Shoulder/Elbow News

The type of infectious organism, patient factors and timing of a revision procedure play critical roles in appropriate treatment of infection after shoulder arthroplasty, according to a presenter.

Regardless of approach or technique, results published in The American Journal of Sports Medicine showed an overall low rate of serious complications in the surgical repair of distal biceps tendon ruptures. However, higher rates of posterior interosseous nerve palsy, heterotopic bone formation and reoperation were found with the double-incision technique.

Despite inferior baseline patient-reported outcomes, patients who underwent rotator cuff repair with concomitant biceps procedure had greater improvement in outcomes at 1-year postoperatively compared with patients who underwent rotator cuff repair alone, according to results.

Results published in Arthroscopy showed patients with a higher median weight and BMI who underwent arthroscopic shoulder surgery had an increased risk of developing lateral femoral cutaneous nerve palsy.

Wright Medical Group N.V. has acquired IMASCAP SAS, a developer of software-based solutions for preoperative planning of shoulder replacement surgery.

Investigators found perioperative gabapentin compared with placebo did not impact the time to postoperative pain resolution. However, gabapentin did have a “modest” impact on opioid cessation in patients who underwent surgery.

Despite concerns about reverse shoulder arthroplasty in younger patients, the procedure has been shown to restore function and improve pain in advanced cases of severe rotator cuff deficiency with associated arthritis and/or bone loss, as well as complex fractures and fracture dislocations, according to a presenter at the American Orthopaedic Society for Sports Medicine Annual Meeting.

Posterior instability is less common than anterior shoulder instability, encompassing approximately 10% of all shoulder instability in young active patients. The etiology of posterior instability is most commonly traumatic dislocation or subluxation that damages the posterior labrum, posterior inferior glenohumeral ligament, and/or the bony glenoid rim (posterior bony Bankart lesion). Traumatic posterior shoulder instability or dislocation is typically seen when a posteriorly directed force is applied to a flexed adducted and internally rotated limb, which forces the humeral head posteriorly. Atraumatic chronic posterior instability is found notably in patients who frequently perform activities with repetitive posterior-directed forces, such as weight lifters or football linemen.

A 16-year-old male hockey player was checked into the boards and sustained an isolated left scapula injury. He had no past medical history and no prior injury, deformity or pain to the left shoulder or scapula. On examination, he was noted to have significant deformity of the left scapula with prominence of the inferior angle, which resulted in the clinical appearance of winging of the scapula. There was associated ecchymosis and tenderness to palpation of the scapular body. The left shoulder had mild to moderate discomfort with active and passive motion, which was full. He had no concomitant injury and was neurovascularly intact to the left upper extremity.

Although both anatomic total shoulder arthroplasty and reverse total shoulder arthroplasty improved patient outcomes at 2-year follow-up, anatomic total shoulder arthroplasty more reliably improved range of motion, according to results.