Backside polyethylene wear in reverse shoulder arthroplasty

Nicholson, Allen D.; Mathew, Joshua I.; Koch, Chelsea N.; Kontaxis, Andreas; Wright, Timothy M.; Taylor, Samuel A.; Blaine, Theodore A.; Dines, Joshua S.; Dines, David M.; Fu, Michael C.; Warren, Russell F.; Gulotta, Lawrence V.

doi:10.1016/j.jse.2021.09.002

Cited by 3 publications

(3 citation statements)

References 35 publications

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“…However, only two of the included studies reported effect size. 9,10 The chi-square test for trends, which can also provide valuable information in the examination of non-statistically significant findings by detecting dose-response effects associated with a variable, was not reported in any of the included articles. It is worth acknowledging, however, that, in most (76.5%) of the articles, the lack of statistical significance of the trend statement was explicitly acknowledged.…”

Section: Discussionmentioning

confidence: 99%

“Trend” Statement Use in the Orthopaedic Literature

Luzzi,

Czerwonka,

Rogalski

et al. 2024

J Am Acad Orthop Surg

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Introduction: For research to effectively guide clinical decision making, appropriate interpretation of data is paramount. The P-value is a useful tool for guiding the interpretation of data. However, despite its utility, the P-value is not without limitations. Of particular concern is the use of “trend statements” to describe non-statistically significant findings, a practice which introduces subjectivity and variability into data interpretation and can lead to the drawing of undue conclusions. Methods: An audit of original research articles published from January 2022 to December 2022 in four high-impact orthopaedic journals was conducted. The selected journals were queried to identify instances in which a non-statistically significant result was labeled as a “trend.” The use of trend statements and associated information was recorded and analyzed. Results: One thousand two hundred sixty articles were included in the analysis. 81 articles (6.4%) included a trend statement to describe a non-statistically significant result. Only two articles (2.5%) formally defined what constituted a trend. In 28.8% of cases, the associated P-value was > 0.10. Discussion: Trend statements are used to describe non-statistically significant findings with moderate frequency in the orthopaedic literature. Given the potentially misleading effects of trend statements, efforts should be made to mitigate their use. If trend statements are to be used, attention should be paid to defining what constitutes a “trend”, explicitly acknowledging the lack of statistical significance of the finding to which the trend statement refers, and avoiding drawing undue conclusions from non-statistically significant data.

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Section: Discussionmentioning

confidence: 99%

“Trend” Statement Use in the Orthopaedic Literature

Luzzi,

Czerwonka,

Rogalski

et al. 2024

J Am Acad Orthop Surg

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“…Often, polyethylene wear without overt implant loosening will present with pain and loss of motion. Plain radiographs may show indirect evidence of polyethylene wear with lucencies around the implants due to inflammatory-induced osteolysis 23 (Figure 2). A joint aspiration may show an increase in inflammatory cells, specifically monocytes.…”

Section: Polyethylene Wearmentioning

confidence: 99%

“…24 At an average of 16 months (10 days to 88 months) after the index procedure, 21 retrieved humeral polyethylene liners from rTSA were examined using light microscopy, and all 21 showed articular-sided damage and 20 showed backside wear as well. 23 Polyethylene wear does seem to be more common after rTSA compared with aTSA, and this was quantified by Terrier et al 25 who used a mathematical musculoskeletal model to determine that, after 1 year of use, the polyethylene volumetric wear was 8.4 mm 3 for aTSA and 44.6 mm 3 for rTSA. In rTSA, increased lateralization reduces the risk of scapular impingement and also likely the rate of polyethylene wear.…”

Section: Polyethylene Wearmentioning

confidence: 99%

Evaluation of the Painful Total Shoulder Arthroplasty

Burrus

Werner

Menendez

et al. 2023

J Am Acad Orthop Surg

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Despite the overall success of anatomic and reverse total shoulder arthroplasties (aTSA and rTSA), some patients continue to have or develop pain postoperatively. As the number of shoulder arthroplasties continues to increase in the United States, it is important that surgeons are able to recognize, diagnose, and treat the various pathologies. Some painful etiologies are specific to either aTSA or rTSA, and others can occur with both implant types. Infections, stiffness, neurologic syndromes, polyethylene wear, aseptic implant loosening, and metal allergies occur, regardless of implant choice. However, after an aTSA, subscapularis repair failure, superior rotator cuff tear, and joint overstuffing can result in shoulder pain. After a rTSA, specific causes of postoperative pain include instability, scapular notching, acromial or scapular spine fractures, subcoracoid pain, and neurologic injury. Regardless of the diagnosis, the surgeon must be methodical in the evaluation and, when appropriate, use blood work, advanced imaging studies, joint aspirations, shoulder arthroscopy, and nerve studies. Once diagnosed, appropriate treatment should be undertaken to resolve the cause of the pain or at least minimize the effect of the pain on the patient's outcome.

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