Abstract:
:Protection of the anterior aspect of the deltoid muscle is critical to the success of shoulder arthroplasty. Between 1975 and 1980, 75 patients with 81 shoulder arthroplasties had exposure via the anteromedial approach with careful anterior deltoid detachment through fascial tissues, systematic repair, and standardized rehabilitation with early passive range of motion. As with other reports on arthroplasty, pain was significantly reduced and motion was improved. No anterior deltoid detachments occurred; deltoid strength was preserved. Greater postoperative deltoid strength was statistically associated with lesser postoperative pain, greater postoperative active elevation, improved limb function, and an enhanced overall result rating. To understand the contemporary indications for this approach better, those undergoing shoulder arthroplasty between 1990 and 1994 were assessed. The anteromedial approach was used in 14 of these 236 shoulders (5.9%). This approach is currently reserved for patients with frail anterior deltoids that will not tolerate retraction, with severely osteopenic humeral shafts that will not tolerate torsion, with extreme scarring and an inflexible deltoid muscle, with severe bony deformity, or with posterosuperior rotator cuff tearing requiring repair. The importance of the anterior deltoid in shoulder arthroplasty cannot be denied. Use of the extended deltopectoral approach with preservation of the deltoid origin insertion is a very positive step forward. In uncommon instances where added exposure is needed, the anteromedial approach with careful attention to incision and repair of the deltoid with appropriate postoperative rehabilitation can accomplish the goal of maintaining anterior deltoid function and enhancing the success of shoulder arthroplasty.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Gill DR,Cofield RH,Rowland Cdoi
10.1016/j.jse.2004.02.009keywords:
subject
Has Abstractpub_date
2004-09-01 00:00:00pages
532-7issue
5eissn
1058-2746issn
1532-6500pii
S1058274604000850journal_volume
13pub_type
杂志文章abstract::The purpose of this study was to investigate the 3-dimensional trabecular bone mineral density (BMD) in the humeral head and determine the effects of trabecular BMD on the pullout strength of cancellous screws. Five regions of interest (ROIs) were defined in the humeral head (superior- anterior, superior-posterior, ce...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2005.09.007
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Delayed surgical treatment of hip fractures is associated with adverse medical outcomes, but it is unclear whether the same is true for proximal humeral fractures. The purpose of this study was to evaluate the relationship between surgical delay for proximal humeral fracture and inpatient adverse events, in-...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.03.010
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Posterior glenoid defects increase the risk of glenoid component loosening after total shoulder arthroplasty (TSA). The goal of this work was to evaluate the mechanical performance of a novel posterior-step glenoid prosthesis, designed to compensate for biconcave (type B2) glenoid defects. Two prototypes ("P...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.12.008
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND/HYPOTHESIS:Open reduction and internal fixation (ORIF) using locked plating has demonstrated promise in the treatment of displaced proximal humerus fractures. The purpose of this article is to describe the surgical technique and to report early clinical results with this technique. METHODS:Important surgica...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.01.001
更新日期:2010-03-01 00:00:00
abstract::In 23 adult patients, cubitus varus deformity was corrected by 3-dimensional osteotomy. During surgery, not only varus but internal rotation, flexion-extension deformity of the elbow, and lateral protrusion of the distal fragment were simultaneously addressed. The mean age of the patients was 26 years. Three showed ta...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(03)00090-9
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:A variety of measurements can be used to assess radiographic osteoarthritic changes of the shoulder. This study aimed to analyze the correlation between the radiographic humeral-sided Samilson and Prieto classification system and 3 different radiographic classifications describing the changes of the glenoid ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.07.007
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Valid patient-reported outcomes (PROs) for the shoulder and elbow do not exist for children. We assessed children's comprehension of the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire and the American Shoulder and Elbow Surgeons (ASES) standardized shoulder assessment form, ident...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.11.009
更新日期:2018-07-01 00:00:00
abstract:HYPOTHESIS:The purpose of this study was to conduct a systematic review of the psychometric evidence relating to Constant-Murley score. MATERIALS AND METHODS:A search of 3 databases (Medline, CINAHL, and EMBASE) and a manual search yielded 35 relevant publications. Pairs of raters used structured tools to analyze thes...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2009.04.008
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:This study assessed whether treating medial end clavicular fractures using an inverted distal clavicle locking plate, twisted through 90° around its axis, would allow for a less invasive surgical approach and improve screw trajectory insertion. MATERIALS AND METHODS:We searched the databases of the 2 senior...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.08.047
更新日期:2019-04-01 00:00:00
abstract::The Oxford shoulder scores (OSS) and Constant scores were collected prospectively for 103 patients treated conservatively for proximal humeral fractures. The paired scores were analyzed by assessing the degree of correlation, the agreement between the scores, and their sensitivity to change. Linear regression analysis...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2007.04.019
更新日期:2008-01-01 00:00:00
abstract:HYPOTHESIS AND BACKGROUND:The role of degeneration is not well understood for rotator cuff pain. If age-related degenerative changes would be the cause of symptoms, degeneration would precede or concur with self-reported pain. We performed 3 systematic literature reviews. Our objectives were to determine the prevalence...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.09.060
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to increase our understanding of the pathoanatomy of the ulnar collateral ligament (UCL) by performing a descriptive analysis of the surgical inspection of the anterior bundle in patients undergoing reconstruction. METHODS:A single-surgeon series of 163 patients who underwent U...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.01.017
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND AND HYPOTHESIS:IDEAL (Iterative Decomposition of Echoes of Asymmetrical Length) imaging is a magnetic resonance imaging sequence that precisely measures rotator cuff muscle fatty infiltration. The influence of lower levels of fatty infiltration on outcomes after rotator cuff repair remains unclear. We hypoth...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.05.018
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Reverse total shoulder arthroplasty (RSA) is a recent concept that enables good functional outcomes in cases of massive rotator cuff tear and cuff tear arthropathy. Design parameters influence the functional results and complications. The purpose of this study is to present the results of a novel RSA, the To...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.04.005
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:We hypothesize that an anatomic repair of the distal biceps tendon would recreate native tendon moment arm and forearm rotation, while a nonanatomic insertion would compromise moment arm and forearm rotation. METHODS:Isometric supination torque was measured at 60° of pronation, neutral, and 60° of supinatio...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.05.027
更新日期:2010-12-01 00:00:00
abstract::Forty patients underwent surgery by a single surgeon for chronic, symptomatic, full-thickness rotator cuff defects. The study evaluated preoperative and intraoperative factors that influence postoperative outcome. The study also correlated objective measures of shoulder function with postoperative symptoms, patient sa...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(96)80017-6
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Previous studies have reported that glenohumeral internal rotation deficit (GIRD) may increase the risk of throwing shoulder injuries. The purpose of this study was to analyze the conditions of throwing shoulder in professional baseball pitchers with GIRD by comparing with those in pitchers without GIRD. ME...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.10.041
更新日期:2020-12-05 00:00:00
abstract::Triceps splitting, triceps reflecting, and olecranon osteotomy are the most common posterior surgical approaches to the adult elbow, but no comparative data exist as to the exposure provided by each approach. The aim of this study was to determine which of these approaches provides the greatest exposure of the distal ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2001.116517
更新日期:2001-07-01 00:00:00
abstract::There has been resistance to the use of interscalene regional block for arthroscopic shoulder surgery because of concerns about potential complications and failed blocks with the subsequent need for general anesthesia. The purpose of this study was to assess whether interscalene regional block is safe and effective an...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2006.01.009
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Serum and synovial markers used to diagnose lower extremity prosthetic joint infection (PJI) have performed poorly for shoulder PJI. As a result, diagnosis is commonly reliant on the accuracy of positive or negative cultures. Next-generation sequencing (NGS) can sequence an entire bacterial genome. This stud...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.08.048
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Posterior glenoid erosion is thought to be initiated by humeral head subluxation. However, it is unknown whether subluxation is entirely caused by soft-tissue instability and unbalanced muscle activity or whether osseous morphology is a contributing factor. We hypothesized that patients with posterior erosio...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.11.002
更新日期:2016-07-01 00:00:00
abstract::Twenty-one elbow dislocations with an associated radial head fracture were treated with immediate joint reduction, stabilization, and early range-of-motion exercises. In all cases initial treatment involved closed reduction of the ulnohumeral joint. For those cases involving minimally displaced and a few moderately di...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(99)90160-x
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:Although the effect of 3-dimensional (3D) planning for total shoulder arthroplasty (TSA) on component positioning and patient outcomes has been increasingly studied, the effect of 3D planning on surgeon decision making has not been well studied. METHODS:A retrospective review was performed of a database con...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.06.032
更新日期:2020-07-07 00:00:00
abstract:BACKGROUND:Reverse shoulder arthroplasty (RSA) has gained increasing popularity in the treatment of rotator cuff tear arthropathy (CTA). The purpose of this study was to evaluate the survival of RSA and the risk factors for revision following RSA. METHODS:RSA patients with CTA or osteoarthritis were identified from th...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.02.060
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:This study evaluated the functional outcomes of bipolar pedicled pectoralis major (PM) transfer to restore elbow flexion. METHODS:We retrospectively reviewed 29 transfers in 28 patients with a mean age of 31.2 years (range, 5-65 years). The loss of elbow flexion was due to brachial plexus palsy in 24 patien...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.06.027
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to determine the results, complications, and failure rates of shoulder arthroplasty in morbidly obese patients. METHODS:Between 1994 and 2005, 45 shoulder arthroplasties were performed for osteoarthritis in patients with a BMI greater than 40. Forty-one shoulders were followed ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2009.02.006
更新日期:2009-11-01 00:00:00
abstract::Over the years, we have observed a shifting among loose shoulder, voluntary dislocation, habitual dislocation, and sustained subluxation, leading us to the conclusion that they are all varieties of the same condition: atraumatic shoulder instability. For this study, we followed the natural course of atraumatic shoulde...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2001.111962
更新日期:2001-03-01 00:00:00
abstract::In a prospective population-based study of all shoulder injuries seen at Malmö General Hospital during 1987, the incidence and causes of major injuries involving fractures of the clavicle, scapula, or proximal humerus and glenohumeral or acromioclavicular dislocations were investigated in children, adults, and the eld...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(05)80063-1
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to determine the influence of current and former tobacco use on minimum 2-year clinical and radiographic outcomes after reverse total shoulder arthroplasty (RTSA). METHODS:Review of primary RTSA patient data identified 186 patients with at least 2 years of follow-up. Patients w...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.05.045
更新日期:2020-02-01 00:00:00
abstract::Large rotator cuff tears represent a challenging problem. The purpose of our study was to evaluate the small intestinal submucosa (SIS) extracellular matrix in reconstruction of such defects in an animal model. Forty rats were equally divided into an SIS group (reconstruction of a large supraspinatus tendon defect by ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2005.06.007
更新日期:2006-03-01 00:00:00