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Outcomes of reverse total shoulder arthroplasty with postoperative scapular fracture. A systematic review
No full textPostoperative scapular fractures are infrequent complications of reverse total shoulder arthroplasty (RTSA). The aim of this study is to discuss the functional outcome, clinical outcome and pain scores of these fractures and to analyze these outcome results based on fracture location. A systematic review in accordance with the PRISMA guidelines was conducted. Pubmed, EMBASE, Web of Science, Cochrane library and Ovid have been screened. A total of 78 RTSA in 12 articles were retained for qualitative analysis. The average minimum follow-up was 33.3 +/- 14.4 months (range 12-60 months) and the mean age was 74.4 +/- 5.6 years (range 63-85 years) with a mean female percentage of 90.9%. Overall, the mean DASH score was 39.8 +/- 9.4 points (range 29.5-48.0 points), ASES score 53.4 +/- 23.3 points (range 13.3-95.0 points), SST 3.2 +/- 2.2 points (range 0.0-5.1 points), the only OSS 28.0 points and Constant-Murley shoulder score 50.5 +/- 20.0 points (range 31.5-69.0). The mean anterior elevation was 91.5 degrees +/- 30.7 degrees (range 46.0 degrees-160.0 degrees), abduction 87.8 degrees +/- 21.8 degrees (range 55.0 degrees-125.0 degrees), external rotation 33.2 degrees +/- 22.2 degrees (range 9.0 degrees-85 degrees) and the only internal rotation was 60.0 degrees. The VAS score averaged of 3.8 +/- 2.8 points (range 0.8-9.0 points). A subgroup analysis of acromial and scapular spine fractures was performed. Acromial and scapular spine fractures have an undeniable effect on RTSA outcomes, however patients still improve compared to their preoperative state. We advise to consider acromial and scapular fractures as different problems, as prognosis is worse for more medial fractures.Loomans, L (corresponding author), Katholieke Univ Leuven, Fac Med, Med, O&N2,Herestr 49,Bus 400, B-3000 Leuven, Belgium.
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Outcomes of reverse total shoulder arthroplasty with postoperative scapular fracture. A systematic review
No full textPostoperative scapular fractures are infrequent complications of reverse total shoulder arthroplasty (RTSA). The aim of this study is to discuss the functional outcome, clinical outcome and pain scores of these fractures and to analyze these outcome results based on fracture location. A systematic review in accordance with the PRISMA guidelines was conducted. Pubmed, EMBASE, Web of Science, Cochrane library and Ovid have been screened. A total of 78 RTSA in 12 articles were retained for qualitative analysis. The average minimum follow-up was 33.3 +/- 14.4 months (range 12-60 months) and the mean age was 74.4 +/- 5.6 years (range 63-85 years) with a mean female percentage of 90.9%. Overall, the mean DASH score was 39.8 +/- 9.4 points (range 29.5-48.0 points), ASES score 53.4 +/- 23.3 points (range 13.3-95.0 points), SST 3.2 +/- 2.2 points (range 0.0-5.1 points), the only OSS 28.0 points and Constant-Murley shoulder score 50.5 +/- 20.0 points (range 31.5-69.0). The mean anterior elevation was 91.5 degrees +/- 30.7 degrees (range 46.0 degrees-160.0 degrees), abduction 87.8 degrees +/- 21.8 degrees (range 55.0 degrees-125.0 degrees), external rotation 33.2 degrees +/- 22.2 degrees (range 9.0 degrees-85 degrees) and the only internal rotation was 60.0 degrees. The VAS score averaged of 3.8 +/- 2.8 points (range 0.8-9.0 points). A subgroup analysis of acromial and scapular spine fractures was performed. Acromial and scapular spine fractures have an undeniable effect on RTSA outcomes, however patients still improve compared to their preoperative state. We advise to consider acromial and scapular fractures as different problems, as prognosis is worse for more medial fractures.Loomans, L (corresponding author), Katholieke Univ Leuven, Fac Med, Med, O&N2,Herestr 49,Bus 400, B-3000 Leuven, Belgium.
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Regarding "Aberrant origin of the long head of the biceps: a case series".
No full textLetter to the editor regarding: Variations of the intra-articular portion of the long head of the biceps tendon: a classification of embryologically explained variations
Are clinical outcomes of frozen shoulder linked to pain, structural factors or pain-related cognitions? An explorative cohort study
No full textBackground: In frozen shoulder (FS), inflammatory-fibrotic adaptations in capsuloligamentous structures are typically linked to perceived glenohumeral stiffness, glenohumeral range of motion (ROM) restrictions and decreased arm function. However, ROM restrictions based on muscle guarding are suggested as well. Objectives: To assess differences between pain, perceived stiffness, ROM restrictions and arm function at time of diagnosis and at four months follow-up and to assess whether perceived stiffness, ROM restrictions and arm function relate to pain, structural and/or cognitive factors. Design: observational cohort study. Methods: In persons with idiopathic FS, pain intensity at rest/at night/during activities (Numeric Rating Scale), perceived stiffness (Numeric Rating Scale), abduction/external rotation ROM (goniometry), and function (Disabilities of the Arm, Shoulder and Hand Questionnaire) were compared between both time points (Wilcoxon-signed rank tests). Spearman correlation coefficients assessed the relation between perceived stiffness, ROM and function on the one hand and structural factors (coracohumeral ligament (CHL) thickness and inferior glenohumeral recess (IGR) perimeter - arthroMRI), pain intensity and pain-related cognitions (Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia) on the other hand. Results: Twenty persons participated (14 female; 56 +/- 8yrs) and three persons dropped out at 4 months. Pain intensity, perceived stiffness, ROM and arm function improved over time. ROM was related to CHL-thickness and IGR-perimeter; perceived stiffness was related to pain intensity; and arm function was related to pain intensity and pain-related cognitions. Conclusion: Objectively measured ROM is related to structural factors, while patient-reported outcomes are related to pain intensity and/or pain-related cognitions. Perceived stiffness does not relate to structural factors
Prebending of Osteosynthesis Plates Versus Screw and Cerclage Fixation for Os Acromiale or Acromion Fracture; the 3D Technique and Mechanical Testing
No full textThree-dimensional applications are on the rise in medicine, mainly to make treatment more patient specific. This study compares the in vitro outcome parameters of 2 surgical techniques: hollow screws with cerclage fixation (HC) versus patient-specific plate osteosynthesis (PO). The techniques were tested on scapulae of 5 fresh-frozen cadavers as a treatment for symptomatic os acromiale or acromion fracture, to assess ultimate failure strength, stiffness, and fracture pattern. An existing osteosynthesis plate is preoperatively shaped by a printed 3-dimensional model of the acromion of the cadaver. The strength for the PO group [mean, 254.08±130.35 N (range, 118.12 to 404.19 N); P=0.10] was significantly different from the HC group [mean, 166.68±65.39 N (range, 91.02 to 226.34 N)]. There was no significant difference between stiffness of the PO group [mean, 13.38±4.99 N/mm (range, 7.02 to 19.22 N/mm); P>0.10] and stiffness of the HC group [mean, 10.22±6.26 N/mm (range, 6.73 to 21.38 N/mm)]. The fracture pattern of the HC is characterized by the screws ripping from the inferior bone cortex, whereas in the PO the posterior screws tear at the superior spine. From ultimate failure strength results can be concluded that patient-specific PO provides a stronger repair construct than cannulated screws and cerclage
Standardised Tendon Fenestration with ITEC-Technique for Lateral Epicondylosis with Injection of Betamethasone versus Autologous Blood
No full textBackground: Infiltration is one of the treatment options for lateral epicondylosis, a degenerative process in the tendon of the musculus extensor carpi radialis brevis. The aim of this study was to evaluate the clinical outcome of a standardised fenestration technique, the Instant Tennis Elbow Cure (ITEC) technique, with injection of betamethasone versus autologous blood.Methods: A prospective comparative study was performed. Twenty-eight patients received an infiltration with 1 mL betamethasone, in combination with 1 mL 2% lidocaine. Twenty-eight patients received an infiltration with 2 mL autologous blood. Both infiltrations were administered using the ITEC-technique. The patients were evaluated at baseline, 6 weeks, 3 months and 6 months using Visual Analogue Scale (VAS), Patient-Rated Tennis Elbow Evaluation (PRTEE) and Nirschl staging.Results: At the 6-week follow-up, the corticosteroid group showed significantly better results for VAS. At the 3-month follow-up, no significant differences were observed for all three scores. At the 6-monthfollow-up, the autologous blood group showed significantly better results for all three scores.Conclusions: Standardised fenestration using the ITEC-technique with corticosteroid infiltration is more effective in reducing pain at the 6-week follow-up. At the 6-month follow-up, the use of autologous blood is more effective in pain reduction and functional recovery
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Assessment of Scapulothoracic, Glenohumeral, and Elbow Motion in Adhesive Capsulitis by Means of Inertial Sensor Technology: A Within-Session, Intra-Operator and Inter-Operator Reliability and Agreement Study
No full textAdhesive capsulitis (AC) is a glenohumeral (GH) joint condition, characterized by decreased GH joint range of motion (ROM) and compensatory ROM in the elbow and scapulothoracic (ST) joint. To evaluate AC progression in clinical settings, objective movement analysis by available systems would be valuable. This study aimed to assess within-session and intra- and inter-operator reliability/agreement of such a motion capture system. The MVN-Awinda® system from Xsens Technologies (Enschede, The Netherlands) was used to assess ST, GH, and elbow ROM during four tasks (GH external rotation, combing hair, grasping a seatbelt, placing a cup on a shelf) in 10 AC patients (mean age = 54 (±6), 7 females), on two test occasions (accompanied by different operators on second occasion). Standard error of measurements (SEMs) were below 1.5° for ST pro-retraction and 4.6° for GH in-external rotation during GH external rotation; below 6.6° for ST tilt, 6.4° for GH flexion-extension, 7.1° for elbow flexion-extension during combing hair; below 4.4° for GH ab-adduction, 13° for GH in-external rotation, 6.8° for elbow flexion-extension during grasping the seatbelt; below 11° for all ST and GH joint rotations during placing a cup on a shelf. Therefore, to evaluate AC progression, inertial sensors systems can be applied during the execution of functional tasks
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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