ABSTRACT
Background@#There are few reports on the revision or reintervention of reverse total shoulder arthroplasty (RTSA) in South Korea.The purpose of this study was to evaluate the true incidence of complications and reintervention of RTSA and clinical and radiological outcomes based on our 14-year experience in RTSA in a Korean population. @*Methods@#Between March 2008 and June 2022, 412 consecutive cases of RTSA were performed in 388 patients with an average age of 74.4 years at our institute. Excluding 23 patients lost to follow-up, 365 patients (373 shoulders including 8 bilateral cases) who underwent primary RTSA with more than 6 months of follow-up were enrolled in this study. We evaluated those who had complications or reintervention including revision RTSA for failed RTSA. Patient charts were reviewed, and clinical outcomes including clinical scores, complications, and reintervention and radiologic outcomes were evaluated at the last follow-up. @*Results@#Among the 373 shoulders that underwent primary RTSA, complications were found in 50 patients (13.94%, 10 men and 40 women with a mean age of 75.9 ± 6.7 years [range, 51–87 years]). The causes of complications were as follows: 13 acromion, coracoid, or scapular spine fractures, 10 loosening (glenoid: 5, humeral stem: 5), 5 infections, 4 periprosthetic fractures, 2 instability, 2 neurologic complications, and 14 miscellaneous complications. Twenty patients (5.63%, 4 men and 16 women with a mean age of 74.2 ± 8.2 years [range, 51–87 years]) underwent reintervention. The interval to the first reintervention was 27.8 ± 23.1 months (range, 0.1–78 months). The causes of reintervention (20 cases) were 8 loosening (glenoid: 4, humeral stem: 4), 5 infections, 5 fractures, and 2 instability. Among them, 15 component revisions (4.02%) were performed. At the last follow-up, American Shoulder and Elbow Surgeons, University of California at Los Angeles, and Simple Shoulder Test scores were improved from 25.4, 12.4, and 1.6 preoperatively to 40.4, 16.2, and 3.2, respectively. Forward flexion (48° to 87°), abduction (52° to 79°), external rotation (18° to 22°), and internal rotation (buttock to L2) were improved. @*Conclusions@#After primary RTSA in a Korean population, the complication, reintervention, and revision rates were 13.94%, 5.63%, and 4.02%, respectively. Careful evaluation of the complications and adequate treatments should be performed.
ABSTRACT
Background@#To evaluate clinical and radiological outcomes of bony increased offset-reverse total shoulder arthroplasty (BIO-RSA) in theAsian population at mid-term follow-up. @*Methods@#From June 2012 to August 2017 at a single center, 43 patients underwent BIO-RSA, and 38 patients with minimum 2 years follow-up were enrolled. We evaluated the clinical and radiological outcomes, and complications at the last follow-up. In addition, we dividedthese patients into notching and no-notching groups and compared the demographics, preoperative, and postoperative characteristics ofpatients. @*Results@#Visual analogue scale, American Shoulder and Elbow Surgeons, University of California-Los Angeles Shoulder Scale, and SimpleShoulder Test scores improved significantly from preoperative (5.00, 3.93, 1.72, 3.94) to postoperative (1.72, 78.91, 28.34, 7.66) (p<0.05)outcomes. All range of motion except internal rotation improved significantly at the final follow-up (p<0.05), and the bone graft waswell-incorporated with the native glenoid in all patients (100%). However, scapular notching was observed in 20 of 38 patients (53%). In thecomparison between notching and no-notching groups (18 vs. 20 patients), there were no significant differences in demographics, radiological parameters, and clinical outcomes except acromion-greater tuberosity (AT) distance (p=0.003). Intraoperative complications included three metaphyseal fractures and one inferior screw malposition. Postoperative complications included ectopic ossification, scapular neckstress fracture, humeral stem relaxation, and late infection in one case each. @*Conclusions@#BIO-RSA showed improved clinical outcomes at mid-term follow-up in Asian population. However, we observed higherscapular notching compared to the previous studies. In addition, adequate glenoid lateralization with appropriate humeral lengthening (ATdistance) might reduce scapular notching.
ABSTRACT
Background@#To evaluate clinical and radiological outcomes of bony increased offset-reverse total shoulder arthroplasty (BIO-RSA) in theAsian population at mid-term follow-up. @*Methods@#From June 2012 to August 2017 at a single center, 43 patients underwent BIO-RSA, and 38 patients with minimum 2 years follow-up were enrolled. We evaluated the clinical and radiological outcomes, and complications at the last follow-up. In addition, we dividedthese patients into notching and no-notching groups and compared the demographics, preoperative, and postoperative characteristics ofpatients. @*Results@#Visual analogue scale, American Shoulder and Elbow Surgeons, University of California-Los Angeles Shoulder Scale, and SimpleShoulder Test scores improved significantly from preoperative (5.00, 3.93, 1.72, 3.94) to postoperative (1.72, 78.91, 28.34, 7.66) (p<0.05)outcomes. All range of motion except internal rotation improved significantly at the final follow-up (p<0.05), and the bone graft waswell-incorporated with the native glenoid in all patients (100%). However, scapular notching was observed in 20 of 38 patients (53%). In thecomparison between notching and no-notching groups (18 vs. 20 patients), there were no significant differences in demographics, radiological parameters, and clinical outcomes except acromion-greater tuberosity (AT) distance (p=0.003). Intraoperative complications included three metaphyseal fractures and one inferior screw malposition. Postoperative complications included ectopic ossification, scapular neckstress fracture, humeral stem relaxation, and late infection in one case each. @*Conclusions@#BIO-RSA showed improved clinical outcomes at mid-term follow-up in Asian population. However, we observed higherscapular notching compared to the previous studies. In addition, adequate glenoid lateralization with appropriate humeral lengthening (ATdistance) might reduce scapular notching.
ABSTRACT
We treated 160 patients with ureteral stones using extracorporeal shock wave lithotripsy (Siemens Lithostar, Germany) and evaluated many factors which influence the results of ESWL such as stone size, location, degree of ureteral obstruction. duration of impaction and adjuvant procedure. Our results showed that. in case of large stones (more than 1 cm in diameter), mid-ureteral stones, long-standing impacted stones or in-situ treatment, the success rates of ESWL were relatively poor. Therefore in cases accompanying the above-mentioned factors, in is necestary to recognize that the patients may be required to repeat ESWL. The results also suggest that the use of an ureteral catheter or stent may contribute to a slightly higher success rate. But we prefer in-situ extracorporeal shock wave lithotripsy to an ureteral stent because it is an invasive procedure.
Subject(s)
Humans , Lithotripsy , Shock , Stents , Ureter , Ureteral Obstruction , Urinary CathetersABSTRACT
Primary malignant lymphomas of bladder are very rare and most of them are secondary neoplasm occurring by direct extension or by metastatic spread. We report a case of malignant lymphoma showing gross involvement of bladder arising from the terminal ileum with a brief review of literature.