Neurologic complications after total shoulder arthroplasty

Lynch, Nancy M.; Cofield, Robert H.; Silbert, Peter L.; Hermann, Róbert

doi:10.1016/s1058-2746(96)80031-0

Cited by 195 publications

(97 citation statements)

References 39 publications

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“…They found that patients with prior surgery and limited external rotation were at increased risk of nerve injury, though nerve monitoring is not needed routinely [32] Lynch et al used neuromonitoring during shoulder arthroplasty and found alerts frequently involving the axillary and musculocutaneous nerves. This can be attributed to the stretch placed on the brachial plexus during humeral positioning and traction during glenoid exposure [33]. Ladderman et al found the prevalence of acute postoperative nerve injury to be significantly more frequent in RSA than in anatomic TSA due to arm lengthening in RSA [34].…”

Section: Nerve Injurymentioning

confidence: 99%

“…The majority of postoperative nerve injury, however, is due to neurapraxia that mainly requires conservative management and close monitoring. Lynch et al found no nerve injuries requiring surgical exploration in 18 shoulder arthroplasties and with all injuries due to a neurapraxia or first-degree injury that resolved spontaneously [33]. Therefore, in the setting of neurapraxia, surgical intervention is not necessary.…”

Section: Nerve Injurymentioning

confidence: 99%

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Management of complications after revision shoulder arthroplasty

Rahmi

Jawa

2015

Curr Rev Musculoskelet Med

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Complications after revision shoulder arthroplasty are similar to those in the primary setting which include instability, fracture, bone loss, infection, nerve injury, and loosening. Unlike in the primary setting, however, the rate of complications for revisions is significantly greater and the management is more complex because of overlapping complications and limited treatment options. Furthermore, there is a paucity of evidence-based literature to direct the management options in these patients. The purposes of this review are to broadly outline the major complications that are seen in revision shoulder arthroplasty and to provide general principles on how to recognize and approach these complex cases.

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Section: Nerve Injurymentioning

confidence: 99%

Section: Nerve Injurymentioning

confidence: 99%

Management of complications after revision shoulder arthroplasty

Rahmi

Jawa

2015

Curr Rev Musculoskelet Med

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“…1 We are seeing reports of plexopathies after ultrasound-guided regional anesthesia and surgery, despite visualization of the injecting needle tip well away from neural elements. 2,3 At our institution, a case of brachial plexopathy after ultrasound-guided regional anesthesia recently occurred, resolving without sequelae.…”

Section: Concerns Regarding Ultrasound-guided Regional Anesthesiamentioning

confidence: 99%

“…The folate inhibitor methotrexate is a risk factor for plexopathies after total shoulder arthroplasty, and there is a report of a patient on cisplantin sustaining brachial plexopathy after an ultrasound-guided interscalene block. 1,3 Cisplatin, like ultrasound, generates free-radicals. 8 Rather than the pharmacologic double crush the authors describe, perhaps it was in fact a triple crush.…”

Section: Concerns Regarding Ultrasound-guided Regional Anesthesiamentioning

confidence: 99%

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Concerns Regarding Ultrasound-guided Regional Anesthesia

Cory¹

2009

Anesthesiology

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The anatomic relationships of the axillary nerve and surgical landmarks for its localization from the anterior aspect of the shoulder

Apaydın

Bozkurt

et al. 2006

Clinical Anatomy

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The axillary nerve has long been known to be one of the nerves vulnerable to damage during shoulder arthroscopic and open surgical procedures. The relationship of the axillary nerve to the shoulder capsule and the subscapularis muscle has not been well defined in orthopedic literature. This descriptive anatomical study aimed to present the course and the relations of the axillary nerve with neighboring neurovascular structures and the shoulder capsule and to define anatomical landmarks and regions that can be used practically in anterior surgical approaches to the shoulder region. To investigate the course of the axillary nerve and its relationship with neighboring structures, 30 shoulders of 15 fixed adult cadavers were dissected under the microscope through an anterior approach. A triangle-shaped anatomic area containing the axillary neurovascular bundle was defined. The closest distance between the axillary nerve and the anteromedial aspect of the coracoid tip and the glenoid labrum was measured as 3.7 cm and 1.1 cm on average, respectively. The distance between the anteromedial aspect of the coracoid tip and the point where the nerve passes through the medial edge of the subscapularis was measured as 2.5 cm on average. The results of this study demonstrate the anatomic pattern and the course of the axillary nerve and its relations with the shoulder capsule. Knowing the exact localization of the axillary nerve under the guidance of the defined anatomic triangle may provide a safer surgery.

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Neurologic complications after total shoulder arthroplasty

Cited by 195 publications

References 39 publications

Management of complications after revision shoulder arthroplasty

Management of complications after revision shoulder arthroplasty

Concerns Regarding Ultrasound-guided Regional Anesthesia

The anatomic relationships of the axillary nerve and surgical landmarks for its localization from the anterior aspect of the shoulder

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