JSES International最新文献

{"title":"Impact of insurance payer type (medicare vs. private) on the patient reported outcomes after shoulder arthroplasty","authors":"Paul V. Romeo MD ,&nbsp;Aidan G. Papalia MBA ,&nbsp;Andrew J. Cecora BS ,&nbsp;Bradley A. Lezak MD ,&nbsp;Matthew G. Alben DO ,&nbsp;Dashaun A. Ragland BS ,&nbsp;Young W. Kwon MD, PhD ,&nbsp;Mandeep S. Virk MD","doi":"10.1016/j.jseint.2024.08.199","DOIUrl":"10.1016/j.jseint.2024.08.199","url":null,"abstract":"<div><h3>Background</h3><div>This study’s purpose is to determine if there is a difference in patient-reported outcome measures (PROMs) following shoulder arthroplasty (SA) based upon payer insurance type, with a secondary outcome of determining if any appreciable difference surpasses the minimal clinically important difference (MCID).</div></div><div><h3>Methods</h3><div>Subjects undergoing anatomic and reverse total shoulder arthroplasty were prospectively enrolled between March 2019 and March 2021. Subjects completed patient reported outcomes measurement information system upper extremity (P-UE), the American Shoulder and Elbow Surgeons score (ASES), and the simple shoulder test (SST) preoperatively and at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months, postoperatively. Descriptive statistics of baseline patient characteristics and preoperative PROMs (ASES, SST, and P-UE) were compared between insurance types.</div></div><div><h3>Results</h3><div>143 patients were identified who met the inclusion criteria for this study. There were 98 patients within the Medicare cohort and 45 patients with private insurance. Patients in the Medicare cohort were older (mean age 70.5 vs. 61.3 years), with high proportion of smokers, diabetics, and reverse total shoulder arthroplasty compared to the private payor cohort. There were no significant differences between the two cohorts with respect to outcomes scores except for significantly better SST in the private insurance cohort (69.3 vs. 79.4, <em>P</em> = .02). No significant differences were noted for the achievement of MCID between cohorts [P-UE (<em>P</em> = 1.0), ASES (<em>P</em> = .25), and SST (0.52)] and pre-to-postoperative improvements for P-UE (<em>P</em> = .62), ASES (<em>P</em> = .4), or SST (0.66).</div></div><div><h3>Conclusion</h3><div>Our study demonstrates that, at a tertiary-level academic institution in a metropolitan city, payor type does not have significant impact on achieving MCID or pre-to-postoperative improvements in PROMs after SA.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 169-174"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081441","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":"Coracoacromial ligament integrity influences scapular spine strain after reverse shoulder arthroplasty","authors":"Cole T. Fleet MESc ,&nbsp;Alicia Kerrigan MD, MSc, FRCSC ,&nbsp;G. Daniel. G. Langohr PhD ,&nbsp;James A. Johnson PhD ,&nbsp;George S. Athwal MD, FRCSC","doi":"10.1016/j.jseint.2024.10.012","DOIUrl":"10.1016/j.jseint.2024.10.012","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this biomechanical study was to examine the effect of coracoacromial (CA) ligament state (intact vs. released) and arm position on acromial and scapular spine strain following reverse total shoulder arthroplasty (rTSA).</div></div><div><h3>Methods</h3><div>Eight cadaveric shoulders were implanted with a custom rTSA system and tested using an in-vitro shoulder simulator. The specimens were cycled through static range of motion in both abduction and forward elevation; first with the CA ligament in the “intact” state followed by the “released” state. Scapular spine strain was quantified via 4 strain gauges placed along anatomic locations on the acromion and scapular spine.</div></div><div><h3>Results</h3><div>Increases in strain were observed across all 4 strain gauge locations upon release of the CA ligament in both 0° of abduction and forward elevation. Increases in the mean strain were observed to be as great as 14% in abduction and 31% in forward elevation. The increases in strain at 0° elevation approached but did not reach statistical significance (<em>P</em> ≥ .072). At 90° of abduction and forward elevation, no increases in the mean strain were observed. The greatest strain was consistently observed with the arm positioned in 0° of forward elevation (<em>P</em> &lt; .001).</div></div><div><h3>Discussion</h3><div>CA ligament release in the setting of rTSA resulted in increased scapular spine and acromial strain with the arm adducted, although these increases in strain were not statistically significant. Caution should be taken intraoperatively as the release of the CA ligament may alter scapular spine and acromion stresses from deltoid loading, which may increase the risk for postoperative scapular spine fracture.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 283-289"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081229","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":"Increased glenoid baseplate retroversion improves internal rotation following reverse shoulder arthroplasty","authors":"Lisa A. Galasso MD ,&nbsp;Bryce N. Clinger MD ,&nbsp;Brian C. Werner MD ,&nbsp;Patrick J. Denard MD","doi":"10.1016/j.jseint.2024.08.185","DOIUrl":"10.1016/j.jseint.2024.08.185","url":null,"abstract":"<div><h3>Background</h3><div>Internal rotation after reverse total shoulder arthroplasty is often unchanged or minimally improved. The primary purpose of this study was to investigate the effects of glenoid baseplate version on postoperative internal rotation. The secondary purpose to investigate the effects of baseplate retroversion on external rotation (ER) and patient-reported outcomes (PROs).</div></div><div><h3>Methods</h3><div>A retrospective review was performed on a prospectively maintained multicenter database of patients who underwent primary reverse shoulder arthroplasty using a 135° humeral prosthesis and lateralized glenoid with minimum 2-year clinical follow-up. Preoperative and postoperative radiographs were reviewed by 2 independent observers who assessed preoperative glenoid version and postoperative glenoid baseplate version. Patients were stratified by postoperative retroversion (&lt;10°, 10°-19° or &gt;20°) and change in version from preoperative to postoperative (ΔRV). Primary outcomes were internal rotation with the arm at 90° (IR90) and internal rotation estimated to nearest spinal level (IRspine). Secondary outcomes were active ER in adduction (ER0), active ER with arm at 90° (ER90), forward flexion (FF), and PROs. Linear regression analyses and 1-way analysis of variance analyses were used for comparisons.</div></div><div><h3>Results</h3><div>Two hundred seventy-four patients with a mean of 71 years of age were included in the study. Patients with &gt;10° of postoperative baseplate retroversion gained 20° of IR90 (<em>P</em> = .005) without loss of ER90 (<em>P</em> &lt; .001) compared to patients with &lt;10° of baseplate retroversion. More than 10° of postoperative baseplate retroversion was associated with significantly improved Constant-Murley scores (41.5, <em>P</em> = .007) and Single Assessment Numeric Evaluation scores (45.4, <em>P</em> = .047) compared to patients with less than &lt;10° of baseplate retroversion. Patients with a ΔRV increase of &gt;10° had significantly improved IR90 (<em>P</em> = .031) without loss of ER90 (<em>P</em> = .019). There was no correlation between ΔRV and IRspine, ER0 or FF, or PROs.</div></div><div><h3>Conclusion</h3><div>With a 135° and lateralized glenoid, postoperative baseplate retroversion of &gt;10° was associated with significantly improved IR90, ER90, Constant-Murley, and Single Assessment Numeric Evaluation scores at 2-year follow-up compared to &lt;10° retroversion. Additionally an increased ΔRV from preoperative to postoperative appears to improve IR90 without limiting ER0 or FF. While baseplate retroversion does not improve IRspine, overall function appears to be improved and therefore consideration may be given to accepting retroversion or intentionally retroverting the baseplate if fixation allows.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 147-154"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081445","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":"Preoperative imaging predicts coracoid graft size and restoration of the glenoid track in Latarjet procedures","authors":"Stephanie A. Boden MD ,&nbsp;Brian M. Godshaw MD ,&nbsp;Jonathan D. Hughes MD ,&nbsp;Volker Musahl MD ,&nbsp;Albert Lin MD ,&nbsp;Bryson P. Lesniak MD","doi":"10.1016/j.jseint.2024.05.012","DOIUrl":"10.1016/j.jseint.2024.05.012","url":null,"abstract":"<div><h3>Background</h3><div>Glenoid bone grafting procedures are often utilized to address glenoid bone loss in patients with recurrent shoulder instability. The purpose of this study was to determine if preoperative advanced imaging can accurately predict coracoid graft size and conversion of off-track to on-track Hill-Sachs lesions in patients undergoing Latarjet procedures.</div></div><div><h3>Methods</h3><div>Patients who underwent Latarjet procedure for shoulder instability at a single institution from 2012 to 2020 with preoperative and postoperative advanced shoulder imaging (computerized tomography or magnetic resonance imaging scans) were retrospectively reviewed. Glenoid diameter, Hill-Sachs interval (HSI), and measurements of the coracoid length, depth, and height were measured on preoperative imaging. Glenoid track (GT), percent glenoid bone loss, predicted restoration of GT, and the difference between HSI and GT (ΔHSI-GT) were calculated.</div></div><div><h3>Results</h3><div>Seventeen patients with a mean age of 25 ± 9 years met inclusion criteria. Average glenoid bone loss preoperatively was 24 ± 7% and average HSI was 27 ± 5mm. The Latarjet procedure reconstructed 116 ± 8% of the native glenoid, and 104 ± 8% of the predicted diameter. Of the 15 patients that had off-track lesions preoperatively, 11 were successfully converted to on-track lesions (73%). The 4 persistent off-track lesions had a significantly higher HSI (32 ± 2 mm vs. 26 ± 4 mm, <em>P</em> = .002). Preoperative measurements accurately predicted postoperative GT status in 94% of cases. At a mean follow-up of 2 years, there was no significant difference in recurrence rate or rate of revision stabilization procedures between patients with on-track versus persistent off-track humeral lesions.</div></div><div><h3>Conclusion</h3><div>Preoperative advanced imaging measurements can accurately predict whether an off-track Hill-Sachs can be converted to on-track after Latarjet procedure, further enhancing shoulder stability.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 1-5"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141275854","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":"Role of three-dimensional computed tomography with humeral subtraction in assessing anteromedial facet coronoid fractures","authors":"Moayd Abdullah H Awad MBBS, FRCSC ,&nbsp;Michael Lapner MD, FRCSC ,&nbsp;Armin Badre MD, MSc, FRCSC","doi":"10.1016/j.jseint.2024.07.003","DOIUrl":"10.1016/j.jseint.2024.07.003","url":null,"abstract":"<div><h3>Background</h3><div>The anteromedial facet (AMF) of the coronoid is a key structure in resisting varus posteromedial rotatory instability (PMRI) of the elbow. However, not all isolated coronoid fractures involve the AMF and not all fractures involving the AMF are the result of a PMRI mechanism. There is debate regarding the management of isolated coronoid fractures. A reliable method of differentiating this heterogeneous group of isolated coronoid fractures is essential to develop an appropriate management algorithm. The aim of this study was to evaluate the role of additional humeral subtraction three-dimensional (3D) images in the detailed assessment of the known radiographic features of AMF fractures with PMRI mechanism.</div></div><div><h3>Methods</h3><div>Three upper extremity fellowship-trained orthopedic surgeons evaluated 32 consecutive CT scans in patients with isolated coronoid fractures, on two occasions separated by at least 5 months. On each occasion, CT scan images were evaluated for fracture morphology and orientation in two rounds. In the first round, the evaluation was made based on all two-dimensional and 3D reconstruction images of the entire elbow; in the second round, the surgeons had access to images from the first round plus 3D reconstruction with humeral subtraction. Statistical analysis to assess agreement amongst the surgeons was performed using the kappa multirater analysis. Intraobserver agreement was evaluated using Pearson’s correlation coefficient.</div></div><div><h3>Results</h3><div>The addition of the humeral subtraction view significantly improved the interobserver agreement for fracture morphology from 0.28 (95% confidence interval [CI] 0.07-0.49) to 0.66 (95% CI 0.46-0.87), <em>P</em> &lt; .001; and for orientation from 0.31 (95% CI 0.09-0.52) to 0.54 (95% CI 0.31-0.77), <em>P</em> &lt; .001. Similarly, the intraobserver Pearson correlation improved from 0.28-0.38 to 0.48-0.76 for fracture morphology, and from 0.36-0.77 to 0.51-0.69 for fracture orientation.</div></div><div><h3>Conclusion</h3><div>3D CT reconstruction with humeral subtraction improved surgeons’ ability to characterize radiographic features of AMF coronoid fractures. Future studies are required to determine whether better characterization of the morphology and orientation of AMF fractures allows for the categorization of these fractures into more homogenous groups and the development of more consistent management algorithms.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 332-338"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844509","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":"Minimally invasive needle tenotomy vs. platelet rich plasma injection in the treatment of chronic elbow epicondylitis","authors":"Chantal T. Nguyen MD,&nbsp;Michelle H. Lee MD,&nbsp;Matthew W. Kaufman MD,&nbsp;Yue Meng MD,&nbsp;Jyotsna A. Koduri MD,&nbsp;Geoffrey Abrams MD,&nbsp;Emilie V. Cheung MD,&nbsp;Michael T. Freehill MD,&nbsp;Eugene Y. Roh MD","doi":"10.1016/j.jseint.2024.08.183","DOIUrl":"10.1016/j.jseint.2024.08.183","url":null,"abstract":"<div><h3>Background</h3><div>Medial and lateral epicondylitis, characterized by repetitive microtraumas to common flexor and extensor tendons, respectively, are common causes of elbow pain in adults. Though symptoms are generally self-limiting, 10% of cases are refractory to conservative management, persisting for greater than 18 months, and leading to surgery, which can have increased risk of complications. There is minimal data on sustained pain relief and functional benefit for newer nonsurgical management options, such as minimally invasive needle tenotomy (MINT), and platelet-rich plasma (PRP) for chronic elbow epicondylitis. Additionally, no previously established correlation exists between magnetic resonance imaging (MRI) severity of chronic epicondylitis with pain and functional improvement in MINT- and PRP-treated patients.</div></div><div><h3>Methods</h3><div>A retrospective review of 51 adults (n = 23 for MINT; n = 28 for PRP) was conducted to investigate long-term outcomes in pain relief (via visual analog scale or VAS) and improvements in upper extremity function (via quick disability of the arm, shoulder, and hand questionnaire or qDASH). These outcomes were correlated with radiographic evidence of epicondylitis severity, assessed by the grade of epicondylitis and percentage thickness of tendon tears.</div></div><div><h3>Results</h3><div>There were significant improvements in pain (VAS), but no significant differences in function (qDASH) following MINT and PRP. On average, VAS score improved by 2.6 (<em>P</em> &lt; .001) post-MINT and by 3.8 (<em>P</em> &lt; .001) post-PRP combined for all follow-up time points. No adverse events were reported over the entire study. A significantly higher percentage of patient-reported pain relief was noted post-MINT at all follow-up time points. VAS and qDASH outcomes post-MINT and post-PRP were not correlated with the initial MRI severity of epicondylitis.</div></div><div><h3>Conclusions</h3><div>There are multifactorial benefits of both MINT and PRP as safe, nonopen surgical modalities that can be used, despite MRI severity, to provide sustained pain relief for patients with refractory elbow epicondylitis.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 231-236"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080825","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":"Approach to shoulder instability: a randomized, controlled trial","authors":"Julien Caron MD FRCSC ,&nbsp;Kellen Walsh MD FRCSC ,&nbsp;Tinghua Zhang MSc ,&nbsp;Rashed AlAhmed MBChB MSc FRCSC ,&nbsp;Peter B. MacDonald MD FRCSC ,&nbsp;Cristina Bassi MD ,&nbsp;J Whitcomb Pollock MD FRCSC MSc ,&nbsp;Katie McIlquham BSc ,&nbsp;Peter Lapner MD FRCSC","doi":"10.1016/j.jseint.2024.09.015","DOIUrl":"10.1016/j.jseint.2024.09.015","url":null,"abstract":"<div><h3>Background</h3><div>The significant rate of recurrent instability following arthroscopic stabilization surgery points to a need for an evidence-based treatment approach. The instability severity index Score (ISI score) is a point-based algorithm that may be used to assist clinicians in selecting the optimal treatment approach, but its efficacy compared with a traditional treatment algorithm has not been previously validated. The aim was to compare two surgical treatment algorithms: the ISI score and a conventional treatment algorithm (CTA).</div></div><div><h3>Methods</h3><div>This was a prospective, randomized controlled trial involving participants who were randomized to either the ISI score or CTA and were followed for 24 months postrandomization. In the ISI score cohort, patients underwent a Latarjet procedure if they presented with a score &gt;3 points. Those scoring ISI score ≦3 points underwent an arthroscopic Bankart repair. Patients randomized to the CTA group underwent a Latarjet procedure if the glenoid bone loss was &gt; 25%. The primary outcome was the Western Ontario Shoulder Instability Index. Secondary outcomes included the American Shoulder and Elbow Surgeons score as well as recurrence rates between groups.</div></div><div><h3>Results</h3><div>Sixty-three patients were randomized to ISI score (n = 31) or CTA (n = 32). At two years, the Western Ontario Shoulder Instability Index score was similar between groups (ISI score: 84.1 ± 16.9, CTA: 85.7 ± 12.5, <em>P</em> = .70). Similarly, no differences were detected in American Shoulder and Elbow Surgeons scores (ISI score: 93.2 ± 16.2, CTA: 92.6 ± 9.9, <em>P</em> = .89). Apprehension was reported in 18.5% for the ISI score group and 20% in the CTA group (<em>P</em> = 1.00). At a 24-month follow-up, there was no difference in redislocations: one in ISI score group and none in the CTA group (<em>P</em> = .48). There were two revision surgeries in the ISI score group and two in the CTA group.</div></div><div><h3>Conclusion</h3><div>This study did not demonstrate any differences in functional outcomes, the incidence of apprehension, or failure rates between the two treatment algorithms at 24-month follow-up.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 290-295"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081189","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":"Preoperative antidepressant use in patients with depression is associated with increased complications and additional shoulder procedures following rotator cuff repair","authors":"Brady P. Moore BS ,&nbsp;Sterling J. DeShazo BS ,&nbsp;Jeremy S. Somerson MD","doi":"10.1016/j.jseint.2024.08.198","DOIUrl":"10.1016/j.jseint.2024.08.198","url":null,"abstract":"<div><h3>Background</h3><div>Preoperative depression has been associated with inferior functional outcomes and increased complications following arthroscopic rotator cuff repair (RCR). This study evaluated the association of antidepressant use with postoperative complications following arthroscopic RCR.</div></div><div><h3>Methods</h3><div>The TriNetX database was used to evaluate postoperative outcomes of patients who underwent arthroscopic RCR from February 24, 2004 to February 24, 2024. Patients diagnosed preoperatively with depression and documented antidepressant use within 1 year preceding surgery were compared to patients with preoperative depression but no history of preoperative antidepressant use. The cohorts were propensity-matched for demographic factors including age, type 2 diabetes, nicotine dependence, alcohol-related and opioid-related disorders, and indicators of depression severity (eg, suicide attempt, history of self-harm, sleep disorders). Outcomes were evaluated within 90 days and 3 years postoperative.</div></div><div><h3>Results</h3><div>A total of 9151 patients with documented antidepressant medication use were matched with 5894 patients with no antidepressant use. Patients using antidepressants demonstrated significantly higher odds of acute postoperative pain (<em>P</em> &lt; .0001), shoulder stiffness (<em>P</em> = .0011), and emergency department visit (<em>P</em> &lt; .0001) within 90 days postoperative and significantly increased odds of shoulder pain (<em>P</em> &lt; .0001); RCR revision surgery (<em>P</em> &lt; .0001); shoulder arthrocentesis, aspiration, and/or injection (<em>P</em> &lt; .0001); and shoulder arthroplasty (<em>P</em> &lt; .0001) within 3 years postoperative.</div></div><div><h3>Conclusion</h3><div>Preoperative antidepressant use was associated with significantly increased odds of acute postoperative pain, emergency department visits, opioid abuse, and additional shoulder procedures following arthroscopic RCR and did not mitigate the deleterious impact of depression on arthroscopic RCR outcomes.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 98-108"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081118","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":"Hand size association with ulnar collateral ligament reconstruction in professional baseball players","authors":"Michael T. Freehill MD ,&nbsp;Michael Walsh MD ,&nbsp;Nathan Richards DO ,&nbsp;John Morasso DO ,&nbsp;Traci A. Ackron DO, MPH ,&nbsp;Emily Lau MD ,&nbsp;Chaoyang Richard Chen MD ,&nbsp;Corey S. Tremble ATC ,&nbsp;Richard K. Ryu MD ,&nbsp;Stephen E. Lemos MD, PhD","doi":"10.1016/j.jseint.2024.08.188","DOIUrl":"10.1016/j.jseint.2024.08.188","url":null,"abstract":"<div><h3>Background</h3><div>Ulnar collateral ligament (UCL) injuries in professional baseball remain a significant problem with debate as to which are the greatest risk factors. Currently, it is unknown if hand size should be considered a predictor for UCL injury. A larger or smaller hand size could have implications on fatigue of the forearm musculature and thus varying amounts of strain seen by the UCL. The purpose of this study was to investigate if there is a correlation between hand size and history of UCL tear requiring a reconstruction. We hypothesize that a smaller hand size will be correlated with higher UCL reconstruction (UCLR) rates in professional baseball players.</div></div><div><h3>Methods</h3><div>One-hundred and eighty-nine professional players from one Major League Baseball organization were recruited in this retrospective study. Four different measurements were used for hand size including the distance from the tip of long finger to wrist crease (closed fingers), the distance from the thumb tip to the small fingertip (closed fingers), the distance between thumb tip and small fingertip (spread fingers), and a modified Nirschl measurement (closed fingers). Statistical analysis including <em>t</em>-test, Chi-squared test, Pearson correlation, and binary logistic regression were performed to determine the statistical significance between these hand size measurements and a history of UCLR.</div></div><div><h3>Results</h3><div>There were 25/189 (13.2%) players with a history of UCLR surgery. The mean age of UCLR group (23.6 ± 3.3 years) was younger than the non-UCLR group (26.2 ± 3.6) (<em>P</em> = .001). Statistical analysis demonstrated the distance between thumb tip and small fingertip (spread fingers) was smaller in the UCLR group compared to the non-UCLR group (20.33 ± 1.18 cm vs. 20.98 ± 1.03 cm; <em>P</em> = .024) and the modified Nirschl measurement (closed fingers) was shorter in the UCLR group (14.45 ± 0.7 cm vs. 14.86 ± 0.91 cm; <em>P</em> = .013). Findings were most notable in players aged less than 21 years with UCLR rates of 57.1% versus players aged more than 21 years (9.7%) (<em>P</em> &lt; .001). Statistical analysis demonstrated a correlation and regression between injury probability and hand measurements (<em>P</em> = .01).</div></div><div><h3>Conclusion</h3><div>This study demonstrated that a smaller hand size did correlate with a history of UCLR in this professional baseball population of players. Further studies are warranted to investigate these associations.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 237-243"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and radiological evaluation of the Bristow–Latarjet procedure in patients with 30 or more years of follow-up","authors":"Arnaldo Amado Ferreira Neto MD, PhD ,&nbsp;Mauro Emilio Conforto Gracitelli MD, PhD ,&nbsp;Jorge Henrique Assunção MD, PhD ,&nbsp;Fernando Brandão de Andrade e Silva MD, PhD ,&nbsp;Verônica Yulin Prieto Chang MD ,&nbsp;Eduardo Angeli Malavolta MD, PhD","doi":"10.1016/j.jseint.2024.08.192","DOIUrl":"10.1016/j.jseint.2024.08.192","url":null,"abstract":"<div><h3>Background</h3><div>The Bristow–Latarjet surgery is the procedure most performed for recurrent anterior shoulder dislocation. There are few studies with a follow-up of more than 20 years. Because it is a nonanatomical technique, there is interest in knowing the clinical and radiological results and the rates of complications in the long term.</div></div><div><h3>Methods</h3><div>We performed a retrospective case series study. Patients with recurrent anterior dislocation of the shoulder who underwent the Bristow–Latarjet procedure were included and followed-up clinically for at least 30 years. We evaluated clinical scores—the Rowe, Western Ontario Shoulder Instability, Single Assessment Numeric Evaluation, and visual analog scale—as well as clinical outcomes: the recurrency (dislocation or subluxation) and seizure. Screw and graft positioning were assessed by computed tomography, the degree of arthropathy by radiography, and subscapularis fatty degeneration as rotator cuff tears by magnetic resonance imaging. Both clinical scores and imaging were obtained at 30 years of surgery.</div></div><div><h3>Results</h3><div>Twenty-seven patients (30 shoulders) were evaluated, with a mean follow-up of 35 ± 4.5 years. The scores obtained were 88.28 ± 15.9 by Rowe, 208 ± 244.2 by the Western Ontario Shoulder Instability examination, 92.5% ± 10.4% by the Single Assessment Numeric Evaluation, and 0.45 ± 1.3 by the visual analog scale. The recurrence rate was 13.3%, with all patients presenting subluxations and no new dislocations. All grafts were positioned below the glenoid equator. In 82.4% of the cases, the grafts were aligned with the articular surface, 5.9% were medially deviated, and 11.8% were laterally deviated. Consolidation occurred in 76.5% of the cases. The screws presented bicortical fixation in 76.5% of the shoulders and inclination in the axial plane of less than 15° in 64.7%. A total of 58.8% of the cases presented with glenohumeral arthropathy, and 75% of the magnetic resonance imagings showed the absence of fatty degeneration.</div></div><div><h3>Conclusion</h3><div>Bristow–Latarjet surgery demonstrates excellent clinical results in most patients after 30 years of follow-up. The recurrence rate is low, as is the complication rate. Glenohumeral arthropathy occurs in most patients without significant clinical repercussions.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 18-24"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081156","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}