The current surgical management of a rotator cuff arthropathy rca offers a wide range of options, such as arthroscopic debridement, arthroplasty 7, 23, 24, fusion and resection arthroplasty, with variable results. Review of fixation techniques for the fourpart fractured. Convertible shoulder system surgical technique tornier upper extremities. Aequalis reverse fracture figure 16 prosthesis tornier. The rehabilitation protocol for total shoulder arthroplasty tsa hemiarthroplasty hhr is based on the latest research. Shoulder system proximal humeral hemiarthroplasty is indicated for most patients with fourpart fractures, displaced.
Hemiarthroplasty for fracture neer type neer developed a foursegment classification system, which remains the standard for the evaluation and treatment of these injuries. May 25, 2015 the aim of this observationnal postmarketing study is to provide additional information on the safety and effectiveness of simpliciti system at 24 months postshoulder arthroplasty, in usual surgical practice. It features a true anatomical reconstruction of the joint, modular components, and is adaptable to a wide range of indications. Hemiarthroplasty for fracture neer type shoulderdoc. Bryant d, litchfield r, sandow m, gartsman gm, guyatt g, kirkley a. Safety and effectiveness of the tornier simpliciti. Shoulder arthroplasty is a complex procedure that is becoming increasingly more.
Sep 16, 2019 a hemiarthroplasty is a replacement of half of the joint. The book begins with a history of rsa followed by a thorough overview of the basic. Treatment of shoulder problems for the primary care physician, seton medical center, grand rounds, austin, texas, march 20, 2003. This website uses cookies to improve your experience while you navigate through the website. Safety and effectiveness of the tornier simpliciti shoulder system in shoulder arthroplasty. Analysis of complications of reverse total shoulder arthroplasty ncbi. The word arthroplasty means to replace the joint, and by adding hemi, this means to do half of the replacement.
Hemiarthroplasty is a technically easier and faster procedure than total. Over the past decade, this prosthetic model has found novel indications for. These articles and resources may be seen in the office. Hemiarthroplasty versus reverse shoulder arthroplasty in 4. Multiple eccentric heads composed of cobaltchromium alloy. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are as essential for the working of basic functionalities of the website. The aim of this book chapter is to describe the methodology for approaching. There are several options to consider when replacing a shoulder. While this procedure has been known to reduce pain, improve strength and increase range of motion in. Surgical position the arm and shoulder are prepped and draped free figure 1.
This year has been very exciting for the charlotte shoulder institute. Copublished with the arthroscopy association of north america, the shoulder. Total shoulder arthroplastyhemiarthroplasty protocol. In the context of total shoulder replacement to relieve pain and significant disability following arthropathy. One third of shoulder surgeons exceed time constraints in their conferences and make no. We identified 272 consecutive shoulder hemiarthroplasty procedures performed between may 1988 and december 2000. Secondary fragment dislocation may prevent bone integration. Shoulder hemiarthroplasty for fractures of the proximal. Over 250,000 doctors use vumedi to improve patient care and grow their practice. The aequalis nail tornier, sa is a straight nail with a length of mm. Technique surgical hemi elbow prosthesis latitude anatomic design rationale design rationale the latitude hemi elbow is the first 3rd generation elbow hemiarthroplasty prosthesis.
The metaphyseal component is available in two diameters 36 mm and 42 mm. Precise surgical technique is critical for success, with proper tension of capsular, muscular, and tendinous surfaces needed for stability. Hemi versus bipolar shoulder arthroplasty for chronic. Identification of the lesser and greater tuberosities and anterosuperior arthrotomy 5. Specific implants for traumatic injuries were used in all cases. About tornier hemiarthroplasty shoulder prosthesis implant 193 l shoulder hemiarthroplasty in female with primary osteoarthritis courtesy of alejandro badia, md.
Indications the therapeutic goals of implanting an anatomical total shoulder prosthesis are to reduce pain andor bring about a functional improvement of the shoulder. The most common complications following primary hemiarthroplasty for proximal humerus fractures relates to surgical technique. Comprehensive total shoulder system surgical technique. Proximal humeral fractures were managed with primary hemiarthroplasty in 57 patients, 53 women 93% and 4 men 7% aged 5187 years mean 72. Good short and midterm results for pain relief and improved function have been reported with the use of a reversed total shoulder prosthesis, developed by. Paff, or clinical decision making regarding the pro. Tenotomy and excision of the long head of the biceps 6. Analysis of complications of reverse total shoulder arthroplasty. Multicenter retrospective study author links open overlay panel n. It is not intended to be a substitute for special instructions from dr. Arthrex cuff arthropathy hemiarthroplasty technique. The clinical outcome of hemiarthroplasty for proximal humeral fractures is not satisfactory. This protocol was adapted from the articles titled. Aana advanced arthroscopic surgical techniques is a comprehensive techniquebased book that presents the latest diagnostic and reconstructive techniques in arthroscopic surgery for the shoulder.
Shoulder hemiarthroplasty replaces half of the joint. In a press release announcing its fda clearance, tornier characterized the simplicity system as a novel, first to market system in the united states which would provide surgeons with an efficient, repeatable surgical technique that is intended to preserve both the patients native bone and avoid further trauma to the surrounding soft. The purpose of this article is to describe a reliable surgical technique using the pectoralis major tendon insertion as a reference for the determination of. Thus, shoulder hemiarthroplasty is widely accepted, for patients with an intact rotator cuff and little or no glenoid wear, two conditions met in avn. The univers cuff arthropathy humeral head system is intended for hemiarthroplasty applications when treating endstage rotator cuff arthropathy and reverse shoulder arthroplasty is not indicated. Wright featuring tornier technology revision shoulder arthroplasty with aequalis flex revive and aequalis perform reversed. The implants are designed to articulate with the native glenoid. Jul 04, 2007 both bipolar and hemiarthroplasty have been used to treat rotator cuff arthropathy rca of the shoulder in patients with low functional demands. Absolute and relative constant scores at 5year followup examination without age or sex normalization, radiographic parameters of calcification, dislocation of tuberosities, prosthetic loosening, and dislocation of joint. Technique operatoire aequalisreversed fracture udkt08. Dec 10, 2019 background shoulder hemiarthroplasty is a shoulder replacement in which the broken humeral head is replaced with an artificial joint and the fractured bone is reconstructed around the artificial joint. Surgical technique distal humerus hemiarthroplasty dhh is a recent therapeutic option for the treatment of some acute unreconstructable humeral.
Boston shoulder institute hemiarthroplasty for communited fracture of the proximal humerus. Aequalis perform surgical technique udtt144 4 with current shoulder arthroplasty systems using a unique glenoid backside radius of curvature, there is a risk to perform excessive reaming to adapt the bone to the prosthesis resulting in. Identify anterior structures and externally rotate the humerus. Background shoulder hemiarthroplasty is a shoulder replacement in which the broken humeral head is replaced with an artificial joint and the fractured bone is reconstructed around the artificial joint. Although most proximal humerus fractures can be treated nonoperatively, 4part fractures and 3part fracturesdislocations in elderly patients often require management with prosthetic arthroplasty. Tornier surgical technique guide copy charlotte shoulder. Hemiarthroplasty was popularized by charles neer, md, 1 and represented a significant advance in shoulder arthroplasty. A comparison of pain, strength, range of motion, and functional outcomes after hemiarthroplasty and total shoulder arthroplasty in patients with osteoarthritis of the shoulder. A displaced fragment is defined as one with displacement of more than 1 cm or angulation of more than 45 degrees fig. Initial firstgeneration designs for total shoulder replacements were constrained, meaning the humeral and glenoid components were mechanically coupled around a fixed center of rotation. The eclipse system has been used successfully to treat primary and posttraumatic osteoarthritis, and has been supported by several clinical publications in the journal of shoulder and elbow surgery, including a thorough 9year prospective cohort that began in 2005.
In most systems, the angle of the humeral cut depuy, tornier is more. Prosthetic replacement with this device may be indicated to relieve severe pain or significant disability following the effects of primary or secondary osteoarthtitis and rheumatoid arthritis. Over the years, shoulder joint replacement has come to be used for many other painful conditions of the shoulder, such as different forms of arthritis. Sep 20, 2016 in a press release announcing its fda clearance, tornier characterized the simplicity system as a novel, first to market system in the united states which would provide surgeons with an efficient, repeatable surgical technique that is intended to preserve both the patients native bone and avoid further trauma to the surrounding soft. Reverse shoulder arthroplasty biomechanics, clinical techniques. Surgical technique prepare acetabulum if acetabular reconstruction is required, prepare the acetabulum using the surgical technique for the intended acetabular component. Present technical comparison of surgical fixation techniques reveals the stateoftheart approach and highlights promising techniques for. Indications for and clinical applications of rsa in a number of surgical. Reverse shoulder arthroplasty includes 2 glenoid components. Functional results of hemiand total shoulder arthroplasty according. Surgical technique is a critical variable in the success of any arthroplasty.
Failure to anatomically secure the tuberosities, restore the humeral height, and recreate the appropriate humeral retroversion are the most likely reasons for failure. Surgical technique for humeral head replacement in fractures of the proximal humerus, san diego shoulder course, tornier shoulder arthroplasty workshop, san diego, california, june 27, 2003. Harvard shoulder service, department of orthopaedics, massachsuetts general hospital, boston ma dr. Proper surgical procedures and techniques are the responsibility of the medical professional. The aequalis shoulder system was born out of a landmark study of the proximal humerus performed by gilles walch, m. Total shoulder arthroplasty versus hemiarthroplasty for. Clavert is a fellow in shoulder surgery, massachusetts general hospital, boston.
All patients underwent surgery under general anaesthesia in the beach chair position. Reverse total shoulder arthroplasty rsa was designed to provide pain relief and improve shoulder function in patients with severe rotator cuff tear arthropathy. The tornier elbow prosthesis is intended for total elbow arthroplasty. We are a recognized leader of surgical solutions for the upper extremities shoulder, elbow, wrist and hand, lower extremities foot and ankle and biologics markets, three of the fastest growing segments in orthopaedics. While use of an axial starter reamer is needed, use of cylindrical reamers is not necessary to prepare the femoral canal.
Shoulder arthroplasty is a rapidly evolving area of orthopedics focused on treating specific, painful ailments of the glenohumeral articulation. The surgical technique used has been described previously raiss et al. Aana advanced arthroscopic surgical techniques is authored by premier arthroscopic surgeons drs. The latitude total elbow is designed to reproduce the patients anatomy. Prosthesis design and placement in reverse total shoulder. Total shoulder arthroplastyhemiarthroplasty protocol phase i. The patients were evaluated in 2009 to establish outcomes after at least 8 years. Tornier aequalis ascend flex convertible shoulder system. Safety and effectiveness of the tornier simpliciti shoulder. Rehabilitation for total shoulder replacement part i. Design rationale the latitude total elbow is the first 3rd generation elbow prosthesis. San diego shoulder institute 2014 total shoulder vs. Complex and revision problems in shoulder surgery 2005 15. The aequalis fx shoulder system provides a foundation for the reattachment of the tuberosities while restoring center of rotation and function to the shoulder low profile for bone grafting.
Hemiarthroplasty of the shoulder after fourpart fracture. Latitude ev total elbow arthroplasty wright medical group. A deltopectoral approach was performed in 53 cases ha group, n 44. Focusing exclusively on reverse shoulder arthroplasty rsa techniques and devices, this. Prior to use of any tornier implant system, the surgeon should refer to the product package insert for complete warnings. Technical pitfalls of shoulder hemiarthroplasty for. International congress of shoulder surgery, washington, d.
A longitudinal incision is made, starting from the acromio. To compare novel looped to conventional knot configurations. It features a true anatomical reconstruction latitude total elbow prosthesis of the joint, modular components, and is adaptable to a wide range of indications. The surgical technique used was the puzzle piece described by brems 4 for. Individual surgeon evaluation of the surgical technique should be performed based on. Hemiarthroplasty versus reverse shoulder arthroplasty in 4part displaced fractures of the proximal humerus.
All indications for shoulder hemiarthroplasty were included except tumours and recent fractures. The management of irreparable rotator cuff tears associated with osteoarthritis of the glenohumeral joint has long been challenging. Present technical comparison of surgical fixation techniques reveals the stateoftheart approach and highlights promising techniques. Rsa group, n 9 and an anterosuperior transdeltoid approach in 45 cases ha group, n. Because this is a conference on surgical technique, we will focus upon. The greatest increase in arm length found for tornier ascend flex 26. Written by leading shoulder specialists, the book provides surgeons and rehabilitation specialists, as well as residents and shoulder fellows, with a valuable. Tornier hemiarthroplasty shoulder prosthesis implant 193. Delta extend depuy in 6 cases, aequalis reversed tornier, edina, mn, usa in. Femoral canal preparation use the box osteotome and canal finder for initial entry into femoral canal. Surgical approaches in shoulder arthroplasty intechopen. Some people also describe the surgery as a partial shoulder replacement.
In this study, 41 patients treated with either a bipolar or hemiarthroplasty were selected retrospectively to detect possible differences in the functional outcome and to evaluate radiological. We are a recognized leader of surgical solutions for the upper extremities shoulder, elbow, wrist and hand, lower extremities foot and ankle and biologics markets, three of. Reverse arthroplasty is gaining in popularity, but hemiarthroplasty still has a role in the management of 4part and some 3part fractures and dislocations. Tornier first introduced the key principles for anatomic shoulder reconstruction with the launch of the aequalis shoulder system nearly two decades ago. Shoulder replacement surgery was first performed in the united states in the 1950s to treat severe shoulder fractures. The aequalis ascend flex shoulder system is to be used only in patients with an intact or. Reverse shoulder arthroplasty current techniques and.
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