607 results match your criteria Osteonecrosis Shoulder


Treatment of Knee Osteochondral Fractures.

Healthcare (Basel) 2022 Jun 8;10(6). Epub 2022 Jun 8.

Department of Morphological Sciences, Carol Davila University of Medicine and Pharmacy, RO-020021 Bucharest, Romania.

Osteochondral lesions (OCLs) that are frequently encountered in skeletally immature and adult patients are more common than once thought, and their incidence rate is rising. These lesions can appear in many synovial joints of the body, such as the shoulder, elbow, hip, and ankle, occurring most often in the knee. The term osteochondral lesion includes a vast spectrum of pathologies such as osteochondritis dissecans, osteochondral defects, osteochondral fractures, and osteonecrosis of the subchondral bone. Read More

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Shoulder Osteoarthritis.

Radiol Clin North Am 2022 Jul;60(4):593-603

Department of Radiology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224-3899, USA.

Glenohumeral osteoarthritis has proven to be a major contributor to shoulder joint pain and dysfunction in the elderly. There are several conditions about the shoulder that contribute to the development of glenohumeral osteoarthritis, which includes traumatic injuries, rotator cuff pathology, glenohumeral instability, glenoid dysplasia, and osteonecrosis. When glenohumeral osteoarthritis pain is refractory to conservative treatment, intra-articular injections and surgery can be performed. Read More

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Rapidly destructive osteonecrosis of the humeral head after arthroscopic rotator cuff repair: a case report.

Authors:
Myung-Seo Kim

BMC Musculoskelet Disord 2022 Jun 4;23(1):532. Epub 2022 Jun 4.

Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, 05278, Seoul, Republic of Korea.

Background: Cases of rapidly destructive osteonecrosis (RDON) of the humeral head after arthroscopic rotator cuff repair (RCR) have rarely been reported, which has prevented a clear consensus on the cause of osteonecrosis.

Case Presentation: A 63-year-old woman without a history of trauma underwent arthroscopic RCR after being diagnosed with a medium-sized full-thickness rotator cuff tear for symptoms of left shoulder pain for six months. The patient had no medical history other than hypertension, and no other potential cause was found for osteonecrosis of the left shoulder prior to surgery. Read More

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Operative Treatment of Proximal Humeral Fractures with Reverse Total Shoulder Arthroplasty in Patients ≥65 Years Old: A Critical Analysis Review.

JBJS Rev 2022 05 1;10(5). Epub 2022 May 1.

NYU Langone Orthopedic Hospital, New York, NY.

»: The majority of proximal humeral fractures (PHFs) in patients who are ≥65 years of age are treated nonoperatively, but certain complex fracture patterns benefit from surgical intervention. However, there continues to be debate regarding the indications for surgery and the optimal surgical treatment (repair versus replacement) in this population.

»: Reverse total shoulder arthroplasty (RTSA) has grown in popularity for surgical treatment of fracture-dislocations and displaced complex PHFs in patients who are ≥65 years of age; it has definite advantages over surgical repair and hemiarthroplasty, but this finding requires additional higher-quality evidence. Read More

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Outcomes and complications after arthroplasty in patients with osteonecrosis of humeral head- systematic review.

J Orthop Sci 2022 Apr 28. Epub 2022 Apr 28.

Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, South Korea. Electronic address:

Background: The purpose of this study was to investigate the outcomes and complications of hemiarthroplasty (HA) and total shoulder arthroplasty (TSA) in patients of osteonecrosis of humeral head (ONHH) through systematic review.

Methods: PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines were followed by utilizing the PubMed, EMBASE, Scopus, Ovid, and Cochrane Library databases. Keywords included ONHH, avascular necrosis, head replacement, hemiarthroplasty, or total shoulder arthroplasty. Read More

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Treatment of avascular necrosis of the humeral head - Postoperative results and a proposed modification of the classification.

BMC Musculoskelet Disord 2022 Apr 27;23(1):396. Epub 2022 Apr 27.

Department of Traumatology, Hand Surgery and Sports Medicine, St. Vincentius Clinic, Teaching Hospital Albert-Ludwigs-University Freiburg, Karlsruhe, Germany.

Background: Avascular necrosis of the humeral head after proximal humeral fracture i.e. type 1 fracture sequelae (FS) according to the Boileau classification is a rare, often painful condition and treatment still remains a challenge. Read More

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Steroid-Induced Osteonecrosis of the Humeral Head in a 20-Year-Old Man Treated with an Osteochondral Autograft: A Case Report.

Mod Rheumatol Case Rep 2022 Apr 23. Epub 2022 Apr 23.

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

To our knowledge, only one previous report described the treatment of osteochondral autograft for steroid-induced osteonecrosis of the humeral head (ONHH) in a middle-aged patient. The present report describes a 20-year-old man who was found to have avascular osteonecrosis of the right humeral head after corticosteroid pulse treatment, followed by oral corticosteroid therapy. The patient complained of serious right shoulder pain and limited range of motion (ROM). Read More

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Single-Stage Bilateral Stemless Shoulder Hemiarthroplasty using a Subscapularis-Sparing Approach for Bilateral Dysbaric Osteonecrosis of the Humeral Head in a Diver: A Case Report.

J Orthop Case Rep 2021 Jun;11(6):102-105

Department of Orthopaedics, Instituto de Seguridad del Trabajo, Viña del Mar, Chile.

Introduction: Dysbaric osteonecrosis (DON) is a specific type of atraumatic osteonecrosis that has been shown to occur mainly in deep-sea divers and workers exposed to increased air pressure environments. The pathophysiology is not entirely understood but is thought to be due to subclinical decompression sickness resulting in arterial gas emboli. This leads to vascular occlusion and subsequent bone death. Read More

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The Prevalence of Hip Pathologies in Adolescent Idiopathic Scoliosis.

J Orthop 2022 May-Jun;31:29-32. Epub 2022 Mar 10.

Departments of Orthopaedic and Neurological Surgery, NYU Langone Orthopedic Hospital; New York Spine Institute, New York, NY, USA.

Background: Adolescent idiopathic scoliosis (AIS) is the most common form of abnormal spine curvature observed in patients age 10 to 18. Typically characterized by shoulder height and waistline asymmetry, AIS may drive uneven distribution of force in the hips, leading to increased rates of concurrent hip diagnoses. The relationship between AIS and concurrent hip diagnoses is underexplored in the literature, and to date, there has been little research comparing rates of hip diagnoses between patients with AIS and those unaffected. Read More

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Persistent Shoulder Pain After Vaccine Administration Is Associated with Common Incidental Pathology: A Systematic Review.

Clin Orthop Relat Res 2022 07 23;480(7):1251-1258. Epub 2022 Mar 23.

Department of Surgery and Perioperative Care, Dell Medical School, the University of Texas at Austin, Austin, TX, USA.

Background: Claims of shoulder injury now account for half of all claims to the Vaccine Injury Compensation Program. Reports from databases of claims or potential adverse events note a relatively high mean age and high prevalences of rotator cuff tendinopathy and adhesive capsulitis-common shoulder problems that might be incidental to vaccination. Published case reports provide much more detail about individual patients than is available in databases. Read More

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Achilles Tendon-Bone Block Allograft for Massive Rotator Cuff Tears With Bony Deficiency of the Greater Tuberosity: A Minimum 2-Year Follow-up Study.

Orthop J Sports Med 2022 Feb 22;10(2):23259671211073719. Epub 2022 Feb 22.

Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland.

Background: Massive rotator cuff tears associated with greater tuberosity bone loss are challenging to treat. Repairing the rotator cuff without addressing the greater tuberosity deficiency may result in poorer clinical outcomes.

Hypothesis: Utilizing an Achilles tendon-bone block allograft to address both the massive rotator cuff tear and greater tuberosity bone loss concurrently can result in improved clinical outcomes. Read More

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February 2022

[Locking plate fixation with fibular strut allograft versus locking plate fixation alone for the treatment of proximal humeral fractures in adults:a Meta-analysis].

Zhongguo Gu Shang 2022 Feb;35(2):186-93

Department of Orthopaedics, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.

Objective: To compare the clinical efficacy of locking plate fixation with a fibular strut allograft (FA group) and locking plate fixation alone (LP group) in the treatment of proximal humeral fractures in adults by Meta-analysis.

Methods: Databases including PubMed, The Cochrane Library, Embase, Chinese BioMedical Literature Database(CBM), China National Knowledge Infrastructure(CNKI), WanFang Data, and China Science and Technology Journal Database (cpvip Database) were searched by computer from establishing to March 2020 to collect studies about locking plate fixation with fibular strut allograft versus locking plate fixation alone for proximal humeral fractures in adults. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Read More

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February 2022

Stemless Total Shoulder: A Review of Biomechanical Fixation and Recent Results.

J Shoulder Elb Arthroplast 2021 26;5:24715492211008408. Epub 2021 Apr 26.

Central Michigan University College of Medicine, Mount Pleasant, Michigan.

Anatomic total shoulder arthroplasty is the replacement of the humeral head and glenoid surfaces with the goal of replicating normal anatomy. It is commonly utilized for patients with osteoarthritis, rheumatoid arthritis, and osteonecrosis, who have decreased range of motion (ROM), persistent pain, and loss of strength. Total shoulder Arthroplasty (TSA) is the third most common joint replacement in the United States. Read More

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Management options for proximal humerus fractures - A systematic review & network meta-analysis of randomized control trials.

Injury 2022 Feb 15;53(2):244-249. Epub 2021 Dec 15.

Sports Surgery Clinic, Dublin, Ireland.

Aims: The purpose of this study is to systematically review the randomized controlled trials on the various treatment options that can be utilized in the management of displaced proximal humerus fractures.

Materials & Methods: Based on the PRISMA guidelines, three independent reviewers performed a systematic review of the literature. Randomized control trials (RCTs) focusing on the outcomes of the following interventions in the management of PHFs were considered for inclusion; (1) non-operative or conservative (NOC) management, (2) open reduction and internal fixation (ORIF), (3) intra-medullary nailing (IMN), (4) shoulder hemi-arthroplasty (HA), and (5) reverse shoulder arthroplasty (RSA). Read More

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February 2022

Outcomes associated with secondary implant removal and arthrolysis in patients with a painful stiff shoulder after proximal humeral fracture fixation.

Bone Joint J 2022 Jan;104-B(1):157-167

Edinburgh Shoulder Clinic, Royal Infirmary of Edinburgh, Edinburgh, UK.

Aims: Open reduction and plate fixation (ORPF) for displaced proximal humerus fractures can achieve reliably good long-term outcomes. However, a minority of patients have persistent pain and stiffness after surgery and may benefit from open arthrolysis, subacromial decompression, and removal of metalwork (ADROM). The long-term results of ADROM remain unknown; we aimed to assess outcomes of patients undergoing this procedure for stiffness following ORPF, and assess predictors of poor outcome. Read More

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January 2022

Reverse shoulder arthroplasty yields similar results to anatomic total shoulder arthroplasty for the treatment of humeral head avascular necrosis.

J Shoulder Elbow Surg 2022 Jun 27;31(6S):S94-S102. Epub 2021 Dec 27.

Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, USA. Electronic address:

Background: Avascular necrosis (AVN) of the humeral head frequently results in humeral head collapse and end-stage arthritic changes of the glenohumeral joint. Despite the recent proliferation of reverse total shoulder arthroplasty (RTSA), reports on the use of RTSA for AVN remain limited. The purpose of this study was to document the outcomes of shoulders indicated for RTSA in the setting of humeral head AVN and compare these with AVN shoulders indicated for the gold standard, anatomic total shoulder arthroplasty (aTSA). Read More

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Osteonecrosis of the humeral head in a human immunodeficiency virus-infected patient under tenofovir disoproxil fumarate-emtricitabine-lopinavir/ritonavir for 10 years: a case report.

J Med Case Rep 2021 Dec 18;15(1):624. Epub 2021 Dec 18.

Unit of Infectious and Tropical Diseases, Assane Seck University, Hospital de la Paix, Ziguinchor, Senegal.

Background: Human immunodeficiency virus-infected patients are 100 times more likely to develop aseptic osteonecrosis compared with the general population. While 90% of cases concern the femoral head, the involvement of humeral bone remains rare.

Case Presentation: We report a case of aseptic osteonecrosis of the left humeral head complicating antiretroviral therapy in a female, 46-year-old, Bissau-Guinean human immunodeficiency virus-infected patient received in a context of progressive pain in the left shoulder followed by limitation of articular movements. Read More

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December 2021

Quantitative contrast enhanced dual energy CT to predict avascular necrosis: a feasibility study of proximal humerus fractures.

BMC Med Imaging 2021 12 11;21(1):191. Epub 2021 Dec 11.

Otto D. Payton Professor of Physical Therapy, Orthopaedic Surgery and Rheumatology, Virginia Commonwealth University, Room B-100, West Hospital, 1200 East Broad Street, Richmond, VA, 23298, USA.

Background: Avascular necrosis is a delayed complication of proximal humerus fractures that increases the likelihood of poor clinical outcomes. CT scans are routinely performed to guide proximal humerus fracture management. We hypothesized iodine concentration on post-contrast dual energy CT scans identifies subjects who develop avascular necrosis and ischemia due to compromised blood flow. Read More

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December 2021

Transarterial Embolization for the Treatment of Chronic Musculoskeletal Pain: A Systematic Review of Indications, Safety, and Efficacy.

ACR Open Rheumatol 2022 Mar 29;4(3):209-217. Epub 2021 Nov 29.

Division of Rheumatology, Hospital for Special Surgery, New York, New York, USA.

Objective: The study objective was to evaluate the safety and efficacy of transcatheter arterial "embolization" (TAE) in the treatment of chronic "musculoskeletal pain" refractory to standard therapy.

Methods: PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were searched for original research articles evaluating TAE in patients with musculoskeletal conditions from database inception to January 21, 2020. Search terms employed were as follows: "embolization", "pain", "knee osteoarthritis", joint replacement, epicondylitis, tenderness, inflammation, WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), microspheres, Embozene, geniculate artery, neovascularity, transcatheter, embolic, imipenem/cilastatin sodium, angiogenesis, and "musculoskeletal". Read More

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Influence of carpal-ulnar translation on clinical outcome after scaphocapitate arthrodesis for the treatment of late-stage Kienböck disease.

J Plast Reconstr Aesthet Surg 2022 Jan 17;75(1):348-355. Epub 2021 Sep 17.

Department of Orthopedic Surgery, Korea University Medicine Anam Hospital, Seoul, South Korea. Electronic address:

Background: This study sought to compare postoperative outcomes after scaphocapitate arthrodesis (SCA) for the treatment of late-stage Kienböck disease according to the amount of ulnar translation of the carpus and to identify surgical factors associated with carpal-ulnar translation.

Methods: Thirty-nine patients diagnosed with Kienböck disease (Lichtman stages III-IV) and treated with SCA were retrospectively reviewed. They were divided into the translated group (n=28) and untranslated group (n=11) according to the presence of carpal-ulnar translation. Read More

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January 2022

Hyaluronic acid injections for treatment of pediatric sickle cell avascular necrosis of the humeral head.

Reg Anesth Pain Med 2022 02 12;47(2):136-138. Epub 2021 Oct 12.

Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Los Angeles, Los Angeles, California, USA.

Background: Avascular necrosis (AVN) can impact up to 50% of patients with sickle cell disease (SCD) and can result in significant pain, decline in physical function and decreased quality of life. While hyaluronic acid (HA) has been used in the adult population for shoulder osteoarthritic pain, we present the first published pediatric case of HA injections in the glenohumeral joint, used to improve function and pain control.

Case Presentation: The patient is a 12-year-old woman with SCD, who suffered from chronic pain due to AVN of the humeral and femoral head. Read More

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February 2022

Outcomes of Arthroscopic Lunate Core Decompression Versus Radial Osteotomy in Treatment of Kienböck Disease.

J Hand Surg Am 2022 07 7;47(7):692.e1-692.e8. Epub 2021 Oct 7.

Department of Orthopedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Center of Orthopaedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences (TUMS), Tehran, Iran. Electronic address:

Purpose: The purpose of the study was to evaluate the functional and radiographic outcomes of arthroscopic lunate decompression versus radial osteotomy in the treatment of Kienböck disease (KD).

Methods: In a prospective cohort design, we enrolled 82 patients with KD with Lichtman stages I to IIIb. Participants assigned themselves to groups by choosing either arthroscopic lunate core decompression and synovectomy (group A; n = 54) or radial osteotomy (group B; n = 28). Read More

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Management of Posttraumatic Avascular Necrosis of the Proximal Humerus.

Orthopedics 2021 Nov-Dec;44(6):367-375. Epub 2021 Oct 1.

The etiology of avascular necrosis (AVN) of the proximal humerus can be classified as idiopathic or posttraumatic, the latter being mainly due to proximal humerus fractures. Evidence suggests that posttraumatic AVN may require surgical intervention more often than idiopathic AVN of the proximal humerus. This article provides a comprehensive review of the management of posttraumatic AVN of the proximal humerus. Read More

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November 2021

Complications of combination intranasal corticosteroids and anti-retroviral therapy.

J Laryngol Otol 2021 Sep 28:1-4. Epub 2021 Sep 28.

ENT Department, Guy's Hospital, London, UK.

Background: Intranasal corticosteroids are widely used for management of many upper airway diseases because of their ability to effectively deliver local relief of inflammation.

Case Report: This paper presents the case of a 51-year-old man with human immunodeficiency virus treated with ritonavir who was started on fluticasone intranasal spray for presumed chronic rhinosinusitis. Months after starting this therapy, he developed symptoms of Cushing's syndrome and avascular necrosis of the shoulder due to the pharmacological interactions between fluticasone and ritonavir. Read More

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September 2021

Incidence of avascular necrosis following biceps tenodesis during proximal humerus open reduction and internal fixation.

Acta Orthop Belg 2021 Jun;87(2):339-346

Avascular necrosis (AVN) may occur in up to 77% of proximal humeral fractures and can cause fixation failure. Risk factors include fracture position, calcar length and medial hinge integrity. We routinely perform intra-articular biceps tenotomy with tenodesis at the level of pectoralis major to facilitate fragment identification and potentially ameliorate post-operative pain relief. Read More

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Staging of osteochondritis dissecans of the elbow based on pathologic progression in the partially detached articular fragment.

J Shoulder Elbow Surg 2022 Feb 31;31(2):391-401. Epub 2021 Aug 31.

Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan.

Background: Osteochondritis dissecans (OCD) is considered to show the following stages of pathologic progression: IA, nearly normal-cartilaginous; IB, deteriorated-cartilaginous; IIA, cartilage-ossifying; and IIB, cartilage-osteonecrotic. However, the validity of this pathologic staging for OCD has yet to be confirmed in a large number of cases.

Purpose: The aim of the present study was to confirm the clinical validity of the proposed pathologic staging of OCD. Read More

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February 2022

Mesenchymal stem cell therapy improved outcome of early post-traumatic shoulder osteonecrosis: a prospective randomized clinical study of fifty patients with over ten year follow-up.

Int Orthop 2021 10 5;45(10):2643-2652. Epub 2021 Aug 5.

Département Chirurgie Orthopédique, Clinique Chirurgicale St Michel, Groupe ELSAN, Av. Orient, 83100, Toulon, France.

Purpose: Post-traumatic osteonecrosis of the humeral head has a risk of progression to collapse in absence of treatment. The purpose of this study was to evaluate the results of mesenchymal stem cell grafting of the pre-collapse humeral head (study group) in adult patients with osteonecrosis and to compare the results with a simple core decompression without cells (control group). Patients After inclusion and randomization of 50 patients, 26 patients were enrolled in a single-blinded study for the cell therapy group. Read More

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October 2021

Dysbaric osteonecrosis of the humeral head in a patient with type 2 decompressive sickness.

Spinal Cord Ser Cases 2021 07 21;7(1):62. Epub 2021 Jul 21.

Trauma and Rehabilitation Unit, Salford Royal NHS Foundation Trust, Stott Lane, Manchester, M6 8HD, UK.

Introduction: Dysbaric osteonecrosis, albeit rare, have been reported in patients with decompression sickness. We report a patient with dysbaric osteonecrosis, diagnosed 60 days after presenting with decompression sickness.

Case Presentation: A 38-year-old, previously fit and healthy male, noted his tank running out of air at approximately 40-50 m while diving, surfaced rapidly before losing consciousness. Read More

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Osteochondral Autograft Transplantation for Capitellar Osteochondritis Dissecans.

Authors:
Dan A Zlotolow

JBJS Essent Surg Tech 2021 Apr-Jun;11(2). Epub 2021 May 12.

Shriners Hospitals for Children, Philadelphia, Pennsylvania.

Background: The goal of the osteochondral autograft transplantation (OAT) procedure is to replace both the bone and cartilage that have been compromised by osteonecrosis of the capitellum, a condition known as osteochondritis dissecans (OCD). In children, the vascularity of the capitellum is limited compared with that in adults because the physis acts as a physical barrier to vascular ingrowth from the metaphysis to the epiphysis. The necrotic subchondral bone cannot keep up with the weight-bearing demands of certain high-level athletes such as gymnasts, accumulating microfractures and eventually crumbling. Read More

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Scaphoid Nonunion Volar Plating with Pure Nonvascularized Cancellous Autograft.

JBJS Essent Surg Tech 2021 Apr-Jun;11(2). Epub 2021 May 27.

Department of Orthopaedic Surgery, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona.

Background: Surgical treatment of scaphoid nonunion has evolved over the years to include a variety of procedures and techniques involving a number of vascularized and nonvascularized bone grafting options and fixation strategies. Volar plating of scaphoid nonunions with use of pure cancellous nonvascularized autograft is a safe and effective treatment method with good functional outcomes and union rates.

Description: Volar plating of the scaphoid nonunion is performed via a volar approach, with debridement and reduction of the nonunion site. Read More

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