The Role of Arthroscopy in Painful Shoulder Arthroplasty: Is Revision Always Necessary?

Guild, Theodore; Kuhn, Gabrielle; Rivers, Marie; Cheski, Rebecca; Trenhaile, Scott W.; Izquierdo, Rolando

doi:10.1016/j.arthro.2020.01.045

Cited by 16 publications

(8 citation statements)

References 12 publications

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“…Guild et al. 19 described 6 cases of arthroscopy used for the treatment of subacromial impingement, adhesive capsulitis, synovitis, and acromioclavicular joint arthritis in patients after RSA. In this case series, arthroscopy alleviated pain, enhanced range of motion, and prevented revision surgery in 4 of the 6 patients.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Management of Stiffness and Anterior Shoulder Pain Following Reverse Shoulder Arthroplasty

Ardebol

Pasqualini

Hartzler³

et al. 2022

Arthroscopy Techniques

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Section: Discussionmentioning

confidence: 99%

Arthroscopic Management of Stiffness and Anterior Shoulder Pain Following Reverse Shoulder Arthroplasty

Ardebol

Pasqualini

Hartzler³

et al. 2022

Arthroscopy Techniques

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“…Danach erfolgt die Inspektion der Rotatorenmanschette. Bei persistierender Bewegungseinschränkung kann das kaudale Release in Betracht gezogen werden [ 11 , 18 ].…”

Section: Bewegungseinschränkung Und „Unklare“ Schmerzenunclassified

Revision der anatomischen Schulterprothese

Mauch

Huth

2023

Orthopädie

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ZusammenfassungMit der steigenden Anzahl der Primärprothetik nehmen die Revisionen der anatomischen Prothese einen immer höheren Stellenwert ein. Die häufigsten Revisionsgründe sind Glenoidlockerung, einschließlich Protrusion, Insuffizienz der Rotatorenmanschette, einschließlich Instabilität, und Früh‑/Spätinfekt. Der glenoidale Defektaufbau kann mit einem Autograft oder Allograft erfolgen. Er wird je nach Größe und Situation ein- oder zweizeitig durchgeführt. Die in den letzten Jahren immer häufiger eingesetzten metaphysär verankerten Prothesen und Kurzschaftprothesen haben die humerale Revision deutlich vereinfacht. Einen anderen Weg beschreiten die Plattformsysteme mit der Möglichkeit der Konversion ohne höhergradige Eingriffe am Glenoid oder Wechsel des Schaftes. Intraoperative Komplikationen treten vor allem humeral auf. Postoperative Komplikationen sind neben der Luxation die Komponentenlockerung und der Infekt. Der Wechsel einer anatomischen Prothese auf eine inverse Prothese zeigt bessere klinische Ergebnisse, sowie niedrigere Komplikationsraten als der Wechsel auf nochmals eine anatomische Prothese.

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“…Cutibacterium acnes is the most common pathogen in infected shoulder arthroplasty and may be present despite normal lab results. Aspiration can be performed and can provide valuable information, although sensitivity has been shown to be low, around 20%, when evaluating for an infection ( 3 , 15 ). Aspirate should be sent for cell count, gram stain, and culture.…”

Section: Evaluation Algorithm ( Figure 1 )mentioning

confidence: 99%

A narrative review of non-infected painful total shoulder arthroplasty: evaluation and treatment

Gabriel¹,

Tucker²,

Boin³

2023

Ann Joint

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Background and Objective The prevalence of shoulder arthroplasty has increased significantly over the past two decades outpacing both total hip and total knee arthroplasty. Total shoulder arthroplasty (TSA) has been shown to significantly improve function and pain in most patients, however, complications after shoulder arthroplasty have been reported to be greater than 10% in anatomic shoulder arthroplasty and 10–47% in reverse shoulder arthroplasty leading to a painful shoulder. As the number of performed primary shoulder arthroplasty increases, the incidence of painful total shoulders and the need for revision shoulder arthroplasty will see a similar trend. Management of post-operative shoulder arthroplasty pain and complications will be even more essential for the orthopedic surgeon in this growing population. Potential sources of pain after shoulder arthroplasty are variable and include infection, implant related complications, hematoma, nerve injury, rotator cuff failure, instability, fracture, among other less prevalent complications. Treatment options for the painful shoulder arthroplasty differ depending on the source of pain, thus early identification of the cause will lead to expedited and appropriate definitive management. The objectives of this narrative review are to highlight the common causes of pain after TSA, provide surgeons an algorithmic approach for working up the painful total shoulder, and discuss treatment options for each source of pain. Methods A database search of PubMed and Google Scholar was conducted including studies relating to painful shoulder arthroplasty evaluation, management, and treatment. Key Content and Findings This review presents an in-depth evaluation to the non-infected, painful shoulder arthroplasty, providing treatment options for each source with the goal of assisting practicing physicians in the management of painful post-operative shoulder arthroplasty. Conclusions With increasing numbers of TSA being performed, a thorough understanding of the potential complications and their treatments is essential. A systematic approach to working up the painful TSA can help identify the source of symptoms more readily. Knowledge of the common complications and their specific causes can help surgeons avoid the painful TSA. This knowledge will also help to successfully treat the painful TSA when it is inevitably encountered.

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The Role of Arthroscopy in Painful Shoulder Arthroplasty: Is Revision Always Necessary?

Cited by 16 publications

References 12 publications

Arthroscopic Management of Stiffness and Anterior Shoulder Pain Following Reverse Shoulder Arthroplasty

Arthroscopic Management of Stiffness and Anterior Shoulder Pain Following Reverse Shoulder Arthroplasty

Revision der anatomischen Schulterprothese

A narrative review of non-infected painful total shoulder arthroplasty: evaluation and treatment

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