Functional and radiographic outcomes of reverse shoulder arthroplasty with a minimum follow-up of 10 years

Background: The use of reverse shoulder arthroplasty (RSA) is becoming increasingly prevalent. However, few studies have been published reporting the long-term outcomes of RSA. This study aims to report the clinical, radiographic, and patient-reported outcomes of the Delta Xtend reverse shoulder prosthesis, performed by a single surgeon and with a minimum follow-up of 10 years. Methods: All RSA procedures performed between 2005 and 2012 were identified. Patients were contacted and invited for a follow-up visit including clinical assessment, radiographs, and patient-reported outcome measures. Patients with a follow-up of less than 10 years were excluded. The revision-free implant survival was calculated at 10 years. Between 2005 and 2012, 119 procedures in 116 patients meeting inclusion criteria were identified. Of these patients, 35 were deceased before reaching the 10-year follow-up and 23 could not be reached. In total, 63 RSAs could be included in 61 patients (response rate: 75%). The median follow-up was 11.7 years (interquartile range [IQR]: 10.5-13.2). Results: Of the 61 patients, 7 patients underwent a revision after a median of 3 years (IQR: 0.2-9.8) during the total follow-up period. The 10-year implant survival was 94% (95% confidence interval: 84-98). At final follow-up, the median anterior elevation was 135° (IQR: 130°-160°), the median abduction was 120° (IQR: 100°-135°), and the median level reached with internal rotation was L5 (IQR: sacrum-L5). The median Auto-Constant score was 68 (IQR: 53-78), the median Subjective Shoulder Value was 80 (IQR: 70-93), and the median pain score was 0.2/10 (IQR: 0-2). In total, radiographs could be obtained in 25 patients (40%). Scapular notching occurred in 10 patients (40%), which was classified as Sirveaux-Nerot grade IV in 3 patients (12%). Ossification occurred in 10 patients (40%), and stress shielding in 2 patients (8%). Radiolucencies were observed around the humeral component in 24 patients (96%) and around the glenoid component in 13 patients (52%). Conclusion: The long-term results of RSA with a Delta Xtend prosthesis are favorable, with long-term improvement in range of motion and patient-reported outcome measures, and a satisfactory implant survival rate. Interestingly, the radiographical analysis showed high prevalence of signs associated with loosening, which did not seem to translate to high complication rates or inferior results.</p

Reverse shoulder arthroplasty with a 155° neck-shaft angle inlay implant design without reattachment of the subscapularis tendon results in satisfactory functional internal rotation and no instability:a cohort study

Background: The aim of this study was to use the Activities of Daily Living which require Internal Rotation (ADLIR) questionnaire to assess the functional internal rotation in patients who had undergone reverse shoulder arthroplasty (RSA) without reattachment of the subscapularis (SSc) tendon at a minimum follow-up of 2 years. The secondary aim was to report the objective range of motion (ROM) and the rate of postoperative instability. Materials and methods: All consecutive primary RSA procedures without reattachment of the SSc tendon that were performed using a Delta Xtend prosthesis (an inlay system with a 155° neck-shaft angle) between January 2015 and December 2020 were identified to ensure a minimum follow-up of 2 years. Patients were contacted and requested to fill in several questionnaires, including the ADLIR and Auto-Constant scores. Results: In total, 210 patients met the inclusion criteria; among those patients, 187 could be contacted and 151 completed questionnaires (response rate: 81%). The SSc tendon was fully detached without repair in all cases, and a superolateral approach was used in 130 (86%) cases. The median follow-up was 4.5 years (range: 2.0–7.6). At final follow-up, the mean ADLIR score was 88/100 (interquartile range (IQR): 81–96). The median level reached in internal rotation was the 3rd lumbar vertebra (IQR: lumbosacral region—12th thoracic vertebra). Of the 210 eligible patients, one required a revision for a dislocation within the first month after primary surgery. With regards to regression analysis with ADLIR score as the outcome, none of the factors were associated with the ADLIR score, although age and smoking approached significance (0.0677 and 0.0594, respectively). None of the explanatory variables were associated with ROM in internal rotation (p &gt; 0.05). Conclusions: This study demonstrates that satisfactory ADLIR scores and internal rotation ROM were obtained at mid-term follow-up after RSA leaving the SSc detached. Leaving the SSc detached also did not lead to high instability rates; only one out of 210 prostheses was revised for dislocation within the first month after primary surgery. Level of evidence III.</p

Lateralising reverse shoulder arthroplasty using bony increased offset (BIO-RSA) or increasing glenoid component diameter:comparison of clinical, radiographic and patient reported outcomes in a matched cohort

Background: This study aims to compare the range of motion (ROM) of reverse shoulder arthroplasty lateralised by bony increased offset (BIO-RSA) using a standard 38-mm (mm) component to regular reverse shoulder arthroplasty (RSA) lateralised by using a 42-mm glenoid component. The secondary aims are to compare patient-reported and radiographic outcomes between the two groups. Materials and Methods: All patients with a BIO-RSA and size 38 glenosphere were retrospectively identified and matched to patients with a regular RSA and size 42 glenosphere. Matched patients were invited for a follow-up visit. ROM was assessed as well as radiographic outcomes (lateralisation, distalisation, inferior overhang, scapular notching, heterotopic bone formation, radiolucency, stress shielding, bone graft healing and viability and complications) and patient-reported outcomes (subjective shoulder value, Constant score, American Shoulder and Elbow Surgeons, activities of daily living which require internal rotation, activities of daily living which require external rotation and a visual analogue scale for pain). Outcomes were compared between the two groups. Results: In total, 38 BIO-RSAs with a size 38 glenosphere were matched to 38 regular RSAs with a size 42 glenosphere. Of the 76 matched patients, 74 could be contacted and 70 (95%) were included. At the final follow-up, there were no differences between the two groups in ROM, patient-reported outcomes or radiographic outcomes (p &gt; 0.485). Conclusions: Using a larger glenosphere is a feasible alternative to BIO-RSA for lateralising RSA, providing comparable ROM, patient-reported and radiographic results, while potentially decreasing costs, operative time and complication rates. Level of evidence III.</p

The bacterial strains characterization problem

The accurate characterization of collections of bacterial strains is a major scientific challenge, since bacteria are indeed responsible of significant plant diseases and thus subjected to official control procedures (e.g., in Europe, Directive 2000/29/EC). The development of diagnostic tests is therefore an important issue in order to routinely identify strains of these species

Field-effect control of superconductivity and Rashba spin-orbit coupling in top-gated LaAlO3/SrTiO3 devices

The recent development in the fabrication of artificial oxide heterostructures opens new avenues in the field of quantum materials by enabling the manipulation of the charge, spin and orbital degrees of freedom. In this context, the discovery of two-dimensional electron gases (2-DEGs) at LAlO3/SrTiO3 interfaces, which exhibit both superconductivity and strong Rashba spin-orbit coupling (SOC), represents a major breakthrough. Here, we report on the realisation of a field-effect LaAlO3/SrTiO3 device, whose physical properties, including superconductivity and SOC, can be tuned over a wide range by a top-gate voltage. We derive a phase diagram, which emphasises a field-effect-induced superconductor-to-insulator quantum phase transition. Magneto-transport measurements indicate that the Rashba coupling constant increases linearly with electrostatic doping. Our results pave the way for the realisation of mesoscopic devices, where these two properties can be manipulated on a local scale by means of top-gates

Temporal resolution deficits in the visual fields of MS patients

AbstractWe assessed the relationship between temporal resolution and MS-induced neuropathy. A diagnostic strategy comprising assessments of temporal resolution at 16 points in the extra-foveal visual field up to 12° from the fovea was first compared with foveal temporal resolution and with a standard VEP procedure in the same MS patients. At the group level, foveal temporal resolution was less sensitive to demyelination than the 16-point diagnostic strategy, the detection rate of which was comparable to that of the VEP procedure. Cross-sensitivity of the VEP and the 16-point diagnostic procedure was low. Subsequently, the average severity of MS-induced temporal resolution deficits was studied at three retinal loci of the same size but different eccentricities. Foveal deficits were not significantly greater than more peripheral deficits within the central 12°

Applied Meteorology Unit - Operational Contributions to Spaceport Canaveral

The Applied Meteorology Unit (AMU) provides technology development, evaluation and transition services to improve operational weather support to the Space Shuttle and the National Space Program. It is established under a Memorandum of Understanding among NASA, the Air Force and the National .Weather Service (NWS). The AMU is funded and managed by NASA and operated by ENSCO, Inc. through a competitively awarded NASA contract. The primary customers are the 45th Weather Squadron (45WS) at Cape Canaveral Air Force Station (CCAFS), FL; the Spaceflight Meteorology Group (SMG) at Johnson Space Center (JSC) in Houston, TX; and the NWS office in Melbourne, FL (NWS MLB). This paper will briefly review the AMU's history and describe the three processes through which its work is assigned. Since its inception in 1991 the AMU has completed 72 projects, all of which are listed at the end of this paper. At least one project that highlights each of the three tasking processes will be briefly reviewed. Some of the projects that have been especially beneficial to the space program will also be discussed in more detail, as will projects that developed significant new techniques or science in applied meteorology

Paper Session I-B - A Decade of Weather Technology Delivered to America\u27s Space Program by the Applied Meteorology Unit

The Applied Meteorology Unit (AMU) is a unique joint venture of NASA, the Air Force and the National Weather Service. The AMU develops, evaluates and transitions new technology and techniques to improve weather support to spaceport operations at the Eastern Range and Kennedy Space Center. Its primary customers are the 45th Weather Squadron at Cape Canaveral Air Force Station, the Spaceflight Meteorology Group at Johnson Space Center, and the National Weather Service Office in Melbourne, FL. Its products are used to support NASA\u27s Shuttle and EL V programs as well as Department of Defense and commercial launches from the Eastern Range . Shuttle support includes landing sites beyond the Eastern Range. This paper will first present a brief overview of the AMU and how it is tasked by its customers to provide high priority products and services. The balance of the paper will present a sampling of products delivered over the last ten years that are currently in operational use. Each example will describe the problem to be solved, the solution provided, and the operational benefits of implementing that solution