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 developed to minimize airborne particulates. This randomized controlled trial evaluated the effectiveness of a localized laminar flow device in reducing the intrusion of ambient airborne particles and bacteria into the surgery site during shoulder arthroplasty as measured by overall particle counts and colony-forming units (CFUs). METHODS:Patients undergoing primary anatomic or reverse shoulder arthroplasty were eligible for participation. After providing informed consent, patients were randomly assigned to the Air Barrier System (ABS) group or control group. For all patients, the ABS was placed on the surgical field; however, it was only turned on by the technician for those randomized to the ABS. Study participants, surgeons, and surgical staff were blinded to group assignment. Bacterial CFUs were collected from within 5 cm of the surgical wound every 10 minutes, whereas airborne particulates were collected every minute. Poisson regression models were used to determine whether differences existed in CFUs and particulate counts between the ABS and control groups. RESULTS:A total of 43 patients were randomized into the ABS (n = 21) or control (n = 22) group. Surgical time (P = .53) and the average staff count (P = .16) in the operating room did not differ between groups. Poisson regression showed that the ABS group had significantly lower CFUs (β = -0.583, P < .001) along with surgical time and particulates with a diameter ≥ 5 μm. Staff count and particulates with a diameter < 5 μm were not significant predictors of CFUs. Infection was not a primary outcome; however, no postoperative infections have been reported in either study group with a minimum of 1-year follow-up for all patients. DISCUSSION:This double-blinded, randomized trial demonstrated that a localized laminar flow device dramatically reduced the count of CFUs in the air directly above the wound and beneath the ABS (adjusted for the number of operating room personnel and surgical time). The use of the device was not associated with a longer case duration; however, some additional setup time was required prior to surgical incision to place the device. Further study is required to determine the clinical implications of this finding-specifically, whether such devices result in lower rates of periprosthetic joint infection after shoulder arthroplasty.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Morris BJ,Kiser CJ,Laughlin MS,Sheth MM,Dunn WR,Elkousy HA,Edwards TBdoi
10.1016/j.jse.2020.08.035subject
Has Abstractpub_date
2020-09-16 00:00:00eissn
1058-2746issn
1532-6500pii
S1058-2746(20)30728-Xpub_type
杂志文章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...
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pub_type: 杂志文章
doi:10.1016/j.jse.2019.04.040
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abstract:BACKGROUND:Reports regarding arthroscopic fixation of the osteochondral fragments for elbow osteochondritis dissecans (OCD) are few. This study assessed the clinical outcomes of arthroscopic fixation of unstable osteochondral fragments by using absorbable pins over a postoperative period of at least 1 year. METHODS:Th...
journal_title:Journal of shoulder and elbow surgery
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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
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doi:10.1016/j.jse.2011.01.006
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:A hyperosmolar irrigation solution has been reported to be safe and have potential benefits for use during shoulder arthroscopy in an animal model study. In this study, the clinical effects of a hyperosmolar solution were compared with a standard isotonic solution when used for shoulder arthroscopy. METHODS...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,随机对照试验
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更新日期:2017-05-01 00:00:00
abstract::One hundred consecutive stiff shoulders in 93 patients resistant to conservative therapy were treated with surgery and intermittent regional anesthesia via indwelling interscalene catheter. Each patient underwent manipulation and one of several operative treatments to release any additional contracture. The indwelling...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2000.106083
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:This study reports the outcomes of reverse shoulder arthroplasty (RSA) in patients younger than 55 years with midterm to long-term follow-up. METHODS:Sixty-seven patients (average age, 47.9 years; range, 21-54 years) were identified who underwent RSA with an average 62.3 months of follow-up (24-144 months)....
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.09.051
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abstract:BACKGROUND:The implication of scapular morphology in rotator cuff tears has been extensively studied. However, the role of the greater tuberosity (GT) should be of equal importance. The aim of this study was to propose a new radiographic marker, the GT angle (GTA), which measures the position of the GT in relation to t...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.02.051
更新日期:2018-08-01 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
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journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.09.015
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journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
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journal_title:Journal of shoulder and elbow surgery
pub_type: 临床试验,杂志文章,多中心研究
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journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.10.024
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abstract:BACKGROUND:If the balance of the rotator cuff force couple is disrupted, pseudoparalysis may occur, but the exact mechanism remains unknown. This study investigated the effect of rotator cuff force couple disruption on active range of motion in massive rotator cuff tear (mRCT) by rotator cuff muscle volume analysis. M...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.03.017
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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
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journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.04.023
更新日期:2021-01-01 00:00:00
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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::Two cases of long thoracic nerve palsy associated with thoracic outlet syndrome are reported. Both patients had abnormal posture, with low-set shoulders and winged scapulae. Clinically there was weakness of the serratus anterior muscle with partial denervotion on electromyography. The diagnosis of thoracic outlet synd...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/S1058-2746(09)80005-0
更新日期:1994-01-01 00:00:00
abstract::The subacromial bursa is the major component of the subacromial gliding mechanism. The neural elements of the subacromial bursa obtained from specimens that underwent autopsy and surgery were investigated by the silver impregnation and immunohistochemical methods with antisera to substance P and calcitonin gene-relate...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(96)80069-3
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abstract:BACKGROUND:The Simple Shoulder Test (SST) is an internationally used patient-reported outcome for clinical practice and research purposes. It was developed for measuring functional limitations of the affected shoulder in patients with shoulder dysfunction and contains 12 questions (yes/no). The purpose of this study wa...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2011.09.026
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abstract::The contribution of the medial and lateral collateral ligaments (MCL, LCL) and muscle forces to the kinematics and stability of the capitellocondylar total elbow arthroplasty was investigated in six fresh cadaveric elbows. The three-dimensional orientation of the ulna relative to the humerus was monitored with the use...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
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journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
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journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
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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
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journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.09.002
更新日期:2020-09-30 00:00:00
abstract::A previous anatomic study has revealed that the lateral collateral ligament (LCL) complex of the elbow has a Y-shaped configuration, which consists of a superior, an anterior, and a posterior band. The LCL complex, including the annular ligament, functions as a 3-dimensional (3D) Y-shaped structure. On the basis of th...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2002.119389
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:A large engaging Hill-Sachs lesion (HSL) with subcritical glenoid bone loss (GBL) is approached through either increasing the glenoid arc by the Latarjet procedure or converting the HSL to an extra-articular defect by arthroscopic Bankart repair with remplissage (BRR). Until now, there has been no evidence-b...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2020.04.032
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate the long-term clinical and radiologic results after arthroscopic transosseous rotator cuff repair (TORCR). METHODS:A total of 69 patients with full-thickness supraspinatus tendon tears with or without infraspinatus tendon tears treated with arthroscopic TORCR by a s...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
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更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:There is an increasing body of literature suggesting that the use of patient-specific instrumentation (PSI) in total shoulder arthroplasty (TSA) results in improved positioning of the glenoid component. The aim of this in vivo study was to assess the accuracy of PSI of the glenoid component in TSA in a conse...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.07.004
更新日期:2018-01-01 00:00:00
abstract:HYPOTHESES:We hypothesized that body mass index (BMI) would be negatively associated with self-reported shoulder function/pain. A second objective was to investigate the significance of other potential contributing factors: age, sex, smoking status, tear size, and workers' compensation (WC) involvement. METHODS:In thi...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.06.011
更新日期:2011-01-01 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
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更新日期:2011-06-01 00:00:00