JSES International最新文献

{"title":"Adolescent coracoid morphology: a computed tomography morphometric analysis of growth across age groups","authors":"Thomas K. Moore MB, BCh, BAO, MCh,&nbsp;Stefan Bauer MD,&nbsp;Cameron Muirhead MBBS,&nbsp;William Blakeney MBBS, MSc, MS, FRACS, FAOA","doi":"10.1016/j.jseint.2026.101739","DOIUrl":"10.1016/j.jseint.2026.101739","url":null,"abstract":"<div><h3>Background</h3><div>Coracoid transfer procedures, particularly the Latarjet, are increasingly employed to manage recurrent anterior shoulder instability in adolescents, given arthroscopic Bankart failure rates exceeding 40% in this young, active population. Despite this growing use, the morphologic characteristics of the adolescent coracoid remain poorly described. The purpose of this study was to describe the morphology and dimensions of the coracoid through adolescence to give insights and guidance for the planning of coracoid transfer procedures.</div></div><div><h3>Methods</h3><div>In this basic science morphometric study, 146 computed tomography scans from 11- to 17-year-old patients were included. Three-dimensional reconstructions were analyzed to obtain coracoid morphometric data, including length, width, and height at key anatomical landmarks. Morphological classification was conducted per established systems. Age-stratified analysis was performed. Interobserver reliability was assessed.</div></div><div><h3>Results</h3><div>Mean coracoid length from tip to base was 41.5 mm (standard deviation [SD] = 4.6, confidence interval [CI]: 40.8-42.3). Mean length from tip to midsection and tip to elbow was 16.1 mm (SD = 3.1, CI: 15.6-16.6) and 25.4 mm (SD = 3.9 mm, CI: 24.8-26.1), respectively. Most dimensions significantly increased in size incrementally each year. Length of the coracoid in both coronal and axial views did not significantly increase between the ages of 11 and 13. By age 14, mean coracoid length was &gt;40 mm and increased significantly with every subsequent year.</div></div><div><h3>Conclusion</h3><div>Adolescent coracoid morphology evolves with age. By mid-adolescence (14 years for both males and females), the adolescent coracoid has similar dimensions to that of the adult, suggesting it may support the feasibility of adult dual-fixation techniques in coracoid transfer procedures. Detailed pre-operative imaging and patient-specific planning remains essential to guide decision-making.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 4","pages":"Article 101739"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370130","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":"The impact of glenoid/humeral lateralization and distalization angles based in the pattern of reverse shoulder arthroplasty","authors":"Giovanni Di Giacomo MD,&nbsp;Leonardo Moreno Rodriguez MD,&nbsp;Petar Golijanin MD,&nbsp;Andrea Vespasiani MD,&nbsp;Valerio Antonini MD,&nbsp;Capt. Matthew T. Provencher MD MBA,&nbsp;Nicola de Gasperis MD","doi":"10.1016/j.jseint.2026.101729","DOIUrl":"10.1016/j.jseint.2026.101729","url":null,"abstract":"<div><h3>Background</h3><div>The biomechanics of reverse shoulder arthroplasty (RSA) rely on deltoid function. The center of rotation of the glenohumeral joint in RSA is more medial and distal when compared to the native joint, and proper soft-tissue tensioning is essential to achieve a stable joint with a good range of motion (ROM). The current RSA systems on the market allow for various placements of humeral and glenoid components (lateralized, medialized, distalized). No post-operative radiographic parameters currently consider the glenoid and humeral components' position separately. The aims of this study are to (1) measure glenoid and humeral component angles specific to different implants and (2) to investigate whether these angles correlate with clinical outcomes.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 74 patients who underwent reverse shoulder prosthesis between 2018 and 2022 was performed. Different subtypes of RSA prosthesis were identified (medialized glenoid/lateralized humerus, lateralized glenoid/medialized humerus, and lateralized glenoid/lateralized humerus). Angle measurements were defined to determine the lateralization and distalization of each component in true anteroposterior radiographs (Grashey view) of the shoulder. The clinical results were collected, including a Simple Shoulder est, Single Assessment Numeric Evaluation, and Constant score.</div></div><div><h3>Results</h3><div>All angles showed excellent intra-rater and inter-rater agreement. No correlation was found between ROM and post-operative radiographic measurements, and there were no significant differences between the different RSA subtypes in clinical outcomes.</div></div><div><h3>Conclusion</h3><div>The main objectives to be met are the post-operative scores, ROM, and patient satisfaction after RSA; however, there are still no reliable measures in post-operative radiographs that correlate with clinical outcomes. The current angles obtained on post-operative radiographs allow us to assess the prosthesis's placement degree due to each of the components but not to predict ROM or clinical outcomes.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 4","pages":"Article 101729"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13311811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353902","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":"Effect of indomethacin prophylaxis on heterotopic ossification after surgical fixation of elbow injuries: a randomized controlled trial","authors":"Abednego C (MBBS, MS),&nbsp;Tharun Teja Aduri (MBBS, MS, MNAMS),&nbsp;Deepak Kumar (MBBS, MS),&nbsp;Himanshu Bhayana (MBBS, MS),&nbsp;Sameer Aggarwal (MBBS, MS),&nbsp;Vijay G. Goni (MBBS, MS, MNAMS)","doi":"10.1016/j.jseint.2026.101740","DOIUrl":"10.1016/j.jseint.2026.101740","url":null,"abstract":"<div><h3>Background</h3><div>Heterotopic ossification (HO) is a recognized complication following operative fixation of elbow trauma. While indomethacin prophylaxis is well established in hip and acetabular surgery, evidence for its role in elbow injuries remains limited. This randomized controlled trial evaluated whether oral indomethacin reduces the incidence and severity of HO after surgical treatment of acute elbow fractures and dislocations.</div></div><div><h3>Methods</h3><div>Eighty-six adults with acute elbow injuries requiring surgical fixation were randomized 1:1 to receive either oral indomethacin (25 mg 3 times daily for three weeks) or no prophylaxis. Eighty-four patients completed follow-up. HO was assessed radiographically at scheduled intervals through the final follow-up and graded using the Hastings and Graham system. The Mantel–Haenszel method was used to calculate a pooled odds ratio adjusted for injury severity.</div></div><div><h3>Results</h3><div>HO developed in 21 of 84 patients (25%), occurring in 14.3% of the indomethacin group vs. 35.7% of controls (<em>P</em> = .018), with indomethacin reducing both incidence (absolute risk reduction 21.4%; number needed to treat = 5) and severity (mean grade, 1.33 vs. 2.93, <em>P</em> = .013). All HO in the indomethacin group were low grade (G1-G2A), whereas high-grade HO (G2C-G3) occurred in 8 of 15 (53.3%) control patients. Stratified analysis demonstrated consistent trends across injury severity levels, with Mantel–Haenszel adjustment yielding similar estimates. Patients with HO in the indomethacin group had a greater range of motion compared to controls.</div></div><div><h3>Discussion and Conclusion</h3><div>Indomethacin prophylaxis was associated with reduced incidence and severity of HO following operative fixation of elbow injuries. These findings should be interpreted in the context of baseline differences in injury severity between groups. Indomethacin may be a useful adjunct in patients at risk of HO following elbow trauma given its low cost, ease of administration and favorable safety profile, although further multicenter studies are required.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 4","pages":"Article 101740"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369918","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":"Long-term follow-up of functional electromyostimulation–augmented home exercise after primary reverse total shoulder arthroplasty: a prospective longitudinal assessment of the original intervention cohort","authors":"Thomas Wittmann MD,&nbsp;Sandra Krawczyk MD,&nbsp;Patric Raiss MD","doi":"10.1016/j.jseint.2026.101744","DOIUrl":"10.1016/j.jseint.2026.101744","url":null,"abstract":"<div><h3>Background</h3><div>Reverse total shoulder arthroplasty (rTSA) reliably reduces pain and restores function, but shoulder function typically plateaus within the first post-operative year and gradually declines thereafter. Motion-triggered functional electromyostimulation (FES) enhances muscle activation and has shown short-term functional benefits in patients after rTSA. The long-term durability of these effects remains unclear, though sustained improvements would increase the clinical value of this time-limited intervention. Therefore, the aim of this study was to evaluate short-term outcomes after at least six months after completion of a FES program and compare them with baseline and immediate postintervention results.</div></div><div><h3>Methods</h3><div>Ten of the initially 14 patients previously enrolled in the intervention arm of a prospective randomized controlled trial were re-evaluated after at least six months after completing a 6-week home-based, deltoid-focused FES program initiated 1 year after primary rTSA. Clinical outcomes included Constant Score (primary outcome), Subjective Shoulder Value, active range of motion, deltoid strength, and scapular kinematics assessed using identical methods to the previous randomized controlled trial.</div></div><div><h3>Results</h3><div>Ten participants (71%) completed the follow-up (FU) at a median of 18 months (range, 6-24 months) after the intervention. The mean Constant Score improved from 65.7 ± 13.2 at baseline to 79.5 ± 7.9 postintervention (<em>P</em> &lt; .001) and remained significantly elevated at FU (84.0 ± 4.2, <em>P</em> &lt; .001 vs. baseline; <em>P</em> = .09 vs. post). Subjective Shoulder Value increased from 70.7 ± 16.9% to 91.1 ± 10.0% postintervention and was maintained at 92.0 ± 7.9% at FU (<em>P</em> &lt; .001 vs. baseline). Abduction range of motion and deltoid strength showed additional long-term gains, whereas no decline was observed in any outcome parameter. No device-related complications occurred.</div></div><div><h3>Conclusion</h3><div>In this single-arm FU, functional outcomes that improved after the FES-augmented program were maintained at mid-term reassessment. Because the control group was not re-evaluated, treatment-specific durability cannot be inferred. No deterioration was observed after discontinuation of device use. Larger controlled studies with long-term comparative FU are required before conclusions regarding treatment-specific benefit can be drawn.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 4","pages":"Article 101744"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369976","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":"Return to work and sports after posterior latissimus dorsi transfer for posterior superior irreparable rotator cuff tears","authors":"Chang Hee Baek MD,&nbsp;Bo Taek Kim MD,&nbsp;Jung Gon Kim MD,&nbsp;Chaemoon Lim MD,&nbsp;Seung Jin Kim MS,&nbsp;Luis Alfredo Miranda MD,&nbsp;Jean Kany MD","doi":"10.1016/j.jseint.2026.101747","DOIUrl":"10.1016/j.jseint.2026.101747","url":null,"abstract":"<div><h3>Background</h3><div>Posterior superior irreparable rotator cuff tears (PSIRCTs) cause substantial functional limitations, particularly in individuals performing physically demanding work or participating in sports. The purpose of this study was to evaluate the rate and timing of return to work (RTW) and return to sports (RTS) following posterior latissimus dorsi (LD) transfer in patients with PSIRCTs and to identify factors associated with successful return. It was hypothesized that patients would demonstrate high RTW and RTS rates.</div></div><div><h3>Methods</h3><div>This retrospective study included patients who underwent posterior LD transfer for PSIRCTs between April 2012 and June 2020. RTW and RTS rates, timing, and levels of return were assessed using structured questionnaires. Clinical outcomes, including visual analog scale, American Shoulder and Elbow Surgeons, Constant, and Single Assessment Numeric Evaluation scores, as well as active range of motion (ROM), were evaluated pre-operatively and post-operatively. Multivariable analysis was used to identify factors associated with RTW and RTS. Patients who had undergone revision surgery, were lost to follow-up, or had unavailable clinical or radiological data were excluded.</div></div><div><h3>Results</h3><div>After excluding 15 patients, 83 patients were included (mean age 61.9 ± 5.3 years; mean follow-up 65.3 ± 13.9 months). Pre-operative occupational demand was classified according to the Dictionary of Occupational Titles criteria as light, medium, or heavy work based on physical workload requirements. Overall, 85.5% of patients returned to work, including 56.6% at their previous work level and 28.9% at a reduced level, while 14.4% did not return. In subgroup analysis, patients with lighter workloads demonstrated higher RTW rates (95.2% vs. 92.3% vs. 75.0%) and shorter return times (4.1 ± 1.1 vs. 4.1 ± 1.2 vs. 5.6 ± 1.6 months) compared with those performing heavy labor. The overall RTS rate was 89.7%, with 72.1% achieving complete RTS and 27.8% partial RTS. On multivariable analysis, higher work intensity and tendon retear were significantly associated with RTW, whereas tendon retear was the only significant predictor of RTS.</div></div><div><h3>Conclusion</h3><div>Posterior LD transfer for PSIRCTs was associated with high rates of RTW and RTS among patients without major post-operative failure. Higher occupational demand was associated with delayed and less complete RTW, while tendon integrity was associated with both RTW and RTS. These findings should be interpreted cautiously because of retrospective design, self-reported activity outcomes, limited subgroup sizes, and exclusion of patients requiring revision surgery or conversion to reverse shoulder arthroplasty.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 4","pages":"Article 101747"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369969","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":"Video-enhanced informed consent improves patient comprehension in reverse total shoulder arthroplasty: a randomized controlled trial","authors":"Paul D. Scheidegger MD,&nbsp;Franziska C.S. Altorfer MD,&nbsp;Bettina Hochreiter MD,&nbsp;Karl Wieser MD,&nbsp;Mazda Farshad MD, MPH,&nbsp;Samy Bouaicha MD","doi":"10.1016/j.jseint.2026.101735","DOIUrl":"10.1016/j.jseint.2026.101735","url":null,"abstract":"<div><h3>Background</h3><div>Informed consent for reverse total shoulder arthroplasty (rTSA) requires thorough patient understanding, yet only 29% of patients adequately comprehend pre-operative information. This study evaluated whether pre-operative educational videos enhance patient comprehension compared to standard verbal explanations alone and assessed impact on consultation time and demographic variations.</div></div><div><h3>Methods</h3><div>This prospective randomized controlled trial included 60 patients undergoing rTSA, assigned 1:1 to video education or control groups. The video group viewed a 2-minute explanatory video before informed consent discussion; the control group received only verbal discussion. Afterward, all participants completed a 7-question test on procedural knowledge, benefits, and risks.</div></div><div><h3>Results</h3><div>The video education group achieved significantly higher scores (5.70/7) compared to controls (4.67/7) (<em>P</em> = .002). Significant improvements were observed across all subgroups. Vulnerable subgroups, including older (<em>P</em> = .02), lower-educated (<em>P</em> = .007) participants, and non-native speakers (<em>P</em> = .04), also demonstrated benefit.</div></div><div><h3>Conclusion</h3><div>An explanatory video before informed consent discussion significantly improved procedural comprehension compared to standard discussion alone. Vulnerable subgroups, older participants, non-native speakers, and those with lower educational attainment showed particular benefit. These findings support integrating video education into standard pre-operative rTSA protocols.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 4","pages":"Article 101735"},"PeriodicalIF":2.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370035","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":"The role of a multidisciplinary approach to opioid reduction for patients with operatively treated upper extremity fractures","authors":"Jack H. Drake MD,&nbsp;Nathan D. Poli MD,&nbsp;Grant R. Keith MD,&nbsp;Gabrielle R. Kuhn MD,&nbsp;Samuel J. Mosiman MS,&nbsp;Paul S. Whiting MD","doi":"10.1016/j.jseint.2026.101685","DOIUrl":"10.1016/j.jseint.2026.101685","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The aim of this study was to determine whether a multimodal program for opioid reduction in upper extremity fracture patients decreased (1) inpatient opioid consumption during post-operative days (PODs) 1-4 and (2) outpatient opioid prescription volume.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a retrospective comparative study of patients with isolated upper extremity fractures admitted to the inpatient orthopedic unit at an academic level 1 trauma center in 2018 and 2020 (pre- and post-program implementation). We calculated total inpatient opioid consumption (measured in morphine milligram equivalents [MMEs]) during POD 1-4 and from opioid prescriptions within 90 days postdischarge. Patients with multiple concurrent fractures, preinjury opioid use, or less than 90-day follow-up were excluded. Descriptive statistics in the form of frequencies (%) and means (standard deviation) were calculated. Linear mixed modeling with repeated measures revealing &lt;em&gt;P&lt;/em&gt; values of .05 or lower was considered statistically significant. Multiple concurrent fractures were defined as bilateral upper extremity injuries, ipsilateral fractures involving separate regions (eg, hand and shoulder), or combined radius and ulna fractures. This modeling was used to evaluate independent predictors of opioid use, including age, American Society of Anesthesiologists class, fracture type, and gabapentin use.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 128 patients with an operatively treated upper extremity fracture were identified (76 in 2018, 52 in 2020). No differences were seen in patient demographics. Pre-operative peripheral nerve block use was similar between groups (&lt;em&gt;P&lt;/em&gt; = .570). Gabapentin was used in a significantly higher proportion of patients in 2020 than it was in 2018 (34% vs. 18.3%, &lt;em&gt;P&lt;/em&gt; = .050). Inpatient opioid consumption significantly decreased from 2018 to 2020 (&lt;em&gt;P&lt;/em&gt; = .003), most notably on POD 1 and 2, with age and American Society of Anesthesiologists class being significant predictors of opioid use (&lt;em&gt;P&lt;/em&gt; = .0012 and &lt;em&gt;P&lt;/em&gt; = .0315, respectively). Mean MMEs on POD 1 were 68.21 in 2018 vs. 50.32 in 2020, whereas mean MMEs on POD 2 were 46.76 in 2018 vs. 12.15 in 2020. Forty-six point zero five percentage of patients in 2018 were taking opioids on POD 2 vs. 26.92% in 2020 (&lt;em&gt;P&lt;/em&gt; = .029). Pain scores on POD 1-4 showed no differences (&lt;em&gt;P&lt;/em&gt; ≥ .4875). 90-day postdischarge opioid prescriptions decreased in 2020, though not significantly. Fracture location and concomitant gabapentin use were significant predictors of outpatient opioid use (&lt;em&gt;P&lt;/em&gt; = .001 and &lt;em&gt;P&lt;/em&gt; = .013, respectively.)&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;A multidisciplinary approach is effective for reducing inpatient opioid consumption in operatively treated upper extremity fracture patients, with the greatest reduction seen on POD 1 and 2. Increases in gabapentin prescriptions following protocol impl","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 3","pages":"Article 101685"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802831","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":"Promoting hematoma-like tissue formation in arthroscopic rotator cuff repair: impact of a bioinductive collagen implant","authors":"Hideki Kinjo MD ,&nbsp;Naoki Suenaga MD, PhD ,&nbsp;Naomi Oizumi MD, PhD ,&nbsp;Jun Kawamata MD ,&nbsp;Kotaro Nishida MD, PhD","doi":"10.1016/j.jseint.2026.101699","DOIUrl":"10.1016/j.jseint.2026.101699","url":null,"abstract":"<div><h3>Background</h3><div>Hematomas, rich in platelet-derived growth factors, are vital in tendon–bone healing. Reportedly, larger hematoma-like tissue (HLT) surrounding the repaired tissue at 6-8 weeks after rotator cuff repair on T2-weighted magnetic resonance imaging effectively predicts structural outcomes (Sugaya classification type 1) at 6 months post-operatively. Recent studies explored the use of a reconstituted type I bovine collagen bioinductive implant derived from the bovine Achilles tendon to improve healing rates and tissue thickness, leading to favorable clinical outcomes. Therefore, we aimed to evaluate whether using this collagen implant to cover the lateral side of the sutured rotator cuff enhances the HLT size, formation, and maintenance at 6-8 weeks post-operatively.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, we analyzed patients who underwent arthroscopic rotator cuff repair using the surface-holding method. Fifty-eight patients were treated without implants (H group), while 58 received bioinductive collagen implants (REGENETEN; Smith &amp; Nephew, Andover, MA, USA) (R group). Magnetic resonance imaging was performed at 1 week and 6-8 weeks post-operatively to evaluate HLT thickness, classified as grades 1 (no HLT), 2 (HLT not exceeding the line connecting the cuff surface and the lateral edge of the greater tuberosity), or 3 (HLT exceeding the line). Retears at 6-8 weeks post-operatively were also assessed.</div></div><div><h3>Results</h3><div>At 1 week post-operatively, 55.2% of the H group and 60.3% of the R group were classified as grade 3, with no significant difference (<em>P</em> = .71). At 6-8 weeks, 22.4% and 63.8% of the H and R groups, respectively, were classified as grade 3 (<em>P</em> &lt; .05). Moreover, 40.6% and 77.1% of the H and R groups, respectively, maintained grade 3 from week 1 to 6-8 weeks post-operatively (<em>P</em> &lt; .05). In addition, in the H group, no case changed from grade 1 or 2 to grade 3, whereas 37.5% of cases in the R group changed from grade 1 to grade 3 and 50% changed from grade 2 to grade 3. Furthermore, the R group had fewer cases in which the HLT became thinner, disappeared, or experienced a retear compared to the H group (<em>P</em> &lt; .05).</div></div><div><h3>Conclusion</h3><div>Implanting a reconstituted type I bovine collagen bioinductive implant in arthroscopic rotator cuff repair using the surface-holding method helps to preserve and enhance HLT thickness, with a higher proportion of patients achieving grade 3 HLT at 6-8 weeks post-operatively. These findings suggest the potential of collagen implants to improve tendon–bone healing and structural outcomes.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 3","pages":"Article 101699"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802832","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":"Operative treatment is associated with improved 3-year survival after periprosthetic humerus fracture","authors":"Alyssa R. Henriquez BS,&nbsp;Bryan Crook MD,&nbsp;Lindsey V. Ruderman BA,&nbsp;Aaron Therien BS,&nbsp;Eoghan T. Hurley MB, MCh, PhD,&nbsp;Christopher Klifto MD,&nbsp;Oke Anakwenze MD MBA,&nbsp;Michael A. Moverman MD","doi":"10.1016/j.jseint.2026.101688","DOIUrl":"10.1016/j.jseint.2026.101688","url":null,"abstract":"<div><h3>Background</h3><div>This study examines the survival implications of operative versus nonoperative management of periprosthetic humerus fractures in a large, single-center cohort.</div></div><div><h3>Methods</h3><div>Patients at a single tertiary care center with periprosthetic humerus fractures about a shoulder prosthesis between January 2013 and March 2024 were retrospectively identified. Patients were stratified according to operative versus nonoperative treatment. The primary outcome was all-cause mortality. Survival was compared using Kaplan–Meier curves and log-rank tests. Prespecified time horizons were 90 days, 1 year, 2 years, and 3 years.</div></div><div><h3>Results</h3><div>Ninety patients with periprosthetic fractures were identified (23 nonoperative, 67 operative). There were 13 total deaths (8/23 [35%] nonoperative, 5/67 [7.5%] operative). Baseline characteristics were largely similar aside from a higher body mass index in the operative group (32 vs. 29 kg/m², <em>P</em> = .046). Age (nonoperative: 74 vs. operative: 71 years, <em>P</em> = .30), sex (<em>P</em> = .40), hand dominance (<em>P &gt;</em> .9), race (<em>P =</em> .07), smoking (<em>P =</em> .40), comorbidity burden (Elixhauser weighted and count <em>P</em> = .20 and <em>P</em> = .60, respectively), and Charlson distribution (<em>P</em> = .20) were all similar between groups. On Kaplan–Meier analysis, early mortality was rare: 90-day survival was 95.7% in the nonoperative group versus 100.0% in the operative group (<em>P</em> = .09). Survival differences widened over time, becoming significant at 3 years after the injury: 1 year (nonoperative: 95.7%; operative: 98.5%; <em>P</em> = .42), 2 years (nonoperative: 90%, operative: 98.5%; <em>P</em> = .09), and 3 years (nonoperative: 72.2%; operative: 96.5%; <em>P</em> = .004).</div></div><div><h3>Conclusions</h3><div>Surgical fixation of periprosthetic humerus fractures is associated with lower mortality that becomes apparent in a delayed fashion and grows over time. By 3 years after the injury, the mortality difference approached 25% between operatively and nonoperatively treated patients. These findings should be validated in larger, multicenter studies.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 3","pages":"Article 101688"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802210","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":"Osteochondral autograft transfer for capitellar osteochondritis dissecans in high-level adolescent athletes","authors":"Aditi S. Desai BS ,&nbsp;Jeffery D. Hassebrock MD ,&nbsp;Grant O. Killian BS ,&nbsp;Andrew T. Mathias BS ,&nbsp;David R. Diduch MD ,&nbsp;A. Bobby Chhabra MD","doi":"10.1016/j.jseint.2026.101680","DOIUrl":"10.1016/j.jseint.2026.101680","url":null,"abstract":"<div><h3>Background</h3><div>Osteochondritis dissecans (OCD) of the capitellum is a condition that predominantly affects high-performing adolescent athletes engaged in repetitive overhead motion and can lead to pain and mechanical symptoms that can interfere with the ability to perform in sports. Optimal surgical management of large OCD lesions remains inadequately studied. Prior studies have shown good short-term outcomes with the use of osteochondral autograft transfer (OAT). This study's primary objective is to evaluate the long-term outcomes of adolescent athletes undergoing OAT procedures for capitellar OCD.</div></div><div><h3>Methods</h3><div>We retrospectively identified 28 patients with large (≥1 cm²) unstable capitellar OCD lesions who underwent OATs from the ipsilateral knee. The average age at the time of surgery was 14.95 years (range, 11-22 years). Time to return to play, post-operative and final level of play, Disabilities of the Arm, Shoulder and Hand (DASH) and Sport-Specific DASH questionnaires, pre-operative and post-operative elbow range of motion, post-operative elbow Single Assessment Numeric Evaluation score, and radiographic outcomes were collected and analyzed. Twenty patients were available for evaluation at an average of 62.4 months of follow-up (range 6 to 164.5 months). Chart review was conducted for the remaining patients.</div></div><div><h3>Results</h3><div>The average return to play timeline was 6.28 months (range, 3-13 months). The return to sport rate was 95%. Eighty percent of pitchers returned to pitching, all throwing by an average of 4 months. The average overall DASH score was 3.79 (95% confidence interval [CI]: 1.83–5.75), and the average Sport Specific DASH score was 7.11 (95% CI: 0.45–14.78). Elbow range of motion significantly improved, with improvement in flexion from a pre-operative average of 130.3° to 140.9° post-operatively (<em>P</em> &lt; .001) and improvement in extension from a pre-operative average of 16.1° to 2.3° post-operatively (<em>P</em> &lt; .001). Average post-operative elbow Single Assessment Numeric Evaluation scores collected from 12/20 patients were 85.8 (range, 60-100). Osseous integration of the graft site was complete in 24 of the patients by the 12-week post-operative visit.</div></div><div><h3>Conclusion</h3><div>Treatment of large, unstable OCD lesions of the capitellum in adolescent athletes is safe, allows for a high rate of return to sport, and has good clinical outcomes with long-term follow-up.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 3","pages":"Article 101680"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802830","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}