Abstract：
BACKGROUND:Total elbow arthroplasty (TEA) can be complicated by periprosthetic joint infection (PJI) with potentially catastrophic failure. The purpose of this study was to describe the results of elbow PJI treatment at a tertiary-care referral center. METHODS:An institutional TEA database was queried for infection and reoperation after TEA. Patients who underwent irrigation and débridement (I&D) with component retention were compared with those who underwent component explantation, antibiotic spacer placement, and reimplantation of a revision TEA. RESULTS:A total of 26 patients (10 men; mean age, 64.3 years) were treated for PJI of TEA. There were 3 polymicrobial infections (11.5%) and 13 Staphylococcus aureus infections (50%) (4 methicillin resistant); 6 patients (23.1%) had negative culture results. Ten patients (38.5%) underwent I&D and component retention, with 5 of those patients (5 of 10, 50%) having recurrent infection at an average of 3.1 years (range, 0.25-7.8 years) after I&D. Of 16 patients who underwent antibiotic spacer placement, 12 (75%) underwent 2-stage reimplantation of a TEA. Among those with reimplantation, 4 of 12 (33.3%) required reoperation. In 3 of 12 (25.0%), reoperation was required for infection, whereas 1 of 12 (8.3%) required surgery for mechanical complications. CONCLUSION:Two-stage revision results in a decreased rate of recurrent PJI. Certain patients (those with poor health or well-fixed components) may be more suitable for I&D and component retention, with a demonstrated 50% success rate over a period of 3 years. Longer-term follow-up may result in higher reinfection rates in both groups.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Zmistowski B,Pourjafari A,Padegimas EM,Sheth M,Cox RM,Ramsey ML,Horneff JG 3rd,Namdari Sdoi
10.1016/j.jse.2018.05.035subject
Has Abstractpub_date
2018-09-01 00:00:00pages
1636-1641issue
9eissn
1058-2746issn
1532-6500pii
S1058-2746(18)30405-1journal_volume
27pub_type
杂志文章abstract：:Between July 1991 and February 1995, 33 patients underwent bipolar shoulder arthroplasty for painful rotator cuff arthropathy of the shoulder. Twenty-two of these patients have been followed for an average of 28 months (range 24 to 48 months) and comprised the study group. All patients had massive, irreparable rotator...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/s1058-2746(97)90083-5
更新日期：1997-11-01 00:00:00
abstract：BACKGROUND:Anterior shoulder dislocation in the young patient is a common problem, yet there is no universal agreement on its management. METHODS:In this study, we comprehensively surveyed all members of the British Elbow and Shoulder Society (BESS) to ascertain their preferred methods of treating young patients with ...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2011.01.006
更新日期：2012-04-01 00:00:00
abstract：BACKGROUND:The aim of this study was to assess the influence of 3-dimensional (3D) preoperative planning and patient-specific instrument (PSI) guidance of glenoid component positioning on its inclination in total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA). MATERIALS AND METHODS:Thirty-six shou...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2015.07.024
更新日期：2016-02-01 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：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:Total elbow arthroplasty (TEA) is associated with high complication rates compared with other large-joint arthroplasties. The frequency and type of complication may differ, depending on the surgical approach. A comparison of outcomes with triceps-off and triceps-on approaches was investigated. METHODS:Seven...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2014.11.038
更新日期：2015-03-01 00:00:00
abstract：BACKGROUND:Irreparable rotator cuff tears (ICTs) remain a challenging treatment dilemma. Superior capsule reconstruction (SCR) acts as a static stabilizer to decrease superior humeral head migration. Latissimus dorsi tendon transfers (LDTs) dynamically decrease superior humeral head migration and improve external rotat...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2019.01.016
更新日期：2019-08-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to evaluate the radiologic and clinical outcomes of coracoclavicular (CC) stabilization using a suture button device for Neer type IIB lateral clavicle fractures. METHODS:Eighteen consecutive patients with Neer type IIB fractures were treated with CC stabilization using a Tight...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2016.09.048
更新日期：2017-05-01 00:00:00
abstract：BACKGROUND:Repair of proximal humeral fractures with locking plates has greatly improved outcomes. However, an alarming rate of complications including screw cutout and impingement under the acromion has recently been reported. A novel locking plate with smooth pegs was developed to reduce these risks. The purpose of t...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2012.04.005
更新日期：2013-04-01 00:00:00
abstract：:The surgical treatment of chronic acromioclavicular injuries remains controversial. There is increasing use of autogenous tendon grafts to perform these reconstructions. This study examined the mechanical properties of differing configurations of these grafts. Mechanical testing of acromioclavicular joint reconstructi...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2008.01.143
更新日期：2008-09-01 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:The management of a failed shoulder arthroplasty represents a complex and difficult problem for the treating surgeon, with potential difficulties and complications that are related to the need to remove a well-fixed stem. The aim of this study is to compare the intraoperative complications, postoperative com...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2015.10.007
更新日期：2016-05-01 00:00:00
abstract：:The most widely used radiographic classification system for acromial morphology identifies three distinct acromial shapes: type I (flat), type II (curved), and type III (hooked). The purpose of this study was to measure the interobserver and intraobserver reliability of determinations of acromial morphology as defined...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/s1058-2746(05)80037-0
更新日期：1995-11-01 00:00:00
abstract：:The strength of classic transosseous suture repair of rotator cuff tendons was compared with similar repairs with four "third-generation" suture anchors. Results demonstrate the repair construct selected had a significant influence on failure at ultimate load (p = 0.005). Among the anchors tested the Statak design was...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/s1058-2746(96)80028-0
更新日期：1996-01-01 00:00:00
abstract：BACKGROUND:Economic evaluations provide decision makers with a tool for reducing health care costs because they assess both the costs and consequences of health care interventions. This study reviewed the quality of published economic evaluations for shoulder pathologies. MATERIALS AND METHOD:A MEDLINE search was cond...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jse.2011.05.019
更新日期：2012-03-01 00:00:00
abstract：HYPOTHESIS:The purpose of this study was to determine the minimal detectable change (MDC) for the Constant score in patients with impingement, a supraspinatus tear, or a massive rotator cuff (RC) tear as observed changes smaller than the MDC might be the result of measurement error. METHODS:The Constant score was reco...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2014.07.003
更新日期：2015-03-01 00:00:00
abstract：BACKGROUND:Partial-thickness rotator cuff tears are likely at least as common as full-thickness rotator cuff tears, and it is critical for surgeons to have knowledge of the tear progression rate of partial-thickness rotator cuff tears when determining surgical or nonsurgical treatment. However, a systematic review inve...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jse.2020.08.022
更新日期：2021-02-01 00:00:00
abstract：BACKGROUND:Distal biceps reconstruction for chronic rupture often requires a graft to recover length and allow for distal tendon reattachment to bone. Our purpose was to assess peak strength and endurance recovery following biceps reconstruction with tendon grafts. HYPOTHESIS:We hypothesized that allograft reconstruct...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2019.12.016
更新日期：2020-04-01 00:00:00
abstract：:The purpose of this study was to document the diagnosis, surgical treatment, and functional outcome in patients with subscapularis ruptures after shoulder arthroplasty. Prospective objective and subjective data were collected on 7 patients with symptomatic rupture of the subscapularis tendon after shoulder arthroplast...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2005.02.013
更新日期：2005-09-01 00:00:00
abstract：HYPOTHESIS:This study was conducted to test the hypothesis that patients would have improved pain and range of motion after conversion total shoulder arthroscopy but that overall outcome would be substantially affected by the need for removal of the humeral component and associated alterations of bony anatomy or soft t...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2011.01.024
更新日期：2011-12-01 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:Although suprascapular nerve injury after SLAP (superior labrum anterior to posterior) repair has rarely been reported, the direction of anchor insertion is toward the suprascapular nerve. The purpose of this study was to evaluate the risk of suprascapular nerve injury during the drilling and anchor insertio...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2010.06.004
更新日期：2011-03-01 00:00:00
abstract：BACKGROUND:Studies have demonstrated mixed results after humeral head replacement (HHR) for osteoarthritis at short- and medium-term follow-up intervals. The purpose of this study was to investigate the long-term outcomes (minimum 10 years) of HHR for the treatment of osteoarthritis. METHODS:This study included 44 sho...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2017.10.017
更新日期：2018-05-01 00:00:00
abstract：BACKGROUND:The purpose of this computed tomography-based study was to quantify erosions in B2 glenoids. We hypothesized that erosions do not occur symmetrically and that they have a predictable orientation. METHODS:This study evaluated 55 type B2 glenoid cases. Computed tomography data were used to create three-dimens...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2014.08.021
更新日期：2015-04-01 00:00:00
abstract：:The subscapularis muscle and tendon were studied in 25 cadaveric specimens. The subscaputaris insertion into the proximal humerus and its musculolendinous junction was defined. We found that the subscapularis muscle had a gradual formation of the musculotendinous junction and, in contrast to classical descriptions, in...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/S1058-2746(09)80039-6
更新日期：1994-07-01 00:00:00
abstract：BACKGROUND:Glenoid bone deficiencies may be addressed by specialized components. The purpose of this study is to evaluate the clinical and radiographic outcomes of 3 different types of nonstandard glenoid components. MATERIALS AND METHODS:Thirty-eight patients with a mean age of 65 years (range, 34-84 years) underwent...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2013.09.023
更新日期：2014-07-01 00:00:00
abstract：BACKGROUND:Although cemented humeral fixation is recognized as the standard of care in total shoulder arthroplasty (TSA), uncemented fixation has the potential to provide stable fixation, decrease operative time, and simplify potential revision procedures. This prospective, randomized, double-blind clinical trial compa...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.jse.2011.01.041
更新日期：2011-06-01 00:00:00
abstract：:Forty-three shoulder arthroplasties performed with the use of cemented Neer II humeral components and followed radiographically for a mean of 6.6 years (range, 2-20 years) were analyzed. A humeral component was considered radiographically "at risk" for clinical loosening when a radiolucent line 2 mm or greater in widt...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1067/mse.2001.118482
更新日期：2001-11-01 00:00:00
abstract：BACKGROUND:Little is known about the morphology of healing rotator cuffs after surgical repair. This investigation aimed to determine whether there are changes in tendon thickness, subacromial bursa, anatomical footprint, tendon vascularity, and capsular thickness after rotator cuff repair, and whether supraspinatus te...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2012.10.047
更新日期：2013-08-01 00:00:00
abstract：BACKGROUND:Treatment of partial thickness supraspinatus tendon tears is controversial with no clearly defined treatment algorithms based on severity of tears. This study aims to evaluate the relationship between depth of partial thickness tears and strain. METHODS:Bursal-sided partial thickness tears were created at 1...
journal_title：Journal of shoulder and elbow surgery
pub_type： 杂志文章
doi：10.1016/j.jse.2008.12.011
更新日期：2009-05-01 00:00:00
