Clinics in Shoulder and Elbow最新文献

{"title":"Total shoulder arthroplasty versus hemiarthroplasty for humeral head avascular necrosis: a meta-analysis.","authors":"Guy Awad, Marc Boutros, Jean-Pierre Saad, Zina Smadi, Raphael Bou Rached, Bassem Elhassan","doi":"10.5397/cise.2025.01347","DOIUrl":"10.5397/cise.2025.01347","url":null,"abstract":"<p><strong>Background: </strong>Avascular necrosis (AVN) of the humeral head can progress to joint collapse and marked functional limitation, often requiring surgical treatment. Total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) are the main surgical treatment options, but their comparative clinical value remains a topic of debate. In particular, uncertainty persists regarding how functional benefit, complication risk, and implant durability should be balanced in contemporary practice. In this meta-analysis, we compared functional outcomes, complication rates, and revision risk between TSA and HA in patients with humeral head AVN.</p><p><strong>Methods: </strong>We performed a systematic search of PubMed, Scopus, Cochrane Library, Embase, and Google Scholar from database inception through November 2025. Nine comparative studies were included. Pooled mean difference (MD) and risk ratio (RR) were calculated using fixed- or random-effects models.</p><p><strong>Results: </strong>HA was associated with significantly higher patient-reported function as measured by American Shoulder and Elbow Surgeons (ASES) scores compared with TSA (MD, 17.12; P<0.00001), whereas TSA resulted in greater external rotation (MD, -10.23°; P=0.02). HA was also associated with a significantly lower overall complication rate compared with TSA (RR, 0.33; P<0.0001). Reported complications included suture abscess, periprosthetic fracture, rotator cuff pathology, postoperative stiffness, and dislocation. Visual analog scale pain score, Simple Shoulder Test score, internal rotation, and revision rates did not differ significantly between procedures (all P>0.05).</p><p><strong>Conclusions: </strong>In humeral head AVN, HA yields higher ASES scores and fewer complications, whereas TSA results in greater external rotation. Pain and revision rates are comparable, supporting the choice of individualized procedure selection based on glenoid status and patient goals. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"252-263"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934109","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":"Acromion to greater tuberosity distance as a predictor of functional outcomes after reverse shoulder arthroplasty.","authors":"Gerald Joseph Zeng, Wai Keong Mak, Ying Hao, Denny Tjiauw Tjoen Lie","doi":"10.5397/cise.2025.01242","DOIUrl":"10.5397/cise.2025.01242","url":null,"abstract":"<p><strong>Background: </strong>Rotator cuff arthropathy is characterized by pain and pseudoparalysis, for which reverse shoulder arthroplasty (RSA) is an established treatment. Appropriate deltoid tensioning is critical to functional outcomes, yet objective radiographic surrogate measures of tensioning remain limited. This study aimed to evaluate the association between acromion to greater tuberosity distance (AGTD) as a surrogate for deltoid tension and postoperative motion, functional outcomes, and pain following RSA.</p><p><strong>Methods: </strong>We conducted an observational retrospective case series, examining 61 patients who underwent RSA. Patients were evaluated using Constant-Murley shoulder score, visual analog scale pain score, Oxford shoulder score, and the University of California, Los Angeles shoulder score. Postoperative assessments were performed at 6-month and 1-year intervals. The AGTD was measured by two independent observers based on postoperative plain radiographs.</p><p><strong>Results: </strong>Mean patient age was 69.9±8.3 years. At 1 year postoperative, significant improvements were observed in forward flexion, abduction, pain, and all functional outcome scores (all P<0.001). Spline modeling demonstrated a non-linear association between AGTD and outcomes, with superior function and lower pain observed within an intermediate AGTD range centered near 45 mm. Both shorter and longer distances were associated with less favorable results.</p><p><strong>Conclusions: </strong>In our study, an intermediate AGTD centered near 45 mm was associated with more favorable functional outcomes, whereas shorter or longer distances demonstrated poorer results. Our findings provide further confirmation that RSA is a dependable treatment option for rotator cuff arthropathy. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"244-251"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934070","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":"Double double-pulley triple row technique for arthroscopic rotator cuff repair: a technical note.","authors":"Jun Lang, Vivek Kumar Morya, Seung-Ho Oh, Jae-Chang Lee, Kyunghwan Jeon, Kyu-Cheol Noh","doi":"10.5397/cise.2026.00031","DOIUrl":"10.5397/cise.2026.00031","url":null,"abstract":"<p><p>The double double-pulley triple-row (DDPTR) technique is an arthroscopic rotator cuff repair method designed for large-to-massive reparable tears for which controlled reduction and secure medial fixation are difficult. DDPTR modifies the previously described double-pulley triple-row (DPTR) concept by adding a third medial-row anchor, allowing two independent double-pulley systems (posterior and anterior) that share a central medial anchor. After reduction with a middle-row knotless anchor, two lateral knotless anchors complete the suture-bridge construct. This Technical Note describes the indications, footprint preparation, anchor placement, and pulley suture management for DDPTR. The biomechanical and clinical advantages of this technique remain to be validated.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"302-307"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875829","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":"Statcast-based evaluation of postoperative performance in Major League Baseball position players following ulnar collateral ligament surgery: a retrospective case-control study.","authors":"Benjamin W King, Evan P Bailey, Jesse Seilern Und Aspang, Kyle Hammond, Richard M Danilkowicz","doi":"10.5397/cise.2025.01361","DOIUrl":"10.5397/cise.2025.01361","url":null,"abstract":"<p><strong>Background: </strong>This study used Statcast-derived metrics to evaluate return to play (RTP) and performance outcomes in Major League Baseball (MLB) position players following ulnar collateral ligament (UCL) surgery.</p><p><strong>Methods: </strong>MLB position players undergoing UCL surgery between 2017 and 2024 were identified using the Tommy John List. A 1:1 age-matched control group of uninjured MLB position players was used for performance comparisons. Performance data from the two seasons before surgery and the two seasons following RTP were collected. The data included usage, offensive performance, batted ball metrics, and defensive performance.</p><p><strong>Results: </strong>Twenty-five MLB position players were confirmed to have undergone UCL surgery (UCL reconstruction=18; UCL repair=7). Twenty-one players (84%) returned to MLB competition with a mean time to RTP of 9.4±3.8 months. Players who underwent UCL repair returned significantly faster than those who underwent reconstruction (7.3±1.6 vs. 10.4±4.2 months, P=0.049). No statistically significant differences were observed between pre- and post-surgery performance across any metric for the full cohort. However, catchers demonstrated statistically significant improvements in average exit velocity and hard-hit percentage compared to both preoperative performance (exit velocity: P=0.04; hard-hit percentage: P=0.03) and matched controls (exit velocity: P=0.046; hard-hit percentage: P=0.04).</p><p><strong>Conclusions: </strong>MLB position players return to competition at a high rate following UCL surgery. Among those who return, Statcast-derived offensive and defensive metrics demonstrate that postoperative changes in performance are minimal and statistically insignificant. Interestingly, catchers demonstrated paradoxical improvements in both postoperative average exit velocity and hard-hit percentage. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"174-182"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469565","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":"Comparison of ultrasound-guided dry needling and platelet-rich plasma injection in the management of refractory lateral epicondyle tendinopathy.","authors":"Mustafa Mert Terzi, Yusuf Kıratlıoğlu, Uğur Bezirgan, Mehmet Armangil","doi":"10.5397/cise.2025.01389","DOIUrl":"10.5397/cise.2025.01389","url":null,"abstract":"<p><strong>Background: </strong>This prospective randomized study aimed to compare the clinical effectiveness of ultrasound-guided dry needling and platelet-rich plasma injections in patients with refractory lateral epicondyle tendinopathy.</p><p><strong>Methods: </strong>Fifty patients (25 in each group) diagnosed with refractory lateral epicondyle tendinopathy were randomized to receive either ultrasound-guided dry needling or platelet-rich plasma injection. Patients were evaluated before treatment and at 1, 3, and 6 months after the intervention using the visual analog scale, the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire, the Patient-Rated Tennis Elbow Evaluation, and grip strength measurements. All procedures were performed under continuous ultrasound guidance.</p><p><strong>Results: </strong>Both groups showed significant improvements in pain, function, and grip strength over time. There were no significant differences in grip strength between the groups at any time point. However, patients treated with platelet-rich plasma showed superior outcomes in pain and functional scores, particularly at the 6-month follow-up. No complications were observed in any of the patients.</p><p><strong>Conclusions: </strong>Both ultrasound-guided dry needling and platelet-rich plasma injections are effective options for refractory lateral epicondyle tendinopathy. Platelet-rich plasma may offer greater clinical benefit, particularly in pain reduction and functional improvement. Further research with larger cohorts is required to establish optimal treatment protocols. Level of evidence: I.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"236-243"},"PeriodicalIF":2.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147782896","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":"Superior versus anteroinferior plating for displaced midshaft clavicle fractures: a systematic review and meta-analysis of union, function, and complications.","authors":"Justin Le, Faisal Al Taie, Tien Lam, Benjamin Hershfeld, Adam D Bitterman, Randy M Cohn","doi":"10.5397/cise.2025.01179","DOIUrl":"10.5397/cise.2025.01179","url":null,"abstract":"<p><strong>Background: </strong>Fixation of clavicular shaft fractures carries risks of nonunion, infection, and functional loss. Although superior and anteroinferior plating have widely been studied, the optimal approach remains debated. Previous literature has relied on indirect comparisons and been limited by early study cutoffs, high heterogeneity, and omission of key outcomes. This meta-analysis directly compared union, function, and complications between superior and anteroinferior plating.</p><p><strong>Methods: </strong>This review followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Eligible studies included randomized trials or prospective/retrospective cohort studies of adults. Outcomes of interest included the Disabilities of the Arm, Shoulder, and Hand (DASH) score; Constant-Murley score; and complications (plate removal, infection, nonunion). Risk of bias was assessed using the Risk of Bias in Nonrandomized Studies of Interventions or Cochrane Risk of Bias 2.0 tool, and certainty of evidence was determined with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Analyses were performed in Review Manager 5.4 (Cochrane).</p><p><strong>Results: </strong>Twelve studies (n=980) were included. Constant-Murley scores did not differ significantly (mean difference [MD]=-1.19; 95% CI, -3.18 to 0.81; P=0.24). Beginning at 2 years, DASH scores showed no difference (MD=1.62; 95% CI, -0.46 to 3.70; P=0.13). Times-tounion (MD=0.41; 95% CI, -0.60 to 1.43; P=0.42) and rates of nonunion (odds ratio [OR]=2.42; 95% CI, 0.59-9.94; P=0.22) were comparable. Plate removal (OR=1.16; 95% CI, 0.82-1.65; P=0.41) and infection (OR=0.81; 95% CI, 0.32-2.06; P=0.66) also showed no significant differences. Heterogeneity was minimal (I2=0).</p><p><strong>Conclusions: </strong>Superior and anteroinferior plating of midshaft clavicle fractures provide comparable union rates, functional outcomes, and complication rates. Selection of the surgical approach should depend on fracture morphology, surgeon preference, and patient-specific factors. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"29 1","pages":"60-72"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310722","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":"Presence of cardiac implantable electronic devices is associated with increased risk of perioperative complications following shoulder arthroplasty.","authors":"Tarishi Parmar, Akin A Adio, Peter Boufadel, Favian Su, Mohammad Daher, Joseph A Abboud","doi":"10.5397/cise.2025.01333","DOIUrl":"10.5397/cise.2025.01333","url":null,"abstract":"<p><strong>Background: </strong>Patients with cardiac implantable electronic devices (CIEDs) increasingly present for elective orthopedic procedures. In this study we evaluate peri-operative complications associated with CIED presence using a large multicenter database.</p><p><strong>Methods: </strong>Retrospective cohort analysis was performed using the TriNetX database. Adults undergoing primary total shoulder arthroplasty (TSA) between 2005 and 2025 were identified and stratified by CIED status. Four propensity score-matched (1:1) analyses were conducted: all TSA patients with versus without CIEDs, (2) patients with cardiac disease with CIED versus without CIEDs, and patients with recent device implantation (<6 months before TSA) versus patients with remote device implantation (>6 months before TSA). Matching balanced demographic factors and comorbidities. Outcomes included 90-day and 2-year complications. Relative risks, 95% CIs, and P-values were calculated using chi-square and t-tests; significance was set at P<0.05.</p><p><strong>Results: </strong>After matching, 6,931 patients were included per cohort. CIED presence was associated with significantly higher 90-day rates of cardiac, renal, infectious, and neurologic complications, as well as increased mortality, readmissions, and emergency department visits. These associations persisted after controlling for underlying cardiac disease. Patients undergoing TSA within 6 months of device implantation experienced higher rates of complications. Revision rates were not significantly different between groups, and mechanical outcome associations were variable.</p><p><strong>Conclusions: </strong>CIED presence was associated with increased systemic complications following TSA, particularly when surgery occurred within 6 months of device implantation. Mechanical outcome differences were less consistent. These findings indicate the necessity of multidisciplinary perioperative planning, thoughtful surgical timing, and prospective studies to better define underlying risk pathways. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"29 1","pages":"96-104"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310732","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":"Impact of routine upright clavicle radiographs on clavicle fracture management.","authors":"Joshua Ungar, Andrew Burcke, Saksham Pruthi, Sahand Fallahi, Beau Chandler, Andrew Schlager, Thomas Revak","doi":"10.5397/cise.2025.01109","DOIUrl":"10.5397/cise.2025.01109","url":null,"abstract":"<p><strong>Background: </strong>We aimed to determine whether increased vertical displacement on upright clavicle radiographs (UCR) compared with supine clavicle radiographs (SCR) influenced the decision to operate.</p><p><strong>Methods: </strong>Adult patients with clavicle fractures identified on initial SCR or computed tomography scans during primary evaluation at a level 1 trauma center from July 2021 to November 2023 were included. The patients also underwent UCR. Exclusion criteria were patients with chronic or pathologic fractures, inadequate imaging, or incomplete documentation. Increases in vertical displacement from SCR to UCR were measured, and we recorded how often these increases on UCR prompted surgical management.</p><p><strong>Results: </strong>Overall, 160 patients (average age 47.0 years; 70% male) met the inclusion criteria. Most of the study population was managed nonoperatively (90%), with only 16 patients (10%) managed surgically. Only two of the 160 patients (1.3%) underwent surgical intervention based primarily on increased vertical displacement on UCR. With an average change of 4.5 mm (95% CI, 3.5-6.6 mm) between SCR and UCR for patients managed nonoperatively, and 5.1 mm (95% CI, 2.7-7.5 mm) for those managed operatively. There was no significant difference in management based on UCR (P=0.71). Subgroup analysis, stratifying patients by either ≥1 cm or <1 cm of displacement, found there was still no statistically significant change in SCR and UCR (P=0.44).</p><p><strong>Conclusions: </strong>Inpatient UCR rarely alters the management of clavicle fractures at our institution, indicating that its use is best reserved for case-by-case consideration. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"52-59"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182791","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":"Parsonage-Turner syndrome: current perspectives on etiology, diagnosis, and management.","authors":"Mohamad Y Fares, Akshay Khanna, Ryan Stadler, Jack Mao, Peter Boufadel, Evangeline F Kobayashi, Joseph A Abboud","doi":"10.5397/cise.2025.00885","DOIUrl":"10.5397/cise.2025.00885","url":null,"abstract":"<p><p>Parsonage-Turner syndrome (PTS) is an underdiagnosed condition that presents with debilitating symptoms in affected patients, with reported incidence rates varying between 1.64 and 3 per 100,000 individuals. Clinical presentation often includes acute shoulder pain associated with neurological deficits that do not follow a regular diagnostic pattern. The cause of this disease is not fully understood, but it is generally triggered by an upper respiratory infection a few weeks prior to presentation. Other associated risk factors include genetic predisposition, vaccines, and surgical intervention. Diagnosis often relies on clinical investigation, holistic physical exam, and appropriate diagnostic studies. Treatment is often conservative, in the form of physical rehabilitation and pain management to avoid muscular atrophy. The condition generally resolves over time, with a recovery rate of 65% at 10 months and a favorable prognosis for most cases. However, recurrences are noted, especially in patients with a genetic predisposition to the condition (75% in the hereditary form vs. 26% in the general form). Future research should explore the pathophysiological processes behind this disease to extrapolate strategies that can achieve an earlier diagnosis and more effective treatment.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"29 1","pages":"161-169"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345363","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":"Concomitant subscapularis tendon repair in reverse total shoulder arthroplasty and assessment of superior migration of reattachment: a cadaveric biomechanical study.","authors":"Yong Bok Park, Su Cheol Kim, Michelle H McGarry, Thay Q Lee, Jae Chul Yoo","doi":"10.5397/cise.2025.00675","DOIUrl":"10.5397/cise.2025.00675","url":null,"abstract":"<p><strong>Background: </strong>Concomitant repair of the subscapularis (SSC) tendon in reverse total shoulder arthroplasty (RTSA) with a lateralized design remains controversial. The present study aimed to evaluate the effect of SSC repair (repair at native insertion, repair at superiorly migrated position, and no repair) on the glenohumeral arc of motion following RTSA in a cadaveric biomechanical setting.</p><p><strong>Methods: </strong>RTSA was performed on eight cadaveric shoulders under six testing conditions as follows: unrepaired SSC/intact teres minor (TM); intact SSC/intact TM; superiorly repaired SSC/intact TM; unrepaired SSC/deficient TM; intact SSC/deficient TM; and superiorly repaired SSC/deficient TM. Increasing load (2.5-N increments) was applied to the middle deltoid (anterior, posterior; 10 N each, middle; 10- 20 N). The resulting abduction and rotation positions were measured.</p><p><strong>Results: </strong>Unrepaired SSC demonstrated greater abduction and reduced internal rotation (IR), whereas SSC repair increased IR, particularly in TM-deficient models. Superiorly repaired SSC had higher glenohumeral abduction and IR than original SSC repair. SSC repair caused excessive IR in the TM deficiency seen with massive rotator cuff tears.</p><p><strong>Conclusions: </strong>Concomitant SSC repair in lateralized RTSA decreased glenohumeral abduction and increased IR. Concomitant SSC repair at the original and superiorly migrated footprints should be carefully considered following lateralized RTSA. Level of evidence: V.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"10-19"},"PeriodicalIF":2.5,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744282","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}