JSES International最新文献

{"title":"Long-term results of open extensive débridement arthroplasty for primary osteoarthritis of the elbow: what direct examination and computed tomography images revealed","authors":"Shuzo Morita MD, PhD ,&nbsp;Naoki Suenaga MD, PhD ,&nbsp;Naomi Oizumi MD, PhD ,&nbsp;Kazuya Inoue MD, PhD ,&nbsp;Yasuhito Tanaka MD, PhD","doi":"10.1016/j.jseint.2024.11.010","DOIUrl":"10.1016/j.jseint.2024.11.010","url":null,"abstract":"<div><h3>Background</h3><div>Although open and arthroscopic débridement arthroplasties are major surgical strategies in patients with primary osteoarthritis of the elbow, the long-term results remain inadequately studied. Therefore, this study aimed to evaluate long-term clinical and radiographic results after extensive débridement arthroplasty (EDA) for primary osteoarthritis of the elbow.</div></div><div><h3>Methods</h3><div>Eleven patients with primary osteoarthritis treated with EDA were able to be retrospectively evaluated by direct examination. The mean age of the seven male and four female patients was 56 years (range, 47-74 years). The surgical procedure involved the removal of all osteophytes and free bodies, release of anterior and posterior capsules, fenestration of the olecranon fossa, and excision of the posterior bundle of the ulnar collateral ligament. At a mean follow-up of 15 years, clinical and radiographic outcomes were assessed.</div></div><div><h3>Results</h3><div>The mean flexion increased significantly from 110.5° to 129.6° postoperatively in the short term and was generally maintained at the final follow-up. Conversely, the mean extension improved significantly from −26.4° to −11.4° postoperatively in the short term; however, at the final examination, it had decreased to −25.5°. According to the Mayo Elbow Performance score, results were excellent for five elbows, good for five, and fair for one. In all cases, postoperative pain was “none” or “mild,” and no postoperative complications were observed. In all cases, recurrence of osteophytes was seen, and the fenestration hole of the olecranon fossa remained open in three elbows, was partially refilled in four elbows and was completely refilled in four elbows at the time of the final follow-up. Univariate analysis revealed that among preoperative variables, age, arc of motion, and extension were prognostic factors that significantly affected postoperative extension in the long term.</div></div><div><h3>Conclusions</h3><div>The present findings indicate that EDA provides marked long-term relief of pain and improved flexion despite the recurrence of restricted extension. Patients with extremely restricted extension preoperatively are at the risk of deteriorated extension over the long term.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 596-600"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593832","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 biceps tenotomy/tenodesis on Popeye sign incidence and functional outcome","authors":"Farah Selman MD ,&nbsp;Laurent Audigé PhD ,&nbsp;Andreas Marc Mueller MD, PhD ,&nbsp;ARCR Study Group ,&nbsp;Karl Wieser MD ,&nbsp;Florian Grubhofer MD","doi":"10.1016/j.jseint.2024.10.015","DOIUrl":"10.1016/j.jseint.2024.10.015","url":null,"abstract":"<div><h3>Background</h3><div>Literature reports varied incidences and clinical relevance of Popeye’s sign in patients who underwent biceps tenotomy or tenodesis. There is no consensus according to indication and outcome. We aimed to evaluate the frequency of the Popeye sign in a large cohort of patients concomitantly treated with an arthroscopic rotator cuff repair (ARCR). We assessed the effect on the clinical outcome based on biceps tendon treatment and Popeye sign.</div></div><div><h3>Methods</h3><div>A cohort of 973 primary ARCR patients from different Swiss and German orthopedic clinics was prospectively documented for up to 24 months postoperatively. All patients who received biceps tendon treatment were included in this study. We assessed Popeye sign occurrence across groups treated either with tenodesis or tenotomy. Additionally, we compared clinical and radiological outcome between Popeye/non-Popeye and tenotomy/tenodesis groups.</div></div><div><h3>Results</h3><div>Eight hundred patients were evaluated, of which 55% (n = 442) underwent tenodesis and 45% (n = 358) received tenotomy of the long head of the biceps tendon. Mean age of the tenodesis group was significantly lower than that of the tenotomy group (55 ± 9 and 61 ± 8 years, <em>P</em> &lt; .001). The other demographics were comparable. Among the patients with tenotomy, 20% (n = 63) developed a Popeye sign, compared to only 6.3% (n = 25) in the tenodesis group (age-adjusted relative risk 3, 95% confidence interval 1.9-4.8; <em>P</em> &lt; .001). There were no significant differences in shoulder function. The subjective shoulder value was lower in the Popeye group (82 ± 19% vs. 86 ± 15%, <em>P</em> = .010).</div></div><div><h3>Conclusion</h3><div>Patients with tenotomy of the biceps tendon are 3 times more likely to develop a Popeye sign compared to tenodesis. Popeye sign after ARCR seems to have no relevant effect on the clinical outcome and pain even though the subjective shoulder value was lower in patients with Popeye sign.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 373-379"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593835","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":"Gender bias in glenosphere size selection in reverse total shoulder arthroplasty: Glenoid size correlates with height and weight, not just gender","authors":"Brendan M. Patterson MD, MPH ,&nbsp;Joseph W. Galvin DO ,&nbsp;Maria F. Bozoghlian MD ,&nbsp;Natalie Glass PhD ,&nbsp;Melissa Wright MD","doi":"10.1016/j.jseint.2024.10.007","DOIUrl":"10.1016/j.jseint.2024.10.007","url":null,"abstract":"<div><h3>Background</h3><div>Optimal glenosphere selection is critical for successful outcomes following reverse total shoulder arthroplasty (rTSA). This study primarily aimed to determine patient-specific variables associated with dimensions of native glenoid anatomy. Secondarily, we aimed to determine the distribution of glenosphere sizes selected in male and female patients with similar-sized glenoids.</div></div><div><h3>Methods</h3><div>Computed tomography scans from patients undergoing rTSA with a diagnosis of cuff arthropathy or irreparable cuff tears were included for analysis. Variables collected included the following: age, gender, height, weight, and glenosphere size. Glenoid dimensions were measured, and interobserver reliability was calculated. Correlation coefficients were calculated for all variables. Multivariate predictive regression models were utilized to determine correlations between patient variables and glenoid width and height.</div></div><div><h3>Results</h3><div>One hundred and eighteen patients (46% male, 54% female) were included for analysis. Taller and male patients were significantly associated with increased glenoid height (<em>P</em> = .0096 and <em>P</em> = .0003, respectively). Females, shorter patients, and patients with decreased body weight were significantly associated with decreased glenoid width (<em>P</em> = .01, <em>P</em> &lt; .0001, and <em>P</em> = .01, respectively). Through stepwise selection, patient height was most strongly associated with glenoid width (<em>P</em> &lt; .0001). For glenoid widths between 25 and 30 mm, there was a significant variation in selected glenosphere sizes based on gender (<em>P</em> &lt; .0001).</div></div><div><h3>Discussion</h3><div>Patient gender and height are significantly associated with glenoid height and width. There remains a strong tendency towards gender bias when selecting glenosphere sizes for patients undergoing rTSA with similar-sized glenoids. This data highlights the importance of considering patient height as well as gender when considering glenoid component size in the setting of rTSA.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 466-471"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593954","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":"Navigation increases the accuracy of glenoid component implantation in reverse total shoulder arthroplasty in shoulders with severe glenoid wear: a comparative cohort study","authors":"Gregory Cunningham MD ,&nbsp;Andres Rodriguez Borgonovo MD ,&nbsp;Miguel Rivera MD ,&nbsp;Rodrigo Brandariz MD","doi":"10.1016/j.jseint.2024.11.009","DOIUrl":"10.1016/j.jseint.2024.11.009","url":null,"abstract":"<div><h3>Background</h3><div>Indications for reverse total shoulder arthroplasty (rTSA) have increased over the years and seem to yield satisfactory functional results even in patients with severe glenoid wear. New technologies, such as navigation, have gained in popularity intending to increase implantation precision, which is a crucial factor for long-term implant survivorship. However, these technologies remain costly and their widespread use for everyday cases has yet to be determined.</div></div><div><h3>Objectives</h3><div>This study aimed to compare the accuracy of glenoid component implantation in consecutive series of patients undergoing rTSA with and without navigation, according to the wear patterns of the glenoid.</div></div><div><h3>Study Design &amp; Methods</h3><div>Two consecutive series of patients operated on by the same shoulder surgeon for rTSA, with and without navigation using the NextAR system (Medacta, Castel San Pietro, Switzerland), were prospectively included in the study. Revision procedures or rTSA requiring glenoid bone graft were not included. Patients' demographics (age, sex, side, and body mass index), preoperative diagnosis, and glenoid wear patterns in both the coronal and axial planes were analyzed and defined as mild and severe. Postoperative implantation accuracy measurements were carried out on postoperative computed tomography scans and consisted of rTSA angle, version, maximal bone purchase of peripheral screws and central peg, and glenosphere eccentricity from the inferior glenoid neck.</div></div><div><h3>Results</h3><div>56 shoulders were included, 28 in each group. There were no significant differences in patient demographics, preoperative diagnosis, and wear pattern severity between both groups. In the navigated group, patients with severe bone wear presented a significantly higher accuracy in all analyzed parameters, whereas patients with mild glenoid defects did not show significant differences in the glenoid implantation version and glenosphere position from the inferior glenoid neck.</div></div><div><h3>Conclusion</h3><div>Navigation significantly improves glenoid implantation accuracy, particularly in patients with severe glenoid wear patterns. While its applicability in standard cases is debatable for experienced shoulder surgeons, it could prove valuable for patients with severe bone defects. Further studies are needed to assess if this will impact clinical and long-term implant survival outcomes.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 492-500"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593958","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":"Cemented vs. cementless stems for reverse shoulder arthroplasty for proximal humerus fractures: a registry analysis with patient-reported outcomes from a level 1 trauma centre","authors":"Kyle Raubenheimer MD ,&nbsp;Mitchell Atkinson MBBS ,&nbsp;Matthew Yan MB BChir, MA(Cantab) ,&nbsp;Michael Perret MBBS(Hons), FRACS ,&nbsp;Stefan Bauer MD ,&nbsp;Dylan Harries BSc (Hons), PhD ,&nbsp;David R.J. Gill MB ChB, FRACS, FAOrthA ,&nbsp;William G. Blakeney MBBS, MS, MSc, FRACS","doi":"10.1016/j.jseint.2024.09.023","DOIUrl":"10.1016/j.jseint.2024.09.023","url":null,"abstract":"<div><h3>Background</h3><div>Reverse total shoulder arthroplasty (rTSA) is being increasingly used in the treatment of comminuted or unreconstructible proximal humerus fractures. It is currently unclear if cementless rTSA have equivocal revision rates, mortality, and functional outcomes compared to cemented or cementless rTSA.</div></div><div><h3>Methods</h3><div>Two data sources were used for this study. All rTSA performed for proximal humerus fractures between 1 January 2010 and 1 January 2020 recorded on the Australian Orthopaedic Association National Joint Replacement Registry were used to determine revision rate and mortality between cemented and cementless rTSA. Patient-reported outcome measurements, including the American Shoulder and Elbow Surgeons score, Oxford Shoulder Score, and single assessment numerical value were obtained via telephone from Royal Perth Hospital (RPH) patients between 01 January 2010 and 10 February 2021.</div></div><div><h3>Results</h3><div>The study included 83 patients who underwent rTSA for proximal humerus fractures at RPH. There were 4335 rTSA procedures identified at other hospitals nationally. Of these, 54% of rTSA used cementless humeral stems. There was no significant difference in revision rate or mortality between cemented and cementless humeral stems adjusted for age and gender. For the RPH cohort, patient-reported outcome measurements scores included American Shoulder and Elbow Surgeons score of 65.9 (CI: 60.6-71.2), Oxford Shoulder Score of 34.6 (CI: 31.9-37.2), and single assessment numerical value of 68.8 (CI: 61.8-75.8).</div></div><div><h3>Conclusion</h3><div>Revision rates and mortality are similar between cemented and cementless humeral stems used for rTSA for proximal humerus fractures. For appropriate patients, cementless humeral stems may be an acceptable first-line treatment for proximal humerus fractures.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 415-421"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients with fibromyalgia have increased risk of 90-day postoperative adverse events following arthroscopic rotator cuff repair","authors":"Albert L. Rancu BS,&nbsp;Beatrice M. Katsnelson BA,&nbsp;Joshua G. Sanchez BA,&nbsp;Adam D. Winter MS,&nbsp;Rajiv S. Vasudevan MD,&nbsp;Jonathan N. Grauer MD","doi":"10.1016/j.jseint.2024.09.018","DOIUrl":"10.1016/j.jseint.2024.09.018","url":null,"abstract":"<div><h3>Background</h3><div>Arthroscopic rotator cuff repair (RCR) is a common surgical intervention for symptomatic rotator cuff tears when conservative management fails. Understanding the potential correlation of short- and long-term outcomes associated with defined comorbidities can help with patient selection, counseling, and related care pathways. The association of fibromyalgia, one potential comorbidity, with outcomes following RCR has not been reported in the literature.</div></div><div><h3>Methods</h3><div>Patients with and without fibromyalgia diagnosed prior to undergoing RCR were identified from the PearlDiver Mariner161 database between 2016 and April 30, 2022, using Current Procedural Terminology codes. The exclusion criteria were age less than 18 years, a diagnosis of neoplasm, trauma, or infection within 90 days prior to surgery, and postoperative records of fewer than 90 days. Patients with and without fibromyalgia were matched in a 1:4 ratio based on age, sex, and Elixhauser Comorbidity Index. Ninety-day adverse events were assessed. Severe adverse events were defined as the occurrence of sepsis, surgical site infection, cardiac events, deep vein thrombosis, or pulmonary embolism. Minor adverse events were defined as the occurrence of wound dehiscence, urinary tract infection, pneumonia, transfusion, hematoma, or acute kidney injury. Also identified was the occurrence of any adverse event, emergency department (ED) visits, and readmission. These outcomes were compared with multivariate analysis. 1-year revisions were assessed with Kaplan–Meier curves and compared with the log-rank test.</div></div><div><h3>Results</h3><div>In total, 295,169 RCR patients were identified, of which fibromyalgia was noted for 12,366 (4.2%). Following matching, the final cohort sizes for those with and without fibromyalgia were 11,387 and 45,354, respectively. Diagnosis of fibromyalgia was independently associated with increased risk of all individual adverse events as well as aggregated incidence of severe, minor, and any adverse events (<em>P</em> &lt; .0001 for all). Additionally, patients with fibromyalgia had independently 90-day increased odds of ED utilization (<em>P</em> &lt; .0001). There was no statistically significant difference in reoperation between the cohorts within 1 year of surgery.</div></div><div><h3>Discussion and Conclusion</h3><div>Fibromyalgia was associated with significantly increased 90-day postoperative adverse events and ED visits. These findings are relevant in surgical planning but are also balanced by a lack of difference in 1-year revisions.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 360-365"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593718","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":"Corrigendum to ‘Bony increased-offset reverse total shoulder arthroplasty (BIO-RSA) associated with an eccentric glenosphere and an onlay 135° humeral component: clinical and radiological outcomes at a minimum 2-year follow-up’ [JSES International Volume 6, Issue 3 (2022) 434-441]","authors":"Philippe Collotte MD ,&nbsp;Marc-Olivier Gauci MD ,&nbsp;Thais Dutra Vieira MD ,&nbsp;Gilles Walch MD","doi":"10.1016/j.jseint.2024.10.001","DOIUrl":"10.1016/j.jseint.2024.10.001","url":null,"abstract":"","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Page 601"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593833","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":"Space flight missions over 6 months significantly increase the risk of shoulder pathology and rotator cuff tears","authors":"Benjamin Fiedler MD,&nbsp;Meghana Jami MD,&nbsp;Srikhar V. Chilukuri BS,&nbsp;Abdullah Ghali MD,&nbsp;Todd Phillips MD,&nbsp;Adil Shahzad Ahmed MD","doi":"10.1016/j.jseint.2024.11.002","DOIUrl":"10.1016/j.jseint.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to determine risk of shoulder injury in astronauts returning from space flight and highlight the need for further exploration of risk factors and preventative strategies.</div></div><div><h3>Methods</h3><div>Using The Lifetime Surveillance of Astronaut Health epidemiology database at National Aeronautics and Space Administration, a retrospective cohort study was conducted to assess the effect of space flight mission duration on rate of shoulder injury among astronauts. Inclusion criteria were all astronauts who participated in space flight regardless of age or space flight mission time. Exclusion criteria were all injuries occurring greater than 5 years following return to Earth. Patient demographics were compared between injured and noninjured cohorts with stratification by shoulder pathology.</div></div><div><h3>Results</h3><div>Of total 242 astronauts, 22 sustained a shoulder injury (9.09%) and 220 did not sustain a shoulder injury (90.91%). Average age of the noninjured cohort was 46 years and average age of the shoulder pathology cohort was 48 years. There were 8 rotator cuff tears, 5 cases of shoulder impingement, 5 shoulder contusions, and 4 rotator cuff sprains/strains. Compared to the noninjured cohort, incidence of all shoulder pathology was significantly associated with space flight missions greater than 6 months (<em>P</em> &lt; .001). Rotator cuff tears in isolation, as well as rotator cuff and impingement pathology combined, were significantly associated with greater than 6 months in space flight (<em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>Space flight missions greater than 6 months were associated with increased risk of shoulder injury, especially rotator cuff tears. However, specific aspects of space flight that increase risk remain understudied. Shoulder injuries upon return to gravitational environments have the potential to negatively impact astronaut health and possibly jeopardize mission success, particularly as upper-extremity mobility is vital in the microgravity environment of space.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 380-384"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593836","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":"Atraumatic elbow avascular necrosis in the adult is rare, multifocal, and associated with systemic corticosteroid use","authors":"Daniel Chiou MD ,&nbsp;Bailey Mooney BS ,&nbsp;Andrew R. Jensen MD, MBE","doi":"10.1016/j.jseint.2024.10.008","DOIUrl":"10.1016/j.jseint.2024.10.008","url":null,"abstract":"<div><h3>Background</h3><div>Atraumatic avascular necrosis (AVN) of the elbow is a rare diagnosis with little literature describing features of this pathology. The purpose of this study is to investigate atraumatic elbow AVN in adults, with a focus on the anatomic distribution of AVN within skeletally mature elbows.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted on six patients who were identified via term searches of elbow magnetic resonance imaging (MRI) done at the authors’ institution that also had appropriate diagnoses. Terms included “necrosis”, “AVN”, and “avascular”. Demographic data were collected, including age of diagnosis, sex, associated comorbidities, use of steroids, use of chemotherapeutic agents, alcohol consumption, smoking status, and associated joint involvement. Clinical information regarding presentation and treatment course were also gathered. Both plain film and MRI were evaluated for identification of anatomic involvement of disease and staging.</div></div><div><h3>Results</h3><div>Six patients were included in the study: three men and three women with a mean age of 26.5 years (17-46) at time of diagnosis. All patients presented with elbow pain and one patient presented additionally with loss of full range of motion. Four of the six patients had a prior cancer diagnosis (T-cell acute lymphoblastic leukemia x2, follicular lymphoma, acute myeloblastic leukemia) that led to chemotherapy exposure, and two of them had additional steroid therapy. Another two had autoimmune diseases (systemic lupus erythematous and dermatomyositis) that required high dose steroid therapy. At time of initial imaging, the capitellum was involved in 8 of 9 elbows, the trochlea in 8 of 9 elbows, the radial head in 4 of 9 elbows, the proximal ulna in 2 of 9 elbows, and the olecranon in 1 of 9 elbows. Only one elbow had additional sites of the elbow affected at future follow-ups. One patient presented with AVN of the capitellum, trochlea, and ulnar neck, and two years later had signs of olecranon osteonecrosis on MRI. Two patients underwent operative treatment with resolution of symptoms.</div></div><div><h3>Conclusion</h3><div>This study describes the anatomic incidence of AVN of the elbow. Most involved are the capitellum and trochlea, with involvement in the radial head, proximal ulna, and olecranon also being observed. This information can be used to help orthopedic surgeons in their diagnosis and clinical decision making for affected patients.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 562-567"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593907","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":"A comparative analysis of short-term results in range of motion following arthroscopic arthrolysis with vs. without peripheral nerve block in cases of elbow stiffness","authors":"Tamara Babasiz MD,&nbsp;Michael Hackl MD,&nbsp;Felix Krane MD,&nbsp;Lars P. Müller MD,&nbsp;Tim Leschinger MD","doi":"10.1016/j.jseint.2024.10.009","DOIUrl":"10.1016/j.jseint.2024.10.009","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate the clinical short-term results in patients with elbow stiffness, particularly focusing on the range of motion (ROM) following arthroscopic arthrolysis. Our objective was to assess potential differences in postoperative outcomes between patients who received an additional peripheral nerve block with postoperative nerve block catheter, and those who exclusively underwent general anesthesia at 6 weeks, 3 months, and 6 months after surgery.</div></div><div><h3>Methods</h3><div>A single-center study was performed on patients undergoing arthroscopic elbow arthrolysis due to persistent elbow stiffness between 2014 and 2018. The participants were divided into 2 cohorts: One underwent arthroscopic elbow arthrolysis with an additional peripheral nerve block, combined with a postoperative nerve block catheter (group 1), while the other received the procedure without peripheral nerve block (group 2). Standardized assessments of ROM and the Disabilities of the Arm, Shoulder, and Hand score were conducted and analyzed preoperatively and at the 6-week, 3-month, and 6-month follow-up.</div></div><div><h3>Results</h3><div>A total of 32 patients were included in this study. In group 1 (18 patients), ROM in extension/flexion improved significantly from 95° (±27.17) to 124.4° (±12.7°; <em>P</em> = .000012) after 6 months. Similarly, a significant improvement from 150° (±29.1) to 170.6° (±13°; <em>P</em> = .0013) was observed after 6 months for ROM in pronation/supination. In contrast, group 2 (14 patients) demonstrated an improvement in elbow motion after 6 months, compared to preoperative values, although this increase did not reach statistical significance after 6 months (ROM extension/flexion, <em>P</em> = .6016; ROM pronation/supination, <em>P</em> = .2461). Furthermore, a significant difference (<em>P</em> = .0199) in the delta values of ROM arc for extension/flexion before surgery and after 6 months was identified when comparing both groups, favoring the patient group with additional regional anesthesia (group 1).</div></div><div><h3>Conclusion</h3><div>Additional peripheral nerve block combined with a postoperative nerve block catheter in arthroscopic arthrolysis in cases of elbow stiffness may be an opportunity to enhance postoperative outcomes by achieving better functional ROM, perhaps through reduced postoperative pain.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 568-573"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593908","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}