• Clinics in Shoulder and Elbow
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• v.19 no.2
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• pp.101-104
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• 2016

Reverse total shoulder arthroplasty has been performed with promising results in rotator cuff tear arthropathy. However, the global complication of the reverse total shoulder arthroplasty is relatively higher than that of the conventional total shoulder arthroplasty. Neurologic complications after reverse total shoulder arthroplasty are rare but there are sometimes remaining sequelae. The cause of the neurologic complication is multifactorial, including arm traction, position and the design of the implant. Most cases of neurologic palsy following reverse total shoulder arthroplasty occur in the axillary nerve and the radial nerve. The authors report on a case of a 71-year-old man with isolated musculocutaneous nerve palsy after reveres total shoulder arthroplasty with related literature.

• Clinics in Shoulder and Elbow
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• v.17 no.3
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• pp.145-150
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• 2014

In the patients of retracted massive rotator cuff tears, there are much of difficulty to functional recovery and pain relief. Nevertheless the development of treatment, there are still debates of the best treatments in the massive rotator cuff tears. Recenlty various of treatments are introduced; these are acromioplasty with debridement, biceps tenotomy, great tuberoplasty with biceps tenotomy, partial repair, mini-open rotator cuff repair, arthroscopic rotator cuff repair, soft tissue augmentation, tendon transfer, flap, hemiarthroplasty, and reverse total shoulder arthroplasty. That there is no difference of result for reverse total shoulder arthroplasty between patients who have massive rotator cuff tear without arthritis and patients who have cuff tear arthropathy. Reverse total shoulder arthroplasty is one of reliable and successful treatment options for massive rotator cuff tear. Especially it is more effective for patients who have a pseudoparalysis.

• Journal of the Korean Orthopaedic Association
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• v.56 no.5
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• pp.367-376
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• 2021

An increasing number of reverse total shoulder arthroplasty procedures has been performed since its introduction to South Korea in 2007. This review discusses the biomechanical rationale behind the development of reverse total shoulder arthroplasty and its outcomes over time. In addition, this paper mentions ways to minimize the risk of complications that may occur and how to manage those complications.

• Clinics in Shoulder and Elbow
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• v.20 no.3
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• pp.172-179
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• 2017

Indications of reverse total shoulder arthroplasty (RTSA) have been consistently extended by technical advancements in reverse arthroplasty prosthesis, continuous development of the implants, accumulated experiences and its successful treatment outcomes; accordingly, its use has rapidly increased. RTSA has been performed for a variety of indications, with variable outcomes depending on the initial diagnosis. However, controversial opinions still exist regarding the design of reverse arthroplasty prosthesis (medialized or lateralized design and the neck-shaft angle of the humeral prosthesis), suture of the subscapularis tendon, use of cement during placement of the humeral prosthesis, and surgical procedures; therefore, these should be investigated so that they can be better understood.

• Clinics in Shoulder and Elbow
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• v.25 no.3
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• pp.244-254
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• 2022

Radiographic osteolysis after total shoulder arthroplasty (TSA) remains a challenging clinical entity, as it may not initially manifest clinically apparent symptoms but can lead to clinically important complications, such as aseptic loosening. A thorough consideration of medical history and physical examination is essential to rule out other causes of symptomatic TSA-namely, periprosthetic joint infection-as symptoms often progress to vague pain or discomfort due to subtle component loosening. Once confirmed, nonoperative treatment of osteolysis should first be pursued given the potential to avoid surgery-associated risks. If needed, the current surgical options include glenoid polyethylene revision and conversion to reverse shoulder arthroplasty. The current article provides a comprehensive review of the evaluation and management of osteolysis after TSA through an evidence-based discussion of current concepts.

• 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.

• Clinics in Shoulder and Elbow
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• v.14 no.2
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• pp.253-261
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• 2011

Purpose: The purpose of the present article is to help orthopedic surgeons better understand the basic principles of unconstrained total shoulder arthroplasty, and to help them perform the best surgical technique for reconstruction. Materials and Methods: In this article, we reviewed in depth current biomechanics, indications & contraindications, surgical techniques, complications and outcomes of unconstrained total shoulder arthroplasty. Additionally, we discussed current issues relevant to total shoulder arthroplasty such as whether a keeled or a pegged glenoid should be used. Results and Conclusion: A thorough understanding of the biomechanics of total shoulder arthroplasty, and the technical details and problems in implantation, are critical to provide the best functional outcome and to avoid the risk of complications.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.125-133
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• 2011

Purpose: The purpose of the present article is to help orthopedic surgeons better understand the function and performance of reverse total shoulder arthroplasty, and also to help them perform the most proper surgical technique for reconstruction. Materials and methods: In this article, the specific technical aspects and pitfalls of reverse total shoulder arthroplasty were reviewed in depth. Additionally, the current issues relevant to the reverse total shoulder arthroplasty such as scapular notching and restoration of active external rotation were discussed. Results and conclusion: An understanding of the biomechanics of reverse total shoulder arthroplasty and the technical details and pitfalls of its implantation are critical in order to provide the best functional outcome without increasing the risk of complications.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.111-116
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• 2011

Purpose: The purposes of this article are to review the mid-term results and the complications after reverse total shoulder arthroplasty and to analyze the influence of the etiology on the result. Materials and Methods: We conducted a systemic review of the published literature with the mid-term follow-up after reverse total shoulder arthroplasty was performed. The overall rates of problems, complications, reoperations and revisions were determined. Results: The reported complication rates varied from 0% to 68%. The first series of reverse prosthesis with at least 2 yrs of follow-up confirmed the preliminary results, with excellent functional outcomes. However, a systemic review of the published literature with a mid-term follow-up showed problems in 44% of the cases, complications in 24% of the cases, reoperations in 3.5% of the cases and revision in 10% of the cases. Conclusion: Reverse total shoulder arthroplasty has relatively high complication and revision rates. So, a reverse prosthesis should be used in patients with very disabling arthropathy and a massive cuff tear and who are over seventy (at least sixty-five) years old.

• Journal of Yeungnam Medical Science
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• v.40 no.3
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• pp.247-251
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• 2023

Background: While some evidence indicates that propofol-based anesthesia has less postoperative pain than sevoflurane-based anesthesia, these results are controversial. We compared acute postoperative pain intensity and opioid consumption after total shoulder arthroplasty between propofol-remifentanil (PR) and sevoflurane-remifentanil (SR) anesthesia. Methods: Among 48 patients undergoing shoulder arthroscopic surgery anesthetized with PR or SR, postoperative pain intensity was assessed at 30 minutes and at 2, 6, 12, and 24 hours. The total patient-controlled analgesia volume and number of patients requiring rescue analgesics were assessed. Results: No significant difference in postoperative pain intensity was observed between the two groups. Postoperative opioid consumption and analgesic requirements were also comparable in the first 24 hours after surgery. Conclusion: PR and SR anesthesia for shoulder arthroscopic surgery provide comparable postoperative analgesia results.