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Revue de L'infirmiere Oct 2019During care follow-up, specifically local post-operative care, nurses closely monitor the surgical site both for healing and for local, regional or general risk of... (Review)
Review
During care follow-up, specifically local post-operative care, nurses closely monitor the surgical site both for healing and for local, regional or general risk of infection. In this context, they are on the front line of identifying and reporting any suspicious clinical conditions. We use the example of a patient who presented with textiloma following orthopaedic shoulder surgery.
Topics: Foreign Bodies; Humans; Nursing Diagnosis; Orthopedic Procedures; Postoperative Complications; Shoulder
PubMed: 31587854
DOI: 10.1016/j.revinf.2019.08.008 -
Radiologic Clinics of North America Jul 2019Shoulder girdle trauma is one of the most common injuries encountered in emergency centers. These injuries can be easily overlooked due to the complex osteology of the... (Review)
Review
Shoulder girdle trauma is one of the most common injuries encountered in emergency centers. These injuries can be easily overlooked due to the complex osteology of the shoulder. Although radiographs are usually sufficient for assessing traumatic shoulder injuries, cross-sectional imaging is sometimes indicated to assess portions of the shoulder not well visualized by radiographs. In this article, the authors review the spectrum of shoulder girdle injuries: sternoclavicular dislocations, clavicle fractures, acromioclavicular separations, shoulder dislocations, scapula fractures, and scapulothoracic dissociation. They also discuss the presentation, imaging evaluation, and classification of these injuries with emphasis on pitfalls in imaging diagnosis and indications for computed tomography/magnetic resonance.
Topics: Humans; Radiography; Shoulder; Shoulder Injuries; Tomography, X-Ray Computed
PubMed: 31076034
DOI: 10.1016/j.rcl.2019.02.013 -
Clinics in Sports Medicine Apr 2022Shoulder surgery introduces important anesthesia considerations. The interscalene nerve block is considered the gold standard regional anesthetic technique and can serve... (Review)
Review
Shoulder surgery introduces important anesthesia considerations. The interscalene nerve block is considered the gold standard regional anesthetic technique and can serve as the primary anesthetic or can be used for postoperative analgesia. Phrenic nerve blockade is a limitation of the interscalene block and various phrenic-sparing strategies and techniques have been described. Patient positioning is another important anesthetic consideration and can be associated with significant hemodynamic effects and position-related injuries.
Topics: Humans; Nerve Block; Patient Positioning; Shoulder
PubMed: 35300836
DOI: 10.1016/j.csm.2021.11.004 -
Journal of Shoulder and Elbow Surgery Apr 2023The purpose of this systematic review was to report outcomes after bilateral shoulder arthroplasty including bilateral total shoulder arthroplasty (TSA), bilateral... (Review)
Review
The purpose of this systematic review was to report outcomes after bilateral shoulder arthroplasty including bilateral total shoulder arthroplasty (TSA), bilateral reverse shoulder arthroplasty (RSA), and ipsilateral TSA with contralateral RSA (TSA/RSA). Two reviewers independently performed a PRISMA-guided systematic search using MEDLINE/PubMed, Embase, and Cochrane Database of Systematic Reviews up to May 11, 2021. The databases were queried using the following search terms: (["bilateral" OR "contralateral"] AND "shoulder" AND ["arthroplast∗" OR "replacement"]). A total of 486 titles/abstracts were screened for eligibility and 19 studies were included in the final analysis. Risk of bias was assessed using Methodological Index for Nonrandomized Studies and Modified Coleman Methodology scores. Analysis compared overall results for bilateral shoulder arthroplasty and sub-group analyses compared TSA (all shoulders from bilateral TSA patients and the TSA shoulder in TSA/RSA patients) to RSA (all shoulders from bilateral RSA patients and the RSA shoulder in TSA/RSA patients), first shoulder arthroplasty to second contralateral shoulder arthroplasty, and interval between arthroplasty (IBA) <20 months to IBA ≥20 months. Nineteen studies analyzed bilateral TSA (n = 3), bilateral RSA (n = 7), and TSA/RSA (n = 8). The mean Methodological Index for Nonrandomized Studies was 18 and mean Modified Coleman Methodology Score was 74, with 63.2% of studies demonstrating level III evidence. A total of 2729 patients (30.4% male; mean age 72.2 years, mean follow-up 47.3 months, mean IBA 20 months) were analyzed. Postoperative forward flexion (142.0° vs. 129.6°), external rotation (ER) (42.5° vs. 25.6°), and internal rotation (60% reaching T12-T8 vs 85.7% reaching L3-L1) were higher for TSA when compared to RSA. Patient reported outcome measures such as Constant-Murley (73.2 vs. 59.2), American Shoulder and Elbow Surgeons (87.9 vs. 77.7), and Single Assessment Numeric Evaluation (SANE) (86.9 vs. 67.8) were higher for TSA when compared to RSA. Patients with IBA ≥20 months demonstrated greater ER and patient satisfaction than patients with IBA <20 months. Postoperative complication rates were 15.1% for TSA and 10.6% for RSA, while reoperation and revision rates were 13.7% for TSA and 7.1% for RSA. Bilateral shoulder arthroplasty results in improvements in motion, strength, pain, function, and high satisfaction. Bilateral TSA is associated with greater improvement in motion and function than bilateral RSA but higher complication, reoperation, and revision rates. IBA ≥20 months is associated with greater ER and satisfaction than IBA <20 months.
Topics: Humans; Male; Aged; Female; Arthroplasty, Replacement, Shoulder; Shoulder Joint; Treatment Outcome; Shoulder; Patient Satisfaction; Range of Motion, Articular; Retrospective Studies
PubMed: 36567015
DOI: 10.1016/j.jse.2022.11.010 -
International Journal of Environmental... Nov 2022Tennis is an asymmetric sport characterized by a systematic repetition of specific movements that may cause disturbances in muscular strength, power, and torque. Thus,...
Tennis is an asymmetric sport characterized by a systematic repetition of specific movements that may cause disturbances in muscular strength, power, and torque. Thus, we assessed (i) the torque, power, ratio production, and bilateral asymmetries in the shoulder's external and internal rotations at 90 and 180°/s angular velocities, and (ii) the point duration influence of the above-mentioned variables. Twenty competitive tennis players performed external and internal shoulder rotations; an isokinetic evaluation was conducted of the dominant and non-dominant upper limbs before and after five and ten forehands. A higher torque production in the shoulder's internal rotations at 90 and 180°/s was observed for the dominant vs. non-dominant sides (e.g., 63.1 ± 15.6 vs. 45.9 ± 9.8% and 62.5 ± 17.3 vs. 44.0 ± 12.6% of peak torque/body mass, < 0.05). The peak torque decreased only after ten forehands (38.3 ± 15.8 vs. 38.2 ± 15.8 and 39.3 ± 16.1 vs. 38.1 ± 15.6 Nm, respectively, < 0.05), but without impacting speed or accuracy. Unilateral systematic actions of tennis players caused contralateral asymmetries, evidencing the importance of implementing compensatory training. The forehand kinematic assessment suggests that racket and wrist amplitude, as well as speed, are important success determinants in tennis.
Topics: Shoulder; Tennis; Torque; Upper Extremity; Biomechanical Phenomena; Shoulder Joint
PubMed: 36497932
DOI: 10.3390/ijerph192315857 -
Brazilian Journal of Physical Therapy 2023Shoulder injuries are associated with proprioceptive deficits. Elastic kinesiology tape (KT) is used for treating musculoskeletal disorders, including shoulder injuries,... (Review)
Review
BACKGROUND
Shoulder injuries are associated with proprioceptive deficits. Elastic kinesiology tape (KT) is used for treating musculoskeletal disorders, including shoulder injuries, as it arguably improves proprioception.
OBJECTIVE
To synthesize the evidence on the effects of elastic KT on proprioception in healthy and pathological shoulders.
METHODS
Four databases (PubMed, WoS, CINAHL, SPORTDiscus) were searched for studies that investigated the effects of elastic KT on shoulder proprioception. Outcome measures were active joint position sense (AJPS), passive joint position sense (PJPS), kinesthesia, sense of force (SoF), and sense of velocity (SoV). Risk of bias (RoB) was assessed using the Cochrane Collaboration RoB tool for randomized controlled trials (RCTs), and the ROBINS-1 for non-RCTs, while the certainty of evidence was determined using GRADE.
RESULTS
Eight studies (5 RCTs, 3 non-RCTs) were included, yielding 187 shoulders (102 healthy and 85 pathological shoulders). RoB ranged from low (2 studies), moderate (5 studies), to high (1 study). Elastic KT has a mixed effect on AJPS of healthy shoulders (n=79) (low certainty). Elastic KT improves AJPS (subacromial pain syndrome and rotator cuff tendinopathy, n=52) and PJPS (chronic hemiparetic shoulders, n=13) among pathological shoulders (very low certainty). Elastic KT has no effect on kinesthesia among individuals with subacromial pain syndrome (n=30) (very low certainty).
CONCLUSION
There is very low to low certainty of evidence that elastic KT enhances shoulder AJPS and PJPS. The aggregate of evidence is currently so low that any recommendation on the effectiveness of elastic KT on shoulder proprioception remains speculative.
Topics: Humans; Shoulder; Range of Motion, Articular; Proprioception; Shoulder Injuries; Musculoskeletal Diseases; Athletic Tape; Pain
PubMed: 37224618
DOI: 10.1016/j.bjpt.2023.100514 -
Journal of Rehabilitation Medicine Aug 2023Post-stroke shoulder pain is a serious challenge for stroke survivors. The aim of this meta-analysis was to review the literature to confirm information on structural... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Post-stroke shoulder pain is a serious challenge for stroke survivors. The aim of this meta-analysis was to review the literature to confirm information on structural changes in post-stroke shoulders detected by ultrasound examination.
METHODS
PubMed, Embase, Web of Science and ClinicalTrials.gov were searched until 7 December 2022, for studies describing shoulder sonographic findings in stroke patients. Two independent authors selected the studies, extracted the data, and performed the critical appraisal.
RESULTS
A total of 23 clinical studies were included. The most prevalent pathologies in hemiplegic shoulders pertained to the biceps long head tendon (41.4%), followed by the supraspinatus tendon (33.2%), subdeltoid bursa (29.3%), acromioclavicular joint (15.0%), and subscapularis tendon (9.2%). The common pathological findings encompassed bicipital peritendinous effusion (39.2%), biceps tendinopathy (35.5%), subdeltoid bursitis (29.3%) and supraspinatus tendinopathy (24.6%). Biceps long head tendon and supraspinatus tendon abnormalities were observed significantly more in the hemiplegic (vs contralateral) shoulders, with odds ratios of 3.814 (95% confidence interval 2.044-7.117) and 2.101 (95% confidence interval 1.257-3.512), respectively. No correlation was observed between motor function and shoulder pathology.
CONCLUSION
Ultrasonography enabled the identification of common shoulder pathologies after stroke. Further research is needed to establish the association between these changes and the clinical course of stroke patients.
Topics: Humans; Shoulder; Hemiplegia; Rotator Cuff; Tendons; Bursitis; Pain
PubMed: 37615388
DOI: 10.2340/jrm.v55.13432 -
Magnetic Resonance Imaging Clinics of... Nov 2019This article discusses the typical findings seen on conventional radiography in 3 common shoulder pathologies, namely glenohumeral instability, rotator cuff pathology,... (Review)
Review
This article discusses the typical findings seen on conventional radiography in 3 common shoulder pathologies, namely glenohumeral instability, rotator cuff pathology, and acromioclavicular joint dislocation. Correlative MR images are used to explain and illustrate the significance of radiographic findings that suggest the presence of underlying shoulder pathology.
Topics: Humans; Joint Diseases; Magnetic Resonance Imaging; Radiography; Shoulder; Shoulder Joint
PubMed: 31575394
DOI: 10.1016/j.mric.2019.07.005 -
The Journal of the American Academy of... Dec 2019The glenohumeral joint is a highly mobile, complex articulation that relies not only on the bony support between the humeral head and glenoid but also on appropriate... (Review)
Review
The glenohumeral joint is a highly mobile, complex articulation that relies not only on the bony support between the humeral head and glenoid but also on appropriate balance and tension of the surrounding soft-tissue structures. Recreating the normal anatomic relationships is a basic premise in joint arthroplasty, which can be challenging in shoulder arthroplasty, as the normal glenohumeral anatomy has considerable variation from patient to patient. Also, as the anatomy of the glenohumeral joint becomes distorted with advanced shoulder pathology, it becomes a challenge to return the shoulder to its premorbid anatomic state. Failure to restore normal anatomic parameters after shoulder arthroplasty has been shown to have deleterious effects on postoperative function and implant survival. As the recognition of this has grown, shoulder prostheses have evolved to allow for considerable more variation in an attempt to recreate patient-specific anatomy. However, understanding the progression of shoulder pathology to better predict the patient's premorbid anatomy remains limited. A thorough understanding of the premorbid and pathologic anatomy of the glenohumeral joint will aid in preoperative planning and intraoperative execution and lead to a more predictable reconstruction of the shoulder, which is critical for a successful outcome after shoulder arthroplasty.
Topics: Arthroplasty, Replacement, Shoulder; Humans; Osteoarthritis; Shoulder; Shoulder Joint
PubMed: 31206438
DOI: 10.5435/JAAOS-D-18-00414 -
Magnetic Resonance Imaging Clinics of... May 2020This article discusses the most common tumor and tumor-like lesions arising at the shoulder. Osseous tumors of the shoulder rank second in incidence to those at the knee... (Review)
Review
This article discusses the most common tumor and tumor-like lesions arising at the shoulder. Osseous tumors of the shoulder rank second in incidence to those at the knee joint and include benign osteochondromas and myeloma or primary malignant lesions, such as osteosarcoma or chondrosarcomas. Soft tissue tumors are overwhelmingly benign, with lipomas predominating, although malignant lesions, such as liposarcomas, can occur. Numerous tumor-like lesions may arise from the joints or bursae, due to either underlying arthropathy and synovitis (eg, rheumatoid arthritis and amyloid) or related to conditions, including tenosynovial giant cell tumor and synovial osteochondromatosis.
Topics: Animals; Bone Neoplasms; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Shoulder; Soft Tissue Neoplasms; Ultrasonography
PubMed: 32241665
DOI: 10.1016/j.mric.2019.12.011