{"title":"Arthroscopic matched osteoplasty of the radial head for painful radiocapitellar osteoarthritis: surgical technique and case series.","authors":"Dani Rotman, Adam C Watts","doi":"10.5397/cise.2024.00073","DOIUrl":"10.5397/cise.2024.00073","url":null,"abstract":"<p><strong>Background: </strong>Radiocapitellar arthritis can cause pain, loss of motion, and impaired elbow function. Current surgical treatment options are limited. We have developed an original and simple surgical technique to address this, called arthroscopic matched osteoplasty of the radial head (AMOR). In AMOR, the radial head is partially resected and recontoured to match the capitellum and decompress the degenerate radiocapitellar articulation while preserving the ulnohumeral articulation where the cartilage is usually well preserved.</p><p><strong>Methods: </strong>Indications and the surgical technique of the AMOR procedure are described. A retrospective observational service evaluation study was conducted from electronic patient records. Collected clinical outcomes included range of motion, pain level, subjective functional score, and general satisfaction with the results of the procedure. The radiographic outcome was radiocapitellar joint space.</p><p><strong>Results: </strong>Between 2017 and 2021, eight consecutive patients underwent AMOR as part of an arthroscopic osteocapsular arthroplasty procedure. Radiographically, the mean radiocapitellar joint space improved from an average of 1.7 mm to 4.6 mm. Clinically, the mean pain score decreased from 8/10 to 3/10. Six of the eight patients (75%) were satisfied with their results. In two cases, initial improvement following surgery lasted less than 1 year, and one of these patients underwent total elbow arthroplasty for painful ulnohumeral osteoarthritis. There were no complications of surgery recorded.</p><p><strong>Conclusions: </strong>AMOR is a safe treatment option for painful radiocapitellar osteoarthritis and can be incorporated as an \"add-on\" procedure by surgeons performing elbow osteocapsular arthroplasty in cases with a positive grip and grind test and radiographic evidence of radiocapitellar OA. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"309-315"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11393442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976815","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":"Improving arthroscopic subscapularis repair: the essential role of surgical anatomical landmarks.","authors":"Sung Il Wang","doi":"10.5397/cise.2024.00577","DOIUrl":"https://doi.org/10.5397/cise.2024.00577","url":null,"abstract":"","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"27 3","pages":"269-271"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11393448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297106","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}
Chang Hee Baek, Bo Taek Kim, Jung Gon Kim, Seung Jin Kim
{"title":"Comparison of clinical outcomes of anterior combined latissimus dorsi and teres major tendon transfer for anterior superior irreparable rotator cuff tear between young and elderly patients.","authors":"Chang Hee Baek, Bo Taek Kim, Jung Gon Kim, Seung Jin Kim","doi":"10.5397/cise.2024.00248","DOIUrl":"10.5397/cise.2024.00248","url":null,"abstract":"<p><strong>Background: </strong>Anterior combined latissimus dorsi and teres major (aLDTM) tendon transfer has shown promise as a treatment for anterior superior irreparable rotator cuff tears (ASIRCTs). Our study aimed to compare aLDTM clinical outcomes for ASIRCTs between young and elderly patients.</p><p><strong>Methods: </strong>This retrospective study reviewed data from patients who underwent aLDTM tendon transfer for ASIRCTs with minimum 2-year follow-up. Clinical evaluations included visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE), active range of motion (aROM), strength, and complications. Radiologic assessments included acromiohumeral distance, Hamada classification, and integrity of transferred tendon. Patients were divided into group total (all ages), group old (≥70 years), and group young (≤60 years).</p><p><strong>Results: </strong>A total of 123 patients were enrolled with 39 in group young (mean age, 56.6±4.9 years) and 27 in group old (mean age, 73.6±2.3 years). Postoperatively, both groups showed significant improvements in VAS, ASES, and SANE scores and improved aROM for forward elevation, abduction, and internal rotation. No significant differences in clinical coutcomes were noted between the groups. Furthermore, similar rates of complications, including retears and postoperative infections, were observed across all three groups.</p><p><strong>Conclusions: </strong>Our study highlights the effectiveness of aLDTM transfer for ASIRCTs with minimal glenohumeral arthritis, demonstrating similar outcomes in both group young and group old patients. Moreover, patients in these distinct age groups showed comparable clinical results when compared to group total. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"327-337"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11393437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976816","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":"Factors associated with long head of the biceps tendon tear severity and predictive insights for grade II tears in rotator cuff surgery.","authors":"Dong-Hyun Lee, Gyu-Min Lee, Hyung Bin Park","doi":"10.5397/cise.2023.01053","DOIUrl":"10.5397/cise.2023.01053","url":null,"abstract":"<p><strong>Background: </strong>In rotator cuff repair, the long head of the biceps tendon (LHB) is commonly used as graft material. However, factors influencing LHB tear severity are poorly understood, and predicting grade II LHB tears is challenging. This study aimed to identify these factors preoperatively.</p><p><strong>Methods: </strong>The demographics, medical parameters, and pain severity of 750 patients who underwent arthroscopic surgery from January 2010 to February 2021 were evaluated to determine the factors associated with LHB tear severity and grade II tears. Both overall and largeto-massive rotator cuff tear (RCT) cohorts underwent ordinal and binary logistic regression analyses. Predictive accuracy for grade II LHB tears was determined using the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>In the overall cohort, high-sensitivity C-reactive protein (hs-CRP) >1 mg/L (P<0.001), subscapularis tear (P<0.001), hypothyroidism (P=0.031), and the tangent sign (P=0.003) were significantly associated with LHB tear severity, and hs-CRP>1 mg/L, subscapularis tear, and Patte retraction degree were significantly associated with grade II LHB tears (P<0.001). In the large-to-massive RCT cohort, hs-CRP>1 mg/L, hypertension, and age ≥50 years (P<0.05) were significantly associated with LHB tear severity, and hs-CRP>1 mg/L (P<0.001) and hypertension (P=0.026) were significantly associated with grade II LHB tears. In both cohorts, hs-CRP >1 mg/L demonstrated good predictive accuracy for grade II LHB tears (AUCs: 0.72 and 0.70).</p><p><strong>Conclusions: </strong>Serum hs-CRP >1 mg/L is associated with LHB tear severity and serves as a reliable predictor of grade II LHB tears, facilitating preoperative assessment of the LHB as potential graft material in arthroscopic rotator cuff repair. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"149-159"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913018","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 the polarity of radial head arthroplasty affect functional outcomes? A systematic review and meta-analysis.","authors":"Kofi Agyeman, Arya Minaie, Seth D Dodds","doi":"10.5397/cise.2023.01088","DOIUrl":"10.5397/cise.2023.01088","url":null,"abstract":"<p><strong>Background: </strong>Radial head arthroplasty allows a high degree of customizability, and implant polarity has emerged as an important variable. The purpose of this meta-analysis was to evaluate differences in functional and clinical outcomes between patients receiving monopolar and bipolar radial head prosthetic implants.</p><p><strong>Methods: </strong>A systematic review and meta-analysis were employed, and 65 articles were identified in three databases. Twelve articles contained non-English or insufficient text and were consequently excluded, and 20 others did not contain sufficient data or follow-up. The remaining 33 articles were qualitatively and quantitatively reviewed.</p><p><strong>Results: </strong>In total, 33 populations were identified, with 809 unduplicated patients: 565 with monopolar and 244 with bipolar implants. In these respective patients, the mean follow-up was 40.2 and 56.9 months. Average Mayo Elbow Performance Score were 86.7 and 87.4 (P=0.80), respectively; average Disability of the Arm, Shoulder, and Hand scores were 17.9 and 14.7 (P=0.47), and average final flexion/extension arcs were 119.4° and 118.7° (P=0.48). Revision rates were 4.07% and 6.56%, while complication rates were 19.65% and 20.08% in the respective monopolar and bipolar patients. These increased relative risks associated with bipolar implants were not significant.</p><p><strong>Conclusions: </strong>Radial head implant polarity does not appear to affect functional outcomes. While bipolar prosthetic design may increase the risks of revision and complications, the increases were not significant. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"141-148"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913013","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}
Ofer Levy, Georgios Arealis, Oren Tsvieli, Paolo Consigliere, Omri Lubovsky
{"title":"Reverse total shoulder replacement for patients with \"weight-bearing\" shoulders.","authors":"Ofer Levy, Georgios Arealis, Oren Tsvieli, Paolo Consigliere, Omri Lubovsky","doi":"10.5397/cise.2023.00535","DOIUrl":"10.5397/cise.2023.00535","url":null,"abstract":"<p><strong>Background: </strong>Reverse total shoulder arthroplasty (rTSA) has gained popularity in recent years and is indicated for a wide variety of shoulder pathologies. However, use of rTSA in patients with \"weight-bearing\" shoulders that support wheelchair use or crutches has higher risk. The aim of this study was to assess the results of rTSA in such patients.</p><p><strong>Methods: </strong>Between 2005 and 2014, 24 patients (30 shoulders) with weight-bearing shoulders were treated with rTSA at our unit. Patients had cuff arthropathy (n=21), rheumatoid arthritis (n=3), osteoarthritis (n=1), acute fracture (n=3), or fracture sequela (n=2). Postoperatively, patients were advised not to push themselves up and out of their wheelchair for 6 weeks. This study was performed in 2016, and 21 patients (27 shoulders) were available for a mean follow-up of 5.6 years (range, 2-10 years). The mean age at surgery was 78 years (range, 54-90 years).</p><p><strong>Results: </strong>Constant-Murley score improved from 9.4 preoperatively to 59.8 at the final follow-up (P=0.001). Pain score improved from 2/15 to 13.8/15 (P=0.001). Patient satisfaction (Subjective Shoulder Value) improved from 0.6/10 to 8.7/10 (P=0.001). Significant improvement in mean range of motion from 46° to 130° of elevation, 14° to 35° of external rotation, and 29° to 78° internal rotation was recorded (P=0.001). Final mean Activities of Daily Living External and Internal Rotation was 32.4/36. Only three patients showed Sirveaux-Nerot grade-1 (10%) glenoid notching and three grade 2 (10%).</p><p><strong>Conclusions: </strong>rTSA can be used for treatment of patients with weight-bearing shoulders. Such patients reported pain free movement, resumed daily activities, and high satisfaction rates. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"183-195"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332124","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":"Arthroscopic treatment of chronic calcific tendinitis with intraosseous migration: a case report.","authors":"Jung Uk Kim, Pei Wei Wang","doi":"10.5397/cise.2023.00654","DOIUrl":"10.5397/cise.2023.00654","url":null,"abstract":"<p><p>We present a case of calcific tendinitis in the shoulder, where calcifications were observed within both the tendon and the adjacent bone. At the time of acute onset, radiographs (including a plain radiograph) and magnetic resonance imaging revealed calcific tendinitis with intraosseous migration. The patient's symptoms did not improve after 5 months of conservative treatment. The patient underwent arthroscopic debridement of the calcific deposits, and the defect was repaired using the double-row repair technique. The patient's symptoms improved 3 months after arthroscopic treatment. We share our unusual experience with arthroscopic debridement in the treatment of chronic calcific tendinitis with intraosseous migration.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"263-266"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139672849","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}
Stijn Gcj de Joode, Ralf Walbeehm, Martijn Gm Schotanus, Ferry A van Nie, Lodewijk W van Rhijn, Steven K Samijo
{"title":"Corrigendum to: The humeral suspension technique: a novel operation for deltoid paralysis.","authors":"Stijn Gcj de Joode, Ralf Walbeehm, Martijn Gm Schotanus, Ferry A van Nie, Lodewijk W van Rhijn, Steven K Samijo","doi":"10.5397/cise.2021.00563.e1","DOIUrl":"10.5397/cise.2021.00563.e1","url":null,"abstract":"","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"267"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912993","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":"Clinics in Shoulder and Elbow achieves Scopus indexing: a milestone in our journey to excellence.","authors":"Hyung Bin Park","doi":"10.5397/cise.2024.00367","DOIUrl":"10.5397/cise.2024.00367","url":null,"abstract":"","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"137"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912989","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}
Alok Rai, Dushyant Chouhan, Sandeep Kumar Nema, Arkesh Madegowda, Rudra Narayan, Bikram K Kar
{"title":"Latarjet operation carries three times the risk of failure in seizure versus non-seizure recurrent anterior dislocation of the shoulder joint: outcome of a systematic review with meta-analysis.","authors":"Alok Rai, Dushyant Chouhan, Sandeep Kumar Nema, Arkesh Madegowda, Rudra Narayan, Bikram K Kar","doi":"10.5397/cise.2023.00948","DOIUrl":"10.5397/cise.2023.00948","url":null,"abstract":"<p><strong>Background: </strong>Recurrent anterior shoulder dislocation (RASD) in cases of seizure disorders (SDs) total 50%-80% of all SD-associated shoulder instabilities. Based on the extent of bone loss, treatment options include bony and soft-tissue reconstructions, arthroplasty, and arthrodesis. The primary objective of this paper was to review the treatment options for RASD in SDs.</p><p><strong>Methods: </strong>Several bibliographic databases were searched for RASD treatment options in SD patients. The demographic outcome measures, the failure rate (defined as the relative risk of recurrence of dislocation postoperation), and the postoperative seizure recurrence rate were recorded.</p><p><strong>Results: </strong>We pooled 171 cases (187 shoulders) from 11 studies. Of these, one, five, two, two, and one reports studied Bankart's operation with remplissage (27 cases/29 shoulders), the Latarjet procedure (106/118), bone block operation (21/23), arthroplasty (11/11), and arthrodesis (6/6), respectively, in treating SD-associated RASD. The relative risk of failure between SD and non-SD patients was 3.76 (1.3610.38) after the Latarjet operation. The failure rates were 17% and 13% for Bankart's operation with remplissage and the Latarjet procedure in SD patients, respectively, but 0% each for bone block operation, arthroplasty, and arthrodesis. The total rate of seizure recurrence after operation was 33% of the pooled cases.</p><p><strong>Conclusions: </strong>SD recurrence in the postoperative period, the size of the bone block, and the muscular attachments to a small coracoid autograft are the determinants of failure among various reconstructive operations in SD-associated RASD. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"160-168"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912997","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}