Data regarding all patients that had AC joint surgery at the single institution between 2013 and 2019 was collected. Chart documentation served to capture details of patient characteristics, imaging findings, operative procedures, postoperative complications, and any subsequent revisions. Comparing initial and final postoperative radiographs, a greater than 50% reduction in radiographic image alignment defined structural failure. Logistic regression analysis was used to analyze variables potentially predicting complications and the need for revisional surgical procedures.
The study population consisted of 279 patients. Among the 279 cases analyzed, 24% (66) exhibited Type III separations, 7% (20) Type IV separations, and 69% (193) Type V separations. 252 (90%) of the 279 surgeries were performed using an open method, and the remaining 27 (10%) were assisted by arthroscopy. In 164 out of 279 cases (59%), an allograft was employed. Amongst the operative techniques, with the potential inclusion of allograft materials, hook plating (1%), modified Weaver Dunn (16%), cortical button fixation (18%), and suture fixation (65%) were frequently observed. At the conclusion of the 28-week follow-up, a total of 108 complications were detected in 97 patients, which represents 35% of the study participants. Complications manifested around the 2021-week mark, on average. An assessment of structural integrity revealed sixty-nine failures, which constitutes twenty-five percent of the total. Among other complications, persistent AC joint pain necessitating injections, clavicle fracture, adhesive capsulitis, and hardware-related issues were common observations. At a mean of 3828 weeks post-index procedure, 21 patients (8%) experienced unplanned revision surgery, stemming primarily from structural failure, hardware problems, or clavicle/coracoid fractures. Patients who underwent surgical intervention later than six weeks post-injury exhibited a substantially elevated risk of developing complications (Odds Ratio [OR] 319, 95% Confidence Interval [CI] 134-777, p=0.0009) and a considerably greater risk of structural failure (OR 265, 95% Confidence Interval [CI] 138-528, p=0.0004). see more Patients undergoing arthroscopic procedures exhibited a statistically significant increase in the likelihood of structural failure (p=0.0002). No meaningful association was found between the use of allografts or specific surgical techniques and the occurrence of complications, structural failure, or revisionary surgery.
Surgical interventions for acromioclavicular joint injuries often present a substantial risk of complications. Loss of reduction is a rather prevalent event in the post-operative timeframe. Nevertheless, the incidence of revisionary surgical procedures remains minimal. The pre-operative counseling of patients hinges on the import of these findings.
Complications are a relatively common consequence of surgical treatments for injuries to the acromioclavicular joint. Postoperative reduction loss is a widely observed phenomenon. Prosthesis associated infection In contrast, the percentage of surgeries needing revision is low. Patient preparation before surgery hinges on these significant findings.
Arthroscopic scapulothoracic bursectomy, with or without partial superomedial angle scapuloplasty, constitutes the prevailing operative treatment for scapulothoracic bursitis. A definitive agreement on the practice of scapuloplasty, in terms of procedure timing and indication, has not yet been established. The scope of prior studies is narrow, limited to small case series, making the optimal surgical indications uncertain. A retrospective analysis of patient-reported outcomes associated with arthroscopic scapulothoracic bursitis treatment forms the core of this study, focusing on a comparison of outcomes in groups undergoing isolated bursectomy versus combined bursectomy and scapuloplasty. According to the authors' hypothesis, bursectomy coupled with scapuloplasty is anticipated to lead to more effective pain management and functional improvement.
Examined were all cases of scapulothoracic debridement, whether or not coupled with scapuloplasty, completed at a solitary academic center between 2007 and 2020. The electronic medical record was utilized to compile data on patient attributes, symptom descriptions, physical examination results, and the consequences of corticosteroid injections. Pain levels, as measured by the Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES) scores, Simple Shoulder Test (SST) results, and SANE scores, were obtained. The statistical comparison of bursectomy-alone and bursectomy-with-scapuloplasty groups included Student's t-test for continuous variables and Fisher's exact test for categorical variables.
Thirty patients had scapulothoracic bursectomy as the singular surgical intervention, with 38 patients undergoing a combined treatment involving bursectomy and scapuloplasty procedures. A total of 56 (82%) cases out of 68 had their final follow-up data completed. Respectively, the final postoperative VAS pain scores (3422 vs. 2822, p=0.351), ASES scores (758177 vs. 765225, p=0.895), and SST scores (8823 vs. 9528, p=0.340) were comparable between the bursectomy-only and bursectomy-with-scapuloplasty cohorts.
In the management of scapulothoracic bursitis, both the surgical removal of the bursa via arthroscopic scapulothoracic bursectomy and the combined surgical approach involving bursectomy and scapuloplasty are recognized as effective treatment strategies. The operative timeline is noticeably accelerated when scapuloplasty is omitted from the procedure. Protein Biochemistry In this review of past cases, the results of these procedures are comparable concerning shoulder function, pain levels, surgical problems, and the need for further shoulder operations. Further investigation into the three-dimensional shape of the scapula could potentially refine the selection of patients for these procedures.
For scapulothoracic bursitis, both the method of arthroscopic scapulothoracic bursectomy and the technique of bursectomy accompanied by scapuloplasty are proven therapeutic interventions. Without scapuloplasty, the operative procedure is completed in a shorter timeframe. This retrospective study of these procedures demonstrates comparable results concerning shoulder function, pain, surgical complications, and subsequent shoulder surgeries. Studies delving deeper into the 3D form of the scapula might result in a more strategic approach to patient selection for these operations.
To assess the robustness of randomized controlled trials (RCTs) evaluating distal biceps tendon repairs, a fragility analysis was conducted in this current study. We hypothesize that the outcomes, categorized into two, will show statistical frailty, with the frailty increasing among statistically significant results, in a manner comparable to other orthopedics sub-fields.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines directed the selection of randomized controlled trials, from 2000 through 2022, published in four PubMed-indexed orthopedic journals, focused on dichotomous outcomes associated with distal biceps tendon repair procedures. To calculate the fragility index (FI) for each outcome, a single outcome event was reversed until the significance was reversed. To compute the fragility quotient (FQ), each fragility index was divided by the study sample. Also calculated for the FI and FQ was the interquartile range (IQR).
Seven randomized controlled trials, characterized by 24 dichotomous outcomes, were chosen from the 1038 articles for the analysis process. The fragility index for all outcomes was 65, with an interquartile range of 4-9, and the corresponding fragility quotient was 0.0077, with an interquartile range of 0.0031-0.0123. Importantly, outcomes exhibiting statistical significance displayed a fragility index of 2 (IQR 2-7) and a fragility quotient of 0.0036 (IQR 0.0025-0.0091), respectively. Across 286% of the studies, the loss to follow-up (LTF) surpassed or equaled 65 patients, corresponding to an average of 27 patients lost to follow-up.
The existing literature surrounding distal biceps tendon repair reveals a potential fragility comparable to that seen in other orthopedic subspecialties. We propose tripling the reporting of the p-value, fragility index, and fragility quotient to bolster the interpretation of clinical implications in biceps tendon repair literature.
A reassessment of the literature surrounding distal biceps tendon repair reveals a fragility index akin to other orthopedic subspecialties, potentially challenging prior assumptions of stability. For improved interpretation of biceps tendon repair studies' clinical findings, we propose reporting the P-value, fragility index, and fragility quotient in triplicate.
Reverse total shoulder arthroplasty (RTSA), previously predominantly reserved for cuff tear arthropathy, is now more often considered for elderly patients with primary glenohumeral osteoarthritis (GHOA) and an intact rotator cuff. In elderly patients with rotator cuff tears, anatomic total shoulder arthroplasty (TSA) is a common choice to avert the requirement for revision surgery, even given the usually excellent results from TSA. The study sought to establish if a difference in outcomes existed for patients aged 70 who underwent RTSA compared to those who had TSA for GHOA.
A US integrated health care system's Shoulder Arthroplasty Registry furnished the data necessary for conducting a retrospective cohort study. From 2012 to 2021, the study included patients who underwent primary shoulder arthroplasty, aged 70, for GHOA and possessed an intact rotator cuff. A comparative analysis of RTSA and TSA was undertaken. Multivariable Cox proportional hazards regression analysis was performed to determine the overall revision risk during the follow-up period. Multivariable logistic regression analysis was subsequently performed to assess the risk of 90-day emergency department visits and 90-day readmissions.
A total of 685 RTSA and 3106 TSA subjects were included in the final study sample. A study revealed a mean age of 758 years, along with a standard deviation of 46, and a remarkable 434% male proportion.