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Journal of Shoulder and Elbow Surgery

Brett D Owens, Joseph Algeri, Vivian Liang, Steven DeFroda
BACKGROUND: High-tensile strength sutures are known to cut through tendon tissue when used for rotator cuff and other tendon repairs, resulting in mechanical failure. The purpose of this study was to test a new suture and compare it with an established suture in a controlled laboratory setting. METHODS: Two sutures, Dynacord and FiberWire, both USP size No. 2, were passed through fresh infraspinatus tendons from 7 matched pairs of ovine shoulders (14 shoulders)...
May 10, 2019: Journal of Shoulder and Elbow Surgery
Krister Jönsson, Michael Werner, Fredrik Roos, Tomas Hultgren
BACKGROUND: We present the long-term results of remodeling of the glenohumeral joint after open subscapularis elongation and relocation of the humeral head in patients with an internal rotation contracture and joint incongruity due to brachial plexus birth palsy. METHODS: In this before-and-after study, 61 patients who underwent open subscapularis elongation and reduction of the glenohumeral joint were evaluated with respect to joint remodeling, with a mean follow-up period of 10...
May 10, 2019: Journal of Shoulder and Elbow Surgery
Pinkawas Kongmalai, William N Levine
BACKGROUND: The Latarjet procedure is the preferred method to treat recurrent anterior shoulder instability with glenoid deficiency. An iatrogenic fracture of the transferred coracoid process is one possible intraoperative complication. METHODS: We propose a rescue technique using double-row suture bridge fixation. Double-loaded 4.5-mm suture anchors were placed medially in the scapular neck. These sutures were then brought over the top of the coracoid fragment, placed around the bony fragment, and fixated to the glenoid face with knotless suture anchors...
May 10, 2019: Journal of Shoulder and Elbow Surgery
Ciaran Doherty, Nicholas D Furness, Timothy Batten, William J White, Jeffrey Kitson, Christopher D Smith
BACKGROUND: Assessment of a painful or stiff shoulder arthroplasty can be challenging. The cause of pain can sometimes be easily identified. However, some patients have normal levels of inflammatory markers, normal plain films, and no clinical signs to indicate a diagnosis. Indolent organisms may not raise blood marker levels or result in obvious radiologic findings such as loosening. We report the utility of performing arthroscopy in these patients for a diagnostic advantage. METHODS: We retrospectively reviewed the health records of all patients who underwent diagnostic shoulder arthroscopy over a 3-year period...
May 10, 2019: Journal of Shoulder and Elbow Surgery
William R Aibinder, Ryan T Bicknell, Stefan Bartsch, Markus Scheibel, George S Athwal
BACKGROUND: It is unknown whether subscapularis management technique has an influence on the outcomes and complications of stemless total shoulder arthroplasty. The purpose of this study, therefore, was to compare outcomes and complications between subscapularis tenotomy, peel, and lesser tuberosity osteotomy used during stemless shoulder arthroplasty. METHODS: We reviewed 188 stemless anatomic total shoulder arthroplasties and compared clinical and functional outcomes between those performed through a subscapularis tenotomy (n = 68), subscapularis peel (n = 65), or lesser tuberosity osteotomy (n = 55)...
May 8, 2019: Journal of Shoulder and Elbow Surgery
Rowan J Michael, Brendan A Williams, Martin D Laguerre, Aimee M Struk, Bradley S Schoch, Thomas W Wright, Kevin W Farmer, Terrie Vasilopoulos, Joseph J King
BACKGROUND: Multiple validated outcome scores are used to assess patients undergoing shoulder arthroplasty. The purpose of this study was to determine whether a correlation exists between 3 commonly used patient-reported outcome (PRO) measures in this population: Shoulder Pain and Disability Index (SPADI), American Shoulder and Elbow Surgeons (ASES) Assessment Form, and Simple Shoulder Test (SST). METHODS: We performed a retrospective review of a shoulder arthroplasty database that routinely collects SPADI, ASES, and SST scores at each visit prospectively...
May 8, 2019: Journal of Shoulder and Elbow Surgery
Craig M Ball
BACKGROUND: Many poor outcomes after arthroscopic rotator cuff (RC) repair relate to failure of tendon healing. The purposes of this study were to provide a better understanding of the magnetic resonance arthrography (MRA) characteristics of the RC tendon repair site after arthroscopic RC repair and to examine how these findings influence patient-reported outcome measures (PROMs) and the presence of persistent symptoms. METHODS: We reviewed 48 shoulders (13 female and 35 male patients; average age, 53...
May 8, 2019: Journal of Shoulder and Elbow Surgery
Homin Lee, Anthony M Vaichinger, Shawn W O'Driscoll
BACKGROUND: Ulnar or humeral component stem fractures after total elbow arthroplasty (TEA) are serious complications. We hypothesized that TEA stem component fractures are fatigue fractures that result from periarticular osteolysis caused by bushing wear, which leads to a region of unsupported stem adjacent to a region where the stem is well-fixed. METHODS: A review of 2637 primary and revision TEA cases from 1972 to 2016 revealed that 47 operations in 46 patients were complicated by or performed to deal with component stem fractures...
May 7, 2019: Journal of Shoulder and Elbow Surgery
Daniel P Leas, Patrick M Connor, Shadley C Schiffern, Donald F D'Alessandro, Katherine M Roberts, Nady Hamid
BACKGROUND: Opioid therapy has been a cornerstone of perioperative pain control for decades in the United States, despite our increased understanding of the morbidity and mortality linked to opioids. The purpose of this study is to explore the safety, efficacy, and feasibility of an entirely opioid-free perioperative pathway in patients undergoing elective shoulder arthroplasty. METHODS: Thirty-five patients undergoing elective total shoulder arthroplasty with a mean age of 71 (range, 50-87) years elected into a comprehensive opioid-free, multimodal pain management protocol...
May 6, 2019: Journal of Shoulder and Elbow Surgery
Satoshi Shinagawa, Hitoshi Shitara, Atsushi Yamamoto, Tsuyoshi Sasaki, Tsuyoshi Ichinose, Noritaka Hamano, Daisuke Shimoyama, Fumitaka Endo, Takuro Kuboi, Tsuyoshi Tajika, Tsutomu Kobayashi, Toshihisa Osawa, Kenji Takagishi, Hirotaka Chikuda
BACKGROUND: The aim of this study was to evaluate the risk of nerve injury with neuromonitoring during reverse total shoulder arthroplasty. MATERIALS: This study included 15 shoulders of 15 patients (11 females and 4 males) who underwent reverse total shoulder arthroplasty. The mean age was 74.8 ± 4.4 years. Nine shoulders had cuff tear arthropathy, 4 had massive rotator cuff tears, 2 had osteoarthritis, and 1 had rheumatoid arthritis. The somatosensory evoked potentials of the median nerve, transcranial motor evoked potentials, and free-electromyograms from 6 upper-extremity muscles were measured intraoperatively...
May 4, 2019: Journal of Shoulder and Elbow Surgery
James A Fagg, Emma J Davies, David Stanley
No abstract text is available yet for this article.
May 2, 2019: Journal of Shoulder and Elbow Surgery
Sambit Sahoo, Jill Mohr, Gregory J Strnad, Jose Vega, Morgan Jones, Mark S Schickendantz, Lutul Farrow, Kurt P Spindler, Joseph P Iannotti, Eric T Ricchetti, Kathleen A Derwin
BACKGROUND: This study tested validity and efficiency of Orthopaedic Minimal Data Set (OrthoMiDaS) Episode of Care (OME). METHODS: We analyzed 100 isolated rotator cuff repair cases in the OME database. Surgeons completed a traditional operative note and OME report. A blinded reviewer extracted data from operative notes and implant logs in electronic medical records by manual chart review. OME and electronic medical record data were compared with data counts and agreement between 40 variables of rotator cuff disease and repair procedures...
May 2, 2019: Journal of Shoulder and Elbow Surgery
Georg Siebenbürger, Tobias Helfen, Niklas Biermann, Florian Haasters, Wolfgang Böcker, Ben Ockert
BACKGROUND: This study compared the clinical and radiologic outcomes of screw tip-augmented locking plate osteosynthesis vs. standard locked plating in elderly patients with displaced proximal humeral fractures. METHODS: Of the 94 patients older than 65 years with displaced proximal humeral fractures, 55 underwent fixation with a locking plate only whereas 39 underwent fixation using a locking plate with fluoroscopy-controlled polymethyl methacrylate augmentation of screw tips...
May 2, 2019: Journal of Shoulder and Elbow Surgery
Alexander Klug, Dennis Wincheringer, Jasmin Harth, Kay Schmidt-Horlohé, Reinhard Hoffmann, Yves Gramlich
BACKGROUND: To date, there is a lack of consensus regarding surgical treatment recommendations for complex proximal humerus fracture (PHF) patterns, especially between joint preservation and joint replacement techniques. METHODS: Between 2012 and 2017, 146 patients (aged 74.1 ± 8.0 years) with complex PHF were treated with locking plates (open reduction-internal fixation [ORIF]) or reverse total shoulder arthroplasty (RTSA). Complications and unplanned revision surgery were recorded in a mid-term follow-up...
May 2, 2019: Journal of Shoulder and Elbow Surgery
Teruhisa Mihata, Masaki Akeda, Michael Künzler, Michelle H McGarry, Masashi Neo, Thay Q Lee
BACKGROUND: In throwing athletes, cubital tunnel syndrome and insufficiency of the ulnar collateral ligament (UCL) are common pathologic processes of the elbow. The objective of this study was to investigate the effect of UCL tears on ulnar nerve elongation in the simulated throwing position. METHODS: Eight fresh frozen cadaveric upper limbs were tested at the simulated late cocking to acceleration phase in the throwing motion using an elbow testing system. Elbow valgus laxity and ulnar nerve length and strain under 2 Nm of applied valgus torque (maximum torque in cadaveric elbow) were evaluated...
April 30, 2019: Journal of Shoulder and Elbow Surgery
Kelechi R Okoroha, Jason E Meldau, Toufic R Jildeh, Jeffrey P Stephens, Vasilios Moutzouros, Eric C Makhni
HYPOTHESIS: Our hypothesis was that an increase in ball weight would result in an increase in medial elbow torque during the pitching motion. METHODS: Youth pitchers were recruited for this study and instructed to throw 5 maximum-effort fastballs from ground level using baseballs of 4 different weights: 85 g (3 oz), 113 g (4 oz), 142 g (5 oz), and 170 g (6 oz). The validated Motus sensor was used to assess medial elbow torque, arm speed, arm slot, and shoulder rotation for each pitch...
April 30, 2019: Journal of Shoulder and Elbow Surgery
Hwan Jin Kim, Young Moon Kee, Jung Youn Kim, Yong Girl Rhee
BACKGROUND: Few studies have assessed the outcomes of staged bilateral arthroscopic rotator cuff repair (ARCR). This study aimed to determine the influencing factors related to the outcomes of patients who underwent staged bilateral ARCR and to verify an optimal interval for performing the second rotator cuff repair in staged bilateral ARCR. METHODS: We analyzed 166 shoulders that underwent staged bilateral ARCR. The average interval between the first- and second-side surgical procedures was 21...
April 30, 2019: Journal of Shoulder and Elbow Surgery
Peter Domos, Enricomaria Lunini, Francesco Ascione, Nicola Serra, Michael J Bercik, Lionel Neyton, Arnaud Godeneche, Gilles Walch
BACKGROUND: The Latarjet procedure is often used to treat shoulder instability in younger patients. Little is reported on the outcomes of this procedure in older (≥40 years) populations. The purpose of this study was to evaluate the clinical and radiographic outcomes of patients aged 40 years or older with recurrent anterior shoulder instability who underwent open Latarjet stabilization. METHODS: A total of 168 patients aged 40 years or older were treated surgically for recurrent anterior shoulder instability with an open Latarjet procedure between 1988 and 2014...
April 28, 2019: Journal of Shoulder and Elbow Surgery
Sumit Raniga, Nikolas K Knowles, Emily West, Louis M Ferreira, George S Athwal
BACKGROUND: The Walch type B glenoid has the hallmark features of retroversion, joint subluxation, and bony erosion. Although the type B glenoid has been well described, the morphology of the corresponding type B humerus is poorly understood. As such, the aim of this imaging-based anthropometric study was to investigate humeral torsion in Walch type B shoulders. METHODS: Three-dimensional models of the full-length humerus were generated from computed tomography data for the Walch type B group (n = 59) and for a control group of normal nonarthritic shoulders (n = 59)...
April 28, 2019: Journal of Shoulder and Elbow Surgery
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