Abstract:
BACKGROUND:The purpose of this study was to introduce the procedure value index (PVI) and apply this value instrument to shoulder arthroplasty. The PVI uses the value equation in units of minimal clinically important difference (MCID) to provide an objective system of quantifying value-driven care. Secondarily, we describe the PVI for both primary anatomic total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA) to highlight value differences between these patient populations. METHODS:Patients undergoing primary shoulder arthroplasty with minimum 2-year follow-up were identified retrospectively. MCIDs were determined for the Simple Shoulder Test (SST) score, American Shoulder and Elbow Surgeons (ASES) score, visual analog scale (VAS) score for pain, and Single Assessment Numeric Evaluation (SANE) score. Cost data were reported as total hospitalization costs, total charges, and total reimbursements. The PVI was calculated as the ratio of outcome improvement in units of MCID over the cost of care. Mean PVIs for TSA and RSA were compared. RESULTS:Five hundred thirty-four patients met the inclusion criteria. MCIDs for the SST, ASES, VAS pain, and SANE scores were 3.61, 29.49, 3.28, and 37.05, respectively. With the exception of the ASES score, improvements in units of MCID were not different between TSA and RSA. However, total hospitalization costs and charges were significantly higher for RSA (P < .001). PVIs based on total hospitalization costs and total charges for the SST, ASES, and VAS pain scores were significantly greater for TSA (P < .05). No other PVI was significantly different. CONCLUSIONS:The PVI was greater for TSA when total hospitalization costs and total charges were considered. The PVI helps highlight value differences in shoulder arthroplasty.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Berglund DD,Law TY,Rosas S,Kurowicki J,Giveans MR,Mijic D,Levy JCdoi
10.1016/j.jse.2018.07.031subject
Has Abstractpub_date
2019-02-01 00:00:00pages
335-340issue
2eissn
1058-2746issn
1532-6500pii
S1058-2746(18)30567-6journal_volume
28pub_type
杂志文章abstract:BACKGROUND:This study investigated the histopathology of the long head of biceps (LHB) tendon and correlated the findings with the macroscopic appearances of the LHB and the size of rotator cuff tears (RCTs) in patients with chronic RCTs. METHODS:We compared biopsy specimens from LHBs in 34 patients with chronic RCTs ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.11.013
更新日期:2014-08-01 00:00:00
abstract::The effectiveness of arthroscopic surgery, supervised exercises, and placebo was compared in 125 patients with rotator cuff disease (impingement syndrome stage II) in a randomized clinical trial. The median age was 48 years, and the median duration of complications was 1 to 2 years. The treatments were arthroscopic su...
journal_title:Journal of shoulder and elbow surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1058-2746(99)90001-0
更新日期:1999-03-01 00:00:00
abstract:HYPOTHESIS AND BACKGROUND:Humeral retroversion is defined as the orientation of the humeral head relative to the distal humerus. Because none of the previous methods used to measure humeral retroversion strictly follow this definition, values obtained by these techniques vary and may be biased by morphologic variations...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.09.041
更新日期:2015-05-01 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:HYPOTHESIS:We reviewed the outcome of angular stable plates in addressing displaced lateral-third clavicle fractures. We investigated union, shoulder function, request for implant removal, and return to sport. Our hypothesis was that these implants provide predictable union and return to sports without the negative con...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.09.024
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Reconstruction of the native plane in biconcave eroded glenoids is difficult. Nevertheless, accurate reconstruction of this plane is imperative for successful total shoulder arthroplasty. This study aims to determine guidelines that can increase the accuracy of glenoid component positioning. METHODS:Three d...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2011.10.030
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to identify characteristics associated with bilateral ruptures of the distal biceps tendons. METHODS:We present a retrospective case series of 25 patients who sustained non-simultaneous bilateral distal biceps brachii tendon ruptures that were repaired surgically, with follow-u...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2009.01.029
更新日期:2009-09-01 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:The aim of this study was to provide subjective and objective results of surgical treatment of unstable elbow dislocations with the hinged external fixation technique. METHODS:Twenty-six patients were available for re-examination after treatment. Parameters used to quantify the subjective functional results...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.09.034
更新日期:2015-02-01 00:00:00
abstract::Glenoid component loosening generates the greatest concern among surgeons performing total shoulder arthroplasty. Laboratory testing of glenoid prostheses may lead to improved design, subsequently leading to a reduction in the incidence of clinical loosening. The goals of this study were to develop a laboratory test m...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2000.105451
更新日期:2000-07-01 00:00:00
abstract::As a less invasive surgery of the shoulder, the mini-open repair was carried out from March 1997 through December 1998 in 22 patients (mini-open repair group) for all types of rotator cuff tears, except massive tears. A transacromial skin incision about 3 cm long was made. The anterior deltoid was split along its musc...
journal_title:Journal of shoulder and elbow surgery
pub_type: 临床试验,杂志文章
doi:10.1067/mse.2001.110514
更新日期:2001-01-01 00:00:00
abstract::The purpose of this study was to describe the extramedullary humeral morphology in paired humeri to determine whether geometric differences exist from side to side in the same individual. The anatomic characteristics of 28 paired, dry cadaveric humeri were measured by use of an electromagnetic tracking system. Of the ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2006.09.016
更新日期:2007-07-01 00:00:00
abstract::The purpose of this anatomic study was to evaluate potential causes of rupture of the distal biceps tendon, to assess the dynamic relationship of the proximal radioulnar joint during pronation and supination, and to identify potential sites of impingement of the distal biceps tendon. For the anatomic study specimens w...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(05)80044-8
更新日期:1995-05-01 00:00:00
abstract:BACKGROUND:The objective measurement of dominant/nondominant arm use proportion in daily life may provide relevant information on healthy and pathologic arm behavior. This prospective case-control study explored the potential of such measurements as indicators of upper limb functional recovery after rotator cuff surger...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.01.017
更新日期:2015-09-01 00:00:00
abstract:METHODS:We investigated the effect of application of fibroblast growth factor (FGF)-2 on the tendon-to-bone remodeling of repaired supraspinatus tendon in rats subjected to bilateral detachment. FGF-2 (100 mg/kg) in a fibrin sealant or sealant alone was applied on the right and left shoulders, respectively. Twelve anim...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2009.01.013
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:The purpose of this study was (1) to evaluate the rates of reverse shoulder arthroplasty (RSA) revisions during a 12-year period, (2) to assess the influence of primary diagnosis and the impact of implant modifications on revisions, (3) to describe surgical management of failed RSA, and (4) to analyze outcom...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.09.027
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Heterotopic ossification (HO) is a well-recognized cause of limited flexion-extension, but it can also limit pronation-supination. There is a paucity of literature concerning restriction of pronation-supination due to HO. METHODS:We conducted a retrospective review of patients who had undergone elbow surger...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.10.029
更新日期:2019-07-01 00:00:00
abstract::The introduction of the reverse shoulder arthroplasty has provided shoulder surgeons with more options for the treatment of complex proximal humeral fractures in the elderly. Early reported results suggest that the average functional outcome may be better than hemiarthroplasty in certain patients and specific clinical...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2013.10.003
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Displaced intra-articular distal humeral fractures are a challenging injury in elderly patients. High rates of complications have led to the increasing use of total elbow arthroplasty (TEA) for primary treatment. This study presents US nationwide trends in primary TEA for distal humeral fractures in elderly ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.05.030
更新日期:2016-11-01 00:00:00
abstract:HYPOTHESIS:Type IIA, IIB, and V lateral clavicular fractures (Craig modification of the Neer classification) are characterized by a constant displacement and are associated with a high rate of nonunion. The aim of this study is to verify whether the reduction and arthroscopic stabilization of these clavicular fractures...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.05.016
更新日期:2014-03-01 00:00:00
abstract::The purpose of this report was to investigate the vascular anatomy of the ulnar nerve at the elbow with a technique of combined India ink and latex injection followed by nondissection chemical debridement. Twenty-two fresh human cadaveric arms were injected with India ink to stain the intraneural microcirculation foll...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(99)90048-4
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Kyphosis is a cause of scapular dyskinesis, which can induce various shoulder disorders, including subacromial impingement syndrome (SIS). This study aimed to clarify the impact of kyphosis on SIS with use of cross-sectional data from the Locomotive Syndrome and Health Outcome in Aizu Cohort Study (LOHAS). ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.04.010
更新日期:2014-12-01 00:00:00
abstract:INTRODUCTION:Structural glenoid bone grafting in reverse total shoulder arthroplasty (RSA) has previously been reported to have good functional outcomes and low complication rates. We have observed different complication rates and hypothesized that baseplate fixation and severity of deformity may be predictors of early...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.07.035
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Posterior humeral decentering presents a challenge in glenohumeral arthroplasty. Soft tissue releases and osteophyte resection can lead to intraoperative decentering not evident preoperatively. Inferior outcomes result if decentering is not addressed as a part of the arthroplasty. When there is >50% posterio...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.02.027
更新日期:2016-12-01 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:Acute Hill-Sachs reduction represents a potential alternative method to remplissage for the treatment of an engaging Hill-Sachs lesion. This study biomechanically compared the stabilizing effects of an acute Hill-Sachs reduction technique and remplissage. METHODS:Six cadaveric shoulders were tested. For the...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.11.050
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Although the rate of periprosthetic joint infection following shoulder arthroplasty is low, it is a morbid and costly complication. Airborne particulates have long been recognized as a potential source of wound contamination, and operating room-mounted and smaller localized laminar airflow devices have been ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.08.035
更新日期:2020-09-16 00:00:00
abstract:HYPOTHESIS:A review of the current literature will show a difference between the biomechanical properties of double-row and single-row rotator cuff repairs. BACKGROUND:Rotator cuff tears commonly necessitate surgical repair; however, the optimal technique for repair continues to be investigated. Recently, double-row r...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2009.07.002
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Preoperative planning software is widely available for most anatomic total shoulder arthroplasty (ATSA) systems. It can be most useful in determining implant selection and placement with advanced glenoid wear. The purpose of this study was to quantify inter- and intrasurgeon variability in preoperative plann...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.04.010
更新日期:2020-12-01 00:00:00
abstract:HYPOTHESIS:The nonanatomical design of reverse shoulder prostheses induce medial displacement of the center of rotation, impingements and may reduce the mobility of the shoulder. The aim of this study is to test the hypothesis that during activities of daily living functional mobility of the shoulder can be restored by...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.09.014
更新日期:2013-07-01 00:00:00