JSES International最新文献

{"title":"Ultrasonographic humeral retrotorsion comparisons in youth gymnasts","authors":"Jacob C. Jones MD ,&nbsp;Cassidy M. Schultz BS ,&nbsp;Caroline C. Podvin BA ,&nbsp;David P. Mikhail BS ,&nbsp;Robert L. Van Pelt MPH ,&nbsp;Joseph Chang MD ,&nbsp;Hamza S. Alizai MD ,&nbsp;Henry B. Ellis MD ,&nbsp;Philip L. Wilson MD","doi":"10.1016/j.jseint.2024.11.005","DOIUrl":"10.1016/j.jseint.2024.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Humeral retrotorsion has been studied in youth baseball but is underexplored in other upper-extremity sports. Gymnasts, who often perform repetitive tumbling and overhead weight bearing, are at risk for shoulder pain and impingement. It is unclear if humeral torsional remodeling contributes to these shoulder conditions. The purpose of this study is to compare humeral retrotorsion in the dominant and nondominant arms of female gymnasts vs. nonupper extremity athletes.</div></div><div><h3>Methods</h3><div>Data were drawn from a prospective upper extremity ultrasound registry including female gymnasts and nonupper extremity female athletes (soccer players) aged 8-14 years with open physes, presenting between March 2021 and July 2023. Exclusion criteria were prior upper extremity surgery and metabolic bone disease. Bilateral humeral torsion was measured by a fellowship-trained physician using validated ultrasound methods. Analyses included chi-square and Mann-Whitney tests.</div></div><div><h3>Results</h3><div>Forty-five female athletes (31 gymnasts and 14 soccer players) were assessed. Mean age was 10.8 years for gymnasts and 10.9 years for soccer players (<em>P</em> = .755). Most athletes (93.3%) were right-hand dominant. Mean humeral retrotorsion in gymnasts was 76.5° (right) and 75.6° (left), and 67.9° (right) and 70.5° (left) in soccer players, with no significant differences in dominant (<em>P</em> = .263) or nondominant arms (<em>P</em> = .228) between groups.</div></div><div><h3>Conclusion</h3><div>Youth gymnasts did not exhibit significant humeral retrotorsion differences compared to controls, suggesting shoulder syndromes in gymnasts may relate more to soft tissue adaptations than bony changes.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 355-359"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593715","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":"Magnetic resonance imaging vs. two- and three-dimensional computed tomography scans for assessment of glenoid inclination and version","authors":"Thomas Wittmann MD ,&nbsp;Tim Rieger ,&nbsp;Sandra Krawczyk ,&nbsp;Tobias Helfen MD ,&nbsp;Inês Santos MSc ,&nbsp;Patric Raiss MD","doi":"10.1016/j.jseint.2024.08.182","DOIUrl":"10.1016/j.jseint.2024.08.182","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Accurate glenoid component placement is crucial for anatomic (aTSA) or reverse (rTSA) total shoulder arthroplasty. Preoperative glenoid assessment in computed tomography (CT) scans with or without planning software seems to be the established method to plan implant positions. Magnetic resonance imaging (MRI) scans can also display the glenoid bone for preoperative assessment while reducing radiation exposure. Therefore, the objective of this study was to manually assess the glenoid version and inclination in 2D MRI and CT scans in cases with degenerative shoulder pathologies. The results were compared to those of an automated 3D planning software to validate the imaging modality for preoperative glenoid assessment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;MRI and CT scans of 146 patients (n = 41 aTSA; n = 105 rTSA) were included in this retrospective, single-center study. Glenoid version and inclination were measured manually according to Friedman et al and Maurer et al on CT and MRI scans by two observers. Subsequently, the results were compared to the automated measurements performed by planning software. A repeated-measures analysis of variance was performed to compare the measured angles, and the interobserver and intraobserver reliability were calculated using the intraclass correlation coefficients. The level of significance was set at &lt;em&gt;P&lt;/em&gt; &lt; .05.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The average glenoid inclination measured in CT scans was 7.94° ± 7.33°, in MRI scans it was 8.56° ± 7.34°, and in automated planning software it was 7.87° ± 7.60°. The analysis of variance revealed significant differences in mean inclination between 2D MRI and 2D CT (&lt;em&gt;P&lt;/em&gt; &lt; .0005) and between MRI and automated software (&lt;em&gt;P&lt;/em&gt; = .011). No significant difference was found between 2D CT scans and automated planning software (&lt;em&gt;P&lt;/em&gt; = 1.000). The mean glenoid version measured in 2D CT scans was −7.94° ± 10.86°, in 2D MRI scans it was −8.04° ± 10.80°, and −8.32° ± 11.53° in the automated planning software. There was no significant difference in between measurement methods (&lt;em&gt;P&lt;/em&gt; = .339). Interobserver reliability analysis showed no statistical differences between the two observers. All measurements had excellent intraobserver reliability.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Preoperative assessment of glenoid version and inclination is crucial in ensuring precise implant positioning and orientation in aTSA and rTSA. This study observed a significant level of concordance between manual and automated measuring techniques utilizing MRI and CT scans. The mean glenoid inclination exhibited a statistically significant difference of less than 1° across the assessment modalities, and no difference for glenoid version was noted. It seems to be questionable if this finding is clinically relevant. MRI may serve as a viable and safe option for assessing glenoid morphology, version, and inclination if CT scans are not a","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 398-403"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593839","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":"Correlation of preoperatively planned humeral component size and actual implanted size: a retrospective and prospective evaluation of anatomic and reverse shoulder arthroplasty","authors":"Brian C. Werner MD ,&nbsp;Bradford Parsons MD ,&nbsp;Jared Johnson MD ,&nbsp;Patrick J. Denard MD","doi":"10.1016/j.jseint.2024.09.020","DOIUrl":"10.1016/j.jseint.2024.09.020","url":null,"abstract":"<div><h3>Background</h3><div>The aims of the study were to (1) evaluate the correlation of planned humeral component diameter with implanted humeral component diameter for reverse total shoulder arthroplasty (rTSA) and (2) to evaluate the correlation of planned humeral components with executed humeral components for stemless anatomic TSA.</div></div><div><h3>Methods</h3><div>Four shoulder surgeons participated in two phases of the study. In the retrospective arm, 3 months of TSA and rTSA cases which were completed with preoperative computed tomography-based planning, but without any humeral planning, were replanned using humeral planning, and the components from the virtual planning compared to the implanted components. In the prospective arm, 3 months of TSA and rTSA cases were prospectively planned by each surgeon. The planned and implanted components were similarly compared.</div></div><div><h3>Results</h3><div>Ninety-seven rTSAs were included (50 retrospective, 48 prospective). In the retrospective analysis, in 60% of cases, the rTSA stem diameter was within one size of the plan; in 84%, it was within two sizes; in 90%, it was within 3 sizes. In the prospective analysis, the rTSA stem diameter was within one size in 73% of cases; in 90% within 2 sizes, and in 94% within 3 sizes (<em>P</em> &gt; .05 all comparisons). The cup diameter was always within one size of the plan; it matched in 84% of the retrospective cases and 90% of the prospective cases (<em>P</em> &gt; .05). Seventy-seven TSAs were included (33 retrospective, 44 prospective). For prosthetic head diameter, in the retrospective analysis, it was an exact match in 52% of patients, within one size in 85% and within two sizes in 100%. In the prospective analysis, the diameter was an exact match in 57%, within one size in 86% and within two sizes in 100% (<em>P</em> &gt; .05 all comparisons). The thickness of the prosthetic component was a match to the plan in 88% of the retrospective cases and 86% of prospective cases (<em>P</em> &gt; .05).</div></div><div><h3>Conclusion</h3><div>For the utilized planning software and implants, humeral planning for rTSA affords some predictability for stem diameter regardless of whether assessed retrospectively or prospectively, with 84%-90% of cases within two diameters of the plan. The inlay humeral cup diameter was an exact match to the plan in 84%-90% of cases. For stemless anatomic TSA, the humeral component diameter was an exact match to the plan in 52%-57%, but within one size in 85%-86% of cases. There were no significant differences if the planning was performed retrospectively or prospectively.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 411-414"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593999","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":"Impact of scapula anatomical landmark positioning on scapular orientation using CT-based 3-dimensional models: an intraobserver repeatability and interobserver reproducibility study","authors":"Florent Moissenet PhD ,&nbsp;Sana Boudabbous MD, PhD ,&nbsp;Nicolas Holzer MD, PhD","doi":"10.1016/j.jseint.2024.09.027","DOIUrl":"10.1016/j.jseint.2024.09.027","url":null,"abstract":"<div><h3>Hypothesis</h3><div>The primary objective of this study was to assess intraobserver repeatability and interobserver reproducibility of the 3-dimensional (3D) coordinates of a set of scapula anatomical landmarks obtained by manual positioning on conventional supine computed tomography (CT) scan–based scapula surface models. The secondary objective was to assess intraobserver repeatability and interobserver reproducibility of the resulting 3D scapular orientation. It was hypothesized that the 3D scapular orientation reliability would be better or similar than established reliability of intraoperative baseplate positioning (ie, version and inclination) in reverse total shoulder arthroplasty.</div></div><div><h3>Methods</h3><div>Three anatomical landmarks, ie, acromial angle, inferior angle, and trigonum spinae, were manually positioned on 81 scapula surface models using updated landmark definitions. These models were obtained by the segmentation of CT scan images acquired from patients undergoing elective reverse total shoulder arthroplasty procedures at the Department of Surgery at Geneva University Hospitals between May 2022 and December 2023. This procedure was repeated 3 times per scapula by 3 independent observers. A set of parameters corresponding to the 3D landmark coordinates (expressed in an average scapula coordinate system) and the 3D scapular orientation (expressed as 3 angles related to the retraction/protraction, lateral/medial rotation, and internal/external rotation) were computed. Intraobserver repeatability and interobserver reproducibility were assessed for each of these parameters using an intraclass correlation coefficient (ICC) as a relative reliability metric. Standard error of measurement (SEM) was also reported as an absolute reliability metric.</div></div><div><h3>Results</h3><div>Intraobserver ICC and interobserver ICC ranged from poor to moderate for acromial angle, poor to excellent for inferior angle, and poor to excellent for trigonum spinae. However, low SEM, ranging from 0.4 mm to 2.4 mm for intraobserver repeatability and from 0.2 mm to 1.8 mm for interobserver reproducibility, was obtained for every coordinate of each anatomical landmark. This results in poor to moderate intraobserver ICC and interobserver ICC for scapula angular orientation. Again, low SEM, ranging from 0.4° to 0.8° for intraobserver repeatability and 0.4° to 0.6° for interobserver reproducibility, was obtained, arguing for reliable measurements.</div></div><div><h3>Discussion</h3><div>This study demonstrates that manual positioning of the 3 scapula anatomical landmarks recommended by the International Society of Biomechanics can be performed in a reliable manner across measures and observers on surface bone models obtained from CT scan images. However, a clear and standardized definition of these landmarks is needed to ensure consistency across measurements.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 524-531"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593722","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":"Doctor, when can I drive? – compensation capability while driving with restricted elbow – a biomechanical analysis","authors":"Erik Schiffner MD,&nbsp;Felix Lakomek MD,&nbsp;Falk Hilsmann MD,&nbsp;Dominique Schoeps MD,&nbsp;Max Prost MD,&nbsp;Christoph Beyersdorf MD,&nbsp;Joachim Windolf PhD,&nbsp;David Latz MD","doi":"10.1016/j.jseint.2024.09.028","DOIUrl":"10.1016/j.jseint.2024.09.028","url":null,"abstract":"<div><h3>Background</h3><div>Every joint participates in a specific range of motion (ROM) while operating a motor vehicle safely. In current literature, there is a paucity of how movement restrictions of the elbow flexion and extension can be compensated by adjacent joints to ensure safe driving. The aim of this study was to analyze movement patterns of the kinematic chain consisting of wrist, elbow, and shoulder while driving with restricted elbow joint.</div></div><div><h3>Methods</h3><div>Twenty participants completed a driving course in a driving simulator in two conditions: a) free ROM of all joints vs. b) restricted right elbow in 90° flexion but with free pronation and supination. To evaluate driving performance, speed, lane accuracy, and shifting time was measured. To analyze the movement pattern, ROM of wrist, elbow, and shoulder were recorded using a full-body motion capture system. Each driving course consisted of three maneuvers, as follows: I shifting, II left turns, and III right turns. Driving performance and movement patterns of condition a) and b) were compared on maneuver I-III.</div></div><div><h3>Results</h3><div>Driving performance: Participants drove their car slower while driving right turns with elbow restriction (a) 37.45 ± 1.66 km/h vs. b) 32.53 ± 1.18 km/h; <em>P</em> = .02). Driving performance was not affected while driving left turns or shifting gears (<em>P</em> &gt; .05). Movement pattern: Participants used their right shoulder in a higher ROM while driving turns with restricted right elbow (<em>P</em> &lt; .05) but the left arm showed no significant different movement pattern (<em>P</em> &gt; .05). The ROM of the left elbow and both shoulders were significantly higher when shifting gears with restricted right elbow (<em>P</em> &lt; .05).</div></div><div><h3>Conclusion</h3><div>This study first describes the changes in movement patterns of the upper extremity while driving with a restricted right elbow. Our data suggest that restricted right elbow flexion or extension can be compensated by the left arm and a different posture of the right shoulder when driving left turns. A different movement pattern of the left elbow and both shoulders is used when changing gears while driving straight. Drivers should be aware when driving turns while shifting gears, and special attention should be paid to the shoulders and left elbow when evaluating the driving capability of patients with movement restriction of the right elbow by physicians.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 542-548"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593905","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":"Projections of utilization of primary and revision shoulder arthroplasty in the United States in the next 40 years","authors":"Andrew J. Cecora BS,&nbsp;Dashaun Ragland BS,&nbsp;Neel Vallurupalli BS,&nbsp;Erel Ben-Ari MD,&nbsp;Jacquelyn J. Xu MA,&nbsp;Brian O. Molokwu MS,&nbsp;Young W. Kwon MD, PhD,&nbsp;Joseph D. Zuckerman MD,&nbsp;Mandeep S. Virk MD","doi":"10.1016/j.jseint.2024.10.013","DOIUrl":"10.1016/j.jseint.2024.10.013","url":null,"abstract":"<div><h3>Background</h3><div>In the past 20 years, the incidence of total shoulder arthroplasty (TSA) has increased greatly, and it is expected to continue growing. Current literature lacks future projections for the utilization of TSA. These projections can help predict demand quantities and anticipate the future burden on the healthcare system. The aim of this study is to determine the predictions of utilization for TSA, primary and revision, through 2060.</div></div><div><h3>Methods</h3><div>This analysis used the publicly available 2000-2019 data from the Center for Medicare and Medicaid Services Medicare Part-B National Summary. Procedure volumes, including TSA and revision TSA, were determined using Current Procedural Terminology codes and were uplifted to account for the growing number of Medicare eligible patients covered under Medicare Advantage. Log-linear, Poisson, negative binomial regression, and autoregressive integrated moving average models were applied to the procedural volumes to generate projections from 2020-2060. The Poisson model was chosen to display the data based on error analysis and prior literature.</div></div><div><h3>Results</h3><div>The projected annual growth from 2020 to 2060 rates for primary and revision TSA are 11.65% growth (95% confidence interval 11.60%-11.69%) and 13.89% growth (95% confidence interval 13.35%-14.42%), respectively. By 2060, the demand for primary TSA and revision TSA is projected to be 10,029,260 and 1,690,634, respectively.</div></div><div><h3>Conclusion</h3><div>The results of this study concluded that both primary and revision TSA procedures are projected to exponentially increase from 2020 to 2060. Additionally, revision procedures are projected to increase at greater rates than their respective primary counterparts.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 472-476"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593955","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 glenoid morphology in on-track and off-track lesions following anterior shoulder dislocation","authors":"Philipp Zehnder MD ,&nbsp;Max Kersten ,&nbsp;Markus Schwarz MD ,&nbsp;Peter Biberthaler MD ,&nbsp;Chlodwig Kirchhoff MD ,&nbsp;Lukas Willinger MD","doi":"10.1016/j.jseint.2024.10.011","DOIUrl":"10.1016/j.jseint.2024.10.011","url":null,"abstract":"<div><h3>Background</h3><div>Anterior shoulder dislocation is a prevalent clinical issue, with high recurrence rates after initial dislocation. Stability of the shoulder joint is maintained by the interplay of static and dynamic stabilizers, including the glenoid and humeral head morphology. Glenoid morphology has been identified as particularly influential in joint stability, and thus the evaluation of glenoid bone loss is crucial in managing shoulder dislocations. This study aimed to investigate the differences in glenoid morphologies between on-track and off-track lesions postdislocation.</div></div><div><h3>Methods</h3><div>This retrospective case-control study included patients who presented with shoulder dislocation at a level 1 trauma center from 2011 to 2020. Patients with anterior shoulder dislocation, complete computed tomography imaging, visible bone loss, and those aged 18 years or more were included. Radiographic parameters were assessed using a certified picture achieving and communication system workstation. The groups were divided into on-track or off-track lesions and their glenoid version, glenoid concavity, and the morphometrical-based bony shoulder stability ratio (BSSR) were compared.</div></div><div><h3>Results</h3><div>Two hundred twelve patients (70% male and mean age of 50 years) were included and no significant difference was found between the on-track and off-track groups in terms of demographics or injury mechanism. Significant differences were noted in the glenoid defect (1.28 mm vs. 4.67 mm, <em>P</em> = .001), glenoid concavity/depth (1.7 mm vs. 1.3 mm, <em>P</em> = .001), the BSSR (40% vs. 33%, <em>P</em> = .001), and glenoid retroversion (4.4 vs. 2.9°, <em>P</em> = .009).</div></div><div><h3>Conclusion</h3><div>Glenoid morphology has become an increasing focus in the treatment of anterior shoulder dislocation. Patients with an off-track lesion appear to have not only greater glenoid loss and a larger Hill-Sachs but also a flatter glenoid with less retroversion. This also appears to lead to a lower BSSR.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 350-354"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593719","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":"Limited health literacy does not adversely affect compliance with postoperative restrictions, 90-day emergency department return, or opioid use following shoulder arthroscopy","authors":"Cameron Smith BA, MPH ,&nbsp;Savino Stallone BS ,&nbsp;Suhirad Khokhar MD ,&nbsp;Eloy Tabeayo MD ,&nbsp;Yungtai Lo PhD ,&nbsp;Konrad I. Gruson MD","doi":"10.1016/j.jseint.2024.08.197","DOIUrl":"10.1016/j.jseint.2024.08.197","url":null,"abstract":"<div><h3>Background</h3><div>Limited health literacy can negatively impact how patients process medical information, make medical decisions, and navigate the healthcare system. The literature with regards to health literacy and its impact on both postoperative compliance and healthcare utilization remains scant.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the records for patients who underwent elective shoulder arthroscopy with a minimum 90-day follow-up at a single academic institution. Demographic data including age, gender, prior ipsilateral shoulder arthroscopy, body mass index and age-adjusted Charlson Comorbidity Index were collected. A validated 9-item literacy in musculoskeletal problems questionnaire to assess musculoskeletal health literacy was administered preoperatively. Postoperative compliance with therapy and surgeon-directed immobilization restrictions, 90-day return to emergency department (ED), and the number of opioid prescriptions filled within 3 months postoperatively was recorded.</div></div><div><h3>Results</h3><div>There were 252 cases included in this study. Seventy-seven (31%) patients demonstrated adequate musculoskeletal health literacy (MHL). On multivariable analysis, limited MHL (LMHL) was not significantly associated with 90-day postoperative ED return, compliance with postoperative surgeon instructions regarding shoulder motion or therapy restrictions, or obtaining ≥2 postoperative opioid prescriptions.</div></div><div><h3>Conclusions</h3><div>LMHL is highly prevalent among patients undergoing elective shoulder arthroscopy. The lack of association between LMHL and postoperative compliance, 90-day ED return, or filling ≥2 postoperative opioid prescriptions suggests that further research is needed to identify more relevant modifiable risk factors that could reduce these negative clinical outcomes and healthcare utilization patterns.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 511-516"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593902","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":"United States opioid prescribing trends after shoulder surgery and their correlation with opioid misuse","authors":"Michael W. Fort MD, MPH ,&nbsp;Kathleen A. Leinweber MD ,&nbsp;Paul M. Werth PhD ,&nbsp;Timothy J. Lin MD, MS ,&nbsp;John-Erik Bell MD ,&nbsp;Daniel C. Austin MD, MS","doi":"10.1016/j.jseint.2024.08.200","DOIUrl":"10.1016/j.jseint.2024.08.200","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Orthopedic surgery has been highlighted as a contributor to the opioid epidemic. There is a paucity of literature focused specifically on opioid prescribing trends following shoulder surgery. Our aims were to describe national and regional trends in opioid prescribing following total shoulder arthroplasty, proximal humerus fracture fixation, and rotator cuff repair (RCR), and to correlate opioid prescribing trends after shoulder surgery with regional heroin use and new opioid misuse diagnoses.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This is a retrospective study of 218,577 patients from a commercial insurance dataset who had undergone orthopedic shoulder procedures from 2014 to 2020. Opioid prescription data within 90-day postoperative were converted to morphine milligram equivalents (MMEs). Multivariate modelling was used to evaluate independent associations between MME’s prescribed and subsequent new postoperative diagnosis of opioid dependence. Additionally, longitudinal mixed effects modeling was employed to understand aggregated prescriber habits by state over time and the subsequent effects on estimates of state heroin use and drug overdose deaths.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;From 2014 to 2020, the mean number of MMEs prescribed nationally decreased by over 50% for total shoulder arthroplasty, proximal humerus fracture fixation, and RCR. Over the study period, most states demonstrated an overall downtrend of 90-day opioid prescribing for these procedures. Individuals with a new opioid misuse diagnosis following shoulder surgery were found to be younger (standardized mean difference [SMD] = 0.27, &lt;em&gt;P&lt;/em&gt; &lt; .001), have increased comorbidities (SMD = 0.38, &lt;em&gt;P&lt;/em&gt; &lt; .001), and increased MME’s prescribed (SMD = 0.94, &lt;em&gt;P&lt;/em&gt; &lt; .001). Increased comorbidity score (odds ratio [OR] = 3.28, &lt;em&gt;P&lt;/em&gt; &lt; .001) and increased 90-day MME’s prescribed (OR = 1.05, &lt;em&gt;P&lt;/em&gt; &lt; .001) were all found to increase the OR of a postoperative opioid misuse diagnosis in patient’s undergoing shoulder surgery, while increased age (OR = 0.97, &lt;em&gt;P&lt;/em&gt; &lt; .001) and patient’s undergoing RCR (OR = 0.79, &lt;em&gt;P&lt;/em&gt; = .001) were found to have a decreased OR of developing a new opioid misuse diagnosis. The predictors of regional heroin use included the within-state 90-day MMEs prescribed (&lt;em&gt;P&lt;/em&gt; = .002). The predictors of drug overdose death included year (&lt;em&gt;P&lt;/em&gt; &lt; .001), but did not include type of surgery or 90-day MMEs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Orthopedic surgeons successfully reduced the number of opioids prescribed nationally after shoulder surgeries by over 50% during our study period with similar trends seen at the state level. Our data indicate a relationship between increased opioid prescribing after shoulder surgery and heroin use. This study highlights that while progress has been made, there is evidence that opioid prescribing following shoulder surgery is associated with t","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 517-523"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593903","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":"Difference in daily tasks execution and elbow joint load: a comparison between patients after total elbow arthroplasty and healthy controls","authors":"Roos G.A. Duijn Msc ,&nbsp;Daniëlle Meijering MD ,&nbsp;Riemer J.K. Vegter PhD ,&nbsp;Alexander L. Boerboom MD ,&nbsp;Denise Eygendaal MD, PhD ,&nbsp;Martin Stevens PhD ,&nbsp;Claudine J.C. Lamoth PhD ,&nbsp;Alessio Murgia PhD","doi":"10.1016/j.jseint.2024.10.017","DOIUrl":"10.1016/j.jseint.2024.10.017","url":null,"abstract":"<div><h3>Background</h3><div>Overloading of the elbow joint is one of the mechanisms responsible for failure of total elbow arthroplasty (TEA). Different activities of daily living (ADL) affect joint loading. However, the alteration in task execution and its impact on joint loads after TEA are not well understood. This study investigates differences between TEA patients and healthy controls in task execution and associated joint loads during simulated ADL.</div></div><div><h3>Methods</h3><div>TEA patients (n = 7) and healthy controls (n = 18) performed 8 simulated ADL tasks. Using musculoskeletal modeling software (OpenSim), joint angles and moments were calculated and joint power was assessed. A mixed model statistical design was performed to determine group and tasks differences.</div></div><div><h3>Results</h3><div>TEA patients showed reduced flexion–extension (FE) range of motion (60.6° ± 25.6 vs. 44.9° ± 19.9, <em>P</em> = .003). Interaction effects between groups and tasks for joint load and peak power were observed. Particularly during rising from a chair, patients showed reduced FE moment (5.7 Nm vs. 14.5 Nm, <em>P</em> = .026), varus-valgus moment (6.0 Nm vs. 14.3 Nm, <em>P</em> = .036), and peak power (3.6 Watt vs. 20.1 Watt, <em>P</em> = .036) compared to healthy controls.</div></div><div><h3>Conclusion</h3><div>TEA patients differ from healthy controls in task execution of ADL tasks regarding the functional elbow FE angle over all 8 ADL tasks and in joint load and peak power for the more straining tasks. The power plots visualizes differences in movement strategy that are of interest for future research on possible training of TEA patients, or prosthesis design, aimed to improve ADL function and enhance prosthesis survival rates.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 2","pages":"Pages 580-589"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593909","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}