JSES International最新文献

{"title":"Variability in preoperative planning software for shoulder arthroplasty","authors":"Ana R. Senra MD ,&nbsp;Diogo Tomaz MD ,&nbsp;Diogo S. Gomes MD ,&nbsp;Nuno S. Gomes MD ,&nbsp;Nuno Sevivas PhD ,&nbsp;Francisco Serdoura MD ,&nbsp;André Pinho PhD ,&nbsp;Alberto Vieira MD ,&nbsp;Nuno Neves PhD ,&nbsp;Carlos M. Dias PhD ,&nbsp;Daniela Linhares PhD ,&nbsp;Maria J. Leite PhD ,&nbsp;Manuel R. Silva PhD","doi":"10.1016/j.jseint.2026.101698","DOIUrl":"10.1016/j.jseint.2026.101698","url":null,"abstract":"<div><h3>Background</h3><div>Three-dimensional preoperative planning is increasingly used in shoulder arthroplasty to optimize implant selection and component positioning. Planning platforms rely on either automated best-fit sphere algorithms or manual landmark-based methods to characterize glenoid morphology, potentially introducing variability. This study aimed to compare 5 commercially available planning platforms and to determine whether differences in analytical algorithms explain intersoftware variability.</div></div><div><h3>Methods</h3><div>Thirty-three patients were included. Preoperative computed tomography scans were analyzed using Blueprint system (Stryker, Kalamazoo, MI, USA), Equinoxe Planning App (Exactech, Gainesville, FL, USA), Signature ONE Surgical Planning System (Zimmer Biomet, Warsaw, IN, USA), MyShoulder system (Medacta, Castel San Pietro, Switzerland), and LimaCorporate Pre-Op Planning Software (LimaCorporate/Enovis, San Daniele del Friuli, Udine, Italy). Glenoid version, inclination, and humeral head subluxation were assessed. Data analysis included a group evaluation for each variable and pairwise comparisons between software. A comparative analysis between automated and manual assessment methods was performed.</div></div><div><h3>Results</h3><div>Significant differences were found between platforms for version (<em>P</em> &lt; .001), inclination (<em>P</em> = .015), and subluxation (<em>P</em> = .032). Agreement was high for subluxation (intraclass correlation coefficient [ICC] = 0.826), moderate to high for version (ICC = 0.749), and low for inclination (ICC = 0.267). Pairwise agreement ranged from 45.5 to 97% for version (highest between Blueprint and LimaCorporate), 30.3–90.9% for inclination, and 60.6–75.8% for subluxation (lowest between Blueprint and LimaCorporate).</div></div><div><h3>Conclusion</h3><div>Significant variability exists between preoperative planning software, particularly for inclination. Automated software demonstrated the highest concordance for version but the lowest concordance for subluxation. These results suggest that, even with similar analytical algorithms, uniformity between software is lacking, potentially impacting surgical planning. Methodological standardization is essential to improve reliability and reproducibility of shoulder arthroplasty planning. Surgeons should consider this variability when planning shoulder arthroplasty and interpreting studies with different planning platforms.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 3","pages":"Article 101698"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802209","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":"Long-term results of surgical management of high-energy scapula fractures at a major trauma center","authors":"Shoib Mahmood MBBS, FRCS (Tr& Orth),&nbsp;Georgios Mamarelis MD, FRCSEd(Tr & Orth), PGCert, Med Ed, MSc,&nbsp;Mochamed Hachem MD, MRCS, FEBOT,&nbsp;Adel Tavakkolizadeh MB, BS, MSC, FRCS (Orth),&nbsp;Karthik Karuppaiah FRCS (T&O),&nbsp;Toby Colegate-Stone MA (Oxon), MBBS, MRCS, MSc (Orth), FRCS (Tr & Orth)","doi":"10.1016/j.jseint.2026.101682","DOIUrl":"10.1016/j.jseint.2026.101682","url":null,"abstract":"<div><h3>Background</h3><div>Scapular fractures are rare injuries typically resulting from high-energy trauma and often occur in polytrauma patients. Historically managed nonoperatively, recent trends in surgical intervention have evolved, particularly in major trauma centers (MTCs) where expertise and case volume have increased. However, there remains limited literature on the surgical management and long-term outcomes of these injuries.</div></div><div><h3>Methods</h3><div>This retrospective cohort study reviewed all patients who underwent surgical fixation for scapular fractures over a 10-year period at a single UK MTC. Patient demographics, injury mechanism, fracture classification (using the Swedish Fracture Registry topographical system), surgical approach, and outcomes were analyzed. Outcomes included objective measures (union, complications, return to work/sport) and patient-reported outcome measures (Oxford Shoulder Score, disability of the arm, shoulder, and hand, American Shoulder and Elbow Surgeons score, EuroQol 5-Dimension questionnaire, and EuroQol Visual Analogue Scale). Statistical analysis included chi-squared and Mann-Whitney-Wilcoxon tests.</div></div><div><h3>Results</h3><div>Forty-five patients (36 males; mean age 46 years) were included. The majority (64%) sustained injuries from road traffic accidents, with 49% classified as having severe or profound injuries (injure severity score &gt;15). Displaced intra-articular fractures represented the most common fracture subtype (53%). At a mean follow-up of 78 months, 56% of patients completed patient-reported outcome measures. Mean scores were Oxford Shoulder Score: 40.1, disability of the arm, shoulder, and hand: 15.3, American Shoulder and Elbow Surgeons score: 82.7, EuroQol 5-Dimension questionnaire: 0.54, and EuroQol Visual Analogue Scale: 82.1. Intra-articular fractures were associated with the highest complication and reoperation rates, primarily due to post-traumatic glenohumeral capsulitis and early arthrosis. The overall complication rate was 35.7%, reducing to 15.6% when excluding capsulitis. No 30-day mortality was observed. Return to work and sport occurred at a mean of 147 and 185 days, respectively.</div></div><div><h3>Conclusion</h3><div>Surgical management of high-energy scapular fractures in a high-volume MTC setting can achieve good long-term clinical outcomes. Intra-articular fracture patterns carry a higher risk of complications and may require further intervention. This study provides the longest reported follow-up of scapula fracture surgery to date and highlights the importance of specialist surgical experience, structured classification, and long-term patient support.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 3","pages":"Article 101682"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147802829","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 regarding \"Grit is not associated with opioid consumption patterns in patients that undergo arthroscopic rotator cuff repair\".","authors":"Tirayut Veerasatian, Schawanya K Rattanapitoon, Nav La, Nathkapach K Rattanapitoon","doi":"10.1016/j.jseint.2026.101619","DOIUrl":"10.1016/j.jseint.2026.101619","url":null,"abstract":"","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"101619"},"PeriodicalIF":2.0,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783187","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":"Do patients trust the tech? Exploring perception, confidence, and knowledge of innovations in shoulder arthroplasty","authors":"Aghdas Movassaghi BS ,&nbsp;Elizabeth W. Chan BS ,&nbsp;Justin T. Childers MS ,&nbsp;Benjamin T. Lack BS ,&nbsp;Garrett R. Jackson MD ,&nbsp;Clyde Fomunung MD ,&nbsp;Roya Osswald ,&nbsp;Vani J. Sabesan MD","doi":"10.1016/j.jseint.2025.101415","DOIUrl":"10.1016/j.jseint.2025.101415","url":null,"abstract":"<div><h3>Background</h3><div>As surgical technologies, such as three-dimensional preoperative planning, computer navigation, and augmented reality, become increasingly utilized in shoulder arthroplasty, questions remain about their value from the patient's perspective. While education and patient interest have driven demand and technology adoption in hip and knee arthroplasty, their role in shoulder procedures remains unclear. This study aimed to evaluate patient perceptions of innovative technologies in shoulder arthroplasty and assess whether preoperative education influences confidence, satisfaction, and expectations.</div></div><div><h3>Methods</h3><div>In this prospective observational study, 87 patients scheduled to undergo shoulder arthroplasty at a single institution completed a preoperative survey assessing demographics, baseline familiarity with surgical technologies, and perceptions of surgeon use of innovative tools prior to seeing their provider. Following this, patients then viewed a standardized educational video on the role of technology in shoulder arthroplasty. Postvideo responses measured changes in confidence, satisfaction, and outcome expectations. Statistical analysis included paired t-tests and analysis of variance to evaluate prepost changes and demographic associations.</div></div><div><h3>Results</h3><div>Over half of patients (56.3%) were unfamiliar with innovative technologies at baseline, yet 60.9% reported increased confidence in surgeons using it. Most patients (66.7%) preferred the use of advanced planning technologies, though only 41.5% would choose a low-volume surgeon using these tools over a high-volume surgeon using conventional techniques. Improvements in confidence were significantly correlated with higher education and income levels (r = 0.31, <em>P</em> = .003). After viewing an educational video, patient confidence in their surgeon increased (<em>P</em> = .03), and expectations for improved outcomes (<em>P</em> &lt; .001), fewer complications (<em>P</em> &lt; .001), less pain (<em>P</em> &lt; .001), and faster recovery (<em>P</em> &lt; .001) significantly rose. Despite favorable perceptions, 62.1% of patients were unwilling to pay more, travel further, or wait longer to receive care involving innovative technologies.</div></div><div><h3>Conclusion</h3><div>Targeted preoperative education on surgical technology may improve patient confidence, strengthen perceptions of surgeon competency, and elevate expectations of care. While enthusiasm for advanced tools was observed following education, broader adoption may still be influenced by cost and accessibility. These findings support the role of brief, technology-focused education in enhancing the overall patient experience in shoulder arthroplasty.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101415"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941283","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":"Bot vs. doc—who is better at reading proximal humerus fracture x-rays?","authors":"Kyle K. Obana MD,&nbsp;Mark Ren MD,&nbsp;Andrew J. Luzzi MD,&nbsp;Matthew R. LeVasseur MD,&nbsp;Hasani W. Swindell MD,&nbsp;William N. Levine MD","doi":"10.1016/j.jseint.2025.101426","DOIUrl":"10.1016/j.jseint.2025.101426","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence is becoming increasingly utilized as a source of convenient, efficient, and cost-effective information. Considering the potential utility of ChatGPT as an adjuvant in clinical decision making, the current study evaluates (1) the accuracy of ChatGPT-5 at evaluating shoulder x-rays containing either normal or proximal humerus fracture (PHFx) diagnoses and (2) interrater reliability between ChatGPT and orthopedic surgeons at different levels of training.</div></div><div><h3>Methods</h3><div>The Stanford University Musculoskeletal Radiographs publicly accessible dataset was utilized, and 70 x-rays (35 PHFx, 35 normal) were analyzed after inclusion and exclusion criteria were applied. X-rays were reviewed independently by an orthopedic surgery junior resident, senior resident, shoulder/elbow fellow, and shoulder/elbow fellowship-trained attending. X-rays for each patient were uploaded to ChatGPT-5 and questions were asked using a response-based algorithm.</div></div><div><h3>Results</h3><div>ChatGPT-5 demonstrated a sensitivity of 61.8%, specificity of 74.3%, and an overall accuracy of 67.1% for PHFx x-rays. ChatGPT incorrectly diagnosed 25.7% of normal x-rays with a fracture or dislocation. ChatGPT incorrectly diagnosed 23.5% of isolated PHFx x-rays as normal, 8.8% with an isolated glenohumeral dislocation without fracture, and 5.7% with a PHFx dislocation. Inter-rater reliability for ChatGPT was slight for displaced parts and poor for fractured part, Neer parts, and located glenohumeral joint. Junior and senior residents had moderate to substantial agreement with the attending reads (fractured part, displaced parts, Neer parts), while the fellow had substantial to almost perfect agreement.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that ChatGPT-5 is highly inaccurate at identifying PHFx on shoulder x-rays, characterizing the fracture patterns, and providing accurate interpretations of shoulder x-rays. Over-reliance on generative artificial intelligence to guide clinical decisions risks harm to the patients and should be approached with limited credence.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101426"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078875","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":"Clinical and structural outcomes of arthroscopic rotator cuff repair augmented with biceps-based partial superior capsular reconstruction and distal tenotomy at two-year follow-up","authors":"Chang Hee Baek MD ,&nbsp;Bo Taek Kim MD ,&nbsp;Gustavo A. Gil Noriega MD ,&nbsp;Jung Gon Kim MD ,&nbsp;Chaemoon Lim MD ,&nbsp;Paulo José Llinás Hernández MD","doi":"10.1016/j.jseint.2025.101433","DOIUrl":"10.1016/j.jseint.2025.101433","url":null,"abstract":"<div><h3>Background</h3><div>Repair of medium to large rotator cuff tears (RCTs) presents ongoing challenges, as the procedure may result in tendon retear and inadequate healing. Partial superior capsular reconstruction (pSCR) using the long head of the biceps tendon (LHBT) has emerged as a biomechanically robust and biologically advantageous technique for augmenting rotator cuff repairs. This study aims to evaluate the clinical and structural outcomes of arthroscopic rotator cuff repair augmented with pSCR using the LHBT combined with distal tenotomy in patients with medium to large reparable RCTs at two years postoperatively.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted on patients who underwent arthroscopic rotator cuff repair augmented with LHBT-based pSCR and distal tenotomy between January 2014 and June 2017. Surgical indications were reparable supraspinatus tears, with or without infraspinatus involvement, accompanied by tendon retraction, high-grade fatty infiltration, and an intact or less than 50% partial tear of the LHBT. Exclusion criteria included prior shoulder surgery, shoulder infection, irreparable subscapularis tear, or incomplete follow-up. Clinical outcomes were assessed using the visual analog scale (VAS) for pain, the American Shoulder and Elbow Surgeons (ASES) score, and range of motion, while structural integrity was evaluated via ultrasonography at the 2-year follow-up.</div></div><div><h3>Results</h3><div>After excluding 10 patients, 45 patients (mean age: 67.2 ± 6.3 years) were included in the analysis. The VAS score improved significantly from 6.1 ± 1.3 to 1.7 ± 1.1, and the ASES score increased from 31.0 ± 7.9 to 77.2 ± 7.7 (both <em>P</em> &lt; .001). Forward elevation improved from 95° to 156°, abduction from 78° to 142°, and external rotation from 33° to 50° (all <em>P</em> &lt; .001). All patients met the minimal clinically important difference for both VAS and ASES scores. Ultrasonography at the 2-year follow-up demonstrated complete healing of the repair with the pSCR construct in 86.7% of patients, partial healing in 6.6%, and complete retear in 6.6%. No patients reported postoperative anterior shoulder pain. Subgroup analysis showed comparable outcomes between single-row repair with pSCR for medium-sized RCTs and double-row repair with pSCR for large-sized RCTs.</div></div><div><h3>Conclusion</h3><div>Arthroscopic rotator cuff repair augmented with LHBT-based pSCR and distal tenotomy resulted in significant improvements in pain and range of motion at the 2-year follow-up in patients with medium to large reparable RCTs. A high healing rate was observed with the pSCR construct, and no significant complications were reported.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101433"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079045","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":"Superior glenoid inclination in shoulder arthroplasty: a comparison of standard to superiorly augmented glenoid implants","authors":"Natalie M. Loewen BESc ,&nbsp;James A. Johnson PhD ,&nbsp;George S. Athwal MD, FRCSC ,&nbsp;G. Daniel G. Langohr PhD","doi":"10.1016/j.jseint.2025.101606","DOIUrl":"10.1016/j.jseint.2025.101606","url":null,"abstract":"<div><h3>Background</h3><div>The success of anatomic total shoulder arthroplasty depends on glenoid component stability, with loosening responsible for nearly half of revision surgeries. Superior glenoid inclination exacerbates component loosening by promoting unbalanced loading by the humeral head. This study investigates a novel superiorly augmented glenoid component designed to correct excessive superior inclination. We hypothesized that increasing augmentation would limit superior humeral head migration and asymmetric loading, thereby increasing compressive rather than tensile stresses at the implant–bone interface.</div></div><div><h3>Methods</h3><div>Finite element models of 8 scapulae with glenohumeral osteoarthritis were fitted with a standard 4-peg component and 3 superiorly augmented components (5°, 10°, and 15° augment angles). Loads angled 25° inferiorly to 25° superiorly were applied. Outcomes included superior–inferior humeral head position and implant–bone interface stresses.</div></div><div><h3>Results</h3><div>For every 5° increase in augmentation, the humeral head translated inferiorly by 0.4 ± 0.1 mm for the 15° native inclination group, 0.3 ± 0.1 mm for 10°, and 0.2 ± 0.1 mm for 5°. Translations ranged between 0.2 mm and 1.0 mm, consistent with previous findings. The humeral head position in the fully corrected state differed significantly from uncorrected states in each native inclination group (<em>P</em> &lt; .01). The percentage of implant–bone interface area in compression increased by 4.3 ± 0.6% per 5° correction for the 15° native inclination group, 2.6 ± 0.6% for 10°, and 1.8 ± 1.9% for 5°.</div></div><div><h3>Discussion</h3><div>Superior augmentation restored humeral head centralization and increased the proportion of the implant–bone interface in compression, decreasing liftoff potential and reducing mechanical risk factors for loosening in patients with excessive superior inclination.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101606"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189220","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":"Structural abnormalities of the elbow joint in high school baseball players exposed to the COVID-19 pandemic during their elementary and junior high school years: a sonographic analysis of 354 players at high school entry","authors":"Ryosuke Nishi RPT, MSc ,&nbsp;Takahisa Ogawa MD, MPH, PhD ,&nbsp;Yuki Obokata RPT, MSc ,&nbsp;Atushi Kubota PhD ,&nbsp;Masashi Aoyagi RPT, PhD ,&nbsp;Kozo Furushima MD, PhD ,&nbsp;Kunio Kamatani MD","doi":"10.1016/j.jseint.2025.101605","DOIUrl":"10.1016/j.jseint.2025.101605","url":null,"abstract":"<div><h3>Background and Hypothesis</h3><div>Previous studies have shown that increased pitching load during growth is associated with medial epicondyle hypertrophy and ulnar collateral ligament thickening. The COVID-19 pandemic caused prolonged restrictions on sports activities among youth, especially during their elementary and junior high school years. We hypothesized that pandemic-related reductions in pitching opportunities would result in a lower prevalence of these structural adaptations in high school baseball players.</div></div><div><h3>Methods</h3><div>Of the 354 high school baseball players enrolled between 2015 and 2025, 119 were pitchers and 235 were fielders. All participants had undergone ultrasound screening at the time of high school enrollment. We categorized them into a Pandemic group (entered high school between 2021 and 2025) and a pre-pandemic group (entered high school in 2020 or earlier). Medial elbow structures were assessed for 5 abnormalities: hypertrophy, irregularity, bone fragment, hypoechoic findings, and thickening. Group differences were analyzed using chi-square tests and odds ratios. Stepwise multivariable logistic regression was conducted to identify independent factors associated with medial epicondyle hypertrophy.</div></div><div><h3>Results</h3><div>The Pandemic group demonstrated a significantly higher prevalence of medial epicondyle hypertrophy compared with the pre-pandemic group (41.1% vs. 28.3%, <em>P</em> = .01), as well as a significantly lower prevalence of ulnar collateral ligament thickening (51.5% vs. 67.5%, <em>P</em> = .01) and hypoechoic findings (23.9% vs. 34.5%, <em>P</em> = .01). Stepwise logistic regression identified membership of the Pandemic group as the sole independent predictor of medial epicondyle hypertrophy (OR = 1.78, 95% CI: 1.14–2.78, <em>P</em> = .01).</div></div><div><h3>Discussion and Conclusion</h3><div>High school baseball players who experienced the COVID-19 pandemic during crucial growth periods exhibited a paradoxical increase in medial epicondyle hypertrophy along with a decrease in ligamentous abnormalities. Supplemental questionnaire data from a subset of participants suggested that abrupt increases in pitching volume after restrictions, rather than total cumulative load, may have contributed to hypertrophy. These findings indicate that sudden changes in throwing load and inadequate physiological adaptation during pandemic-related restrictions may have disrupted normal remodeling processes in the developing elbow. To prevent elbow abnormalities in growing baseball players, comprehensive throwing load management—including frequency and intensity, not just pitch count—is essential, with particular attention to gradual return-to-throwing programs after prolonged inactivity.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101605"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189218","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 Pectoralis Minor Release on Neuropathic Pain and Shoulder Function in Frozen Shoulder Surgery","authors":"A. Misir ,&nbsp;O. Hancerli","doi":"10.1016/j.jseint.2025.101448","DOIUrl":"10.1016/j.jseint.2025.101448","url":null,"abstract":"","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101448"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147538188","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":"Age does not affect reliability of the Radiographic Union Score for HUmeral fractures score","authors":"David Karimi MD ,&nbsp;Peter Bremholm MD ,&nbsp;Kasper Eriksen MD ,&nbsp;Line Houkjær MD ,&nbsp;Martin Hochheim MD ,&nbsp;Kristoffer Hare MD, PhD ,&nbsp;Joakim Jensen MD ,&nbsp;Bjarke Viberg MD, PhD ,&nbsp;Dennis Karimi MD PhD","doi":"10.1016/j.jseint.2025.101615","DOIUrl":"10.1016/j.jseint.2025.101615","url":null,"abstract":"<div><h3>Background</h3><div>A key challenge of humeral shaft fracture management is nonunion after nonsurgical treatment. The Radiographic Union Score for HUmeral fractures (RUSHU) assesses early fracture healing; however, the effect of patient age on its reliability remains unclear.</div></div><div><h3>Methods</h3><div>In this validation study, 143 adult patients with nonsurgically managed humeral shaft fracture were included (nonelderly 18-64 years, n = 71; elderly ≥65 years, n = 72). Six raters with varying experience (medical students, residents, consultants) independently scored 6-week radiographs using RUSHU. Intra-rater and inter-rater reliability were evaluated for total scores, a binary RUSHU (&lt;8 vs. ≥ 8), and individual cortices using weighted Cohen's kappa, Fleiss' kappa, and intraclass correlation coefficients.</div></div><div><h3>Results</h3><div>Mean RUSHU scores were similar between nonelderly (6.9 ± 2.0) and elderly patients (7.0 ± 1.9; <em>P</em> = .95). Intra-rater reliability was excellent for total RUSHU scores (κ = 0.92, 95% confidence interval (CI): 0.88-0.95) and moderate to excellent for the binary RUSHU (κ = 0.82, 95% CI: 0.72-0.91), with no age-related differences. Inter-rater reliability for total RUSHU was fair by Fleiss' kappa (κ = 0.24, 95% CI: 0.22-0.26) and moderate to good by intraclass correlation coefficient (0.69, 95% CI: 0.52-0.77). Binary scoring improved agreement (κ = 0.59-0.61). Inter-rater reliability also increased significantly with Cohen's kappa across rater pairs (κ = 0.45-0.82), experience levels (κ = 0.66-0.81), and within individual cortices (κ = 0.33-0.54). No significant differences were observed between age groups by experience level or individual cortices.</div></div><div><h3>Conclusion</h3><div>Age did not influence RUSHU reliability. Intra-rater reliability was moderate to excellent, and inter-rater reliability was fair to excellent depending on the statistical method utilized. Agreement improved with binary RUSHU and stratifying raters by experience and pairs. This indicated that RUSHU had measurable reliability. Reliabilities were consistent across age groups, cortices, and levels of clinical experience.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101615"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188555","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}