Shoulder 153 articles
Grammont’s Idea: The Story of Paul Grammont’s Functional Surgery Concept and the Development of the Reverse Principle
The increased use of the reverse prosthesis over the last 10 years is due to a large series of publications using the reverse prosthesis developed by Paul Grammont. However, there is no article reporting the story of the concepts developed by Grammont.
Management of the cuff-deficient arthritic shoulder has long been challenging. Early unconstrained shoulder arthroplasty systems were associated with high complication and implant failure rates. The evolution toward the modern reverse shoulder arthroplasty includes many variables of constrained shoulder arthroplasty designs.
Emerging Ideas: Evaluation of Stem Cells Genetically Modified with Scleraxis to Improve Rotator Cuff Healing
Rotator cuffs heal with an interposed layer of scar tissue that makes repairs prone to failure. Cell-based biologic therapies have the potential to augment this healing process. Scleraxis (Scx) is a transcription factor that is involved in tendon development during embryogenesis, and may help drive stem cells toward tenocyte differentiation in adults.
Scapular notching is a unique complication of Grammont-style reverse total shoulder arthroplasty. While reverse total shoulder arthroplasty has revolutionized the treatment of pseudoparalysis secondary to cuff tear arthropathy, the implications of scapular notching with regard to patient function and implant stability remain unclear.
Scapular notching, erosion of the scapular neck related to impingement by the medial rim of the humeral cup during adduction, is a radiographic sign specific to reverse shoulder arthroplasty (RSA). Its clinical and radiological consequences remain unclear.
The best location for biceps tenodesis is controversial as surgeons have begun to question whether tenodesis location affects the incidence of residual bicipital postoperative pain. An open distal tenodesis technique has been previously proposed to eliminate remaining symptoms at the bicipital groove.
Functional Recovery Period after Arthroscopic Rotator Cuff Repair: Is it Predictable Before Surgery?
Several studies have reported functional recovery of the shoulder after arthroscopic rotator cuff repair (ARCR). Preoperative estimation of the time required for functional recovery is important for determining surgical indications and for planning timing of the surgery and an appropriate postoperative physical therapy.
A concern regarding reverse shoulder arthroplasty (RSA) is the possibly higher complication rate compared with conventional unconstrained shoulder arthroplasty.
Reverse shoulder arthroplasty (RSA) improves function in selected patients with complex shoulder problems. However, we presume patient function would vary if performed primarily or for revision and would vary with other patient-specific factors.
Early failure due to glenoid loosening with anatomic total shoulder arthroplasty in patients with severe rotator cuff deficiency led to the development of the reverse ball-and-socket shoulder prosthesis. The literature reports improved short-term pain and function scores following modern reverse total shoulder arthroplasty (RTSA) in patients with cuff tear arthropathy (CTA).