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 containing TSA cases for which the glenoid component was planned with a commercially available 3D computed tomography software program (Virtual Implant Positioning; Arthrex, Inc.) from 2016 to 2019. A total of 6483 cases planned by 417 surgeons were included. The glenoid version (Vtech) and inclination (Itech) of the Virtual Implant Positioning technician plan as well as the surgeon's final plan for version (Vsurg) and inclination (Isurg) were extracted. When the version and/or inclination of the surgeon plan matched that of the technician, that variable was defined as "accepted." The rates of acceptance of Vtech and Itech were calculated and analyzed for association with implant type, native version and inclination, and running case count. A subgroup analysis of high-volume users (n > 30 cases) was analyzed to determine if any of the variables independently was associated with surgeon acceptance. RESULTS:There was a very high rate of matching of version (66%), inclination (72%), or both (55%) and a low rate (18%) where neither parameter of the glenoid plan matched that of the technician. In univariate analysis, as the case count and retroversion increased the rate of accepting of version dropped noticeably (70%-50% and 47%, respectively [ P< .0001]). The rate of accepting the plan for inclination did not vary much as case count changed. In the multivariate analysis, 23 of 56 high-volume surgeons had at least 1 independent factor associated with accepting the technician-planned glenoid version, and 5 surgeons had 2 independent factors. In the multivariate analysis of matching glenoid inclination, 27 of 56 high-volume surgeons had at least 1 independent factor associated with accepting the technician-planned glenoid version, and 9 surgeons had 2 or more independent factors. CONCLUSIONS:In a large database of TSAs with 3D-planned glenoids, there were high rates of cases with surgeon agreement with an initial plan provided by an industry technician: 66% in version, 72% in inclination, 55% for both version and inclination. Surgeon acceptance of the initial plan decreased as pathoanatomy increased and case count increased. Shoulder surgeons should be aware that an initial 3D preoperative plan provided by industry represents a potential source of cognitive bias in shoulder arthroplasty planning.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Hartzler RU,Denard PJ,Griffin JW,Werner BC,Romeo AAdoi
10.1016/j.jse.2020.06.032subject
Has Abstractpub_date
2020-07-07 00:00:00eissn
1058-2746issn
1532-6500pii
S1058-2746(20)30549-8pub_type
杂志文章abstract::Cadaveric anatomic dissections of 50 shoulders have been done with measurement and histologic analysis of the coracoacromial ligament. In subjects older than 50 years of age the coracoacromial ligament does not have a constant form. Three main types were identified: quadrangular, Y-shaped, and a broad band. A previous...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(95)80021-2
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:This study evaluated patients with and without a prosthetic dislocation after reverse total shoulder arthroplasty (RTSA) to identify risk factors for instability. METHODS:Dislocation and nondislocation cohorts were established for analysis in 119 patients who had undergone RTSA at our institution between 20...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.04.015
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Shoulder arthroplasty is the fastest growing joint replacement surgery in the United States, and optimal postoperative pain management is critical to optimize outcomes for these surgeries. Liposomal bupivacaine (LB) has gained popularity for its potential to provide extended postoperative pain relief with po...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jse.2017.06.044
更新日期:2017-10-01 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:BACKGROUND:The role of Propionibacterium acnes in shoulder arthroplasty and broadly in orthopedic prosthetic infections has historically been underestimated, with biofilm formation identified as a key virulence factor attributed to invasive isolates. With an often indolent clinical course, P acnes infection can be diff...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.09.042
更新日期:2017-04-01 00:00:00
abstract::A retrospective case-control study was undertaken to evaluate the pathologic radiographic changes that occur in primary osteoarthritis of the elbow. The radiographs of 50 patients with primary osteoarthritis of the elbow were compared with an age- and sex-matched control group to distinguish those features specific to...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2006.08.005
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:The eccentric glenosphere (EG) has been proposed as a way to prevent scapular notching in reverse shoulder arthroplasty (RSA). The purpose of this study was to investigate whether the use of an EG decreases scapular notching compared to matched standard concentric glenosphere (CG) controls. METHODS:A retros...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.10.032
更新日期:2020-12-01 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: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:Reverse shoulder arthroplasty (RSA) humeral implant parameters have been previously studied with respect to range of motion, deltoid function, and stability. However, limited literature exists on the influence of humeral design features on scapular spine strain. The purpose of this cadaveric biomechanical si...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.06.011
更新日期:2020-07-02 00:00:00
abstract:BACKGROUND:Symptomatic meso- type os acromiale is a common pathology with inconsistent outcomes of treatment with various surgical techniques. We report the outcome of a new technique for arthroscopic fusion of symptomatic os acromiale with absorbable screws. MATERIALS AND METHODS:The study included 8 shoulders in 8 p...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2011.12.011
更新日期:2012-12-01 00:00:00
abstract::The purpose of this study was to evaluate the results of an anatomic open stabilization procedure. Twenty-three consecutive patients with traumatic, recurrent, anterior glenohumeral instability were managed with a modified open procedure. All had a Bankart lesion. A standardized, true anatomic capsulolabral reconstruc...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2003.09.006
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Little is known about the role that a torn superior labrum (SLAP) plays in glenohumeral stability after biceps tenodesis. This biomechanical study evaluated the contribution of a type II SLAP lesion to glenohumeral translation in the presence of biceps tenodesis. The authors hypothesize that subsequent to bi...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.07.036
更新日期:2014-04-01 00:00:00
abstract::Most rotator cuff surgery is performed on chronic tears, but changes in the composition of chronically torn tendons remain poorly understood. In this study we surgically created supraspinatus tears in the rat and analyzed the composition of the tendon over time using immunohistochemistry. We found that collagen types ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2004.09.021
更新日期:2005-01-01 00:00:00
abstract::Currently, there is no information in the literature on operative treatment of proximal humeral fractures in patients with rheumatoid arthritis. Eleven patients underwent osteosynthesis of the proximal humerus from December 1987 to December 2002. Nine patients were treated for acute fractures, and two were treated for...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2005.02.023
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Lesser tuberosity osteotomy has become a popular method of subscapularis management during total shoulder arthroplasty with high healing rates and reliable functional recovery. One major advantage of this technique is the ability to monitor healing using routing radiographs. Recognition of displacement of th...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.07.015
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Reverse shoulder arthroplasty leads to arm lengthening. Different techniques have been described to determine postoperative lengthening. The purpose of this study was to evaluate the reliability of the acromiohumeral distance (AHD) in determining arm lengthening after reverse shoulder arthroplasty. METHODS:...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jse.2016.02.017
更新日期:2016-09-01 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::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: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: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::Glenoid component loosening is the most common early mode of failure of total shoulder arthroplasty (TSA) We hypothesised that the use of a pegged glenoid component with a modern glenoid reaming system and an instrumented cement pressurization technique would achieve a low prevalence of early radiolucent lines. Of 81 ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jse.2008.01.147
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Two popular systems for classifying rheumatoid arthritis affecting the elbow are the Larsen and Sharp schemes. To our knowledge, no study has investigated the reliability of these 2 systems. We compared the intraobserver and interobserver agreement of the 2 systems to determine whether one is more reliable t...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.07.074
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate the long-term functional and cosmetic results as well as the sagittal and coronal plane remodeling of displaced supracondylar humerus fractures treated with open reduction and internal fixation. METHODS:In total, 49 patients (11 boys and 38 girls) with Gartland type III...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.12.010
更新日期:2015-04-01 00:00:00
abstract::Fifty patients who underwent reoperation for failure of previous repair of rotator cuff rupture were evaluated 24 to 84 months after final repair (mean 30 months). Forty-eight of these patients had undergone all previous attempts at repair elsewhere. Most patients had had one or two earlier attempts, but four patients...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/S1058-2746(09)80054-2
更新日期:1992-11-01 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:Bone marrow aspirate has been used in recent years to augment tendon-to-bone healing, including in rotator cuff repair. However, the healing mechanism in cell-based therapy has not been elucidated in detail. METHODS:Sixteen athymic nude rats were randomly allocated to 2 groups: experimental (human mesenchym...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.09.036
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Glenoid replacement is challenging due to the difficult joint exposure and visualization of anatomical reference landmarks. Improper positioning of the glenoid component or inadequate correction of the retroversion using currently available instrumentation may lead to early failure. The objective of this stu...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jse.2009.02.022
更新日期:2009-11-01 00:00:00
abstract::We dissected 80 shoulders from 44 fresh cadavers to define variants of the coracoacromial ligament and their relationship to rotator cuff degeneration. The shapes and the geometric data of the ligaments were investigated, and the rotator cuffs of the cadavers were evaluated macroscopically. Five main types of coracoac...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2007.05.015
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Magnetic resonance imaging (MRI) findings in asymptomatic patients have been described for hips, knees, ankles, shoulders, and intervertebral disks. No such description exists for the elbow. METHODS:MRI scans of 189 asymptomatic elbows divided into 3 groups by age (group 1, 20-39 years; group 2, 40-59 years...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.05.006
更新日期:2019-06-01 00:00:00