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Arthroscopic reduction of a chronically dislocated reversed shoulder arthroplasty.

ABSTRACT: We present the case of a 64-year-old female patient who had a traumatic dislocation of a reversed shoulder arthroplasty that was unnoticed for 5 weeks and that was reduced arthroscopically. Arthroscopy of the shoulder, as in other joints with prostheses, can facilitate the treatment of conditions that would otherwise require the use of open surgery to solve them and that might become more frequent because of the widespread use of reversed shoulder arthroplasties, which have a high rate of dislocation.

SUBMITTER: Arriaza R

PROVIDER: S-EPMC3882698 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Arthroscopic reduction of a chronically dislocated reversed shoulder arthroplasty.

Arriaza Rafael R Couceiro Gonzalo G Fernández J César JC

Arthroscopy techniques 20131017 4

We present the case of a 64-year-old female patient who had a traumatic dislocation of a reversed shoulder arthroplasty that was unnoticed for 5 weeks and that was reduced arthroscopically. Arthroscopy of the shoulder, as in other joints with prostheses, can facilitate the treatment of conditions that would otherwise require the use of open surgery to solve them and that might become more frequent because of the widespread use of reversed shoulder arthroplasties, which have a high rate of disloc ...[more]

PMID: 24400193

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Project description:Various types of sedation can be used for the reduction of a dislocated total hip arthroplasty. Traditionally, an opiate/benzodiazepine combination has been employed. The use of other pharmacologic agents, such as etomidate and propofol, have more recently gained popularity. Currently no studies directly comparing these sedation agents have been carried out. The purpose of this study is to compare differences in reduction and sedation outcomes, including recovery times, of these 3 sedation agents.We performed a retrospective chart review examining 198 patients who presented with dislocated total hip arthroplasty at 2 academic affiliated medical centers. The patients were grouped according to the type of sedation agent. We calculated percentages of reduction and sedation complications along with recovery times. Reduction complications included fracture, skin or neurovascular injury, and failure of reduction requiring general anesthesia. Sedation complications included use of bag-valve mask and artificial airway, intubation, prolonged recovery, use of a reversal agent, and inability to achieve sedation. We then compared the data for each sedation agent.We found reduction complications rates of 8.7% in the propofol, 24.7% in the etomidate, and 28.9% in the opiate/benzodiazepine groups. The propofol group was significantly different from the other 2agents (p ≤ 0.01). Sedation complications were found 7.3% of the time in the propofol , 11.7% in the etomidate , and 21.3% in the opiate/benzodiazepine group, (p=0.02 propofol vs. others) . Average recovery times were 25.2 minutes for propofol, 30.8 minutes for etomidate, and 44.4 minutes for opiate/benzodiazepine (p = 0.05 for propofol vs. other agents).For reduction of dislocated total hip arthroplasty under procedural sedation, propofol appears to have fewer complications and a trend toward more rapid recovery than both etomidate and opiate/benzodiazepine. These data support the use of propofol as first line agent for procedural sedation of dislocated total hip arthroplasty, with fewer complications and a shorter recovery period.

Dataset Information

Arthroscopic reduction of a chronically dislocated reversed shoulder arthroplasty.

Publications

Arthroscopic reduction of a chronically dislocated reversed shoulder arthroplasty.

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