Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Mar 2015
Agreement of olecranon fractures before and after the exposure to four classification systems.
Although classification systems of olecranon fractures are important to help choose the best treatment and to predict prognosis, their degree of observer agreement is poorly investigated. The objective of this study was to investigate the intraobserver and interobserver reliability of currently used classification systems for olecranon fractures. Our hypothesis is that the Colton classification presents an acceptable agreement because it is simpler to use; on the other hand, considering the AO classification's complexity, we expect it to reach a lower level of agreement. ⋯ No classification system is widely accepted because it can be affected by interobserver variability, which can raise questions about its use in a research as well as in a clinical context.
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J Shoulder Elbow Surg · Mar 2015
Comparative analysis of anatomic and reverse total shoulder arthroplasty: in-hospital outcomes and costs.
The rate of shoulder arthroplasty has continued to increase at an exponential rate during the past decade in large part owing to approval by the Food and Drug Administration of reverse shoulder arthroplasty. Whereas reverse shoulder arthroplasty has resulted in expanded surgical indications, there are numerous reports of relatively high complication rates. The increased prevalence of both anatomic and reverse shoulder arthroplasty underscores the need to elucidate whether perioperative outcomes are influenced by type of total shoulder arthroplasty. The purpose of this study was to determine the impact of shoulder arthroplasty type, anatomic or reverse, with respect to perioperative adverse events, in-hospital death, prolonged hospital stay, nonroutine disposition, and hospital charges in a nationally representative sample. ⋯ Despite the expanding indications for reverse shoulder arthroplasty, it is an independent risk factor for inpatient morbidity, mortality, and hospital costs and should perhaps be offered more judiciously and performed in the hands of appropriately trained shoulder specialists.
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J Shoulder Elbow Surg · Mar 2015
Range of motion and isometric strength of shoulder joints of team handball athletes during the playing season, Part II: changes after midseason.
Our objective was to investigate the influence of workload and consecutive changes on active range of motion and isometric strength of team handball athletes' throwing shoulders (TSs) because the available data are insufficient. ⋯ Our data verify changes and influences, such as an increasing GIRD, at the overhead TS joint in accordance with the workload during team handball season. ER gain did improve after the half-season period but did not fully compensate the GIRD at the TS.
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J Shoulder Elbow Surg · Feb 2015
Comparative StudyOutcomes after shoulder replacement: comparison between reverse and anatomic total shoulder arthroplasty.
Anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA) are increasingly common procedures employed to treat arthritic conditions. Although TSA is a widely accepted procedure for glenohumeral arthritis with intact rotator cuff, concerns about RTSA persist because of variable complication rates and outcomes. ⋯ TSA and RTSA have similar complication rates, need for revision, patient-reported outcomes, and range of motion at 2 years of follow-up. The use of side-by-side cohorts in this study allows standardized comparison between these 2 shoulder arthroplasty procedures.
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J Shoulder Elbow Surg · Feb 2015
Analysis of perioperative morbidity and mortality in shoulder arthroplasty patients with preexisting alcohol use disorders.
Shoulder arthroplasty is becoming increasingly popular in the United States. Given the high prevalence of alcohol abuse and its implications in postoperative morbidity and the increasing incidence of shoulder arthroplasty, it is prudent to explore the effect of alcohol use disorders (AUDs) in this patient population. In this study, we considered numerous outcome variables, including perioperative complications, in-hospital death, prolonged hospital stay, and nonroutine discharge. ⋯ Patients undergoing shoulder arthroplasty with a preexisting AUD have a greater likelihood of perioperative complications and health care resource utilization after shoulder arthroplasty. Presurgical alcohol screening may prove effective in identifying at-risk patients, and providing interventions before surgery may effectively limit the complication profile.