Breaking News
June 17, 2018 - Sunovion Announces FDA Acceptance of New Drug Application for Apomorphine Sublingual Film (APL-130277)
June 17, 2018 - Bid to beat obesity focuses on fat that keeps us warm
June 17, 2018 - Work Stress May Increase Risk of Developing Atrial Fibrillation
June 17, 2018 - New Zealand’s secret recipe for active school travel: The neighborhood built environment
June 17, 2018 - New Medscape report reveals sexual harassment rate of physicians
June 17, 2018 - Surgical Blood Transfusions Tied to Clot Risk
June 17, 2018 - CDC chief makes $375K, far exceeding his predecessors’ pay
June 17, 2018 - Education linked to higher risk of short-sightedness
June 17, 2018 - Patients with Moderate-to-Severe Ulcerative Colitis Achieved Clinical and Endoscopic Remission with Mirikizumab in Phase 2 Trial
June 17, 2018 - UA registers a more customised multifocal lens to correct presbyopia
June 17, 2018 - U.S. FDA and European Medicines Agency Accept Regulatory Submissions for Review of Talazoparib for Metastatic Breast Cancer Patients with an Inherited BRCA Mutation
June 17, 2018 - Vaginal estrogen tablets, moisturizers and placebo gel all can improve vaginal discomfort
June 17, 2018 - Addition of Bezafibrate Beneficial in Primary Biliary Cholangitis
June 17, 2018 - Radiation Therapy for Cancer – National Cancer Institute
June 17, 2018 - Technology could help pregnant women detect health complications
June 17, 2018 - Study finds drop in frequent use of ED after Affordable Care Act
June 17, 2018 - Do Antipsychotic Meds for Kids Raise Diabetes Risk?
June 17, 2018 - New light shed on mechanisms of paediatric epilepsy
June 17, 2018 - People who deeply grasp the pain or happiness of others also process music differently in the brain
June 16, 2018 - Scientists discover how cancer-targeting ‘Natural Killer’ cells are fueled in the body
June 16, 2018 - New England Journal of Medicine Publishes Pivotal Cemiplimab Trials Showing Positive Results in Advanced Cutaneous Squamous Cell Carcinoma
June 16, 2018 - Annual Report to the Nation: overall cancer mortality continues to decline, prostate cancer mortality has stabilized
June 16, 2018 - Ibuprofen, acetaminophen more effective than opioids in treating dental pain
June 16, 2018 - Intra-Cellular Therapies Initiates Rolling Submission of New Drug Application for Lumateperone for Treatment of Schizophrenia
June 16, 2018 - Price competition for generic drugs linked to increase in manufacturing-related recalls
June 16, 2018 - Researchers develop biomimetic nanosystem to deliver therapeutic proteins to target tumors
June 16, 2018 - Negative Pressure Wound Tx No Benefit for Lower Limb Open Fx
June 16, 2018 - Should I Get Screened for Prostate Cancer?
June 16, 2018 - Biochemist, physicist team to see antibacterial TCS deform mitochondria
June 16, 2018 - New 2D Superresolution mode for ZEISS Airyscan offers higher resolution in live cell imaging
June 16, 2018 - Money Spurs Those With Heart Disease to Step Lively
June 16, 2018 - Lower Dose of Prostate Cancer Drug with Food
June 16, 2018 - New findings demonstrate how the food we eat affects biochemical signals in the gut
June 16, 2018 - Scientists develop method to determine metabolic activity of neural networks
June 16, 2018 - Topical gel may lower breast cancer risk in women with dense breast tissue
June 16, 2018 - Research team diagnoses asthma with nasal brush test
June 16, 2018 - Dacomitinib Shows More than Seven-Month Improvement in Overall Survival Compared to an Established Therapy in Advanced NSCLC with EGFR-Activating Mutations
June 16, 2018 - Novel PET imaging noninvasively pinpoints colitis inflammation
June 16, 2018 - New clinical trial of MS drug will be first to recognize needs of wheelchair users
June 16, 2018 - Evoke Announces FDA Submission of New Drug Application for Gimoti
June 16, 2018 - New study links gray hair with immune system activity and viral infection
June 16, 2018 - Various E-cigarette flavorings may increase risk of cardiovascular disease
June 16, 2018 - Research sheds light on pathways involved in transmitting itch sensations from skin to brain
June 16, 2018 - Eminent biologist resigns over allegations of gender discrimination and sexual harassment
June 16, 2018 - Consuming sugary soft drinks can make you fat
June 16, 2018 - CDC: Preterm Births Increased in United States During 2014-2016
June 16, 2018 - Adolescents with hay fever have higher rates of anxiety and depression, lower resistance to stress
June 16, 2018 - Metabolic process providing energy to heart muscle fails to mature in babies with hypertrophy
June 16, 2018 - TU Graz researchers manipulate enzymes to build ring-shaped molecular structures
June 16, 2018 - Looking Good! Plastic Surgery for Men Surges
June 16, 2018 - Discovery of how HIV hedges its bets opens the door to new therapies
June 15, 2018 - Researchers evaluate left ventricular systolic function after pulmonary valve replacement
June 15, 2018 - New resource launched based on first-hand experiences of premature baby loss
June 15, 2018 - About Teen Pregnancy | Teen Pregnancy | Reproductive Health
June 15, 2018 - In southern Mozambique, one out of three people diagnosed with HIV do not disclose their status
June 15, 2018 - Researchers discover genomic characteristics that define testicular germ cell cancer
June 15, 2018 - Engineers create first 3D computer model to show breast duct development
June 15, 2018 - ANU scientists invent new system that could help crack down on illegal drug trade
June 15, 2018 - Study shows remarkable plasticity of the brain in finding work-arounds after catastrophic injuries
June 15, 2018 - Study finds higher response to anti-PD1 immunotherapy in older melanoma patients
June 15, 2018 - New Data from Phase 1 Study of Ivosidenib or Enasidenib in Combination with Azacitidine Demonstrate Robust Responses and a Well Tolerated Safety Profile in Newly Diagnosed IDHm AML Patients
June 15, 2018 - Smoking, lack of exercise linked to early death after divorce
June 15, 2018 - Researchers identify gene enhancer that affects sex determination
June 15, 2018 - New collaboration integrates Intabio’s Blaze solution with Bruker’s mass spectrometers
June 15, 2018 - Blood samples can be used to uncover genetic secrets inside the brain
June 15, 2018 - Palatin Technologies Announces FDA Acceptance for Review of Bremelanotide NDA
June 15, 2018 - Can you rely on the drugs that your doctor prescribes?
June 15, 2018 - WHO: Paraguay achieves malaria-free status
June 15, 2018 - Investigating Enamel Nanostructure with Nanoindentation
June 15, 2018 - FDA Approves Moxidectin for the Treatment of River Blindness
June 15, 2018 - Researchers discover cell structure that plays a role in epigenetic inheritance
June 15, 2018 - Study shows how using service dogs may provide physiological benefits to veterans with PTSD
June 15, 2018 - New chemical solution could reduce chances of infection associated with root canal work
June 15, 2018 - Fat and carb rich foods preferred by the brain
June 15, 2018 - Scientists discover unique feature in the ‘antennae’ of light-sensing neurons
June 15, 2018 - Researchers observe increase in activity of neurons grown on single layer of graphene
June 15, 2018 - Researchers find enzyme responsible for aircraft noise-related vascular damage
June 15, 2018 - Study shows improvements in adherence, outcomes of gout patients receiving text message reminders
June 15, 2018 - Accelerated brain maturation linked to stress in childhood
June 15, 2018 - FDA Alert: Compounded Products Containing Triamcinolone-Moxifloxacin by Guardian Pharmacy Services (Dallas, Texas): Alert to Health Professionals
Reverse shoulder replacement provides lasting improvement for younger patients

Reverse shoulder replacement provides lasting improvement for younger patients

image_pdfDownload PDFimage_print

For younger patients with severe damage to the rotator cuff muscles, a “reverse” shoulder replacement provides lasting improvement in shoulder function, according to a study in The Journal of Bone & Joint Surgery. The journal is published in partnership with Wolters Kluwer.

“In the absence of treatment alternatives, reverse total shoulder arthroplasty [RTSA] is a justifiable treatment for patients with a massive, irreparable rotator cuff tear before the age of 60,” according to the report by Christian Gerber, MD, of the University of Zurich and colleagues. Despite a substantial risk of complications, most patients are satisfied with the outcomes of RTSA at follow-ups of a decade or longer.

Stable Long-Term Results of RTSA in Patients Younger than 60

The researchers analyzed the long-term outcomes of RTSA in 20 patients, average age 57 years. All had “massive, irreparable” tears of the rotator cuff muscles, causing shoulder “pseudoparalysis,”with little no ability to lift the arm.

This group of patients typically gets limited benefit from shoulder replacement with conventional implants, which rely on the rotator cuff muscles to provide shoulder movement. The RTSA technique-;using an implant in which the natural locations of the shoulder “ball and socket” are reversed-;uses other muscles to move the shoulder, providing an alternative when the rotator cuff is severely damaged or destroyed.

When first introduced, RTSA was performed mainly in elderly patients who placed low demands on the shoulder. With refinements in technique and components in more recent years, the procedure has been used in younger, more active patients. But there are concerns about how well the results of RTSA will hold up over time in this group of patients.

The new study focused on long-term outcomes of RTSA in patients under age 60. The patients underwent follow-up examination between eight and 19 years after surgery (average 11.7 years). Three patients had RTSA in both shoulders, for a total of 23 procedures.

Compared to their preoperative status, most patients had substantial long-term improvement after RTSA. The average Constant score-;a standard assessment accounting for shoulder motion, strength, daily activities, and pain-;at the time of final-follow-up improved from 24 to 59 (out of a possible 100).

Patients’ ratings of “subjective shoulder value” improved from 20 percent to 71 percent (compared to 100 percent for a normal shoulder). Shoulder movement and strength increased, while pain decreased. The improvement was similar for patients with and without prior shoulder surgery.

However, complications occurred in 39 percent of the shoulders. Further surgery was required in six shoulders; in two cases, the RTSA procedure was considered a failure.

When complications occurred, long-term shoulder functioning was not as good but even with the high complication rate, 72 percent of patients rated their satisfaction level as excellent or good.

The results alleviate concerns that the clinical benefits of RTSA might not hold up over time in younger, more active patients. Despite its high complication rate, Dr. Gerber and colleagues conclude that RTSA “provides substantial and lasting improvement” in shoulder function and pain, in a group of patients with limited treatment options.

Source:

http://wolterskluwer.com/company/newsroom/news/2017/10/good-long-term-improvement-after-reverse-shoulder-replacement-in-patients-under-60.html

Tagged with:

About author

Related Articles