Abstract:
BACKGROUND:There is currently disagreement among experts in the field of shoulder surgery when attempting to define the term "pseudoparalysis." Multiple surgical techniques to address this condition have been investigated; however, many studies have recruited heterogeneous patient populations and have used varying definitions of pseudoparalysis. This makes it difficult to compare outcomes among various techniques. To our knowledge, no previous study has surveyed international experts regarding the definition of pseudoparalysis using a questionnaire and video-based patient assessment. The purpose of this study was to evaluate the level of agreement among shoulder surgeons in defining and applying the term "pseudoparalysis." We hypothesized that inter-rater agreement for classifying patients as having pseudoparalysis would be poor. METHODS:Members of the American Shoulder and Elbow Surgeons, the European Society for Surgery of the Shoulder and the Elbow, and our national shoulder and elbow society were surveyed on 2 occasions using an electronic questionnaire. All surgeons were asked to identify their preferred definition of pseudoparalysis from 1 of 4 options. The surgeons then viewed video examinations of 10 patients and labeled them as having pseudoparalysis or not. Inter-rater reliability and intrarater reliability were calculated as κ coefficients. The Pearson χ2 test was used to detect associations between the preferred definition and demographic information. RESULTS:A total of 246 surgeons responded to at least 1 survey. Overall inter-rater agreement on classifying patients as having pseudoparalysis based on video consultation showed a κ value of 0.59 (95% confidence interval [CI], 0.58-0.60). The same verbal definition was selected by 56.1% of surgeons. The surgeons were not internally consistent in their choice of definition, with intrarater reliability showing a κ value of 0.64 (95% CI, 0.48-0.81). Intrarater reliability for classifying patients as having pseudoparalysis was better, with a κ value of 0.78 (95% CI, 0.72-0.83). An association was observed between how surgeons defined pseudoparalysis and their age (P = .03), as well as their shoulder caseload percentage (P = .04). CONCLUSION:Shoulder surgeons do not agree on how best to define pseudoparalysis of the shoulder. Inter-rater agreement based on video consultation was weak overall and improved with the elimination of an outlier video. Intrarater agreement was less frequent when selecting a preferred definition compared with classifying patients as having pseudoparalysis based on video examinations. Surgeons may rely less on explicit criteria and more on a conceptual framework when assigning a "pseudoparalytic" label. Care should be taken with use of the term "pseudoparalysis" in clinical outcome studies when there is clearly a lack of consensus among experts in defining this term.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Fahey CJ,Delaney RAdoi
10.1016/j.jse.2020.08.029subject
Has Abstractpub_date
2020-09-09 00:00:00eissn
1058-2746issn
1532-6500pii
S1058-2746(20)30709-6pub_type
杂志文章abstract::The purpose of this study was to assess the functional outcome of the terrible triad of the shoulder, a rare combination of anterior shoulder dislocation, massive rotator cuff tear, and neurologic injury. Six patients with this condition have been treated at our institution since 1990. The mean age was 57 years. All p...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(03)00216-7
更新日期:2003-11-01 00:00:00
abstract::The purpose of this study was to define the anatomy and dimensions of the rotator interval (RI). Thirty-two fresh-frozen cadaveric shoulders were thawed, all external musculature was removed, and coracoid osteotomy was performed to visualize the rotator cuff and RI. The 3 sides of the RI (triangle) were measured in dy...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2005.02.022
更新日期:2005-11-01 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:Patients undergoing shoulder surgery in the beach chair position may be at increased risk for serious neurocognitive complications due to cerebral ischemia. We sought to define the incidence, patient risk factors, and clinical sequelae of intraoperative cerebral desaturation events. METHODS:Regional cerebra...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.12.036
更新日期:2013-09-01 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:BACKGROUND:After isolated subscapularis repair, improvement in shoulder function has been reported at short-term review. The purpose of this study was to determine whether arthroscopic subscapularis repair provides durable improvement in objective and subjective shoulder function with a low structural retear rate. MET...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.03.024
更新日期:2019-11-01 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:BACKGROUND:Total excision of the clavicle is rarely performed. No previous study has documented long-term outcomes with objective measurements of strength, motion, and patient-centered outcomes. We present the long-term consequences of total claviculectomy on shoulder girdle function, global upper extremity function, a...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.05.011
更新日期:2014-02-01 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: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:Results of shoulder arthroplasty have been reported to be inferior with posterior glenoid wear and accompanying subluxation of the humeral head. The purpose of this study was to examine the effect of posterior glenoid wear on posterior subluxation of the humeral head. MATERIAL AND METHODS:A custom loading d...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.04.010
更新日期:2010-10-01 00:00:00
abstract:INTRODUCTION:Patients may experience a loss of internal rotation (IR) and external rotation (ER) after reverse total shoulder arthroplasty (RTSA). We hypothesized that alterations in the glenosphere position will affect the amount of impingement-free IR and ER. MATERIALS AND METHODS:Computed tomography (CT) scans of t...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.07.013
更新日期:2013-06-01 00:00:00
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::The aim of this study was to investigate tendon integrity after surgical repair of single-tendon rotator cuff lesions. In 31 patients, 31 single-tendon repairs were evaluated. Thirty-one patients were available for clinical assessment and magnetic resonance imaging (MRI) at follow-up. A standard series of MR images wa...
journal_title:Journal of shoulder and elbow surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s1058-2746(99)90136-2
更新日期:1999-05-01 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::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:Significant controversy surrounds optimal treatment of displaced 4-part proximal humeral fractures. Reverse total shoulder arthroplasty (RTSA) has recently been proposed as an alternative to hemiarthroplasty (HA) and open reduction-internal fixation (ORIF). Several authors have questioned the additional impl...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.07.044
更新日期:2014-02-01 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: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: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: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: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 Disabilities of the Arm, Shoulder and Hand (DASH) instrument was developed to assess the disability experienced by patients with any musculoskeletal condition of the upper extremity and to monitor change in symptoms and upper-limb function over time. The 30 items are scored on a 5-point rating scale. The...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jse.2019.09.026
更新日期:2020-05-01 00:00:00
abstract::Hemophilia is an X-linked recessive deficiency of clotting factor VIII (hemophilia A) or IX (hemophilia B) that can result in hemarthrosis of various joints, including the elbow. Left unchecked, this can lead to progressive joint destruction and significant morbidity. Appropriate management of the elbow joint through ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2015.06.018
更新日期:2015-10-01 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: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::A modified technique of scapulothoracic fusion was used in 6 patients who did not have muscular dystrophy and who were later evaluated clinically. The cause of the painful winging of the scapula was traumatic disruption of the trapezius and the accessory nerve in 3 patients, injury to the brachial plexus in 2, and Spr...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2004.09.008
更新日期:2005-07-01 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
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:This study was conducted to identify the rate of failure of operative treatment of lateral epicondylitis, defined as progression to ipsilateral revision surgery, and associated patient-specific risk factors for failure. METHODS:A national database was used to identify patients undergoing surgical treatment ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.10.022
更新日期:2017-04-01 00:00:00