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7. Relationship between the prosthesis scapular neck angle and clinical outcomes in reverse shoulder arthroplasty.

Author

Zino Kuhn, M, Hao, Kevin A, Cueto, Robert J, Dean, Ethan W, King, Joseph J, Schoch, Bradley S, Wright, Jonathan O, Farmer, Kevin W, Struk, Aimee M, and Wright, Thomas W

Subjects
REVERSE total shoulder replacement, TOTAL shoulder replacement, TREATMENT effectiveness, PROSTHETICS, RANGE of motion of joints
Abstract

Background: Optimal glenosphere positioning in reverse shoulder arthroplasty (RSA) remains highly debated. We aimed to characterize the association between the prosthesis scapular neck angle (PSNA) and postoperative range of motion (ROM) and clinical outcome scores. Methods: A retrospective review of 284 RSAs using a single design with minimum 2-year follow-up was performed. Glenosphere tilt was measured postoperatively using PSNA. ROM and functional outcome scores were assessed preoperatively and at latest follow-up. The PSNA was dichotomized to inferior or superior groups (>90° vs ≤ 90°, respectively) and stratified into quartiles; ROM and outcome score measures were compared between groups controlling for inferior glenosphere overhang. Results: No range of PSNA was consistently associated with superior ROM, clinical outcome scores, or rates of complications including scapular notching. However, greater preoperative to postoperative improvement in active FE was found for superiorly (PSNA ≤ 90°) versus inferiorly tilted glenospheres (37° ± 33° vs 53° ± 35°, P = 0.005) and the greater improvement in active FE (57° ± 35°, P = 0.004) was further isolated to the first quartile (mean 85.1° ± 3.5°). Discussion: A lack of variation in clinical outcomes based on PSNA suggests negligible short-term (median follow-up 3.1 years) clinical significance when glenosphere tilt falls within the distribution of this cohort (mean 92.6° ± 6.2°). [ABSTRACT FROM AUTHOR]

Published
2023
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10. List of Contributors

Author

Afroze, Syeda H., primary, Alpini, Gianfranco, additional, Anderson, Eric C., additional, Atala, Anthony, additional, Badylak, Stephen F., additional, Baiguera, Silvia, additional, Baiocchi, Leonardo, additional, Baptista, Pedro M., additional, Bejarano-Pineda, Lorena, additional, Benedetti, Enrico, additional, Beraldi, Rosanna, additional, Berdichevski, Alexandra, additional, Bhuyan, Mohammod, additional, Bishop, Alex G., additional, Bitar, Khalil N., additional, Blose, Kory J., additional, Brasile, Lauren, additional, Braza, Faouzi, additional, Breuer, Christopher K., additional, Brouard, Sophie, additional, Brown, Bryan N., additional, Burke, George W., additional, Butler, Peter E., additional, Butler, Colin R., additional, Calderon, Damelys, additional, Cancedda, Ranieri, additional, Cantero Peral, Susana, additional, Carbone, Marco, additional, Castanares-Zapatero, Diego, additional, Castro Santa, Edward, additional, Chatenoud, Lucienne, additional, Chawla, Reema, additional, Chen, Linda, additional, Chiono, Valeria, additional, Ciancio, Gaetano, additional, Ciardelli, Gianluca, additional, Ciccarelli, Olga, additional, Collienne, Christine, additional, Corradini, Francesca, additional, Cortiella, Joaquin, additional, Cravedi, Paolo, additional, Cypel, Marcelo, additional, Da Sacco, Stefano, additional, Date, Hiroshi, additional, Davies, Paige S., additional, De Coppi, Paolo, additional, De Luca, Michele, additional, Dean, Ethan W., additional, Degauque, Nicolas, additional, Domínguez-Bendala, Juan, additional, Dubernard, Jean Michel, additional, ElBackly, Rania M., additional, English, Karen, additional, Fändrich, Fred, additional, Farney, Alan C., additional, Faulk, Denver M., additional, García-Arrarás, José E., additional, Gianello, Pierre, additional, Giangreco, Adam, additional, Glaser, Shannon S., additional, Gobble, Ryan, additional, Goldstein, Aaron S., additional, Grant, Christa N., additional, Grikscheit, Tracy C., additional, Gruessner, Angelika C., additional, Gruessner, Rainer W.G., additional, Guillot, Pascale V., additional, Hamilton, Nicholas, additional, Hantson, Philippe, additional, Hemal, Sij, additional, Hematti, Peiman, additional, Hynds, Robert E., additional, Inverardi, Luca, additional, Jacquet, Luc M., additional, Janes, Sam M., additional, Jell, Gavin, additional, Jensen, Kendal, additional, Jochmans, Ina, additional, Kanai, Nobuo, additional, Katari, Ravi, additional, Keshavjee, Shaf, additional, Kim, Jaehyup, additional, Kim, Yeonhee, additional, King, Nancy M.P., additional, Kobayashi, Eiji, additional, Koshiba, Takaaki, additional, Krawiec, Jeffrey T., additional, Kurobe, Hirotsugu, additional, Lai, Quirino, additional, Lanzoni, Giacomo, additional, Laterre, Pierre-François, additional, Lerut, Jan P., additional, Lerut, Toni, additional, Li, Ou, additional, Macchiarini, Paolo, additional, Maghsoudlou, Panagiotis, additional, Mamode, Nizam, additional, Manzia, Tommaso M., additional, Martinez-Fernandez, Almudena, additional, Martovetsky, Gleb, additional, Mastrogiacomo, Maddalena, additional, Masuda, Shigeo, additional, McQuilling, John P., additional, Mehra, Mandeep R., additional, Menasché, Philippe, additional, Meng, Fanyin, additional, Mironi-Harpaz, Iris, additional, Mirzazadeh, Majid, additional, Moiemen, Naiem S., additional, Moran, Emma, additional, Muiesan, Paolo, additional, Nardo, Tiziana, additional, Nelson, Timothy J, additional, Netti, Paolo A., additional, Neuberger, James M., additional, Nigam, Sanjay K., additional, Ohe, Hidenori, additional, Okano, Teruo, additional, Opara, Emmanuel C., additional, Orgill, Dennis P., additional, Otte, Jean-Bernard, additional, Ozer, Sinan, additional, Pareta, Rajesh A., additional, Patel, Timil, additional, Pellegrini, Graziella, additional, Peloso, Andrea, additional, Perin, Laura, additional, Petruzzo, Palmina, additional, Pinheiro, Rafael S., additional, Pirenne, Jacques, additional, Poindexter, Lauren K., additional, Pucéat, Michel, additional, Pugliese, Alberto, additional, Raghavan, Shreya, additional, Rahal, Kinan, additional, Rama, Paolo, additional, Remuzzi, Andrea, additional, Remuzzi, Giuseppe, additional, Reyna-Soriano, Daniel, additional, Rico Juri, Juan M., additional, Ricordi, Camillo, additional, Roberts, Keith J., additional, Rocco, Kevin A., additional, Rodriguez-Devora, Jorge I., additional, Rogers, Jeffrey, additional, Rudnick, David A., additional, Ruggenenti, Piero, additional, Sageshima, Junichiro, additional, Salvatori, Marcus, additional, Samavedi, Satyavrata, additional, Sannino, Alessandro, additional, Scalera, Irene, additional, Sedaghati, Tina, additional, Sedrakyan, Sargis, additional, Seifalian, Alexander M., additional, Seifalian, Amelia, additional, Seliktar, Dror, additional, Selvaggi, Gennaro, additional, Shapira-Schweitzer, Keren, additional, Shinoka, Toshiharu, additional, Shupe, Thomas, additional, Smith, Nicholas R., additional, Soulillou, Jean-Paul, additional, Spinelli, Valentina, additional, Sutherland, David E.R., additional, Tara, Shuhei, additional, Teratani, Takumi, additional, Terzic, Andre, additional, Thomas, Sunu S., additional, Tisone, Giuseppe, additional, Totonelli, Giorgia, additional, Tzakis, Andreas, additional, Tzvetanov, Ivo G., additional, Udelsman, Brooks V., additional, Uygun, Basak E., additional, Vacanti, Joseph P., additional, Van Caenegem, Olivier, additional, Van Dyke, Mark, additional, Van Raemdonck, Dirk E., additional, Vorp, David A., additional, Vyas, Dipen, additional, Wang, Kun, additional, Weinbaum, Justin S., additional, Wertheim, Jason A., additional, Williams, David F., additional, Wittebole, Xavier, additional, Wong, Melissa H., additional, Wood, Kathryn J., additional, Xu, Tao, additional, Yamato, Masayuki, additional, You, Sylvaine, additional, Yuan, Yuyu, additional, Zambon, Joao Paulo, additional, Zattoni, Michela, additional, and Zhu, Lei, additional

Published
2014
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13. Comparison of the Biological Equivalence of Two Methods for Isolating Bone Marrow Mononuclear Cells for Fabricating Tissue-Engineered Vascular Grafts

Author

Kurobe, Hirotsugu, primary, Tara, Shuhei, additional, Maxfield, Mark W., additional, Rocco, Kevin A., additional, Bagi, Paul S., additional, Yi, Tai, additional, Udelsman, Brooks V., additional, Dean, Ethan W., additional, Khosravi, Ramak, additional, Powell, Heather M., additional, Shinoka, Toshiharu, additional, and Breuer, Christopher K., additional

Published
2015
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15. Factors Associated with the Transfer of Pediatric Patients with Supracondylar Humerus Fractures to a Level I Pediatric Trauma Center.

Author

RUSSO, GLENN S., FERRUCCI, ALLEN M., MILLER, CHRISTOPHER P., DEAN, ETHAN W., STROHBEHN, GARTH W., DEAN, NATALIE E., and SHARKEY, MELINDA S.

Abstract

Objective: To compare the characteristics of pediatric patients with supracondylar humerus fractures transferred to a level I pediatric trauma center to those who presented directly to our institution. Methods: Retrospective chart review of patients with a supracondylar humerus fracture during a 42-month period (2008-2011) at a major level I pediatric trauma center were reviewed. Of 195 patients, 37 were transferred from outside hospitals. Results: After multivariable analysis, it was determined that transferred patients were significantly more likely to present on the weekends (p = 0.003) and require operative treatment (p < 0.001) as compared to nontransferred patients. Conclusions: Injuries requiring operative treatment and presentation on a weekend were independent predictors of the transfer of pediatric patients with supracondylar humerus fractures. [ABSTRACT FROM AUTHOR]

Published
2015

16. Influence de l’allongement huméral sur les résultats cliniques de l’arthroplastie inversée de l’épaule

Author

Hao, Kevin A., Dean, Ethan W., Hone, Keegan M., King, Joseph J., Schoch, Bradley S., Dean, Natalie E., Farmer, Kevin W., Struk, Aimee M., and Wright, Thomas W.

Abstract

Deltoid tensioning secondary to humeral lengthening after reverse shoulder arthroplasty (RSA) is commonly theorized to be crucial to improving range of motion (ROM) but may predispose patients to acromial/scapular spine fractures and neurologic injury. Clinical evidence linking patient outcomes to humeral lengthening is limited. This study assesses the relationship between humeral lengthening and clinical outcomes after RSA.

Published
2022
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17. Rate of improvement in shoulder strength after anatomic and reverse total shoulder arthroplasty.

Author

Hao KA, Wright TW, Schoch BS, Wright JO, Dean EW, Struk AM, and King JJ

Abstract

Background: The rate at which patients regain shoulder strength after anatomic and reverse total shoulder arthroplasty (TSA) is unknown. In this study, we aimed to quantify differences in the timeline during which patients gained shoulder strength after primary anatomic and reverse TSA., Methods: We retrospectively reviewed prospectively collected data from 374 shoulders after primary anatomic TSA (aTSA) and 601 shoulders after primary reverse TSA (rTSA). Postoperative improvement in external rotation (ER) strength and forward elevation (FE) strength from baseline was assessed at 3 months, 6 months, 1 year, and 2 years. Percent change in mean shoulder strength between each time point was determined for anatomic and reverse groups separately. A handheld dynamometer was used to assess ER strength with the involved shoulder in 0° ER, 0° abduction, and the elbow in 90° flexion and FE strength with the involved shoulder in the scapular plane at 30° of flexion and 30° of abduction., Results: Both aTSA and rTSA groups ceased to have statistically significant gains in FE strength after 1 year postoperatively. In contrast, patients continued to have statistically significant gains in ER strength between 1 year and 2 years postoperatively after rTSA ( P  = .001), but not after aTSA ( P  = .476). Both aTSA and rTSA groups saw improvement in strength in both ER (+32.1% and +51.4%, respectively) and FE (+38.3% and +90.3%, respectively) at 2-year follow-up. The aTSA group's ER and FE strength increased the most between 3 and 6 months (+16.2% and +35.7%, respectively). In contrast, the rTSA group gained the most ER strength between 6 months and 1 year (+14.8%) and the greatest FE strength between baseline and 3 months (+40.3%)., Conclusion: Patients gain ER strength earlier and FE strength later after aTSA compared with rTSA. Most gains in strength occurred in the first year. However, statistically significant gains in shoulder ER strength in the rTSA group continued between 1 year and 2 years postoperatively, suggesting that 2-year follow-up may be inadequate to capture the full benefits of rTSA on shoulder strength. The results of this study provide insight into the timeline of strength recovery after aTSA and rTSA that will help inform patient counseling and future study design.

Published
2021
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18. Current advances in the translation of vascular tissue engineering to the treatment of pediatric congenital heart disease.

Author

Dean EW, Udelsman B, and Breuer CK

Subjects
Animals, Blood Vessel Prosthesis Implantation methods, Blood Vessel Prosthesis Implantation trends, Child, Humans, Models, Animal, Tissue Engineering trends, Tissue Scaffolds, Translational Research, Biomedical trends, Blood Vessel Prosthesis, Heart Defects, Congenital surgery, Tissue Engineering methods, Translational Research, Biomedical methods
Abstract

Tissue-engineered vascular grafts (TEVGs) hold great promise for the improvement of outcomes in pediatric patients with congenital cardiac anomalies. Currently used synthetic grafts have several limitations, including thrombogenicity, increased risk of infection, and lack of growth potential. The first pilot clinical trial of TEVGs demonstrated the feasibility of this new technology and revealed an excellent safety profile. However, long-term follow-up from this trial revealed the primary graft-related complication to be stenosis, affecting 16 percent of grafts within 7 years post-implantation. In order to determine the mechanism behind TEVG stenosis and ultimately to create improved second generation TEVGs, our group has returned to the bench to study vascular neotissue formation in a variety of large and small animal models. The purpose of this report is to review the recent advances in the understanding of neotissue formation and vascular tissue engineering.

Published
2012

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