If you watch football or basketball on TV, the players take some horrific falls and bounce up to keep playing. Kids tumble and fall all the time, usually without bad results. Who hasn't tripped and come home with skinned knees and wounded pride, nothing more? But put us in the geriatric generation and falls become serious problems. A fall certainly brought me to this place and time.
However we came to rTSA, a fall after surgery is even worse. A great deal of the stability of the implant is due to tissue ingrowth. Any event that disrupts the knitting together of living tissue with bionic implant is undesirable but a fall in this early healing phase poses a serious risk for thepatient.
In a small study of 41 surgeries on 37 different patients (28 women, 9 men) the surgical results were generally satisfactory with improved abduction and flexion. However, complications included four falls that resulted in glenoid loosening. That does not sound like much but it is a statistical rate of 10%.
This indicates that there is an increased risk of falling for the rTSA patient and such a fall can be a particular problem if the glenoid fixation depends on bone ingrowth. When one falls the natural response is to put out your arm to try to catch yourself. A new glenoid screwed into soft bones will not hold up to such events. But why is this patient susceptible to falls? We tend to be older than the average orthopedic patient. Disabling one of our arms creates a balance problem and leaves the patient a bit off kilter. It may be that medication to help with balance can have the opposite effect. Sometimes the more anxious we are about our gait, the worse we are at walking.
Whatever...we need to be aware and careful. Falling is never good, right now it's a disaster.
However we came to rTSA, a fall after surgery is even worse. A great deal of the stability of the implant is due to tissue ingrowth. Any event that disrupts the knitting together of living tissue with bionic implant is undesirable but a fall in this early healing phase poses a serious risk for thepatient.
In a small study of 41 surgeries on 37 different patients (28 women, 9 men) the surgical results were generally satisfactory with improved abduction and flexion. However, complications included four falls that resulted in glenoid loosening. That does not sound like much but it is a statistical rate of 10%.
This indicates that there is an increased risk of falling for the rTSA patient and such a fall can be a particular problem if the glenoid fixation depends on bone ingrowth. When one falls the natural response is to put out your arm to try to catch yourself. A new glenoid screwed into soft bones will not hold up to such events. But why is this patient susceptible to falls? We tend to be older than the average orthopedic patient. Disabling one of our arms creates a balance problem and leaves the patient a bit off kilter. It may be that medication to help with balance can have the opposite effect. Sometimes the more anxious we are about our gait, the worse we are at walking.
Whatever...we need to be aware and careful. Falling is never good, right now it's a disaster.
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