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Bulletin of the Hospital For Joint... 2013Glenoid wear is common in the setting of shoulder arthritis. Severe glenoid erosion presents a serious challenge to the surgeon performing a shoulder arthroplasty. This... (Review)
Review
Glenoid wear is common in the setting of shoulder arthritis. Severe glenoid erosion presents a serious challenge to the surgeon performing a shoulder arthroplasty. This paper presents the various classification schemes for glenoid erosion. The results of the six main treatment options for shoulder arthroplasty with an eroded glenoid are reviewed. The six treatment options include: 1. eccentric reaming, 2. bone grafting, 3. use of inset glenoid, 4. use of an augmented (asymmetric) glenoid component, 5. hemiarthroplasty, and 6. reverse shoulder arthroplasty. A treatment algorithm is proposed based on the amount of glenoid erosion. Severe glenoid wear resulting in the need for shoulder replacement surgery is a challenge; however, new tools for dealing with this complicated entity are rapidly evolving, including the use of augmented anatomic glenoid components and reverse shoulder arthroplasty with augmented baseplates.
Topics: Arthritis; Arthroplasty, Replacement; Glenoid Cavity; Humans; Shoulder Joint; Treatment Outcome
PubMed: 24328580
DOI: No ID Found -
Acta Ortopedica Mexicana 2015
Review
Topics: Arthroplasty, Replacement; Humans; Joint Prosthesis; Prosthesis Design; Shoulder Joint
PubMed: 26999928
DOI: No ID Found -
Archives of Pathology & Laboratory... Dec 2021The incidence, distribution, and significance of calcium pyrophosphate dihydrate deposition (CPPD) disease have not been extensively compared among various total joint...
CONTEXT.—
The incidence, distribution, and significance of calcium pyrophosphate dihydrate deposition (CPPD) disease have not been extensively compared among various total joint resections.
OBJECTIVE.—
To investigate and define the clinical and pathologic features of CPPD in hip, shoulder, and knee arthroplasties.
DESIGN.—
We retrospectively reviewed consecutive total hip, knee, and shoulder arthroplasty cases (N = 3195) confirmed pathologically between January 1, 2017, and October 10, 2018, comparing clinical and pathologic data.
RESULTS.—
Among 2004 hip arthroplasties, 61 (3%) had CPPD on pathologic examination; the majority had a histologic diagnosis of osteoarthritis, followed by fracture and avascular necrosis. Of 1113 knee arthroplasties, 98 (9%) had CPPD; all had a histologic diagnosis of osteoarthritis. Among 78 shoulder arthroplasties, 10 (13%) had CPPD; all but one had a histologic diagnosis of osteoarthritis. Patients with hip and knee CPPD were significantly older than those without CPPD. Of the 169 pathologically detected CPPD cases, only 35 (21%) were documented on preoperative radiologic images or by other clinical means; radiology reports were significantly more likely to document chondrocalcinosis in the knees than in the hips. Histologically, CPPD was noted almost exclusively in the separately submitted soft tissues/joint capsule, concomitantly involving the articular cartilage surface in only 3.0% (5 of 169) of cases.
CONCLUSIONS.—
Calcium pyrophosphate dihydrate deposition is more than twice as likely to occur in the knees and shoulders compared with the hips. Patients with CPPD in the knees or hips are usually not recognized preoperatively/radiologically and constitute a significantly older population. Reliably establishing the diagnosis of CPPD requires pathologic examination of the submitted soft tissue/joint capsule.
Topics: Arthroplasty; Calcium Pyrophosphate; Humans; Incidence; Knee Joint; Retrospective Studies; Shoulder Joint
PubMed: 33720299
DOI: 10.5858/arpa.2020-0594-OA -
Clinical Orthopaedics and Related... Sep 2011Scapular notching is a unique complication of Grammont-style reverse total shoulder arthroplasty. While reverse total shoulder arthroplasty has revolutionized the... (Review)
Review
BACKGROUND
Scapular notching is a unique complication of Grammont-style reverse total shoulder arthroplasty. While reverse total shoulder arthroplasty has revolutionized the treatment of pseudoparalysis secondary to cuff tear arthropathy, the implications of scapular notching with regard to patient function and implant stability remain unclear.
QUESTIONS/PURPOSES
We reviewed literature to determine the etiology and incidence, radiographic progression and effect on implant stability, relationship with postoperative function, and risk factors for the development of scapular notching.
METHODS
We reviewed PubMed, the Cochrane Central Register of Controlled Trials, and EMBASE with the terms "reverse total shoulder arthroplasty" and "scapular notching." Inclusion criteria were a level of evidence of IV (or better). Twenty-four articles were selected after manual review.
RESULTS
Scapular notching after reverse total shoulder arthroplasty is due to repetitive contact between the polyethylene of the humeral component and the inferior scapular neck during adduction, leading to erosion of the scapular neck, polyethylene wear, joint inflammation, and potential implant loosening. Scapular notching appears between 6 and 14 months postoperatively, with an incidence of 44% to 96%. Radiographic progression and effect on patient function remain controversial. Predictors of scapular notching include surgical approach, glenoid wear, preoperative diagnosis, infraspinatus muscle quality, cranial-caudal positioning, and tilt of the glenosphere.
CONCLUSIONS
Improved understanding of the etiology and risk factors for scapular notching will lead to refinement in implant technology and surgical technique that may translate into improved patient function and implant longevity for Grammont-style reverse total shoulder arthroplasty.
Topics: Arthroplasty, Replacement; Biomechanical Phenomena; Humans; Joint Prosthesis; Muscle Strength; Postoperative Complications; Prosthesis Design; Radiography; Range of Motion, Articular; Recovery of Function; Risk Assessment; Risk Factors; Scapula; Shoulder Joint; Time Factors; Treatment Outcome
PubMed: 21128030
DOI: 10.1007/s11999-010-1720-y -
BMC Musculoskeletal Disorders Jan 2023To evaluate the shoulder anatomical characteristics in asymptomatic Chinese adults.
BACKGROUND
To evaluate the shoulder anatomical characteristics in asymptomatic Chinese adults.
METHODS
The prospective study enrolled individuals without shoulder pain at Beijing Tiantan Hospital Affiliated to Capital Medical University between January 2019 and January 2020. Six radiographic parameters were measured and analyzed, including glenoid plane to the acromion (GA), glenoid plane to the lateral aspect of the humeral head (GH), acromion index (AI), lateral acromial angle (LAA), acromion-humeral interval (AHI), and critical shoulder angle (CSA).
RESULTS
103 participants (51 males and 52 females) were enrolled. The mean values of GA, GH, AI, CSA, LAA, and AHI were 32.88 ± 5.68 mm, 47.16 ± 4.82 mm, 0.70 ± 0.11, 37.45 ± 6.00°, 6.32 ± 3.99°, and 9.611.86 mm, respectively. Females had lower GA (30.78 ± 5.06 vs. 35.01 ± 5.51 mm, P < 0.001) and GH (44.28 ± 3.67 vs. 50.11 ± 4.02 mm, P < 0.001) than males and LAA was significantly smaller in the Bigliani flat type compared with the curved type and the hooked type (5.07 ± 2.31° vs 12.33 ± 5.46°vs 10.00 ± 3.37, P = 0.001).
CONCLUSIONS
Females had lower GA and GH than males in asymptomatic Chinese Han adults. Asymptomatic Chinese Han subjects with Bigliani flat type had lower LAA. CSA appears lager in Chinese Han individuals. Curve type of acromion performed lager LAA. The results may help establish an anatomical model of the shoulder joint and elucidate the anatomy features of the shoulder joint in asymptomatic Chinese Han adults.
Topics: Male; Female; Adult; Humans; Shoulder Joint; Rotator Cuff Injuries; Prospective Studies; East Asian People; Shoulder; Acromion
PubMed: 36709290
DOI: 10.1186/s12891-023-06172-9 -
Journal of Anatomy Mar 2018Although several studies have been published regarding the morphology and anatomical variations of the human shoulder joint, most have dealt with adult individuals....
Although several studies have been published regarding the morphology and anatomical variations of the human shoulder joint, most have dealt with adult individuals. Those looking into the development of the joint have been focused on specific structures or have observed specimens in advanced gestational stages. The goal of this paper is to perform a complete analysis of the embryonic and early fetal development of the elements in the shoulder joint, and to clarify some contradictory data in the literature. In our study, serial sections of 32 human embryos (Carnegie stages 16-23) and 26 fetuses (9-13 weeks) were analyzed. The chondrogenic anlagen of the humerus and the medial border of the scapula can be observed from as early as Carnegie stage 17, whereas that of the rest of the scapula appears at stage 18. The osteogenic process begins in week 10 for the humeral head and week 11 for the scapula. At stage 19 the interzone becomes apparent, which will form the glenohumeral joint. In the next stage the glenohumeral joint will begin delaminating and exhibiting a looser central band. Denser lateral bands will join the humeral head (caput humeri) and the margins of the articular surface of the scapula, thus forming the glenoid labrum, which can be fully appreciated by stage 22. In 24-mm embryos (stage 21) we can observe, for the first time, the long head of the biceps tendon (which is already inserted in the glenoid labrum by week 9), and the intertubercular sulcus, whose depth is apparent since week 12. Regarding ligamentous structures, the coracohumeral ligament is observed at the end of Carnegie stage 23, whereas the primitive glenohumeral ligament already appeared in week 10. The results of this study provide a detailed description of the morphogenesis, origin and chronological order of appearance of the main intrinsic structures of the human shoulder joint during late embryonic and early fetal development. We expect these results to help explain several functional aspects of the shoulder joint, and to clarify some contradictory data in the literature regarding this complex anatomical and biomechanical structure, helping future researchers in their efforts.
Topics: Embryo, Mammalian; Fetus; Humans; Shoulder Joint
PubMed: 29193070
DOI: 10.1111/joa.12753 -
Singapore Medical Journal Sep 2010Of all the joints in the human body, the shoulder has the greatest range of motion. This allows complex movements and functions to be carried out, and is of vital... (Review)
Review
Of all the joints in the human body, the shoulder has the greatest range of motion. This allows complex movements and functions to be carried out, and is of vital importance to the activities of daily living and work. Any restriction or pain that involves the joint puts a huge amount of strain on patients, especially those who are in their most productive years of life. Frozen shoulder, a frequently encountered disorder of the shoulder, has been well recognised since the early 1900s. Although benign, it has great impact on the quality of life of patients. This article aims to provide an overview of the nature and the widely accepted management of this condition based on other studies.
Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Arthroscopy; Electric Stimulation Therapy; Female; Humans; Inflammation; Joint Diseases; Male; Middle Aged; Orthopedics; Pain; Shoulder Joint
PubMed: 20938608
DOI: No ID Found -
Italian Journal of Pediatrics Jul 2022Primary Synovial Chondromatosis (PSC) is a rare benign tumor of the synovial membrane in which cartilage metaplasia produces calcific loose bodies within the articular...
BACKGROUND
Primary Synovial Chondromatosis (PSC) is a rare benign tumor of the synovial membrane in which cartilage metaplasia produces calcific loose bodies within the articular space. Only a few cases are reported in the pediatric population and its etiology remains unknown. This condition typically affects large weight-bearing joints with pain, swelling and decrease range of motion. Due to its slow progressions, delayed diagnosis is frequent and differential diagnosis should consider other chronic arthritis and malignancies. While arthroscopic removal of loose bodies is the current treatment up to now, the association of partial or complete synovectomy is debated.
CASE PRESENTATION
We report about a 14-year-old girl with a long-lasting right shoulder pain, especially during movements or exercise, localized tenderness and hypotonia of the glenohumeral joint. No previous trauma was mentioned. Blood exams, Mantoux test and plain radiography of the right shoulder were unremarkable. Ultrasound imaging revealed echogenic and calcified bodies stretching the glenohumeral joint and dislocating the long head of biceps tendon. Magnetic resonance showed a "rice-grain" pattern of the right shoulder. From an arthroscopic surgery, multiple loose white bodies were removed within the synovial membrane, and synovial chondromatosis was confirmed by histological analysis. At one month follow up visit, the patient completely recovered without pain.
CONCLUSION
Synovial chondromatosis is a very uncommon cause of mono articular pain in children, especially when it affects shoulder. Pediatricians should keep in mind this condition to avoid delayed diagnosis and treatment, even in consideration of the low risk of malignant transformation. Through this case, we would highlight common diagnostic pitfalls and treatment of synovial chondromatosis.
Topics: Adolescent; Arthroscopy; Child; Chondromatosis, Synovial; Female; Humans; Joint Loose Bodies; Shoulder Joint; Shoulder Pain
PubMed: 35908061
DOI: 10.1186/s13052-022-01332-4 -
Clinics in Orthopedic Surgery Sep 2020Ehlers-Danlos Syndrome (EDS) is a hereditary disorder of the connective tissue, which has been classified into numerous subtypes over the years. EDS is generally... (Review)
Review
Ehlers-Danlos Syndrome (EDS) is a hereditary disorder of the connective tissue, which has been classified into numerous subtypes over the years. EDS is generally characterized by hyperextensible skin, hypermobile joints, and tissue fragility. According to the 2017 International Classification of EDS, 13 subtypes of EDS have been recognized. The majority of genes involved in EDS are either collagen-encoding genes or genes encoding collagen-modifying enzymes. Orthopedic surgeons most commonly encounter patients with the hypermobile type EDS (hEDS), who present with signs and symptoms of hypermobility and/or instability in one or more joints. Patients with joint hypermobility syndrome (JHS) might also present with similar symptomatology. This article will focus on the surgical management of patients with knee or shoulder abnormalities related to hEDS/JHS.
Topics: Ehlers-Danlos Syndrome; Humans; Joint Instability; Knee Joint; Shoulder Joint
PubMed: 32904109
DOI: 10.4055/cios20103 -
The Journal of Bone and Joint Surgery.... Nov 2006The floating shoulder is defined as ipsilateral fractures of the midshaft of the clavicle and the neck of the glenoid. This rare injury can be difficult to manage... (Review)
Review
The floating shoulder is defined as ipsilateral fractures of the midshaft of the clavicle and the neck of the glenoid. This rare injury can be difficult to manage without a thorough understanding of the complex anatomy of the shoulder girdle. Surgical intervention needs to be considered for all of these injuries. While acceptable results can be expected with non-operative management of minimally-displaced fractures, displacement at one or both sites is best managed with surgical reduction and fixation.
Topics: Biomechanical Phenomena; Clavicle; Fracture Healing; Humans; Orthopedic Procedures; Shoulder Fractures; Shoulder Joint; Treatment Outcome
PubMed: 17075083
DOI: 10.1302/0301-620X.88B11.17997