International Journal of Shoulder Surgery

The case of a 29-year-old man who had osteochondritis dissecans on the medial aspect of the humeral head is reported. Repetitive micro-trauma at a low elevated arm position was thought to have induced the osteochondral lesion.

Primary bone tumors around the elbow represent <1% of all the skeletal tumors. Surgery with or without adjuvant therapy (radiotherapy, chemotherapy) is the treatment of choice for malignant tumors. Reconstruction of the elbow and forearm in malignant tumors is challenging as it involves a complex interplay between multiple joints which need to be stabilized for the optimal functional outcome. We describe a new technique for the reconstruction of the elbow after resection of a proximal ulna tumor with articular radio-ulnar synostosis with the creation of a single bone forearm...

PURPOSE: Glenoid component loosening remains a common mode of failure for total shoulder arthroplasty and has inspired improvements in implant design, instrumentation, and surgical technique. The purpose of this manuscript was to evaluate the incidence of radiolucent lines and glenoid seating on initial postoperative radiographs using a modern pegged-glenoid design, instrumentation, and surgical technique. MATERIALS AND METHODS: We performed a retrospective analysis of a consecutive series of 100 pegged-glenoid total shoulder replacements...

PURPOSE: Glenoid component malposition is associated with poor function and early failure of both anatomic and reverse total shoulder arthroplasty. Glenoid positioning is challenging particularly in the setting of bone loss or deformity. Recently, the use of computer assistance has been shown to reduce implantation error. The aim of this study is to evaluate the accuracy of patient-specific instrumentation in cases of anatomic and reverse shoulder replacement in vivo. METHODS: Twenty patients underwent total shoulder arthroplasty using a computed tomography (CT)-based patient-specific instrumentation (PSI) system, ten anatomic and ten reverse...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Rotator cuff tears have been reported to be uncommon following total shoulder arthroplasty (TSA). Postoperative rotator cuff tears can lead to pain, proximal humeral migration, and glenoid component loosening. The purpose of this paper was to evaluate the incidence of post-TSA rotator cuff tears or dysfunction in osteoarthritic patients. A systematic review of multiple databases was performed using preferred reporting items for systematic reviews and meta-analyses guidelines. Levels I-IV evidence clinical studies of patients with primary osteoarthritis with a minimum 2-year follow-up were included...

PURPOSE: There are multiple reported risk factors and a wide range of reported blood transfusion rates for total shoulder arthroplasty (TSA). There are no evidence-based guidelines for blood transfusions in TSA patients. MATERIALS AND METHODS: We utilized the Nationwide Inpatient Sample to analyze 51,191 patients undergoing TSA between 1998 and 2011. The purpose was to describe the incidence and identify the preoperative factors that are independently associated with blood transfusion after TSA...

[This corrects the article on p. 76 in vol. 8, PMID: 25258498.].

[This corrects the article on p. 43 in vol. 9, PMID: 25937713.].

[This corrects the article on p. 131 in vol. 9, PMID: 26622130.].

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Combined pectoralis major disruption and proximal humeral fractures are uncommon. A simple radiologic diagnostic tool which consists of the measurement of the displacement from the humeral shaft to the lateral side of the humeral head (lateral to the outer proximal cortex) can help to diagnose this combined lesion.

Pinning with metallic wires is a suitable therapeutic option for proximal humeral fractures. Loosening and migration of such devices from this site is uncommon. Despite infrequently occurring, however, the literature reports dramatic and potentially lethal complications related to wires dislocation. A 69-year-old woman underwent closed reduction and fixation of a proximal 3-part humeral fracture by mean of two retrograde Kirschner wires and one anterograde threaded pin. One month after surgery, during a routine follow-up control, it was diagnosed the migration of the threaded pin in the left lung parenchyma...

This reports presents the case of a combined clavicle fracture malunion and chronic Type IV acromioclavicular (AC) joint dislocation. The patient was seen acutely in the emergency department following a mountain bike accident at which time the clavicle fracture was identified and managed conservatively however the AC dislocation was not diagnosed. The patient presented 25 months following the injury with persistent pain and disability and was treated with clavicle osteotomy and AC stabilization. We document the clinical details, surgical treatment and outcome...

Young patients with glenohumeral arthritis are an ongoing treatment challenge. They typically have high demands of their shoulders, require long-term durability due to their young age, and often have altered local anatomy, through their disease process (instability arthropathy, juvenile rheumatoid arthritis, etc.) or from previous surgery (capsulorraphy arthropathy, chondrolysis, etc.). Workup to evaluate underlying causes of early arthritis, and to exclude infectious causes are necessary. When nonoperative management fails, arthroscopic debridement, hemiarthroplasty (isolated, with glenoid reaming, or with biological interposition), and total shoulder arthroplasty are treatment options available to the treating surgeon...

PURPOSE: The purpose of this study is to assess the outcomes of a consecutive series of patients who underwent revision surgery after humeral head resurfacing (HHR). Our joint registry was queried for all patients who underwent revision arthroplasty for failed HHR at our institution from 2005 to 2010. Eleven consecutive patients (average age 54 years; range 38-69 years) that underwent revision of 11 resurfacing arthroplasties were identified. The primary indication for resurfacing had been osteoarthritis in six, glenoid dysplasia in two, a chondral lesion in two, and postinstability arthropathy in one patient...

BACKGROUND: The Nice knot is a bulky double-stranded knot. Biomechanical data supporting its use as well as the number of half hitches required to ensure knot security is lacking. MATERIALS AND METHODS: Nice knots with, one, two, or three half-hitches were compared with the surgeon's and Tennessee slider knots with three half hitches. Each knot was tied 10 times around a fixed diameter using four different sutures: FiberWire (Arthrex, Naples, FL), Ultrabraid (Smith and Nephew, Andover, MA), Hi-Fi (ConMed Linvatec, Largo, FL) and Force Fiber (Teleflex Medical OEM, Gurnee, IL)...

BACKGROUND: As the incidence of reverse shoulder arthroplasty (RSA) increases, so will the revision burden. At times, the revision surgeon may be faced with a well-fixed component on one side of the joint and revision implants from a different manufacturer. The ability to use glenoid and humeral implants from different manufacturers could simplify the revision procedure. This study hypothesized that across a range of RSA systems, some implants would demonstrate high size compatibility and others would demonstrate low compatibility...