"Stability and Instability of RTSA"
|
|
|
- Kenneth McBride
- 5 years ago
- Views:
Transcription
1 Orthopedics Update «Reverse Total Shoulder Arthroplasty» Stability and Instability of RTSA A. LÄDERMANN Orthopaedics and Traumatology, La Tour Hospital, Meyrin, Switzerland Orthopaedics and Traumatology, Geneva University Hospitals, Switzerland Faculty of Medicine, Geneva, Switzerland
2 Disclosures I have no potential conflicts with this presentation
3 Table of Contents Prevalence Causes Prevention Treatment
4 3.4% 1-5% 3 Prevalence Early complication 61% in the first 3 months 2 Surgical error Late PE wear, trauma, hematogenous infection Anterior, posterior, lateral 1. Molé D, Favard L. Excentered scapulohumeral osteoarthritis. Rev Chir Orthop Molé D. Master Shoulder Course, Berlin Trappey. What Are the Instability and Infection Rates After Reverse Shoulder Arthroplasty? Clin Orthop 2011
5 Causes The further backward you look, the further forward you can see. Winston Churchill
6 At least 7 causes Causes 1.Failure to restore intraoperatively length of humerus 1 1. Lädermann A. Objective evaluation of lengthening in reverse shoulder arthroplasty. JSES 2009
7 Causes Biomechanics changes produced by the design: secondary complications 1 Displacement in the frontal plane of the center of rotation: _ Shortening: dislocation 2 poor function 3 1. Farshad M, Gerber C. Reverse total shoulder arthroplasty: from the most to the least common complication. International Orthopaedics 2010; 34: Lädermann A. Objective evaluation of lengthening in reverse shoulder arthroplasty. JSES Lädermann A et al. Influence of arm lengthening in reverse shoulder arthroplasty. JSES 2012
8 Cause Control of lengthening is thus the key to avoid many complications. You really control only few factors that determine arm lengthening : Position of the glenosphere in the vertical plan (you do not choose) Glenosphere size (3 mm) arm > 300 mm, 1% Eccentric glenosphere (2-4 mm) 1% Humerus length (cut, spacer, poly) (several cm, >10%) Key!
9 Cause No standardized technique to determine deltoid tension (arm lengthening). Rely on intraoperative factors?: Difficult reduction No pistoning Tight conjoint tendon No asymmetric subluxation Tilting during adduction Safer to use «Jedi skill that involves using the force» 1 1. Phipatanakul W, Norris T. In: Arthitis and Arthroplasty: The shoulder. Editors Dines DM, Laurencin CT, Williams GR. Saunders Elsevier
10 Causes Documentation included preoperative, postoperative and contralateral AP scaled radiographs of humeri. 1. Lädermann A. Objective evaluation of lengthening in reverse shoulder arthroplasty. JSES 2009
11 Measure in 58 patients Humeral lengths: Causes Difference in pre-postoperative (CP-CHipsi): 2 ± 7 mm (range: -9 to16, p=0.243). Postoperative shortening (observed in all dislocations n=6) was -30 ± 18 mm (range: -50 mm to -10 mm, p<0.0001). Arm lengthening: Compared to preop ipsi side: arm lengthening 23 ± 12 mm (range: 1 to 47, p<0.001), correspond to deltoid re-tensioning. Compared to contralateral: arm lengthening 20 ± 11 mm. 1) Lädermann A. Objective evaluation of lengthening in reverse shoulder arthroplasty. JSES 2009
12 Discussion Technique of preoperative measure to objectively determine the height of RSA. 1. Lädermann A. Objective evaluation of lengthening in reverse shoulder arthroplasty. JSES 2009
13 2. Failure to restore posteratively length of humerus Acromial/spine fractures Causes Not described in series, 1-2 but personal communications 3 and case report 4 Courtesy of F. Goelke 1. Walch G et a. Acromial insufficiency in reverse shoulder arthroplasties. JSES Wahlquist TC. Acromial base fractures after reverse total shoulder arthroplasty: report of five cases. JSES Goelke F. Personal communication. Master shoulder course Berlin. 4. Levy JC. Postoperative acromion base fracture resulting in subsequent instability of reverse shoulder replacement. JSES 2012
14 3. Impingement Biomechanics changes produced by the design: secondary complications 1 Causes Medialization center of rotation: - Notching 2 (inferior impingement) -No neck (AP impingement) Importance of humeral version 3 1) Farshad M, Gerber C. Reverse total shoulder arthroplasty: from the most to the least common complication. International Orthopaedics 2010; 34: ) Simovitch RW et al. Predictors of scapular notching in patients managed with the Delta III reverse total shoulder replacement. J Bone Joint Surg Am ) Favre et al. The effect of component positioning on intrinsic stability of the reverse shoulder arthroplasty. JSES 2010
15 Cause 4. Muscle insufficiency Main cause of instability of the RSA is the large anteroinferior release performed through the DP approach (subscapularis and inferior GH ligament) Subscapularis Absence or failure of repair 1 (1-12%) Grade 3 FI 2 Imbalance LDT without subscapularis Deltoid? 3 1) Edward et al. Subscapularis insufficiency and the risk of shoulder dislocation after reverse shoulder arthroplasty. J Shoulder Elbow Surg ) Molé D, Favard L. Excentered scapulohumeral osteoarthritis. Rev Chir Orthop ) Lädermann A. Reverse shoulder arthroplasty with deltoid insufficiency. In press
16 Cause 5. Humeral bone insufficiency
17 Cause 6. Infection Instability accompanied by infection in 44% cases. 1. Gallo et al. Instability after reverse total shoulder replacement. JSES 2011
18 7. Neurological lesions Causes Biomechanics changes produced by the design: secondary complications 1 Displacement in the frontal plane of the centre of rotation: Lengthening: Acromial fracture Neurological lesions Permanent arm abduction 1. Farshad M, Gerber C. Reverse total shoulder arthroplasty: from the most to the least common complication. International Orthopaedics 2010; 34:
19 Recent postoperative lesion Causes Prospective. Same operative technique. Control EMG 3.6 weeks postoperative RSA group (n=19) ASA group (n=23) Axillary n. 6 0 Suprascapular n. 2 0 Musculocutaneous n. 2 0 Ulnar n. 1 0 Plexus lesion 1 1 Total (patients) 12 / 9 patients 1 / 1 patient 45% acute, 18% worsening, 63% neurological impairment! Lädermann A et al. Prevalence of neurological lesion after total shoulder arthroplasty. JBJS Am 2011
20 Results Significantly increased risk for a neurological lesion with increasing arm lengthening (p<0.001)
21 Prevention 1. Baseplate positionning: Low position frontal plane 1 Inferior tilt? 1. Nyffeler RW et al. Biomechanical relevance of glenoid component positioning in the reverse Delta III total shoulder prosthesis. J Shoulder Elbow Surg Edwards TB et al. Inferior tilt of the glenoid component does not decrease scapular notching in reverse shoulder arthroplasty: results of a prospective randomized study. JSES 2012
22 Prevention 2. Glenosphere design: Eccentric Does not prevent but Tilt decreases notching 1. Mizuno. The clinical and radiographical results of reverse total shoulder arthroplasty with eccentric glenosphere. Int Orthop 2012
23 Prevention 2. Glenosphere design: Eccentric Tilt Size (36 vs 42) Instability rate with 42 : 0% Instability rate with 36 : 4,3% Molé D. RSA instability. Shoulder Master Course, Berlin, 2013.
24 2. Glenosphere design: Eccentric Tilt Size (36 vs 42) Prevention Glenoid lateralization (less notching/impingement? Less tension (less neurological lesion?) 1. Boileau P et al. BIO RSA. Minimizing Scapular Impingement While Maximizing Glenoid Fixation. Clin Orthop 2011.
25 3. Humeral design: Lower inclination angle limits notching but Easier lateral dislocation Prevention
26 Prevention 4. Approach Superior approach have less dislocation 5% with DP approach 1% with superior approach 1 Role of the subscapularis 2 1. Molé D. RSA instability. Shoulder Master Course, Berlin, ) Edward et al. Subscapularis insufficiency and the risk of shoulder dislocation after reverse shoulder arthroplasty. J Shoulder Elbow Surg. 2009
27 My philosophy Restore humeral length for stability Restore arm length for function Aim 0-2 cm Subscapularis lesion DP, repair if possible Intact subcapularis Superior approach Glenoid lateralization with both approach Large head according to the size of the patient
28
29
30
31
32 Treatment Analyze (surgical error) 1st episode Close reduction, abduction sling 4w Note efficient most of the time Recurrence: surgical management Deltoid/soft-tissue tension is the key Scaled X-ray both humeri Restore humeral length (PE, spacer) Think about the glenoid!
33 Teamwork Alone we can do so little, together we can do so much. Helen Keller Thank you to Gilles Walch
34 Thank you for your attention.
Reverse Total Shoulder Arthroplasty: A New Frontier (of Complications)
Reverse Total Shoulder Arthroplasty: A New Frontier (of Complications) Emilie Cheung, MD Associate Professor Chief Shoulder Elbow Svc Stanford University Department of Orthopedic Surgery Procedure volumes
Biomechanical concepts of total shoulder replacement. «Shoulder Course» Day 1. Richard W. Nyffeler Orthopädie Sonnenhof Bern. 11. Sept.
Biomechanical concepts of total shoulder replacement Richard W. Nyffeler Orthopädie Sonnenhof Bern First total shoulder prosthesis Jules Emile Péan, 1830-1898 Monobloc prostheses Charles Neer, 1917-2011
Immediate post surgical findings of soft tissue swelling, subcutaneous emphysema, and skin staples for reverse total shoulder arthroplasty.
Immediate post surgical findings of soft tissue swelling, subcutaneous emphysema, and skin staples for reverse total shoulder arthroplasty. REVERSE TOTAL SHOULDER ARTHROPLASTY WITH FRACTURED ACROMION Above:
Shoulder Arthroplasty. Valentin Lance 3/24/16
Shoulder Arthroplasty Valentin Lance 3/24/16 Outline Background Pre-operative imaging assessment Total Shoulder Arthroplasty: Standard and Reverse Complications Other shoulder hardware Hemiarthroplasty
Scapular notching in reverse shoulder arthroplasties: The influence of glenometaphyseal angle
Orthopaedics & Traumatology: Surgery & Research (2011) 97S, S131 S137 ORIGINAL ARTICLE Scapular notching in reverse shoulder arthroplasties: The influence of glenometaphyseal angle V. Falaise a, C. Levigne
SSSR. 1. Nov Shoulder Prosthesis. Postoperative Imaging. Florian M. Buck, MD
Shoulder Prosthesis Postoperative Imaging Florian M. Buck, MD Shoulder Prosthesis Surgical Approach Findings Imaging Modalities Postoperative Problems Shoulder Prosthesis What are we talking about Anatomical
Index. B Backslap technique depth assessment, 82, 83 diaphysis distal trocar, 82 83
Index A Acromial impingement, 75, 76 Aequalis intramedullary locking avascular necrosis, 95 central humeral head, 78, 80 clinical and functional outcomes, 95, 96 design, 77, 79 perioperative complications,
Advantages to medialize less
Advantages to medialize less less RSP? Clinical and radiological results Ph Valenti, D Katz, Ph Sauzieres J Kany, K Elkolti, P Gleyze Paris, Lorient, Toulouse, Lyon, Colmar Delta RSP CTA pseudoparalytic
Augmented Glenoid Component for Bone Deficiency in Shoulder Arthroplasty
Clin Orthop Relat Res (2008) 466:579 583 DOI 10.1007/s11999-007-0104-4 SYMPOSIUM: NEW APPROACHES TO SHOULDER SURGERY Augmented Glenoid Component for Bone Deficiency in Shoulder Arthroplasty Robert S. Rice
Proximal Humeral Fractures RSA v HHR. Proximal Humeral Fractures RSA v HHR. Introduction
Proximal Humeral Fractures RSA v HHR Xavier A. Duralde, MD Peachtree Orthopaedic Clinic Atlanta, GA Proximal Humeral Fractures RSA v HHR Consultant: Smith+Nephew Board of Directors: CORR Introduction Incidence
Clinical Outcomes and Complications during the Learning Curve for Reverse Total Shoulder Arthroplasty: An Analysis of the First 40 Cases
Original Article Clinics in Orthopedic Surgery 2017;9:213-217 https://doi.org/10.4055/cios.2017.9.2.213 Clinical Outcomes and Complications during the Learning Curve for Reverse Total Shoulder Arthroplasty:
No Financial Disclosures
Rehabilitation Following Total and Reverse Shoulder Arthroplasty, PT, DPT, SCS, CSCS No Financial Disclosures Total Shoulder Arthroplasty Arthritic shoulder increasing in prevalence More active as we age
Matthew D. Saltzman, MD a, Deana M. Mercer, MD c, Winston J. Warme, MD b, Alexander L. Bertelsen, PA-C b, Frederick A. Matsen III, MD b, *
J Shoulder Elbow Surg (2010) 19, 1028-1033 www.elsevier.com/locate/ymse A method for documenting the change in center of rotation with reverse total shoulder arthroplasty and its application to a consecutive
Optimizing Deltoid Efficiency with Reverse Shoulder Arthroplasty Using a Novel Inset Center of Rotation Glenosphere Design
S37 Optimizing Deltoid Efficiency with Reverse Shoulder Arthroplasty Using a Novel Inset Center of Rotation Glenosphere Design Christopher P. Roche, M.S., M.B.A., Matthew A. Hamilton, Ph.D., Phong Diep,
Conflicts of Interest Consulting (C), Royalty (R)
Principles of Anatomic Total Shoulder Arthroplasty Joseph P. Iannotti MD, PhD Maynard Madden Professor and Chairman Orthopaedic and Rheumatologic Institute Cleveland Clinic Conflicts of Interest Consulting
Radiology Case Reports. Scapular Spine Stress Fracture as a Complication of Reverse Shoulder Arthroplasty
Radiology Case Reports Volume 2, Issue 2, 2007 Scapular Spine Stress Fracture as a Complication of Reverse Shoulder Arthroplasty Kimberly J. Burkholz, Catherine C. Roberts, and Steven J. Hattrup We report
Shoulder Joint Examination. Shoulder Joint Examination. Inspection. Inspection Palpation Movement. Look Feel Move
Shoulder Joint Examination History Cuff Examination Instability Examination AC Joint Examination Biceps Tendon Examination Superior Labrum Examination Shoulder Joint Examination Inspection Palpation Movement
Conversion of Anatomic TSA to RSA
Conversion of Anatomic TSA to RSA Joseph A. Abboud, M.D. Professor of Shoulder and Elbow Surgery Senior Vice-President at the Rothman Institute Philadelphia, PA Disclosures Joseph A. Abboud, MD Depuy Synthes
Making sense of all our measures-inclination, version, subluxation, reaming depth & implant seating
Thursday - ANATOMIC SHOULDER ARTHROPLASTY 7:00-7:15a Welcome and Introduction of Faculty Athwal, Keener, 7:15-7:22a The ABC s of the Walch Classification Walch 7:22-7:32a How I use x-rays, CT +/- MRI for
Patient ID. Case Conference. Physical Examination. Image examination. Treatment 2011/6/16
Patient ID Case Conference R3 高逢駿 VS 徐郭堯 55 y/o female C.C.: recurrent right shoulder dislocation noted since falling down injury 2 years ago Came to ER because of dislocation for many times due to minor
Revision of reversed total shoulder arthroplasty. Indications and outcome
Farshad et al. BMC Musculoskeletal Disorders 2012, 13:160 RESEARCH ARTICLE Open Access Revision of reversed total shoulder arthroplasty. Indications and outcome Mazda Farshad *, Marion Grögli, Sabrina
Anatomic Total Shoulder Arthroplasty: Optimizing Outcomes and Avoiding Complications
Anatomic Total Shoulder Arthroplasty: Optimizing Outcomes and Avoiding Complications Dr. Ryan T. Bicknell, MD, MSc, FRCSC Associate Professor Division of Orthopaedic Surgery, Departments of Surgery, Mechanical
The Shoulder. Anatomy and Injuries PSK 4U Unit 3, Day 4
The Shoulder Anatomy and Injuries PSK 4U Unit 3, Day 4 Shoulder Girdle Shoulder Complex is the most mobile joint in the body. Scapula Clavicle Sternum Humerus Rib cage/thorax Shoulder Girdle It also includes
ANATOMIC TOTAL SHOULDER REPLACEMENT:
The Shoulder Replacement A total shoulder arthroplasty (TSA) is a surgery to replace the damaged parts of the ball and socket shoulder joint with an artificial prosthesis. The damage to the shoulder can
Rehabilitation Guidelines for Labral/Bankert Repair
Rehabilitation Guidelines for Labral/Bankert Repair The true shoulder joint is called the glenohumeral joint and consists humeral head and the glenoid. It is a ball and socket joint. Anatomy of the Shoulder
D Degenerative joint disease, rotator cuff deficiency with, 149 Deltopectoral approach component removal with, 128
Index A Abduction exercise, outpatient with, 193, 194 Acromioclavicular arthritis, with, 80 Acromiohumeral articulation, with, 149 Acromio-humeral interval (AHI), physical examination with, 9, 10 Active
P. Trouilloud M. Gonzalvez P. Martz H. Charles F. Handelberg R. W. Nyffeler E. Baulot DuocentricÒ Group
DOI 10.1007/s00590-013-1213-2 ORIGINAL ARTICLE Duocentric Ò reversed shoulder prosthesis and Personal Fit Ò templates: innovative strategies to optimize prosthesis positioning and prevent scapular notching
Accuracy of CT-based measurements of glenoid version for total shoulder arthroplasty
J Shoulder Elbow Surg (2009) -, 1-6 www.elsevier.com/locate/ymse Accuracy of CT-based measurements of glenoid version for total shoulder arthroplasty Heinz R. Hoenecke Jr., MD*, Juan C. Hermida, MD, Cesar
S h o u l d e r Solutions by Tornier C o n v e r T i b l e S h o u l d e r S y S T e m
S h o u l d e r Solutions by Tornier C o n v e r t i b l e s h o u l d e r s y s t e m C o n v e r t i b l e s h o u l d e r s y s t e m A n a t o m i c Aequalis Ascend Flex - UDZF131 One System. Two Solutions.
Les séquelles traumatiques. Ph. Valenti, J. Kany, D. Katz
Indications et Techniques Les séquelles traumatiques Ph. Valenti, J. Kany, D. Katz Paris Shoulder Unit Clinique Bizet (Paris, France) Disclosures Arthroplasty Consultant : FH orthopaedics receive royalties
The Irreparable Rotator Cuff Tear:
The Irreparable Rotator Cuff Tear: Trauma 101: Shoulder Session #2 Brian Grawe, MD Assistant Professor Orthopaedics & Sports Medicine 5/10/2018 Brian Grawe, MD Assistant Professor Phone Number: 513-558-4516
Reversed Revised : What to do when it goes wrong?
Acta Orthop. Belg., 2014, 80, 314-321 ORIGINAL STUDY Reversed Revised : What to do when it goes wrong? Bart Middernacht, Alexander Van Tongel, Lieven De Wilde From Department of Orthopaedics, University
Reverse Total Shoulder Arthroplasty Protocol
General Information: Reverse Total Shoulder Arthroplasty Protocol Reverse or Inverse Total Shoulder Arthroplasty (rtsa) is designed specifically for the treatment of glenohumeral (GH) arthritis when it
Reverse Total Shoulder Arthroplasty Protocol Shawn Hennigan, MD
General Information: Reverse Total Shoulder Arthroplasty Protocol Shawn Hennigan, MD Reverse or Inverse Total Shoulder Arthroplasty (rtsa) is designed specifically for the treatment of glenohumeral (GH)
Analysis of a retrieved Delta III total shoulder prosthesis
Analysis of a retrieved Delta III total shoulder prosthesis R. W. Nyffeler, C. M. L. Werner, B. R. Simmen, C. Gerber From the University of Zurich, Zurich, Switzerland A reversed Delta III total shoulder
Managing acromial fractures: prevention and treatment, both nonoperative and operative
Review Article Page 1 of 8 Managing acromial fractures: prevention and treatment, both nonoperative and operative Christopher D. Joyce, Adam J. Seidl Department of Orthopaedics, University of Colorado,
AJO DO NOT COPY. The low grade of the intrinsic stability of the shoulder. Total Reverse Shoulder Arthroplasty: European Lessons and Future Trends
A Review Paper Total Reverse Shoulder Arthroplasty: European Lessons and Future Trends Ludwig Seebauer, MD Abstract In the late 1980s, Grammont introduced a new reverse total shoulder arthroplasty (TSA),
Scapular Notching. Recognition and Strategies to Minimize Clinical Impact. Gregory P. Nicholson MD, Eric J. Strauss MD, Seth L.
Clin Orthop Relat Res DOI 10.1007/s11999-010-1720-y SYMPOSIUM: REVERSE TOTAL SHOULDER ARTHROPLASTY Scapular Notching Recognition and Strategies to Minimize Clinical Impact Gregory P. Nicholson MD, Eric
SHOULDER ANATOMY Karl Wieser, MD Department of Orthopedics, University of Zurich, Balgrist, Switzerland
20th Course in Shoulder Surgery Balgrist SHOULDER ANATOMY Karl Wieser, MD Department of Orthopedics, University of Zurich, Balgrist, Switzerland www.balgrist.ch ANATOMY OVERVIEW courtesy of Georg Lajtai
Current Controversies in Shoulder Surgery:
Current Controversies in Shoulder Surgery: Shoulder Instability Rotator Cuff Injury and Repair Reverse Shoulder Arthroplasty Brian Feeley, MD UC San Francisco Sports Medicine and Shoulder Surgery Disclosures
I (and/or my co-authors) have something to disclose.
Shoulder Anatomy And Biomechanics Nikhil N Verma, MD Director of Sports Medicine Professor, Department of Orthopedics Rush University Team Physician, Chicago White Sox and Bulls I (and/or my co-authors)
IMPINGEMENT-TESTSTESTS
«thinking about.» DIFFERENTIAL DIAGNOSIS: Looking for the causes of Which special tests do you use in your shoulder examination? Ann Cools, PT, PhD Ghent University - Belgium Dept of Rehabilitation Sciences
Shoulder and Elbow ORTHOPAEDIC SYPMPOSIUM APRIL 8, 2017 DANIEL DOTY MD
Shoulder and Elbow ORTHOPAEDIC SYPMPOSIUM APRIL 8, 2017 DANIEL DOTY MD Shoulder Articulations Glenohumeral Joint 2/3 total arc of motion Shallow Ball and Socket Joint Allows for excellent ROM Requires
Zimmer Patient Specific Instruments (PSI) for Reverse Shoulder Arthroplasty
Zimmer Patient Specific Instruments (PSI) for Reverse Shoulder Arthroplasty Ryan Krupp, M.D. Norton Orthopaedic Specialists Louisville, KY Anand Murthi, M.D. MedStar Union Memorial Hospital Baltimore,
Upper Limb Biomechanics SCHOOL OF HUMAN MOVEMENT STUDIES
Upper Limb Biomechanics Phases of throwing motion 1. Wind up Starts: initiate first movement Ends: lead leg is lifted & throwing hand removed from glove COG raised 2. Early Cocking Start: lead leg is lifted
P V S MEMORIAL HOSPITAL LTD.
SHOULDER XRAYS Instability Series o True AP (Grashey s) o Axillary o Stryker Notch view o True AP in Internal rotation o Scapular Y view o West Point view for Bony Bankart ( looks like modif axillary view)
Reverse Total Shoulder Protocol
Marion Herring, M.D. OrthoVirginia PH: (804) 270-1305 FX: (804) 273-9294 www.orthovirginia.com Reverse Total Shoulder Protocol General Information: Reverse Total Shoulder Arthroplasty (rtsa) is designed
Orthopedics - Dr. Ahmad - Lecture 2 - Injuries of the Upper Limb
The shoulder and the upper arm Fractures of the clavicle 1. Fall on the shoulder. 2. Fall on outstretched hand. In mid shaft fractures, the outer fragment is pulled down by the weight of the arm and the
Optimal Baseplate Rotational Alignment in Reverse Total Shoulder Arthroplasty: A Three-Dimensional Computer-Aided Design Study.
Optimal Baseplate Rotational Alignment in Reverse Total Shoulder Arthroplasty: A Three-Dimensional Computer-Aided Design Study. Byron F. Stephens, MD 1, Casey T. Hebert 2, Thomas W. Throckmorton, MD 1,
Page 1. Shoulder Injuries in Sports.
www.schulterteam.ch Shoulder Injuries in Sports Matthias A Zumstein Shoulder, Elbow and Orthopaedic Sports Medicine Department of Orthopedic Surgery and Traumatology University of Berne, Switzerland matthias.zumstein@insel.ch
Reverse Total Shoulder Arthroplasty Improves Function in Cuff Tear Arthropathy
Clin Orthop Relat Res (2011) 469:2476 2482 DOI 10.1007/s11999-010-1683-z SYMPOSIUM: REVERSE TOTAL SHOULDER ARTHROPLASTY Reverse Total Shoulder Arthroplasty Improves Function in Cuff Tear Arthropathy Betsy
Reverse Total Shoulder. Dr. Minoo Patel
Reverse Total Shoulder Dr. Minoo Patel AOA VIC, Lorne, 2011 The role of the rotator cuff Depress and humeral head (against the force of the deltoid) Keep the humeral head co-apted in the glenoid Initiate
Reverse Total Shoulder Arthroplasty with Latissimus dorsi tendon transfer Protocol:
Adam N. Whatley, M.D. 6550 Main St., STE. 2300 Zachary, LA 70791 Phone(225)658-1808 Fax(225)658-5299 Reverse Total Shoulder Arthroplasty with Latissimus dorsi tendon transfer Protocol: General Information:
Assessment of Scapular Morphology and Surgical Technique as Predictors of Notching in Reverse Shoulder Arthroplasty
An Original Study Assessment of Scapular Morphology and Surgical Technique as Predictors of Notching in Reverse Shoulder Arthroplasty Vani Sabesan, MD, Mark Callanan, MD, Vinay Sharma, BA, and J. Michael
Technique. Aequalis Resurfacing Humeral Head
S u r g i c a l Technique Aequalis Resurfacing Humeral Head 1 The Aequalis Resurfacing Humeral Head has been developed in conjunction with Drew Miller, MD - Atlanta, GA. The Aequalis Resurfacing Humeral
Region of upper limb attachment to the trunk Proximal segment of limb overlaps parts of the trunk (thorax and back) and lower lateral neck.
Region of upper limb attachment to the trunk Proximal segment of limb overlaps parts of the trunk (thorax and back) and lower lateral neck. includes Pectoral Scapular Deltoid regions of the upper limb
REMINDER. an exercise program. Senior Fitness Obtain medical clearance and physician s release prior to beginning
Functional Forever: Exercise for Independent Living REMINDER Obtain medical clearance and physician s release prior to beginning an exercise program for clients with medical or orthopedic concerns. What
I have no relevant disclosures pertaining to this talk.
Bryan Houseman, D.O., ATC Orthopaedic Trauma and Fracture Surgeon New Hampshire Orthopaedic Center September 10, 2016 I have no relevant disclosures pertaining to this talk. From Rockwood & Green, 8 th
Why are these shoulder replacements called a reverse prosthesis?
PATIENT GUIDE TO REVERSE PROSTHESIS Edward G. McFarland MD The Division of Sports Medicine and Shoulder Surgery The Department of Orthopaedic Surgery The Johns Hopkins University Baltimore MD Why are these
Evaluating Scapular Notching after Reverse Total Shoulder Arthroplasty
ORIGINAL ARTICLE Clinics in Shoulder and Elbow Vol. 18, No. 4, December, 2015 http://dx.doi.org/10.5397/cise.2015.18.4.248 CiSE Clinics in Shoulder and Elbow Evaluating Scapular Notching after Reverse
Index. ESSKA 2018 G. Milano et al. (eds.), Management of Failed Shoulder Surgery,
A Acromial fractures, 186 Acromioclavicular joint (ACJ) instability, 55, 97 case study, 98 100 classification, 85 clinical relevant situations, 86 dislocation, 97 98 insufficient fixation, 87 88 operative
Shoulder Arthroplasty
Shoulder Arthroplasty Nathan G. Everding, MD Specializing in Hand, Wrist, Elbow & Shoulder Surgery Syracuse Orthopedic Specialists SJH Family Practice Refresher course 3/8/19 Shoulder Arthroplasty Rate
Bulletin of the Hospital for Joint Diseases 2013;71(4):284-93
284 Impact of Inferior Glenoid Tilt, Humeral Retroversion, Bone Grafting, and Design Parameters on Muscle Length and Wrapping in Reverse Shoulder Arthroplasty Christopher P. Roche, M.S., M.B.A., Phong
SHOULDER INSTABILITY
SHOULDER INSTABILITY Dr.KN Subramanian M.Ch Orth., FRCS (Tr & Orth), CCT Orth(UK) Consultant Orthopaedic Surgeon, Special interest: Orthopaedic Sports Injury, Shoulder and Knee Surgery, SPARSH Hospital
An evaluation of the radiological changes around the Grammont reverse geometry shoulder arthroplasty after eight to 12 years
UPPER LIMB An evaluation of the radiological changes around the Grammont reverse geometry shoulder arthroplasty after eight to 12 years B. Melis, M. DeFranco, A. Lädermann, D. Molé, L. Favard, C. Nérot,
Shoulder Instability. Fig 1: Intact labrum and biceps tendon
Shoulder Instability What is it? The shoulder joint is a ball and socket joint, with the humeral head (upper arm bone) as the ball and the glenoid as the socket. The glenoid (socket) is a shallow bone
Proximal Humerus Fractures: contemporary perspectives
Proximal Humerus Fractures: contemporary perspectives Diego L Fernandez M.D Professor of Orthopaedic Surgery Department of Orthopaedic Surgery Lindenhof Hospital, Berne, Switzerland www.diegofernandez.ch
Total Shoulder Arthroplasty
1 Total Shoulder Arthroplasty Surgical indications and contraindications Anatomical Considerations: Total shoulder arthroplasty surgery involves the replacement of the humeral head and the glenoid articulating
Risks of loosening of a prosthetic glenoid implanted in retroversion
Risks of loosening of a prosthetic glenoid implanted in retroversion Alain Farron, MD, a Alexandre Terrier, PhD, b and Philippe Büchler, PhD, b Lausanne, Switzerland Osteoarthritis of the shoulder is frequently
Structure and Function of the Bones and Joints of the Shoulder Girdle
Structure and Function of the Bones and Joints of the Shoulder Girdle LEARNING OBJECTIVES: At the end of this laboratory exercise the student will be able to: Palpate the important skeletal landmarks of
The use of the Lima reverse shoulder arthroplasty for the treatment of fracture sequelae of the proximal humerus
J Orthop Sci (2012) 17:141 147 DOI 10.1007/s00776-011-0185-5 ORIGINAL ARTICLE The use of the Lima reverse shoulder arthroplasty for the treatment of fracture sequelae of the proximal humerus Angel Antonio
Biomechanical Impact of Posterior Glenoid Wear on Anatomic Total Shoulder Arthroplasty
S5 Biomechanical Impact of Posterior Glenoid Wear on Anatomic Total Shoulder Arthroplasty Christopher P. Roche, M.S., M.B.A., Phong Diep, B.S., Sean G. Grey, M.D., and Pierre-Henri Flurin, M.D. Abstract
Prosthetic design of reverse shoulder arthroplasty contributes to scapular notching and instability
Submit a Manuscript: http://www.wjgnet.com/esps/ Help Desk: http://www.wjgnet.com/esps/helpdesk.aspx DOI: 10.5312/wjo.v7.i11.738 World J Orthop 2016 November 18; 7(11): 738-745 ISSN 2218-5836 (online)
)532( COPYRIGHT 2018 BY THE ARCHIVES OF BONE AND JOINT SURGERY
)532( COPYRIGHT 2018 BY THE ARCHIVES OF BONE AND JOINT SURGERY RESEARCH ARTICLE The Midterm Results of the Delta Xtend Reverse Shoulder System: A Five-Year Outcome Study John G. Horneff, MD; Thema A. Nicholson,
Massive Rotator Cuff Tears. Rafael M. Williams, MD
Massive Rotator Cuff Tears Rafael M. Williams, MD Rotator Cuff MRI MRI Small / Partial Thickness Medium Tear Arthroscopic View Massive Tear Fatty Atrophy Arthroscopic View MassiveTears Tear is > 5cm
Shoulder Injury Evaluation.
Shoulder Injury Evaluation www.fisiokinesiterapia.biz Basic Anatomy & Kinesiology 3 Bone Structures Clavicle Scapula Humerus Evaluation Principles Always follow a standard progression Determine the target
Surgical. Technique. AEQUALIS Spherical Base Glenoid. Shoulder Prosthesis.
Surgical Technique Shoulder Prosthesis AEQUALIS Spherical Base Glenoid www.tornier.com CONTENTS CONTENTS 1. Subscapularis 2. Anterior capsule 3. Humeral protector 4. Inserting retractors 1. DESIGN FEATURES
Use of a partial humeral head resurfacing system for management of an osseous mechanic... Page 1 of 12 Int J Shoulder Surg. 2011 Jan-Mar; 5(1): 17 20. doi: 10.4103/0973-6042.80465. PMCID: PMC3109768 Copyright
"Zero-Position" Functional Shoulder Orthosis for Postoperative. management of rotator cuff injuries.
"Zero-Position" Functional Shoulder Orthosis for Postoperative Management of Rotator Cuff Injuries Jiro Ozaki, M.D. Ichiro Kawamura INTRODUCTION Many shoulder orthoses such as the airplane splint, the
WEEKEND 2 Shoulder. Shoulder Active Range of Motion Assessment
Virginia Orthopedic Manual Physical Therapy Institute - 2016 Technique Manual WEEKEND 2 Shoulder Shoulder Active Range of Motion Assessment - Patient Positioning: Standing, appropriately undressed so that
Secret shoulder secrets Dominik Meyer
Secret shoulder secrets Dominik Meyer Head of the prostheses better too big or too small? In case of stiffness: smaller (loosening of capsule) In case of hyperlaxity / instability or strong correction
POSTERIOR INSTABILITY OF THE SHOULDER Vasu Pai
POSTERIOR INSTABILITY OF THE SHOULDER Vasu Pai Posterior instability is less common among cases of shoulder instability, accounting for 2% to 10% of all cases of instability. More common in sporting groups:
Shoulder: Clinical Anatomy, Kinematics & Biomechanics
Shoulder: Clinical Anatomy, Kinematics & Biomechanics Dr. Alex K C Poon Department of Orthopaedics & Traumatology Pamela Youde Nethersole Eastern Hospital Clinical Anatomy the application of anatomy to
Reverse Total Shoulder Arthroplasty: Early Outcome and Complication Report
ORIGINAL ARTICLE Clinics in Shoulder and Elbow Vol. 17, No. 2, June, 2014 http://dx.doi.org/10.5397/cise.2014.17.2.68 CiSE Clinics in Shoulder and Elbow Reverse Total Shoulder Arthroplasty: Early Outcome
DISTINGUISHING BETWEEN ACUTE AND CHRONIC ROTATOR CUFF INJURIES IN WORKERS COMPENSATION PATIENTS
DISTINGUISHING BETWEEN ACUTE AND CHRONIC ROTATOR CUFF INJURIES IN WORKERS COMPENSATION PATIENTS Lyndon B. Gross M.D. Ph.D. The Orthopedic Center of St. Louis SHOULDER PAIN Third most common musculoskeletal
MUSCLES OF SHOULDER REGION
Dr Jamila EL Medany OBJECTIVES At the end of the lecture, students should: List the name of muscles of the shoulder region. Describe the anatomy of muscles of shoulder region regarding: attachments of
Shoulder Biomechanics
Shoulder Biomechanics Lecture originally developed by Bryan Morrison, Ph.D. candidate Arizona State University Fall 2000 1 Outline Anatomy Biomechanics Problems 2 Shoulder Complex Greatest Greatest Predisposition
Managing Glenoid Bone Deficiency The Augment Experience in Anatomic and Reverse Shoulder Arthroplasty
Managing Glenoid Bone Deficiency The Augment Experience in Anatomic and Reverse Shoulder Arthroplasty Publish date: March 5, 2018 Authors: Rowan J. Michael, MD Bradley S. Schoch, MD Joseph J. King, MD
REHABILITATION FOR SHOULDER FRACTURES & SURGERIES. Clavicle fractures Proximal head of humerus fractures
REHABILITATION FOR SHOULDER FRACTURES & SURGERIES Clavicle fractures Proximal head of humerus fractures By Dr. Mohamed Behiry Lecturer Department of physical therapy for Orthopaedic and its surgery. Delta
Revision of total shoulder arthroplasty
Orthopaedics & Traumatology: Surgery & Research (2013) 99S, S12 S21 Available online at www.sciencedirect.com REVIEW ARTICLE Revision of total shoulder arthroplasty L. Favard Orthopaedic and Trauma Surgery,
Scapular Notching on Kinematic Simulated Range of Motion After Reverse Shoulder Arthroplasty Is Not the Result of Impingement in Adduction
Article Scapular Notching on Kinematic Simulated Range of Motion After Reverse Shoulder Arthroplasty Is Not the Result of Impingement in Adduction LAEDERMANN, Alexandre, et al. Abstract Impingement after
Returning the Shoulder Back to Optimal Function. Scapula. Clavicle. Humerus. Bones of the Shoulder (Osteology) Joints of the Shoulder (Arthrology)
Returning the Shoulder Back to Optimal Function Sternum Clavicle Ribs Scapula Humerus Bones of the Shoulder (Osteology) By Rick Kaselj Clavicle Scapula Medial Left Anterior Clavicle Inferior View 20 degree
Influence of Glenosphere Design on Outcomes and Complications of Reverse Arthroplasty: A Systematic Review
Original Article Clinics in Orthopedic Surgery 2016;8:288-297 http://dx.doi.org/10.4055/cios.2016.8.3.288 Influence of Glenosphere Design on Outcomes and Complications of Reverse Arthroplasty: A Systematic
What s New in the Treatment of Proximal Humerus Fractures?
NHMI Winter Meeting Stowe, VT January 2015 What s New in the Treatment of Proximal Humerus Fractures? John Bell, M.D., M.S. Associate Professor Shoulder and Elbow Surgery Dartmouth-Hitchcock Medical Center
Title: Scapular Notching on Kinematic Simulated Range of Motion after Reverse Shoulder Arthroplasty is not the Result of Impingement in Adduction
1 2 Title: Scapular Notching on Kinematic Simulated Range of Motion after Reverse Shoulder Arthroplasty is not the Result of Impingement in Adduction 3 4 Running title: Scapular notching in RSA 5 6 7 Alexandre
REMINDER. Obtain medical clearance and physician s release prior to beginning an exercise program for clients with medical or orthopedic concerns
Understanding Shoulder Dysfunction REMINDER Obtain medical clearance and physician s release prior to beginning an exercise program for clients with medical or orthopedic concerns What is a healthy shoulder?
Shoulder Injuries. Glenoid labrum injuries. SLAP Lesions
Shoulder Injuries functional anatomy clinical perspective impingement rotator cuff injuries glenoid labrum injuries dislocation Glenoid labrum injuries SLAP lesions stable or unstable traction/compression
Convertibilité. Ph. Valenti. Paris Shoulder Unit Clinique Bizet (Paris, France)
Convertibilité Ph. Valenti Paris Shoulder Unit Clinique Bizet (Paris, France) Disclosures Arthroplasty Consultant : FH orthopaedics receive royalties Arthroscopy Consultant : Zimmer Biomet Arthrex In Last
Reverse Geometry Shoulder Arthroplasty
1.0 Policy Statement... 2 2.0 Purpose... 2 3.0 Scope... 2 4.0 Health & Safety... 2 5.0 Responsibilities... 2 6.0 Definitions and Abbreviations... 3 7.0 Guideline... 3 7.1 Pre-Operative... 3 7.2 Post-Operative...