JSES International最新文献

{"title":"Impact of estrogen replacement therapy on outcomes following total shoulder arthroplasty: a propensity-matched retrospective cohort study of 1,779 patients","authors":"Seyedeh Zahra Mousavi BS ,&nbsp;Ethan R. Harris BS ,&nbsp;Sanjana Agarwal BS ,&nbsp;Prasenjit Saha BA ,&nbsp;Eve R. Glenn ScB ,&nbsp;Henry M. Fox MD ,&nbsp;Umasuthan Srikumaran MD, MBA, MPH","doi":"10.1016/j.jseint.2025.04.022","DOIUrl":"10.1016/j.jseint.2025.04.022","url":null,"abstract":"<div><h3>Background</h3><div>While estrogen is essential for bone remodeling, its impact on joint health is more nuanced. Previous studies suggest that high estrogen states, including those induced by estrogen replacement therapy (ERT), are associated with osteoarthritis and an increased risk of revisions after hip and/or knee arthroplasty. Given the rise in total shoulder arthroplasty (TSA) cases, it is important to investigate factors that may impact its outcomes. This study aimed to evaluate whether ERT use impacts TSA outcomes at 2, 4, and 10 years postoperatively.</div></div><div><h3>Materials and methods</h3><div>This was a retrospective cohort study of females aged ≥55 years who underwent TSA, using the TriNetX Research Network. Patients were stratified by ERT use for at least 1-5 years preoperatively. One-to-one propensity score matching was performed based on age, race, bone density, osteoarthritis, and other comorbidities. Primary outcomes were revision rates at 2, 4, and 10 years. Secondary outcomes included prosthetic joint infections, mechanical complications, and shoulder instability, as well as 90-day postoperative medical complications. Tests of significance and risk ratios (RR) were calculated to compare outcomes with an alpha of &lt;0.05.</div></div><div><h3>Results</h3><div>After matching, 1,779 patients were included in each group. At 90 days, the ERT cohort had a higher risk of deep vein thrombosis (RR =1.91; <em>P</em> = .012). At 2 and 4 years postoperatively, the ERT group had a significantly higher risk of revisions (RR = 1.71 and 1.59, respectively), shoulder instability (RR = 1.81 and 1.80), and overall mechanical complications (RR = 1.60 and 1.67). At 10 years, the risk for revisions (RR = 1.59; <em>P</em> = .002) and mechanical complications (RR = 1.43; <em>P</em> = .005) persisted.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that ERT is associated with long-term increased risk of revision procedures and mechanical complications following TSA. This demonstrates the complex relationship between estrogen and bone health, highlighting the need for future studies investigating the impact of ERT on implant survival and osseointegration.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1345-1351"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605414","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":"Return to yoga following anatomic or reverse total shoulder arthroplasty","authors":"Tammy R. Hoffman BS ,&nbsp;Lisa A. Galasso MD ,&nbsp;Matthew B. Noble DO ,&nbsp;Javier Ardebol MD, MBA ,&nbsp;Patrick J. Denard MD","doi":"10.1016/j.jseint.2025.01.013","DOIUrl":"10.1016/j.jseint.2025.01.013","url":null,"abstract":"<div><h3>Background</h3><div>Returning to sport is an important consideration for joint replacement. Currently, there is a lack of knowledge regarding returning to yoga following shoulder arthroplasty. The purpose of this study was to examine patients’ ability to return to yoga after primary total shoulder arthroplasty. Secondary outcome measures were analyzed including range of motion (ROM) and patient-reported outcomes (PROs). Additionally, any differences between anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) were investigated.</div></div><div><h3>Methods</h3><div>A retrospective study was performed on patients who underwent primary aTSA or rTSA between 2012 and 2022. Inclusion criterion was a minimum follow-up of 2 years, and yoga was reported as their primary sporting activity prior to arthroplasty. Yoga participation was recorded before and after shoulder arthroplasty, as well as time to return to previous activity level and satisfaction. Range of motion including forward flexion, external rotation, and internal rotation, as well as PROs including visual analog scale for pain, American Shoulder and Elbow Surgeons score, and subjective shoulder value were collected preoperatively and postoperatively. Postoperative results were compared based on patients’ ability to return to participation in yoga.</div></div><div><h3>Results</h3><div>Fifteen patients (6 aTSA and 9 rTSA) with a mean age of 69 ± 6 years met the study criteria and were evaluated at a mean of 44 ± 22 months postoperative. At 6 months postoperative, 60% (9/15) of patients reported being able to return to their activity, whereas 100% (15/15) had returned by the 12-month postoperative point. At the final follow-up, 80% (12/15) of patients noted that their ability to return to yoga following shoulder arthroplasty improved compared to baseline, 13% (12/15) reported that this ability was unchanged, and 7% (1/15) reported decreased ability.</div><div>There was no statistically significant difference in PROs between rTSA and aTSA (visual analog scale <em>P</em> = .08, American Shoulder and Elbow Surgeons score <em>P</em> = .79, subjective shoulder value <em>P</em> = .29). Likewise, there was no statistically significant difference in postoperative ROM when comparing rTSA and aTSA groups (forward flexion <em>P</em> = .47, external rotation <em>P</em> = .22, internal rotation <em>P</em> = .29).</div></div><div><h3>Conclusion</h3><div>Patients who engage in yoga have a high return to sport rate following either aTSA or rTSA, although full return may take up to 1 year postoperatively. The vast majority of patients also report improvement in their ability to perform yoga following shoulder arthroplasty. Among yoga participants, postoperative ROM, including internal rotation, appears to be similar between aTSA and rTSA.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1210-1214"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605518","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":"Analysis of patients with differing short-term rates of improvement and long-term rates of decline in range of motion and after anatomic and reverse total shoulder arthroplasty","authors":"Christopher P. Roche MSE, MBA ,&nbsp;Josie Elwell PhD ,&nbsp;Richard Jones MD ,&nbsp;Howard Routman DO ,&nbsp;Ryan Simovitch MD ,&nbsp;Pierre-Henri Flurin MD ,&nbsp;Thomas W. Wright MD ,&nbsp;Joseph D. Zuckerman MD","doi":"10.1016/j.jseint.2025.04.018","DOIUrl":"10.1016/j.jseint.2025.04.018","url":null,"abstract":"<div><h3>Background</h3><div>Patients with anatomic (aTSA) and reverse total shoulder arthroplasty (rTSA) can have different short-term rate of improvement (ROI) and different long-term rate of decline (ROD) in range of motion (ROM). This study aims to quantify and compare these rates and identify risk factors associated with a slow ROI and a fast ROD after both aTSA and rTSA.</div></div><div><h3>Methods</h3><div>This 8-year minimum longitudinal outcome study compares active ROM in 1272 primary aTSA (n = 688) and rTSA (n = 584) patients across 8357 visits and identified patient cohorts with a slow, average, and fast ROI from 0-2 years after surgery and a slow, average, and fast ROD 8 years after surgery relative to peak improvement achieved 2-3 years after surgery. A multivariate regression analysis was performed to identify patient, implant/operative, or postoperative risk factors associated with a slow ROI and fast ROD after both aTSA and rTSA.</div></div><div><h3>Results</h3><div>The results of this 1272 patient long-term clinical outcome study demonstrates that aTSA and rTSA patients with a slow ROI were associated with high preoperative ROM and patients with a fast ROI were associated with low preoperative ROM. aTSA and rTSA patients with high preoperative ROM experienced declines in ROM during the first 3 months, but later recovered at a similar rate and achieved similar peak improvements. aTSA patients with a slow ROI had significantly higher preoperative abduction, internal rotation score, and external rotation, whereas rTSA patients with a slow ROI were significantly more likely to have diabetes, injections, and significantly higher preoperative abduction and internal rotation score. aTSA patients with a fast ROD were significantly more likely to have heart disease and glenoid radiolucent lines, whereas rTSA patients with a fast ROD were significantly more likely to have comorbidities and experience revision surgery.</div></div><div><h3>Discussion</h3><div>The rate of improvement in ROM during the short-term recovery period after aTSA and rTSA is highly dependent on preoperative ROM, whereas the rate of decline in ROM at long-term follow-up is generally impacted by systemic health issues (ie, heart disease and more comorbidities), compromised implant fixation (ie, radiolucent lines after aTSA), and the onset of revision surgery. These findings may be beneficial for patient counseling and expectation management, especially to encourage patients who may have experienced a decline in ROM during the first 3 months after surgery.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1327-1338"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605522","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 comparative study in the functional outcomes after conventional Deltopectoral approach vs. anterior deltoid split approach for fixation of proximal humerus fractures","authors":"Shradha A. Kulkarni MS Orthopaedics, DNB Orthopaedics,&nbsp;Mansoor Malnas Postgraduate Student-MS Orthopaedics (final year- 3rd year),&nbsp;Karan Bhanushali MS Othopaedics, DNB Orthopaedics,&nbsp;Parag K. Munshi MS Orthopedics, Dorth, DNB, MchOrth, FRCS (Gen Surg), FRCS (Orth)","doi":"10.1016/j.jseint.2025.04.019","DOIUrl":"10.1016/j.jseint.2025.04.019","url":null,"abstract":"<div><h3>Background</h3><div>Proximal humeral fractures represent 4%-5% of all fractures, with increasing frequencies in the geriatric population due to conditions such as osteoporosis and high-velocity injuries. Treatment options vary based on factors like age, bone quality, fracture complexity, and surgical expertise. Management may involve conservative methods or surgical procedures, such as open reduction and internal fixation using Proximal Humerus Interlocking Osteosynthesis (PHILOS) plates. The choice of approach depends on the fracture fragments and their displacement. This study compares the functional outcomes of 2 surgical approaches: ‘The Conventional Deltopectoral approach and the Anterior Deltoid split approach’, postoperatively at a 1 year follow-up measured using Neer's Criteria.</div></div><div><h3>Methods</h3><div>This prospective observational study was conducted at a tertiary care hospital from April 2021 to November 2022. It included 40 patients with displaced proximal humerus fractures, equally divided into 2 groups: 1 treated with the conventional Deltopectoral approach, and the other with the Anterior Deltoid split approach. All patients underwent fixation with PHILOS. Functional outcomes were assessed at 4 weeks, 3 months, 6 months, 9 months, and finally at 1 year using Neer's criteria.</div></div><div><h3>Results</h3><div>Patients had similar functional outcomes at the 1-year follow-up in both groups. The Anterior Deltoid split approach had advantages such as less intraoperative blood loss and better early functional scores due to minimal soft tissue dissection. However, it involved a longer operative time than the Deltopectoral approach. The Deltopectoral approach provided a wider surgical field and was more effective for treating anterior dislocations. The Deltopectoral approach had a higher risk of humeral head necrosis, likely due to extensive soft tissue disruption, whereas the deltoid split approach better preserved blood supply, reducing risk of avascular necrosis. The deltoid split approach was ideal for posterior comminution, posterior fracture dislocations, and utilized an avascular plane, while the Deltopectoral approach was preferred for medial calcar comminution, anterior fracture dislocations, and followed an internervous plane.</div></div><div><h3>Conclusion</h3><div>Both the Deltopectoral and Anterior Deltoid split approaches are effective in managing proximal humerus fractures, with no significant differences in long-term functional outcomes. The choice of approach should depend on the surgeon's familiarity with the technique, specific fracture characteristics, and the need to minimize soft tissue damage to enhance recovery and reduce the chances of avascular necrosis. This study suggests that either approach can provide satisfactory functional results in open reduction and internal fixation with PHILOS plating for proximal humerus fractures.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1076-1082"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605909","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":"Lateral epicondyle fracture presenting severe elbow instability in adolescence: a case report","authors":"Takanobu Higashi MD,&nbsp;Fumiaki Takase MD, PhD,&nbsp;Takako Kanatani MD, PhD","doi":"10.1016/j.jseint.2025.02.024","DOIUrl":"10.1016/j.jseint.2025.02.024","url":null,"abstract":"","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1396-1399"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605976","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":"Comparison of reliability in two-dimensional computed tomography vs. two-dimensional magnetic resonance imaging for on-track/off-track measurements: analysis of key values for glenohumeral bone loss","authors":"Jonathan Horng MD ,&nbsp;Anthony Magee MD ,&nbsp;James Pruneski MD ,&nbsp;Liang Zhou MD ,&nbsp;William Daner MD ,&nbsp;Kyong S. Min MD","doi":"10.1016/j.jseint.2025.02.014","DOIUrl":"10.1016/j.jseint.2025.02.014","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of the current study was to compare the intraobserver and interobserver reliability in glenoid track measurement using two-dimensional (2D) computed tomography (CT) vs. 2D magnetic resonance imaging (MRI). Our hypothesis was that on-track and off-track assessments using 2D CT and 2D MRI would demonstrate consistent results with good-to-excellent reliability.</div></div><div><h3>Methods</h3><div>Electronic medical records from 2009 to 2019 were reviewed for patients with known shoulder instability and bipolar bone loss. Using 2D CT and 2D MRI, the glenoid and humeral head bone loss was measured to calculate the glenoid track and to assess for on-track and off-track lesions.</div></div><div><h3>Results</h3><div>A total of 24 patients met the inclusion criteria. The overall intraobserver reliability for 2D CT vs. 2D MRI was none to moderate for on-track and off-track assessments (κ = 0.083, 0.25, 0.5). Interobserver reliability for MRI scan was fair for on-track and off-track assessments (κ = 0.299). There was significant correlation between MRI and CT-derived measurements for all included variables (<em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>On-track and off-track assessments using 2D CT and 2D MRI demonstrated inconsistent results; therefore, the additional information provided by 2D CT may be of significant value for clinical decision-making.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1029-1033"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604988","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":"Higher incidence of osteosynthesis of proximal humerus fractures in Germany—an epidemiological study comparing osteosynthesis of the proximal humerus and shoulder arthroplasty in Germany, Austria, and Switzerland","authors":"Johanna E. Müller Dr. med ,&nbsp;Angela Jussel MD ,&nbsp;Emily Procter PhD ,&nbsp;Ulrich H. Brunner Dr. med (Prof)","doi":"10.1016/j.jseint.2025.02.008","DOIUrl":"10.1016/j.jseint.2025.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Proximal humerus fractures (PHF) are one of the most common fractures in elderly patients, but consensus about optimal management is lacking. Conservative therapy has been recommended for elderly patients, though many countries report an increase in surgical procedures. There has also been a rapid increase in shoulder arthroplasty internationally, though large variation exists in the use of these procedures. The aim of this study was to compare the relative incidence of osteosynthesis of the proximal humerus and shoulder arthroplasty approximately over a decade in Germany, Austria, and Switzerland.</div></div><div><h3>Methods</h3><div>National statistics databases were searched for cases of osteosynthesis of the proximal humerus (2011-2019) and shoulder arthroplasty (2009-2019) in Germany, Austria, and Switzerland. Case retrieval was based on national operation codes. National census estimates were used to calculate incidence rates per person-year.</div></div><div><h3>Results</h3><div>The relative incidence of osteosynthesis of the proximal humerus is 1.7 times higher in Germany than in Switzerland and Austria. The relative incidence did not increase in any country between 2011 and 2019. In Germany, osteosynthesis was performed for relatively more elderly patients of ≥70 years compared to the other 2 countries and relatively more female patients compared to Austria. The relative incidence of shoulder arthroplasty increased similarly in all 3 countries between 2009 and 2019. The largest increase was seen in patients of ≥70 years; in this group the incidence more than doubled over the 10-year period in both Switzerland and Austria. Shoulder arthroplasty was more common in Switzerland for patients of ≥40 years compared to the other countries (1.8 times higher on average). Fracture endoprostheses were more common in Germany compared to Switzerland (38% vs. 23% of all shoulder arthroplasties in 2017). Germany had a higher rate of surgical management of PHF, that is, both osteosynthesis and arthroplasty as a primary management strategy.</div></div><div><h3>Conclusion</h3><div>The overall trends of these procedures are similar in Germany, Austria, and Switzerland within the investigated period; however, some differences in surgical strategy could be identified, for example, reliance on osteosynthesis in elderly female patients with PHF in Germany.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1015-1020"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604966","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":"Reduced scapular neck impingement in 145° neck-shaft angle semi-inlay compared with 155° neck-shaft angle inlay reverse total shoulder arthroplasty during active external rotation","authors":"Itaru Kawashima MD, PhD ,&nbsp;Norimasa Takahashi MD, PhD ,&nbsp;Keisuke Matsuki MD, PhD ,&nbsp;Ryo Haraguchi MD ,&nbsp;Hayato Ryoki MD ,&nbsp;Thomas W. Wright MD ,&nbsp;Scott A. Banks PhD","doi":"10.1016/j.jseint.2025.03.001","DOIUrl":"10.1016/j.jseint.2025.03.001","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to measure the distance between the scapular neck and the humeral polyethylene insert in shoulders with a 145° neck-shaft-angle (NSA) semi-inlay reverse total shoulder arthroplasty (rTSA) during active external rotation and to compare it with the distance in shoulders with a 155° NSA inlay rTSA.</div></div><div><h3>Methods</h3><div>Twenty shoulders with 145° NSA semi-inlay rTSA and 18 shoulders with 155° NSA inlay rTSA were analyzed. Each shoulder underwent computed tomography and fluoroscopy. Fluoroscopic images were acquired during the activity, starting from internal rotation at the side and progressing to maximum external rotation, while keeping the shoulder adducted. Using model-image registration techniques, the poses of 3-dimensional models were iteratively adjusted to match their silhouettes with those in the fluoroscopic images. Based on the 3-dimensional kinematics of the implants, the closest distance between the scapular neck and polyethylene insert was computed. The data from 10° internal rotation to 50° external rotation were used for analysis. It was also evaluated whether the distance approached within 1 mm, as it was considered that impingement occurred between the scapular neck and polyethylene insert at this proximity.</div></div><div><h3>Results</h3><div>The distance between the scapular neck and the polyethylene insert significantly decreased as the shoulder externally rotated (<em>P</em> &lt; .001). This distance was significantly larger in shoulders with semi-inlay rTSA compared to those with inlay rTSA (<em>P</em> &lt; .001). The rate of shoulders that approached within 1 mm of distance during activity was significantly lower in the semi-inlay rTSA group than in the inlay rTSA group [20.0% (4/20) vs. 83.3% (15/18), respectively, <em>P</em> &lt; .001].</div></div><div><h3>Conclusions</h3><div>The distance between the scapular neck and the polyethylene insert during active external rotation was greater in a 145° NSA semi-inlay rTSA compared to a 155° NSA inlay rTSA. This study supports the notion that a 145° NSA semi-inlay rTSA significantly reduces scapular notching compared to a 155° NSA inlay rTSA. However, scapular notching, especially caused by maximum external rotation, should still be considered in shoulders with a 145° NSA semi-inlay rTSA as well, as the distance significantly decreases during external rotation.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1244-1250"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605096","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":"Augmented reality significantly reduces the absolute error between achieved and planned inclination and version of the glenoid baseplate for reversed shoulder arthroplasty","authors":"Franck Dordain MD ,&nbsp;Geoffroy Nourrissat MD ,&nbsp;Floris van Rooij MSc ,&nbsp;Mathieu Ferrand MD ,&nbsp;Eric Petroff MD ,&nbsp;Maxime Antoni MD","doi":"10.1016/j.jseint.2025.01.017","DOIUrl":"10.1016/j.jseint.2025.01.017","url":null,"abstract":"<div><h3>Background</h3><div>To determine whether using augmented reality with a head-mounted display (AR-HMD) would reduce deviations between planned and achieved reverse total shoulder arthroplasty (rTSA) glenoid baseplate inclination and version.</div></div><div><h3>Methods</h3><div>Ten fresh frozen shoulders from 5 human cadavers, which were free from fractures or other bony pathologies were used. Computed tomography scans were acquired for each shoulder, and imported into image 3-dimensional processing software to plan rTSA, and notably to define the target inclination and version of the glenoid baseplate. Two experienced surgeons placed a 1.6-mm Kirschner wire on the glenoid baseplate insertion site in each shoulder (5 per surgeon) using conventional instruments, and the AR-HMD was used to measure the inclination, version, in addition to the number of outliers. Afterward, using the AR-HMD (Pixee Medical, Besançon, France) the surgeons drilled and inserted the Kirschner wire for the glenoid baseplate positioning, and computed tomography was used to measure the inclination, version, and number of outliers.</div></div><div><h3>Results</h3><div>Absolute deviations between planned and achieved inclination were significantly smaller when using AR-HMD (0.9° ± 1.6°, range 0°-5°) than without AR-HMD (5.1°± 3.7°, range 0°-10°) (<em>P</em> = .007), and there were fewer outliers with absolute deviation when using AR-HMD (n = 1) than without using AR-HMD (n = 7). Absolute deviations between planned and achieved version were significantly smaller when using AR-HMD (0.7° ± 0.5°, range 0°-1°) than without AR-HMD (5.5° ± 4.4°, range 0°-14°) (<em>P</em> = .007), and there were fewer outliers with absolute deviation when using AR-HMD (n = 0) than without using AR-HMD (n = 7). Mean distance from entry point was −1.1 ± 1.7 mm in the superior–inferior axis, and 0.5 ± 0.9 mm in the anterior–posterior axis.</div></div><div><h3>Conclusion</h3><div>AR-HMD significantly reduces the absolute error between achieved and planned inclination and version of the glenoid baseplate during rTSA, though further studies are required to confirm the benefits of this technology in clinical settings.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1215-1219"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605519","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":"Safety of bioinductive bovine collagen implants for arthroscopic rotator cuff repair","authors":"Hideki Kinjo MD ,&nbsp;Naoki Suenaga MD, PhD ,&nbsp;Naomi Oizumi MD, PhD ,&nbsp;Kotaro Nishida MD, PhD","doi":"10.1016/j.jseint.2025.03.009","DOIUrl":"10.1016/j.jseint.2025.03.009","url":null,"abstract":"<div><h3>Background</h3><div>Bioinductive reconstituted type I bovine collagen implants for augmenting arthroscopic rotator cuff repair (ARCR) may improve the healing rate and thickness of repaired tendons. However, there are concerns regarding the inflammatory responses and foreign body reactions associated with the use of foreign substances. This study aimed to evaluate the safety of type I bovine collagen bioinductive implants in ARCR.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on 74 patients who underwent ARCR using the surface-holding method; 37 patients were treated with bioinductive collagen implants (R group) and 37 patients were treated without implants (N-R group). The participants underwent routine preoperative blood tests at 1 and 2 weeks postoperatively. Magnetic resonance imaging (MRI) was performed at 1 week and 6-8 weeks postoperatively. The safety of the implant was assessed using serum inflammatory responses, such as C-reactive protein (CRP) and white blood cell (WBC) counts, and the presence of effusions in the glenohumeral joints and subacromial bursa on MRI. In addition, the need for reoperation owing to infection or foreign body reactions was examined. Statistical analyses were performed using Mann–Whitney <em>U</em> tests and Wilcoxon signed–rank tests for CRP and WBC counts and Fisher’s exact probability tests for effusions on MRI. Statistical significance was set at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>CRP levels and WBC counts normalized within 2 weeks postoperatively in both the R and N-R groups, with no significant differences between the groups at any time point. Effusions in the glenohumeral joints and subacromial bursa were present in both groups and were not significantly different between the R and N-R groups at 1 and 6-8 weeks postoperatively. No reoperations due to infection or inflammatory responses were observed within 6 months postoperatively in either group.</div></div><div><h3>Conclusion</h3><div>The use of reconstituted type I bovine collagen bioinductive implants in ARCR did not significantly affect postoperative inflammatory responses or increase the risk of effusion. The absence of reoperations due to clinical infections or foreign body reactions further supports the safety of the implants.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 4","pages":"Pages 1177-1182"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604974","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}