Orthopedic Reviews最新文献

{"title":"Extracorporeal Shockwave Therapy in Pain Management - an In-Depth Narrative Review.","authors":"Wisdom Ufondu, Oludotun Ogunsola, Ava Williams, Kayla Valenti, Gabriella Herbert, Ezinne Ezenekwe, Justin Bufano, Toyyib Suleiman, Fredrick Esiso, David Jevotovsky, Jamal Hasoon, Vwaire Orhurhu","doi":"10.52965/001c.154361","DOIUrl":"10.52965/001c.154361","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this narrative review is to explain the cellular mechanisms behind chronic pain, the mechanisms behind extracorporeal shockwave therapy, and its efficacy for the treatment of various chronic pain conditions including tendinopathies, greater trochanteric pain, de quervain tenosynovitis, myofascial pain, plantar fasciitis, fibromyalgia, osteoarthritis, fractures, osteonecrosis, bone edema, coccydynia, low back pain, chronic pelvic pain syndrome/chronic prostatitis, ulcers, and carpal tunnel syndrome.</p><p><strong>Recent findings: </strong>Many recent clinical trials and meta-analyses from the year 2024 overall supported the efficacy of extracorporeal shockwave therapy for the treatment of chronic pain conditions with minimal adverse effects.</p><p><strong>Summary: </strong>Extracorporeal shockwave therapy is a novel technique that uses mechanotransduction to induce a cellular response that prevents central sensitization, reduces inflammation, and contributes to healing that alleviates pain. The specific mechanisms through which extracorporeal shockwave therapy are largely unknown or poorly understood. A literature search of Scopus, PubMed, Embase, and the Cochrane Database of Systematic Reviews was conducted to identify 84 studies from 2000-2024 evaluating the efficacy of extracorporeal shockwave therapy for the treatment of chronic pain conditions. The results indicate that extracorporeal shockwave therapy holds strong promise for the treatment of numerous chronic pain pathologies with minimal adverse effects and should be studied further.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"154361"},"PeriodicalIF":1.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13464606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148724105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Cephalomedullary Nail Design Influence Risk of Varus Collapse in Subtrochanteric Femur Fractures?","authors":"Momin Ahmed, John Mickley, Andres Lopez, Patrick Baki, Alex Moses, Porter Young","doi":"10.52965/001c.166437","DOIUrl":"10.52965/001c.166437","url":null,"abstract":"<p><strong>Background: </strong>Cephalomedullary nails (CMNs) are frequently utilized for subtrochanteric femur fractures but a lack of cortical fit in proximal fractures may lead to varus deformity. We hypothesize that as the difference between fracture site canal width and diameter of the nail increases so will the risk of varus deformity.</p><p><strong>Methods: </strong>A retrospective study of subtrochanteric femur fractures fixed with CMNs at an academic, level one trauma center over a 6.5-year period was performed. Patients were divided into two cohorts: CMN with sliding blade/screw (TFNA) or greater trochanteric entry recon nail (GTE). The primary outcome analyzed was the correlation between nail-canal mismatch with final neck shaft angle. Secondary outcomes analyzed included rates of nonunion and malunion.</p><p><strong>Results: </strong>Seventy-one patients met the inclusion criteria (35 TFNA and 36 GTE). There was not a significant correlation between the nail-canal mismatch with final neck shaft angle for GTE nails (Pearson correlation coefficient r: -0.187, p=0.274). However, when TFNAs were subdivided into 125° and 130° cohorts, there was a stronger negative correlation for 125° (r: -0.678, p=0.001) compared to the 130° (r: -0.515, p=0.041). For 125° TFNAs, linear regression analysis demonstrated that for every 1 mm increase in nail-canal mismatch there was a decrease in final neck shaft angle by 0.757⁰. There was no difference in secondary outcomes.</p><p><strong>Conclusion: </strong>GTE nails and TFNAs have similar rates of malunion and nonunion when managing subtrochanteric femur fractures. However, 125° TFNAs may be associated with increased varus neck shaft angles as the nail-canal mismatch increases.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"166437"},"PeriodicalIF":1.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13464711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes of dual locking-plate fixation for bicondylar tibial plateau fractures via two mini-incisions: A prospective study.","authors":"Ngoc Quyen Le, Khac Xuan Hoang, Trong Xuan Cuong Tran","doi":"10.52965/001c.165504","DOIUrl":"10.52965/001c.165504","url":null,"abstract":"<p><strong>Background: </strong>Bicondylar tibial plateau fractures are complex injuries that frequently involve a posteromedial fragment and carry a high risk of post-traumatic osteoarthritis. However, long-term outcome data on dual locking-plate fixation are limited, particularly in Southeast Asian populations.</p><p><strong>Objective: </strong>The aim of this prospective study was to evaluate longitudinal clinical and imaging outcomes of bicondylar tibial plateau fractures managed with anterolateral and posteromedial locking plates via two mini-incisions.</p><p><strong>Methods: </strong>This prospective study included 55 patients treated with open reduction and dual locking-plate fixation via anterolateral and posteromedial mini-incisions. Outcomes included radiographic parameters, clinical function and complications.</p><p><strong>Results: </strong>The mean age was 45.4 ± 12.4 years; 60% of patients were male and motorcycle accidents accounted for 90.9% of injuries. Forty-five patients (81.8%) completed the 60-month assessment. Lateral plateau depression was reduced from 5.25 mm preoperatively to 1.00 mm postoperatively and was 2.17 mm at 5 years. KSS Knee peaked at 12 months (83.4 ± 8.2) and was 78.9 ± 8.8 at 5 years; the Rasmussen clinical score followed a similar trajectory. The overall complication rate was 23.6%, with a single deep infection (1.8%). Kellgren-Lawrence grade ≥ 2 increased from 14.5% of injured knees at 12 months to 53.3% at 60 months. Schatzker VI was associated with smaller Rasmussen clinical improvement than Schatzker V (-2.09; p = 0.023).</p><p><strong>Conclusions: </strong>Dual locking-plate fixation through two mini-incisions provides favorable clinical and functional outcomes up to 5 years for bicondylar tibial plateau fractures; however, progressive post-traumatic osteoarthritis remains a long-term concern warranting surveillance.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"165504"},"PeriodicalIF":1.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13464399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous Bilateral Quadriceps Tendon Rupture After Low-Energy Trauma in a 73-Year-Old Man: A Case Report and Literature Review.","authors":"Konstantinos Makiev, Theodoros Chouliaras, Antigoni Gkoudina, Vasileios Chouliaras","doi":"10.52965/001c.166122","DOIUrl":"10.52965/001c.166122","url":null,"abstract":"<p><p>Simultaneous bilateral quadriceps tendon rupture is an exceptionally rare injury of the knee extensor mechanism and may present a diagnostic challenge, particularly after low-energy trauma. Prompt recognition is essential to restore knee extension and ambulatory function. We report the case of a 73-year-old man who presented to the Emergency Department after falling while descending stairs and landing directly onto both knees. He developed immediate bilateral knee pain and inability to ambulate. Clinical examination revealed palpable suprapatellar defects bilaterally, inability to perform straight leg raise, and loss of active knee extension in both knees. Plain radiographs demonstrated bilateral patella baja with central calcific densities suggestive of pre-existing degenerative tendon changes. Based on the evident clinical findings, no further magnetic resonance imaging was required. The patient underwent urgent bilateral surgical repair using a transosseous patellar tunnel technique with No. 5 nonabsorbable Ethibond sutures in a locking Krackow configuration. A structured postoperative rehabilitation program with progressive mobilization and strengthening was implemented. At 18-month follow-up, the patient reported no pain, independent ambulation without assistive devices, unrestricted activities of daily living, full knee extension, and flexion to approximately 130° bilaterally. This case highlights that simultaneous bilateral quadriceps tendon rupture may occur even in the absence of major systemic comorbidity and should be considered in elderly patients presenting with acute bilateral knee pain and extensor mechanism dysfunction after minor trauma. Early surgical repair combined with structured rehabilitation can result in excellent functional recovery.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"166122"},"PeriodicalIF":1.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13464398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional alignment preserves the native Coronal Plane Alignment of the Knee phenotype while improving early clinical outcomes after robotic-assisted total knee arthroplasty.","authors":"Georgii Airapetov, Alexey Prizov, Armen Daniliyants, Rasul Aliev, Ahmat Abdulaye, Varvara Iatsukova","doi":"10.52965/001c.166120","DOIUrl":"10.52965/001c.166120","url":null,"abstract":"<p><strong>Background: </strong>Functional alignment (FA) has emerged as a personalized strategy for robotic-assisted total knee arthroplasty (ra-TKA), aiming to preserve constitutional knee anatomy and native soft-tissue balance. However, evidence directly comparing robotic-assisted FA and mechanical alignment (MA) using the same robotic platform remains limited.</p><p><strong>The aim of the study: </strong>To compare the early clinical, radiographic, and constitutional phenotype outcomes of ra-TKA performed using FA and MA.</p><p><strong>Methods: </strong>In this prospective randomized single-center study, 100 patients with primary varus knee osteoarthritis underwent primary ra-TKA using the CORI Surgical System and were randomized to the FA (n=50) or MA (n=50) group. Clinical outcomes (KSS, FJS-12, VAS), radiographic alignment (HKA, LDFA, MPTA), soft-tissue release, and postoperative CPAK phenotype preservation were evaluated over 12 months.</p><p><strong>Results: </strong>Both groups demonstrated significant postoperative improvement. At 3 months, the FA group achieved significantly higher KSS Knee, KSS Function, and FJS-12 scores together with lower VAS pain scores than the MA group (all p<0.05). These differences were no longer significant at 12 months. FA required fewer soft-tissue releases while maintaining radiographic accuracy comparable to MA. Constitutional CPAK phenotype was preserved in 82% of FA patients, whereas all mechanically aligned knees were converted to CPAK phenotype V. Native joint-line orientation and constitutional varus alignment were preserved in all FA cases.</p><p><strong>Conclusion: </strong>Robotic-assisted functional alignment provides accurate and reproducible component positioning while preserving constitutional knee phenotype and reducing soft-tissue release. Although long-term clinical outcomes were comparable, FA resulted in superior early functional recovery and represents a safe personalized alignment strategy.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"166120"},"PeriodicalIF":1.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13464598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Returning to Sports and High-Impact Exercise After Total Hip Arthroplasty: What Should We Be Recommending in 2026?","authors":"Sean C Clark, Jan Eric Rohdenburg, Michael J Taunton, Mario Hevesi","doi":"10.52965/001c.165090","DOIUrl":"10.52965/001c.165090","url":null,"abstract":"<p><p>The total number of total hip arthroplasties performed each year is expected to increase significantly over the coming decades. As a result, an increasing number of young patients are undergoing total hip arthroplasty while similarly, a growing subset of active elderly patients desire to return to sports or high-impact activity after surgery. Patients are typically provided restrictions and activities to avoid following surgery. For these patients, there is no clear consensus or guidelines regarding whether they should limit their activity level postoperatively and in particular, if returning to high-impact exercise increases their risk of complications and subsequent revision surgery. This article will discuss the most common complications after total hip arthroplasty and whether patients who return to sports or a high-impact activity after surgery may be more predisposed to these complications in comparison to their more sedentary peers.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"165090"},"PeriodicalIF":1.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance-Related Musculoskeletal Disorders in Musicians: Global Research Trends and Emerging Themes in Occupational and Neurological Injury.","authors":"Isaac Son, Pranay Gadikota, Latha Ganti, Omar Viswanath","doi":"10.52965/001c.165224","DOIUrl":"10.52965/001c.165224","url":null,"abstract":"<p><strong>Introduction: </strong>Performance-related musculoskeletal disorders (PRMDs) are common health conditions affecting musicians and can significantly impact performance and the longevity of a musicians' career. PRMDs include both overuse injuries and focal dystonia.</p><p><strong>Methods: </strong>This bibliometric analysis examined research trends on musician PRMDs using 1,094 publications indexed in the Web of Science Core Collection between the periodic time frame of 1984 and 2026. VOSviewer was used primarily to analyze publication output, authorship patterns, citation networks, and keyword relationships.</p><p><strong>Results: </strong>Results showed steady growth in research activity, particularly after 2009, with Germany, the United States, and Australia emerging as leading contributors. Eckart Altenmüller was identified as the most prolific author, while keyword analysis revealed two major research themes: occupational health and neurological disorders.</p><p><strong>Discussion: </strong>The findings found through this paper demonstrates the increasing recognition of musician health as an interdisciplinary field while highlighting the need for a greater integration between research areas and stronger evidence-based treatment approaches.</p><p><strong>Conclusion: </strong>Future research should focus and aim to publish interdisciplinary collaboration, longitudinal studies, and standardized prevention and management strategies for musicians with PRMDs.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"165224"},"PeriodicalIF":1.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Sciatic Neuropathy Following Ankle Surgery and Peripheral Nerve Blockade: A Case-Based Review.","authors":"Anvinh Nguyen, Christopher L Robinson, Jamal Hasoon, Vu Nguyen","doi":"10.52965/001c.165506","DOIUrl":"10.52965/001c.165506","url":null,"abstract":"<p><p>Peripheral nerve blocks are commonly used for intraoperative and postoperative analgesia in foot and ankle surgery due to superior pain control and opioid-sparing effects. Although considered safe, neurologic complications can occur and present diagnostic and management challenges for the anesthesiologist. This case-based educational review describes a 72-year-old patient who developed persistent postoperative sciatic-distribution motor and sensory deficits after ankle open reduction and internal fixation performed with adductor canal and popliteal sciatic nerve blocks. The clinical scenario highlights the difficulty of determining causation when neurologic deficits arise in the setting of regional anesthesia, surgery, tourniquet use, and patient-specific risk factors. Through this clinical scenario, key perioperative considerations are reviewed, including risk factors for nerve injury, recognition of abnormal block recovery, diagnostic evaluation, and evidence-based management strategies. This structured case discussion is designed for anesthesiology trainees and perioperative clinicians to support safe regional anesthesia practice and early identification of neurologic complications.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"165506"},"PeriodicalIF":1.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth Plate Injuries, Skeletal Maturity, and Bone Health in Young Dancers: A Bibliometric Analysis.","authors":"Zara Liles-Henry, Vedha Dande, Latha Ganti, Omar Viswanath","doi":"10.52965/001c.165228","DOIUrl":"10.52965/001c.165228","url":null,"abstract":"<p><strong>Background: </strong>High demands and repetitive loads experienced by young dancers are of major concern regarding growth plate injury and issues of skeletal maturity during development. While dance medicine has become an accepted subspecialty, an evaluation of research literature regarding these specific issues among a youth population has been lacking to observe patterns and gaps. To address these challenges, bibliometric analyses are useful tools to visualize scientific productivity, leading scholars, and research clusters in this niche sports medicine topic.</p><p><strong>Methods: </strong>A bibliometric review was conducted on the WoSCore Collection of scholarly articles from 1973 to 2026. Using keywords \"dance,\" \"growth plate,\" \"physis,\" and \"skeletal maturity,\" results were filtered to yield papers that focused on these topics in young dancers. These data included publication year, author, journal, and geographic origin. These findings were exported to Microsoft Excel for graphical analysis and VOSviewer for keyword co-occurrence and research clusters.</p><p><strong>Results: </strong>A limited but increasing body of literature has been produced on this topic since the early 2000s, with an increase in the number of publications post-2010. Most of the research originated in the United States, with limited studies in several European countries and Australia. Most papers on this topic were published in the Journal of Dance Medicine and Science. Themes within the literature included the mechanisms of physeal injury, female athlete triad, and training load and its effects on bone health, with Steinberg and Stracciolini being the lead investigators on several large-scale research projects.</p><p><strong>Conclusion: </strong>The research on dance-associated growth plate injuries and skeletal maturity in the last 20 years primarily comprises data obtained through studies of classical ballet dancers and comes from Western countries. The evidence on long-term outcomes and styles other than ballet is lacking. Multi-center longitudinal research with evidence-based programs is needed.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"165228"},"PeriodicalIF":1.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Value of Scapular-Targeted Rehabilitation Within the Rotator Cuff Care Continuum: A Systematic Review and Meta-analysis of Conservative and Postoperative Evidence.","authors":"Abdulelah F Alshehri, Waleed O Samarkandi, Khulud A Alshahrani, Abrahim Sulaiman Alreyaee, Altowairqi Raad Hameed A, Ghyda Trad A Alasmari, Maali Malawi Alshahrani, Bushra Yahya Al-Amer, Fai A Alqahtani, Abdullah Loay Bohairi, Alayham Hakiem, Joud Fahad Albishri, Nada Hadi Alqahtani, Thurya A Asiri, Raghad Y Alwadai","doi":"10.52965/001c.165083","DOIUrl":"10.52965/001c.165083","url":null,"abstract":"<p><strong>Background: </strong>Scapular-targeted rehabilitation is increasingly incorporated into the management of rotator cuff-related shoulder disorders; however, its clinical value across both conservative and postoperative stages of care remains uncertain.</p><p><strong>Objective: </strong>To evaluate the effectiveness of scapular-targeted rehabilitation on pain, disability, and shoulder function across the rotator cuff care continuum.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted in accordance with PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, and Web of Science were searched from inception through May 2026. Eligible studies included adults with rotator cuff-related shoulder pain, subacromial pain syndrome, subacromial impingement syndrome, scapular dyskinesis-associated shoulder disorders, or patients undergoing rehabilitation following rotator cuff repair. Randomized controlled trials were included in quantitative synthesis. Random-effects models were used to pool standardized mean differences (SMDs) or mean differences (MDs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Nine studies met the inclusion criteria, comprising seven randomized controlled trials, one propensity score-matched study, and one single-group pre-post study. Meta-analysis demonstrated that scapular-targeted rehabilitation significantly reduced pain compared with control interventions (SMD -0.88, 95% CI -1.71 to -0.06; I²=84.8%) and significantly improved shoulder function measured by the Constant-Murley Score (MD 6.94, 95% CI 0.37 to 13.52; I²=85.7%). Disability outcomes favored scapular-targeted rehabilitation but did not reach statistical significance (SMD -0.47, 95% CI -1.05 to 0.11; I²=72.8%). Postoperative studies generally reported favorable effects on pain, function, and range of motion, although evidence was insufficient for quantitative synthesis.</p><p><strong>Conclusions: </strong>Scapular-targeted rehabilitation appears to be a useful adjunct within comprehensive rotator cuff rehabilitation, with evidence supporting improvements in pain and shoulder function. Evidence for disability reduction and postoperative effectiveness remains inconclusive, warranting further high-quality trials across the rotator cuff care continuum.</p>","PeriodicalId":19669,"journal":{"name":"Orthopedic Reviews","volume":"18 ","pages":"165083"},"PeriodicalIF":1.6,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}