JSES International最新文献

{"title":"Radial head arthroplasty vs. open reduction and internal fixation in Mason 3 radial head fractures: meta-analysis of prospective trials","authors":"Domenico De Mauro MD ,&nbsp;Sami Abou Chakra ,&nbsp;Francesco Liuzza MD ,&nbsp;Amarildo Smakaj MD ,&nbsp;Giuseppe Rovere MD, PhD ,&nbsp;Giulio Maccauro MD (Prof.) ,&nbsp;Omar El Ezzo MD","doi":"10.1016/j.jseint.2024.08.180","DOIUrl":"10.1016/j.jseint.2024.08.180","url":null,"abstract":"<div><h3>Background</h3><div>Radial head fractures (RHF) represent about one-third of all elbow fractures, comprising approximately 2%-5% of all fractures sustained. The aims of this systematic review and meta-analysis are as follows: (i) to compare complications rate in patients undergoing radial head arthroplasty (RHA) or open reduction and internal fixation as surgical treatments for Mason type 3 RHF; (ii) to compare clinical outcome and functional score in patients undergoing RHA or ORIF in Mason type 3 RHF.</div></div><div><h3>Methods</h3><div>Following the preferred reporting items for systematic reviews and meta-analyses guidelines, a comprehensive literature systematic review of literature was conducted up to March 2024. All prospective studies were included. The analysis employed the log odds ratio (OR) and 95% confidence interval (CI) as the outcome measure.</div></div><div><h3>Results</h3><div>Six studies were incorporated into the systematic review. A total of three studies, published between 2009 and 2021, were included in the meta-analysis. A cohort of 169 patients affected by Mason 3 RHFs was collected. The ORIF group included 65 patients, and 26 events of complications after ORIF were observed. RHA group, instead, consisted of 70 patients, and 8 events of complications were identified.</div></div><div><h3>Conclusion</h3><div>Our findings reveal that the Mason type 3 RHFs treated with open reduction and internal fixation, exhibits a higher risk of complications compared to those patients treated with RHA. Moreover, the standardized mean difference analysis suggests that the ORIF group demonstrates a lower mean Broberg and Morrey Elbow score in comparison to the RHA group, with a higher functional recovery in RHA group.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 260-267"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081060","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":"Biomechanical enhancement in rotator cuff repairs: the impact of innovative nanofiber technology","authors":"James Johnson PhD ,&nbsp;Ben Gadomski PhD ,&nbsp;Daniel Regan DVM, PhD, DACVP ,&nbsp;Jed Johnson PhD ,&nbsp;Brad Nelson MS, PhD, DVM, DACVS ,&nbsp;Kirk McGilvray PhD ,&nbsp;Kevin Labus PhD ,&nbsp;Anthony Romeo MD ,&nbsp;Jeremiah Easley DVM, Dipl, ACVS","doi":"10.1016/j.jseint.2024.08.203","DOIUrl":"10.1016/j.jseint.2024.08.203","url":null,"abstract":"<div><h3>Background</h3><div>Rotator cuff repair surgeries often face high failure rates, particularly in cases involving tendon degeneration. Traditional repair techniques and devices frequently fail to adequately restore a healthy native enthesis and strong tendon-bone integration. This study investigates the efficacy of a novel, fully synthetic, bioresorbable nanofiber scaffold in restoring the native enthesis and enhancing the biomechanical properties and overall success of rotator cuff repairs, particularly in the context of chronically degenerated tendons.</div></div><div><h3>Methods</h3><div>This study used an ovine model to simulate chronic tendon degeneration with subsequent rotator cuff transection and repair. All repairs were performed using the standard double-row configuration with suture tape; half of the repairs were augmented with the bioresorbable nanofiber scaffold. Nondestructive biomechanical testing was conducted to assess the strength of the repair constructs, followed by histological analysis of all tendon samples to evaluate tissue regeneration and integration at the repair site.</div></div><div><h3>Results</h3><div>Results demonstrated that the scaffold group achieved significantly improved biomechanical properties (peak force, peak stress, equilibrium force, and equilibrium stress) compared to the suture only group, indicating enhanced repair strength and native enthesis restoration. Scaffold samples exhibited significantly decreased cross-sectional areas (ie, less fibrosis) which were similar to healthy tendons. Histological findings indicated the scaffold did not impede re-establishment of Sharpey-like fibers at the tendon insertion.</div></div><div><h3>Conclusion</h3><div>This study provides compelling evidence that the use of a fully synthetic, bioresorbable nanofiber scaffold in rotator cuff repair significantly improves biomechanical outcomes and enthesis regeneration. These improvements were achieved while retaining close to native tendon thickness. The findings suggest that this scaffold represents a significant advancement in rotator cuff repair technology, offering a promising solution to enhance repair strength and quality of bone-tendon integration, especially in challenging cases of tendon degeneration.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 116-122"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081225","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":"High and low body mass index increases the risk of short-term postoperative complications following total shoulder arthroplasty","authors":"Salvatore Capotosto MD ,&nbsp;Matthew Kim MD ,&nbsp;Kenny Ling MD ,&nbsp;Alireza Nazemi MD ,&nbsp;Ryan Tantone MD ,&nbsp;Elizabeth Wang MD ,&nbsp;David E. Komatsu PhD ,&nbsp;Edward D. Wang MD","doi":"10.1016/j.jseint.2024.08.176","DOIUrl":"10.1016/j.jseint.2024.08.176","url":null,"abstract":"<div><h3>Background</h3><div>Several studies have investigated the impact of body mass index (BMI) on total shoulder arthroplasty (TSA) outcomes and reported contrasting results. Therefore, this study aims to better understand the impact of BMI on 30-day post-TSA outcomes by performing a comprehensive risk stratification based on BMI using a large national database.</div></div><div><h3>Methods</h3><div>All patients undergoing TSA, both anatomic and reverse, between 2015 and 2019 were queried from the American College of Surgeons National Surgical Quality Improvement Program database. The study population was stratified into 6 cohorts: BMI &lt; 18.5 kg/m² (underweight), BMI of 18.5-24.9 kg/m² (reference cohort), BMI of 25.0-29.9 kg/m² (overweight), BMI of 30.0-39.9 kg/m² (obese), BMI of 40.0-49.9 kg/m² (morbidly obese), and BMI ≥ 50.0 kg/m² (super-morbidly obese). Postoperative complications within 30 days of surgery were collected. Multivariate logistic regression was conducted to investigate the association between BMI values and postoperative complications. Additionally, to facilitate a direct comparison with existing literature, and further validate our study methodology, a subgroup analysis with multivariate logistic regression was made comparing 2 groups: BMIs &gt; 30 kg/m² and BMIs &lt; 30 kg/m². Odds ratios (ORs) were reported with a 95% confidence interval. The level of statistical significance was set at <em>P</em> &lt; .05. The analyses were conducted using SPSS 26.0.</div></div><div><h3>Results</h3><div>A total of 22,542 patients undergoing TSA between 2015 and 2019 were reported in the database. Of these, 410 patients did not have reported BMIs, leaving 22,132 patients for the analysis (1.8% attrition bias). The underweight cohort had a greater likelihood of mortality (OR, 6.184; <em>P</em> = .008) and nonhome discharge (OR, 1.824; <em>P</em> = .008). The morbidly obese cohort had a greater likelihood of developing wound infections (OR, 5.254; <em>P</em> &lt; .002). The super-morbidly obese cohort presented a greater likelihood of developing wound infections (OR, 13.431; <em>P</em> = .002) and nonhome discharge (OR, 1.525; <em>P</em> = .035).</div></div><div><h3>Conclusion</h3><div>Patients with BMI less than 18 and more than 40 were associated with an increased incidence of 30-day postoperative TSA complications such as wound infection, nonhome discharge, and mortality. Based on these findings, preoperative risk stratification based on BMI remains an important part of elective surgery.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 141-146"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081404","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":"Identification of an anatomical safe zone for humeral cerclage passage","authors":"Matthew T. Gulbrandsen MD ,&nbsp;Lea E. McDaniel MD ,&nbsp;Clayton H. Hui BS ,&nbsp;Jeremy R. Brown MD ,&nbsp;Taha M. Taka MD ,&nbsp;Marc G. Lubitz MD ,&nbsp;Anup A. Shah MD ,&nbsp;Evan S. Lederman MD ,&nbsp;Wesley P. Phipatanakul MD","doi":"10.1016/j.jseint.2024.08.187","DOIUrl":"10.1016/j.jseint.2024.08.187","url":null,"abstract":"<div><h3>Background</h3><div>Cerclage techniques have been used in the humerus in the setting of fractures and shoulder arthroplasty. Cerclage usage in the humerus has the potential to injure neurovascular structures. There is current literature describing deeper anatomic structures surrounding the humerus but not more superficial landmarks in reference to neurovascular structures. The purpose of this study was to determine safe zones for cerclage passage around the humerus.</div></div><div><h3>Methods</h3><div>Eight fresh-frozen cadaveric specimens with no history of deformity, prior surgery, or trauma to the shoulder or arm were used in this study. A standard extended deltopectoral approach was performed in all 8 specimens. Dissection was performed to identify the various musculotendinous and neurovascular structures surrounding the humerus. Cerclage sutures were placed around the humerus. Measurements were made from the radial and axillary nerve to anatomic structures and the cerclage sutures.</div></div><div><h3>Results</h3><div>The radial nerve entered the spiral groove on average 45.8 mm distal (range: 30.4 to 63.3 mm) to the inferior aspect of the pectoralis major tendon. Cerclage suture passed just distal to the inferior aspect of the pectoralis major tendon did not violate the radial nerve. The axillary nerve was located on the humerus an average of 5.3 mm (range: 2.4-10 mm) proximal to the superior aspect of the latissimus dorsi tendon insertion. A safe zone for cerclage passage was not identified distal to the radial nerve entering the spiral groove.</div></div><div><h3>Conclusion</h3><div>The radial nerve entered the spiral groove on the humerus distal to the pectoralis insertion in all specimens. The axillary nerve started to contact the humerus proximal to the latissimus dorsi in all specimens. In this study, we found that cerclage passage medial to lateral from the latissimus dorsi proximally to the area just distal to the inferior pectoralis major insertion distally is a safe zone for cerclage passage.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 6-11"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081439","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":"Lower trapezius tendon transfer for massive irreparable rotator cuff tears improves outcomes in patients with high grade fatty infiltration of teres minor","authors":"Eva Gusnowski MD, FRCSC ,&nbsp;Eric Wagner MD ,&nbsp;Sheila McRae PhD ,&nbsp;Hayden Cooke MD ,&nbsp;Anthony Karzon MD ,&nbsp;Michael Gottschalk MD ,&nbsp;Peter MacDonald MD, FRCSC ,&nbsp;Jarret Woodmass MD, FRCSC","doi":"10.1016/j.jseint.2024.11.014","DOIUrl":"10.1016/j.jseint.2024.11.014","url":null,"abstract":"<div><h3>Background</h3><div>This study compares postoperative outcomes of lower trapezius tendon transfers (LTTTs) in massive irreparable rotator cuff (RC) tears based on the degree of teres minor (TM) fatty infiltration.</div></div><div><h3>Methods</h3><div>In this prospective longitudinal observational study, patients with massive RC tears undergoing arthroscopic-assisted LTTT by two surgeons were screened. TM fatty infiltration on preoperative magnetic resonance imaging was graded using the Goutallier classification. Two groups were created as follows: group A included grades 0 and 1 (no or little fatty infiltration), and group B included grades 2 to 4 (moderate-to-severe fatty infiltration). Participants completed the Single Assessment Numeric Evaluation (SANE) score preoperatively, and 12- and/or 24 months postoperatively along with a clinical assessment. Independent t-tests compared groups, and paired t-tests compared pre-vs. postoperative results. Significance was defined as <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>There were 47 patients in group A and 19 in group B. No group differences were found in preoperative SANE score, forward elevation or active external rotation (ER). Both groups showed significant postoperative improvements in SANE score with no differences between the groups. An ER lag sign was observed in 18/47 patients (38.3%) in group A and 11/19 patients (57.9%) in group B (<em>P</em> = .177). Preoperative ER strength was significantly different in group A (2.9 kg) vs. group B (0.7 kg; <em>P</em> = .001), but postoperative ER strength was similar (<em>P</em> = .931).</div></div><div><h3>Conclusion</h3><div>LTTT is a suitable salvage procedure regardless of the degree of TM fatty infiltration and should be considered an alterative procedure to latissimus dorsi tendon transfer in patients with high-grade TM fatty infiltration.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 296-300"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081463","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 Bankart repair augmented with glenoid bone dry allograft","authors":"Thomas Boissinot MD ,&nbsp;Antoine Baltassat MD ,&nbsp;Hugo Barret MD ,&nbsp;Mathieu Girard MD ,&nbsp;Pierre Mansat MD, PhD ,&nbsp;Nicolas Bonnevialle MD, PhD","doi":"10.1016/j.jseint.2024.09.008","DOIUrl":"10.1016/j.jseint.2024.09.008","url":null,"abstract":"<div><h3>Background</h3><div>The recurrence rate of shoulder instability after arthroscopic isolated Bankart repair is up to 25% at long term, especially in case of bipolar bone loss. Bony augmentation with free bone dry allograft would be an option to reconstruct a glenoid subcritical bone defect and to minimize the failure rate.</div></div><div><h3>Methods</h3><div>This case series included patients with anterior shoulder instability treated by arthroscopic free bone dry allograft (Supercrit, BIOBank, Lieusaint, Ile-de-France, France), fixed with a cortical button as an augmentation of Bankart repair and reviewed with a minimum follow-up of 2 years. Clinical assessment was based on active range of motion, shoulder apprehension test, as well as Walch-Duplay Score, Rowe Score, and Subjective Shoulder Value. Radiological evaluation was based on postoperative and last follow-up computed tomography scan to assess bone block positioning, glenoid enlargement, allograft healing, and/or resorption.</div></div><div><h3>Results</h3><div>Five patients were included with a mean follow-up of 50 months (range 44-56). None of the patients reported a recurrence, but apprehension test was positive in one. Mean Walch-Duplay Score, Rowe Score, and Subjective Shoulder Value were 88 points (70-11), 93 points (75-100), and 89% (80-95), respectively. No surgical complications were recorded. The mean preoperative anterior glenoid bone loss was 13.8% (7-19). At last follow-up, graft resorption was observed in all patients, reaching 100% of the initial volume in 4 cases.</div></div><div><h3>Conclusion</h3><div>This study showed satisfactory clinical results of Bankart repair augmented with dry bone allograft in the treatment of anterior shoulder instability with glenoid subcritical bone loss. However, anatomical results were disappointing, with graft resorption that raises the question of going ahead with such a procedure.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 40-45"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes following surgical fixation of acromion fractures","authors":"Tram L. Tran MD, MPH ,&nbsp;Molly G. Sekar MD ,&nbsp;Nik Bhardwaja BS ,&nbsp;Jessica McGraw-Heinrich MD ,&nbsp;Michael D. McKee MD ,&nbsp;Niloofar Dehghan MD","doi":"10.1016/j.jseint.2024.11.016","DOIUrl":"10.1016/j.jseint.2024.11.016","url":null,"abstract":"<div><h3>Background</h3><div>Acromial fractures are rare in the traumatic setting; however, they have recently gained attention due to the increase in incidence as a result of a postoperative complication of reverse total shoulder arthroplasty. While historically these fractures were routinely treated nonoperatively, there is evidence that surgery can improve outcomes. The study aims to evaluate clinical outcomes following surgical treatment of acromion fractures and compare outcomes among patients with an intact rotator cuff against those with a deficient rotator cuff or reverse shoulder arthroplasty.</div></div><div><h3>Methods</h3><div>This is a retrospective review of patients with acromion fractures that were treated with open reduction internal fixation between January 2014 and March 2023. Patients were stratified into three cohorts as follows: 1) rotator cuff intact; 2) rotator cuff impaired; and 3) presence of reverse total shoulder arthroplasty.</div></div><div><h3>Results</h3><div>Thirty-seven patients were included in the study with a mean follow-up of 9 months (range 0.5-77). The mechanism of injury was stress fracture (46%), high-energy trauma (32%), or low-energy falls (22%). The mean time to surgery was 6 months (0-24). Older age and female sex were associated with stress fractures (<em>P</em> &lt; .05). The odds of having a stress fracture were higher in patients with an impaired rotator cuff (OR 6.5, <em>P</em> = .04) or reverse total shoulder arthroplasty (OR 2.8, <em>P</em> = .02) compared to those with an intact rotator cuff. The mean shoulder flexion improved from 81 degrees preoperatively to 113 degrees at the time of the last visit (<em>P</em> = .02). The mean shoulder external rotation improved from 24 degrees preoperatively to 48 degrees at the time of the last visit (<em>P</em> = .04). The nonunion rate was 19% (7 of 37) and the reoperation rate was 11% (4 of 37) for removal of broken hardware or nonunion revision. Two patients went on to have reverse total shoulder arthroplasty. There were no differences in nonunion or reoperation rates among patients with an intact cuff, an impaired cuff, or the presence of shoulder arthroplasty.</div></div><div><h3>Discussion and conclusion</h3><div>Patients with rotator cuff dysfunction or presence of reverse total shoulder arthroplasty are more likely to have acromion stress fractures compared to those with an intact rotator cuff. Surgical fixation of acromion fractures can improve the shoulder range of motion and pain scores. The nonunion rate is lower for surgical fixation compared to existing literature on nonoperative treatment of acromion fractures.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 301-305"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081204","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":"Reverse shoulder arthroplasty in ankylosing spondylitis with partial scapular ankylosis","authors":"Stefan Bauer MD ,&nbsp;Abdelkader Shekhbihi MD ,&nbsp;George Athwal MD ,&nbsp;Gilles Walch MD","doi":"10.1016/j.jseint.2024.09.009","DOIUrl":"10.1016/j.jseint.2024.09.009","url":null,"abstract":"","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 194-200"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081222","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":"Triceps insertion violation from commonly applied olecranon plating system: a comparison","authors":"Ahmed A. Habis MD, MSc, FRCSC ,&nbsp;Kevin Nguyen MASc ,&nbsp;Julie Chan MD, MHSc, FRCSC ,&nbsp;Emad Anam MD, MSc, FRCSC ,&nbsp;Ryan T. Bicknell MD, MSc, FRCSC ,&nbsp;Heidi-Lynn Ploeg PhD, PEng, FASME, FORS ,&nbsp;Parham Daneshvar MD, FRCSC","doi":"10.1016/j.jseint.2024.12.004","DOIUrl":"10.1016/j.jseint.2024.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Surgeons generally avoid compromising tendon insertions during fracture fixation; however, it is a common practice to violate the triceps tendon insertion during olecranon plate fixation. The assumption in these procedures is that minimal triceps insertion is disrupted. The purpose of this study was to quantify the degree of triceps insertion that is violated, intentionally peeled off, by commonly utilized olecranon plating systems. The secondary objectives are to measure the surface area of the triceps insertion and olecranon using a 3-dimensional (3D) technique and compare them to 2 similar papers that were done using 2-dimensional (2D) measurements. Evaluating the amount of olecranon plates’ violation to the triceps insertion was not one of the objectives of those papers. It was hypothesized that olecranon plate fixation violates a larger portion of the triceps footprint than previously thought.</div></div><div><h3>Methods</h3><div>Six olecranon plate designs and 12 cadaveric upper-extremity specimens were used. Olecranon plates, triceps insertion footprints, and olecranon surface areas were digitized as 3D surface models with a laser scanner (SG100; ShapeGrabber Inc., Ottawa, Canada). The violated triceps insertion footprint area, required to accommodate the plate surface on the olecranon, was calculated using 3D modeling software (MeshLab; ISTI - CNR Research Center, Pisa, Italy). Results were compared with both 2D and 3D measurements and the 2D surface area measurements of 2 previous studies.</div></div><div><h3>Results</h3><div>The median triceps insertion footprint violation for 6 common olecranon plates was 46% (range, 40%-62%) using 3D analysis, and 47% (range, 41%-64%) using 2D analysis. The greatest footprint violations were observed with Synthes – Wide VA at 62% and Smith-Nephew Peri-LOC (Smith &amp; Nephew, Andover, MA, USA) plates at 58%, while the least violation was seen with Wright Medical EPS (Wright Medical, Memphis, TN, USA) and Synthes – Extended (DePuy Synthes, Raynham, MA, USA) plates at 40%. The median triceps insertion surface area was 254 mm² (range, 193-348 mm²) and 260 mm² (range, 171-364 mm²) using 2D and 3D methods, respectively. Median olecranon surface area was 645 mm² (range, 478-775 mm²) and 573 mm² (range, 411-722 mm²) by 2D and 3D methods, respectively.</div></div><div><h3>Conclusions</h3><div>Many commonly used olecranon plating systems violate a large portion of the triceps insertion footprint which is up to 62% in this study. A better understanding of the triceps insertion footprint, olecranon anatomy, and clinical implications of triceps footprint disruption may lead to improvements in olecranon plate design and postoperative outcomes. Future studies should assess the possibility of any clinical implications of triceps insertion disruption.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 326-331"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081320","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":"Evaluation of supraspinatus muscle-to-fat infiltration for rotator cuff tear patients using dual-energy computed tomography","authors":"Naoki Takatori MD, PhD ,&nbsp;Yoshiyasu Uchiyama MD, PhD ,&nbsp;Takeshi Imai MD, PhD ,&nbsp;Masahiko Watanabe MD, PhD","doi":"10.1016/j.jseint.2024.09.012","DOIUrl":"10.1016/j.jseint.2024.09.012","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to assess fatty infiltration of the supraspinatus muscle (Ssp) using dual-energy computed tomography (CT) in patients with rotator cuff tear.</div></div><div><h3>Methods</h3><div>This study examined 44 patients (49 shoulders; 21 men, 23 women; mean age, 69 years) who underwent magnetic resonance imaging (MRI) and dual-energy CT. Three orthopedic surgeons evaluated fatty infiltration of the Ssp using the Goutallier classification of MRI, and three orthopedic surgeons measured attenuation (in Hounsfield units) for the same slice using dual-energy CT. We evaluated the following: 1) interobserver reliability of the Goutallier classification, 2) correlations between intramuscular muscle-to-fat ratio and tear size in the rotator cuff or Goutallier classification, and 3) the spectrum curve of attenuation for each energy level of the Goutallier stage.</div></div><div><h3>Results</h3><div>The κ value for interobserver reliability was 0.721. Significant positive correlations were identified between intramuscular muscle-to-fat ratio and cuff tear size and intramuscular muscle-to-fat ratio and Goutallier classification. Moreover, the Ssp showed no change in attenuation at Goutallier stage 0, but as Goutallier stage increased, attenuation decreased at low energy.</div></div><div><h3>Conclusion</h3><div>We investigated the evaluation of fatty infiltration in Ssp using dual-energy CT in patients with rotator cuff tears. Positive correlations were seen between the Goutallier classification from MRI and rotator cuff intramuscular fat ratio from dual-energy CT. Moreover, changes in attenuation showed that higher Goutallier stages contained more fat. Our data suggest the potential utility of dual-energy CT for evaluating fatty infiltration of rotator cuff muscles.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 130-135"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081327","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}