6 research outputs found
Traumatic inferior shoulder dislocation: A case report with a comprehensive review of acute care and post-reduction management strategies
No full textBackground: Traumatic inferior shoulder dislocation is a rare kind of shoulder dislocation that accounts for less than 5 % of all shoulder dislocations. It usually occurs after a fall with the arms lifted. After observing three cases at our hospital, we decided to perform a literature analysis to assess the associated and concomitant injuries that occur with luxatio erecta humeri (LEH), as well as the clinical outcomes. Case report: We present case studies of traumatic LEH in male patients. Cases 1 and 2 both had concomitant lower limb injuries, whereas Case 3 had a brachial plexus injury. In all cases, traction-countertraction was used to successfully execute emergent closed reduction. At 18 months of follow-up, Case 2 reported instability and persistent pain. Case 1 had a greater tuberosity fracture that was successfully treated non-surgically. Discussion: Although inferior shoulder dislocations are rare, concomitant and associated injuries are not uncommon. Following a closed reduction and a brief period of immobility, the outcomes are generally favourable. However, concomitant injuries requiring referral for orthopaedic care are reported in literature. Conclusion: In patients presenting with inferior shoulder dislocation, clinicians should have high index of suspicion for concomitant intrinsic shoulder injuries, requiring advanced imaging and referral to orthopaedic surgeons
A narrative review of treatment strategies for major glenoid defects during primary reverse shoulder arthroplasty, with a focus on the use of structural bone graft
No full textStructural glenoid defects are common during primary reverse shoulder arthroplasty (RSA) and are often associated with poor outcomes.
The lack of pre-operative imaging protocols for determining the depth and degree of glenoid wear hinders our ability to accurately plan and correct these defects.
Although bone grafting has been reported to be effective in reducing glenoid wear during RSA, there is limited information on when to utilise it and how to prepare the graft.
We conducted this review to assess the evidence for the management of glenoid defects, with an emphasis on bone grafts to treat structural glenoid bone loss in primary RSA patients
The correlation between clinical and radiological severity of osteoarthritis of the knee
No full textIntroduction: Primary osteoarthritis (OA) is a common cause of knee pain. Appropriate management of knee OA is based on clinical and radiological findings. Pain, deformity, and functional impairments are major clinical factors considered along with radiological findings when making management decisions. Differences in management strategies might exist due to clinical and radiological factors. This study aims at finding possible associations between clinical and radiological observations. Methods: A prospective cross-sectional study of 52 patients with primary osteoarthritis of the knee managed conservatively at a tertiary hospital arthroplasty clinic was conducted for three months. English speaking patients with primary OA were identified and included in this study. Pain and functional impairment were assessed using Wong-Baker Faces pain scale, The Knee Society Score (KSS), and Western Ontario and McMaster Osteoarthritis Index (WOMAC). The Body Mass Index (BMI) of all participants was measured. Standard two views plain radiographs were used for radiographic grading of the OA. Anonymized radiographs were presented to two senior consultant orthopaedic surgeons who graded the OA using Kellgren and Lawrence (KL) and Ahlbäck classification systems. The severity of the functional impairment and pain score was then compared to the radiological grading. Results: The average age of our participants was 63 ± 9 years. Their average BMI was 34.9 ± 8.4 kg/m2, median self-reported pain, total WOMAC, and pain WOMAC scores were 8, 60, and 13, respectively. We observed no significant correlation between BMI and pain scores. Inter-rater reliability for KL and Ahlbäck grading was strong. There was no significant correlation between WOMAC scores and the radiological grades. Conclusion: There was no correlation between pain and functional scores, patient factors and radiological severity of OA of the knee
Pre-operative planning for reverse shoulder arthroplasty in low-resource centres : a modified Delphi study in South Africa
No full textDATA AVAILABILITY STATEMENT :
The datasets used and analyzed during the current study are avail-
able from the corresponding author on reasonable request.BACKGROUND : Pre-operative planning for reverse shoulder arthroplasty (RSA) poses challenges, particularly when dealing with glenoid bone loss. This modified Delphi study aimed to assess expert consensus on RSA planning processes and rationale, specifically targeting low-resourced institutions. Our objective was to offer pre-operative decision-making algorithms tailored for surgeons practising in resource-constrained hospitals with limited access to computed tomography (CT) scans. METHODS : A working group generated statements on pre-operative imaging and glenoid of glenoid morphology and intra-operative decision-making. The study was conducted in three stages, with virtual consensus meetings in between. Stages 2 and 3 consisted only of closed questions/statements. The statements with over 70% were considered consensus achieved and those with less than 10% were considered disagreement consensus achieved. RESULTS : Twelve shoulder surgeons participated, with 67% having over five years of experience in shoulder arthroplasty. In the absence of glenoid bone loss, the sole use of plain radiographs for pre-operative planning reached consensus and is recommended by these groups, while 100% advise using CT scans when bone loss is present. Most surgeons (70%) recommend using patient-specific instrumentation (PSI) in cases of structural bone loss. Most of the statements on intra-operative decision-making related to component placement and enhancing stability failed to reach consensus. CONCLUSION : While consensus was achieved on most aspects of pre-operative imaging and planning, technical aspects of surgery lacked consensus. Planning for patients with structural glenoid bone loss necessitates CT scans and planning tools.http://www.sicot-j.orghj2024Orthopaedic SurgerySDG-03:Good heatlh and well-bein
Pre-operative planning for reverse shoulder arthroplasty in low-resource centres: A modified Delphi study in South Africa
No full textBackground: Pre-operative planning for reverse shoulder arthroplasty (RSA) poses challenges, particularly when dealing with glenoid bone loss. This modified Delphi study aimed to assess expert consensus on RSA planning processes and rationale, specifically targeting low-resourced institutions. Our objective was to offer pre-operative decision-making algorithms tailored for surgeons practising in resource-constrained hospitals with limited access to computed tomography (CT) scans. Methods: A working group generated statements on pre-operative imaging and glenoid of glenoid morphology and intra-operative decision-making. The study was conducted in three stages, with virtual consensus meetings in between. Stages 2 and 3 consisted only of closed questions/statements. The statements with over 70% were considered consensus achieved and those with less than 10% were considered disagreement consensus achieved. Results: Twelve shoulder surgeons participated, with 67% having over five years of experience in shoulder arthroplasty. In the absence of glenoid bone loss, the sole use of plain radiographs for pre-operative planning reached consensus and is recommended by these groups, while 100% advise using CT scans when bone loss is present. Most surgeons (70%) recommend using patient-specific instrumentation (PSI) in cases of structural bone loss. Most of the statements on intra-operative decision-making related to component placement and enhancing stability failed to reach consensus. Conclusion: While consensus was achieved on most aspects of pre-operative imaging and planning, technical aspects of surgery lacked consensus. Planning for patients with structural glenoid bone loss necessitates CT scans and planning tools
Scoping Review of Biologic Scaffold in Rotator Cuff Repair Augmentation: Evidence based recommendations for use in Low-to-Middle Income Countries
No full textThis scoping review aims to map and synthesize the existing evidence on biologic scaffold augmentation in rotator cuff repair, focusing on indications and contraindications, clinical benefits and harms, cost–benefit considerations, and applicability to low- and middle-income country (LMIC) settings. The review will identify the types of scaffolds used, clinical scenarios in which they are recommended or discouraged, and reported outcomes across clinical and economic domains. Expected outcomes include a comprehensive evidence map, identification of knowledge gaps, and guidance to inform future research, clinical decision-making, and resource-appropriate implementation
