• Title/Summary/Keyword: Shoulder osteoarthritis

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When should reverse total shoulder arthroplasty be considered in glenohumeral joint arthritis?

  • Jo, Young-Hoon;Kim, Dong-Hong;Lee, Bong Gun
    • Clinics in Shoulder and Elbow
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    • v.24 no.4
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    • pp.272-278
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    • 2021
  • Anatomical total shoulder arthroplasty (TSA) has been used widely in treatment of glenohumeral osteoarthritis and provides excellent pain relief and functional results. Reverse total shoulder arthroplasty (RSA) was created to treat the complex problem of rotator cuff tear arthropathy. RSA also has been performed for glenohumeral osteoarthritis even in cases where the rotator cuff is preserved and has shown good results comparable with TSA. The indications for RSA are expanding to include tumors of the proximal humerus, revision of hemiarthroplasty to RSA, and revision of failed TSA to RSA. The purposes of this article were to describe comprehensively the conditions under which RSA should be considered in glenohumeral osteoarthritis, to explain its theoretical background, and to review the literature.

Effects of the Progressive Exercise Program on Flexibility, Grip Strength, Pain, and Fatigue for Osteoarthritis Patients (점진적 운동강화 자조관리프로그램이 골관절염 환자의 유연성과 악력, 통증 및 피로에 미치는 효과)

  • Kim, Sam-Sook;Lee, Eun-Nam
    • Journal of muscle and joint health
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    • v.16 no.2
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    • pp.184-192
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    • 2009
  • Purpose: The purpose of this study was to examine the effects of a progressive exercise program for osteoarthritis patients. Methods: This study was performed from 24th March. to 7th July. 2009. Thirty six osteoarthritis patients were participated in the progressive exercise program. Outcome measures were shoulder flexibility, knee flexibility, grip strength, pain intensity, number of pain site and fatigue. SPSS/WIN Version 14.0 was used for the data analysis. Results: At the completion of 6 weeks of progressive exercise program, there were statistically significant differences in shoulder flexibility and knee flexibility. But no significant differences were found in grip strength, pain, number of pain site and fatigue between pretest and posttest. Conclusion: Progressive exercise program was proved to be an effective nursing intervention for improving the shoulder and knee flexibility. However, progressive exercise program did not increase pain & fatigue.

Arthroscopic Treatment of Elbow Osteoarthritis and Arthroscopic Ulnar Nerve Decompression

  • Chung, Seok Won
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.256-263
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    • 2016
  • Although arthroscopic surgery has been used conventionally, it has not been widely adopted yet due to the risks of complications, including nerve damage, technical difficulties, and limited indications. As shown in other joints, however, the use of an arthroscope will gradually increased in the elbow joint ('Arthroscopy always wins'). Herein, arthroscopic treatments and arthroscopic ulnar nerve decompression will be discussed in cases of elbow osteoarthritis.

Mid-term Clinical and Radiological Outcomes of Latissimus Dorsi Tendon Transfer in Massive Rotator Cuff Tears

  • Suh, Dongwhan;Ji, Jong-Hun;Tankshali, Kirtan;Kim, Eung-Sic
    • Clinics in Shoulder and Elbow
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    • v.22 no.4
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    • pp.220-226
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    • 2019
  • Background: This retrospective study was undertaken to evaluate mid-term clinical and radiological outcomes of lattisimus dorsi (LD) tendon transfer in patients with irreparable massive rotator cuff tears (MRCT). We hypothesize that LD tendon transfer would provide safe and satisfactory clinical outcomes at mid-term follow-up. Methods: From November 2008 to December 2016, 23 patients ($57.5{\pm}4.4years$; 20 male, 3 female) who underwent LD tendon transfer for massive tears, were enrolled. Inclusion criteria were irreparable MRCT. Exclusion criteria included full thickness subscapularis tear, rotator cuff arthropathy, anterosuperior rotator cuff tear, and osteoarthritis. Mean follow-up period was $4.7{\pm}4.0years$ (range, 2-12 years). Clinical assessment (American Shoulder and Elbow Surgeons [ASES], University of California, Los Angeles [UCLA], Simple Shoulder Test [SST]) and radiographic assessment (osteoarthritis [OA], acromiohumeral distance [AHI]) were evaluated. Results: ASES, UCLA and SST scores, and range of motion (ROM), except internal rotation, improved significantly at the last followup (p<0.05). Also, AHI was significantly improved at the last follow-up, from 6.6 mm to 8.2 mm (p=0.008). At the final follow-up, the radiologic stages of the glenohumeral osteoarthritis were determined as stage 1 in 9 patients, stage 2 in 10 patients, stage 3 in 2 patients, and stage 4 in 2 patients. Complications were observed in 21.7% cases: 3 re-tears and 2 infections were noted in our study. Conclusions: LD tendon transfer for irreparable MRCT provides satisfactory clinical outcomes at mid-term follow-up. Mild degenerative osteoarthritis (stage 1, 2) of the shoulder joint are common at the mid-term follow-up. Also, complications such as tear, infection should be considered.

'MEMIARTHROPLASTY VS. TOTAL SMOULDER ARTHROPLASTY'

  • Bigliani Louis U.
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2002.10a
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    • pp.7-7
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    • 2002
  • Historically, the decision to perform a hemiarthroplasty (HHR) versus a total shoulder arthroplasty (TSA) is based on the status of the glenoid and the status of the soft tissues (rotator cuff). In disease processes where the glenoid articular cartilage is relatively well preserved such as avascular necrosis and complex proximal humerus fractures, most orthopaedists recommend performing a HHR while preserving the native glenoid articular surface. At the other end of the spectrum, if the glenoid has excessive bone loss or is unreconstructible, a HHR is the preferred procedure. In patients who have deficient so(t-tissues (rotator cuff) such as rotator cuff tear arthropathy and, occasionally, rheumatoid arthritis, a HHR is the procedure of choice. The indications for HHR in osteoarthritis remain somewhat controversial. There is mounting evidence that performing a HHR for osteoarthritis is inferior to TSA. Recent developments, or 'third generation techniques and materials', in shoulder arthroplasty are expected to improve the longevity of TSA, particularly the glenoid component. In addition, newer designs of reverse-ball prostheses are entering the market with promising early results in patients with deficient rotator cuff mechanisms.

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Mid- to long-term success rate and functional outcomes of acromioclavicular injections in patients with acromioclavicular osteoarthritis

  • Nienke Miedema;Inger Sierevelt;Tjarco Dirk Willem Alta;Roderick Jan Maximiliaan Vossen;Arthur van Noort
    • Clinics in Shoulder and Elbow
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    • v.26 no.2
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    • pp.175-181
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    • 2023
  • Background: Acromioclavicular (AC) osteoarthritis (OA) is a frequent pathology of the shoulder in elderly patients. Drug injection plays an important role in treatment of AC OA. Literature has demonstrated excellent short-term results regarding shoulder function and pain. However, mid- to long-term results are lacking. The aim of this study was to assess the efficacy of a single intra-articular AC injection in patients with AC OA and to identify predictive factors for success. Methods: A retrospective study was performed to analyze success rate, shoulder function, and pain perception after a single intra-articular injection in patients with AC OA. Success was defined as the absence of reinterventions such as additional injection or surgery. Outcome measures were 1-year success rate and clinical outcome scores of Numeric Rating Scale (NRS) for pain, Oxford Shoulder Score, and Subjective Shoulder Value. Results: Ninety-eight patients participated in this study. At a median final follow-up of 0.8 years (interquartile range, 0-6), 57 of these patients (58%) had undergone a reintervention. The 1-year success rate was 47% (95% confidence interval, 37%-57%), with NRS at rest as the sole factor significantly associated with success. Thirty patients not requiring reintervention reported significant improvement from baseline for all reported outcome measures at final follow-up. Conclusions: AC injections offer a 1-year success rate of 47%. The AC injection produces good mid- to long-term clinical outcomes regarding shoulder function, quality of life, and pain perception in one-third of patients. Further research is essential to analyze mid- to long-term outcomes of AC injections.

Acute Ulnar Nerve Palsy after Outerbridge-Kashiwagi Procedure - A Case Report - (Outerbridge - Kashiwagi 술식 후 발생한 급성 척골 신경 마비 - 증례보고 -)

  • Jeon In-Ho;Min Woo-Kie;Oh Chang-Wug;Hwang In-Hwan;Kim Poong-Taek
    • Clinics in Shoulder and Elbow
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    • v.8 no.2
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    • pp.176-180
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    • 2005
  • The Outerbridge-Kashiwagi (O-K) procedure is one of popular procedures for the treatment of osteoarthritis of the elbow. Although reliable outcome has been reported in the literature, intraoperative and postoperative complications may occur. Acute postoperative neurologic complications are rarely reported in the literature. We report a case of acute complete ulnar neuropathy following O-K procedure in the elbow with longstanding flexion loss. Prophylactic ulnar nerve decompression during the O-K procedure should be considered in the elbows with osteoarthritis and prolonged severe flexion contracture.