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Pesquisa : E04.555.110.110.299 [Categoria DeCS]
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[PMID]:29201302
[Au] Autor:Padegimas EM; Narzikul A; Lawrence C; Hendy BA; Abboud JA; Ramsey ML; Williams GR; Namdari S
[Ad] Endereço:Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
[Ti] Título:Antibiotic Spacers in Shoulder Arthroplasty: Comparison of Stemmed and Stemless Implants.
[So] Source:Clin Orthop Surg;9(4):489-496, 2017 Dec.
[Is] ISSN:2005-4408
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Background: Antibiotic spacers in shoulder periprosthetic joint infection deliver antibiotics locally and provide temporary stability. The purpose of this study was to evaluate differences between stemmed and stemless spacers. Methods: All spacers placed from 2011 to 2013 were identified. Stemless spacers were made by creating a spherical ball of cement placed in the joint space. Stemmed spacers had some portion in the humeral canal. Operative time, complications, reimplantation, reinfection, and range of motion were analyzed. Results: There were 37 spacers placed: 22 were stemless and 15 were stemmed. The stemless spacer population was older (70.9 ± 7.8 years vs. 62.8 ± 8.4 years, = 0.006). The groups had a similar percentage of each gender (stemless group, 45% male vs. stemmed group, 40% male; = 0.742), body mass index (stemless group, 29.1 ± 6.4 kg/m vs. stemmed group, 31.5 ± 8.3 kg/m ; = 0.354) and Charlson Comorbidity Index (stemless group, 4.2 ± 1.2 vs. stemmed group, 4.2 ± 1.7; = 0.958). Operative time was similar (stemless group, 127.5 ± 37.1 minutes vs. stemmed group, 130.5 ± 39.4 minutes). Two stemless group patients had self-resolving radial nerve palsies. Within the stemless group, 15 of 22 (68.2%) underwent reimplantation with 14 of 15 having forward elevation of 109° ± 23°. Within the stemmed group, 12 of 15 (80.0%, = 0.427) underwent reimplantation with 8 of 12 having forward elevation of 94° ± 43° (range, 30° to 150°; = 0.300). Two stemmed group patients had axillary nerve palsies, one of which self-resolved but the other did not. One patient sustained dislocation of reverse shoulder arthroplasty after reimplantation. One stemless group patient required an open reduction and glenosphere exchange of dislocated reverse shoulder arthroplasty at 6 weeks after reimplantation. Conclusions: Stemmed and stemless spacers had similar clinical outcomes. When analyzing all antibiotic spacers, over 70% were converted to revision arthroplasties. The results of this study do not suggest superiority of either stemmed or stemless antibiotic spacers.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Artroplastia do Ombro/efeitos adversos
Infecções Relacionadas à Prótese/tratamento farmacológico
Prótese de Ombro/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Hemiartroplastia/efeitos adversos
Seres Humanos
Masculino
Meia-Idade
Duração da Cirurgia
Infecções Relacionadas à Prótese/microbiologia
Infecções Relacionadas à Prótese/cirurgia
Amplitude de Movimento Articular
Reoperação
Estudos Retrospectivos
Articulação do Ombro/fisiopatologia
Tobramicina/administração & dosagem
Vancomicina/administração & dosagem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 6Q205EH1VU (Vancomycin); VZ8RRZ51VK (Tobramycin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.4055/cios.2017.9.4.489


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[PMID]:28742777
[Au] Autor:Mueller KG; Memtsoudis SG; Mariano ER; Baker LC; Mackey S; Sun EC
[Ad] Endereço:From *Duke University, Durham, North Carolina; †Department of Anesthesiology, Hospital for Special Surgery, New York, New York; ‡Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford University, California; §Anesthesiology and Perioperative Care Service, Veterans Affairs, Palo Alto Health Care System, Palo Alto, California; ‖Department of Health Research and Policy, Stanford University School of Medicine, Stanford University, Stanford, California; and ¶National Bureau of Economic Research, Cambridge, Massachusetts.
[Ti] Título:Lack of Association Between the Use of Nerve Blockade and the Risk of Persistent Opioid Use Among Patients Undergoing Shoulder Arthroplasty: Evidence From the Marketscan Database.
[So] Source:Anesth Analg;125(3):1014-1020, 2017 09.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Persistent opioid use following surgery has received increasing attention from policymakers, researchers, and clinicians. Perioperative nerve blockade has been hypothesized to decrease the risk of persistent opioid use. We examined whether nerve blockade was associated with a decreased risk of persistent opioid use among patients undergoing shoulder arthroplasty, a procedure with high rates of persistent postoperative pain. METHODS: Using health care claims data, we constructed a sample of 6695 patients undergoing shoulder arthroplasty between 2002 and 2012 and used billing data to identify the utilization of nerve blockade. We then used a multivariable logistic regression to estimate the association between nerve blockade and 2 measures of opioid use: having filled at least 1 prescription for an opioid between postoperative days (PODs) 0 and 90, and between POD 91 and 365. This regression adjusted for a variety of potential confounders, such as preoperative opioid use and medical history. RESULTS: There was no association between nerve blockade and our 2 measures of persistent opioid use: adjusted odds ratio, 1.12 (97.5% confidence interval, 0.939-1.34; P = .15) for opioid use between POD 0 and 90, and adjusted odds ratio, 0.997 (97.5% confidence interval, 0.875-1.14; P = .95) for opioid use between POD 91 and 365. CONCLUSIONS: Although the use of perioperative nerve blockade may offer short-term benefits, in this study, it was not associated with a reduction in the risk of persistent opioid use for patients undergoing shoulder arthroplasty.
[Mh] Termos MeSH primário: Artroplastia do Ombro/tendências
Bases de Dados Factuais/tendências
Bloqueio Nervoso/tendências
Transtornos Relacionados ao Uso de Opioides/prevenção & controle
Dor Pós-Operatória/prevenção & controle
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Masculino
Meia-Idade
Transtornos Relacionados ao Uso de Opioides/diagnóstico
Transtornos Relacionados ao Uso de Opioides/epidemiologia
Dor Pós-Operatória/diagnóstico
Dor Pós-Operatória/epidemiologia
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/prevenção & controle
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002031


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[PMID]:29257012
[Au] Autor:Sanchez-Sotelo J; Wagner ER; Sim FH; Houdek MT
[Ad] Endereço:Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
[Ti] Título:Allograft-Prosthetic Composite Reconstruction for Massive Proximal Humeral Bone Loss in Reverse Shoulder Arthroplasty.
[So] Source:J Bone Joint Surg Am;99(24):2069-2076, 2017 Dec 20.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Reverse total shoulder arthroplasty (RTSA) performed in the setting of massive proximal humeral bone loss often requires special reconstructive techniques. Restoration of the proximal part of the humerus with an allograft provides a number of theoretical benefits, including implant support, restoration of humeral length, deltoid tensioning, and an opportunity to repair the posterior aspect of the cuff to improve strength in external rotation and repair of the subscapularis to improve stability. However, reverse allograft-prosthesis composites (APCs) are costly, are technically demanding to use, and can be compromised by progressive allograft resorption. METHODS: Between 2005 and 2012, the lead author used an APC reconstruction in 8 primary and 18 revision RTSAs (26 patients; mean age, 62 years; mean body mass index, 27.9 kg/m). The indications for the primary RTSAs included severe proximal humeral bone loss after trauma (n = 5) and tumor resection (n = 3). The indications in the revision setting were failed hemiarthroplasty (n = 11), anatomic total shoulder arthroplasty (n = 4), and reverse arthroplasty (n = 3). The most common reason for revision was instability (n = 10). A compression plate was used for graft-to-host fixation in all shoulders. Shoulders were assessed for pain, motion, American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST) score, Neer score, revision or reoperation, radiographic evidence of graft union or resorption, and implant fixation. The mean duration of follow-up was 4 years (range, 2 to 10 years). RESULTS: RTSA using an APC construct resulted in substantial improvements in pain scores (p < 0.0001), elevation (p < 0.0001), and external rotation (p = 0.004). With the numbers available, there were no significant differences in clinical outcomes between primary and revision cases. No patients required revision surgery for nonunion at the host-allograft junction. The mean time to union was 7 months, with 1 patient requiring bone-grafting for delayed union. Other complications included dislocation, deep infection, graft fracture, and periprosthetic fracture distal to the previous APC construct in 1 patient each. The 2 and 5-year revision-free survival rate was 96%. CONCLUSIONS: Reconstruction of proximal humeral bone loss with an APC at the time of primary or revision RTSA is safe and effective, with acceptable functional outcomes and complication rates. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Artroplastia do Ombro/efeitos adversos
Reabsorção Óssea/diagnóstico por imagem
Transplante Ósseo/métodos
Instabilidade Articular/prevenção & controle
Articulação do Ombro/diagnóstico por imagem
Prótese de Ombro
[Mh] Termos MeSH secundário: Adulto
Idoso
Artroplastia do Ombro/métodos
Reabsorção Óssea/fisiopatologia
Reabsorção Óssea/cirurgia
Estudos de Coortes
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Desenho de Prótese
Recuperação de Função Fisiológica/fisiologia
Reoperação/métodos
Estudos Retrospectivos
Medição de Risco
Articulação do Ombro/fisiopatologia
Articulação do Ombro/cirurgia
Transplante Homólogo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.01495


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[PMID]:29206789
[Au] Autor:Somerson JS; Matsen FA
[Ad] Endereço:The University of Texas Medical Branch, Galveston, Texas.
[Ti] Título:Functional Outcomes of the Ream-and-Run Shoulder Arthroplasty: A Concise Follow-up of a Previous Report.
[So] Source:J Bone Joint Surg Am;99(23):1999-2003, 2017 Dec 06.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We previously reported the results at an average of 4.5 years after treatment of 176 patients with the ream-and-run arthroplasty. In the present study, we present the patient self-reported functional outcomes and clinical implant survival of the original cohort at a mean of 10 years (range, 5 to 16 years). Twenty-eight (16%) of the 176 patients had a subsequent procedure, 11 (6%) died, and 30 (17%) had <5 years of follow-up. The Simple Shoulder Test (SST) score at the time of the latest follow-up was a median of 11 points (interquartile range, 9 to 12 points) and a mean (and standard deviation) of 10 ± 2.6 points, out of a possible 12 points. The present study demonstrates that the improvement in function and comfort derived from the ream-and-run procedure can be sustained at the time of mid-term follow-up. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Artroplastia do Ombro/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Avaliação da Deficiência
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Recuperação de Função Fisiológica
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171208
[Lr] Data última revisão:
171208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.17.00201


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[PMID]:29040126
[Au] Autor:Ernstbrunner L; Suter A; Catanzaro S; Rahm S; Gerber C
[Ad] Endereço:1Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
[Ti] Título:Reverse Total Shoulder Arthroplasty for Massive, Irreparable Rotator Cuff Tears Before the Age of 60 Years: Long-Term Results.
[So] Source:J Bone Joint Surg Am;99(20):1721-1729, 2017 Oct 18.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There has been serious concern regarding the longevity and durability of outcomes of reverse total shoulder arthroplasty (RTSA) in younger patients. It was the purpose of this study to analyze long-term outcomes and complications of RTSA for irreparable rotator cuff tears in patients younger than 60 years. METHODS: Twenty patients (23 shoulders) with a mean age of 57 years (range, 47 to 59 years) were evaluated at a mean of 11.7 years (range, 8 to 19 years) after RTSA. Fifteen shoulders (65%) had undergone previous non-arthroplasty surgery. Longitudinal clinical and radiographic outcomes were assessed. RESULTS: At the time of final follow-up, the mean absolute and relative preoperative Constant score (CS) (and standard deviation) had improved from 24 ± 9 to 59 ± 19 points (p < 0.001) and from 29% ± 11% to 69% ± 21% (p < 0.001), respectively. The mean Subjective Shoulder Value (SSV) had increased from 20% ± 13% to 71% ± 27% (p < 0.001). There were also significant improvements in the mean active anterior elevation (from 64° to 117°), active abduction (from 58° to 111°), pain scores, and strength (all p ≤ 0.001). Clinical outcomes did not significantly deteriorate beyond 10 years and the functional results of patients with previous surgical procedures were not significantly inferior to the results of those with primary RTSA. The grade of, and number of patients with, radiographically apparent notching increased over time; the mean relative CS was lower in patients in whom the notching was grade 2 or higher (57%) than it was in those with no or grade-1 notching (81%; p = 0.006). Nine (39%) had ≥1 complication, with 2 failed RTSAs (9%). CONCLUSIONS: RTSA in patients younger than 60 years leads to substantial subjective and functional improvement without clinical deterioration beyond 10 years. It is associated with a substantial complication rate, and complications compromise ultimate subjective and objective outcomes. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Artroplastia do Ombro/métodos
Lesões do Manguito Rotador/cirurgia
[Mh] Termos MeSH secundário: Fatores Etários
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Radiografia
Recuperação de Função Fisiológica
Estudos Retrospectivos
Lesões do Manguito Rotador/diagnóstico por imagem
Lesões do Manguito Rotador/patologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171018
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.17.00095


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[PMID]:28953626
[Au] Autor:Cao X; Pan F
[Ad] Endereço:aDepartment of Anesthesiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University bDepartment of Anesthesiology and Pain Medicine, Peking University People's Hospital, Peking University, Beijing, China.
[Ti] Título:Comparison of liposomal bupivacaine infiltration versus interscalene nerve block for pain control in total shoulder arthroplasty: A meta-analysis of randomized control trails.
[So] Source:Medicine (Baltimore);96(39):e8079, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This meta-analysis aimed to compare the efficiency and safety of liposomal bupivacaine infiltration and interscalene nerve block for pain control after total shoulder arthroplasty. METHODS: A systematic search was performed in Medline (1966 to May 2017), PubMed (1966 to May 2017), Embase (1980 to May 2017), ScienceDirect (1985 to May 2017) and the Cochrane Library. Only randomized controlled trials (RCTs) were included. Reported surgical outcomes, including visual analogue scale (VAS) scores, opioid consumption, length of stay, and postoperative adverse effects including the risk of nausea and vomiting. Meta-analysis was performed using Stata 11.0 software. RESULTS: Four RCTs including 510 patients met the inclusion criteria. The present meta-analysis indicated that there were no significant differences between groups in terms of VAS score at 12 hours (standard mean difference [SMD] = 0.272, 95% CI: -0.150 to 0.695, P = .207), 24 hours (SMD = -0.056, 95% CI: -0.458 to 0.346, P = 0.785), and 48 hours (SMD = 0.183, 95% CI: -0.148 to 0.513, P = .278). Liposomal bupivacaine infiltration groups required an equivalent amount of opioids at postoperative 12 hours (SMD = -0.039, 95% CI: -0.222 to 0.143, P = .672), 24 hours (SMD = 0.046, 95% CI: -0.136 to 0.228, P = .618) and 48 hours (SMD = -0.025, 95% CI: -0.207 to 0.157, P = .785). CONCLUSION: Liposomal bupivacaine infiltration provides equivalent postoperative pain control compared with interscalene nerve block following total shoulder arthroplasty. Both of them can reduce the consumption of opioids without severe adverse effects. More high-quality RCTs with long follow-up period are necessary for proper comparisons of the efficacy and safety of liposomal bupivacaine infiltration with interscalene nerve block.
[Mh] Termos MeSH primário: Anestésicos Locais/uso terapêutico
Artroplastia do Ombro/efeitos adversos
Bupivacaína/uso terapêutico
Bloqueio Nervoso/métodos
Dor Pós-Operatória/prevenção & controle
[Mh] Termos MeSH secundário: Analgésicos Opioides/efeitos adversos
Analgésicos Opioides/uso terapêutico
Anestésicos Locais/efeitos adversos
Bupivacaína/efeitos adversos
Seres Humanos
Tempo de Internação
Músculos do Pescoço
Bloqueio Nervoso/efeitos adversos
Medição da Dor
Náusea e Vômito Pós-Operatório/diagnóstico
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Analgesics, Opioid); 0 (Anesthetics, Local); Y8335394RO (Bupivacaine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008079


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[PMID]:28906369
[Au] Autor:He J; Wang XE; Yuan GH; Zhang LH
[Ad] Endereço:aDepartment of Neurology, Shandong Provincial Qianfoshan Hospital, Shandong University bSurgical Department, Jinan Infectious Diseases Hospital, Jinan cDepartment of Anesthesiology, Shouguang City People's Hospital, Shouguang City, Shandong dEmergency Department, Zaozhuang Municipal Hospital, Zaozhuang, China.
[Ti] Título:The efficacy of tranexamic acid in reducing blood loss in total shoulder arthroplasty: A meta-analysis.
[So] Source:Medicine (Baltimore);96(37):e7880, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The purpose of this meta-analysis is to compare the efficacy of tranexamic acid (TXA) versus placebo after a total shoulder arthroplasty (TSA). METHODS: In April 2017, a systematic computer-based search was conducted in the databases of PubMed, Embase, Web of Science, Cochrane Library, and Google. Studies comparing TXA versus placebo in reducing blood loss after TSA were included. The endpoints were the need for transfusion, blood loss in drainage, hemoglobin drop, and total blood loss. Stata 12.0 software was used for the meta-analysis. RESULTS: Six studies involving a total of 637 patients met the inclusion criteria. The meta-analysis revealed that, compared with control groups, treatment with TXA could decrease the need for transfusion (P < .00001), blood loss in drainage (P = .000), hemoglobin drop (P = .001), and total blood loss (P = .000). CONCLUSION: TXA can decrease the need for transfusion as well as total blood loss in TSA patients. There was a negative correlation between the TXA dose and the need for transfusion and blood loss in drainage. Because the administration route and the dose of TXA were different, more studies are needed in order to identify the optimal dose and route.
[Mh] Termos MeSH primário: Antifibrinolíticos/uso terapêutico
Artroplastia do Ombro
Perda Sanguínea Cirúrgica/prevenção & controle
Ácido Tranexâmico/uso terapêutico
[Mh] Termos MeSH secundário: Seres Humanos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Antifibrinolytic Agents); 6T84R30KC1 (Tranexamic Acid)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007880


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[PMID]:28880117
[Au] Autor:Lübbeke A; Rees JL; Barea C; Combescure C; Carr AJ; Silman AJ
[Ad] Endereço:a Division of Orthopaedic Surgery and Traumatology , Geneva University Hospitals , Geneva , Switzerland.
[Ti] Título:International variation in shoulder arthroplasty.
[So] Source:Acta Orthop;88(6):592-599, 2017 Dec.
[Is] ISSN:1745-3682
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background and purpose - The number of shoulder registries increases. We assessed international trends in use of shoulder arthroplasty, and described the current state of procedure selection and outcome presentation as documented in national and regional joint registries. Methods - Published reports from 9 population-based shoulder arthroplasty registries (country/region: Norway, Sweden, New Zealand, Denmark, California, Australia, Emilia-Romagna, Germany, and United Kingdom) were analyzed. Data were extracted on age, sex, disease indication, type of surgical procedure, surgical volume, and outcomes. Results - Shoulder arthroplasty incidence rate in 2012 was 20 procedures/10 population with a 6-fold variation between the highest (Germany) and lowest (United Kingdom) country. The annual incidence rate increased 2.8-fold in the past decade. Within the indications osteoarthritis, fracture, and cuff-tear arthropathy variations in procedure choice between registries were large. Outcomes evaluation focused on revision in all registries, but different measures and strata were used. Only Australia provided revision rates for prosthesis brands stratified by both indication and procedure. Finally, in 2 registries with available data surgeons performed on average 10-11 procedures yearly. Interpretation - Annual incidence rates of shoulder arthroplasty have almost tripled over the past decade. There is wide variation in procedure selection for the major indications, a low average surgeon volume, a substantial number of brands with small annual volume, and large variation in outcome presentation. The internationally increasing registry activity is an excellent basis for improving the so far weak evidence in shoulder arthroplasty.
[Mh] Termos MeSH primário: Artroplastia do Ombro/estatística & dados numéricos
Osteoartrite/epidemiologia
Sistema de Registros
Articulação do Ombro
[Mh] Termos MeSH secundário: Idoso
Conjuntos de Dados como Assunto
Feminino
Saúde Global
Seres Humanos
Incidência
Masculino
Osteoartrite/cirurgia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170908
[St] Status:MEDLINE
[do] DOI:10.1080/17453674.2017.1368884


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[PMID]:28872528
[Au] Autor:Iannotti JP; Jun BJ; Patterson TE; Ricchetti ET
[Ad] Endereço:1Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.
[Ti] Título:Quantitative Measurement of Osseous Pathology in Advanced Glenohumeral Osteoarthritis.
[So] Source:J Bone Joint Surg Am;99(17):1460-1468, 2017 Sep 06.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Osteoarthritis of the glenohumeral joint has typical patterns of deformity as described by Walch et al. However, more severe glenoid pathology may be difficult to classify. The purpose of this study was to use 3-dimensional computed tomography (3-D CT) imaging analysis to define common pathologic subtypes that can be differentiated from the current Walch classification. METHODS: We performed quantitative measurements of premorbid and pathologic anatomy using preoperative 3-D CT scans from 155 cases of advanced glenohumeral osteoarthritis that underwent anatomic or reverse total shoulder arthroplasty. We defined premorbid glenohumeral anatomy on the basis of previously validated methods using 3-D glenoid vault and humeral best-fit circle models including the premorbid glenoid version, joint-line medialization, and humeral-glenoid alignment (HGA). We determined the anatomic features that differentiate new glenoid morphologic subtypes from the existing Walch classification both qualitatively and quantitatively. RESULTS: We defined 2 new glenoid subtypes (B3 and C2) for which the glenoid pathology and humeral alignment were not defined in the original Walch classification. The B3 glenoid has high pathologic retroversion, normal premorbid version, and acquired central and posterior bone loss that, on average, is greater than that of the B2 glenoid. The C2 glenoid is dysplastic with high pathologic retroversion, high premorbid version, and acquired posterior bone loss, giving it the appearance of a biconcave glenoid with posterior translation of the humeral head. This C2 glenoid can be confused with the B2 glenoid. CONCLUSIONS: The B3 and C2 patterns have qualitative and quantitative differences that may result in different clinical outcomes than classic B2 or C types; therefore, our findings suggest that these new subtypes should be included in a new or modified classification system.
[Mh] Termos MeSH primário: Osteoartrite/diagnóstico por imagem
Osteoartrite/patologia
Articulação do Ombro/diagnóstico por imagem
Articulação do Ombro/patologia
[Mh] Termos MeSH secundário: Artroplastia do Ombro
Estudos de Coortes
Cavidade Glenoide
Seres Humanos
Imagem Tridimensional
Osteoartrite/classificação
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170906
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.00869


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[PMID]:28860399
[Au] Autor:Swarup I; Henn CM; Nguyen JT; Dines DM; Craig EV; Warren RF; Gulotta LV; Henn RF
[Ad] Endereço:Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA.
[Ti] Título:Effect of pre-operative expectations on the outcomes following total shoulder arthroplasty.
[So] Source:Bone Joint J;99-B(9):1190-1196, 2017 09.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Few studies have evaluated the relationship between patients' pre-operative expectations and the outcome of orthopaedic procedures. Our aim was to determine the effect of expectations on the outcome after primary anatomical total shoulder arthroplasty (TSA). We hypothesised that patients with greater expectations would have better outcomes. PATIENTS AND METHODS: Patients undergoing primary anatomical TSA completed the Hospital for Special Surgery's Shoulder Expectations Survey pre-operatively. The American Shoulder and Elbow Surgeons (ASES), Shoulder Activity Scale (SAS), Short-Form-36 (SF-36), and visual analogue scale (VAS) for pain, fatigue, and general health scores were also collected pre-operatively and two years post-operatively. Pearson correlations were used to assess the relationship between the number of expectations and the outcomes. Differences in outcomes between those with higher and lower levels of expectations for each expectation were assessed by independent samples -test. Multivariable linear regression analysis was used to control for potential confounding factors. RESULTS: A total of 67 patients were evaluated two years post-operatively. Most parameters of outcome improved significantly from baseline and most patients were satisfied. A greater number of expectations was associated with a significantly greater improvement in the ASES score (p = 0.02). In the multivariable analysis, a greater number of expectations was an independent predictor of better ASES, VAS and SF-36 scores, as well as improvements in ASES and VAS pain scores (p < 0.05). Greater expectations for many specific expectation questions were significantly associated with better outcomes (p < 0.05). CONCLUSION: TSA is a successful procedure with significant improvements in outcome, and greater pre-operative expectations are associated with better outcomes. Cite this article: 2017;99-B:1190-6.
[Mh] Termos MeSH primário: Artroplastia do Ombro/psicologia
Satisfação do Paciente
[Mh] Termos MeSH secundário: Adulto
Avaliação da Deficiência
Feminino
Seres Humanos
Masculino
Medição da Dor
Sistema de Registros
Estudos Retrospectivos
Inquéritos e Questionários
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170902
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B9.BJJ-2016-1263.R1



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