JSES International最新文献

{"title":"Translating humeral posture into prosthetic planning: BMI, humeral abduction resting angle, and simulated range of motion in an Altivate 135° reverse shoulder arthroplasty model","authors":"Wei Shao MD ,&nbsp;Abdelkader Shekhbihi MD ,&nbsp;William G. Blakeney MD ,&nbsp;Jean-David Werthel MD ,&nbsp;Stefan Bauer MD","doi":"10.1016/j.jseint.2025.05.001","DOIUrl":"10.1016/j.jseint.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Scapular notching in reverse total shoulder arthroplasty is more prevalent in slim patients and less frequent in obese patients. Current arthroplasty planning software often lacks the integration of patient-specific arm positioning when aiming to predict impingement-free motion. This study hypothesizes that obese patients exhibit a more abducted humeral resting position, measured as the humeral abduction resting angle (HARA) and reverse shoulder arthroplasty (RSA)-HARA, and that greater abduction increases impingement-free range of motion (ROM).</div></div><div><h3>Methods</h3><div>Standing radiographs of 141 shoulders (121 patients) were analyzed to measure HARA (humeral center line to vertical plumb line) and RSA-HARA, defined as the angle between the humeral center line and supraspinatus fossa line influenced by RSA implantation and scapular posture. A subsequent computer modeling study of 22 computed tomography scans simulated RSA-HARA positions of 0°, 15°, 30° (Altivate; Enovis, Austin, TX, USA; 36 mm and 36-4 mm glenoid heads, standard insert, jump height = 10 mm, liner stability ratio = 202%), and 20° (semiconstrained insert, jump height = 11.3 mm, liner stability ratio = 202%). The ROM parameters—extension, external rotation, internal rotation, and adduction—were compared using a 135° humeral stem and gender-specific glenoid head configurations. Flexion, abduction and extension were not recorded.</div></div><div><h3>Results</h3><div>Body mass index showed a moderate positive correlation with HARA (R = 0.48, <em>P</em> &lt; .001) and a weak positive correlation with RSA-HARA (R = 0.37, <em>P</em> &lt; .001). HARA ranged from 0° to 43° (mean 12°), and RSA-HARA from 0° to 54° (mean 26°). An RSA-HARA of 30° significantly increased ROM for external rotation (74° vs. 38°, <em>P</em> &lt; .001) and internal rotation (101° vs. 70°, <em>P</em> &lt; .001) compared to 0°. Semiconstrained inserts at 20° showed superior ROM for internal (84° vs. 70°, <em>P</em> &lt; .05) and external rotation (58° vs. 38°, <em>P</em> &lt; .05) compared to standard inserts at 0°.</div></div><div><h3>Conclusions</h3><div>Body mass index was moderately correlated with HARA (R = 0.48) and weakly correlated with RSA-HARA (R = 0.37). A greater RSA-HARA was associated with improved impingement-free ROM. Patients with increased HARA may benefit from more retentive liners, offering stability without compromising ROM. Customizable preoperative planning software incorporating HARA, RSA-HARA, and scapulothoracic posture are important to optimize RSA planning.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1636-1644"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108778","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 glenohumeral adduction restriction in frozen shoulder as a predictor of intra-articular lesion severity: a comparison study of the freezing and frozen phases","authors":"Masatoshi Amako MD, PhD ,&nbsp;Junichiro Hamada MD, PhD ,&nbsp;Hiroshi Karasuno RPT, PhD ,&nbsp;Ryo Sahara RPT ,&nbsp;Mitsukuni Yamaguchi RPT, PhD ,&nbsp;Yuichiro Yano MD, PhD ,&nbsp;Yoshihiro Hagiwara MD, PhD ,&nbsp;Kazuya Tamai MD, PhD ,&nbsp;Kiyohisa Ogawa MD, PhD","doi":"10.1016/j.jseint.2025.04.041","DOIUrl":"10.1016/j.jseint.2025.04.041","url":null,"abstract":"<div><h3>Background</h3><div>Glenohumeral adduction restriction (AR), which is found in rotator cuff tears, is also observed in frozen shoulder (FS). AR was examined using an adduction test and treated through adduction manipulation. We aimed to compare the incidence and severity of AR and investigate clinical characteristics and outcomes of the freezing and frozen phases.</div></div><div><h3>Methods</h3><div>Two hundred sixteen patients with FS were enrolled in this study; consequently, 120 were classified into the freezing phase (mean age 58 years, 37 men) and 56 into the frozen phase (mean age 55.4 years, 29 men). Using the adduction test, the patients in 2 phases were divided into 2 groups, with and without AR. The glenohumeral adduction angle (GAA) was measured radiographically. Treatments in the freezing phase were physiotherapy and/or adduction manipulation and joint manipulation and physiotherapy for the frozen phase. We recorded the visual analog scale of pain severity, EuroQol-visual analog scale, flexion, abduction, external rotation (ER), internal rotation, and American Shoulder and Elbow Surgeons and Constant scores at the baseline and at the 1-, 3-, 6-, 12-, and 24-month follow-ups.</div></div><div><h3>Results</h3><div>Seventy-five of 120 patients in the freezing phase were divided into group 1 without AR and 45 into group 2 with AR. Eight of 56 patients in the frozen phase were classified into group 3 without AR and 48 into group 4 with AR. AR was identified in 37.5% of patients in the freezing phase and 85.7% in the frozen phase. The mean GAA decreased from the freezing (−3.0°) to the frozen phases (−18.3°). GAA was positively correlated with ER. The treatment duration in group 1 (5.2 M) was shorter than in group 2 (7.4 M), and the percentage of transition to joint manipulation in group 1 (5.3%) was lower than in group 2 (17.8%). Complete rupture of intra-articular soft tissues was observed in group 4 but not in group 3 with magnetic resonance imaging. Clinical items, except for ER in the freezing phase (group 1 vs. 2) and frozen phase (group 3 vs. 4), were not significantly different from those at the initial visit to the 24-month follow-up appointment.</div></div><div><h3>Conclusion</h3><div>The incidence and severity of AR increase from the freezing phase to the frozen phase. AR correlating with ER reflects the progression of intra-articular lesions, which prolongs the treatment duration and increases the joint manipulation rate in the freezing phase. Negative AR in the frozen phase suggests mild intra-articular pathologies.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1546-1554"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109045","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":"Modeling life cycle analysis of eco-designed practices in arthroscopic rotator cuff repair: a pilot study","authors":"Charlotte Martin MD ,&nbsp;Cléa Ohannessian MD ,&nbsp;Fabrice Ferré MD, PhD ,&nbsp;Fanny Vardon MD, PhD ,&nbsp;Nicolas Bonnevialle MD, PhD ,&nbsp;Vincent Minville MD, PhD","doi":"10.1016/j.jseint.2025.04.009","DOIUrl":"10.1016/j.jseint.2025.04.009","url":null,"abstract":"<div><h3>Background</h3><div>Climate change represents a critical public health challenge, with health-care systems contributing 5.5%-8% of global greenhouse gas emissions.</div></div><div><h3>Methods</h3><div>This pilot study assessed the environmental impact of arthroscopic rotator cuff repair, a common surgical procedure, and evaluates the potential of eco-designed care practices to reduce this impact. Environmental impact was evaluated through life cycle analysis using the ReCIPE method, measuring CO2 production and 11 other environmental indicators. Data collection included resource use, waste generation, and procedural details from representative surgeries. The model also implemented measures such as reusable surgical equipment, reduced halogenated anesthetics, optimized waste sorting, and locally produced, sustainable staff garments.</div></div><div><h3>Results</h3><div>Results showed a 54% reduction in CO2 emissions (109.2 kgCO2eq vs. 51.1 kgCO2eq) and significant improvements across all assessed environmental categories, including a 60% decrease in stratospheric ozone depletion and a 52% reduction in ozone formation. Each surgical phase demonstrated decreased environmental impact, particularly in waste management and anesthesia.</div></div><div><h3>Conclusion</h3><div>While limited by its single-center design, this study highlights the feasibility of integrating eco-design principles into health-care practices. These findings emphasize the importance of reducing the environmental footprint of surgical care, aligning with global sustainability goals. Future research should expand on these preliminary findings to develop standardized eco-design strategies in health-care systems.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1481-1486"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109051","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":"Reverse shoulder replacement for the treatment of proximal humerus fractures: a current literature review","authors":"Henry A. Kuechly BS,&nbsp;Allison K. Perry MD,&nbsp;Brian M. Grawe MD","doi":"10.1016/j.jseint.2024.06.006","DOIUrl":"10.1016/j.jseint.2024.06.006","url":null,"abstract":"<div><div>Reverse shoulder arthroplasty (RSA) received Food and Drug Administration approval in 2003 and has become one of the most performed orthopedic procedures. Proximal humerus fractures (PHFs), in particular, have become a very common indication for RSA. Specifically, 3-part and 4-part fractures in older individuals with poorer bone quality and/or limited physical demands are amenable to RSA. Given the aging population, the use of RSA for the treatment of PHFs is expected to increase. However, the complex nature of PHF morphology and the multiple treatment options underscores the fact that not every patient or every PHF is indicated for RSA. Therefore, it is important to develop a thorough understanding of indications and contraindications of RSA in the setting of PHF. Overall, this procedure provides adequate functional outcome scores, range of motion, and pain control as compared to other surgical treatments for PHFs. The purpose of this review is to provide a comprehensive and critical overview of the history, indications, surgical considerations and complications, postoperative course, and future of RSA specifically within the context of PHFs.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1855-1859"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108223","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":"Absence of scapular notching in lateralized reverse shoulder arthroplasty: a mid-term clinical and radiological evaluation","authors":"Valentina Sanzo MD ,&nbsp;Michele Mercurio MD ,&nbsp;Paola Morabito MD ,&nbsp;Filippo Familiari MD ,&nbsp;Giorgio Gasparini MD ,&nbsp;Olimpio Galasso MD","doi":"10.1016/j.jseint.2024.08.195","DOIUrl":"10.1016/j.jseint.2024.08.195","url":null,"abstract":"<div><h3>Background</h3><div>Lateralized reverse shoulder arthroplasty (LRSA) has been conceived to improve clinical and functional outcomes and reduce complication rates and scapular notching in comparison with medialized implant. The purpose of this study was to evaluate the mid-term clinical and radiological outcomes, the survival rate, and the health-related quality of life in a prospective series of patients who underwent LRSA and to identify the possible predictors of clinical outcomes.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study on prospectively collected data of 29 patients who underwent LRSA. Thirteen (45%) patients suffered from primary osteoarthritis (OA), 12 (41%) patients suffered from cuff tear arthropathy, and 4 (14%) patients suffered from secondary OA due to fracture sequelae. Each patient was evaluated preoperatively and at follow-up by radiological and computed tomography and by assessing the range of motion, the Constant–Murley Score, and the short form 12.</div></div><div><h3>Results</h3><div>After a mean follow-up of 52.3 ± 17.4 (range, 24-101) months, a statistically significant recovery of the forward flexion, abduction, and external rotation range of motion as well as the Constant–Murley Score and short form 12 physical component values was reported. Higher postoperative functional outcomes were noted in patients suffering from primary OA in comparison with patients suffering from cuff tear arthropathy or secondary OA. No cases of scapular notching (0%) and just one case (3.4%) of grade 1 heterotopic ossification were observed.</div></div><div><h3>Conclusions</h3><div>Satisfactory clinical and radiological outcomes of LRSA can be expected after a mean 52.3-month follow-up, with no cases of scapular notching and exceptionally low rates of radiological complications.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1871-1875"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108224","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":"Repair integrity and clinical outcome after arthroscopic rotator cuff repair under low repair tension","authors":"Satoshi Miyake MD, PhD,&nbsp;Terufumi Shibata MD, PhD,&nbsp;Shunsuke Kobayashi MD,&nbsp;Kei Matsunaga MD,&nbsp;Yozo Shibata MD, PhD,&nbsp;Teruaki Izaki MD, PhD,&nbsp;Takuaki Yamamoto MD, PhD","doi":"10.1016/j.jseint.2025.04.020","DOIUrl":"10.1016/j.jseint.2025.04.020","url":null,"abstract":"<div><h3>Background</h3><div>Excessively high repair tension negatively affects clinical outcomes after rotator cuff repair. This study was performed to examine the clinical outcomes and repair integrity of the rotator cuff in patients treated by arthroscopic rotator cuff repair (ARCR) under low repair tension (&lt;10 N) (ie, low-tension ARCR).</div></div><div><h3>Methods</h3><div>The study involved patients who underwent low-tension ARCR between January 2020 and December 2021. The single-row or triple-row technique was used for low-tension ARCR. We excluded 10 patients who underwent other procedures, other types of repair, or partial repair, as well as 4 patients who underwent an ultrasound evaluation of cuff integrity. Clinical evaluations included the visual analog scale (VAS) for pain, range of motion (ROM), and clinical scores (Japanese Orthopaedic Association [JOA] shoulder score, University of California at Los Angeles [UCLA] shoulder score, and simple shoulder test [SST]), assessed preoperatively and 2 years postoperatively. Structural repair integrity was evaluated by magnetic resonance imaging at 12 months postoperatively. Statistical analyses were performed using Statistics Package for Social Science software (version 29.0.0; IBM Corp., Armonk, NY, USA). The Wilcoxon signed-rank test was performed to compare continuous and continuously ranked data (VAS score, ROM, JOA shoulder score, UCLA score, and SST score). A <em>P</em> value of &lt; .05 was considered statistically significant.</div></div><div><h3>Results</h3><div>This retrospective case series involved 77 patients with a mean age of 65.9 ± 9.5 years (range, 42-85 years) and a mean follow-up period of 25.3 ± 3.3 months (range, 24-38 months). All patients had a full-thickness rotator cuff tear, classified as small in 5 patients, medium in 47, large in 25, and massive in 0. The mean tear size was 506.0 ± 332.5 mm². All patients underwent low-tension ARCR (single-row, n = 48; triple-row, n = 29). Repair tension was measured using a digital tensiometer. The VAS score at rest (48.6-1.1, <em>P</em> &lt; .001), in motion (75.2-5.4, <em>P</em> &lt; .001), and at night (62.0-1.5, <em>P</em> &lt; .001); ROM with forward flexion (124°-167°, <em>P</em> &lt; .001), abduction (109°-167°, <em>P</em> &lt; .001), external rotation (56.0°-68.6°, <em>P</em> &lt; .001), and internal rotation (14.1°-9.0°, <em>P</em> &lt; .001); JOA shoulder score (66.5-98.1, <em>P</em> &lt; .001); UCLA shoulder score (15.9-34.2, <em>P</em> &lt; .001); and SST score (4.5-10.7, <em>P</em> &lt; .001) were significantly better at the 2-year follow-up than before surgery. Two patients developed a retear (2.6%).</div></div><div><h3>Conclusion</h3><div>Low-tension ARCR resulted in a low retear rate and good clinical outcomes.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1493-1503"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108308","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 outcomes of the Latarjet procedure in a North American population","authors":"Walter R. Smith MD ,&nbsp;Allyson N. Pfeil BS ,&nbsp;Matthew A. Coker BS ,&nbsp;Ross Doehrmann DO ,&nbsp;Alexandra Mathews HS ,&nbsp;Derek Fukuda HS ,&nbsp;Hussein A. Elkousy MD ,&nbsp;Corey F. Hryc PhD ,&nbsp;T. Bradley Edwards MD","doi":"10.1016/j.jseint.2025.04.033","DOIUrl":"10.1016/j.jseint.2025.04.033","url":null,"abstract":"<div><h3>Background</h3><div>Anterior glenohumeral instability often necessitates surgical intervention to prevent recurrence. The open Latarjet procedure is a technique that transfers the coracoid process and conjoined tendon to the anterior glenoid for a triple blocking effect. Originally popularized in Europe, this procedure has become increasingly performed in North America. This study aims to present the long-term outcomes of the largest series of Latarjet procedures performed in North America.</div></div><div><h3>Methods</h3><div>Patients from two surgeons at a single site who underwent the Latarjet procedure between January 2003 and January 2023 were invited to complete a digital survey capturing their clinical history and perspectives. One hundred eighteen patients completed patient-reported outcome measures including Single Assessment Numeric Evaluation and Western Ontario Shoulder Instability Index and responded to questions about dislocations, prior and additional surgery, and instability.</div></div><div><h3>Results</h3><div>Overall, 94.07% of respondents required no additional shoulder surgery, 94.92% reported no dislocations, and 83.90% reported no slipping. The mean Single Assessment Numeric Evaluation and Western Ontario Shoulder Instability Index scores were 84.01 and 21.01, respectively.</div></div><div><h3>Discussion</h3><div>Short-, mid-, and long-term results indicate positive clinical outcomes. The long-term data suggest that these benefits are durable, and the Latarjet procedure should be considered as a viable and reliable treatment option for anterior glenohumeral instability. This study indicates that long-term Latarjet clinical and patient outcomes are consistent and favorable in a North American patient population.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1437-1442"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108310","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":"Functional and radiological outcomes of arthroscopic scapular spine bone block “diamond” fixation for recurrent anterior shoulder instability with subcritical glenoid bone loss","authors":"Abdul-ilah Hachem MD ,&nbsp;Diego Gonzalez-Morgado MD, PhD ,&nbsp;Gonzalo Barraza MD ,&nbsp;Fernando Alvarado MD ,&nbsp;Alvaro Minuesa-Madruga MD ,&nbsp;Xavi Rius MD","doi":"10.1016/j.jseint.2025.05.016","DOIUrl":"10.1016/j.jseint.2025.05.016","url":null,"abstract":"<div><h3>Background</h3><div>Arthroscopic glenoid reconstruction with free bone blocks reduces recurrence in anterior shoulder instability. The scapular spine bone block has been described to address subcritical glenoid bone loss (GBL), though its clinical outcomes are still unclear. This study aimed to report the functional and radiological outcomes of patients with anterior shoulder instability and GBL &lt;15% who underwent arthroscopic glenoid reconstruction using a scapular spine bone block fixed with knotless suture anchors in a “diamond” configuration.</div></div><div><h3>Methods</h3><div>A tricortical spine bone graft was harvested. Two knotless all-suture anchors were centrally placed at the glenoid defect. Each anchor included 1 suture for repair and another for transport. The repairs suture from the anchors were interconnected through two holes, creating a bridge over the graft tunnels. The remaining suture limbs were inserted into a third knotless anchor midway between the initial two, establishing a stable configuration for secure fixation. Range of motion, patient-reported outcomes, return to sport, instability recurrence, complications, and reintervention were assessed at a minimum 2 years postoperatively. The glenoid surface area was measured preoperatively, postoperatively, and at a 2-year follow-up, with graft resorption evaluated at a 2-year follow-up.</div></div><div><h3>Results</h3><div>Three patients were included. The GBL ranged from 8% to 13%. Range of motion was similar between sides at the 2-year follow-up. Patients scored higher in patient-reported outcomes from baseline to the 1-year and 2-year follow-ups. All patients returned to sports within 8 months. No recurrent instability or reinterventions occurred. At 3 months postoperatively, all patients achieved graft union, with complete glenoid surface area remodeling at 2-year follow-up.</div></div><div><h3>Conclusion</h3><div>Arthroscopic scapular spine bone block fixation using knotless suture anchors in a “diamond” configuration is effective and safe for treating recurrent anterior shoulder instability with &lt;15% GBL, facilitating an early return to sports.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1449-1456"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108508","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":"Why do patients not return to sports or work after anatomical or reverse total shoulder arthroplasty? A systematic review and meta-analysis","authors":"Wouter J. van der Poel BSc Med ,&nbsp;Arno A. Macken MD ,&nbsp;Denise Eygendaal MD (Prof.) ,&nbsp;Geert A. Buijze MD, PhD ,&nbsp;Michel P.J. van den Bekerom MD (Prof.)","doi":"10.1016/j.jseint.2025.05.028","DOIUrl":"10.1016/j.jseint.2025.05.028","url":null,"abstract":"<div><h3>Background</h3><div>Several studies have been published regarding the rate of return to sports or work after shoulder arthroplasty. However, there are no systematic reviews regarding the reasons for not returning to sports or work. The aim of this study is to assess the rate of return to sports or work and the reasons not to return to sports or work in patients undergoing total shoulder arthroplasty.</div></div><div><h3>Methods</h3><div>The search was performed on the 23rd of April 2024 in multiple databases. Studies reporting return to work or return to sport after anatomic total shoulder arthroplasty (aTSA) or reverse total shoulder arthroplasty (rTSA) with a minimum follow-up of 2 years and studies reporting the reasons for no return to sport or no return to work after anatomical or reverse shoulder arthroplasty were included.</div></div><div><h3>Results</h3><div>Our search resulted in 393 articles, of which 31 studies were included. In total, 18 studies reported the reasons for not returning, whereas 13 did not. The mean (95% confidence interval) return rate to sport was 91% (86%-95%) after aTSA and 80% (72%-89%) after rTSA. Reasons not to return to sport were shoulder related in 13 of the 27 cases after aTSA and in 6 of the 19 cases after rTSA. The mean (95% confidence interval) return rate to work was 76% (59%-93%) after aTSA and 46% (26%-66%) after rTSA. Reasons not to return to work were shoulder related in 4 of the 15 cases after aTSA and in 8 of the 35 cases after rTSA.</div></div><div><h3>Conclusion</h3><div>A high return to sport can be expected after total shoulder arthroplasty. The rate of return to work after aTSA is high; this is in contrast to patients with an rTSA who are less likely to return to work. Interestingly, most reasons not to return to sport or work after shoulder arthroplasty are not shoulder related. Reporting of reasons not to return to sport or work is limited; this should be considered in future studies.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1713-1722"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108618","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":"Sleep quality and response after rotator cuff repair, total shoulder arthroplasty, and reverse shoulder arthroplasty","authors":"Evan A. O'Donnell MD ,&nbsp;Sally Jo MD ,&nbsp;Florian Grubhofer MD ,&nbsp;Jillian E. Haberli BS ,&nbsp;Nicholas Wiley BS ,&nbsp;Lukas Ernstbrunner MD, PhD ,&nbsp;Jon J.P. Warner MD","doi":"10.1016/j.jseint.2025.05.034","DOIUrl":"10.1016/j.jseint.2025.05.034","url":null,"abstract":"<div><h3>Background</h3><div>Sleep disturbance secondary to shoulder pathology is a common complaint. Previous studies have shown improvement in sleep quality after common shoulder procedures. The purpose of this study was to assess sleep quality response after arthroscopic rotator cuff repair (aRCR), anatomic total shoulder arthroplasty (aTSA), and reverse total shoulder arthroplasty (rTSA). Our hypothesis was that sleep disturbance is greater in degree and longer lasting in postoperative recovery after aRCR compared to shoulder arthroplasty.</div></div><div><h3>Methods</h3><div>The Pittsburgh Sleep Quality Index and Visual Analog Scale–Quality of Sleep were prospectively collected in consecutive patients undergoing aRCR, aTSA, and rTSA between 2018 and 2020. Sleep quality and patient reported outcome measures, including the American Shoulder and Elbow Surgeons shoulder score, Single Assessment Numeric Evaluation (SANE) score, and visual analog scale pain score, were measured preoperatively and at 2 weeks, 6 weeks, 3 months, and 6 months postoperatively. Patient demographics, preoperative diagnosis, and comorbidities were recorded. Univariate and multivariate analyses were performed. Correlations between sleep quality metrics and patient reported outcome measures were assessed.</div></div><div><h3>Results</h3><div>One hundred forty-one patients who underwent shoulder surgery participated in this study (aRCR: n = 34, aTSA: n = 58, rTSA: n = 49). With all shoulder surgeries pooled together, there were significant improvements in sleep quality as measured by Pittsburgh Sleep Quality Index and Visual Analog Scale–Quality of Sleep from preoperative to final follow-up (8.8 vs. 6.0, 55.4 vs. 75.2, <em>P</em> &lt; .01 for both, respectively). The rate and magnitude of sleep quality improvement varied by surgical intervention. Sleep quality after aTSA and rTSA showed statistical improvement by 6 weeks postoperatively, which was durable through final follow-up. In contrast, after aRCR patients demonstrated a trend toward worsening sleep quality at 2 weeks with improvement by 3 months postoperatively. In multivariable regression analyses, only the type of surgical intervention, and not preoperative diagnosis or comorbidities, was associated with sleep quality at the final follow-up. Quality of sleep strongly correlated with the SANE score (r = 0.45, <em>P</em> &lt; .01).</div></div><div><h3>Conclusion</h3><div>Sleep quality improves after shoulder surgery, although the rate of recovery varies by surgical intervention. Sleep quality improves more rapidly after shoulder arthroplasty when compared to aRCR. The SANE score may be a useful surrogate metric in assessing sleep quality.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1739-1744"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108621","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}