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Muscles of the Shoulder01:23

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The thermodynamic processes can be classified into reversible and irreversible processes. The processes that can be restored to their initial state are called reversible processes. It is only possible if the process is in quasi-static equilibrium, i.e., it takes place in infinitesimally small steps, and the system remains at equilibrium However, these are ideal processes and do not occur naturally. An ideal system undergoing a reversible process is always in thermodynamic equilibrium within...
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A diode is reverse-biased when the positive terminal of an external voltage source is connected to the n-type material and the negative terminal to the p-type material. This configuration opposes the natural direction of current flow through the diode, effectively increasing the width of the depletion region and the barrier potential. The reverse bias condition produces a minimal leakage current, primarily due to minority charge carriers. This leakage becomes significant when the reverse...
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Total voids in concrete encompass gel water volume, capillary pores, and entrapped air. Gel water (retained within the cement hydration products) and physically entrapped or adsorbed water are significant for the hydration process. For complete hydration, it's estimated that the space needed for the products of a cubic centimeter of cement doubles. Capillary pores constitute the unoccupied space within the hydrated cement paste, with their size largely influenced by the water-to-cement...
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Total Internal Reflection Fluorescence Microscopy01:05

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Total internal reflection fluorescence microscopy or TIRF is an advanced microscopic technique used to visualize fluorophores in samples close to a solid surface with a higher refractive index, such as a glass coverslip. TIRF only allows fluorophores in proximity to the solid surface to be excited. When light from a medium with a lower refractive index (such as air) hits the glass coverslip at a critical angle, the light undergoes total internal reflection stead of passing through the glass.
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LETTER TO THE EDITOR REGARDING: Torrens C, González-García C, Díez-Izquierdo M, Santana F. Three-week immobilization vs. no immobilization in primary reverse total shoulder arthroplasty: a randomized controlled trial. J Shoulder Elbow Surg. 2025 Nov;34(11):2543-2549. doi:10.1016/j.jse.2025.02.015.

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Related Experiment Video

Updated: Feb 8, 2026

Reverse Total Shoulder Arthroplasty
10:10

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Published on: July 5, 2011

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Instability after reverse total shoulder arthroplasty.

Emilie V Cheung1, Eric J Sarkissian1, Alex Sox-Harris1

  • 1Department of Orthopaedic Surgery, Stanford University Medical Center, Redwood City, CA, USA.

Journal of Shoulder and Elbow Surgery
|June 24, 2018
PubMed
Summary
This summary is machine-generated.

Instability after reverse total shoulder arthroplasty (RTSA) is linked to male gender, prior surgery, and certain fractures. Avoiding subscapularis repair increases dislocation risk, with some cases needing further revision surgery.

Keywords:
Reverse total shoulder arthroplastycomplication reverse shoulderdislocation prosthesisprosthetic dislocationprosthetic instabilityrecurrent instabilityrevision shoulder arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Arthroplasty Research

Background:

  • Reverse total shoulder arthroplasty (RTSA) is a common procedure for complex shoulder conditions.
  • Prosthetic dislocation is a significant complication following RTSA, impacting patient outcomes.
  • Identifying risk factors for RTSA instability is crucial for improving surgical success rates.

Purpose of the Study:

  • To identify preoperative and intraoperative risk factors associated with prosthetic dislocation after RTSA.
  • To analyze the correlation between RTSA design parameters and the incidence of instability.
  • To determine independent predictors of instability in patients undergoing RTSA.

Main Methods:

  • A retrospective analysis of 119 patients who underwent RTSA between 2011 and 2014.
  • Patients were divided into dislocation and nondislocation cohorts for comparative analysis.
  • Logistic regression modeling was employed to identify independent predictors of instability.

Main Results:

  • The study found an overall instability rate of 9.2% (11 patients) in the early postoperative period.
  • Dislocations occurred at a mean of 8 weeks postoperatively.
  • Risk factors for instability included male gender, prior open shoulder surgery, fracture sequelae (nonunion), and absence of subscapularis repair.

Conclusions:

  • Absence of subscapularis repair was an independent predictor of instability after RTSA.
  • A significant portion (45%) of initial dislocations required revision surgery, sometimes with inadequate outcomes from initial management.
  • Careful management of initial instability is essential, particularly in revision and post-traumatic cases, as simple interventions like thicker polyethylene inserts may not suffice.