572 results match your criteria Osteonecrosis Shoulder

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

Spinal Cord Ser Cases 2021 Jul 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.

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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Prevalence of avascular necrosis in idiopathic inflammatory myositis: a single center experience.

Rheumatology (Oxford) 2021 Jun 27. Epub 2021 Jun 27.

Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Objectives: To assess the prevalence of avascular necrosis (AVN) in a large cohort of patients with idiopathic inflammatory myopathies (IIM) and define the major associated risk factors.

Methods: We retrospectively reviewed the electronic medical records of all patients with a definitive diagnosis of IIM enrolled in our registry between 2003-2017 and followed until 2020. Pertinent demographic, clinical, serologic and imaging data were collected. Read More

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The humeral head: A review of the blood supply and possible link to osteonecrosis following rotator cuff repair.

J Anat 2021 Jun 23. Epub 2021 Jun 23.

Department of Anatomy and Cellular Biology, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates.

Trauma, corticosteroid therapy and metabolic diseases are well established aetiologies of humeral head osteonecrosis; however, there is increasing evidence that arthroscopic rotator cuff surgery may be another possible cause. One of the reasons is that there may be inadvertent damage to the arterial blood supply to the humeral head during surgical intervention. The blood supply to the humeral head displays large amounts of variation with regard to origin, course and distribution. Read More

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Surgical treatment of humeral head avascular necrosis in patients with sickle cell disease: a systematic review.

JSES Int 2021 May 26;5(3):391-397. Epub 2021 Mar 26.

Department of Orthopedic Surgery, King Fahad Hospital of the University, Khobar, Saudi Arabia.

Background: Sickle cell disease is the leading etiology for atraumatic humeral head avascular necrosis worldwide. Treatment of this condition is not standardized, with only few studies evaluating clinical outcomes after surgical interventions. The aim of this study was to review the available evidence on the results of surgical intervention for humeral head avascular necrosis in the sickle cell disease population. Read More

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Antegrade intramedullary fixation for adolescent fifth metacarpal neck fracture and its impact on epiphyseal growth.

BMC Musculoskelet Disord 2021 Jun 15;22(1):546. Epub 2021 Jun 15.

Department of Surgical Center, Karamay Central Hospital of Xinjiang, 834000, Karamay, China.

Background: Antegrade intramedullary nailing (AIMN) with Kirschner wire (K-wire) is a minimally invasive osteosynthesis technique. This procedure has been widely performed to treat the fifth metacarpal neck fracture (FMNF) in adults. This study was performed to determine whether using AIMN with a single K-wire to treat FMNF in adolescents would have good clinical and radiographic outcomes. Read More

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Outcomes following fracture fixation with the Equinoxe® proximal humerus plate: an improvement over PHILOS®?

Eur J Orthop Surg Traumatol 2021 Jun 9. Epub 2021 Jun 9.

Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, 301 E 17th Street, Suite 1402, New York, NY, 10003, USA.

Introduction: The purpose of this study is to compare patient outcomes between the Equinoxe® (Exactech, Gainesville, Fla) proximal humerus locking plate and the PHILOS® (Synthes, Paoli, PA) proximal humerus locking plate.

Methods: Two hundred and seventy-one patients with a displaced proximal humerus fracture presented to our academic medical center between February 2003 and October 2020. Functional outcomes assessed included the Disabilities of the Arm, Shoulder, and Hand questionnaire and shoulder range of motion. Read More

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Postoperative Outcome of Patients Who Underwent Total Joint Replacement During the Tanezumab Phase 3 Osteoarthritis Development Program: A 24-Week Observational Study.

Surg Technol Int 2021 05 27;38. Epub 2021 May 27.

Medicine Team Leader, Pfizer Inc, Groton, Connecticut.

Introduction: This prospective cohort study (ClinicalTrials.gov identifier: NCT02674386) evaluated the postoperative outcomes of patients who had undergone total joint replacement (TJR) while participating in one of three tanezumab (a nerve growth factor inhibitor) randomized phase 3 osteoarthritis (OA) studies.

Materials And Methods: Eligible patients were those who underwent TJR (knee, hip, or shoulder) at any time during any of three tanezumab randomized phase 3 OA studies. Read More

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Pyrocarbon Humeral Head in a Shoulder Hemiarthroplasty: Preliminary Results at 3 Years Follow-Up and Review of the Current Literature.

Case Rep Orthop 2021 14;2021:6633690. Epub 2021 Apr 14.

Department of Orthopedics, Centro Hospitalar e Universitário do Porto, Portugal.

Shoulder hemiarthroplasty is a viable option in young patients with an intact rotator cuff in order to preserve the native glenoid. To avoid the dreaded and expected wear of the glenoid in very active shoulders, implants with humeral head coated with a high resistant and elastic material-pyrolytic carbon-are now an option. The authors present the first pyrocarbon coated hemishoulder arthroplasty performed at our Orthopedic Department in a patient with osteonecrosis of the humeral head. Read More

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Stable osteosynthesis of cage in cage technique for surgical treatment of proximal humeral fractures.

BMC Surg 2021 May 4;21(1):233. Epub 2021 May 4.

Department of Orthopaedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.

Background: The treatment of a displaced proximal humeral fracture is still a matter of controversy. The purpose of this study was to report outcomes at a long-term follow-up after fixation augmentation using peek (polyether-ether-ketone) cage and locking compression plate (LCP).

Methods: A total of 27 patients (average age 53. Read More

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Humeral Head Osteonecrosis: Outcomes of Hemiarthroplasty After Minimum 10-Year Follow-Up.

Rev Bras Ortop (Sao Paulo) 2021 Feb 16;56(1):91-97. Epub 2020 Mar 16.

Grupo de Cirurgia de Ombro e Cotovelo, Santa Casa de São Paulo, São Paulo, SP, Brasil.

 To analyze long-term functional and radiographic results of partial shoulder replacement for humeral head osteonecrosis.  Retrospective review of thirteen cases, with a mean postoperative follow-up of 17 years (range 10 to 26 years). The findings from the last follow-up were compared to those in which the patients had one year of postoperative follow-up. Read More

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February 2021

Microvascular Reconstruction of Osteonecrosis: Assessment of Long-term Quality of Life.

Otolaryngol Head Neck Surg 2021 Feb 23:194599821990682. Epub 2021 Feb 23.

School of Medicine, Oregon Health and Science University, Portland, Oregon, USA.

Objective: Review long-term clinical and quality-of-life outcomes following free flap reconstruction for osteonecrosis.

Study Design: Retrospective multi-institutional review.

Setting: Tertiary care centers. Read More

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February 2021

Core decompression with autologous bone marrow aspirate injection in humeral head osteonecrosis in adults with sickle cell disease.

Int Orthop 2021 05 5;45(5):1257-1261. Epub 2021 Feb 5.

Almaviva Santé, Clinique Arago, Paris, France.

Purpose: Sickle cell disease is often associated with osteonecrosis of the humeral head with a risk of progression to humeral head collapse. The aim of this study was to evaluate the clinical outcome and the effect on the necrosis evolution of humeral head core decompression with autologous bone marrow aspirate injection in these patients.

Methods: Forty shoulders in 23 patients were treated with core decompression with autologous concentrated iliac crest bone marrow aspirate injection. Read More

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Complications Associated with Posterior Cruciate Ligament Reconstruction and Avoiding Them.

J Knee Surg 2021 May 5;34(6):587-591. Epub 2021 Feb 5.

Division of Sports Medicine and Shoulder Surgery, Hospital for Special Surgery, New York City, New York.

Posterior cruciate ligament (PCL) injuries often occur as part of a multiligament injury pattern and can present a significant challenge to the treating surgeon. When PCL reconstruction is indicated, complications can arise in the intraoperative and postoperative period that lead to poor outcomes. These complications include neurovascular injury, fracture, compartment syndrome, persistent posterior laxity, motion loss, residual knee pain, osteonecrosis, and heterotopic ossification. Read More

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Aseptic osteonecrosis of the shoulder: Etiologies, diagnosis and medical management.

R Lancigu L Rony

Morphologie 2021 Jun 21;105(349):148-154. Epub 2021 Jan 21.

Département de chirurgie osseuse, CHU Angers, 4, rue Larrey, 49933 Angers cedex 9, France; GEROM - Groupe Etudes Remodelage Osseux et bioMatériaux, IRIS-IBS institut de biologie en santé, université d'Angers, 49933 Angers, France.

Aseptic osteonecrosis of the humeral head is a multifactorial entity in which the final common pathway results in disrupted blood supply, increased intraosseous pressure, and bone death. It follows a pathologic and radiographic pattern of progression similar to that seen at the hip. Much of the information regarding the disease has been extrapolated from findings in the femoral head. Read More

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Gas in Joints After Diving: Computed Tomography May Be Useful for Diagnosing Decompression Sickness.

Wilderness Environ Med 2021 Mar 10;32(1):70-73. Epub 2020 Dec 10.

Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizuoka, Japan. Electronic address:

A 26-y-old experienced scotoma scintillans after 59 min of scuba diving at a maximum depth of 26 m. After the patient smoked a cigarette, the scotoma scintillans ceased. However, he then developed a headache, general fatigue, and shoulder and elbow pain. Read More

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Cell therapy for posttraumatic shoulder osteonecrosis.

Morphologie 2021 Jun 9;105(349):162-169. Epub 2020 Dec 9.

Department of Orthopaedic and Traumatology Surgery, Hospital Henri-Mondor, University Paris East, Créteil, France. Electronic address:

Purpose: This study compared the clinical and radiological results of bone marrow mesenchymal stem cell implantation with traditional simple core decompression (CD) using a matched pair case-control design for osteonecrosis of the humeral head (ONHH) after fracture of the proximal humerus.

Patients: We retrospectively reviewed 64 patients who had surgery for ONHH. Thirty patients had been treated with cell therapy between 2010 and October 2015, with 18 patients at pre-collapse stage (8 stages-I, 10 stages-II), and 12 patients at post-collapse stages (7 stages-III and 5 stages-IV). Read More

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Fatigue fracture of an uncemented Zweymüller femoral stem at the neck-shoulder junction.

BMJ Case Rep 2020 Nov 30;13(11). Epub 2020 Nov 30.

Orthopedisch Centrum Oost Nederland OCON, Hengelo, The Netherlands

A fracture through the neck of the femoral stem in total hip arthroplasty is extremely rare. We report a neck fracture of a cementless Zweymüller stem, one of the most implanted stems worldwide. According to our knowledge, this is the first thorough case description of a neck fracture of a cementless Zweymüller stem. Read More

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November 2020


Wiad Lek 2020 ;73(9 cz. 1):1870-1873


Shoulder arthroplasty (SA) has improved significantly over the last twenty years. It offers the effective treatment for patients with severe shoulder dysfunctions. The indicationsfor this procedure have recently expanded tremendously. Read More

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October 2020

The Separation of Antler Polypeptide and Its Effects on the Proliferation and Osteogenetic Differentiation of Bone Marrow Mesenchymal Stem Cells.

Evid Based Complement Alternat Med 2020 30;2020:1294151. Epub 2020 Sep 30.

State Key Laboratory of Precision Measurement Technology and Instruments, Tianjin University, Tianjin 300072, China.

Background: Colla Cornus Cervi (CCC) has been used as a traditional Chinese medicine in the treatment of osteoporosis and osteonecrosis of the femoral head. However, the bioavailability of CCC is seriously limited owing to its large molecular weight and complex ingredients. In the present study, antler polypeptide was separated from CCC, and the effects of antler polypeptide on rat bone marrow mesenchymal stem cells (BMSCs) were investigated. Read More

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September 2020

Limited Carpal Fusion in Kienböck's Disease: Early Results following Scaphocapitate Arthrodesis.

J Wrist Surg 2020 Oct 12;9(5):404-410. Epub 2020 Jun 12.

Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

 Kienböck's disease leading to progressive carpal collapse alters the wrist biomechanics leading to early arthritis and degenerative changes. Out of multiple surgical procedures present, no gold standard has been described. Scaphocapitate arthrodesis (SCA) is limited carpal fusion which shifts the loading axis toward radioscaphoid joint. Read More

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October 2020

Shoulder Osteonecrosis: Pathogenesis, Causes, Clinical Evaluation, Imaging, and Classification.

Orthop Surg 2020 Oct 4;12(5):1340-1349. Epub 2020 Oct 4.

Clinique St. Michel, Groupe ELSAN, Toulon, France .

The humeral head is the second most common site for nontraumatic osteonecrosis after the femoral head, yet it has attracted relatively little attention. Osteonecrosis is associated with many conditions, such as traumatism, corticosteroid use, sickle cell disease, alcoholism, dysbarism (or caisson disease), and Gaucher's disease. The diagnosis is clinical and radiographic with MRI, with radiographs being the basis for staging. Read More

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October 2020

Management of Glenohumeral Joint Osteoarthritis.

J Am Acad Orthop Surg 2020 Oct;28(19):781-789

From the University of Texas Southwestern Medical Center (Dr. Khazzam), Dallas, TX, the University of Washington Medical Center (Dr. Gee), Seattle, WA, the Kaiser Permanente in Los Angeles (Dr. Pearl), and the University of Southern California (Dr. Pearl), Los Angeles, Los Angeles, CA.

The Management of Glenohumeral Joint Osteoarthritis Evidence-Based Clinical Practice Guideline is based on a systematic review of published studies for the treatment of glenohumeral joint osteoarthritis. The purpose of this clinical practice guideline is to address the management of patients with glenohumeral joint osteoarthritis. It is not intended to address the management of glenohumeral joint arthritis from etiologies other than osteoarthritis (ie, rheumatoid arthritis, inflammatory arthritis, posttraumatic arthritis, osteonecrosis, rotator cuff tear arthroplasty, capsulorrhaphy arthroplasty, and postinfections arthroplasty) This guideline contains 13 recommendations to assist all qualified and appropriately trained healthcare professionals involved in the management of glenohumeral joint osteoarthritis. Read More

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October 2020

Dysbaric osteonecrosis in technical divers: The new 'at-risk' group?

Diving Hyperb Med 2020 Sep;50(3):295-299

Department of Anaesthesiology, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand.

Introduction: Dysbaric osteonecrosis (DON) in people working under increased atmospheric pressure is well documented. It is generally less common in military and commercial divers than in caisson workers, except in some high-risk groups, such as in many indigenous diving industries where workers have little or no understanding of decompression principles. With the increasing popularity within the recreational diving community of deep air and mixed-gas decompression diving ('technical diving'), it is likely that diving physicians may see an increase in the prevalence of DON in this group in the future. Read More

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September 2020

Humeral head necrosis associated to shaft non-union with massive bone loss: a case report.

Acta Biomed 2020 09 7;91(3):e2020076. Epub 2020 Sep 7.

Politecnico di Milano.

Humeral non-union is a rare complication in shaft fractures, as well as humeral head necrosis is a possible complication in fracture involving the proximal third especially in four-part fractures. The presence of head osteonecrosis and diaphyseal non-union in the same arm represents a formidable challenge for an orthopaedic surgeon. We could not find any similar report in the literature dealing with this issue thus far. Read More

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September 2020

Osteochondral autograft transplantation for the treatment of steroid-induced osteonecrosis of the humeral head: a case report.

J Shoulder Elbow Surg 2021 02 10;30(2):e76-e83. Epub 2020 Sep 10.

Department of Orthopedic Surgery, Osaka Medical College, Takatsuki, Osaka, Japan.

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February 2021

Vascularized Capitate Transposition for the Treatment of Stage IIIB Kienböck Disease.

J Hand Surg Am 2020 Nov 21;45(11):1085.e1-1085.e11. Epub 2020 Aug 21.

Department of Hand and Foot Surgery, The First Hospital of Jilin University, Changchun, Jilin Province, China. Electronic address:

Purpose: The treatment of Kienböck disease (KD) continues to be controversial. In this study, we report the long-term follow-up outcomes of patients who were diagnosed with stage IIIB KD treated with vascularized capitate transposition.

Methods: A total of 16 patients were retrospectively reviewed. Read More

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November 2020

Arthroscopic osteosynthesis of capitellum fractures: Feasibility study and clinical study on 2 cases.

J Orthop Sci 2021 Jul 16;26(4):604-609. Epub 2020 Aug 16.

Shoulder and Elbow Service, CHRU Strasbourg, Avenue Molière, 67098, Strasbourg Cedex, France; Institut of Anatomy, Faculté de Médecine, 4, Rue Kirschleger, 67085, Strasbourg Cedex, France; Hôpitaux Universitaires de Strasbourg, Centre de Chirurgie Pédiatrique, Strasbourg, France. Electronic address:

Background: The current management of displaced capitellum fractures is traditionally surgical. Most authors perform open reduction and internal fixation. The working hypothesis was that closed reduction and internal fixation of capitellum fractures is achievable by arthroscopy. Read More

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Avascular Necrosis of the Humeral Head in a Patient with Methylenetetrahydrofolate Reductase 1 Gene Polymorphism: A Case Report.

JBJS Case Connect 2020 Jul-Sep;10(3):e1900486

1Department of Orthopedic Surgery, 99th Medical Group, Nellis Air Force Base, Las Vegas, Nevada 2Department of Orthopaedic Surgery & Rehabilitation, Loyola University Health System, Maywood, Illinois.

Case: Atraumatic avascular necrosis (AVN) of the humeral head is a debilitating condition with an insidious onset and progressively worsening pain. We report a case of a woman who presented with left shoulder pain with a medical history of a rare genetic polymorphism in the methylenetetrahydrofolate reductase (MTHFR) gene. Advanced imaging demonstrated focal AVN of her humeral head. Read More

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