Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Jun 2013
Proximal humerus cortical bone thickness correlates with bone mineral density and can clinically rule out osteoporosis.
Bone mineral density measurements with dual-energy x-ray absorptiometry (DXA) are commonly used to diagnose osteoporosis and assess fracture risk. This study describes the association between radiographic measures of proximal humeral cortical bone thickness and bone mineral density measured by DXA. The study also assesses the discriminative capability of clinical cortical bone thickness measurements at the proximal humerus to differentiate patients with osteoporosis. ⋯ Average cortical bone thickness measurements obtained from standard anteroposterior shoulder radiographs are correlated with DXA. Furthermore, they provide a clinically relevant, rapid, sensitive, and inexpensive method for ruling out osteoporosis.
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J Shoulder Elbow Surg · Jun 2013
Comparative StudyDistal-third clavicle fracture fixation: a biomechanical evaluation of fixation.
Approximately 25% of distal clavicle fractures are unstable. Unstable patterns have longer times to union and higher nonunion rates. Stable restoration of the distal clavicle is important in decreasing the nonunion rate in distal clavicle fractures. The purpose of this study was to biomechanically compare operative constructs for the treatment of unstable, comminuted distal-third clavicle fractures in a cadaveric model using a locking plate and coracoclavicular reconstruction. We hypothesized that the combination of coracoclavicular reconstruction and a distal clavicle locking plate is biomechanically superior to either construct used individually. ⋯ Greater fracture stability was achieved with the combination of the AC TightRope and locking clavicle plate construct than with either alone, suggesting a possibility for increased fracture-healing rates.
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J Shoulder Elbow Surg · May 2013
Midterm results of a total shoulder prosthesis fixed with a cementless glenoid component.
The aim of this study was to evaluate the midterm results and complications of a total shoulder arthroplasty implanted with a metal-backed, bone-ingrowth glenoid component. ⋯ After midterm follow-up, clinical outcomes of patients operated on with a cementless, metal-backed glenoid implant improved significantly. However, an unacceptable rate of complications and revisions was found. Glenoid loosening predominantly occurred in patients with preoperative eccentric glenoid morphology and was also related to cranial migration of the proximal humerus during the follow-up period.
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J Shoulder Elbow Surg · May 2013
The Latarjet coracoid process transfer procedure: alterations in the neurovascular structures.
The Latarjet coracoid process transfer procedure is an established, reliable treatment for glenoid deficiency associated with recurrent anterior shoulder instability, but changes in neurovascular anatomy resulting from the procedure are a concern. The purpose of our cadaveric study was to identify changes in the neurovascular anatomy after a Latarjet procedure. ⋯ The Latarjet procedure resulted in consistent and clinically significant alterations in the anatomic relationships of the musculocutaneous and axillary nerves, which may make them vulnerable to injury during revision surgery.
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J Shoulder Elbow Surg · May 2013
Randomized Controlled Trial Multicenter StudySodium hyaluronate for the treatment of chronic shoulder pain associated with glenohumeral osteoarthritis: a multicenter, randomized, double-blind, placebo-controlled trial.
Nonoperative treatments for glenohumeral osteoarthritis (GH-OA) are limited. Intra-articular therapy with sodium hyaluronate (HA) has been effective in treating OA of the knee. Therefore, we sought to evaluate the efficacy and safety of HA in treating chronic pain associated with GH-OA. ⋯ A numeric advantage, but without statistical significance, was found for HA ITT patients with GH-OA. Although data for a subset of HA patients without concomitant pathologies reached statistical significance, additional randomized trials are needed to confirm the clinical implication of this outcome.