JSES International最新文献

{"title":"Neuroticism is related to functional outcomes after surgically treated proximal humerus fractures","authors":"Denise E. de Gruijter MD ,&nbsp;Leanne S. Blaas MD ,&nbsp;Kelly van Winden BSc ,&nbsp;Rosa E. Boeschoten MSc, PhD ,&nbsp;Susan van Dieren MSc, PhD ,&nbsp;Michel P.J. van den Bekerom MD, PhD ,&nbsp;Robert Jan Derksen MD, PhD, MSc","doi":"10.1016/j.jseint.2025.02.018","DOIUrl":"10.1016/j.jseint.2025.02.018","url":null,"abstract":"<div><h3>Background</h3><div>It is known that physical factors play an important role in the outcome after a proximal humerus fracture (PHF). However, an increasing body of evidence shows that psychological factors are of importance as well. As such, it follows that the level of neuroticism in a patient might be especially important. This study aims to examine the correlation between neuroticism levels and functional outcomes following surgically treated PHFs.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort analysis. Patients with PHFs who were surgically treated from 2013 to 2023 and had a minimum 1-year follow-up were eligible. During follow-up, shoulder range of motion and functional scores (Constant Shoulder Score [CSS], Oxford Shoulder Score, and quick Disability of the Arm, Shoulder and Hand) were measured. To ascertain the level of neuroticism, the short-revised version of the Eysenck Personality Questionnaire was administered.</div></div><div><h3>Results</h3><div>In total, 65 patients were included in the study. Eighty-nine percent of included subjects were women (n = 58) and the median age was 72.3 ± 7.4 years. Seventy-four percent (n = 48) was treated with a reverse total shoulder arthroplasty and 60% (n = 39) was operated on their dominant side. The level of neuroticism is correlated with the CSS for fracture side (r = −0.28; <em>P</em> = .023), correlated with the Oxford Shoulder Score (r = −0.46; <em>P</em> &lt; .001) and to the quick Disability of the Arm, Shoulder and Hand (r = 0.30; <em>P</em> = .017). The CSS difference score between the fracture side and the nonaffected side was not correlated with the level of neuroticism (r = 0.20; <em>P</em> = .12).</div></div><div><h3>Conclusion</h3><div>A higher level of neuroticism is related to worse functional outcomes after a surgically treated PHF.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1034-1039"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604990","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":"Anteromedial facet coronoid fractures: an algorithmic approach for assessment and management based on 3 dimensional computed tomography humeral subtraction","authors":"Armin Badre MD, MSc, FRCSC ,&nbsp;Moayd Abdullah H. Awad MBBS, FRCSC ,&nbsp;Robert Chan MD, MSc, FRCSC ,&nbsp;Michael Lapner MD, FRCSC","doi":"10.1016/j.jseint.2025.04.015","DOIUrl":"10.1016/j.jseint.2025.04.015","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Isolated coronoid fractures without concomitant radial head injury raise suspicion for an anteromedial facet (AMF) fracture as a result of a varus posteromedial rotatory instability (VPMRI) mechanism. However, not all isolated coronoid fractures involve the AMF, nor are they all the result of a VPMRI mechanism. AMF fractures as a result of a VPMRI mechanism have been reported to have specific radiographic features (medially oblique, concave, with extension to the sublime tubercle). We hypothesized that a detailed assessment of the pattern of AMF fracture utilizing three-dimensional computed tomography with digital subtraction of the humerus allows for a reliable treatment algorithm to avoid over- or under-treatment of these complex injuries.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This was a retrospective case series of patients with isolated coronoid fractures involving the AMF. Patients with an AMF fracture meeting radiographic features consistent with a VPMRI mechanism were managed operatively, and those with an AMF fracture that did not meet one of the radiographic features of a VPMRI mechanism were considered for nonoperative management. Our primary outcome was the appropriateness of this treatment algorithm by assessing whether any patients in the nonoperative group required later surgical intervention or developed any evidence of subluxation or degenerative changes. Secondary outcomes were elbow and forearm range of motion, functional outcome, patient-reported outcomes, and complications at the final follow-up.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;43 patients with a minimum of 6 months of follow up were reviewed. 28 patients met all radiographic features of VPMRI and underwent surgical stabilization. After an average follow up of 17 ± 14 months, they achieved an elbow arc of 130° ± 19°, forearm arc of 153° ± 13°, Mayo Elbow Performance Index of 98.4 ± 4.0, quick disabilities of the arm, shoulder, and hand of 8.3 ± 9.1, patient-rated elbow evaluation of 18.2 ± 9.1, and a single assessment numeric evaluation score of 90% ± 11%. The incidence of overall complications was 64%. 15 remaining patients did not meet at least one radiographic feature of VPMRI and all but one were managed nonoperatively. After an average follow up of 15 ± 13 months, they achieved an elbow arc of 136° ± 8°, forearm arc of 158° ± 12°, Mayo Elbow Performance Index of 99.0 ± 3.7, quick disabilities of the arm, shoulder, and hand of 6.8 ± 4.8, patient-rated elbow evaluation of 15.9 ± 6.3, and a single assessment numeric evaluation score of 93% ± 7%. Importantly, no patient developed any evidence of late instability, incongruity, or degenerative changes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The proposed algorithm based on a detailed assessment of the pattern of AMF fracture provides a reliable decision tool for the management of these injuries. Utilizing this decision tool and appropriate nonoperative or operative intervention can lead to good-","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1418-1427"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605408","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":"Impact of prior arthroscopic rotator cuff repair on postoperative outcomes of reverse shoulder arthroplasty: a comparative analysis of muscle strength recovery and clinical results","authors":"Yoshihiro Hirakawa MD, PhD ,&nbsp;Tomoya Manaka MD, PhD ,&nbsp;Katsumasa Nakazawa MD, PhD ,&nbsp;Yoichi Ito MD, PhD ,&nbsp;So Taniguchi MD ,&nbsp;Ayako Ogura PT ,&nbsp;Hidetomi Terai MD, PhD","doi":"10.1016/j.jseint.2025.04.021","DOIUrl":"10.1016/j.jseint.2025.04.021","url":null,"abstract":"<div><h3>Background</h3><div>Although the postoperative outcomes of reverse total shoulder arthroplasty (rTSA) are favorable, few studies have examined the impact of previous arthroscopic rotator cuff repair (ARCR) on rTSA outcomes in detail. This study aimed to evaluate and compare the short-term outcomes of rTSA in patients without previous ARCR (control group) and those with a history of ARCR (previous ARCR group). By focusing on postoperative range of motion, clinical scores, and muscle strength over a minimum 2-year follow-up period, we sought to reveal critical insights into how previous ARCR influences recovery trajectories.</div></div><div><h3>Methods</h3><div>We analyzed all patients diagnosed with cuff tear arthropathy or massive rotator cuff tears who underwent rTSA between April 2014 and March 2021, with at least two years of follow-up. The follow-up rate was 81.4% (228/280). The exclusion criteria included revision arthroplasty, infection, previous open surgery, and additional tendon transfer. The key metrics assessed were range of motion, American Shoulder and Elbow Surgeons (ASES) score, Constant score (CS), visual analog scale score for pain, and muscle strength.</div></div><div><h3>Results</h3><div>In total, 228 patients were included: 182 (mean age: 76 years) in the control group and 46 (mean age: 75 years) in the previous ARCR group. Active elevation improved significantly from 77° to 121° in the control group and from 81° to 116° in the previous ARCR group. External rotation at the side showed no significant change in either group, whereas internal rotation worsened postoperatively in both groups. The ASES, CS, and visual analog scale scores showed significant improvements 2 years postoperatively in both groups. However, the control group had significantly higher postoperative ASES and CS scores than those in the previous ARCR group. Muscle strength significantly improved in the control group but not in the previous ARCR group.</div></div><div><h3>Conclusion</h3><div>Postoperative muscle strength improvement was not observed in patients undergoing rTSA with a history of ARCR, and their postoperative clinical outcomes were inferior to those undergoing rTSA without a history of ARCR. This deficiency in muscle strength improvement may contribute to the differences in clinical scores, a factor that surgeons need to consider.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1339-1344"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605523","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":"Short-term clinical and functional outcomes of distal biceps tendon fixation: all-suture vs. titanium anchors","authors":"Felix Hochberger MD ,&nbsp;Julian Hess MD ,&nbsp;Christian Konrads MD ,&nbsp;Tizian Heinz MD ,&nbsp;Ella Segatz ,&nbsp;Maximilian Rudert MD ,&nbsp;Kilian List MD","doi":"10.1016/j.jseint.2025.03.012","DOIUrl":"10.1016/j.jseint.2025.03.012","url":null,"abstract":"<div><h3>Background</h3><div>The objective of this study was to evaluate the preliminary clinical and functional outcomes of patients with distal biceps tendon ruptures undergoing surgical fixation using 2 intramedullary all-suture anchors (ASAs) and to compare these outcomes with a control group treated with 2 intramedullary titanium anchors (TAs).</div></div><div><h3>Methods</h3><div>A retrospective case series was conducted on patients who underwent distal biceps tendon fixation using either TAs (Mitek Sports Medicine, Raynham, MA, USA) or ASAs (Arthrex, Naples, FL, USA). Clinical and functional outcomes were evaluated at a mean follow-up of 24 months, using the Mayo Elbow Performance Score, Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire, and visual analog scale. Secondary assessments included isometric strength testing with the IsoForce Control Dynamometer (IsoForce, Dübendorf, Switzerland) and the identification of postoperative complications, such as heterotopic ossification (HO).</div></div><div><h3>Results</h3><div>A total of 53 patients (23 ASA, 30 TA) were included in the final analysis, with ASA patients being slightly younger (55.2 ± 9.8 years vs. 63.2 ± 7.7 years, <em>P</em> &lt; .05) and the only group to include females (4), as the TA cohort comprised exclusively male patients. The average follow-up duration was 33.8 ± 9.3 months for the ASA group and 45.4 ± 11.1 months for the TA group. HOs were significantly more prevalent in the TA group (37.5% vs. 17.2%, <em>P</em> &lt; .05). Functional outcomes, measured by Mayo Elbow Performance Score and QuickDASH, and strength recovery ratios were comparable across both groups, though ASA patients demonstrated higher absolute isometric strength values at specific flexion angles (<em>P</em> &lt; .05). Both anchor systems delivered equivalent functional and clinical outcomes after 1 year postoperatively.</div></div><div><h3>Conclusion</h3><div>Both, ASAs and TAs, achieved excellent functional and clinical outcomes in distal biceps tendon fixation with low complication rates. ASA demonstrated significant fewer HOs compared to TA.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1400-1405"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605977","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":"Early and subsequent radiographic changes during the occurrence of osteochondritis dissecans of the elbow","authors":"Masatoshi Takahara MD, PhD ,&nbsp;Tomohiro Uno MD, PhD ,&nbsp;Tamotsu Kamishima MD, PhD ,&nbsp;Daiichiro Takahara MD ,&nbsp;Ryo Mitachi PT ,&nbsp;Hiroshi Satake MD, PhD ,&nbsp;Michiaki Takagi MD, PhD","doi":"10.1016/j.jseint.2025.03.015","DOIUrl":"10.1016/j.jseint.2025.03.015","url":null,"abstract":"<div><h3>Background</h3><div>Little is known about the radiographic changes before and after osteochondritis dissecans (OCD) occurrence. The aim was to clarify the earliest and subsequent radiographic changes.</div></div><div><h3>Methods</h3><div>Among 120 patients with capitellar OCD, we selected the patients who had consecutive radiographs of the elbow before and after OCD occurrence. We retrospectively clarified the earliest and subsequent changes.</div></div><div><h3>Results</h3><div>Four (3%) boys met the criteria. All four had been in baseball team and had medial elbow pain with medial epicondylar apophysitis. They had no lateral elbow pain or abnormal findings of the capitellum. After the mean of 3.5 months from initial presentation, OCD silently occurred in the capitellum at the mean age of 11.4 years. The earliest detectable radiographic change was subtle rarefaction at the ossifying subchondral bone surface in the lateral aspect of the capitellum; however, it was too subtle and limited to be recognizable as OCD. These features gradually became more evident and expanded, eventually leading to flattening and depression of the subchondral bone surface, accompanied by subchondral bone cysts surrounded by sclerotic bone. The capitellar lesions were diagnosed as early OCD.</div></div><div><h3>Discussion</h3><div>This is the first report to show the radiographic changes before and after OCD occurrence. The earliest change was subtle rarefaction. Repetitive forces on the preadolescent capitellum may cause stress injury at the secondary physis followed by rarefaction of the ossifying subchondral bone. Micromovements of the overlying cartilage would allow the side-by-side concurrence of subchondral bone cysts, resulting in subchondral depression, eventually leading to recognizable early OCD.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1406-1411"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605978","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":"Changes in mental health and joint-specific patient-reported outcome measures following arthroscopic shoulder labral repair","authors":"Kristen E. Hines BS ,&nbsp;Natalie A. Lowenstein MPH ,&nbsp;Jillian L. Mazzocca BA ,&nbsp;Cale A. Jacobs PhD ,&nbsp;Elizabeth G. Matzkin MD","doi":"10.1016/j.jseint.2025.02.022","DOIUrl":"10.1016/j.jseint.2025.02.022","url":null,"abstract":"<div><h3>Background</h3><div>The purpose was to identify the effects of mental health on postoperative outcomes following arthroscopic labral repair. It was hypothesized that low preoperative mental health, measured by the Veterans RAND 12-Item Health Survey Mental Component Score (VR-12 MCS), would demonstrate inferior patient-reported outcome measures preoperatively and postoperatively, but that improvement would be similar.</div></div><div><h3>Methods</h3><div>Fifty subjects undergoing a primary arthroscopic anterior labral repair were included. Subjects completed the VR-12 MCS, Pain Visual Analog Scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and Single Assessment Numeric Evaluation (SANE) at 4 timepoints. Subjects with a VR-12 MCS score below 42.9 were classified to a low MCS cohort and those with a VR-12 MCS score above 42.9 were cataloged to a high MCS group. Patient-reported outcome measures were compared between the 2 groups.</div></div><div><h3>Results</h3><div>At mean follow-up of 18.7 months, ASES (<em>P</em> &lt; .001), VAS (low MCS <em>P</em> = .004; high MCS <em>P</em> &lt; .001), and SANE (<em>P</em> &lt; .001) scores significantly improved for both cohorts. The low MCS group had significantly lower ASES scores at both points (<em>P</em> = .01); however, the preoperative to postoperative change in ASES (<em>P</em> = .32) did not differ. VR-12 MCS scores remained constant in the high MCS cohort but significantly improved for the low MCS cohort (<em>P</em> = .01).</div></div><div><h3>Conclusion</h3><div>Patients in the low VR-12 MCS group had lower postoperative outcomes but demonstrated similar preoperative to postoperative improvements in ASES, SANE, and VAS to those in the high group. VR-12 MCS significantly improved for the low MCS group suggesting that low preoperative mental health scores should not be considered a contraindication for surgery and mental health scores are modifiable.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1154-1158"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604953","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":"Blood loss, complications, and the role of suction drains in shoulder arthroplasty: a systematic review and meta-analysis","authors":"Luiz Henrique Oliveira Almeida MD ,&nbsp;Vitor La Banca MD ,&nbsp;Octavio Matsumoto MD ,&nbsp;Arthur Steven de Sá MD ,&nbsp;Ana Victória Palagi Viganó MD ,&nbsp;Gabriel Kalman MedStud ,&nbsp;Felipe Fernandes Gonzalez MD, MSc ,&nbsp;Guilherme Henrique Vieira Lima MD ,&nbsp;Joel Murachovsky MD, PhD ,&nbsp;Roberto Yukio Ikemoto MD, PhD","doi":"10.1016/j.jseint.2025.03.007","DOIUrl":"10.1016/j.jseint.2025.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Total shoulder replacement, including both anatomic and reverse procedures are one of the treatment options for shoulder arthritis and proximal humerus fractures, with consistently favorable outcomes in terms of pain relief and function improvement. During surgery, some surgeons prefer to place suction drains in the deep tissue to prevent hematomas or seromas, thereby reducing risks like wound dehiscence and infections. However, the routine use of suction drains in other orthopedic surgeries, such as hip and knee arthroplasty, has been questioned, with studies suggesting they may lead to extended hospital stays and increased need for transfusions without significantly reducing complications. Given the conflicting evidence in the literature about suction drains in shoulder arthroplasty, this study aims to evaluate their efficacy in reducing complications and in consequence the need for hospital stay and reoperations.</div></div><div><h3>Methods</h3><div>This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. The inclusion criteria encompassed studies comparing outcomes of patients undergoing shoulder arthroplasty (anatomic or reverse) with and without suction drains. Databases such as PubMed, Lilacs, Cochrane Library, and Scopus were searched, with no restrictions on language or publication date. Data extraction was performed for duration of hospital stay, transfusions, infections, wound dehiscence, reoperations, and hemoglobin changes. Meta-analyses were conducted using a random-effects model for mean differences (MDs) and odds ratios (ORs).</div></div><div><h3>Results</h3><div>Six studies with a total of 22,710 patients were included. The mean patient age was 68.8 years, with a slight female predominance. Anatomic and reverse shoulder arthroplasties were both commonly performed. There was no significant difference in hospital stay (MD: 8.78 hours), infection rates (OR: 0.64; 95% confidence intervals (CI): 0.30-1.35), or reoperation rates (OR: 1.62; 95% CI: 0.16-16.23) between patients with drains and those without. However, hemoglobin loss was significantly greater in the drain group (MD: 0.31; 95% CI: 0.02-0.60).</div></div><div><h3>Conclusion</h3><div>The use of suction drains in shoulder arthroplasty does not significantly reduce infection or wound-related complications and is associated with increased hemoglobin loss. These findings suggest that the routine use of drains in shoulder arthroplasty may not provide tangible benefits and should be reconsidered to optimize patient outcomes.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1266-1273"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605099","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":"Tendon stump change as a risk factor for structural failure of arthroscopic rotator cuff repair","authors":"Jun Kawamata MD ,&nbsp;Shoji Fukuta MD, PhD ,&nbsp;Masashi Kano MD ,&nbsp;Kohei Yoshikawa MD ,&nbsp;Koichi Sairyo MD, PhD","doi":"10.1016/j.jseint.2025.02.011","DOIUrl":"10.1016/j.jseint.2025.02.011","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to identify risk factors for retear after arthroscopic rotator cuff repair (ARCR) using the suture bridge method and to assess the relation between preoperative and postoperative tendon condition and retear.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients who underwent ARCR for a medium tear. Potential risk factors, including tear width, anteroposterior and medial-lateral tear width, atrophy, fatty degeneration, and condition of the tendon stump (Ishitani's classification and rotator cuff/deltoid muscle [C/D] ratio), were identified on magnetic resonance preoperatively. Magnetic resonance imaging was performed regularly after surgery, and the C/D ratio in the sutured cuff was evaluated. Shoulders that were Sugaya type I-III were classified as the repair group and those that were type IV or V as the retear group. Risk factors for retear were analyzed by univariable and multivariable analyses.</div></div><div><h3>Results</h3><div>We analyzed 175 patients in 183 shoulders. The overall retear rate was 13.1%. Multivariable analysis revealed medial-lateral width (odds ratio: 0.88; 95% confidence interval: 0.82-0.95; <em>P</em> &lt; .001) and C/D ratio (odds ratio: 0.30; 95% confidence interval: 0.16-0.58; <em>P</em> &lt; .001) as independent risk factors for retear. At 3 weeks postoperatively, the C/D ratio was significantly higher in the retear group (1.70 ± 1.47 vs. 0.84 ± 0.72; <em>P</em> = .002).</div></div><div><h3>Conclusions</h3><div>The C/D ratio and tear width were risk factors for retear after ARCR using the suture bridge method. The C/D ratio was higher in retear cases both preoperatively and postoperatively.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1118-1123"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605132","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":"Feasibility of subantimicrobial-dose doxycycline for elbow tendinopathy","authors":"Brett G. Toresdahl MD ,&nbsp;Joshua Dines MD ,&nbsp;Harry G. Greditzer IV MD ,&nbsp;Andy O. Miller MD ,&nbsp;Miguel Otero PhD ,&nbsp;Jamie S. Egbert MPH ,&nbsp;Brianna Quijano MS ,&nbsp;Scott Rodeo MD","doi":"10.1016/j.jseint.2025.03.019","DOIUrl":"10.1016/j.jseint.2025.03.019","url":null,"abstract":"<div><h3>Background</h3><div>Elbow tendinopathy is a common condition among athletes and the general population and can result in significant disability and time loss from work. Despite traditional treatments, symptoms often persist for more than 6 months. Doxycycline has been suggested as having treatment potential for tendinopathy as a matrix metalloproteinase inhibitor. The objective of this study was to evaluate the feasibility of subantimicrobial dose (SD) doxycycline as a low-cost adjunctive treatment in the nonsurgical management of elbow tendinopathy.</div></div><div><h3>Methods</h3><div>Subjects received doxycycline 20 mg twice per day for 12 weeks in addition to standard of care, including a home exercise program and a counterforce brace. Any potential side effects were reported weekly, and the remaining pills were counted at 12 weeks. Patient-reported outcome measures were collected at baseline, 4, 8, and 12 weeks. Ultrasound, grip strength, and laboratory values were assessed at baseline and 12 weeks.</div></div><div><h3>Results</h3><div>Our sample consisted of 21 patients (average age 50.9 years, 57.1% male). The median weeks of elbow pain at baseline was 14 (interquartile range 15). SD doxycycline resulted in no significant side effects or changes to laboratory values. Median medication compliance was 96% by pill count. Patient-reported outcome measures and grip strength were recorded at multiple time points in the follow-up.</div></div><div><h3>Conclusion</h3><div>Patients with elbow tendinopathy tolerated SD doxycycline well and the majority were compliant with a twice-daily regimen for 12 weeks. Our cohort demonstrated improvements in symptoms and grip strength. Further research is needed to determine if SD doxycycline contributes to this improvement.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1412-1417"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605407","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":"Do shoulder kinematics change after reverse total shoulder arthroplasty?","authors":"Itaru Kawashima MD, PhD ,&nbsp;Eric R. Wagner MD, MS ,&nbsp;Joseph J. King MD ,&nbsp;Zaamin B. Hussain MD, EdM ,&nbsp;Sameer R. Khawaja BS ,&nbsp;Jaden C. Hadrick BS ,&nbsp;Krishna N. Chopra MA ,&nbsp;Michael B. Gottschalk MD ,&nbsp;Scott A. Banks PhD ,&nbsp;Thomas W. Wright MD","doi":"10.1016/j.jseint.2025.04.025","DOIUrl":"10.1016/j.jseint.2025.04.025","url":null,"abstract":"<div><h3>Background</h3><div>Reverse total shoulder arthroplasty (rTSA) is believed to alter shoulder kinematics. However, it remains unclear whether the kinematic changes observed in shoulders following rTSA were present preoperatively or developed as a result of the surgery. Furthermore, the impact of preoperative scapulohumeral rhythm (SHR) on the postoperative SHR after rTSA is also poorly understood. The primary aim of this study was to compare shoulder kinematics before and after rTSA using the 3-dimensional (3D) to 2-dimensional model-image registration with dynamic digital radiography images. The secondary purpose was to evaluate whether preoperative SHR correlates with postoperative SHR after rTSA.</div></div><div><h3>Methods</h3><div>Twenty shoulders in 19 patients that underwent rTSA were included. Dynamic digital radiography images were performed preoperatively and 6 months or later postoperatively to assess shoulder motion during scapular plane abduction. 3D surface models of preoperative scapula and humerus, and postoperative scapula and humerus with implants were created from the preoperative and postoperative computed tomography images. Scapular and humeral kinematics were evaluated using a 3D to 2-dimensional model image registration method. Each kinematics parameter was calculated at 10° increments from 20° to 90° of humeral abduction. The mean SHR was also calculated from the humeral position at side to 90° or to the maximum humeral abduction if it was less than 90°. Linear mixed-effects models for repeated measures were used to compare kinematics at each humeral abduction between preoperative and postoperative conditions. The correlation between the preoperative mean SHR and the postoperative mean SHR was assessed using Pearson's product-moment correlation statistic.</div></div><div><h3>Results</h3><div>A significant postoperative increase in scapular posterior tilt was observed (<em>P</em> = .019). However, changes in SHR, scapular upward rotation, or scapular and humeral internal/external rotation from preoperative to postoperative conditions were not statistically significant. Additionally, a significant correlation was not detected between the preoperative and postoperative mean SHR.</div></div><div><h3>Conclusion</h3><div>rTSA significantly increases scapular posterior tilt postoperatively compared to the preoperative condition. However, significant changes from the preoperative to postoperative conditions were not demonstrated for other kinematic parameters.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1357-1364"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605921","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}