JSES International最新文献

{"title":"Biomechanical evaluation of different screw fixation methods for Ogawa type I coracoid process base fracture","authors":"Yiwen Tan MD ,&nbsp;Zhao Tan MD ,&nbsp;Hu Zhang PhD ,&nbsp;Fangfang Mou MD","doi":"10.1016/j.jseint.2025.101423","DOIUrl":"10.1016/j.jseint.2025.101423","url":null,"abstract":"<div><h3>Background</h3><div>The internal fixation of Ogawa type I coracoid fractures is relatively difficult, and there is no consensus on the fixation method, which is also prone to screw cutout. This study aims to evaluate the biomechanical properties of 5 different screw internal fixation methods for Ogawa type I coracoid process base fracture through biomechanical experiments.</div></div><div><h3>Hypothesis</h3><div>The biomechanical effects of the 5 fixation methods are different.</div></div><div><h3>Methods</h3><div>Fifteen fresh adult scapula specimens were randomly selected to create models of Ogawa type I coracoid process base fracture. Five fixation methods were used: single hollow screw fixation entirely within the bone (M1), single hollow screw fixation partially exiting below the vertical part of the coracoid process (M2), single hollow screw fixation partially exiting above the vertical part of the coracoid process and extending to the scapular spine (M3), dual hollow screw fixation entirely within the bone (M4), and dual hollow screw fixation combining M1+M3 (M5). All specimens were randomly divided into 5 groups of 3, each corresponding to a fixation method. Biomechanical experiments of compression, tension, and rotation were conducted to assess the stability of each fixation method.</div></div><div><h3>Results</h3><div>There was no significant difference in bone mineral density among the groups (<em>P</em> = .873). At the compression end point, M2 sustained the lowest force and M4 the highest, with the ranking M2 &lt; M3 &lt; M1 &lt; M5 &lt; M4; the intergroup difference was statistically significant (<em>P</em> = .022). At the tension end point, M3 sustained the lowest force and M5 the highest, with the ranking M3 &lt; M2 &lt; M1 &lt; M4 &lt; M5; the intergroup difference was statistically significant (<em>P</em> = .019). At the torsion end point, M2 showed the lowest torque and M5 the highest, with the ranking M2 &lt; M3 &lt; M1 &lt; M4 &lt; M5; the intergroup difference was statistically significant (<em>P</em> = .032).</div></div><div><h3>Conclusion</h3><div>The dual-screw fixation methods (M4 and M5) demonstrated the best stability in treating Ogawa type I coracoid process base fracture, with no significant difference between M5 and M4. For single-screw fixation, the entirely intraosseous method (M1) was more stable than the “in-out-in” methods, and the mode with partial downward exit (M2) should be avoided.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101423"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188556","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":"Optimizing tendon-to-bone healing: a comparative study of intratunnel and anatomical repairs in rotator cuff tears","authors":"Muzaffer Agir MD ,&nbsp;Koray Sahin MD ,&nbsp;Anil Pulatkan MD ,&nbsp;Mehmet Kapicioglu MD ,&nbsp;Fatih Yamak PhD ,&nbsp;Ergun Bozdağ PhD ,&nbsp;Ayse Nur Toksoz Yildirim MD ,&nbsp;Kerem Bilsel MD","doi":"10.1016/j.jseint.2025.101425","DOIUrl":"10.1016/j.jseint.2025.101425","url":null,"abstract":"<div><h3>Background</h3><div>Rotator cuff tears are a leading cause of shoulder pain, with high rerupture rates despite advancements in surgical techniques. Tendon-to-bone healing failure is often attributed to insufficient fibrocartilage regeneration at the repair site. Intratunnel repair (TR) has been proposed as an alternative approach to enhance healing by increasing tendon-bone contact and exposure to marrow-derived stem cells. However, its effectiveness in chronic rotator cuff tears remains unclear. This study aims to compare the biomechanical and histological outcomes of TR and surface repair (SR) in a rabbit model. We hypothesized that TR might offer advantages in tendon-to-bone healing compared to SR, particularly through enhanced contact area and marrow exposure.</div></div><div><h3>Methods</h3><div>A chronic rotator cuff tear model was created in 36 New Zealand White rabbits by tenotomizing the subscapularis tendon and preventing spontaneous healing for 8 weeks. The right shoulders underwent TR, while the left shoulders received SR. Biomechanical and histological evaluations were performed at 4, 8, and 12 weeks postrepair. Biomechanical testing assessed failure load, stiffness, and elongation. Histological assessments included collagen fiber organization, fibrocartilage formation, vascularity, and tendon maturation using Modified Watson tendon maturation scoring. Statistical analyses were conducted using nonparametric tests with a significance level of <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>Biomechanical results showed no significant differences in failure load between TR and SR at any time point (<em>P</em> = .423, <em>P</em> = .423, <em>P</em> = .631). However, at 12 weeks, the stiffness of TR was significantly higher than SR (<em>P</em> = .005). Early histological findings showed similar tendon maturation, collagen alignment, and vascularity in both groups. By 12 weeks, the SR group exhibited significantly better collagen organization (<em>P</em> = .006), vascularity (<em>P</em> = .002), and Modified Watson tendon maturation score (<em>P</em> = .004) compared to TR. The tidemark line, a key indicator of fibrocartilage development, was observed in all SR samples at 12 weeks but was absent in most TR specimens.</div></div><div><h3>Discussion</h3><div>Contrary to our hypothesis, TR did not demonstrate superior healing outcomes compared to SR. While TR provided similar biomechanical properties, its histological outcomes were inferior over time. We speculate that increased inflammatory response and tendon micromotion within the tunnel may have contributed to the inferior histological healing observed in the TR group.</div></div><div><h3>Conclusion</h3><div>These findings suggest that TR does not offer significant advantages over SR in chronic rotator cuff tears. Further studies are needed to optimize healing strategies within the bone tunnel.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101425"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078871","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":"Humeral head deviation and velocity in multidirectional instability of the glenohumeral joint: a cine magnetic resonance imaging study","authors":"Kazuhisa Matsui PT, PhD, MSc ,&nbsp;Takashi Tachibana PT ,&nbsp;Katsuya Nobuhara MD, PhD ,&nbsp;Yasushi Uchiyama PT, PhD","doi":"10.1016/j.jseint.2025.101419","DOIUrl":"10.1016/j.jseint.2025.101419","url":null,"abstract":"<div><h3>Background</h3><div>Manual clinical tests for shoulder instability rely heavily on subjective assessments of humeral head translation, making objective quantification challenging. This study hypothesized that patients with multidirectional glenohumeral instability (MDI) would demonstrate greater humeral head deviation and faster deviation velocity than healthy controls during active shoulder rotation, as assessed using cine magnetic resonance imaging (MRI).</div></div><div><h3>Methods</h3><div>Fourteen participants (eight shoulders with MDI and 20 healthy shoulders) underwent cine MRI while performing active shoulder rotation with the arm at the side. Humeral head deviation, deviation amplitude, and deviation velocity were calculated and compared between the groups using Welch's <em>t</em>-test.</div></div><div><h3>Results</h3><div>The MDI group showed significantly greater humeral head deviation, wider amplitude of deviation, and faster deviation velocity than the control group (<em>P</em> = .008 for anterior deviation, <em>P</em> = .009 for posterior deviation). The deviation amplitude exceeded 35% of the glenoid width in MDI shoulders, surpassing established clinical thresholds.</div></div><div><h3>Conclusion</h3><div>Patients with MDI demonstrated quantifiable dynamic instability on cine MRI. This modality may provide objective support for clinical findings. However, validation in larger cohorts is warranted to confirm these findings, given the limited number of MDI shoulders (n = 8).</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101419"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904065","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":"Intraoperative doppler flowmetry evaluation of humeral head perfusion after proximal humerus fracture","authors":"A.P. Paksoy ,&nbsp;S.B. Bahlawane ,&nbsp;D.B. Back ,&nbsp;R.O. Dey Hazra ,&nbsp;U.S. Stöckle ,&nbsp;P.M. Moroder ,&nbsp;D.A. Akgün","doi":"10.1016/j.jseint.2025.101464","DOIUrl":"10.1016/j.jseint.2025.101464","url":null,"abstract":"","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101464"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147537696","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":"Effect of Preservation of Soft Tissue Remnant at the Tendon Footprint During Arthroscopic Rotator Cuff Repair. A Propensity Score–Matched Study","authors":"A. Scaini ,&nbsp;L. Vitella ,&nbsp;A. Bergomi ,&nbsp;E. Maggini ,&nbsp;G. Milano","doi":"10.1016/j.jseint.2025.101477","DOIUrl":"10.1016/j.jseint.2025.101477","url":null,"abstract":"","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101477"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147537884","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":"Male sex and higher body weight are associated with lower concentrations of perioperative antibiotic prophylaxis in shoulder synovial fluid","authors":"A. Wafaisade ,&nbsp;L. Arnold ,&nbsp;T.R. Pfeiffer ,&nbsp;S. Krombholz ,&nbsp;B. Bouillon ,&nbsp;M. Thevis ,&nbsp;S. Ubl","doi":"10.1016/j.jseint.2025.101463","DOIUrl":"10.1016/j.jseint.2025.101463","url":null,"abstract":"","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101463"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147538446","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":"Antimicrobial Prophylaxis for Skin Colonization with Cutibacterium Acnes in Primary Open Shoulder Surgery: A Double Blinded Randomized Controlled Trial Preliminary Results","authors":"D. Rouleau ,&nbsp;Y. Tran ,&nbsp;J. Hebert-Davies ,&nbsp;G.Y. Laflamme ,&nbsp;S. Leduc ,&nbsp;B. Benoit ,&nbsp;M. Malo ,&nbsp;E. Sandman","doi":"10.1016/j.jseint.2025.101460","DOIUrl":"10.1016/j.jseint.2025.101460","url":null,"abstract":"","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101460"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147538566","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":"Short-term complications following distal humerus open reduction and internal fixation","authors":"Sashrik Sribhashyam BA ,&nbsp;Grayson M. Talaski BSE ,&nbsp;Shahabeddin Yazdanpanah MS ,&nbsp;Carl Edge MD ,&nbsp;Matthew S. Smith MD ,&nbsp;Andrew S. Cuthbert MD ,&nbsp;Jennifer L. Vanderbeck MD","doi":"10.1016/j.jseint.2026.101620","DOIUrl":"10.1016/j.jseint.2026.101620","url":null,"abstract":"<div><h3>Background</h3><div>Distal humerus fractures (DHFs) account for around 2% of all adult fractures. Since nonoperative strategies often lead to loss of motion and disability from prolonged immobilization, open reduction and internal fixation (ORIF) is a commonly employed first-line treatment for reconstructable DHFs and can yield satisfactory outcomes. Surgical recovery, however, is not without complications, with reported rates up to 30%. Prior studies often report ORIF in pooled or comparative settings, leaving a gap in isolated ORIF outcomes. Therefore, this study aims to analyze short-term postoperative complications following DHF ORIF.</div></div><div><h3>Methods</h3><div>The American College of Surgeons National Surgery Quality Improvement Program database was queried using the Current Procedural Terminology code 24579. Patients with missing relevant variables were excluded. Postoperative outcomes included surgical site infection, wound dehiscence, return to the operating room (ROR), and any adverse event (AAE), among others. Continuous variables were reported as mean (standard deviation) and binary variables as number (%). Multivariate logistic regression with Bonferroni correction was used to model associated risk factors. Additionally, threshold analysis was applied to operative time for modeling complication risk.</div></div><div><h3>Results</h3><div>A total of 833 patients were identified (mean age = 53.9 ± 19.9; 71.8% female; 70.1% white; 68.3% outpatient; 50.1% American Society of Anesthesiologists class 2). Cohort comorbidities included smoking (18%) and diabetes (8.9%; 5.3% non-insulin dependent; 3.6% insulin-dependent). Overall, complication rates were low, with AAE occurring at 5.2% within 30 days. Surgical site infection, ROR, and wound dehiscence were all below 2%. Age (odds ratio [OR] = 1.03), operative time (OR = 1.01), hospital length of stay (OR = 1.2), and smoking (OR = 2.07) significantly increased AAE risk. A 97.1-minute significant operative time threshold was calculated, with complication rates of 7.8% and 1.4% above and below this cutoff, respectively (OR = 5.62).</div></div><div><h3>Discussion</h3><div>DHF ORIF demonstrates low short-term complication rates. However, factors such as increased age and smoking elicit reasonable operative concerns. Prolonging operative time was significantly associated with increased risks for AAE, the highest of which was observed beyond a 97-minute threshold for operative time. Targeted counseling is recommended, and future studies are warranted to further granularize outcomes.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101620"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189219","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":"A prospective randomized controlled trial on the effect of music therapy intervention on pain and anxiety in adult patients undergoing total shoulder arthroplasty","authors":"Raymond Y. Kim MD ,&nbsp;Hannah H. Nam MD ,&nbsp;Janice W. Stouffer MT-BC ,&nbsp;Christina A. Myers MT-BC ,&nbsp;Susan E. Hassenbein CCRP ,&nbsp;Gary F. Updegrove MD ,&nbsp;Vernon M. Chinchilli PhD ,&nbsp;Yue Zhang MPH ,&nbsp;Sanjib Adhikary MD ,&nbsp;April D. Armstrong MD","doi":"10.1016/j.jseint.2025.101438","DOIUrl":"10.1016/j.jseint.2025.101438","url":null,"abstract":"<div><h3>Background</h3><div>Leading studies have demonstrated that patients treated with music therapy (MT) show decreased pain intensity, anxiety, length of hospitalization, and increased pain relief. This study investigated whether MT would reduce pre- and postoperative pain and anxiety in patients undergoing shoulder arthroplasties.</div></div><div><h3>Methods</h3><div>This was a prospective, randomized, nonblinded clinical trial. Patients were randomized into 3 groups: live MT, recorded MT, and control. The primary objective was to determine the change in pain and anxiety scores from pre-MT to post-MT. Linear mixed-effects models were developed to account for repeated measurements within each patient, analyzing pain scores and anxiety T-scores.</div></div><div><h3>Results</h3><div>Total of 108 patients were included in the study. Patients receiving live MT reported significantly greater reduction in pain score (<em>P</em> = .0013) and anxiety score (<em>P</em> = .0002) compared to patients in the control. Patients receiving recorded MT also reported significantly greater reduction in pain score (<em>P</em> = .0142) and anxiety score (<em>P</em> = .0186) compared to patients in the control group. There were no significant differences in pain score (<em>P</em> = .4663) or anxiety score (<em>P</em> = .1791) between the live and recorded MT groups.</div></div><div><h3>Conclusions</h3><div>Patients receiving MT intervention had a significantly greater reduction in pain and anxiety scores compared to the control. Findings were not dependent on live vs. recorded presentation. This study demonstrates the potential benefits of incorporating MT to minimize anxiety and postoperative pain in patients undergoing shoulder arthroplasties.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101438"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079043","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":"Maximal scapular protraction increases the safety distance of the spinal accessory nerve during lower trapezius tendon harvest: a cadaveric study","authors":"Abdul-ilah Hachem MD ,&nbsp;Betlem Fargues MD ,&nbsp;Gonzalo Barraza MD ,&nbsp;Fernando Alvarado MD ,&nbsp;Xavi Rius MD ,&nbsp;Jose Luis Agullo MD, PhD ,&nbsp;Diego Gonzalez-Morgado MD, PhD ,&nbsp;Bassem Elhassan MD","doi":"10.1016/j.jseint.2026.101622","DOIUrl":"10.1016/j.jseint.2026.101622","url":null,"abstract":"<div><h3>Background</h3><div>The lower trapezius (LT) transfer is a reliable option for treating irreparable posterosuperior rotator cuff tears. The procedure restores external rotation by reproducing the line of pull of the posterosuperior rotator cuff. Despite its proven clinical benefits, the spinal accessory nerve (SAN) remains at risk during LT harvest due to its close relationship with the medial border of the scapula. Moreover, accurate separation of the LT from the middle trapezius (MT) is crucial to obtain the full muscle excursion and optimal mechanical vector of the harvested portion of the muscle. The first aim of this study is to quantify the change in SAN–scapula distance between neutral and maximal scapular protraction positions, and the second aim is to identify a consistent anatomical landmark to differentiate the LT from the MT during tendon harvest.</div></div><div><h3>Methods</h3><div>Ten fresh-frozen human torsos (20 shoulders) were dissected. Each specimen was positioned in a beach-chair setup at 70°, and the LT and MT insertions were exposed through a posterior approach. The SAN was identified medial to the scapular border and marked. Distances between the SAN and the medial border of the scapula spine were measured in 2 standardized positions by 2 observers and compared: neutral (0° forward flexion, 20° abduction) and maximal protraction (90° forward flexion, 20° adduction). To identify a reproducible landmark distinguishing the LT from the MT, a straight line was drawn from the trapezius tubercle toward the vertebral spinous process, and its vertebral intersection was recorded. For comparison, another line following the axis of the scapular spine was traced to evaluate which orientation excluded proximal LT fibers.</div></div><div><h3>Results</h3><div>The mean SAN–scapula distance measured 20.4 ± 2.3 mm in the neutral position and increased to 31.8 ± 2.8 mm in maximal protraction, demonstrating a mean increase of 11.4 mm (95% confidence interval, 11.0–11.9; <em>P</em> &lt; .001). The SAN was located at a minimum of 17 mm from the medial border of the scapula in neutral position. The reference line from the trapezius tubercle to the vertebral column consistently intersected T3–T4, corresponding to the upper origin of the LT.</div></div><div><h3>Conclusion</h3><div>Maximal scapular protraction increases the distance between the SAN and the medial border of the scapula, providing a greater margin of safety during LT tendon harvest. In addition, a straight line from the trapezius tubercle to the vertebral spine facilitates clear differentiation of LT fibers from the MT.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101622"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147310840","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}