Reverse Total Shoulder Arthroplasty as Treatment for Rotator Cuff-Tear Arthropathy and Shoulder Dislocations in an Elderly Male with Parkinson’s Disease

We report the case of a 70-year-old male with Parkinson’s disease (PD) and recurrent traumatic left shoulder dislocations. This case is rare because (1) he had a massive irreparable rotator cuff tear and end-stage arthritis (i.e., rotator cuff-tear arthropathy) of the same shoulder and (2) his shoulder was ultimately reconstructed with a reverse total shoulder arthroplasty (RTSA). His first dislocation occurred after a fall. Recurrent shoulder dislocations occurred despite successful closed reduction and physical therapy. Initial surgical treatment included an open capsular-labral reconstruction; RTSA was not an ideal option because of the presumed risk of failure from PD-related dyskinesias. However, the capsular-labral reconstruction failed after he lost balance and stumbled but did not fall. A RTSA was then done which restored the patient’s shoulder stability and greatly improved his pain. At final follow-up two years later, he reported pain relief and improved function. This was partially attributed to the fact that he had moved to an assisted living center. He also began using an electric wheelchair one year after the RTSA. We report this case because of the unusual set of conditions and circumstances, namely, the implantation of a RTSA in a patient with PD and shoulder instability

Variation in Timing of Planting Influences Bluebunch Wheatgrass Demography in an Arid System

Establishing perennial grasses from seed in postdisturbance Wyoming big sagebrush (Artemesia tridentata subsp. wyomingensis Welsh) communities is often unsuccessful, due in part to a lack of knowledge of the seedling ecology of perennial grasses. We examined the influence of planting timing on germination and seedling demography of bluebunch wheatgrass (Pseudoroegneria spicata [Pursh] A. Love) in the northern Great Basin. In 2008 (year 1) and 2009 (year 2) we planted seeds monthly, September- December, in 1-m2 plots (500 seeds per plot) using a randomized block design with five replications. Germination timing was indexed using seed bags placed adjacent to 1-m2 plots and retrieved at 2-wk intervals in fall and 1 mo intervals in spring. Seedlings were marked in March-June of the year following planting; seedlings alive in July were considered initially established. Planting in September and October had up to 80% germination prior to winter, whereas December plantings germinated mainly in spring and at reduced rates (15-35%). Seeds planted in September and October emerged approximately a month earlier than November-December plantings. The percentage of germinated seeds that emerged was highest for September-October plantings but the percentage of emergent seeds surviving to the end of the first growing season was highest for later plantings. Final seedling density was lowest for November planting in year 1 and highest for September and October planting in year 2. Our data indicate that timing of and performance at critical stages of seedling development were affected by planting month. We suggest that it may be possible to use emerging technologies (e.g., seed coatings or germplasm manipulations) to produce variable chronologies of seedling development with single plantings and allow managers to exploit multiple temporal windows of opportunity for seedling establishment.The Rangeland Ecology & Management archives are made available by the Society for Range Management and the University of Arizona Libraries. Contact [email protected] for further information.Migrated from OJS platform August 202