The Experts below are selected from a list of 54 Experts worldwide ranked by ideXlab platform
William H Seitz - One of the best experts on this subject based on the ideXlab platform.
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Surface arthroplasty in shoulder arthritis
Seminars in Arthroplasty, 2004Co-Authors: Katherine Gordiev, William H SeitzAbstract:Use of a resurfacing arthroplasty in shoulder arthritis has the advantage of bone preservation. It diminishes the risk of periprosthetic fractures of the humeral shaft by avoiding the stress concentration effect associated with stemmed implants. Revision or, when rarely needed, arthrodesis may be undertaken more easily since the bone stock has been maintained. The largest studies to date have concluded that the indications for this surface replacement are the same as those for the conventional stemmed prostheses, namely osteoarthritis, rheumatoid arthritis, avascular necrosis, instability Arthropathy, Posttraumatic Arthropathy, and cuff Arthropathy. The best results have been achieved in primary osteoarthritis. Results for other indications are comparable with those for stemmed prostheses with a similar follow-up and case mix. Use in cuff tear Arthropathy has yielded successful outcomes consistent with the limited goals in these patients, similar to those with use of available stemmed implants but with technical advantages. The implant is not suitable where the humeral head is insufficient or in four-part fractures. In such cases, a stemmed implant should be used. Access to the glenoid is more difficult with this technique because of humeral head retention resulting in a greater propensity to perform hemiarthroplasty.
Katherine Gordiev - One of the best experts on this subject based on the ideXlab platform.
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Surface arthroplasty in shoulder arthritis
Seminars in Arthroplasty, 2004Co-Authors: Katherine Gordiev, William H SeitzAbstract:Use of a resurfacing arthroplasty in shoulder arthritis has the advantage of bone preservation. It diminishes the risk of periprosthetic fractures of the humeral shaft by avoiding the stress concentration effect associated with stemmed implants. Revision or, when rarely needed, arthrodesis may be undertaken more easily since the bone stock has been maintained. The largest studies to date have concluded that the indications for this surface replacement are the same as those for the conventional stemmed prostheses, namely osteoarthritis, rheumatoid arthritis, avascular necrosis, instability Arthropathy, Posttraumatic Arthropathy, and cuff Arthropathy. The best results have been achieved in primary osteoarthritis. Results for other indications are comparable with those for stemmed prostheses with a similar follow-up and case mix. Use in cuff tear Arthropathy has yielded successful outcomes consistent with the limited goals in these patients, similar to those with use of available stemmed implants but with technical advantages. The implant is not suitable where the humeral head is insufficient or in four-part fractures. In such cases, a stemmed implant should be used. Access to the glenoid is more difficult with this technique because of humeral head retention resulting in a greater propensity to perform hemiarthroplasty.
Lars Irlenbusch - One of the best experts on this subject based on the ideXlab platform.
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Indication, Technique and Long-term Results after Shoulder Arthrodesis Performed with Plate Fixation.
Zeitschrift fur Orthopadie und Unfallchirurgie, 2018Co-Authors: Ulrich Irlenbusch, Olaf Rott, Lars IrlenbuschAbstract:Arthrodesis of the shoulder joint is a radical event, so it is difficult to explain its significance to patients. It has been the last resort in hopeless cases. Knowledge of long-term results and evaluation of advantages and disadvantages seems to be helpful in this regard. Eleven patients with mean age of 45 (31 - 58) years were operated between 2000 and 2013. All patients could be included in the investigation (FU mean 8.5 [3 - 16] years; 8 male and 3 female; right 9, left 2). Patients had the following indications: persistent instability 5 (2 with epilepsy), rotator cuff rupture 2 (1× after combined latissimus dorsi and teres major transfer), brachial plexus injury/defect 2, locked dislocation 1 and Posttraumatic Arthropathy 1. Fixation with DC plate (pre-bent to 110°) was used in all cases; with special focus on placing at least one screw in the scapular neck. The targeted arthrodesis position was abduction 30°, forward flexion 30°, and internal rotation 30°. Active abduction improved from 12 to 63°, forward flexion from 21 to 79° and internal rotation from 10 to 47° (mean values). In the resting position with hanging arm aside, mean abduction was 3° and forward flexion 8°. Nine of 11 patients had considerable relief of pain, from 8.3 to 2.4 points VAS. Five patients rated the outcome as excellent, 3 as good and 1 as satisfactory. Nine patients would repeat the procedure. In summary, an Oxford Shoulder Score of 31.6 points was achieved, and SSV of 58%. Bony fusion was achieved in all cases, 3 - 4 months p. o. in mean. There were no important neurological or angiological complications. Plate arthrodesis in the technique used achieves high fusion and a low complication rate. Relief of pain and functional improvement are astonishing. Analysis of our results indicates that correction of the positions mentioned above is necessary: i. o. arthrodesis position for abduction 25° (by means of pre-bending plate of 105°), forward flexion 20° and internal rotation 30° are suggested. Georg Thieme Verlag KG Stuttgart · New York.
Ulrich Irlenbusch - One of the best experts on this subject based on the ideXlab platform.
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Indication, Technique and Long-term Results after Shoulder Arthrodesis Performed with Plate Fixation.
Zeitschrift fur Orthopadie und Unfallchirurgie, 2018Co-Authors: Ulrich Irlenbusch, Olaf Rott, Lars IrlenbuschAbstract:Arthrodesis of the shoulder joint is a radical event, so it is difficult to explain its significance to patients. It has been the last resort in hopeless cases. Knowledge of long-term results and evaluation of advantages and disadvantages seems to be helpful in this regard. Eleven patients with mean age of 45 (31 - 58) years were operated between 2000 and 2013. All patients could be included in the investigation (FU mean 8.5 [3 - 16] years; 8 male and 3 female; right 9, left 2). Patients had the following indications: persistent instability 5 (2 with epilepsy), rotator cuff rupture 2 (1× after combined latissimus dorsi and teres major transfer), brachial plexus injury/defect 2, locked dislocation 1 and Posttraumatic Arthropathy 1. Fixation with DC plate (pre-bent to 110°) was used in all cases; with special focus on placing at least one screw in the scapular neck. The targeted arthrodesis position was abduction 30°, forward flexion 30°, and internal rotation 30°. Active abduction improved from 12 to 63°, forward flexion from 21 to 79° and internal rotation from 10 to 47° (mean values). In the resting position with hanging arm aside, mean abduction was 3° and forward flexion 8°. Nine of 11 patients had considerable relief of pain, from 8.3 to 2.4 points VAS. Five patients rated the outcome as excellent, 3 as good and 1 as satisfactory. Nine patients would repeat the procedure. In summary, an Oxford Shoulder Score of 31.6 points was achieved, and SSV of 58%. Bony fusion was achieved in all cases, 3 - 4 months p. o. in mean. There were no important neurological or angiological complications. Plate arthrodesis in the technique used achieves high fusion and a low complication rate. Relief of pain and functional improvement are astonishing. Analysis of our results indicates that correction of the positions mentioned above is necessary: i. o. arthrodesis position for abduction 25° (by means of pre-bending plate of 105°), forward flexion 20° and internal rotation 30° are suggested. Georg Thieme Verlag KG Stuttgart · New York.
Vincent M. Moretti - One of the best experts on this subject based on the ideXlab platform.
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Recent National Trends and Outcomes in Total Ankle Arthroplasty in the United States.
The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 2018Co-Authors: Danil Rybalko, Garrett Schwarzman, Vincent M. MorettiAbstract:Total ankle arthroplasty (TAA) is an evolving option for treating ankle arthritis. We assessed the national trends in usage and perioperative outcomes of TAA in the United States. International Classification of Diseases, 9th revision (ICD-9), codes were used to search the National Hospital Discharge Survey database for TAA from 1997 to 2010. Patient demographics, comorbidities, hospitalization length, discharge disposition, blood transfusion, lower extremity deep vein thrombosis, pulmonary embolism, and mortality data were gathered. Trends were evaluated using linear regression with Pearson's correlation coefficient, and statistical comparisons were performed using Student's t test and z-test for proportions with significance at p = .05. We identified 120 patients with TAA. TAA demonstrated a positive correlation with time (r = 0.57), significantly increasing from 2.4 cases per 100,000 admissions from 1997 to 2003 to 3.5 cases per 100,000 from 2004 to 2010 (p = .04). The mean age was 57.8 (range 19 to 83) years. The mean number of comorbidities was 4.5 (range 1 to ≥7). Although patient age remained stable (p = .21), the mean number of comorbidities significantly increased from 4.0 from 1997 to 2003 to 4.8 from 2004 to 2010 (p = .02); 8 patients (6.7%) had diabetes, 71 (59.2%) had primary osteoarthritis, and 35 (29.2%) had Posttraumatic Arthropathy. The mean length of stay significantly decreased from 3.1 to 2.3 days (p = .03). Three patients (2.5%) required a blood transfusion. No deep vein thrombosis or PE was diagnosed. No patients died during the operative admission; 95 patients (87%) were discharged home and 14 (13%) required a skilled rehabilitation facility. Discharge patterns showed no significant change with time (p = .59). Usage of TAA in the United States has increased nearly 50% over the past 14 years. TAA was associated with shorter hospitalization, infrequent rehabilitation facility requirements, and few perioperative complications.