Abstract:
:Interscalene block (ISB) of the brachial plexus is frequently used for patients undergoing ambulatory shoulder surgery. We previously reported that the incidence of postoperative complaints (neurapraxia) after an ISB was low (3% at 2 weeks), but objective neurologic assessment was not included in the study. The present study combines subjective findings with both preoperative and postoperative objective sensory and motor assessments after an ISB. We prospectively evaluated 133 patients undergoing elective ambulatory shoulder surgery. ISB anesthesia was accomplished by use of 1.5% mepivacaine alone or in combination with bupivacaine (0.5%-0.75%) via a paresthesia technique and a 23-gauge needle. All of the blocks were performed by experienced anesthesiologists. The number of passes with the needle, site of paresthesia, ease of performing the block, and success of the ISB were recorded for each patient. Neurologic assessment was performed preoperatively and up to 2 weeks postoperatively by 1 of 4 health care professionals but not by the anesthesiologists who performed the ISB and included diminished sensation, localized nerve pain, Semmes-Weinstein monofilament pressure threshold sensibility, Weber static 2-point discrimination, and grip strength changes. Patients with postoperative changes were followed up until resolution of symptoms occurred. Successful surgical anesthesia was achieved in 98% of the patients. There was 1 major perioperative complication (0.7%), a seizure that occurred within 5 minutes of the ISB. Two (1.4%) complained of transient postoperative neurapraxias. Neither patient had any changes in objective sensory and motor measurements. Hence, there was no correlation between subjective complaints and objective findings in this study. This study demonstrates that, in the hands of anesthesiologists doing predominantly regional anesthesia, there is a 1.4% incidence of neurologic complications after an ISB. ISB is a safe and effective technique for patients undergoing ambulatory shoulder surgery when an anesthesiologist experienced with regional anesthesia is involved.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Faryniarz D,Morelli C,Coleman S,Holmes T,Allen A,Altchek D,Cordasco F,Warren RF,Urban MK,Gordon MAdoi
10.1016/j.jse.2006.02.001subject
Has Abstractpub_date
2006-11-01 00:00:00pages
686-90issue
6eissn
1058-2746issn
1532-6500pii
S1058-2746(06)00089-9journal_volume
15pub_type
杂志文章abstract:BACKGROUND:The Latarjet procedure is often used to treat shoulder instability in younger patients. Little is reported on the outcomes of this procedure in older (≥40 years) populations. The purpose of this study was to evaluate the clinical and radiographic outcomes of patients aged 40 years or older with recurrent ant...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.02.004
更新日期:2019-09-01 00:00:00
abstract:HYPOTHESIS:Recent studies have demonstrated a potentially critical role of matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) in the pathophysiology of rotator cuff tears. We hypothesize that local delivery of a MMP inhibitor after surgical repair of the rotator cuff will improv...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2009.07.010
更新日期:2010-04-01 00:00:00
abstract::A review of 30 patients who underwent a primary repair of their rotator cuff 10 years previously was performed. The average age of the patients at the time the operation was performed was 51 years (range 20 to 65 years). Twenty-seven men and three women were reviewed. An acromioplasty was performed in all patients. No...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/1058-2746(93)90001-W
更新日期:1993-03-01 00:00:00
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 standardize...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2004.02.009
更新日期:2004-09-01 00:00:00
abstract::Although glenoid component loosening has been recognized as a common reason for failure after total shoulder arthroplasty, there are few studies on the outcome of revision surgery for this problem. The purpose of this study is to determine the outcome of patients who underwent revision for glenoid component loosening....
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2007.09.003
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Post-traumatic elbow arthrofibrosis (PEA) and its associated limitations to elbow range of motion (ROM) are a recognized consequence of trauma to the pediatric elbow. Closed manipulation under anesthesia (CMUA) of the elbow can be performed in pediatric patients as a nonoperative attempt to improve dysfuncti...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.10.004
更新日期:2020-02-01 00:00:00
abstract::There is little information available concerning the results of rotator cuff debridement in patients with rheumatoid arthritis (RA). We performed a review of 16 shoulders with underlying RA that underwent arthroscopic rotator cuff tear debridement; there were 10 full-thickness tears and 6 partial-thickness tears. Of t...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2006.04.014
更新日期:2007-01-01 00:00:00
abstract::Reconstruction of a normal glenohumeral relationship is desirable for a successful arthroplasty. Double-contrast computed tomography was performed on 49 healthy shoulders in young volunteers. For creation of a uniform spatial reference system, the subjects were positioned in a thoracobrachial orthosis with the arm add...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(02)86884-7
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:In 2013 Moor et al introduced the concept of the critical shoulder angle (CSA) and suggested that an abnormal CSA was a leading factor in development of rotator cuff tear (RCT) and osteoarthritis (OA) of the shoulder. This study assessed whether the CSA was associated with RCT and OA and tested the inter- an...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.06.001
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:The optimal technique for arthroscopic rotator cuff repair is still controversial. Large tears with a high grade of retraction have an especially high risk of retearing. This study reports the clinical and radiologic results of a triple-row modified suture bridge technique for the treatment of full-thickness...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.06.010
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Osteointegration of press-fit radial head implants is achieved by limiting micromotion between the stem and bone. Aspects of stem design that contribute to the enhancement of initial stability (ie, stem diameter and surface coating) have been investigated. The importance of total prosthesis length and level ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2011.11.025
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:This study aimed to determine the extent to which the medial collateral ligament (MCL) can be visualized during a standard posterior arthroscopic view of the elbow. METHODS:Eight fresh human cadaveric elbows were placed in a simulated lateral decubitus position. Standard elbow arthroscopy was performed on e...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.04.040
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Straight antegrade intramedullary nailing of proximal humerus fractures has shown promising clinical results. However, up to 36% of all humeri seem to be "critical types" in terms of the potential violation of the supraspinatus (SSP) tendon footprint by the nail's insertion zone. The aims of this study were ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.10.021
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Interscalene brachial plexus blocks are a common modality used to provide adjunctive pain relief with shoulder replacement surgery. In 2018, the Federal Drug Administration approved the use of liposomal bupivacaine (LB) for such nerve blocks. We sought to evaluate whether this formulation of bupivacaine woul...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.09.017
更新日期:2020-10-09 00:00:00
abstract:BACKGROUND:Accurate glenoid component placement is important to prevent glenoid component failure in total shoulder arthroplasty (TSA). Navigation may reduce the variability of glenoid component version and inclination; therefore, the aims of this study were to determine, in patients undergoing TSA, whether computer na...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.04.037
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Large glenoid defects present a challenge during primary and revision reverse total shoulder arthroplasty (RTSA) especially when humeral head autograft is not available as a bone graft source. The purpose of this study was to evaluate the clinical and radiographic outcomes of RTSA with concomitant structural...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.07.011
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Health care payers, including the federal government, increasingly base reimbursement on quality. Payers consider readmission rates after total joint arthroplasty an indicator of quality. The Patient Protection and Affordable Care Act contains provisions that preclude payment of hospital cost associated with...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.08.007
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:The high incidence of rotator cuff disease combined with high failure rates for nonoperative treatment of full-thickness rotator cuff tears underlines the importance of improving nonoperative management of rotator cuff tears. The study objective was to assess changes in in vivo glenohumeral kinematics of pat...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.08.048
更新日期:2016-04-01 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:BACKGROUND:Instability arthropathy is a known cause of glenohumeral osteoarthritis (OA) among patients with and without prior shoulder stabilization. This study aims to compare the clinical, radiographic, and patient-reported outcome measure (PROM) scores among total shoulder arthroplasty (TSA) patients with and withou...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.04.003
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:To examine the rates and predictors of deep periprosthetic infections after shoulder hemiarthroplasty. METHODS:We used prospectively collected institutional registry data on all primary shoulder hemiarthroplasty patients from 1976-2008. We estimated survival free of deep periprosthetic infections using Kapl...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2011.08.067
更新日期:2012-10-01 00:00:00
abstract::Articular-surface partial-thickness rotator cuff tears play a significant role in shoulder pathology, but the role of the articular-surface tissue is poorly understood. This investigation assessed the effect of an articular-surface partial-thickness rotator cuff tear on intratendinous strain fields. A magnetic resonan...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2002.126767
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:Increased critical shoulder angles consist of both the acromial cover and glenoid inclination and have been found in patients with rotator cuff pathology. The purpose of this study was to determine the correlation of the critical shoulder angle and glenoid inclination and to determine the difference in gleno...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.07.013
更新日期:2015-12-01 00:00:00
abstract::Studies show that the radial head is a significant stabilizer to valgus and varus stresses and external rotatory stability. We review the outcomes of patients who had radial head replacement in our institution. Six patients with Mason-Johnston type III or IV radial head fractures underwent radial head replacement and ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2007.07.020
更新日期:2008-03-01 00:00:00
abstract::During a 6-year period, 2 surgeons prescribed active elbow exercises and avoidance of shoulder abduction (varus stress) for 23 patients (15 men, 8 women) with a mean age of 43 years (range, 19-74 years) who had slight residual subluxation of a dislocated elbow after either nonoperative (3 simple dislocations and 2 fra...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2007.06.006
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:The precarious anatomy of the articular surface of the distal humerus, as well as its meager subchondral bony support and limited soft-tissue attachments, presents enormous challenges for the operative correction of post-traumatic intra-articular deformities. This study presents 8 patients who underwent arti...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.12.020
更新日期:2014-04-01 00:00:00
abstract:INTRODUCTION:Cutibacterium acnes is one of the major pathogens responsible for infection after shoulder surgery. Surgical dissection of the dermis may expose C. acnes from sebum-producing hair follicles. Due to contact with surgeon's gloves and instruments these are further spread throughout the surgical field. The pur...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.11.018
更新日期:2021-01-06 00:00:00
abstract::Stability of the glenohumeral joint with an anterior, posterior, and inferior displacement force of 50 N was measured in a dynamic shoulder model. Controlled hydrodynamic actuator forces were applied to the deltoid muscle and to the rotator cuff in seven anatomic specimens. During elevation of the arm the position of ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(98)90182-3
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Semiconstrained total elbow arthroplasty is used to improve elbow function and reduce pain. Although effective, high complication rates exist, with the polyethylene bushing especially susceptible to failure. The Discovery Elbow System (Biomet Inc, Warsaw, IN, USA) contains a spherical bearing designed to min...
journal_title:Journal of shoulder and elbow surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jse.2013.12.033
更新日期:2014-05-01 00:00:00
abstract::A prospective study was undertaken to determine if patients recover pre-injury level of shoulder function 1 year after 1 part proximal humeral fractures. Of the 67 patients enrolled, 43 were female and 24 male with an average age of 64.8 years (range, 25-90 years). All patients underwent a similar treatment protocol c...
journal_title:Journal of shoulder and elbow surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jse.2007.07.016
更新日期:2008-03-01 00:00:00