Recent experience in total shoulder replacement.

Neer, Charles S.; Watson, K. C.; Stanton, F J

doi:10.2106/00004623-198264030-00001

Cited by 1,088 publications

(488 citation statements)

References 0 publications

Supporting

Mentioning

452

Contrasting

Unclassified

Order By: Relevance

“…The Neer score [5] was excellent in one, satisfactory in six, and unsatisfactory in five cases. The reason for an unsatisfactory result was the result of resection arthroplasty for deep infection in two cases and lack of motion in three cases.…”

Section: Resultsmentioning

confidence: 85%

“…Of the 12 patients, nine were seen by us (RHC, JWS) in followup and three were contacted by telephone. Pain was graded by the patients preoperatively and postoperatively on a scale ranging from one to five as previously published by Neer et al [5] and Cofield [3] in which no pain is graded as one point, slight pain as two points, pain after unusual activities as three points, moderate pain as four points, and severe pain as five points. Range of motion in active forward elevation and external rotation were recorded in degrees, and internal rotation was graded by the posterior spinal segment that the patient could reach with the thumb.…”

Section: Methodsmentioning

confidence: 99%

“…The Neer rating system [5] was used to grade the functional result after revision arthroplasty. To be considered as having an excellent result, patients had to have no or slight pain, had to be satisfied with their results, had to have at least 140°of active forward elevation, and at least 45°of external rotation.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Infection Associated With Hematoma Formation After Shoulder Arthroplasty

Cheung

Sperling

Cofield

2008

Clinical Orthopaedics &Amp; Related Research

129

View full text Add to dashboard Cite

Hematoma formation requiring operative treatment after shoulder arthroplasty may be associated with higher patient morbidity. We therefore determined whether there was an association of hematoma formation requiring operative treatment with deep infection after shoulder arthroplasty. Between 1978 and 2006, we performed 4147 shoulder arthroplasties in 3643 patients. Of these, 12 shoulders (0.3%) underwent reoperation for hematoma formation. The mean time interval from arthroplasty to surgery for the hematoma was 7 days (range, 0.5-31 days). Among nine cases in which cultures were taken, six had positive cultures; the organisms included Propionibacterium acnes in three, Staphylococcus epidermidis in one, Streptococcus species in one, and Staphylococcus epidermidis with Peptostreptococcus in one. The minimum followup was 12 months (mean, 68 months; range, 12 to 294 months

show abstract

Section: Resultsmentioning

confidence: 85%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Infection Associated With Hematoma Formation After Shoulder Arthroplasty

Cheung

Sperling

Cofield

2008

Clinical Orthopaedics &Amp; Related Research

129

View full text Add to dashboard Cite

show abstract

“…Periprosthetic fractures associated with anatomic shoulder arthroplasty are relatively uncommon, with an incidence between 0.6% and 3% [1,6,8,9,12,15,18,19,[24][25][26].…”

Section: Introductionmentioning

confidence: 99%

What Are Risk Factors for Intraoperative Humerus Fractures During Revision Reverse Shoulder Arthroplasty and Do They Influence Outcomes?

Wagner

Houdek

Elhassan

et al. 2015

Clin Orthop Relat Res

View full text Add to dashboard Cite

Background With the increase in shoulder arthroplasty rates, the number of perioperative complications, such as periprosthetic fractures, continues to be a rise; however, the risk factors and incidence of intraoperative complications, such as fractures, during revision reverse shoulder arthroplasty are not well established. Questions/purposes We evaluated patients receiving a reverse shoulder arthroplasty to determine (1) the frequency and characteristics of intraoperative humerus fractures, (2) the risk factors for fracture, (3) the complications associated with treatment of fractures, and (4) clinical and functional outcomes after treatment. Methods Using one institution's total joint registry, we performed a retrospective analysis of medical records of 224 patients (230 shoulders) who underwent revision surgery to reverse shoulder arthroplasty, from 2005 to 2012, for failed total shoulder arthroplasty. Reverse shoulder arthroplasty was used when there was a deficient rotator cuff, prior instability, or deficient glenoid bone stock. Intraoperative periprosthetic humerus fractures occurred in 36 shoulders (16%) (36 patients). The clinical outcome analysis included 29 patients with a minimum 2-year clinical followup (mean followup, 3.1 years; range, 2.0À6.3 years). The control group consisted of 188 patients (194 shoulders), and it was used for risk-factor calculation; whereas only 150 patients (154 shoulders) in the control group had a minimum 2-year followup, and thus only 150 patients (154 shoulders) made up the comparators (controls) for outcome-analysis comparisons. Risk factors were assessed using univariate analysis with odds ratios (OR), whereas implant survival and complications were assessed using the Kaplan-Meier method. Results Three displaced and 33 nondisplaced fractures occurred during revision reverse total shoulder arthroplasties. Most of the fractures (81%) occurred during component removal of cemented (n = 11) and cementless (n = 25) components. Intraoperative fractures only were treated with stabilization of the prosthetic stem in 28 patients, while adjunctive internal fixation was used in eight patients. Risk of intraoperative periprosthetic fractures was increased by factors including female sex (n =18 women; OR, 2.41; range, 1.11À5.68; p = 0.03); history of instability (n = 27; OR, 2.65; range, 1.18À5.93; p = 0.02); and prior hemiarthroplasty (n = 22; OR, 2.34; range, 1.13À4.84; p = 0.03). There were two postoperative fractures in patients who had an intraoperative fracture and both were treated nonoperatively. Overall, three (8%) revision procedures were performed in patients with intraoperative fractures, with 2-and 5-year survivorship estimates of 94% and 85%, respectively, compared with 89% and 84%, respectively for patients without an intraoperative fracture (p = 0.45). At latest followup, patients

show abstract

“…In a review of his series dating from 1973 to 1981, Neer [35,36] acknowledged outcomes of arthroplasty were poorer when the rotator cuff was not functional. He initially explored constrained designs, believing this would obviate the need for reconstruction of the rotator cuff.…”

Section: Rotator Cuff and Constraint In Total Shoulder Arthroplastymentioning

confidence: 99%

A History of Reverse Total Shoulder Arthroplasty

Flatow

Harrison

2011

Clinical Orthopaedics &Amp; Related Research

183

108

View full text Add to dashboard Cite

Background Management of the cuff-deficient arthritic shoulder has long been challenging. Early unconstrained shoulder arthroplasty systems were associated with high complication and implant failure rates. The evolution toward the modern reverse shoulder arthroplasty includes many variables of constrained shoulder arthroplasty designs. Questions/purposes This review explores the development of reverse shoulder arthroplasty, specifically describing (1) the evolution of reverse shoulder arthroplasty designs, (2) the biomechanical variations in the evolution of this arthroplasty, and (3) the current issues relevant to reverse shoulder arthroplasty today. Methods Using a PubMed search, the literature was explored for articles addressing reverse shoulder arthroplasty, focusing on those papers with historical context. Results Results of the early designs were apparently poor, although they were not subjected to rigorous clinical research and usually reported only in secondary literature. We identified a trend of glenoid component failure in the early reverse designs. This trend was recognized and reported by authors as the reverse shoulder evolved.Authors reported greater pain relief and better function in reverse shoulder arthroplasty with the fundamental change of Grammont's design (moving the center of rotation medially and distally). However, current reports suggest lingering concerns and challenges with today's designs. Conclusions The history of reverse shoulder arthroplasty involves the designs of many forward-thinking surgeons. Many of these highly constrained systems failed, although more recent designs have demonstrated improved longevity and implant performance. Reverse shoulder arthroplasty requires ongoing study, with challenges and controversies remaining around present-day designs.

show abstract

Recent experience in total shoulder replacement.

Cited by 1,088 publications

References 0 publications

Infection Associated With Hematoma Formation After Shoulder Arthroplasty

Infection Associated With Hematoma Formation After Shoulder Arthroplasty

What Are Risk Factors for Intraoperative Humerus Fractures During Revision Reverse Shoulder Arthroplasty and Do They Influence Outcomes?

A History of Reverse Total Shoulder Arthroplasty

Contact Info

Product

Resources

About