2 de febr. 2019

Video interessant per explicar el tema de la guia...

Rotator cuff tears after total shoulder arthroplasty in primary osteoarthritis: A systematic review

Aquesta revisió sistemàtica suggereix que la disfunció del manegot després de la pròtesi total d'espatlla  pot ser més comuna del que es va informar anteriorment.

Al final totes seran inverses!!

2 d’oct. 2018

GUIES PER LA COLOCACIÓ DE LA GLENA

Totes les companyies que fan protesi van en la mateixa direcció i Materialise talla el bacalla en el tema de les guies personalitzada 3D.
  Zimmer-biomet,
 DJO ( Frankle)
 Mathys
 Wrigth
Materialise llançara Surgi Case Connect 1.0  un soft per implementar la planificacio+ impressio 3D als hospitals. 


30 de jul. 2018

Mes de plaquetes mes factorets per FACTURAR







Platelet-rich plasma in fibrin matrix to augment rotator cuff repair: a prospective, single-blinded, randomized study with 2-year follow-up

Our results showed no benefit from PRPFM used for rotator cuff repair according to the WORC Index, Simple Shoulder Test, and shoulder strength index.

Dr quan temsp recuperare la funcio despres de la pròtesi ?

Molt interesant per les espectatives dels pacients en la consulta...







Establishing maximum medical improvement following reverse total shoulder arthroplasty for rotator cuff deficiency
Results
MMI occurred at 1 postoperative year following rTSA. When preoperative measures were compared with 1-year postoperative outcomes, all but 1 PROM demonstrated significant clinical improvement (P < .001). There were no significant improvements between any 2 subsequent time points beyond 1 year (P > .050). Range of motion significantly improved between preoperative and 1-year levels (P < .001). No PROMs or range-of-motion parameters significantly improved beyond 1 year (P > .999).

Conclusions

Patients achieved MMI at 1 postoperative year following rTSA. Patients showed rapid improvements in subjective symptoms within the first 3 months and continued to gradually improve until 1 year. Surgeons should counsel patients with these evidence-based expectations for clinical recovery, particularly the time frame of expected improvements in pain, function, and range of motion, as well as risks of and plans of action for postoperative complications.

12 de maig 2018

CHARLSON COMORBIDITY INDEX

Aprofitant el article anterior descobreixo el index de Charlson per mesurar comorbilitats i poder comparar edad amb comorbilitats... De pas un excel que ajuda a calcular-ho.

Aqui el paragraf en que es fa esmena :

General patient health at index surgery was measured using the Charlson Comorbidity Index (CCI). The CCI is a validated measure of burden of disease. Comorbidities are weighted from 1 to 6 for mortality risk and disease severity and then summed to form the total CCI score. Complication rates were stratified by CCI scores to analyze the association between base- line comorbidity burden and surgical complications after shoulder arthroplasty.  Rates of complications, admission for a surgical complication, and revisions were calculated for each surgical group and for combinations of surgical group and comorbidity score.

TAXA COMPLICACIONS PROTESI ESPATLLA

Shoulder arthroplasty in the US Medicare population: a 1-year evaluation of surgical complications, hospital admissions, and revision surgery

Background: The objective of this study was to describe patients receiving each shoulder arthroplasty procedure and to assess surgical complications, hospital admissions for surgical complications, and surgical revisions among Medicare beneficiaries undergoing shoulder arthroplasty.

Methods: Medicare patients receiving shoulder arthroplasty in the United States in 2011 were identi- fied from Medicare administrative data and classified by surgery type: 
1.- shoulder hemiarthroplasty (HA)
2.- anatomic total shoulder arthroplasty (TSA)
3.- reverse shoulder arthroplasty (RSA). 
Surgical complications, hospital admissions, and revisions were identified during the year after the index arthroplasty procedure.

Results: Therewere 24,441 patients who met all inclusion criteria.
20.0% received HA, 
42.5% - TSA, 
37.4% - RSA. 
Compared with RSA and TSA recipients, HA recipients tended to be older and sicker and were more likely to be Medicaid eligible. The rate of new surgical complications and related hospital admissions was greatest during the first 50 days after surgery but remained significant and stable throughout the remainder of the year. 

Rates of complications and related hospital admissions were greatest for HA recipients 
HA (17.4% and 6.6%, respectively),
RSA (14.2% and 5.1%) 
TSA (9.4% and 4.0%).

Conclusions: The rate of adverse surgical outcomes after shoulder arthroplasty differed across popu- lations that received HA, TSA, and RSA and across patients within each group by comorbidity burden. The finding that the rate of surgical complications and related hospital admissions remained meaningful during the entire year after surgery suggests that a postoperative follow-up period longer than the traditional 90 days may be warranted.

Pot ser que l'alta incidència de revisions de les hemi sigui un altre factor mes que ha fet augmentar la indicació d'una Inversa?. "Si non e vero ....