JSES International最新文献

{"title":"What information does the surgeon need before using software to plan a total shoulder arthroplasty? An international perspective","authors":"Justine Barbier MD ,&nbsp;Olivier Verborgt MD, PhD ,&nbsp;Joseph P. Iannotti MD, PhD ,&nbsp;Philippe Collin MD ,&nbsp;Matthias A. Zumstein MD","doi":"10.1016/j.jseint.2024.09.006","DOIUrl":"10.1016/j.jseint.2024.09.006","url":null,"abstract":"<div><div>Shoulder arthroplasty is a surgical procedure that is increasingly being used to treat patients with shoulder joint disorders, such as osteoarthritis and rotator cuff tears. Preoperative planning and the accurate transfer of this plan to the surgical procedure are critical for the success of the surgery. Three-dimensional (3D) preoperative planning software that assists with arthroplasty requires some basic surgical planning steps. These steps include segmentation of the bones, defining anatomic landmarks, 3D templating, and positioning of the planned implant. Surgical planning is thereby influenced by the surgeon’s preferred implant and surgical technique, which is influenced by the bone and soft tissue pathology. Only the bone pathology is defined within the 3D preoperative planning software and in some software the premorbid patient-specific normal anatomy is defined. Each software utilizes its specific methods.</div><div>These 3D preoperative planning software programs have generally been found to improve the accuracy of preoperative planning and the execution of implant positioning. However, it is important for shoulder surgeons to be aware that these systems are not all comparable, have their limitations and potential pitfalls, and therefore can potentially introduce errors into the surgical procedure.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 944-953"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942865","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":"Improved total shoulder arthroplasty outcomes associated with semaglutide utilization in patients with type II diabetes: a promising new addition to preoperative optimization","authors":"Anthony E. Seddio BS,&nbsp;Christopher V. Wilhelm MD,&nbsp;Michael J. Gouzoulis BS,&nbsp;Wasif Islam MD,&nbsp;Rajiv S. Vasudevan MD,&nbsp;Scott J. Halperin MD,&nbsp;Lee E. Rubin MD,&nbsp;Michael J. Medvecky MD,&nbsp;Kenneth W. Donohue MD,&nbsp;Jonathan N. Grauer MD","doi":"10.1016/j.jseint.2024.10.006","DOIUrl":"10.1016/j.jseint.2024.10.006","url":null,"abstract":"<div><h3>Background</h3><div>Semaglutide (the active agent in Ozempic [Novo Nordisk, Plainsboro, NJ, USA]) has been increasingly recognized as one of the most effective medications in the management of type II diabetes mellitus (T2DM). Patients with T2DM undergoing orthopedic surgery, such as total shoulder arthroplasty (TSA), may be using this medication for management of their disease. While T2DM has been associated with inferior postoperative TSA outcomes, the correlation of preoperative semaglutide use on such outcomes has never been characterized.</div></div><div><h3>Methods</h3><div>T2DM patients undergoing TSA (anatomic or reverse) were identified from the PearlDiver M165Ortho database using administrative coding. T2DM patients who utilized semaglutide within 1 year before TSA were identified and matched 1:4 with T2DM patients who did not based on age, sex, Elixhauser Comorbidity Index, end-organ diabetes complications, body mass index, tobacco, insulin, and metformin use. Incidence of 90-day adverse events were compared by univariable and multivariable analyses.</div></div><div><h3>Results</h3><div>After matching, there were 632 T2DM +semaglutide and 2302 T2DM −semaglutide patients. On multivariable analysis of the matched populations, T2DM +semaglutide patients had significantly lower odds of surgical site infection (odds ratio (OR) 0.25, <em>P</em> = .003), cardiac events (OR 0.32, <em>P</em> = .003), venous thromboembolism (OR 0.36, <em>P</em> = .001), pneumonia (OR 0.25, <em>P</em> &lt; .001), urinary tract infection (OR 0.30, <em>P</em> &lt; .001), acute kidney injury (OR 0.39, <em>P</em> &lt; .001), and emergency department visit (OR 0.37, <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>The current study encouragingly found reductions in 90-day adverse outcomes following TSA for patients with T2DM using semaglutide preoperatively. Further prospective analysis is warranted as the observed findings suggest clinical benefit of semaglutide integration into preoperative optimization pathways by the studied patient population.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 735-740"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942941","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":"Postoperative rehabilitation and return to sport criteria following distal biceps tendon rupture surgery","authors":"Brian M. Phelps MD ,&nbsp;Alysa Birnbrich MD ,&nbsp;William Singer BS ,&nbsp;Kihoon Bohle BS ,&nbsp;Andrew George MD ,&nbsp;Robert A. Jack II MD","doi":"10.1016/j.jseint.2025.02.013","DOIUrl":"10.1016/j.jseint.2025.02.013","url":null,"abstract":"<div><h3>Background</h3><div>Within the clinical literature, there is no consensus on optimal rehabilitation for return to sport (RTS) after distal biceps tendon rupture (DBTR) repair. The authors hypothesize that surgeons will utilize time-based criteria for RTS rather than performance-based or functional criteria for RTS.</div></div><div><h3>Methods</h3><div>Level 1-4 studies that evaluated DBTR with a minimum of 12 months follow-up were eligible. Exclusion criteria included studies that treated DBTR nonoperatively, lacked RTS criteria, or included revision surgery. Studies were evaluated for RTS criteria, timeline/rate of RTS, and methodologic quality.</div></div><div><h3>Results</h3><div>Out of 671 studies identified, 5 met inclusion criteria. These included 268 patients playing 22 different sports. Timeline for return ranged from 3 to 130 weeks. Range of motion exercises followed by strengthening (100%) and multiphase rehabilitation program (100%) were the most common parameters emphasized in rehabilitation protocols, followed by immediate postoperative cast/splint immobilization (80%). All studies included a timeline for RTS; however, no article listed subjective or specific objective measurement criteria for RTS.</div></div><div><h3>Conclusion</h3><div>There is no consensus on RTS criteria in the literature. Eighty percent of the included studies reported utilizing initial cast/splint immobilization; 100% reported a multiphase program consisting of some form of progressive range of motion followed by strengthening. Sixty percent reported a supervised physical therapy routine. One hundred percent reported timing after surgery as a criterion for RTS, but this timing varied greatly across the included studies.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 929-933"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943018","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":"Using deep learning to predict postoperative pain in reverse shoulder arthroplasty patients","authors":"Tim Schneller MSc ,&nbsp;Andrea Cina MSc ,&nbsp;Philipp Moroder MD ,&nbsp;Markus Scheibel MD ∗ ,&nbsp;Asimina Lazaridou PhD ∗","doi":"10.1016/j.jseint.2024.11.020","DOIUrl":"10.1016/j.jseint.2024.11.020","url":null,"abstract":"<div><h3>Background</h3><div>Most research on shoulder arthroplasty has predominantly concentrated on optimizing treatment to enhance shoulder function with comparatively less emphasis on postsurgical pain. Yet, pain is an equally significant or even more important outcome in orthopedic surgery. The aim of this study was to develop a deep learning algorithm for predicting postsurgical pain after reverse total shoulder arthroplasty (rTSA).</div></div><div><h3>Methods</h3><div>Clinical data of rTSA patients were extracted from a local shoulder arthroplasty registry and used to build an artificial neural network, which was set up with input from 34 preoperative features including demographics, disease-related information, clinical, and self-report assessments. The target variable was a binary classification derived from a numeric pain rating scale (0-10): if the pain scored 3 or higher, it was classified as positive; if the pain score was 2 or lower, it was classified as negative. The model was internally validated with a test dataset that was comprised of 20% of the whole dataset. Model performance was evaluated on the testset using the metrics accuracy, precision, recall, and f1-score.</div></div><div><h3>Results</h3><div>Our model, including data from 1707 patients (pain: n = 705, no pain: n = 1002), achieved a 63% accuracy rate in predicting postsurgical pain 2 years following rTSA. Identification of the most critical factors indicating low postsurgical pain was performed by SHapley Additive exPlanations analysis, which included a low American Society of Anesthesiologists physical status classification, a low Quick Disability of the Arm, Shoulder and Hand questionnaire score, private insurance status, primary OA, being admitted due to illness as opposed to due to an accident, low pain levels, occasional alcohol consumption, low shoulder pain and disability index and functional scores.</div></div><div><h3>Conclusion</h3><div>We successfully developed an artificial neural network to predict postsurgical pain after rTSA. Additional efforts are still required to refine the models’ performance, such as including further parameters predictive of pain and considering other machine learning algorithms. In a clinical setting, the implementation of such a prediction model could optimize surgical indications and help manage patient expectations more effectively.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 748-755"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943142","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":"Reverse total shoulder arthroplasty outcomes in elderly patients","authors":"Farah Selman MD ,&nbsp;Brett Moreira MD ,&nbsp;Nicholas P.J. Perry MD ,&nbsp;Philipp Kriechling MD ,&nbsp;Maximilian Gressl ,&nbsp;Karl Wieser MD","doi":"10.1016/j.jseint.2025.01.006","DOIUrl":"10.1016/j.jseint.2025.01.006","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies have found varied outcomes for elderly patients following reverse total shoulder arthroplasty (rTSA). Results for very old patients are rare. The purpose of this study was to analyze functional and radiographic outcomes after rTSA in patients aged 85 years and older and to compare them to a younger population.</div></div><div><h3>Methods</h3><div>Of 1460 patients treated with rTSA from 2005 to 2020, 5% (n = 74) were ≥85 years. 32 patients were excluded due to travel difficulties, death, refuse to participate and lost to follow-up. 42 patients with a minimum follow-up of 2 years were included and matched for sex, body mass index, American Society of Anesthesiologists Score, surgical indication, smoking, alcohol consume, and follow-up time to a younger population with a mean age of 69.5 ± 9 years. Statistical analysis was performed based on preoperative and postoperative range of motion (ROM), pain scores and patient satisfaction. Postoperative X-rays were evaluated for notching, radiolucency, bone formation and resorption, implant migration and periprosthetic fractures.</div></div><div><h3>Results</h3><div>42 cases with a mean age of 87 ± 2 years were included, 71% female. Indications for rTSA were rotator cuff (RC) tear with arthritis (36%), RC arthropathy (17%), RC tear without arthritis (17%), primary arthritis (17%), proximal humeral fracture (10%), failed osteosynthesis (7%), and instability (2%). Mean follow-up was 47 ± 22 months. Except for age, there were no significant differences in the matching cohort. In the elderly cohort, relative Constant-Murley Score (CMS) improved postoperative significantly from 41 ± 20 to 83 ± 11 and subjective shoulder value from 38 ± 20 to 80 ± 19. All aspects of ROM, except for external rotation, improved significantly. Abduction force and pain improved as well. Radiolucency around the glenoid (21%), bone formation (4.9%) and implant migration (4.9%) were significantly associated with poorer outcome in the absolute CMS (<em>P</em> = .013, <em>P</em> = .002 and <em>P</em> = .008). One patient (1/42, 2.4%) suffered multiple shoulder dislocations and needed a revision. No other reoperations were performed. Comparison between patients over 85 years and the younger matched control group showed no significant differences in relative CMS, subjective shoulder value, and ROM at final follow-up.</div></div><div><h3>Conclusion</h3><div>Patients aged 85 years and older can expect significant improvement in shoulder function and significant reduction of pain after rTSA. Overall clinical outcome is comparable to a younger population. Complication and revision rates are low. Age should not be a limiting factor when considering rTSA.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 815-822"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941824","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":"Adequacy of ChatGPT responses to frequently asked questions about shoulder arthroplasty: is it an appropriate adjunct for patient education?","authors":"Christopher K. Johnson MD, MS ,&nbsp;Krishna Mandalia BS ,&nbsp;Jason Corban FRCSC ,&nbsp;Kaley E. Beall MPH ,&nbsp;Sarav S. Shah MD","doi":"10.1016/j.jseint.2025.01.008","DOIUrl":"10.1016/j.jseint.2025.01.008","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) large language models, such as ChatGPT, have numerous novel applications in medicine, one of which is patient education. Several studies in other specialties have investigated the adequacy of ChatGPT-generated responses to frequently asked questions (FAQs) by patients, with largely positive results. The purpose of this study is to evaluate the accuracy and clarity of ChatGPT-generated responses to website-derived FAQs relating to shoulder arthroplasty.</div></div><div><h3>Methods</h3><div>Ten questions regarding shoulder arthroplasty were compiled from the websites of 5 leading academic institutions. These questions were rated on a scale from 1 to 4, corresponding to “excellent response not requiring clarification,” “satisfactory requiring minimal clarification,” “satisfactory requiring moderate clarification,” and “unsatisfactory requiring substantial clarification,” respectively, by 2 orthopedic surgeons. A senior shoulder arthroplasty surgeon arbitrated disagreements. Cohen’s Kappa coefficient was utilized to assess inter-rater agreement.</div></div><div><h3>Results</h3><div>After arbitration, only one response was rated as “excellent response not requiring clarification.” Nine of 10 responses required clarification. Four were rated as a “satisfactory requiring minimal clarification,” 5 were rated as a “satisfactory requiring moderate clarification,” and none were rated as “unsatisfactory requiring substantial clarification”. The Kappa coefficient was 0.516 (<em>P</em> = .027), indicating moderate agreement between reviewers.</div></div><div><h3>Conclusion</h3><div>When queried with FAQs regarding shoulder arthroplasty, ChatGPT’s responses were all deemed ‘satisfactory’, but most required clarification. This may be due to the nuances of anatomic vs. reverse shoulder replacement. Thus, patients may find benefit in using ChatGPT to guide whether or not they should seek medical attention, but are limited in the detail and accuracy of treatment-related questions. While a helpful tool to start provider–patient conversations, it does not appear that ChatGPT provides quality, verified, data-driven answers at this time, and should be used cautiously in conjunction to provider–patient discussions. Although the use of ChatGPT in answering FAQs is limited at the moment, orthopedic surgeons should continue to monitor the use of ChatGPT as a patient education tool, as well as the expanding use of AI as a possible adjunct in clinical decision-making.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 830-836"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941826","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":"Rates of retear following rotator cuff repair are similar between men and women","authors":"Jonathan D. Harley BA ,&nbsp;Lucas J. Ray MD ,&nbsp;Conner P. Olson BA ,&nbsp;Spencer M. Comfort MD ,&nbsp;Alicia K. Harrison MD ,&nbsp;Bryan M. Saltzman MD ,&nbsp;Allison J. Rao MD","doi":"10.1016/j.jseint.2024.12.009","DOIUrl":"10.1016/j.jseint.2024.12.009","url":null,"abstract":"<div><h3>Hypothesis</h3><div>A systematic review and meta-analysis was conducted investigating sex-based differences in retear rate after arthroscopic rotator cuff repair (RCR). It is hypothesized that females experience a higher rate of retear than males.</div></div><div><h3>Methods</h3><div>We performed a systematic review of 3 databases according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were included if they were written in English, published in a peer-reviewed journal, included patients with a history of arthroscopic RCR, reported failure rate based on sex, and had level of evidence 3 or higher. To assess failure, we used retear as our primary outcome, defined as a loss of structural integrity of the rotator cuff after primary repair, confirmed by imaging. Complications, reoperation, and patient-reported outcomes (PRO) were secondary outcomes.</div></div><div><h3>Results</h3><div>In 11 eligible studies, there were 3134 patients, 1787 female (57%) and 1476 male (43%). Of 11 studies, 10 reported sex-specific rates of retear, 3 reported complications by sex, 3 reported reoperation by sex, and 2 reported PROs by sex. A random-effects model demonstrated no significant difference in retear rates between females and males (mean difference, .010 [95% CI, −.068 to .087]; <em>P</em> = .81). Limited reporting prevented analysis for complication or reoperation rates. One study found significantly higher American Shoulder and Elbow Surgeons scores (92.2 vs. 88.2, <em>P</em> = .002), Constant-Murley Score scores (92.2 vs. 81.8, <em>P</em> &lt; .001) and significantly lower visual analog scale pain scores (.75 vs. 1.39, <em>P</em> &lt; .001) for males compared with females. No other significant differences in PROs were found. A random-effects model showed a significant difference in age between patients with and without retear (mean difference, 4.38 years [95% CI, 1.81-6.95]; <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>Female and male patients showed no significant difference in retear rate following arthroscopic RCR. Retears were associated with increased age, which aligns with previous findings in the existing literature. Since many studies reported only one or a few of the desired outcomes, increasing the uniformity of outcome reporting related to RCR failure may be beneficial.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 691-697"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942916","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":"Surgical management of elbow heterotopic ossification: postoperative outcomes with and without continuous passive motion rehabilitation","authors":"Stanley Liu MA ,&nbsp;Krishin Shivdasani MD, MPH ,&nbsp;Michael Scheidt MD ,&nbsp;Andrew L. Chen MD ,&nbsp;Nickolas G. Garbis MD ,&nbsp;Dane H. Salazar MD, MBA","doi":"10.1016/j.jseint.2025.02.002","DOIUrl":"10.1016/j.jseint.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>Continuous passive motion (CPM) has been an accepted method of orthopedic postoperative rehabilitation for decades. However, its efficacy remains disputed and there is a paucity of literature looking at the impact of CPM after operative management of elbow heterotopic ossification (HO). This retrospective study aims to compare long-term clinical outcomes after surgical excision of elbow HO between patients with and without postoperative CPM.</div></div><div><h3>Methods</h3><div>A retrospective case series was conducted on patients who underwent inpatient surgical excision of elbow HO at an academic level I trauma center between September 1999 and August 2022. Forty-eight patients (51 elbows) were identified, consisting of 16 cases that were rehabilitated with CPM and 35 cases that were not. Long-term follow-up examinations included measurement of elbow flexion–extension and pronosupination arcs, Mayo Elbow Performance Scores, and visual analog scale pain scores. Mann–Whitney <em>U</em> tests were used for statistical analysis.</div></div><div><h3>Results</h3><div>Patients had a minimum follow-up of 2 years with an average follow-up of 8 years (range 2-24 years). Utilizing CPM vs. no CPM postoperatively was associated with a significantly greater gain in preoperative to final follow-up flexion–extension arc (100° vs. 50°, <em>P</em> = .003) and a significantly smaller loss in intraoperative to final follow-up flexion–extension arc (0° vs. −15°, <em>P</em> = .018). However, it should be noted that there were no significant differences in the final range of motion based on CPM usage (110° vs. 110°, <em>P</em> = .228). Additionally, patients that utilized CPM reported a significantly greater Mayo Elbow Performance score at final follow-up (<em>P</em> = .045).</div></div><div><h3>Conclusion</h3><div>A CPM rehabilitation regimen after surgical excision of elbow HO may result in improved long-term patient-reported functional outcomes, but further investigation with a prospective, randomized protocol should be pursued.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 924-928"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943017","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":"Long-term nonsteroidal anti-inflammatory drug use is associated with rotator cuff tears in adult patients","authors":"Sailesh V. Tummala MD,&nbsp;Romir P. Parmar BS,&nbsp;Alejandro Holle BS,&nbsp;Joseph C. Brinkman MD,&nbsp;Jeffrey D. Hassebrock MD,&nbsp;John M. Tokish MD","doi":"10.1016/j.jseint.2024.11.021","DOIUrl":"10.1016/j.jseint.2024.11.021","url":null,"abstract":"<div><h3>Background</h3><div>To determine if long-term nonsteroidal anti-inflammatory drug (NSAID) is associated with rotator cuff tears (RCTs) in an adult population.</div></div><div><h3>Methods</h3><div>A retrospective study using a national database was performed. All patients with a diagnosis of long-term NSAID use with active records for at least 1 year or 2 years were identified. These patients were matched 1:1 to controls without NSAID use based on age, gender, and Charlson comorbidity index. Rates of new rotator cuff tendon tears were compared. Subgroup analyses in the following age ranges for each sex were done: 35-45, 46-55, 56-65, and 66-75.</div></div><div><h3>Results</h3><div>Out of 499,240 patients with chronic NSAID use, 10,180 patients sustained a RCT compared to 7471 of the control patients (2.04% vs. 1.50%, respectively; odds ratio [OR]: 1.18; 95% confidence interval [CI]: 1.14-1.21; <em>P</em> &lt; .001). Male NSAID users in the 46-55 age range had higher rates of RCTs compared to matched control patients (OR: 1.41; 95% CI: 1.30-1.52; <em>P</em> &lt; .001). Female NSAID users in the 46 to 55 age range had higher rates of RCTs compared to matched control patients (OR: 1.40; 95% CI: 1.31-1.49; <em>P</em> &lt; .001). Comparable results were seen in the 56-65 age range for both males and females. Furthermore, chronic NSAID users (n = 1888; 18.5%) underwent rotator cuff repair at higher rates compared to controls (n = 1223; 16.4%; <em>P</em> = .01).</div></div><div><h3>Conclusion</h3><div>Long-term NSAID use is associated with an increased incidence of rotator cuff tendon tears at the 1- and 2-year follow-up periods in adult patients, particularly those in the 46-55 age range.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 666-671"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942597","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 review of patient matched implants for shoulder arthroplasty","authors":"Patrick J. Carroll BMBS, BBLS, MCh, MRCSI, MFSEM, FRCSI (Tr & Orth),&nbsp;George S. Athwal MD, FRCSC","doi":"10.1016/j.jseint.2024.07.009","DOIUrl":"10.1016/j.jseint.2024.07.009","url":null,"abstract":"<div><h3>Background</h3><div>Advances in technology have enabled implant designers and shoulder surgeons to strive towards improving implant survival and patient outcomes. Patient matched implants (PMIs) for arthroplasty have developed from the use of technologies such as computer aided design and computer-aided manufacturing technology and three-dimentional printing.</div></div><div><h3>Methods</h3><div>We conducted a computerized search of the electronic databases. We included studies which reported on PMI used in shoulder arthroplasty. Data were extracted by authors, publication year, study level, study type, demographic data (age, sex, sample size), type of arthroplasty, follow-up time, and outcomes.</div></div><div><h3>Results</h3><div>5 studies were identified as being eligible for this analysis. 55 patients and 57 shoulders were included. The average age was 72.3 across 5 studies. Average follow-up was 28.26 months. 22/57 (39%) were for primary shoulder arthroplasty and 35/57 (61%) were revision procedures. 50/56 (89%) of shoulders improved. 7/56 (13%) of shoulder had a complication.</div></div><div><h3>Discussion</h3><div>PMI for shoulder arthroplasty has so far only been used for severe glenoid bone loss in primary and revision shoulder arthroplasty. PMI can not only be used in the severe glenoid bone loss patient but there are some advantages to using it in the regular patient who attends seeking a shoulder arthroplasty. A limitation of our review is that there are no studies published on PMI for primary shoulder arthroplasty without significant glenoid bone loss. A paradigm shift in shoulder arthroplasty may occur where PMI is not only used for glenoid bone loss and challenging revision cases but also in primary shoulder arthroplasty without significant bone loss.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 960-967"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141843777","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}