JSES International最新文献

{"title":"Endoscopy for neurogenic thoracic outlet syndrome: effectiveness and safety assessments","authors":"Jose Carlos Garcia Jr. PhD ,&nbsp;Marcos Felipe de Paula Correa MD ,&nbsp;Giulia Wendt Fadel MD ,&nbsp;Ricardo Berriel Mendes MD ,&nbsp;Jesely Myrrha Garcia PT ,&nbsp;Paulo Cavalcante Muzy MD ,&nbsp;Diogo Alberto Lopes Bader MD","doi":"10.1016/j.jseint.2024.12.006","DOIUrl":"10.1016/j.jseint.2024.12.006","url":null,"abstract":"<div><h3>Background</h3><div>Thoracic outlet syndrome (TOS) is a complex and multifactorial condition characterized by the compression of neural, arterial, or venous structures. Traditional surgical approaches use open dissections presenting substantial recurrence rates of 15-20%. This study aimed to explore the safety and efficacy of endoscopic surgery for neurogenic TOS treatment, given the evolution of surgical techniques toward minimally invasive approaches.</div></div><div><h3>Methods</h3><div>A study was conducted involving 30 patients who were resistant to conservative treatment, presented with objective images of neurogenic compromise at the brachial plexus, and underwent brachial plexus endoscopy. Outcomes were assessed using the Visual Analog Scale for Pain and the Quick Disabilities of the Arm, Shoulder, and Hand score, both pre- and postsurgery, with a minimum follow-up of 24 months postoperatively.</div></div><div><h3>Results</h3><div>The results indicated a significant improvement in symptoms. All patients experienced clinical improvement and resumed their normal activities. The average Visual Analog Scale for Pain score decreased from 5.57 ± 2.18 before surgery to 1.30 ± 1.02 after surgery (<em>P</em> &lt; .01). The average Quick Disabilities of the Arm, Shoulder, and Hand score decreased from 41.89 ± 12.80 before surgery to 5.39 ± 6.74 after surgery (<em>P</em> &lt; .01). There were no requirements for surgical reintervention, and no patients suffered neurological injuries or other complications.</div></div><div><h3>Conclusion</h3><div>The results of this study affirm that the endoscopic technique evaluated is both an effective and safe treatment modality for neurogenic TOS. It offers the advantages of low morbidity and expedited recovery, making it particularly suitable for patients with neurogenic TOS, including those with a low vascular component. Nevertheless, for cases where vascular compression is pronounced and/or patient have already presented previous vascular repercussions such as thrombosis, open surgical techniques for rib resection remain as the gold standard, therefore should be considered as a primary treatment.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 852-858"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the influence of obesity on rotator cuff repair surgical and functional outcomes: a meta-analysis","authors":"Ahmed Alhussain MD ,&nbsp;Hussam A. Alhathlol MBBS ,&nbsp;Abdulkareem A. Alsharif MBBS ,&nbsp;Khalid M. Alsikhan MBBS ,&nbsp;Nouf A. Almagushi MBBS","doi":"10.1016/j.jseint.2024.12.005","DOIUrl":"10.1016/j.jseint.2024.12.005","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a major global health burden and is linked to numerous comorbidities, including musculoskeletal disorders. Among these, rotator cuff disorders are a leading cause of shoulder pain. Although the impact of obesity on procedures such as hip and knee arthroplasty is well documented, its effect on rotator cuff repair has been less explored. This meta-analysis aimed to evaluate the influence of obesity on surgical and functional outcomes following rotator cuff repair.</div></div><div><h3>Methods</h3><div>The review was conducted following the PRISMA guidelines and registered in PROSPERO (CRD42024556254). A comprehensive search of PubMed, Google Scholar, and Web of Science was performed. The outcomes evaluated included functional outcomes such as the American Shoulder and Elbow Surgeons score and range of motion. For surgical outcomes, the variables evaluated included retear, readmission, and reoperation. Statistical analysis was performed via Review Manager (Cochrane Collaboration. Review Manager [RevMan], London, UK. Version 5.4 2020) and Comprehensive Meta-Analysis v3 software.</div></div><div><h3>Results</h3><div>Twelve studies comprising 79098 patients were included. The obese patients had significantly poorer functional outcomes, with lower Single Assessment Numeric Evaluation and American Shoulder and Elbow Surgeons scores. Obese patients also had statistically significant impairments in the internal rotation function of the shoulder joint. These patients also exhibited a higher risk of readmission and reoperation. No significant differences were found in terms of operative time, postoperative pain, or surgical site infection.</div></div><div><h3>Conclusion</h3><div>Obesity negatively impacts the surgical and functional outcomes of rotator cuff repair, leading to worse functional scores, limited range of motion, and increased risks of readmission and reoperation. These findings underscore the importance of weight management strategies to optimize outcomes for obese patients undergoing rotator cuff repair.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 683-690"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A functional evaluation of the rotator cuff length after reverse total shoulder arthroplasty","authors":"Jan Herregodts MD ,&nbsp;Mathijs Verhaeghe Ir. ,&nbsp;Didier Poncet Ir. ,&nbsp;Lieven De Wilde MD, PhD ,&nbsp;Alexander Van Tongel MD, PhD ,&nbsp;Stijn Herregodts Ir PhD","doi":"10.1016/j.jseint.2024.12.012","DOIUrl":"10.1016/j.jseint.2024.12.012","url":null,"abstract":"<div><h3>Background</h3><div>A biomechanical result of the reverse total shoulder arthroplasty (rTSA) design is the medialization and inferiorization of the greater tuberosity, which influences the length of the cuff muscles. A well-known complication after rTSA is a lack of external rotation force. The purpose of this study was to investigate the difference in the length of the cuff muscles in a native shoulder and in shoulders treated with six commercial rTSA designs.</div></div><div><h3>Methods</h3><div>Six implant systems were implanted on identical sawbones. A robotic setup was used to perform and control the shoulder’s position and measurements. The muscle lengths were measured by draw wire encoders.</div></div><div><h3>Results</h3><div>In the three functional positions, the length of the cuff muscles was significantly lower in the Delta Xtend. In all measured positions, there was a strong negative correlation between the medialization of the humerus and the length of the cuff muscles. A lower position of the humerus after rTSA had a positive impact on the length of the infraspinatus and subscapularis.</div></div><div><h3>Discussion</h3><div>This study found a distinct difference in the slackening of the cuff muscles. Still, in the commercial reverse shoulder arthroplasty designs studied, this slackening never exceeded 15% in the above-mentioned maneuvers, which is functional and safe for the remnants of the muscles.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 788-797"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional outcome of patients treated with Latarjet procedure experience from resource limited setup","authors":"Tariku Beriso MD ,&nbsp;Samuel Kebede MD ,&nbsp;Mamo Deksisa MD ,&nbsp;Mahder Eshete MD","doi":"10.1016/j.jseint.2025.01.021","DOIUrl":"10.1016/j.jseint.2025.01.021","url":null,"abstract":"<div><h3>Background</h3><div>The shoulder joint has a great arc of motion, and it frequently develops recurrent instability. The Latarjet procedure was used frequently to treat recurrent shoulder instability and was also used for patients with fixed chronic shoulder dislocation that was unreduced for more than 3 weeks. There is a research gap in resource-limited settings regarding this topic. The aim of this study was to assess the functional outcome of patients who underwent a Latarjet procedure for recurrent shoulder instability and fixed unreduced shoulder dislocation separately.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted on the functional outcome of patients treated with the Latarjet procedure done at Saint Paul’s Hospital Millennium Medical College from August 2019 to October 2022. Outcomes were assessed using the Rowe score and the University of California Los Angeles (UCLA) shoulder scale. Descriptive statistics were used with frequency, percentage, tables, and texts based on the nature of the data. Mean, median, and standard deviation were used to describe continuous variables.</div></div><div><h3>Results</h3><div>Of the total of 45 patients included in the study, 25 patients (55.6%) were presented with recurrent anterior shoulder instability, whereas the remaining 20 patients (44.4%) were presented with chronic locked anterior shoulder dislocation. The mean Rowe and UCLA scores of patients with recurrent shoulder instability were 92 and 32.36, respectively, with 92% of them having an excellent Rowe grade. The mean Rowe and UCLA scores of patients with fixed unreduced chronic shoulder dislocations were 71.75 and 24.85, respectively, with only 30% excellent Rowe grade. The complication rate was 20% with recurrent instability rate of 6.7%.</div></div><div><h3>Conclusion</h3><div>The Latarjet procedure has excellent outcomes and is safe for patients with recurrent shoulder instability. Fixed unreduced chronic shoulder dislocation has a lower functional outcome score after the Latarjet procedure. Appropriate patient selection and identification should be employed for better outcomes.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 651-654"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of clinical and radiological parameters for recurrence after primary anterior shoulder dislocation","authors":"Avneet Singh Sandhu MS,&nbsp;Bishak S. Reddy MS,&nbsp;Vivek Pandey MS","doi":"10.1016/j.jseint.2025.01.002","DOIUrl":"10.1016/j.jseint.2025.01.002","url":null,"abstract":"<div><h3>Background</h3><div>Recurrent shoulder dislocation risk is influenced by modifiable (sports participation, immobilization after first anterior dislocation of shoulder (FADS), timing of athletic activity resumption) and nonmodifiable factors like age, sex, hypermobility, and the initial mechanism of injury. These factors, individually or in combination, contribute to an increased risk of recurrent shoulder dislocation. This study aims to ascertain the factors contributing to recurrent anterior shoulder dislocation, explore their interplay, and assess their impact on the overall frequency of dislocations.</div></div><div><h3>Methods</h3><div>Clinical data regarding patient demographics, mechanism of injury, number of dislocations, night dislocations, and sports participation were retrospectively collected for 206 subjects. Radiological data, including glenoid bone loss and glenoid track, were also collected and analyzed.</div></div><div><h3>Results</h3><div>Out of 206, 195 patients were men (94.7%). The mean age ± standard deviation at which men and women experienced their FADS was 25.3 ± 8.25 and 33.7 ± 9.43 years, respectively. Although FADS was common in overhead sports vs. other sports (83% vs. 17%), there was no difference in further recurrences between the two groups (<em>P</em> = .98). The second or further dislocations were more frequent in nonimmobilized shoulders than immobilized for 2-3 weeks (<em>P</em> = .006). The mean time gap between the first and second dislocation for self-reduced and doctor-reduced cases was 36.33 ± 1 08.48 and 53.43 ± 112.07 weeks (<em>P</em> = .022), respectively. Those with recurrent dislocation during sleep had 22.2 total dislocations compared to 8.3 who did not (<em>P</em> = .002). The mean glenoid bone loss in patients with dislocations during sleep-present and the sleep-absent groups was 15.34% and 10.12% (<em>P</em> = .028), respectively. The mean number of dislocations within the 0-10%, 10-20%, and 20-30% bone loss groups was 5.1, 9.9, and 29.9, respectively (<em>P</em> = .001), demonstrating a linear relationship with increasing bone loss. Furthermore, patients with off-track Hill Sachs lesions had a higher propensity for dislocation (<em>P</em> = .011).</div></div><div><h3>Conclusion</h3><div>Recurrence is more common in men and occurs at a younger age than in women. It is common in overhead sports. People who self-reduce their initial dislocation than doctor reduced, or nonimmobilized ones have a greater recurrence rate. Frequent dislocations during sleep have a strong association with higher glenoid bone loss. Increasing glenoid bone loss and off-track Hill Sachs lesion are also strongly associated with increased recurrent dislocations.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 632-638"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The present and future of preoperative planning","authors":"Ruth A. Delaney FRCS","doi":"10.1016/j.jseint.2024.09.002","DOIUrl":"10.1016/j.jseint.2024.09.002","url":null,"abstract":"<div><div>Preoperative planning for shoulder arthroplasty has become widely used for primary cases and now also in revision situations. From the initial, two-dimensional manual planning efforts on computed tomography scans, planning has evolved to now using three-dimensional planning software programs. A number of different programs exist with various methods underpinning their chosen landmarks and segmentation methods. Preoperative planning has allowed for development of execution tools to translate the preoperative plan to intraoperative reality. This article considers the particular relevance of preoperative arthroplasty planning to the shoulder joint, the current status of preoperative planning, the reasons to engage with preoperative planning, the execution tools available as an extension of preoperative planning, and the future of intraoperative execution technologies associated with planning. Preoperative planning is the foundation of prospective advances in these so-called enabling technologies and the future of preoperative planning will be shaped by a desire to continue to optimize execution techniques in shoulder arthroplasty, with the ultimate goal of using these techniques to achieve improved patient outcomes.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 954-959"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic intra-articular vs. subpectoral biceps tenodesis with concomitant rotator cuff repair leads to equivocal MCID achievement","authors":"Dylan N. Greif MD ,&nbsp;Hashim J.F. Shaikh BS ,&nbsp;Devon E. Anderson MD, PhD ,&nbsp;Robert Bronstein MD ,&nbsp;Gregg T. Nicandri MD, PhD ,&nbsp;Brian D. Giordano MD ,&nbsp;Ilya Voloshin MD ,&nbsp;Michael D. Maloney MD ,&nbsp;Sandeep Mannava MD, PhD","doi":"10.1016/j.jseint.2025.01.020","DOIUrl":"10.1016/j.jseint.2025.01.020","url":null,"abstract":"<div><h3>Background</h3><div>Pathologies involving the long head of the biceps brachii tendon often accompany rotator cuff tears, contributing to increased physical pain. Disagreement exists in the literature regarding the outcomes of open subpectoral vs. arthroscopic biceps tenodesis during concomitant arthroscopic rotator cuff repair (ARCR), with limited studies assessing Patient-Reported Outcomes Measurement Information System (PROMIS) in this context. This study aims to evaluate a cohort undergoing open subpectoral vs. arthroscopic intra-articular biceps tenodesis with concomitant ARCR, examining differences in PROMIS outcomes and the ability to achieve a minimal clinically important difference (MCID). We hypothesize there is not a significant difference in attaining MCID for PROMIS outcomes between open subpectoral and arthroscopic intra-articular biceps tenodesis during ARCR.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on patients undergoing ARCR with concurrent biceps tenodesis. Patient-reported outcomes, including PROMIS Depression, Pain Interference, and Physical Function scores, were retrospectively reviewed. The patient cohort was stratified into two groups based on the type of biceps tenodesis performed. MCID was defined as half the standard deviation of the average preoperative scores for each cohort. Regression analysis was performed to control for the influence of confounding variables. Statistical significance was determined at a <em>P</em> value threshold of &lt;.05.</div></div><div><h3>Results</h3><div>A total of 197 patients were included for final data analysis. 100 patients underwent arthroscopic biceps tenodesis and 97 patients who underwent open biceps tenodesis, with average follow-up 2.39 vs. 2.21 years, respectively. Bivariate analysis showed no significant differences between subpectoral and arthroscopic cohorts in demographic or clinical variables. Both groups exhibited significant improvement at the final follow-up in all three PROMIS domains without statistically significant intergroup differences. Multivariate analysis identified racial and insurance disparities in preoperative scores but not in postoperative outcomes. Logistic regression indicated PROMIS domains and anchor usage predicted MCID, with no significant difference based on biceps tenodesis type.</div></div><div><h3>Conclusion</h3><div>This study suggests that open subpectoral vs. arthroscopic intra-articular biceps tenodesis during concomitant ARCR does not significantly impact PROMIS outcomes or the likelihood of achieving MCID.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 728-734"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of ulnar nerve gliding exercise in the nonoperative treatment of cubital tunnel syndrome","authors":"Yoshiaki Nishide OT ,&nbsp;Teruhisa Mihata MD, PhD ,&nbsp;Muneaki Abe MD, PhD","doi":"10.1016/j.jseint.2025.02.001","DOIUrl":"10.1016/j.jseint.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>In cubital tunnel syndrome, inflammation and edema around the ulnar nerve inhibit physiologic nerve gliding, causing pain, paresthesia, and muscle weakness. The objective of this study was to investigate the clinical outcomes of our developed ulnar nerve gliding exercise for cubital tunnel syndrome.</div></div><div><h3>Methods</h3><div>Seventeen patients with cubital tunnel syndrome underwent ulnar nerve gliding exercise. All patients had numbness and paresthesia of the ulnar aspect of the forearm and hand and tenderness over the cubital tunnel. Before treatment, 15 patients had McGowan grade 2 (moderate) abnormality, and 2 patients had grade 3 (severe). For our nonsurgical ulnar nerve release, an occupational therapist applied repetitive passive wrist movement at maximal elbow flexion position to improve ulnar nerve gliding twice weekly for 20 minutes each session (average treatment period: 5.8 months). Data regarding the visual analog scale of paresthesia, rate of positive elbow flexion tests, Semmes–Weinstein monofilament test, grip strength, pulp pinch strength, and motor and sensory nerve conduction velocities (6 accepted patients) before ulnar nerve gliding exercise were compared with the values at the final follow-up (average follow-up period: 64 months).</div></div><div><h3>Results</h3><div>Ulnar nerve gliding exercise significantly decreased the severity of paresthesia overall (<em>P</em> &lt; .0001). In addition, the elbow flexion test (<em>P</em> = .0002) and Semmes–Weinstein monofilament test (<em>P</em> &lt; .0001) improved and grip strength (<em>P</em> &lt; .0001) and pulp pinch strength (<em>P</em> &lt; .0001) increased comparable to those on the contralateral side. Motor and sensory nerve conduction velocities after ulnar nerve gliding exercise improved in 5 of 6 patients (83%) and 4 of 6 patients (67%), respectively. One patient with McGowan grade 3 abnormality failed ulnar nerve gliding exercise and underwent anterior subcutaneous transposition of the ulnar nerve.</div></div><div><h3>Conclusion</h3><div>The ulnar nerve gliding exercise by using repetitive passive wrist movement at the maximal elbow flexion can be a useful option for moderate cubital tunnel syndrome.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 920-923"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Older age and diabetes mellitus are negative prognostic factors for shoulder manipulation under ultrasound-guided cervical nerve root block for frozen shoulder: a retrospective cohort study","authors":"Ryosuke Takahashi MD ,&nbsp;Ryosuke Sagami MD ,&nbsp;Yohei Harada MD, PhD ,&nbsp;Yukihiro Kajita MD, PhD","doi":"10.1016/j.jseint.2024.11.022","DOIUrl":"10.1016/j.jseint.2024.11.022","url":null,"abstract":"<div><h3>Background</h3><div>Manipulation under ultrasound-guided cervical nerve root block (MUC) for frozen shoulder has successful clinical outcomes; however, some cases remain refractory. Therefore, we aimed to investigate the outcomes of MUC for frozen shoulder.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 126 frozen shoulders in 113 patients who underwent MUC. We defined frozen shoulder as a limited shoulder range of motion (ROM) (passive forward flexion &lt;120°, external rotation &lt;30°, or internal rotation lower than L3). Patients who fulfilled any one of the criteria were considered to have frozen shoulder. The refractory group included patients who fulfilled any of the criteria for frozen shoulder at 12 months after MUC; those in the success group fulfilled none of the criteria. The ROM, Constant Shoulder score, and University of California, Los Angeles score were evaluated before and 12 months after MUC. Multiple logistic regression analysis was performed to identify risk factors.</div></div><div><h3>Results</h3><div>Twelve months after MUC, both the success (n = 112 frozen shoulders in 100 patients) and refractory groups (n = 14 frozen shoulders in 13 patients) showed significantly improved ROM and functional scores. Although the groups did not differ significantly before MUC, the refractory group showed significantly inferior outcomes to the success group at 12 months after MUC. Age and the presence of diabetes mellitus (DM) were significantly higher in the refractory group than in the success group. Multiple logistic regression analysis revealed older age and the presence of DM as independent risk factors for refractory clinical outcomes. Receiver operating characteristic curve analysis showed that the cutoff value of age for refractory of MUC was 56 years.</div></div><div><h3>Conclusion</h3><div>Older age and the presence of DM are negative prognostic factors for MUC in frozen shoulder. This result may be useful when counseling patients with these conditions.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 672-677"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotics in arthroplasty: how good are they?","authors":"Maxim Vanderstappen MD ,&nbsp;Johannes H.M. van Ochten MD ,&nbsp;Olivier Verborgt MD, PhD","doi":"10.1016/j.jseint.2024.09.005","DOIUrl":"10.1016/j.jseint.2024.09.005","url":null,"abstract":"<div><div>Robotic systems have emerged as indispensable allies in the surgical arena, revolutionizing traditional practices and enhancing the capabilities of health-care professionals. Far removed from the autonomous robots depicted in science fiction, these robotic systems operate under the skilled guidance of surgeons, who control specialized instruments via intuitive consoles and often with the help of robotic product specialists. This symbiotic relationship between man and machine has propelled robotic surgery to the forefront of medical innovation, offering a plethora of benefits that transcends the limitations of conventional surgical techniques. In orthopedic surgery, robotic-assisted knee and hip arthroplasty has experienced rapid growth, and the next field of interest is, without a doubt, shoulder arthroplasty. Digitalization and the use of robotics in shoulder arthroplasty has drawn a lot of attention with the goal to improve the correction of joint deformities and component implantation, possibly leading to enhanced patient outcomes. This next evolution in surgical technology aims to make shoulder replacements more accurate and reproducible in both easy and challenging shoulders and usable by both low-volume and highly experienced surgeons. Nevertheless, robotic-assisted shoulder arthroplasty presents significant challenges related to cost, implant selection, training, and long-term efficacy. Addressing these challenges will require collaboration between surgeons, manufacturers, and regulatory bodies to ensure the safe and effective integration of robotic technology into orthopedic shoulder practice.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 968-973"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}