Clinics in Shoulder and Elbow最新文献_第7页

Frozen shoulder: a narrative review of current treatment concepts and the underlying scientific evidence. 肩周炎：当前治疗概念和基础科学证据的叙述性回顾。

IF 1.7

Clinics in Shoulder and Elbow Pub Date : 2025-12-01 Epub Date: 2025-11-13 DOI: 10.5397/cise.2025.00220

Jun-Young Kim, Nitesh Gahlot, Hyung Bin Park

引用次数: 0

Effects of tear size on outcomes after acellular dermal matrix-augmented rotator cuff repair. 撕裂大小对脱细胞真皮基质增强肩袖修复术后疗效的影响。

IF 1.7

Clinics in Shoulder and Elbow Pub Date : 2025-12-01 Epub Date: 2025-10-02 DOI: 10.5397/cise.2025.00745

Ji-Hun Park, Jung-Han Kim, Hyung-Jun Koo

{"title":"Effects of tear size on outcomes after acellular dermal matrix-augmented rotator cuff repair.","authors":"Ji-Hun Park, Jung-Han Kim, Hyung-Jun Koo","doi":"10.5397/cise.2025.00745","DOIUrl":"10.5397/cise.2025.00745","url":null,"abstract":"Background: Acellular dermal matrix (ADM) patch augmentation in rotator cuff repair reinforces the repaired tendon and provides additional structural support. This study aimed to compare outcomes based on rotator cuff tear size.Methods: We retrospectively reviewed patients who underwent ADM-augmented rotator cuff repair at two hospitals between April 2021 and April 2023. After excluding subjects with <2 years of follow-up or no magnetic resonance imaging (MRI) at 6 months, patients were grouped based on tear size: ≤30 mm (group 1) and >30 mm (group 2). Outcomes were American Shoulder and Elbow Surgeons score, Constant-Murley score, University of California, Los Angeles score, pain visual analog scale score, and range of motion (ROM). Retear was defined based on Sugaya type 4-5 on 6-month MRI.Results: Both groups showed significant improvement in postoperative clinical outcomes compared with preoperative outcomes, with no significant intergroup differences. ROM gains were limited overall, with significant increases only in group 1 for forward flexion and scaption. Stiffness occurred in 4.8% of group 1 and 17.9% of group 2 patients. Retear was found in 1 of 21 patients (4.8%) in group 1 and 7 of 28 (25.0%) in group 2.Conclusions: Arthroscopic rotator cuff repair with ADM patch augmentation showed reduced retear rates and improved clinical outcomes across tear sizes. Postoperative ROM improvements were limited, and stiffness tended to occur more frequently in larger tears. Thus, the success of ADM patch augmentation depends on patient selection and appropriate graft application. Level of evidence: III.","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"437-445"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12698345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207912","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}

引用次数: 0

Arm positions with increased risk of subscapularis external impingement at the subcoracoid arch. 臂位与肩胛下肌外撞击在喙下弓的风险增加。

IF 1.7

Clinics in Shoulder and Elbow Pub Date : 2025-12-01 Epub Date: 2025-11-21 DOI: 10.5397/cise.2025.00213

Su Cheol Kim, Michelle H McGarry, Thay Q Lee, Jae Chul Yoo

{"title":"Arm positions with increased risk of subscapularis external impingement at the subcoracoid arch.","authors":"Su Cheol Kim, Michelle H McGarry, Thay Q Lee, Jae Chul Yoo","doi":"10.5397/cise.2025.00213","DOIUrl":"10.5397/cise.2025.00213","url":null,"abstract":"Background: A cadaveric biomechanical study was used to analyze arm positions that could lead to increased risk of subscapularis tears due to subcoracoid impingement.Methods: Six cadaveric shoulders (two male and four female; mean age, 68.4±2.3 years) were evaluated for subcoracoid external impingement using a custom shoulder testing system with a pressure-mapping sensor. The contact area and the mean and peak contact pressures between the subcoracoid arch and the subscapularis complex were measured. Eight arm positions were assessed, including 20° and 60° forward flexion (FF) and abduction (ABD) with maximal internal rotation (IR) and external rotation (ER).Results: The overall incidence of subcoracoid impingement was 52.1% across all tests, with no contact observed at 20° ABD in the maximal IR position. Except for 20° ABD with maximal IR, the mean contact area significantly differed across the seven arm positions (P=0.009). However, mean and peak contact pressures did not show significant differences (P=0.188 and P=0.065, respectively). The highest mean contact pressure was recorded at 60° ABD with maximal ER (25.7±17.4 kPa), followed by 20° FF with maximal IR (23.2±12.5 kPa), 60° FF with maximal IR (18.2±8.3 kPa), and 60° ABD with maximal IR (18.3±12.0 kPa). The contact area and peak contact pressure exhibited similar trends to mean contact pressure.Conclusions: This cadaveric study demonstrated increased subcoracoid arch contact when shoulders were at 20° and 60° FF with IR and at 60° ABD with both ER and IR. These findings suggest potential external subscapularis impingement in these positions, although not all comparisons were statistically significant. Level of evidence: Cadaveric biomechanical study.","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"28 4","pages":"480-488"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12698352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726397","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}

引用次数: 0

Life devoted to healing: remembering a pioneer who never stopped serving. 一生致力于治疗：纪念一位从未停止服务的先驱。

IF 1.7

Clinics in Shoulder and Elbow Pub Date : 2025-12-01 Epub Date: 2025-11-28 DOI: 10.5397/cise.2025.01095

Hyung Bin Park, Kyu-Hak Jung

引用次数: 0

Corticosteroid infiltration in partial distal biceps ruptures. 二头肌远端部分破裂的皮质类固醇浸润。

IF 1.7

Clinics in Shoulder and Elbow Pub Date : 2025-12-01 Epub Date: 2025-11-21 DOI: 10.5397/cise.2025.00647

Elisabeth A Wörner, Elisa L Zwerus, Ante Prkic, Femke M A P Claessen, Bertram The, Denise Eygendaal

{"title":"Corticosteroid infiltration in partial distal biceps ruptures.","authors":"Elisabeth A Wörner, Elisa L Zwerus, Ante Prkic, Femke M A P Claessen, Bertram The, Denise Eygendaal","doi":"10.5397/cise.2025.00647","DOIUrl":"10.5397/cise.2025.00647","url":null,"abstract":"Background: Little is known about the potential negative or positive effects of peritendinous infiltration with corticosteroids in the non-surgical treatment of partial distal biceps tendon tears. Peritendinous fluid, synovitis, and bursitis often accompany partial tears and can be a source of persistent pain. We hypothesize that peritendinous corticosteroid infiltration is a safe non-surgical treatment option for complaints related to a partial distal biceps tendon rupture.Methods: A single-center retrospective analysis was performed on a cohort of 52 patients with partial distal biceps tears (<50% of the footprint involved), as confirmed by magnetic resonance imaging. All patients received an ultrasound-guided intrabursal peritendinous infiltration with 1 mL of triamcinolone acetonide (10 mg/mL) and 4 mL of 2% lidocaine HCl. Patient files were reviewed for demographic information, date of injury, injury mechanism, treatment modality (operative or nonoperative), clinical follow-up (2011-2021), and complications, including progression to a complete rupture.Results: The median duration of follow-up after infiltration was 15 months (1.2-45 months). No infiltration-related complications were observed following infiltration therapy. Surgical reconstruction was ultimately performed in 65% of the patients with a partial tear. One patient sustained a trauma to the elbow in the weeks following infiltration, resulting in a complete tear.Conclusions: Infiltration with corticosteroids is a safe treatment option for patients with a partial tear of the distal biceps who failed progressive exercise therapy. Surgical reconstruction was avoided in 35% of patients following infiltration treatment. Level of evidence: IV.","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"28 4","pages":"475-479"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12698355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145726461","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}

引用次数: 0

Outcome comparison of lower trapezius tendon transfer and arthroscopic rotator cuff tear repair using muscle advancement for massive rotator cuff tear: a systematic review. 下斜方肌腱转移和关节镜下肩袖撕裂肌推进修复大面积肩袖撕裂的疗效比较：一项系统综述。

IF 2.5

Clinics in Shoulder and Elbow Pub Date : 2025-12-01 Epub Date: 2025-09-11 DOI: 10.5397/cise.2025.00171

Jun Lang, Vivek Kumar Morya, Kyu-Cheol Noh

{"title":"Outcome comparison of lower trapezius tendon transfer and arthroscopic rotator cuff tear repair using muscle advancement for massive rotator cuff tear: a systematic review.","authors":"Jun Lang, Vivek Kumar Morya, Kyu-Cheol Noh","doi":"10.5397/cise.2025.00171","DOIUrl":"10.5397/cise.2025.00171","url":null,"abstract":"Background: This systematic review evaluates the clinical outcomes of two distinct, arthroscopic techniques for the surgical repair of massive rotator cuff tears; lower trapezius tendon (LTT) transfer and muscle advancement (MA).Methods: Eleven studies, involving 433 patients, selected based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, were analyzed.Results: MA significantly improves functional outcomes, demonstrated by higher Constant-Murley scores (mean difference: 26.26 vs. 18.31, P<0.001), University of California, Los Angeles shoulder scores (14.95 vs. 8.3, P<0.001), acromiohumeral distance (AHD; 1.94 mm vs. 0.40 mm, P<0.001), and greater abduction recovery (46.48° vs. 31.86°, P=0.030). However, visual analog scale score was better reduced in the LTT transfer groups (-3.69 vs. -2.33, P<0.001), with greater external rotation improvement (25.67° vs. 7.74°, P<0.001) and lower retear rates (11.89% vs. 19.42%, P=0.031). The complication profiles differed between techniques: LTT transfer carried a higher risk of graft rupture (2.64% vs. 0%, P=0.031), while arthroscopic MA was associated with increased postoperative stiffness (2.91% vs. 0%, P=0.011).Conclusions: Arthroscopic MA is recommended for younger, active patients with mobile residual tissue to optimize abduction and AHD restoration. In contrast, LTT transfer is better suited for cases involving massive defects requiring dynamic stabilization and external rotation recovery. These findings emphasize the importance of individualized surgical planning that considers tear severity, tissue viability, and patient functional demands. Despite limitations stemming from retrospective study designs and clinical heterogeneity, this review highlights the distinct clinical advantages and appropriate indications for both techniques.","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"504-516"},"PeriodicalIF":2.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12698359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207844","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}

引用次数: 0

Midshaft clavicular fractures in adolescents: a comprehensive review of diagnosis and management. 青少年锁骨中轴骨折：诊断和治疗的综合综述。

IF 1.7

Clinics in Shoulder and Elbow Pub Date : 2025-12-01 Epub Date: 2025-09-18 DOI: 10.5397/cise.2025.00500

Heather L MacEwen, Michael Morell, Scott Feeley, Nicholas Lopreiato, Chris Renninger, Daniel Song

{"title":"Midshaft clavicular fractures in adolescents: a comprehensive review of diagnosis and management.","authors":"Heather L MacEwen, Michael Morell, Scott Feeley, Nicholas Lopreiato, Chris Renninger, Daniel Song","doi":"10.5397/cise.2025.00500","DOIUrl":"10.5397/cise.2025.00500","url":null,"abstract":"Midshaft clavicular fractures account for approximately 80% of all clavicle fractures in pediatric and adolescent populations and represent up to 15% of all fractures in adolescents. These injuries commonly result from falls, sports-related trauma, or motor vehicle accidents, with adolescent males experiencing fractures at rates up to three times higher than females. This review examines the diagnosis, classification, and management of these fractures, highlighting the nuances between pediatric and adult treatment approaches. Historically, nonoperative management has been favored, leveraging the adolescent clavicle's remodeling capacity. Recent trends reflect increasing operative interventions, driven by adult studies demonstrating faster recovery and improved functional outcomes in displaced fractures. While nonoperative treatment, using slings or figure-of-8 braces, remains effective for most cases, operative fixation, including open reduction and internal fixation or elastic stable intramedullary nailing, is indicated for open fractures, neurovascular injury, or significant displacement. Studies demonstrate high union rates with both methods, but operative treatment offers quicker return to activity, albeit with higher risks of hardware- related complications. The Function after Adolescent Clavicle Trauma and Surgery study notably supports nonoperative management, showing similar long-term functional outcomes compared to operative treatment. Future research should focus on refining patient-reported outcome measures specific to adolescents and identifying subsets of patients who may benefit from surgery. Shared decision-making remains crucial for optimal patient-centered care.","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"495-503"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12698346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207857","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}

引用次数: 0

Arcuate osteoplasty for brachial plexus paralysis after plate fixation of mid-clavicle fracture: a case report and literature review. 弓形成形术治疗锁骨中段骨折钢板固定后臂丛麻痹1例并文献复习。

IF 1.7

Clinics in Shoulder and Elbow Pub Date : 2025-09-01 Epub Date: 2025-03-20 DOI: 10.5397/cise.2024.00717

Dongju Shin, Jae Hwi Han

引用次数: 0

Current comorbidity indices inadequately identify patients who experience early adverse outcomes following total shoulder arthroplasty. 目前的合并症指数不能充分识别全肩关节置换术后早期不良后果的患者。

IF 1.7

Clinics in Shoulder and Elbow Pub Date : 2025-09-01 Epub Date: 2025-08-26 DOI: 10.5397/cise.2025.00584

Alexander R Zhu, Eve R Glenn, Laurence Okeke, James H Padley, Edward G McFarland

{"title":"Current comorbidity indices inadequately identify patients who experience early adverse outcomes following total shoulder arthroplasty.","authors":"Alexander R Zhu, Eve R Glenn, Laurence Okeke, James H Padley, Edward G McFarland","doi":"10.5397/cise.2025.00584","DOIUrl":"10.5397/cise.2025.00584","url":null,"abstract":"Background: Patient-related outcomes are increasingly emphasized in anatomic (ATSA) or reverse total shoulder arthroplasty (RTSA). Identifying patients at risk of adverse outcomes is key to mitigating complications. Comorbidity indices such as the American Society of Anesthesiologists Physical Status (ASA), classification, modified Charlson Comorbidity Index (mCCI), Elixhauser Comorbidity Measure (ECM), and 5-Factor Modified Frailty Index (mFI-5) can predict postoperative complications but were developed primarily for inpatient populations. Whereas studies have assessed these indices for total joint arthroplasty, few have assessed their performance for complications following TSA. This study compared their prognostic values for 30-day adverse outcomes after TSA.Methods: Using the National Surgical Quality Improvement Program database, 39,810 patients who underwent ATSA or RTSA (2011- 2022) were analyzed. Logistic regression evaluated six outcomes: non-home discharge, length of stay greater than 1 day, major or minor complications, readmission, and mortality. Predictive performance was assessed using the concordance statistic (C statistic), where values greater than 0.7 indicate good discrimination and those greater than 0.8 indicate excellent discrimination.Results: Of all the indices, only the mCCI was a good predictor of non-home discharge (C statistic, 0.713; 95% CI, 0.705-0.722). The ASA, ECM, and mFI-5 demonstrated limited predictive value for all outcomes.Conclusions: Among the indices analyzed, only the mCCI demonstrated acceptable predictive accuracy and only for discharge destination. None of the indices effectively identified patients at risk for adverse outcomes, underscoring the need for a TSA-specific scoring system. Level of evidence: III.","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"28 3","pages":"342-351"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145597536","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}

引用次数: 0

Allograft-prosthetic composite versus megaprosthesis for proximal humerus reconstruction after tumor resection: a meta-analysis of clinical outcomes. 同种异体复合假体与巨型假体在肿瘤切除后肱骨近端重建中的应用：临床结果的荟萃分析。

IF 1.7

Clinics in Shoulder and Elbow Pub Date : 2025-09-01 Epub Date: 2025-08-26 DOI: 10.5397/cise.2025.00388

Mohammad Daher, Mohamad Y Fares, Steve S Gill, Peter Boufadel, Andrew R Jensen, William C Eward, Adam Z Khan, John G Horneff, Joseph A Abboud

{"title":"Allograft-prosthetic composite versus megaprosthesis for proximal humerus reconstruction after tumor resection: a meta-analysis of clinical outcomes.","authors":"Mohammad Daher, Mohamad Y Fares, Steve S Gill, Peter Boufadel, Andrew R Jensen, William C Eward, Adam Z Khan, John G Horneff, Joseph A Abboud","doi":"10.5397/cise.2025.00388","DOIUrl":"10.5397/cise.2025.00388","url":null,"abstract":"Background: Allograft prosthetic composite (APC) and megaprosthesis (MP) have both been used to reconstruct the proximal humerus after its resection due to primary or secondary tumors. However, varied results have been reported in the literature with no consensus on which reconstruction has better overall outcomes.Methods: PubMed, Cochrane, and Google Scholar (pages 1-20) were queried through September 2024. The compared outcomes consisted of adverse events, patient-reported outcomes measures, and range of motion. Ten studies and 400 patients were included, with 115 in the APC group and 285 in the MP group.Results: The APC group had a higher rate of reoperations (odds ratio, 2.50; 95% CI, 1.40-4.45; P=0.002) than did the MP group over an average follow-up of 7.0 years. However, better postoperative flexion (mean difference, 10.11; 95% CI, 5.33-14.90; P<0.001) and Musculoskeletal Tumor Society scores (mean difference, 3.73; 95% CI, 1.37- 6.08; P=0.002) were seen in the APC group.Conclusions: The present study shows a lower rate of revision with the use of MP but better functional outcomes and forward flexion with APC as the surgical option for proximal humerus reconstruction. Level of evidence: III.","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":" ","pages":"298-305"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754601","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}

引用次数: 0