ISSN:0885-9698    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0885-9698    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:Total shoulder arthroplasty is a potent means of enhancing the lives of those afflicted with debilitating arthritis of the glenohumeral joint. Advances in prosthetic design allow improved implant fixation and greater flexibility in manipulating the essential balance of the joint's soft tissues. This article describes on; method of performing a total shoulder arthroplasty emphasizing the utility o.' modular prostheses in achieving this balance.

ISSN:0885-9698    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:We performed a porous-coated hemiarthroplasty with biologic resurfacing of the glenoid in a total of 14 patients between 1989 and 1992; six of these patients had >2 years of follow-up. The patients ranged in age from 33 to 54 years old. They had diagnoses of osteoarthritis (one case), postreconstruction arthritis (four cases), and posttraumatic arthritis (one case). The biologic resurfacing was done using either autogenous fascia lata or anterior shoulder capsule. Average postoperative elevation was 138°. external rotation 50°, and internal rotation to the T12 spinous process, showing an average increase of 57°, 45°, and six spinal segments, respectively. There were no donor site complication and no infections. Using Ncer's full exercise rating scale, we obtained five execllent results and one satisfactory result. We conclude that biologic resurfacing of the gleniod improves results of hemiarthroplasty and should be strongly considered for active young patients with end-stage glenohumeral arthritis.

ISSN:0885-9698    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:Surgical reconstruction in shoulders with glenohumeral arthritis and rotator cufF deficiency is a challenging task. A number of alternatives, such as the use of constrained and unconstrained shoulder arthroplasty, have been advanced to treat this problem. In our experience, humeral hemiarthroplasty and total shoulder arthroplasty have yielded similar satisfactory results with respect to pain relief and function in patients with glenohumeral arthritis and cuff deficiency. However, better active elevation is often achieved with hemiarthroplasty, perhaps because there is less lateralization of the humerus, facilitating rotator cuff repair. Humeral hemiarthroplasty also avoids the risk of glenoid loosening, which may occur more frequently in rotator cuff-deficient shoulders, because of eccentric glenoid loading by the superiorly migrated humeral component. In cases in which the rotator cuff tear is easily reparable with tissue of satisfactory quality, total shoulder arthroplasty is a good option. However, when the cuff tear is larger and the tissue is atrophic and deficient, humeral hemiarthroplasty is preferred. The rotator cuff is repaired as well as possible, emphasizing anterior and posterior stability for the implant over complete superior coverage. This article reviews our operative technique and results with prosthetic replacement in the rotator cuffdeficient shoulder.

ISSN:0885-9698    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:This paper describes the design rationale of the Select Shoulder, our surgical technique, and our 6-year clinical results utilizing this trapezoid-shaped prosthesis with a proximal porous coating and a medial suture hole. Surgery was performed on 24 patients with 24 four-part fractures or fracture dislocations. The patients were not randomized. The decision to use bone cement was based on the ability (or lack thereof) to obtain a stable interference fit. In the noncemented group, the results were better and we were able to avoid the devastating complication of tuberosity nonunion.

ISSN:0885-9698    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:Complex fractures of the proximal humerus are rare and very demanding to treat. Operative treatment is advisable in cases where there is displacement of>1 cm or angulation of >45°. This paper describes the operative technique for use of the Mouradian nail in two-, three-, and four-part fractures and fracture dislocations of the proximal humerus.

ISSN:0885-9698    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:Approximately 10% of fractures of the glenoid cavity are significantly displaced and require surgical management. This report describes the available surgical approaches, bone stock, and fixation techniques. We further oiler recommendations relative to each fracture type.

ISSN:0885-9698    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:The original anterior capsulolabral reconstruction was developed to address anterior glenohumcral instability in athletes. The modification dcscribed in this article include the use of Mitek suture anchors and a horizontal rather a “T” capsulotomy. The procedure emphasizes reconstruction of injured tissue most specifically the inferior glenohumeral ligament, while preserving muscul tendinous attachments and avoiding capsuloligamentous overshortening. Motion is begun immediately postoperatively. A supervised rchabilit ation program is utilized allowing early return of motion and function.

ISSN:0885-9698    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Summary:Arthroscopy-assistcd rotator cuff repair utilizes advanced arthroscopic techniques and consists of arthroscopic subacromial decompression and rotator cuff mobilization, with rotator cuff repair being performed through a small deltoid- splitting incision that does not require release of the deltoid origin from the acromion. It is well tolerated by most patients and can be performed as an outpatient procedure. This approach to rotator cuff repair allows for easier and earlier rehabilitation because the deltoid does not have to be protected. Two-year followup results are similar to outcomes reported for open techniques.

ISSN:0885-9698    

出版商:OVID    

年代:1993

数据来源: OVID