Browsing by Subject "shoulder"

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    Iatrogenic Injury to the Suprascapular Nerve Following Reverse Shoulder Arthroplasty: A Case Report.
    (Journal of shoulder and elbow arthroplasty, 2022-01) Long, Jason; Liles, Jordan; Anakwenze, Oke; Klifto, Christopher
    The location and course of the suprascapular nerve (SSN) to the glenohumeral joint places this nerve at risk when operating around the shoulder. Iatrogenic injury to the suprascapular nerve has been described in several different procedures including, rotator cuff repairs, posterior capsulorraphy, Bankart repairs, SLAP lesion repairs, Latarjet procedures, and shoulder arthroplasty. We present a case of iatrogenic suprascapular nerve injury due to superior glenoid baseplate screw placement following primary reverse shoulder arthroplasty (RSA), a novel approach to diagnosis of nerve injury, and treatment.
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    In Vivo Assessment of Exercise-Induced Glenohumeral Cartilage Strain.
    (Orthopaedic journal of sports medicine, 2018-07-13) Zhang, Hanci; Heckelman, Lauren N; Spritzer, Charles E; Owusu-Akyaw, Kwadwo A; Martin, John T; Taylor, Dean C; Moorman, CT; Garrigues, Grant E; DeFrate, Louis E
    The human shoulder joint is the most mobile joint in the body. While in vivo shoulder kinematics under minimally loaded conditions have been studied, it is unclear how glenohumeral cartilage responds to high-demand loaded exercise.A high-demand upper extremity exercise, push-ups, will induce compressive strain in the glenohumeral articular cartilage, which can be measured with validated magnetic resonance imaging (MRI)-based techniques.Descriptive laboratory study.High-resolution MRI was used to measure in vivo glenohumeral cartilage thickness before and after exercise among 8 study participants with no history of upper extremity injury or disease. Manual MRI segmentation and 3-dimensional modeling techniques were used to generate pre- and postexercise thickness maps of the humeral head and glenoid cartilage. Strain was calculated as the difference between pre- and postexercise cartilage thickness, normalized to the pre-exercise cartilage thickness.Significant compressive cartilage strains of 17% ± 6% and 15% ± 7% (mean ± 95% CI) were detected in the humeral head and glenoid cartilage, respectively. The anterior region of the glenoid cartilage experienced a significantly higher mean strain (19% ± 6%) than the posterior region of the glenoid cartilage (12% ± 8%). No significant regional differences in postexercise humeral head cartilage strain were observed.Push-ups induce compressive strain on the glenohumeral joint articular cartilage, particularly at the anterior glenoid. This MRI-based methodology can be applied to further the understanding of chondral changes in the shoulder under high-demand loading conditions.These results improve the understanding of healthy glenohumeral cartilage mechanics in response to loaded upper extremity exercise. In the future, these methods can be applied to identify which activities induce high glenohumeral cartilage strains and deviations from normal shoulder function.
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    SHOULDER DISARTICULATION FITTING WITH 6 INDEPENDENTLY CONTROLLED MOTORS AFTER TARGETED HYPER-REINNERVATION NERVE TRANSFER SURGERY
    (2005) Miller, L.A.; Lipschutz, R.D.; Weir, R.W.; Williams, T.W.; Stubblefield, K.A.; Heckathorne, C.W.; Kuiken, T.A.
    In 2002, targeted hyper-reinnervation nerve transfer surgery was performed unilaterally on a bilateral shoulder disarticulation amputee. The goal of this surgery was to create additional sites using the remaining unused brachial plexus nerves to allow simultaneous control of multiple movements using more natural control schemes [1,2,3]. As a result of the nerve transfer procedure, 4 new myoelectric control sites were created on the left pectoralis muscle. Subsequent prosthetic fitting found that the user was able to operate the elbow and hand in a coordinated fashion using three electrodes. Various outcome measurements showed an improvement in prosthetic function. However, with the increase in the number of input signals, a goal was set to build a prosthesis with the maximum number of controlled motors available. Six motorized components were identified: three were commercially available in the USA, one was commercially available in other countries and two were a research prototype.
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    Understanding Preferences for Treatment After Hypothetical First-Time Anterior Shoulder Dislocation: Surveying an Online Panel Utilizing a Novel Shared Decision-Making Tool.
    (Orthop J Sports Med, 2017-03) Streufert, Ben; Reed, Shelby D; Orlando, Lori A; Taylor, Dean C; Huber, Joel C; Mather, Richard C
    BACKGROUND: Although surgical management of a first-time anterior shoulder dislocation (FTASD) can reduce the risk of recurrent dislocation, other treatment characteristics, costs, and outcomes are important to patients considering treatment options. While patient preferences, such as those elicited by conjoint analysis, have been shown to be important in medical decision-making, the magnitudes or effects of patient preferences in treating an FTASD are unknown. PURPOSE: To test a novel shared decision-making tool after sustained FTASD. Specifically measured were the following: (1) importance of aspects of operative versus nonoperative treatment, (2) respondents' agreement with results generated by the tool, (3) willingness to share these results with physicians, and (4) association of results with choice of treatment after FTASD. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: A tool was designed and tested using members of Amazon Mechanical Turk, an online panel. The tool included an adaptive conjoint analysis exercise, a method to understand individuals' perceived importance of the following attributes of treatment: (1) chance of recurrent dislocation, (2) cost, (3) short-term limits on shoulder motion, (4) limits on participation in high-risk activities, and (5) duration of physical therapy. Respondents then chose between operative and nonoperative treatment for hypothetical shoulder dislocation. RESULTS: Overall, 374 of 501 (75%) respondents met the inclusion criteria, of which most were young, active males; one-third reported prior dislocation. From the conjoint analysis, the importance of recurrent dislocation and cost of treatment were the most important attributes. A substantial majority agreed with the tool's ability to generate representative preferences and indicated that they would share these preferences with their physician. Importance of recurrence proved significantly predictive of respondents' treatment choices, independent of sex or age; however, activity level was important to previous dislocators. A total of 125 (55%) males and 33 (23%) females chose surgery after FTASD, as did 37% of previous dislocators compared with 45% of nondislocators. CONCLUSION: When given thorough information about the risks and benefits, respondents had strong preferences for operative treatment after an FTASD. Respondents agreed with the survey results and wanted to share the information with providers. Recurrence was the most important attribute and played a role in decisions about treatment.