Conversion of Glenohumeral Fusion to Reverse Total Shoulder Arthroplasty: A Case Report.

CASE: A 41-year-old woman presented 5 years after glenohumeral arthrodesis. She experienced symptomatic relief following conversion to reverse total shoulder arthroplasty, regaining nearly full passive range of motion and >50% of normal active forward flexion, abduction, internal rotation, and external rotation. CONCLUSION: Conversion from glenohumeral arthrodesis to reverse total shoulder arthroplasty in a patient with a functioning deltoid and adequate bone stock may provide symptomatic relief and improved function in the setting of symptomatic glenohumeral arthrodesis refractory to conservative measures.

Blood supply to the chicken femoral head.

The purpose of this study was to conduct a comprehensive evaluation of the vascular supply to the femoral head, including the vessels that give rise to the terminal perfusing branches. Using a casting agent, we highlighted the anatomy of the external iliac and ischiatic arteries with their associated branches after anatomic dissection of 24 hips from 12 Leghorn chickens. We confirmed published findings regarding perfusion of the femoral head and identified 3 previously undescribed arterial branches to this structure. The first branch (the acetabular branch of the femoralis artery) was supplied by the femoralis artery and directly perfused the acetabulum and femoral head. The second branch (the lateral retinacular artery) was a tributary of the femoralis artery that directly supplied the femoral head. Finally, we found that the middle femoral nutrient artery supplies a previously undescribed ascending intraosseous branch (the ascending branch of the middle femoral nutrient artery) that perfuses the femoral head. Precise understanding of the major vascular branches to the femoral head would allow for complete or selective ligation of its blood supply and enable the creation of a reproducible bipedal model of femoral head osteonecrosis.