Amsterdam UMC Location University of Amsterdam, Department of Orthopedic Surgery and Sports Medicine, Amsterdam, The Netherlands
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Department of Orthopedic Surgery, Shoulder and Elbow Unit, OLVG, Amsterdam, The Netherlands
Department of Orthopedic Surgery, Medische Kliniek Velsen, Velsen-Noord, The Netherlands
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Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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Purpose: Total elbow arthroplasty (TEA) is rarely performed compared to other arthroplasties. For many surgical procedures, literature shows better outcomes when they are performed by experienced surgeons and in so-called ‘high-volume’ hospitals. We systematically reviewed the literature on the relationship between surgical volume and outcomes following TEA.
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Methods: A literature search was performed using the MEDLINE, EMBASE and CINAHL databases. The literature was systematically reviewed for original studies comparing TEA outcomes among hospitals or surgeons with different annual or career volumes. For each study, data were collected on study design, indications for TEA, number of included patients, implant types, cut-off values for volume, number and types of complications, revision rate and functional outcome measures. The methodological quality of the included studies was assessed using the Newcastle–Ottawa Scale.
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Results: Two studies, which included a combined 2301 TEAs, found that higher surgeon volumes were associated with lower revision rates. The examined complication rates did not differ between high- and low-volume surgeons. In one study, low-hospital volume is associated with an increased risk of revision compared to high-volume hospitals, but for other complication types, no difference was found.
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Conclusions: Based on the results, the evidence suggests that high-volume centers have a lower revision rate in the long term. No minimum amount of procedures per year can be advised, as the included studies have different cut-off values between groups. As higher surgeon- and center-volume, (therefore presumably experience) appear to yield better outcomes, centralization of total elbow arthroplasty should be encouraged.
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, regardless of the time since onset. Within this group, patients’ history, clinical examination, and imaging are crucial to differentiate both subtypes. Type B1 has been described as functional shoulder instability with either voluntarily (controllable) or
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/nonunion Tuberosity insufficiency 27 (7.3%) Greater tuberosity 12 (3.2%) Lesser tuberosity 4 (1.1%) 5 (1.3%) 6 (1.6%) Full-thickness tendon lesion B1 B2 B3 B4 Avulsion of tendinous attachments Midsubstance tear Fosbury flop tear Bony adhesions 334 (90
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FORE (Foundation for Research and Teaching in Orthopedics, Sports Medicine, Trauma, and Imaging in the Musculoskeletal System), Meyrin, Switzerland
Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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). Normolax Hyperlax Atraumatic (A) A1 Atraumatic MDI A2 Hypermobile painful shoulder Traumatic (B) B1 Traumatic MDI B2 Hyperlax MDI The authors classify symptomatic multidirectional pathological laxity primarily as
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, which described posterior subluxation of the humeral head on the glenoid, resulting in asymmetric glenoid loading and subsequent posterior arthritic wear patterns ( Fig. 2 ). More specifically, B1 identified posterior wear without significant glenoid
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Trauma and Orthopedics Department, Centre of Posgraduate Medical Education, Otwock, Poland
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distally to the tip of the stem. Figure 5 Worland classification. It divides fractures into three types: A, B, C and type B further into three subtypes: B1, B2, B3. Type A and C are similar to regions 1 and 4 of Campbell classification
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introduced by Euler and Rüedi, those fractures can be classified as type B1. 4 Aetiologically, a scapular spine fracture can either occur without 1 or with 2 association to a reverse shoulder arthroplasty (RSA). The latter can be classified
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Dynamic shoulder instability classification of Gerber and Nyfeller ( 8 ). Classification Description B1: Chronic locked dislocation Locked instability caused by major trauma B2: Unidirectional instability without hyperlaxity
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School of Surgery, University of Western Australia, Perth, Australia
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of Bone and Joint Surgery 1988 70 130 – 134 . ( https://doi.org/10.1302/0301-620X.70B1.3339045 ) 27 Bliven KCH & Parr GP . Outcomes of the Latarjet procedure compared with Bankart repair for recurrent traumatic anterior shoulder instability
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Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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defined categories (B1, B2, B3, and C) in regard to glenoid retroversion and humeral head subluxation. 59 Currently, it is still debated whether posterior humeral subluxation is the cause or consequence of increased retroversion. 60 Static posterior
