Notes

A good off-resonance insensitive orthogonal CSPAMM series (ORI-O-CSPAMM) for that buying of CSPAMM and also MICSR grids in half check period.
New types of glenoid bone block fixation, involving suture buttons, suture anchors or even implant-free impaction of the graft, have been recently introduced. In contrast to screws which allow for a rigid fixation of the bone block, these alternative procedures provide a non-rigid type of fixation.

Two reviewers independently conducted the search in a systematic way (according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) using the MEDLINE/PubMed database and the Cochrane Database of Systematic Reviews. These databases were queried with the terms "Latarjet" OR "Eden-Hybbinette" OR "bone block" AND "anterior" AND "shoulder" AND "instability."

Eight out of the 325 initial studies were finally chosen according to our inclusion-exclusion criteria. In total, 750 patients were included in this review. The overall anterior instability recurrence rate for patients treated with non-rigid fixation was 2.6%, while the overall rate of non-union or graft osteolysis was 5.4%.

Regardless of the graft type, bone block non-rigid fixation showed satisfactory clinical and functional outcomes for the treatment of anterior shoulder instability with substantial glenoid bone deficiency. Furthermore, non-rigid fixation resulted in adequate bone graft healing and osseous incorporation. Abemaciclib clinical trial Lastly, given the relative lack of data, further prospective controlled studies are required to assess bone block non-rigid fixation procedures in comparison with the traditional rigid (with screws) fixation techniques.

Systematic review, IV.
Systematic review, IV.The purpose of this review was to update the complication profile of reverse total shoulder arthroplasty (rTSA) post-2010, given greater procedural familiarity, improved learning curves, enhanced implant designs, and increased attention to the nuances of patient selection. Three electronic databases were searched and screened in duplicate from 1 January 2010 to 16 December 2018 based on predetermined criteria. Twenty-two studies examining 1455 patients (26% male; mean age 73.4 ± 3.6; mean follow-up 23.4 ± 14.3 months) were reviewed. Post-operative motion ranged a mean 122.4° ± 11.5° flexion, 109° ± 19.4° abduction, and 33° ± 11.2°/41° ± 5° external/internal rotation. Post-operative mean Constant score was 58.9 ± 10.1, American Shoulder Elbow Surgeon score was 73.4 ± 6.1, Simple Shoulder Test score was 63.5 ± 6.5, and a Visual Analog Scale pain score was 1.6 ± 0.9. The overall complication rate was 18.2% and major complication rate was 15.4%. Compared to pre-2010, the overall complication rate of 18.2% is lower than previous rates of 19%-68%, with the rate of "major" complications dropping three-fold from 15.4% to 4.6%. The data suggest that rTSA is a safe and efficacious alternative to aTSA and HA, and the "stale" nature of previous complication profiles are points fundamental to perioperative discussions surrounding rTSA.
is the most commonly detected pathogen during shoulder surgery. Lack of typical infection signs make
infections difficult to diagnose. This systematic review aims to determine which pre- and peroperative diagnostic tools are most reliable to identify
infections after shoulder surgery.

PubMed/Embase were searched for diagnostic studies. Methodological quality of included studies was assessed using QUADAS-2. Forest plots summarized results (sensitivity and specificity) for each pre- and peroperative diagnostic tool.

Twenty-two studies were included, of which 8 described preoperative, 10 peroperative, and 4 both pre- and peroperative diagnostic tools. Quality of the studies varied widely. For preoperative tools, synovial calprotectin, interleukin-6, and combined interleukin-6/interleukin-2/tumor necrosis factor-α had the best efficacy measures. Pre-revision biopsies and arthroscopic tissue cultures were the best peroperative tools.

Despite a lack of evidence and the use of different
infection criteria and reference standards, the use of combined interleukin-6/interleukin-2/tumor necrosis factor-α as preoperative and arthroscopic tissue cultures as peroperative diagnostic tool is for now recommended based on results and validity. More research should be performed to provide valid evidence on these tools. In order to do so, an internationally accepted definition of
infections is essential.

Systematic review.
Systematic review.
Upper limb arthroplasty is an increasingly used treatment modality for end-stage joint disease of the shoulder, elbow and wrist. Whilst complications have been reported, the risk of venous thromboembolism has received less attention when compared to the lower limb. Guidance to aid clinical decision-making remains limited. This review aims to ascertain whether venous thromboembolism prophylaxis is beneficial after upper limb major joint replacement surgery.

A systematic review was performed in April 2019, utilising EMBASE, MEDLINE, Cochrane and Google Scholar. All clinical studies reporting venous thromboembolism incidence and risk reduction (after prophylaxis) in upper limb joint replacement were included.

Twenty-four observational studies were identified. The reported incidence of venous thromboembolism ranged from 0.2% to 16% (weighted mean 0.68%) and 0.2% to 0.8% (weighted mean 0.49%) in shoulder and elbow arthroplasty, respectively. No records for wrist arthroplasty were found. In the literature, baseline venous thromboembolism risk of patients without an operation is reported as 0.5%.

There is a lack of good quality evidence regarding the risks and benefits of venous thromboembolism prophylaxis in upper limb major joint replacement surgery. We recommend further research, ideally formal randomised controlled trials to guide recommendations. Although venous thromboembolism is rare in upper limb surgery, surgeons should remain vigilant to this possibility.
There is a lack of good quality evidence regarding the risks and benefits of venous thromboembolism prophylaxis in upper limb major joint replacement surgery. We recommend further research, ideally formal randomised controlled trials to guide recommendations. Although venous thromboembolism is rare in upper limb surgery, surgeons should remain vigilant to this possibility.
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