JSES International最新文献

{"title":"Cross-cultural adaptation and psychometric properties of the Argentine version of the shoulder pain and disability index (SPADI) in patients with shoulder disorders","authors":"Juan C. Porollan PT ,&nbsp;Santiago Soliño PT ,&nbsp;Franco J. Fabani PT ,&nbsp;María G. de Ilzarbe PT ,&nbsp;Micaela Oyola PT ,&nbsp;Tomás A. Bossio PT ,&nbsp;Julián M. Morales PT ,&nbsp;Joaquín López PT ,&nbsp;Federico J. Villalba PT ,&nbsp;Gastón Muhafara PT ,&nbsp;Pablo O. Policastro PT","doi":"10.1016/j.jseint.2024.11.008","DOIUrl":"10.1016/j.jseint.2024.11.008","url":null,"abstract":"<div><h3>Background</h3><div>Shoulder disorders are some of the leading causes of musculoskeletal conditions with a significant economic impact worldwide. The Shoulder Pain and Disability Index (SPADI) questionnaire has proved to be a valid and useful tool for the assessment of disability; however, reporting of properties in several languages has been inconsistent, and the quality of the studies available is low. Moreover, there is only one version in Spanish, designed in Spain, which does not consider the linguistic differences existing in Argentina. Therefore, the aim of the present study was to conduct the cross-cultural adaptation of the SPADI and assess its reliability, validity, responsiveness, and interpretability in subjects with shoulder disorders.</div></div><div><h3>Materials and methods</h3><div>The study was conducted following the COSMIN Guidelines (COnsensus-based Standards for the Selection of health Measurement INstruments). We included Argentine residents, older than 18 years of age, referred to physiotherapy for shoulder disorders.</div></div><div><h3>Results</h3><div>A total of 101 patients were evaluated. Reliability was acceptable with an intraclass correlation coefficient of 0.89. The standard error of measurement and minimal detectable change were 2.18 and 6.05, respectively. Construct validity was excellent, and responsiveness was high. Also, the minimal clinically important difference was 18.46 points, the substantial clinical benefit was 27.69 points, and the symptom acceptable level value was 21.35 points.</div></div><div><h3>Conclusion</h3><div>A cross-cultural adaptation of the Argentine version of the SPADI was conducted. This version proved to be valid, reliable, and responsive with interpretability values.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 532-541"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593723","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":"Ultrasonography of lateral elbow pain through a weighted varus flexion position contributes to detect minor instabilities","authors":"Aurelien Traverso MD ,&nbsp;Valeria Vismara MD ,&nbsp;Simone Cassin MD ,&nbsp;Andrea Zagarella MD ,&nbsp;Pietro Randelli Pr ,&nbsp;Paolo Arrigoni MD","doi":"10.1016/j.jseint.2024.11.003","DOIUrl":"10.1016/j.jseint.2024.11.003","url":null,"abstract":"<div><h3>Background</h3><div>Recent evidence indicates that lateral elbow pain may not stem solely from extra-articular or tendon-related sources, but rather be part of a multifactorial process that also involves intra-articular factors. Therefore, diagnosis of minor elbow instability is often delayed, waiting for conservative measures to assess the problem. A timely diagnosis could help achieve better patient care. While ultrasound (US) stress tests have been instrumental in evaluating joint instability across various anatomical sites, their role in diagnosing minor instability of the lateral elbow remains unexplored. The aim of this study is to assess the presence of lateral joint opening in a functional position using dynamic varus-stressed US in patients with clinically suspected atraumatic minor instability.</div></div><div><h3>Materials and methods</h3><div>Patients with suspected minor instability were compared to a control group with nonpathologic elbows. Eligible patients underwent varus stress US of the elbow with 70° of flexion of the elbow and a 3 kg weight fixed to the wrist. The presence of lateral widening and its increase were documented and compared between the groups. The test was named Highlight Elbow Lateral Pathology with UltraSound (HELP US). Sixty-five elbows were evaluated in this study. There were 35 patients in the case group (80% male, mean age 47 years) and 30 healthy controls (77% male, mean age 49 years).</div></div><div><h3>Results</h3><div>The mean lateral elbow joint width was 26.7% in the pathological group, meanwhile, in the control arm, the mean lateral elbow joint width increase was 3.2%. The groups had a significant difference in the widening of the lateral elbow during the HELP US test (<em>P &lt; .01</em>). Within the cases, a total of 17 patients (48%) had a history of previous corticosteroid injections. The mean lateral elbow joint width increase was 27%, showing no difference with those patients who showed no history of previous corticosteroid injections.</div></div><div><h3>Conclusions</h3><div>The HELP US test can detect changes in the lateral elbow compartment and can depict lateral elbow articular space widening. This is a valid diagnostic tool and should be implemented in evaluating all patients complaining of lateral elbow pain. The HELP US test could help physicians screen for a timely diagnosis of minor instability and speed up the request for second-level imaging studies to those patients that effectively require it the most.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 590-595"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593831","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":"Effectiveness of nonoperative treatment in patients with glenohumeral osteoarthritis: a prospective cohort study","authors":"Favian Su MD,&nbsp;Hayden Sampson BS,&nbsp;Christopher Anigwe MD,&nbsp;C. Benjamin Ma MD,&nbsp;Drew A. Lansdown MD,&nbsp;Brian T. Feeley MD","doi":"10.1016/j.jseint.2024.08.189","DOIUrl":"10.1016/j.jseint.2024.08.189","url":null,"abstract":"<div><h3>Background</h3><div>There is limited evidence supporting the use of nonoperative strategies in the treatment of glenohumeral osteoarthritis (GHOA). Recent clinical practice guidelines have stated that it is unclear whether nonoperative management of GHOA would produce a clinically important difference in pain or function. Therefore, the purpose of this study was to determine the effectiveness of nonoperative treatment on patient-reported outcomes (PROs) and to identify factors that could predict which patients would undergo total shoulder arthroplasty (TSA).</div></div><div><h3>Methods</h3><div>62 patients with primary GHOA were recruited. Patients could choose to receive or refuse different nonoperative modalities, including physical therapy (PT) and corticosteroid injections, based on their preference. American Shoulder and Elbow Surgeons (ASES) score were administered at baseline, 3, 6, and 12 months to evaluate treatment response. Demographic, clinical, and radiographic characteristics were compared between patients who failed and did not fail nonoperative management. Failure was defined as having undergone TSA.</div></div><div><h3>Results</h3><div>14 (23%) patients who initially attempted nonoperative management underwent TSA at 7.7 months (range, 1.6-25.2 months). In patients who continued nonoperative management, only 19 (31%) patients met the minimum clinical important difference and 26 (42%) patients achieved patient acceptable symptom state. There was no significant difference in the change in ASES score between patients who did and did not undergo PT (<em>P</em> = .524). A lack of belief in PT (HR = 33.6 [95% CI: 5.26-214], <em>P</em> &lt; .001), decrease in ASES score (HR = 6.25 [95% CI: 2.04-20.0], <em>P</em> = .001]), female sex (HR = 5.38 [95% CI: 1.31-22.1], <em>P</em> = .020), and lower resilience (HR = 7.14 [95% CI: 1.78-33.3], <em>P</em> = .006) were independently associated with failure of nonoperative treatment. Patients who received at least one glenohumeral corticosteroid injection (HR = 0.16 [95% CI: 0.04-0.67], <em>P</em> = .012) or had more joint space remaining (HR = 0.22 [95% CI: 0.06-0.80], <em>P</em> = .021) had a decreased risk of failure.</div></div><div><h3>Conclusions</h3><div>Approximately, 30% of patients with GHOA who chose their nonoperative treatment regimen had clinically meaningful improvements in symptoms. Despite this, patients elected to undergo TSA less than 25% of the time at short-term follow-up. PT was not beneficial in the treatment of GHOA. Screening questionnaires that evaluate a patient’s belief in PT and resilience could potentially be used to identify which patients will fail nonoperative treatment.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 404-410"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593904","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":"Three-dimensional evaluation of stem placement accuracy with the conventional guide in reverse shoulder arthroplasty and its relevance to clinical outcomes","authors":"Katsumasa Nakazawa MD ,&nbsp;Tomoya Manaka MD, PhD ,&nbsp;Yukihide Minoda MD, PhD ,&nbsp;Yoshihiro Hirakawa MD, PhD ,&nbsp;Yoichi Ito MD, PhD ,&nbsp;Hayato Shimizu MD ,&nbsp;Ryosuke Iio MD ,&nbsp;Hiroaki Nakamura MD, PhD","doi":"10.1016/j.jseint.2024.09.030","DOIUrl":"10.1016/j.jseint.2024.09.030","url":null,"abstract":"<div><h3>Background</h3><div>Placement of retroversion of the stem (RS) is important in reverse shoulder arthroplasty. A conventional guide, based on the forearm, has been used for stem placement; however, only a few studies have reported the accuracy of stem placement using conventional guides. In this study, a three-dimensional postoperative evaluation software was used to investigate the accuracy of RS placement using a conventional guide and its effect on postoperative outcomes.</div></div><div><h3>Methods</h3><div>This retrospective study was performed by a single surgeon (a board-certified specialist with more than 15 years of experience in performing reverse shoulder arthroplasty) using the Exactech Equinoxe Reverse Shoulder System (Exactech Inc., Gainesville, FL, USA). Forty-nine patients who were followed up for at least 2 years were included. The target RS angle of the humeral component was set to 20°. Postoperative implant placement, including RS, was assessed with a three-dimensional planning software using computed tomography images obtained postoperatively. Postoperative range of motion and its relationship with clinical outcomes were also evaluated as clinical assessment. Furthermore, a subanalysis was performed comparing the 0-20° RS group with the other groups.</div></div><div><h3>Results</h3><div>The mean postoperative RS was 13.2 ± 11.9° and was placed within 0-20° in 31/49 patients (63.3%). A correlation was observed between postoperative external rotation and RS (r = 0.30, <em>P</em> = .03). In a further subanalysis, the Constant–Murley score was significantly higher in the 0-20° RS group (<em>P</em> = .03).</div></div><div><h3>Conclusion</h3><div>Placement of the RS using a conventional guide varied from the target position. RS correlated with postoperative external rotation, and RS within 0-20° significantly improved clinical outcomes. These results suggested that accurate placement of the RS may improve clinical outcomes. Therefore, the development of surgical assistive technologies for accurate placement is necessary to ensure accurate stem placement to avoid human error.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 436-444"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594054","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":"Patients posture affects clinical outcomes and range of motion after reverse total shoulder arthroplasty: A clinical study","authors":"Philipp Kriechling MD ,&nbsp;Georgios Neopoulos MD ,&nbsp;Alexander Berger MD,&nbsp;Philipp Stein BSc,&nbsp;Tobias Götschi PhD,&nbsp;Florian Grubhofer MD,&nbsp;Karl Wieser MD","doi":"10.1016/j.jseint.2024.10.002","DOIUrl":"10.1016/j.jseint.2024.10.002","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Movement limitations following implantation of reverse total shoulder arthroplasty (rTSA) have been observed in some patients postoperatively, with implant design and positioning recognized as important influential factors. Recent analyses have identified patient’s posture, measured as scapula internal rotation on computed tomography (CT), as an additional factor influencing the functional outcome after rTSA. However, no clinical study has correlated the preoperatively photo-documented posture to functional outcome. It was the aim of this study to correlate preoperatively photo-documented posture to scapula orientation using CT and analyze the influence on functional outcome following rTSA implantation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A prospectively enrolled rTSA database was retrospectively reviewed to include a total of 360 patients with a minimum follow-up of 2 years. Patient’s posture was analyzed using standardized preoperative photo and video documentation. The posture was defined following the classification system of Moroder et al as type A (upright posture, retracted scapulae), type B (intermediate), and type C (kyphotic posture with protracted scapulae). In addition, CT data were used to measure scapula position (internal rotation). Correlation analyses between them were conducted. Postoperative range of motion (ROM) and clinical outcomes (absolute Constant-Murley Score and relative Constant-Murley Score) were compared between the different posture types.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;According to the photo-documented posture types, the patients were divided into posture types A (n = 59), B (n = 253) and C (n = 48). Average absolute Constant-Murley Score differed significantly among the groups (69 ± 16 vs. 69 ± 14 vs. 64 ± 16, &lt;em&gt;P&lt;/em&gt; &lt; .05) favoring patients with posture types A and B over type C. In terms of ROM, flexion, abduction, and internal rotation significantly differed among the groups. Types A and B exhibited better flexion and abduction (flexion 124 ± 26° and 123 ± 23° vs. 113 ± 25°, abduction 140 ± 34° and 137 ± 30° vs. 128 ± 34°). Patients with posture type A demonstrated superior internal rotation (CS points: 5.9 ± 2.9 vs. 5.0 ± 2.7 vs. 4.4 ± 2.8, &lt;em&gt;P&lt;/em&gt; &lt; .05). External rotation was better for type A compared to type C (A: 33 ± 17° vs. B: 30 ± 16° vs. C: 28 ± 18°). Correlation analysis of posture classification using photo documentation and CT scan showed poor reliability (r = 0.35).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Patients with clinical posture types A and B exhibited improved ROM values compared to type C postures. Clinical outcome scores were also notably superior in types A and B. However, the measurement of scapula internal rotation on supine CT does not reliably correlate with photo documentation of patient’s posture. Preoperatively, patient’s posture should be considered in rTSA planning because of the potential influence on ROM and clinical outcomes.&lt;","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 445-452"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594055","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 and radiographic outcomes following anatomic coracoclavicular ligament reconstruction using 4-strand taped suspensory fixation in an active-duty military population","authors":"Michael Czarnecki DO ,&nbsp;Jonathan Horng MD ,&nbsp;Jonah Liwag MD ,&nbsp;Haley Johnson MD ,&nbsp;James A. Pruneski MD ,&nbsp;Christian Cruz MD ,&nbsp;Kyong S. Min MD","doi":"10.1016/j.jseint.2024.10.004","DOIUrl":"10.1016/j.jseint.2024.10.004","url":null,"abstract":"<div><h3>Background</h3><div>Acromioclavicular (AC) joint injuries are common in young, active populations. However, there is a paucity of literature reporting surgical outcomes following the treatment of AC joint injuries in the military population. Therefore, the purpose of this study was to evaluate the clinical and radiographic outcomes of active-duty military members who underwent arthroscopic-assisted anatomic coracoclavicular ligament reconstruction using a 4-strand suspensory fixation with taped sutures for treatment of high-grade AC joint injuries with a minimum 1-year follow-up.</div></div><div><h3>Methods</h3><div>A retrospective review was performed on all patients with Rockwood grade IIIB-V AC joint separations who underwent anatomic coracoclavicular ligament reconstruction using a 4-strand suspensory fixation with taped sutures at a single military treatment facility between January 2015 and May 2022. Clinical outcome measures included the Single-Assessment Numerical Evaluation (SANE) score and patient satisfaction using the Likert Scale. Radiographic outcomes were measured by classifying the amount of residual AC joint separation on postoperative radiographs utilizing the Rockwood classification.</div></div><div><h3>Results</h3><div>Coracoclavicular ligament reconstruction a using 4-strand suspensory fixation with taped sutures was performed in 15 consecutive patients, all of which were active-duty military males with a mean age of 35.8 years. Preoperatively, there were 10 patients with grade IIIB injuries, 1 patient with a grade IV injury, and 4 patients with grade V injuries. The average preoperative SANE score was 40.0. The average length of time from injury to surgery was 46.5 weeks. Patient-reported outcomes were available for 12 of the 15 patients (80%) at an average of 4.9 years postoperatively with an average postoperative SANE score of 77.1 (<em>P</em> = .0002); 11 of these 12 patients (92%) reported they were either satisfied or extremely satisfied with the outcome of the surgery. Postoperative radiographs were available for 14 of the 15 patients (93%) at an average of 2.7 years postoperatively revealing 13 patients had maintained grade I reduction while 1 patient had a grade III separation.</div></div><div><h3>Conclusion</h3><div>Coracoclavicular ligament reconstruction a using 4-strand suspensory fixation with taped sutures resulted in significantly improved radiographic and patient-reported outcomes in this retrospective review of active-duty military members with grade IIIB-V AC joint separations.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 346-349"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593714","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 and radiological results of reverse total shoulder arthroplasty with or without lateralization as revision procedure for failed arthroplasty","authors":"Jan-Philipp Imiolczyk MD ,&nbsp;Laurent Audigé DVM, PhD ,&nbsp;Florian Freislederer MD ,&nbsp;Philipp Moroder MD ,&nbsp;David Endell MD ,&nbsp;Raphael Trefzer MD ,&nbsp;Markus Scheibel MD","doi":"10.1016/j.jseint.2024.10.014","DOIUrl":"10.1016/j.jseint.2024.10.014","url":null,"abstract":"<div><h3>Background</h3><div>As reverse total shoulder arthroplasty (rTSA) becomes a common treatment option in the revision setting, common problems associated with Grammont’s design such as scapular notching, instability, and rotator cuff weakening occur. Design changes associated with superior outcomes in primary rTSA, such as glenoid or humeral lateralization have not yet been examined in the revision settings. The purpose of this consecutive series of revision rTSA is to evaluate the clinical and radiological short-term results after aseptic and septic revision rTSA and explore potential benefits of metallic glenoid and humerus lateralization.</div></div><div><h3>Methods</h3><div>In this study, patients treated with an rTSA between 2014 and 2020 after failed shoulder arthroplasty were included. Forty-five consecutive patients were divided into comparative groups using lateralized rTSA with metallic baseplate augmentation (latrTSA) and additional humeral lateralization using a 145° onlay curved stem (bi-latrTSA); or no baseplate offset with a Grammont-type 155° stem (non-latrTSA). Further, outcome of postinfection revision rTSAs was compared to aseptic loosening. Constant-Murley-Score, subjective shoulder value, shoulder range of motion including Apley’s scratch test, abduction strength, and pain levels were assessed. Radiographs were reviewed for implant loosening, scapular notching, fractures, and osteolysis. Lateralization and distalization shoulder angle were measured at the final follow-up.</div></div><div><h3>Results</h3><div>Thirty-eight patients showed significant improvement in all functional measurements at the final 2-year follow-up compared to the baseline (<em>P</em> &lt; .01). There were no significant differences in favor of glenoid or bipolar lateralization. However, no scapular notching was seen in patients with both humeral and glenoid lateraliazion (non-latrTSA: 33%; latrTSA: 8%; bi-latrTSA: 0%; <em>P</em> = .103), with no signs of implant loosening. Patients with bi-latrTSA showed significantly greater lateralization shoulder angle (<em>P</em> = .017); distalization shoulder angle was lower, but not significantly (<em>P</em> = .230). Postinfectious rTSA after aseptic loosening (n = 19; 55%) presented better internal rotation (<em>P</em> = .036) compared to postinfectious rTSA. The overall complication rate was 16% and 8% leading to revision.</div></div><div><h3>Conclusion</h3><div>rTSA is a viable option for revision cases and presents good results after failed shoulder arthroplasty, including the infected shoulder. The effect of metallic augmentation on clinical results is not comparable to those in literature in primary rTSA setting due to advanced preoperative medialization. However, scapular notching was prevented in all cases with bipolar lateralization.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 477-485"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593956","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":"Evaluating proximal ulnar morphology in relation to the humeral flexion–extension axis","authors":"Cornille Minnaert MD ,&nbsp;Jan Herregodts MD ,&nbsp;Stijn Herregodts Jr. PhD ,&nbsp;Lieven De Wilde MD, PhD ,&nbsp;Alexander Van Tongel MD, PhD","doi":"10.1016/j.jseint.2024.10.016","DOIUrl":"10.1016/j.jseint.2024.10.016","url":null,"abstract":"<div><h3>Background</h3><div>The study aimed to evaluate the 3D relationship between the plane of the posterior surface of the olecranon, a newly defined plane through the ridge of the greater sigmoid notch (GSN), and the ulno-humeral flexion–extension axis (FE axis), respectively.</div></div><div><h3>Methods</h3><div>Twenty-four healthy left elbows were computed tomography scanned and 3D-segmented. First, a Cartesian ulnar coordinate system (UCS) was determined. Next, several anatomical landmarks were identified. The UCS and landmarks were assessed for repeatability and reproducibility. The orientation of the posterior surface and the plane through the GSN was evaluated relative to the anatomical FE axis.</div></div><div><h3>Results</h3><div>Both the UCS and the landmarks were considered repeatable and reproducible. In the axial plane, the mean angle between the posterior surface and the FE axis was 3° (standard deviation: ±5°, 95% confidence interval [CI]: [−6°; 12°]) external rotation. The mean axial angle between the GSN and the FE axis was 88° (standard deviation: ±3°, 95% CI: [83°; 94°]) external rotation.</div></div><div><h3>Conclusion</h3><div>This study concludes that the angulation between the posterior plane surface and the FE axis is highly variable (95% CI range: 18°). The plane through the ridge of the GSN of a healthy proximal ulna could provide a more reliable anatomical landmark to estimate the position of the elbow FE axis compared to the posterior surface (95% CI range: 11°).</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 574-579"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593469","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 superior capsular reconstruction with acellular human dermal allograft for irreparable rotator cuff tears: outcomes, complications, and reoperations at 2-year minimum follow-up","authors":"Gabrielle Dykhouse BS ,&nbsp;Erick Marigi MD ,&nbsp;Anthony Finocchiaro BS ,&nbsp;Joshua S. Dines MD ,&nbsp;Michael C. Fu MD, MHS","doi":"10.1016/j.jseint.2024.11.007","DOIUrl":"10.1016/j.jseint.2024.11.007","url":null,"abstract":"<div><h3>Background</h3><div>Management of posterosuperior irreparable rotator cuff tears (IRCTs) remains challenging without clear consensus among shoulder surgeons. Arthroscopic superior capsular reconstruction (SCR) with dermal allograft has been proposed as a promising treatment option. However, current investigations are limited to short term studies and recent data has suggested variable clinical outcomes. Therefore, the purpose of this investigation was to report intermediate-term clinical outcomes in patients who underwent arthroscopic SCR with a dermal allograft for IRCTs.</div></div><div><h3>Methods</h3><div>Over a 4-year period (2016–2020), all patients who underwent an arthroscopic dermal allograft SCR with a minimum 2-year follow-up period were identified. SCR with dermal allograft was performed for patients with an IRCT utilizing a 3-mm acellular dermal allograft. Collected clinical outcomes included range of motion, strength, Numeric Rating Scale for pain, American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form score, Single-Assessment Numeric Evaluation score, complications, and reoperations.</div></div><div><h3>Results</h3><div>The final cohort included 41 dermal allograft SCR performed in 40 patients (1 bilateral) with a majority male cohort (n = 29; 72%), a mean age of 67 ± 7 years, body mass index of 28.4 ± 5.0, and follow-up of 5.3 ± 1.4 years. Clinically, there was a significant improvement in preoperative and postoperative Numeric Rating Scale pain scores from 5.0 to 1.8 (<em>P</em> &lt; .001), but no differences in preoperative and postoperative forward flexion (<em>P</em> = .268), abduction (<em>P</em> = .822), external rotation (<em>P</em> = .323), or internal rotation (<em>P</em> = .995). The final postoperative American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form and Single-Assessment Numeric Evaluation scores were 66 ± 28 and 59 ± 30, respectively. There were 8 (19.5%) complications, which consisted primarily of symptomatic graft failure in 6 (14.6%) shoulders and progression of rotator cuff arthropathy in 2 (4.9%) shoulders. Reoperations occurred in 6 (14.3%) shoulders: 4 (9.8%) were conversion to reverse total shoulder arthroplasty and 2 (4.9%) were arthroscopic revision dermal allograft SCR with partial repair and reattachment of the torn graft.</div></div><div><h3>Conclusion</h3><div>At a cohort mean of 5 years after arthroscopic SCR with dermal allograft for IRCTs, patients experienced sustained pain relief but no significant improvement in shoulder function. Additionally, 20% sustained a postoperative complication with a 14% reoperation rate. These findings should be considered when counseling patients about the challenges of managing IRCTs and the possible outcomes of utilizing dermal allograft SCR as a surgical modality.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 385-389"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593837","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":"Can popular AI large language models provide reliable answers to frequently asked questions about rotator cuff tears?","authors":"Ulas Can Kolac MD ,&nbsp;Orhan Mete Karademir ,&nbsp;Gokhan Ayik MD ,&nbsp;Mehmet Kaymakoglu MD ,&nbsp;Filippo Familiari MD ,&nbsp;Gazi Huri MD","doi":"10.1016/j.jseint.2024.11.012","DOIUrl":"10.1016/j.jseint.2024.11.012","url":null,"abstract":"<div><h3>Background</h3><div>Rotator cuff tears are common upper-extremity injuries that significantly impair shoulder function, leading to pain, reduced range of motion, and a decrease in quality of life. With the increasing reliance on artificial intelligence large language models (AI LLMs) for health information, it is crucial to evaluate the quality and readability of the information provided by these models.</div></div><div><h3>Methods</h3><div>A pool of 50 questions was generated related to rotator cuff tear by querying popular AI LLMs (ChatGPT 3.5, ChatGPT 4, Gemini, and Microsoft CoPilot) and using Google search. After that, responses from the AI LLMs were saved and evaluated. For information quality the DISCERN tool and a Likert Scale was used, for readability the Patient Education Materials Assessment Tool for Printable Materials (PEMAT) Understandability Score and the Flesch-Kincaid Reading Ease Score was used. Two orthopedic surgeons assessed the responses, and discrepancies were resolved by a senior author.</div></div><div><h3>Results</h3><div>Out of 198 answers, the median DISCERN score was 40, with 56.6% considered sufficient. The Likert Scale showed 96% sufficiency. The median PEMAT Understandability score was 83.33, with 77.3% sufficiency, while the Flesch-Kincaid Reading Ease score had a median of 42.05 with 88.9% sufficiency. Overall, 39.8% of the answers were sufficient in both information quality and readability. Differences were found among AI models in DISCERN, Likert, PEMAT Understandability, and Flesch-Kincaid scores.</div></div><div><h3>Conclusion</h3><div>AI LLMs generally cannot offer sufficient information quality and readability. While they are not ready for use in medical field, they show a promising future. There is a necessity for continuous re-evaluation of these models due to their rapid evolution. Developing new, comprehensive tools for evaluating medical information quality and readability is crucial for ensuring these models can effectively support patient education. Future research should focus on enhancing readability and consistent information quality to better serve patients.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 390-397"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593838","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}