This update is a review of the most impactful studies related to shoulder and elbow surgery from April 2015 to March 2016. Included are clinical and basic science studies primarily from The Journal of Bone & Joint Surgery, the Journal of Shoulder and Elbow Surgery, and The American Journal of Sports Medicine. Specific emphasis has been placed on higher-quality research (Level-I and II studies) and particularly relevant Level-III and IV studies. The level of evidence is provided.
Increased length of hospital stay, early readmission, and revision surgical procedures are adverse events that increase the cost of shoulder arthroplasty. Matsen et al. analyzed data from the New York Statewide Planning and Research Cooperative System on more than 17,000 primary shoulder arthroplasties performed over a 13-year period to identify factors associated with prolonged hospitalization and perioperative adverse events requiring readmission or revision procedures1. Longer hospital stays were associated with female sex, advanced patient age, Medicaid insurance, medical comorbidities, arthroplasties to treat fracture, and lower surgeon case volumes. The need for readmission was more likely with advanced patient age and select medical comorbidities related to heart and lung disease or electrolyte imbalance. Revision procedures were more common in younger patients and in patients with a diagnosis of primary or posttraumatic glenohumeral arthritis. That study demonstrated medical comorbidities as the primary reason for readmission following shoulder arthroplasty.
Wirth reported successful short-term results of hemiarthroplasty and biologic glenoid resurfacing with meniscal allograft in 20092. Given concerns for deterioration of results over time, Bois et al. obtained intermediate-term follow-up on the same series of patients at a mean follow-up of 8.3 years3. The authors reported that radiographic indices of posterior subluxation did not significantly increase from the immediate postoperative imaging to the latest radiographs, but the glenohumeral …
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