5 research outputs found
Osteoporosis in the Setting of Shoulder Arthroplasty: A Narrative Review
Patients who undergo shoulder surgery are frequently affected by osteoporosis and osteopenia, and the prevalence of this association is expected to increase due to the growing number of elderly individuals undergoing these procedures. It may be advisable to conduct a preoperative DXA scan for orthopedic surgical candidates at high risk, to detect those who could benefit from early intervention and avoid any related adverse events. Some of these complications include periprosthetic fractures, infection, subsequent fragility fractures, and have an all-cause revision arthroplasty at 2 years post-op. Some studies analyzed the beneficence of antiresorptive medications pre-operatively but the latter did not show favorable outcomes. Surgical management may include cementing components of the prosthesis as well as modifying the diameter of the shoulder stem. Nevertheless, more studies are needed to evaluate the efficacy of any intervention, whether medical or surgical, to avoid any shoulder arthroplasty related-complication that may be precipitated by the reduced bone mineral density
Anterior Shoulder Instability and Open Procedures: History, Indications, and Clinical Outcomes
The shoulder, being the most mobile joint in the human body, is often susceptible to dislocations and subluxations more so than other joints. As such, shoulder instability constitutes a common complaint among patients worldwide, especially those who are young, participate in contact sports, and have increased innate flexibility in their joints. Management options in the setting of instability vary between conservative and surgical options that aim to mitigate symptoms and allow return of function. Surgical options can be arthroscopic and open, with a general shift among surgeons towards utilizing arthroscopic surgery in the past several decades. Nevertheless, open procedures still play a role in managing shoulder instability patients, especially those with significant bone loss, recurrent instability, coexisting shoulder pathologies, and high risk of failure with arthroscopic surgery. In these clinical settings, open procedures, like the Latarjet procedure, open Bankart repair, glenoid bone augmentation using iliac crest autograft or distal tibial allograft, and salvage options like glenohumeral arthrodesis and arthroplasty may show good clinical outcomes and low recurrence rates. Each of these open procedures possesses its own set of advantages and disadvantages and entails a specific set of indications based on published literature. It is important to cater treatment options to the individual patient in order to optimize outcomes and reduce the risk of complications. Future research on open shoulder stabilization procedures should focus on the long-term outcomes of recently utilized procedures, investigate different graft options for procedures involving bone augmentation, and conduct additional comparative analyses in order to establish concrete surgical management guidelines
Evaluation of online video content related to reverse shoulder arthroplasty: a YouTube-based study
Background Reverse shoulder arthroplasty (RSA) has evolved continuously over recent years, with expanded indications and better outcomes. YouTube is one of the most popular sources for health-related information available to patients. Evaluating the quality of YouTube videos concerning RSA is important to ensure proper patient education. Methods YouTube was queried for the term “reverse shoulder replacement.” The first 50 videos were evaluated using three different scores: Journal of the American Medical Association (JAMA) benchmark criteria, the global quality score (GQS), and the reverse shoulder arthroplasty-specific score (RSAS). Multivariate linear regression analyses were conducted to determine the presence of a relationship between video characteristics and quality scores. Results The average number of views was 64,645.78±264,160.9 per video, and the average number of likes was 414 per video. Mean JAMA, GQS, and RSAS scores were 2.32±0.64, 2.31±0.82, and 5.53±2.43, respectively. Academic centers uploaded the highest number of videos, and surgical techniques/approach videos was the most common video content. Videos with lecture content predicted higher JAMA scores whereas videos uploaded by industry predicted lower RSAS scores. Conclusions Despite its massive popularity, YouTube videos provide a low quality of information on RSA. Introducing a new editorial review process or developing a new platform for patients’ medical education may be necessary. Level of evidenceNot applicable
Online resources for information on shoulder arthroplasty: an assessment of quality and readability
Background Many patients use online resources to educate themselves on surgical procedures and make well-informed healthcare decisions. The aim of our study was to evaluate the quality and readability of online resources exploring shoulder arthroplasty. Methods An internet search pertaining to shoulder arthroplasty (partial, anatomic, and reverse) was conducted using the three most popular online search engines. The top 25 results generated from each term in each search engine were included. Webpages were excluded if they were duplicates, advertised by search engines, subpages of other pages, required payments or subscription, or were irrelevant to our scope. Webpages were classified into different source categories. Quality of information was assessed by HONcode certification, Journal of the American Medical Association (JAMA) criteria, and DISCERN benchmark criteria. Webpage readability was assessed using the Flesch reading ease score (FRES). Results Our final dataset included 125 web pages. Academic sources were the most common with 45 web pages (36.0%) followed by physician/private practice with 39 web pages (31.2%). The mean JAMA and DISCERN scores for all web pages were 1.96±1.31 and 51.4±10.7, respectively. The total mean FRES score was 44.0±11.0. Only nine web pages (7.2%) were HONcode certified. Websites specified for healthcare professionals had the highest JAMA and DISCERN scores with means of 2.92±0.90 and 57.96±8.91, respectively (P<0.001). HONcode-certified webpages had higher quality and readability scores than other web pages. Conclusions Web-based patient resources for shoulder arthroplasty information did not show high-quality scores and easy readability. When presenting medical information, sources should maintain a balance between readability and quality and should seek HONcode certification as it helps establish the reliability and accessibility of the presented information. Level of evidenceIV