4.1 of 44 Ratings
Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC.
A 67-year-old male presents with left shoulder pain. He underwent surgery on his left shoulder 10 years prior. Initially, he was pain-free following surgery, however, his pain has returned and has been increasing in intensity. On physical examination, his incision is healed with no erythema. He actively exhibits 120° of forward flexion, 25° of external rotation, and internal rotation to L3. He exhibits 5/5 strength with forward flexion, internal rotation, and external rotation. He has a negative belly-press test, negative hornblower's sign, and a negative Spurling's test. Distally, he is neurovascularly intact. Joint aspiration is performed in the office and reveals a white blood cell count (WBC) of 1900 x10^9/L, with 20% polymorphonuclear leukocytes (PMNs). Cultures were held for 3 weeks and exhibited no growth to date. Radiographs are obtained and shown in Figures A & B. Which of the following is the next best step in the treatment of this patient?
Magnetic resonance imaging (MRI) of the shoulder to evaluate the rotator cuff
Humeral head revision and placement of prosthetic glenoid component
Two-stage revision with placement of an antibiotic spacer
Revision total shoulder arthroplasty with a cemented humeral stem
Revision to an implant with a center of rotation that is moved infero-medially
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A 60-year-old man has chronic shoulder pain and weakness. Radiographs show moderate glenohumeral arthritis and narrowing of the acromio-humeral distance. He is scheduled to undergo either hemiarthroplasty or total shoulder arthroplasty. His postoperative function will be most affected by which of the following factors?
The integrity of the rotator cuff
The integrity of the coracoacromial ligament
The presence of glenoid wear
The presence of an inferior head osteophyte
The extent of AC joint arthritis
A 78-year old female sustained a 4-part proximal humerus fracture on her dominant side 2 days ago and undergoes a shoulder hemiarthroplasty. Intraoperatively, the lesser tuberosity reduction was difficult and placed too close to the greater tuberosity, which was anatomic. What post-operative problem is likely to result due to the position of the lesser tuberosity?
external rotation deficit
internal rotation deficit
forward elevation weakness
elbow flexion weakness