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Agendas involving Controlled Elements: Removing [123I]Ioflupane From Timetable 2 with the Managed Substances Take action. Final tip.
Periprosthetic infection is a relatively rare but potentially devastating complication after shoulder arthroplasty. The purpose of this article is to review the incidence, diagnosis, prevention, and management of periprosthetic infections after reverse shoulder arthroplasty, with a focus on literature published within the last 5years.

The 2018 International Consensus Meeting on Musculoskeletal Infection provides us with a framework for the diagnosis and management of periprosthetic infections after shoulder arthroplasty. Reverse shoulder arthroplasty has a higher reported rate of infection compared with anatomic total shoulder arthroplasty. Our current diagnostic tests do not appear to be as sensitive when compared with the hip and knee literature. Similar success has been reported with single and two-stage revision protocols, although prospective comparative data are lacking. The significance of unexpected positive cultures during revision arthroplasty remains unclear. We report current diagnostic and thhoulder arthroplasty. Much of the current literature does not distinguish between anatomic and reverse shoulder arthroplasty. Further high-level studies are warranted to refine these definitions and guide management.
The adaptation of new technology in joint replacement surgery is often associated with a learning curve, as performance tends to improve with experience. The purpose of this review is to define the learning curve and its relevance to joint replacement surgery in the setting of new technological advances, and to draw analogies with the learning curve of basic surgical training.

Assessing a surgeon's learning curve for a new technology is complicated and difficult. With every learning curve, the first patients subjected to the novel technology may be at higher risk for adverse events until the learning curve is overcome and a steady state is reached. While measures of performance can be clear and direct in some professions, learning curves with new technology in total joint arthroplasty have been difficult to quantify. find more Most attempts measure surgical learning curves via an evaluation of the surgical process or patient outcomes. There are published results of both process (i.e., operative time, accuracy of im(i.e., complication rate, revision rate) utilized as proxy for performance during learning curves. We review the concept of the learning curve in joint replacement surgery, highlighting examples of learning curves with adaptation of new technologies, and conclude with a discussion of dilemmas and challenges.
Superior capsular reconstruction (SCR) is a surgical procedure that has been developed to provide an alternative for joint preservation in patients with massive irreparable rotator cuff tears. The purpose of this review is to assess the improvements in biomechanical properties and functional outcomes of this novel procedure.

Biomechanically, SCR decreases superior translation and subacromial contact pressure. Glenoid fixation is maximized with three anchors, while margin convergence to any remaining rotator cuff improves stability, and findings vary based on graft type. Clinically, SCR has been associated with improvement in functional outcome in the setting of an isolated procedure, or in conjunction with rotator cuff repair. Outcomes appear to be dependent upon indications. However, in select cases, SCR may even be successful in reversing pseudoparalysis. SCR seems to lead to improved biomechanics for the cuff-deficient shoulder resulting in satisfactory functional outcomes. While surgical techniques haollow-up studies are needed to continue to refine indications for SCR as a joint preservation effort in the setting of irreparable massive rotator cuff tears without arthritis.
This article aims to provide a comprehensive understanding of the evaluation, diagnosis, and management of scapular dyskinesis and its impact on the kinetic chain in tennis athletes.

Optimal glenohumeral biomechanics are intimately associated with proper scapular motion and function. The tennis serve requires the scapula to act as a force transducer in the kinetic chain to convert potential energy generated in the lower extremities to kinetic energy in the upper extremity. Any aberration within this complex kinetic chain will result in force uncoupling and increases the potential for injury through compensatory mechanisms. Specifically, scapular dyskinesis has been associated with an increased risk of shoulder pain of up to 43% in overhead athletes. These pathologies include rotator cuff disease, subacromial and posterior impingement, labral injuries, and SLAP tears. Although the direct causality of these injuries remains controversial, multiple kinematic studies have demonstrated altered scapular positioscapular dyskinesis has been associated with an increased risk of shoulder pain of up to 43% in overhead athletes. These pathologies include rotator cuff disease, subacromial and posterior impingement, labral injuries, and SLAP tears. Although the direct causality of these injuries remains controversial, multiple kinematic studies have demonstrated altered scapular positioning increasing the predilection for soft tissue pathology. The diagnosis of scapular dyskinesis is predicated upon a thorough history, physical examination, and observational analysis of key nodes in the kinetic chain during tennis activity. Conservative management remains the mainstay of treatment and consists of a graduated physical therapy regimen. Although shoulder pain in the overhead athletes is often multifactorial, early recognition and treatment of scapular dyskinesis generally carry a favorable prognosis and result in improved patient outcomes.
This review presents epidemiology, etiology, management, and surgical outcomes of rotator cuff injuries in tennis players.

Rotator cuff injuries in tennis players are usually progressive overuse injuries ranging from partial-thickness articular- or bursal-sided tears to full-thickness tears. Most injuries are partial-thickness articular-sided tears, while full-thickness tears tend to occur in older-aged players. The serve is the most energy-demanding motion in the sport, and it accounts for 45 to 60% of all strokes performed in a tennis match, putting the shoulder at increased risk of overuse injury and rotator cuff tears. Studies have shown deficits in shoulder range of motion and scapular dyskinesia to occur even acutely after a tennis match. First-line treatment for rotator cuff injuries in any overhead athlete consists of conservative non-operative management with appropriate rest, anti-inflammatory drugs, followed by a specific rehabilitation program. Operative treatment is usually reserved for older-aged players and to those who fail to return to play after conservative measures.
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