Journal of Shoulder and Elbow Surgery

BACKGROUND: Reliable prediction of postoperative dislocation after reverse total shoulder arthroplasty (RSA) would inform patient counseling as well as surgical and postoperative decision making. Understanding interactions between multiple risk factors is important to identify those patients most at risk of this rare but costly complication. To better understand these interactions, a new game-theory-based approach was undertaken to develop machine learning models capable of predicting dislocation-related 90-day readmission following RSA...

BACKGROUND: This study aims to investigate the clinical efficacy of the olecranon osteotomy approach and the Bryan-Morrey approach in total elbow arthroplasty (TEA). METHODS: In this retrospective study, 49 patients with elbow disease were treated with TEA. A total of 22 patients with TEA by olecranon osteotomy approach were designated as group A, and 27 patients with TEA by Bryan-Morrey approach were designated as group B. There were 22 males and 27 females; ages 32 to 82 years with a mean age of 62 years...

BACKGROUND: Prior studies have failed to show differences in functional outcomes for patient-reported sling use after rotator cuff repair. Temperature sensing devices are used to more accurately measure brace adherence. The purposes of this study were to quantify actual sling adherence and its predictors, and to establish whether increased sling adherence is associated with improved functional and image-based outcomes. METHODS: We performed a prospective cohort study of 65 patients undergoing shoulder surgery requiring at least four weeks of postoperative sling use...

INTRODUCTION: Severe glenohumeral osteoarthritis (GHOA) with posterior glenoid erosion remains challenging to address for shoulder surgeons. While anatomic total shoulder arthroplasty (TSA) has historically been the choice treatment, reverse shoulder arthroplasty (RSA) offers an alternative option. Limited evidence exists directly comparing these two treatments in a similar patient population. The purpose of this study was to compare the clinical outcomes of patients with GHOA and Walch B2 and B3 glenoid morphologies treated with TSA and RSA...

BACKGROUND: Over the last few decades, several databases and clinical registries have been used to generate studies for orthopedic surgery research including shoulder arthroplasty. Observational database studies present data that is best used to provide information regarding associations between variables but is unable to prove causation. Yet, there remains a tendency for authors to use causal language and conclusive statements in published shoulder arthroplasty literature utilizing such databases...

BACKGROUND: Recent evidence indicates that combined upper extremity blood flow restriction (BFR, applied distally to the shoulder) and low-load resistance exercise (LIX) augments clinically meaningful responses in shoulder region tissues proximal to the occlusion site. The purpose of this investigation was to determine the efficacy of BFR-LIX for the shoulder when added to standard offseason training in Division IA collegiate baseball pitchers. We hypothesized that BFR-LIX would augment training-induced increases in shoulder-region lean mass, rotator cuff strength, and endurance...

BACKGROUND: In the United States, testosterone therapy has increased over recent years. Anabolic steroid use has been associated with tendon rupture, although there is a paucity of evidence evaluating the risk of biceps tendon injury (BTI) with testosterone therapy. The aim of this study was to quantify the risk of BTI after initiating testosterone therapy. METHODS: This is a retrospective cohort study utilizing the PearlDiver database. Records were queried between 2011 and 2018 for patients aged 35-75 years old who filled a testosterone prescription for a minimum of 3 months...

BACKGROUND: Modification of total elbow arthroplasty (TEA) implants may be necessary in selected patients with substantial anatomic bone deformity or those undergoing revision surgery. The purpose of this study was to investigate the prevalence and consequences of implant modifications during TEA at our institution. We hypothesized that TEA implant modification would be more common in revisions than in primary replacements, and that it would not be associated with worse clinical outcomes or increased rates of radiographic or surgical complications directly related to the implant modification...

PURPOSE: To evaluate mid-term outcome of LUCL repair with triceps autograft in patients with PLRI under recalcitrant lateral epicondylitis. METHODS: In total 25 elbows (23 patients) with recalcitrant epicondylitis longer than 12 months were included into this retrospective study. All patients underwent arthroscopic instability examination. In 18 elbows (16 patients, mean age 47.4 years, range 25-60) PLRI was verified, and a LUCL repair using an autologous triceps tendon graft was performed...

INTRODUCTION: Bariatric surgery (BS) is a debated, yet commonly used management strategy in the treatment of morbidly obese patients. Despite recent advances in BS techniques, there is limited data on the potential impact of prior BS in patients undergoing shoulder arthroplasty. This investigation evaluated the outcomes of primary shoulder arthroplasty (SA) in patients with prior BS when compared to matched controls. METHODS: Over a 31-year period (1989 - 2020), 183 primary SA (12 hemiarthroplasties [HA], 59 anatomic total shoulder arthroplasties [aTSA], and 112 reverse shoulder arthroplasties [rTSA]) in patients with prior BS and a minimum of 2-year follow-up had been performed at a single institution...

BACKGROUND: The Latarjet coracoid transfer procedure reliably stabilizes the glenohumeral joint for shoulder instability. However, complications such as graft osteolysis, non-union and fracture continue to affect patient clinical outcomes. The double screw (SS) construct is regarded as the gold standard method of fixation. SS constructs are associated with graft osteolysis. More recently, a double button technique (BB) has been suggested to minimize graft related complications. However, BB constructs are associated with fibrous non-union...

INTRODUCTION: Heterotopic ossification is a frequent complication following surgical treatment of elbow trauma. The use of indomethacin to prevent heterotopic ossification is reported in the literature, however, its effectiveness is controversial. The purpose of this randomized, double blind, placebo-controlled study was to determine if indomethacin is effective in reducing the incidence and severity of heterotopic ossification after surgical management of elbow trauma. METHODS: Between February 2013 and April 2018, 164 eligible patients were randomized to receive postoperative indomethacin or placebo medications...

PURPOSE: Arthroscopically modified Eden-Hybinette procedures for glenohumeral stabilization have been used for a long time. With the advancement of arthroscopic techniques and the development of sophisticated instruments, a double Endobutton fixation system has been used clinically to secure bone graft to the glenoid rim placed through a specifically designed guide. The purpose of this report was to evaluate clinical outcomes and serial glenoid remodeling process following all-arthroscopic anatomical glenoid reconstruction using autologous iliac crest bone grafting technique through one tunnel fixation...

BACKGROUND: Intra-articular soft arthroscopic Latarjet technique (in-SALT) involves augmentation of arthroscopic Bankart repair (ABR) with soft-tissue tenodesis of long head of biceps to upper subscapularis. This study was conducted to investigate superiority of outcomes of in-SALT-augmented ABR over those of concurrent ABR and antero-superior labral repair (ASL-R) in management of type-V SLAP lesion. METHODS: This prospective cohort study (conducted between January, 2015 and January, 2022) included 53 patients with arthroscopic diagnosis of type-V SLAP lesion...

BACKGROUND: While numerous studies exist evaluating the short-term clinical outcomes for patients who have undergone elbow arthroscopy for osteochondritis dissecans (OCD) of the capitellum, the literature on minimum 2-year clinical outcomes for a large cohort of patients is limited. PURPOSE: /Hypothesis: We hypothesized that clinical outcomes for patients treated arthroscopically for OCD of the capitellum would be favorable, with improved postoperative subjective functional and pain scores, and with acceptable return to play for these patients...

BACKGROUND: The use of tranexamic acid has become widespread in orthopedics to promote hemostasis and has been successfully used to reduce blood loss and infection risk in joint arthroplasty. However, the cost-effectiveness of routine tranexamic acid use for the prevention of periprosthetic infections in total shoulder arthroplasty (TSA) remains unknown. METHODS: The acquisition cost of tranexamic acid ($5.22) for our institution, along with values from the literature for the average cost of infection-related care ($55,243) and the baseline infection rates for patients without tranexamic acid use (0...

BACKGROUND: Vitality-threatening proximal humerus fractures often provide an indication for prosthetic treatment. We investigated the issue of how anatomic hemiprostheses perform in younger, functionally challenging patients with the use of a specific fracture stem and systematic tuberosity management in medium-term follow-up. METHODS: Thirteen skeletally mature patients with a mean age of 64 ± 9 years and a minimum follow-up of 1 year after primary open-stem hemiarthroplasty for 3- and 4-part proximal humeral fractures were included...

BACKGROUND: Recently, a stemless reverse shoulder arthroplasty (RSA) design was developed in order to preserve bone stock. Clinical and radiological studies of such design with larger cohorts with over 100 patients are not frequent. The purpose of this study was to present clinical and radiological results of a newly developed stemless RSA. The hypothesis was that this design would provide similar clinical and radiological results compared to other stemless and stemmed implants. METHODS: Between September 2015 and December 2019, all patients who had a primary EASYTECH® stemless RSA were considered eligible for inclusion in this prospective multi-center study...

BACKGROUND: Adhesive capsulitis (AC) is a common clinical condition of the shoulders without a clear pathophysiology or etiology. Although thyroid disease has been linked to AC, an appropriate understanding of the disease and its epidemiological evidence are lacking. This meta-analysis investigated the association of AC with thyroid disease and identified which manifestations of thyroid disease contribute to the risk of AC. METHODS: The databases of PubMed, Embase, and Scopus were searched for literature retrieval up to September 20, 2022...

BACKGROUND: Acute Rockwood type III-V acromioclavicular (AC) dislocations have been treated with numerous surgical techniques over the years. The purpose of this study was to perform a network meta-analysis (NMA) of randomized controlled trials (RCTs) to quantitatively define the optimal treatment for operative AC dislocations. METHODS: A literature search of three databases was performed on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...