA has been used to improve function and decrease pain in patients with shoulder arthritis since about 1970. Modern reverse shoulder arthroplasty was developed and introduced in Europe in the late 1980s due to disappointing results of anatomic shoulder arthroplasty in patients with shoulder arthritis and massive rotator cuff tears. The success of reverse shoulder arthroplasty in this patient population has led to the expansion of the indications for reverse replacement to include shoulder arthritis with an intact cuff, especially with substantial glenoid bone deformity. Despite this expansion, anatomic arthroplasty remains the procedure of choice for patients with shoulder arthritis, an intact rotator cuff and mild to moderate glenoid deformity. The return of motion, especially internal rotation, is better with anatomic replacement. In addition, the infection rates of 1% vs.1.5% to 2% and dislocation rates of 1% vs. 1.5% to 2% are lower with anatomic replacement, multiple sources reported. Finally, stress fractures of the scapular spine and acromion are unique to reverse TSA (3% to 11%) and usually result in permanent decrease in function and an increase in pain. Reverse TSA, therefore, is currently reserved for patients with substantial rotator cuff dysfunction and/or severe glenoid deformity. Advances in surgical technique and technology will improve the results of both anatomic and reverse TSA, but anatomic arthroplasty will likely remain the procedure of choice for many patients with shoulder arthritis.

BOSTON — According to a presenter at the American Orthopaedic Society for Sports Medicine Annual Meeting, time had a significant impact on rotator cuff tear size progression from preoperative MRI-measured dimensions to dimensions taken at the time of repair.

Recently published results showed a survival rate of 97.4% at 8 years with a specific reverse shoulder arthroplasty prosthesis.

Published results showed the American Shoulder and Elbow Surgeons computerized adaptive testing system is reliable for assessing outcomes in patients undergoing shoulder surgery and can be used interchangeably with the full ASES instrument.

EFORT Open Reviews is the new open access journal from EFORT and Bone & Joint Publishing. All articles are free to read online with no subscription required.

Published results showed collegiate athletes experienced more upper extremity injuries and missed days due to upper extremity injury when they had a history of upper extremity surgery prior to collegiate athletics.

Published results showed operative costs were associated with most short-term costs in shoulder arthroplasty.