Clinics in Shoulder and Elbow最新文献

{"title":"Current concepts in arthroscopic rotator cuff repair.","authors":"Kang-San Lee, Dong-Hyun Kim, Seok Won Chung, Jong Pil Yoon","doi":"10.5397/cise.2025.00010","DOIUrl":"10.5397/cise.2025.00010","url":null,"abstract":"<p><p>Rotator cuff repair has experience great development, transitioning from open surgical techniques to minimally invasive arthroscopic methods. This review explores its historical development, current repair techniques, biomechanical considerations, and advances in materials and biological augmentation. It also addresses strategies for managing partial-thickness and massive tears, compares single-row and double-row repairs, and highlights the importance of individualized postoperative rehabilitation. By integrating biomechanical precision with biological innovations, modern rotator cuff repair aims to improve healing rates, reduce retear risk, and optimize functional outcomes.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"28 1","pages":"103-112"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617442","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":"Diagnostic accuracy of clinical tests after subacromial lidocaine injection and ultrasonography for evaluating supraspinatus tendon disorder.","authors":"Jansen Lee, Andri Maruli Tua Lubis, Iman Widya Aminata, Renaldi Prasetia","doi":"10.5397/cise.2024.00738","DOIUrl":"10.5397/cise.2024.00738","url":null,"abstract":"<p><strong>Background: </strong>Accurate pathoanatomic diagnosis of the cause of shoulder pain cannot rely solely on clinical tests. Similarly, diagnosis based on imaging results alone is not reliable due to the high prevalence of asymptomatic pathology. This study aims to assess the diagnostic accuracy of clinical testing with lidocaine injection and ultrasonography as a screening method for detecting supraspinatus disorders compared with magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>Patients with supraspinatus-related shoulder pain were collected from outpatient clinics. Clinical tests, ultrasonography, and subacromial lidocaine injections were performed, with tests repeated post-injection. The results were confirmed with MRI findings.</p><p><strong>Results: </strong>Of 78 patients, the average age was 58±6 years, with 76.9% being normal weight females. Moderate shoulder pain was reported by 75.6% of participants, predominantly on the dominant right side (84.6%), with a significant correlation (P<0.05). The Hawkins-Kennedy test (0.73) and Neer sign (0.68) had the best sensitivity, while the drop arm test (0.93) showed the highest specificity for tendon pathology. For full-thickness tears, the Hawkins-Kennedy and empty can test (0.76) had the best sensitivity, and the drop arm test (0.82) had the best specificity. Lidocaine injection reduced sensitivity but increased specificity, with the drop arm test reaching 0.96. Supraspinatus ultrasonography was over 90% accurate compared with MRI, with a kappa value above 0.7.</p><p><strong>Conclusions: </strong>Subacromial lidocaine injection reduces sensitivity but increases the specificity of clinical tests for supraspinatus tendon disorders. Ultrasonography can be used as a screening tool for supraspinatus tendon abnormalities. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"28 1","pages":"68-76"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617444","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":"Dose- and sex-dependent effects on umbilical cord-derived mesenchymal stem cell efficacy in regeneration of a full-thickness tendon defect in a rat model.","authors":"Ji-Hye Yea, Chris Hyunchul Jo","doi":"10.5397/cise.2024.00626","DOIUrl":"10.5397/cise.2024.00626","url":null,"abstract":"<p><strong>Background: </strong>Mesenchymal stem cells (MSCs) have shown potential in regenerative medicine. In the present study the effects of MSC dosage and recipient sex on tendon regeneration were evaluated.</p><p><strong>Methods: </strong>A full-thickness tendon defect (FTTD) was created on supraspinatus tendons (SSTs) of rats and cryoprotective solution (CPS) and MSCs (0.05, 0.1 and 0.5 million MSCs [M-MSC] for female groups and 1.0 M-MSC for both female and male groups) were applied. After 2 and 4 weeks, macroscopic and histological evaluations were performed.</p><p><strong>Results: </strong>Total macroscopic scores were improved in all MSC groups compared with the CPS group, with no significant differences among the MSC groups. Furthermore, all MSC groups had lower total degenerative scores than the CPS group; however, only 0.1 M-MSC, 0.5 M-MSC, and 1 M-MSC groups showed significantly improved hyalinization compared with the CPS group at 4 weeks. Collagen organization and coherence were higher in all MSC groups than in the CPS group at both 2 and 4 weeks; however, 0.5 M-MSC and 1 M-MSC groups scored better than the 0.05 M-MSC group at 4 weeks. Heterotopic matrix analysis revealed smaller glycosaminoglycan (GAG)-rich areas in the 0.1 M-MSC, 0.5 M-MSC, and 1 M-MSC groups compared with the CPS group at 4 weeks. Overall, macroscopic and histological evaluations were not significantly different between female and male groups except for GAG-rich area.</p><p><strong>Conclusions: </strong>The MSC dosage affected collagen and heterotopic matrix formation in a FTTD rat model; however, the efficacy of MSCs (1.0 M dose) in collagen regeneration was not affected based on the sex of the recipient. Level of evidence: I.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"28 1","pages":"49-59"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617446","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":"The role of vitamin D in shoulder health: a comprehensive review of its impact on rotator cuff tears and surgical results.","authors":"Mohammad Daher, Oscar Covarrubias, Ryan Lopez, Peter Boufadel, Maria Catherine Rita Hachem, Ziad Zalaquett, Mohamad Y Fares, Joseph A Abboud","doi":"10.5397/cise.2024.00220","DOIUrl":"10.5397/cise.2024.00220","url":null,"abstract":"<p><p>Vitamin D deficiency is highly prevalent in the general population and is associated with various chronic health conditions. In addition to its role in bone mineralization, Vitamin D has various physiological effects that may impact the pathogenesis of shoulder pathologies. Vitamin D deficiency may also affect outcomes after shoulder surgeries, such as rotator cuff repair and total shoulder arthroplasty. Vitamin D plays a role in tissue healing, bone growth, and maintenance of homeostasis in skeletal muscle cells. Vitamin D also has anti-inflammatory effects that are important to rotator cuff health. Vitamin D deficiency is highly prevalent in patients with rotator cuff tears, suggesting its role as a potential risk factor. Vitamin D deficiency has been associated with decreased preoperative shoulder strength as well as increased re-tear rates, postoperative stiffness, and the need for revision surgery in patients who underwent rotator cuff repair. Studies have also demonstrated a potential association between vitamin D deficiency and increased risk of revision after total shoulder arthroplasty. Further research is necessary to elucidate the direct role of vitamin D in the pathogenesis of rotator cuff tears and its impact on clinical outcomes after rotator cuff surgery and total shoulder arthroplasty.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"93-102"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976823","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":"Use of posteroanterior reference guides for bone block or coracoid process transfer in anterior glenohumeral instability: a cadaveric study of the relationship to the suprascapular nerve.","authors":"Musammad Rashida Begum, Rory Cuthbert, Cameron Andrew Joseph Dott, Owen O'Neill, Mohammed Tahir, Adrian Carlos, Livio Di Mascio","doi":"10.5397/cise.2024.00465","DOIUrl":"10.5397/cise.2024.00465","url":null,"abstract":"<p><strong>Background: </strong>Iatrogenic suprascapular nerve injury secondary to posterior drilling or screw penetration is a recognized complication of bone block or coracoid process transfers for anterior glenohumeral instability. We present the first cadaveric study that assesses the safety of posteroanterior reference guides and quantifies the relationship of the suprascapular nerve to posterior glenoid fixation with suture buttons.</p><p><strong>Methods: </strong>Anterior glenoid bone block reconstruction with suture buttons utilizing a posteroanterior reference guide was performed in 10 fresh frozen cadavers via a posterior portal. Bullets were inserted in predefined superior and inferior guide holes via percutaneous incisions to facilitate posteroanterior drilling. Looped guide wires were used to deliver suture buttons from anterior to posterior positions. The shoulder joint was disarticulated and the infraspinatus sharply elevated until the suprascapular nerve was visualized. Four independent static measures of the shortest distance from the superior drill sleeve to the lateral aspect of the suprascapular nerve were recorded.</p><p><strong>Results: </strong>The suprascapular nerve was not compromised utilizing the posteroanterior guide and suture button fixation technique in any specimen. The mean distance from superior sleeve tunnel to the suprascapular nerve was 5.00 mm (range, 3.25-8.00 mm) in females and 6.80 mm (range, 5.50-8.75 mm) in males. The shortest distance was 3.25 mm and the longest was 8.75 mm.</p><p><strong>Conclusions: </strong>The use of posteroanterior reference guides for suture button fixation was not associated with iatrogenic suprascapular nerve injury in the specimens examined. However, the proximity of the suprascapular nerve underscores the need for caution. Comparative analysis with anteroposterior bone block techniques is required to establish the potential benefits of this procedure. Level of evidence: V.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"3-8"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883203","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":"Evaluating transosseous anchorless repair for arthroscopic rotator cuff surgery: a comparative study with double row anchor repair.","authors":"Shyam Sundar, Rohit Mahesh Sane, Raghulraj Sundaramoorthy, Munis Ashraf, David V Rajan","doi":"10.5397/cise.2024.00556","DOIUrl":"10.5397/cise.2024.00556","url":null,"abstract":"<p><strong>Background: </strong>This retrospective observational study compared outcomes of arthroscopic rotator cuff surgery using double row anchor repair (DRR) versus transosseous anchorless repair (TAR) in patients with small to large full-thickness rotator cuff tears.</p><p><strong>Methods: </strong>A total of 42 patients underwent DRR (n=20) or TAR (n=22) between January 2022 and May 2023. Patients were matched based on age, sex, body mass index, and tear severity. Baseline demographics, including diabetes, smoking status, and Cofield classification, were compared. Functional outcomes were assessed using University of California, Los Angeles (UCLA) and American Shoulder and Elbow Surgeons (ASES) scores, along with range of motion (ROM) parameters: forward flexion, extension, internal rotation, external rotation, and abduction.</p><p><strong>Results: </strong>Baseline characteristics were similar between groups (P>0.05). TAR showed higher UCLA scores at 3 and 6 months (P<0.001) and superior ASES scores at 3 (P=0.025) and 6 months (P<0.001) compared to DRR. By 1 year, no significant differences were observed in UCLA (P=0.101), ASES (P=0.051), or ROM parameters (P>0.05).</p><p><strong>Conclusions: </strong>Both DRR and TAR showed comparable outcomes at 1 year. However, TAR demonstrated early functional benefits at 3 and 6 months, indicating potential advantages in the initial recovery phase. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"23-30"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773007","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":"Anterolateral rotatory instability of the elbow: a possible etiology of primary osteoarthritis.","authors":"Young-Bok Kim, James S Fitzsimmons, Enrico Bellato, Shawn W O'Driscoll, Hyo Seok Jang, Dae-Wook Kim","doi":"10.5397/cise.2024.00416","DOIUrl":"10.5397/cise.2024.00416","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study is to describe anterolateral rotatory instability (ALRI) as a possible etiology of primary osteoarthritis (OA) of the elbow.</p><p><strong>Methods: </strong>We examined 76 fresh frozen cadaveric elbows (male:female, 56:20; mean age, 81 years) for patterns of cartilage erosion that could be due to ALRI. These included erosions on the lateral trochlear ridge (LTR) lesion, crescent rim of the radial head (RC) lesion or the ventral capitellum (VC) lesion. The extent and location of the lesions were mapped by image processing of photographs of the humeral and radial articular surfaces, and the degeneration of the articular surface was graded.</p><p><strong>Results: </strong>Ten of 76 specimens (13%) had one or more lesions consistent with ALRI. LTR lesions were most common and were seen in 10 of 10 specimens (100%), typically involving the distal 30% of the LTR. RC lesions were seen in 9 of 10 and were located on anteromedial crescent of the radial head ranging from 6 to 10 o'clock. VC lesions were seen in 8 of 10 specimens directed anteroinferiorly about 60° to the long axis of the humerus.</p><p><strong>Conclusions: </strong>ALRI is a possible mechanism initiating primary OA of the elbow. It has a characteristic pattern of triple lesions involving the LTR, the RC, and the VC. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"27 4","pages":"419-427"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11615464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773014","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":"Persistent lateral elbow pain from overlooked posterolateral impingement of the elbow: a literature review and guidance for treatment.","authors":"Gur-Aziz Singh Sidhu, Niyam Amanullah, Harjot Kaur, Saphalya Pattnaik, Neil Ashwood, Andrew Peter Dekker, Harpal Singh Selhi","doi":"10.5397/cise.2023.01081","DOIUrl":"10.5397/cise.2023.01081","url":null,"abstract":"<p><p>Posterolateral impingement is sometimes diagnosed as a cause of refractory elbow pain, often after other treatments have been tried for common conditions such as lateral epicondylitis (tennis elbow) or subtly different conditions common in throwing athletes, such as valgus extension overload syndrome. Arthroscopic surgical treatment is effective when targeting abnormal anatomy such as plical folds. Partial excision of the olecranon must be undertaken with caution because it can lead to instability. This systematic review of the current literature uses a narrative synthesis to identify anatomical morphological variations of the olecranon, humeral and capitellar geometry, and overloading of the lateral part of the elbow as causative factors for this condition and discusses how arthroscopic techniques can resolve symptoms. Further understanding of the static and dynamic anatomy of the lateral part of the elbow will help to develop future treatment and preventive strategies.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"487-495"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11615467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976820","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":"Is partial excision of the radial head safe and effective in all-arthroscopic treatment of terrible triad fractures?","authors":"Hyung Gyu Cho, Gyeong Hoon Lim, Min Su Joo, Jae Won Kim, Jun Ho Park, Jeong Woo Kim","doi":"10.5397/cise.2024.00703","DOIUrl":"10.5397/cise.2024.00703","url":null,"abstract":"<p><strong>Background: </strong>Our study aimed to evaluate the clinical and radiologic results of all-arthroscopic treatment of terrible triad injuries followed-up for a minimum of 5 years and investigate how arthroscopic partial excision for radial head fractures affects the results at the final follow-up.</p><p><strong>Methods: </strong>We retrospectively reviewed consecutive patients with terrible triad injuries who underwent all-arthroscopic treatment between January 2011 and June 2018. In group I, we performed conservative or arthroscopic fixation of stable radial head fractures, while in group II, arthroscopic partial excision of unstable radial head fractures involving <30%-50% of the articular surface area was performed. Clinical outcomes were measured by visual analog scale score and assessment of instability, range of motion (ROM), and Mayo Elbow Performance Score. Radiological outcomes were evaluated using x-rays, and the integrity of the repaired lateral collateral ligament complex was confirmed through magnetic resonance imaging.</p><p><strong>Results: </strong>Thirty-two patients with an average age of 49.5±16.2 years met the inclusion criteria and were followed-up for a mean of 82.7±22.2 months. Twenty patients were assigned to group I and 12 patients to group II. Clinical outcomes showed no significant differences between the two groups at the final follow-up (P>0.05). On radiological evaluation, more heterotopic ossifications were found in the radial head excision group (group II, 66.7% vs. group I, 35%; P=0.02); however, there was no significant difference in ROM between the two groups (P>0.05).</p><p><strong>Conclusions: </strong>In all-arthroscopic treatment of terrible triad injuries, arthroscopic partial excision of the radial head did not seem to have a significant impact on elbow joint stability. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"454-463"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11615460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629620","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":"The impact of supraspinatus tear on subscapularis muscle atrophy and fatty infiltration.","authors":"Su Cheol Kim, Seung Jin Yoo, Je Hyeong Jo, Jong Hyun Lee, Eugene Baek, Sang Min Lee, Jae Chul Yoo","doi":"10.5397/cise.2024.00521","DOIUrl":"10.5397/cise.2024.00521","url":null,"abstract":"<p><strong>Background: </strong>Aimed to report the prevalence and predisposing factors affecting subscapularis muscle atrophy and fatty infiltration (MAFI) in patients without a subscapularis tear, and to analyze the effect of this condition on surgical outcomes.</p><p><strong>Methods: </strong>Between 2020 and 2022, 153 patients (mean age 58.1 ± 10.2 years; 84 men and 69 women) who underwent repair of posterosuperior cuff tears, with no subscapularis tears identified during arthroscopy were retrospectively analyzed. Baseline characteristics, preoperative and follow-up (6 months) magnetic resonance imaging findings, arthroscopic findings, and clinical outcomes (>1 year) were recorded.</p><p><strong>Results: </strong>The prevalence of subscapularis MAFI (Goutallier grade 1 or 2) was 73.9% (113/153), of which the prevalence of Goutallier grade 2 was 23.5% (36/153). From multivariable logistic regression analysis, female sex (odds ratio [OR], 5.6; 95% CI, 1.7-18.6; P=0.005), older age (OR, 1.1; 95% CI, 1.0-1.1; P=0.052), advanced supraspinatus MAFI by Goutallier grade (OR, 3.2; 95% CI, 1.5-6.9; P=0.004), and synovitis (OR, 2.8; 95% CI, 1.1-7.9; P=0.030) were identified as independent predisposing factors for subscapularis MAFI. However, patients with preoperative subscapularis MAFI exhibited similar final range of motion, pain and function, and belly press strength compared to those without preoperative subscapularis MAFI.</p><p><strong>Conclusions: </strong>Subscapularis MAFI is frequently observed conditions even in the absence of subscapularis tears, and this condition could be affected by supraspinatus MAFI, female sex, older age, and synovitis. However, because subscapularis MAFI does not affect the surgical outcome, surgeons need not be concerned about this condition when repairing posterosuperior rotator cuff tear. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"437-446"},"PeriodicalIF":1.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11615468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669207","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}