Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Sep 2011
Do less medialized reverse shoulder prostheses increase motion and reduce notching?
Cuff tear arthropathy is the primary indication for total reverse shoulder arthroplasty. In patients with pseudoparalytic shoulders secondary to irreparable rotator cuff tear, reverse shoulder arthroplasty allows restoration of active anterior elevation and painless shoulder. High rates of glenoid notching have also been reported. We designed a new reverse shoulder arthroplasty with a center of rotation more lateral than the Delta prosthesis to address this problem. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Sep 2011
Can reverse shoulder arthroplasty be used with few complications in rheumatoid arthritis?
Many patients with rheumatoid arthritis develop superior migration of the humeral head because of massive cuff tears, causing loss of active motion. Reverse shoulder arthroplasty could potentially restore biomechanical balance but a high incidence of glenoid failure has been reported. These studies do not, however, typically include many patients with rheumatoid arthritis (RA) and it is unclear whether the failure rates are similar. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Sep 2011
Does norepinephrine influence pain behavior mediated by dorsal root ganglia?: a pilot study.
Postganglionic neurons in the sympathetic nervous system reportedly are involved in lumbar radicular pain and release norepinephrine (NE), a neurotransmitter. Increased numbers of sympathetic nerve fibers have been found in dorsal root ganglion (DRG) neurons in a root constriction model. Whether this is a reasonable model for pain, however, is unclear ⋯ An α(2)-antagonist may be an appropriate agent for trials to treat lumbar radicular pain.
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Clin. Orthop. Relat. Res. · Sep 2011
A complication-based learning curve from 200 reverse shoulder arthroplasties.
Reported early complication rates in reverse total shoulder arthroplasty have widely varied from 0% to 75% in part due to a lack of standard inclusion criteria. In addition, it is unclear whether revision arthroplasty is associated with a higher rate of complications than primary arthroplasty. ⋯ Level IV, therapeutic study. See the guidelines online for a complete description of level of evidence.
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Clin. Orthop. Relat. Res. · Sep 2011
Multicenter StudyRelationships of the lateral femoral cutaneous nerve to bony landmarks.
The lateral femoral cutaneous nerve (LFCN) can be at risk during, for example, the insertion of pins in the anterior superior iliac spine (ASIS) during external fixation of the pelvis, total hip arthroplasty through a direct anterior approach, open surgery for impingement in the hip through an anterior approach, and periacetabular osteotomy. During surgery, the surgeon usually assumes the location of the LFCN by using the ASIS as a landmark. ⋯ The LFCN may emerge from the lateral border of the psoas major above or below the IC. The AC/AB ratio can help surgeons to find the LFCN in patients with different body types.