JSES International最新文献

{"title":"Influence of preoperative diagnosis on outcomes after reverse total shoulder arthroplasty: a systematic review","authors":"Molly M. Piper BS,&nbsp;Anthony Imbrogno DO,&nbsp;John T. Strony MD,&nbsp;Bhargavi Maheshwer MD,&nbsp;Robert J. Gillespie MD,&nbsp;Raymond E. Chen MD,&nbsp;Michael R. Karns MD","doi":"10.1016/j.jseint.2025.06.002","DOIUrl":"10.1016/j.jseint.2025.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Reverse total shoulder arthroplasty (rTSA) is currently used to treat a variety of preoperative diagnoses. Patient outcomes after rTSA may be affected by the indication in which it is used to treat.</div></div><div><h3>Methods</h3><div>A literature search of the PubMed and MEDLINE databases was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Studies were included if they reported patient-reported outcome measures (PROMs) following rTSA for the following preoperative indications: glenohumeral osteoarthritis, acute proximal humerus fracture (PHF), chronic PHF sequelae, inflammatory arthritis, revision arthroplasty, humeral head avascular necrosis, massive rotator cuff tear without arthritis, and rotator cuff tear arthropathy. The most used PROMs among the studies were the American Shoulder and Elbow Surgeons shoulder score and the Single Assessment Numeric Evaluation or the Subjective Shoulder Value. Forward elevation and external rotation were also evaluated.</div></div><div><h3>Results</h3><div>There were 30 studies from the literature review that met inclusion criteria with a total of 3,463 patients. The average age of included patients ranged from 60 to 84 years. All studies reported improved American Shoulder and Elbow Surgeons and Single Assessment Numeric Evaluation or Subjective Shoulder Value scores as well as improved range of motion following rTSA. Patients who underwent rTSA for acute or chronic PHF or failed primary arthroplasty reported lower PROMs when compared to patients undergoing rTSA for other conditions of the glenohumeral joint.</div></div><div><h3>Conclusion</h3><div>Understanding the influence of preoperative diagnosis on rTSA outcomes can assist clinicians with preoperative risk stratification as well as managing patient expectations.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1893-1899"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty and comorbidity burden independently predict higher healthcare costs and nonhome discharges after total shoulder arthroplasty","authors":"Cory K. Mayfield MD ,&nbsp;Julian Wier MD ,&nbsp;Kevin C. Liu MD ,&nbsp;Eric H. Lin BA ,&nbsp;Cailan L. Feingold BS ,&nbsp;Alexander E. Weber MD ,&nbsp;Seth C. Gamradt MD ,&nbsp;Joseph N. Liu MD ,&nbsp;Frank A. Petrigliano MD","doi":"10.1016/j.jseint.2025.05.024","DOIUrl":"10.1016/j.jseint.2025.05.024","url":null,"abstract":"<div><h3>Background</h3><div>With an aging population, total shoulder arthroplasty (TSA) will more frequently be performed in older adults. Comorbidity burden and frailty are two distinct risk factors for adverse outcomes; however, their independent effect on outcomes after TSA is unknown. The aim of this study was to determine the effect of frailty and comorbidities on postoperative healthcare utilization after TSA.</div></div><div><h3>Methods</h3><div>Patients who underwent primary, elective anatomic or reverse TSA between January 1, 2016, and December 31, 2020, were identified using the Premier Healthcare Database. Frailty was defined using the Johns Hopkins Adjusted Clinical Groups Frailty Index. Comorbidity burden was defined via the Elixhauser Comorbidity Index (unhealthy &gt;2 comorbidities). These were then used to define healthy, frail, unhealthy, and frail/unhealthy patients. Rates of protracted (&gt;2 days) length of stay (LOS), skilled nursing facility (SNF) discharges, and readmission were then compared between groups. Multivariable models were conducted to evaluate the adjusted effect of frailty and comorbidity burden.</div></div><div><h3>Results</h3><div>86,356 patients who underwent TSA were identified. 53,913 were categorized as healthy, 29,461 as unhealthy, 1,640 as frail, and 1,342 as frail/unhealthy. The frail/unhealthy cohort had the highest rates of protracted LOS (65.06%), SNF discharges (29.90%), and readmissions (5.00%). The frail cohort had higher rates of protracted LOS (48.96% vs. 39.78%) and SNF discharges (16.77% vs. 9.94%), with similar readmission rates (3.35% vs. 3.18%) when compared to the unhealthy group. These overall trends persisted after accounting for potential confounding factors.</div></div><div><h3>Conclusion</h3><div>When both present, frailty and comorbidity appear to be a major driver of increased healthcare utilization after TSA. These data can be used to guide patient expectations and illustrate the need for postoperative pathways for these patients.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1698-1704"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stemless total shoulder arthroplasty with nonspherical polyethylene humeral head","authors":"Hans R. Bloch MD ,&nbsp;Jens Agneskirchner MD, PhD ,&nbsp;Philipp Meyer MD ,&nbsp;Stefano Di Fabio MD ,&nbsp;Lorenzo Banci MSc ,&nbsp;Andreas Niemeier MD","doi":"10.1016/j.jseint.2025.05.010","DOIUrl":"10.1016/j.jseint.2025.05.010","url":null,"abstract":"<div><h3>Background</h3><div>The use of a nonspherical humeral head has been recently introduced in anatomic total shoulder arthroplasty (aTSA). This multicenter observational study investigated the early outcomes of a novel shoulder prosthesis with a nonspherical polyethylene humeral head in a consecutive series of patients with stemless aTSA.</div></div><div><h3>Methods</h3><div>From January 2022 to December 2022, 35 patients (35 shoulders) with primary glenohumeral osteoarthritis received a stemless implant with inverted bearing materials: a nonspherical polyethylene humeral head articulating with a metal glenoid. Axial plane glenoid morphology was Walch A2 in 26 patients, B2 in 7, and C in 2. At 2-year follow-up, patients were assessed through subjective satisfaction; implant awareness; active range of motion; Constant-Murley Score; American Shoulder and Elbow Surgeons; and Disabilities of the Arm, Shoulder, and Hand scores. Postoperative radiographs were assessed for radiolucent lines, component loosening, and migration. Any complications and revisions were recorded.</div></div><div><h3>Results</h3><div>At 2-year follow-up, mean forward elevation increased from 91.0° (standard deviation [SD], 27.7°) to 146.0° (SD, 19.1°) (<em>P</em> &lt; .001) and mean external rotation from 16.6° (SD, 11.6°) to 48.8° (SD, 18.4°) (<em>P</em> &lt; .001). Disabilities of the Arm, Shoulder, and Hand, American Shoulder and Elbow Surgeons, and Constant-Murley Scores improved from 60.4, 35.7, and 37.5 to 18.9, 82.0, and 75.0, respectively (<em>P</em> &lt; .001). All patients were satisfied and reported no awareness of their artificial shoulder. Radiographically, all implants appeared stable and osseointegrated. There was no implant-related revision, reoperation, or complication.</div></div><div><h3>Conclusion</h3><div>The early clinical and radiographic results of this novel implant are promising and support the concept of inverted bearing materials in stemless aTSA, demonstrating improvements that outreach the relative substantial clinical benefit for the patients.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1668-1677"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strength testing, especially of the abducted shoulder, aids in diagnosis of rotator cuff tears: a study of senior athletes participating in upper extremity dominant sports","authors":"Jason D. Woollard PT, PhD ,&nbsp;Patrick J. McMahon MD","doi":"10.1016/j.jseint.2025.05.029","DOIUrl":"10.1016/j.jseint.2025.05.029","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Small supraspinatus tears can be difficult to diagnose on history and physical examination alone. Normalized strength assessment may aid in diagnosis. We examined shoulder strength normalized to body weight and the nondominant shoulder as well as abduction (AB)/external rotation (ER) and ER/internal rotation strength ratios in senior athletes to determine if they aid in the diagnosis of supraspinatus tears.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Ultrasound imaging of the dominant shoulder's rotator cuff was performed in 79 athletes over the age of 60 who were participating in an upper extremity dominant sport. The supraspinatus tendon condition was categorized into 3 groups: 1) intact (normal/tendinosis), 2) partial-thickness tear, and 3) full-thickness tear. Shoulder strength was assessed with a handheld dynamometer and normalized to body weight, the nondominant shoulder or as AB/ER and ER/internal rotation strength ratios. Receiver-operating characteristic (ROC) curves assessed the accuracy of cut points in the strength data for discriminating full tears from partial or no tears. We hypothesized there would be diminished shoulder strength for glenohumeral AB and ER, when normalized to body weight, in athletes with full-thickness supraspinatus tendon tears compared to those with partial-thickness supraspinatus tears or an intact tendon.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;No differences among the 3 supraspinatus classifications were found for shoulder strength normalized to the nondominant shoulder or for shoulder strength ratios. However, senior athletes with full-thickness supraspinatus tendon tears had significantly less strength as a percentage of body weight for shoulder AB at 90° and shoulder ER at 90° of AB compared to athletes with intact tendons. ROC curve analysis revealed the best strength test for discriminating a full-thickness supraspinatus tendon tear from an intact tendon was strength of ER at 90° of AB. The ROC curve analyses found a full-thickness supraspinatus tear could be correctly detected 76% of the time when a strength cut point of 12% of bodyweight for ER strength at 90° of AB was used to categorize subjects as having an intact or torn tendon.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;No differences among the 3 supraspinatus classifications were found for shoulder strength normalized to the nondominant shoulder or for shoulder strength ratios. However, senior athletes with full-thickness supraspinatus tendon tears had significantly less strength as a percentage of body weight for shoulder AB at 90° and shoulder ER at 90° of AB compared to athletes with intact tendons. ROC curve analysis revealed the best strength test for discriminating a full-thickness supraspinatus tendon tear from an intact tendon was strength of ER at 90° of AB. The ROC curve analyses found a full-thickness supraspinatus tear could be correctly detected 76% of the time when a strength cut point of 12% of bodyweight for ER st","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1570-1578"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Restoration of rotator cuff muscle forces in lower trapezius transfer and superior capsular reconstruction in massive rotator cuff tear","authors":"Farid Amirouche PhD ,&nbsp;Nirav Mungalpara MD ,&nbsp;Sunjung Kim PhD ,&nbsp;Cody Lee MD ,&nbsp;Kevin Chen BA ,&nbsp;Hayden Baker MD ,&nbsp;Aravind Athiviraham MD ,&nbsp;Elhassan Bassem MD ,&nbsp;Nicholas Maassen MD ,&nbsp;Jason Koh MD","doi":"10.1016/j.jseint.2025.05.011","DOIUrl":"10.1016/j.jseint.2025.05.011","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the biomechanical effects of lower trapezius tendon transfer (LTT), superior capsular reconstruction (SCR), and their combination on rotator cuff muscle force restoration in irreparable massive rotator cuff tears (MRCTs). We hypothesized that combining LTT with SCR would yield superior biomechanical restoration compared to either technique alone.</div></div><div><h3>Methods</h3><div>Eight fresh-frozen cadaveric shoulders were tested under the following 6 sequential conditions: (1) intact control, (2) supraspinatus tear, (3) MRCT (supraspinatus and infraspinatus tear), (4) LTT using an Achilles allograft, (5) LTT combined with SCR, and (6) SCR alone. Muscle forces in the teres minor (TM) and subscapularis (SubS) were measured during humeral abduction using a dynamic shoulder testing system.</div></div><div><h3>Results</h3><div>TM force decreased by 21.6% after a supraspinatus tear and by 49.7% after MRCTs. LTT alone restored 84.5% of intact TM force, LTT with SCR restored 89.8%, and SCR alone restored 65%. SubS force increased by 115% following a supraspinatus tear and by 194% after MRCTs. LTT restored 71% of SubS force, LTT with SCR restored 90%, and SCR alone restored 46%. These differences were statistically significant across conditions (<em>P</em> &lt; .05), particularly between the massive tear and reconstructive states.</div></div><div><h3>Conclusions</h3><div>Combining LTT and SCR demonstrated the most effective restoration of rotator cuff biomechanics, surpassing the results of individual techniques. Statistical analysis confirmed significant improvements in TM and SubS force restoration when using LTT with SCR compared to isolated reconstructions.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1532-1540"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of aging and estrogen deficiency on extracellular matrix-related gene expression in rotator cuff tendons: in vitro and in vivo rat model","authors":"Mitsuyoshi Matsumoto MD ,&nbsp;Kentaro Uchida PhD ,&nbsp;Ryo Tazawa MD, PhD ,&nbsp;Tomonori Kenmoku MD, PhD ,&nbsp;Kosuke Inoue MD ,&nbsp;Gen Inoue MD, PhD ,&nbsp;Masashi Takaso MD, PhD","doi":"10.1016/j.jseint.2025.05.021","DOIUrl":"10.1016/j.jseint.2025.05.021","url":null,"abstract":"<div><h3>Background</h3><div>Injuries to the rotator cuff, including the supraspinatus, infraspinatus, subscapularis, and teres minor tendons, can cause significant pain and loss of function. Aging and postmenopause detrimentally affect the extracellular matrix (ECM) of these tendons, accelerating their degeneration. This study aimed to investigate the effects of aging and estrogen deficiency on the ECM-related gene expression of rotator cuff tendons.</div></div><div><h3>Methods</h3><div>Female Wistar rats aged 12, 24, and 48 weeks were used to assess ECM-related gene expression in tendon insertions from the supraspinatus and infraspinatus tendons. Estrogen deficiency was modeled in female Wistar rats by performing bilateral ovariectomy (OVX), and a sham-operated group was used as the control group. Quantitative reverse-transcription polymerase chain reaction (qPCR) and RNA-sequencing (RNA-Seq) analyses were performed on harvested rotator cuff tissues 8 weeks postoperatively. Primary cells derived from these tissues were cultured and exposed to 17β-estradiol at various concentrations (0, 1, and 10 nM) for different durations (3, 6, and 24 hours), and their responses were analyzed using qPCR.</div></div><div><h3>Results</h3><div><em>Col1a1</em>, <em>Col3a1</em>, and <em>Eln</em> mRNA levels were significantly decreased with age. RNA-Seq analysis comparing OVX rats to sham-operated controls revealed 41 downregulated and 36 upregulated genes; <em>Eln</em> expression was significantly reduced, while <em>Col1a1</em> and <em>Col3a1</em> were unchanged; <em>Eln</em> expression was significantly reduced, while <em>Col1a1</em> and <em>Col3a1</em> were unchanged. Pathway analysis revealed enrichment in the JAK-STAT and AMPK pathways among the downregulated genes in OVX groups compared to sham-operated controls. These findings were validated by qPCR, which confirmed the RNA-Seq results and showed a significant reduction in <em>Eln</em> expression in the OVX group. In vitro experiments with rotator cuff–derived cells derived from 8-week-old rats exposed to 17β-estradiol showed no significant changes in <em>Col1a1</em> and <em>Col3a1</em> expression. However, <em>Eln</em> mRNA expression was significantly upregulated after 24 hours of exposure to 10 ng/mL 17β-estradiol.</div></div><div><h3>Conclusion</h3><div>Aging was associated with reduced expression of <em>Col1a1</em>, <em>Col3a1</em>, and <em>Eln</em> in rotator cuff tendons, while estrogen deficiency selectively decreased <em>Eln</em> expression without affecting collagen genes. In vitro, 17β-estradiol stimulation increased <em>Eln</em> expression in tendon-derived cells. These results suggest that aging and estrogen deficiency affect ECM gene expression through distinct mechanisms, and may contribute differently to the pathophysiology of rotator cuff degeneration associated with aging and menopause.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1555-1561"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged early postoperative adduction restriction is significantly associated with shoulder stiffness 1 year after arthroscopic rotator cuff repair","authors":"Yuki Miyasaka RPT, Med ,&nbsp;Takahiro Sekiguchi RPT ,&nbsp;Norimasa Takahashi MD, PhD ,&nbsp;Toshiki Nagaoka RPT ,&nbsp;Keisuke Kimura RPT ,&nbsp;Kohei Matsuda RPT ,&nbsp;Keisuke Matsuki MD, PhD ,&nbsp;Shota Hoshika MD, PhD ,&nbsp;Hiroyuki Sugaya MD, PhD ,&nbsp;Itaru Kawashima MD, PhD","doi":"10.1016/j.jseint.2025.05.006","DOIUrl":"10.1016/j.jseint.2025.05.006","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative shoulder stiffness (POSS) is one of the most common complications of arthroscopic rotator cuff repair (ARCR). Although adduction restriction is commonly observed in the early postoperative period, it remains unclear whether a prolonged duration of this restriction impacts the development of POSS. The aim of this study was to investigate whether early postoperative adduction restriction is associated with the occurrence of POSS 1 year after ARCR.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included patients who underwent ARCR at a single institution between April 2017 and June 2018. A total of 96 shoulders were analyzed. Active and passive range of motion were assessed preoperatively and at 12 months postoperatively. Adduction restriction was evaluated in two positions: the droop position and the intermediate position. Adduction restriction was defined as resolved when the medial side of the arm made contact with the side of the body. Based on these evaluations, the duration of persistent postoperative adduction restriction was evaluated. POSS was defined as passive external rotation at the side of less than 30° at 12 months after surgery according to the previous studies. Patients were assigned to one of two groups: Group N, without POSS group, or Group S, with POSS group. Propensity score matching was used to ensure comparability between groups. The duration of persistent postoperative adduction restriction was compared between the groups.</div></div><div><h3>Results</h3><div>After propensity score matching, 38 shoulders were analyzed (19 in Group N and 19 in Group S). While no significant difference in the duration of persistent postoperative adduction restriction in the droop position between the groups was observed, the duration in the intermediate position was significantly shorter in Group N compared to Group S (7 ± 3 weeks vs. 10 ± 4 weeks, <em>P</em> = .007).</div></div><div><h3>Conclusion</h3><div>The duration of persistent adduction restriction in the intermediate position was significantly longer in shoulders with POSS at 12 months after ARCR compared to those without POSS. Prolonged early postoperative adduction restriction may associate with the occurrence of POSS 12 months after ARCR.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1511-1516"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor regarding “Can popular artificial intelligence large language models provide reliable answers to frequently asked questions about rotator cuff tears?”","authors":"Hinpetch Daungsupawong PhD,&nbsp;Viroj Wiwanitkit MD","doi":"10.1016/j.jseint.2025.04.039","DOIUrl":"10.1016/j.jseint.2025.04.039","url":null,"abstract":"","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Page 1780"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the impact of large language learning models on publications in the Journal of Shoulder and Elbow Surgery","authors":"Andrew S. Miller MD ,&nbsp;Anisha Tyagi BS ,&nbsp;Suleiman Y. Sudah MD ,&nbsp;Alexander Rompala MD ,&nbsp;Allen D. Nicholson MD ,&nbsp;Uma Srikumaran MD, MBA, MPH ,&nbsp;Mariano E. Menendez MD","doi":"10.1016/j.jseint.2025.05.027","DOIUrl":"10.1016/j.jseint.2025.05.027","url":null,"abstract":"<div><h3>Background</h3><div>There has been growing interest in the application of artificial intelligence (AI) within academic research to enhance writing, data interpretation, and other tasks. However, it also raises concerns about plagiarism and fraudulent content. While AI-detection tools are available, no systematic review has examined AI use in shoulder and elbow surgery. This study evaluates AI utilization in <em>Journal of Shoulder and Elbow Surgery</em> (JSES) articles before and after the release of ChatGPT (Generative Pre-trained Transformer)-3.5 and explores its correlation with the country of publication.</div></div><div><h3>Methods</h3><div>We analyzed 232 publications in JSES, from January to April in both 2022 and 2024. Abstracts and full-length texts were manually entered and analyzed using ZeroGPT, an AI-content detector, and ChatGPT detector. A secondary analysis was performed on publications with suspected AI use of greater than 10%, 20%, 30%, 40%, and 50%. Variables analyzed were year of publication, country of origin, and probability of AI use. Univariate analyses according to geographic region were conducted on publications with a suspected AI percentage &gt; 10% and &gt; 20%.</div></div><div><h3>Results</h3><div>A total of 232 publications were identified, 114 from January to April 2022 (pre-ChatGPT) and 118 from January to April 2024 (post-ChatGPT). The average percentage AI generation was 26% ± 18% within the abstracts and 5% ± 3% within the full-body text of included publications. While there was no significant difference in the suspected use of AI within the full texts before and after the launch of ChatGPT (4.7% ± 3.3% in 2022 vs. 5.3% ± 3.6% in 2024; <em>P</em> = .19), there was a significant increase in the suspected use of AI within the abstracts of articles published after the launch of ChatGPT(21.1% ± 12.8% vs. 30.1% ± 21.6%; <em>P</em> = .0002. Abstracts with a suspected AI percentage &gt; 10% constituted 74.6% of the publications in 2022 and 86.4% in 2024; <em>P</em> = .003. Similarly, abstracts with suspected AI percentage exceeding 20%, 30%, 40%, and 50% also demonstrated statistically significant increases between the 2 periods (<em>P</em> &lt; .05 for all). Univariate analysis revealed that European publications had significantly lower AI content above &gt; 10% (<em>P</em> = .04; odds ratio 0.53, 95% confidence interval: 0.26-0.81).</div></div><div><h3>Conclusion</h3><div>This study highlights increased use of AI within the writing of JSES publications since the launch of ChatGPT-3.5. While the integration of AI introduces new opportunities in scientific research, there are ethical and methodological challenges that must be carefully considered.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1803-1808"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher postoperative gabapentin doses are associated with pulmonary complications after total shoulder arthroplasty","authors":"Julian Wier MD ,&nbsp;Cory K. Mayfield MD ,&nbsp;Kevin C. Liu MD ,&nbsp;Eric H. Lin BA ,&nbsp;Cailan L. Feingold BS ,&nbsp;Alexander E. Weber MD ,&nbsp;Seth C. Gamradt MD ,&nbsp;Joseph N. Liu MD ,&nbsp;Frank A. Petrigliano MD","doi":"10.1016/j.jseint.2025.04.035","DOIUrl":"10.1016/j.jseint.2025.04.035","url":null,"abstract":"<div><h3>Background</h3><div>Gabapentinoids are increasingly being used as adjunctive analgesic medications after total shoulder arthroplasty (TSA). However, data suggest that when used in conjunction with opioids, gabapentinoids may induce sedation and possibly potentiate respiratory depression. The aim of this study was to evaluate the impact of gabapentin postoperative pulmonary complications and total opioid utilization after primary TSA.</div></div><div><h3>Methods</h3><div>Patients who underwent primary, elective anatomic and reverse TSA from January 1, 2016, to December 31, 2020, were identified using the Premier Healthcare Database. The cumulative postoperative day 1 gabapentin exposure was calculated and divided into four groups: (“Control Dose”: 0 mg, “Low Dose”: 1-300 mg, “Moderate Dose”: 301-900 mg, and “High Dose” &gt;900 mg) based on distribution and commonly used inpatient dosing regimens. Multivariable models were conducted to evaluate the effect of gabapentin doses compared to none using the adjusted odds ratio (aOR) of pulmonary complications. Average daily morphine milligram equivalents (MMEs) were evaluated between groups.</div></div><div><h3>Results</h3><div>A total of 86,137 patients who underwent TSA were identified; of these, 62,621 (72.70%) patients comprised the Control cohort, while 12,051 (13.99%) were categorized into the Low Dose; 9,465 (10.99%) into the Moderate Dose; and 2,000 (2.32%) into the High Dose cohort. Compared to the patients in the Control cohort, those in the Low (aOR: 1.15, 95% confidence interval [CI]: 1.02-1.30), Moderate (aOR: 1.17, 95% CI: 1.02-1.33), and High Dose (aOR: 1.45, 95% CI: 1.15-1.82) had increased odds of pulmonary complications. Average daily MME was 46.21 ± 100.98; 40.35 ± 63.57; 42.70 ± 54.10; and 49.15 ± 68.72 milligrams in the Control, Low, Moderate, and High Dose cohorts, respectively.</div></div><div><h3>Conclusion</h3><div>Exposure to gabapentin during the perioperative period after TSA is independently associated with an increased risk of postoperative pulmonary complications. We observed no clinically significant differences in overall MME intake.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1630-1635"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}