JSES International最新文献

{"title":"Normalized preoperative muscle volume correlates with shoulder strength at minimum 2 years after lateralized reverse total shoulder arthroplasty","authors":"William G. Blakeney MBBS, MSc, MS, FRACS ,&nbsp;Wei Shao MD ,&nbsp;Jean-David Werthel MD ,&nbsp;Allan Wang MD, FRACS, PhD ,&nbsp;Stefan Bauer MD","doi":"10.1016/j.jseint.2025.04.037","DOIUrl":"10.1016/j.jseint.2025.04.037","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative strength is an important outcome measure after reverse total shoulder arthroplasty (rTSA). The objective of our study was to evaluate whether preoperative deltoid and rotator cuff muscle volume correlate with clinical outcomes and shoulder force testing at a minimum follow-up of 2 years after rTSA.</div></div><div><h3>Methods</h3><div>A retrospective study of 39 patients (27 females and 12 males) undergoing rTSA was performed and the muscle volumes of deltoid and rotator cuff musculature were evaluated using a validated preoperative planning computed tomography protocol (Glenosys 10.6.4; Imascap, Brest, France), which automatically calculates muscle volumes and 3-dimensional fatty infiltration in percent. Absolute deltoid and rotator cuff muscle volumes were normalized to the humeral head size. Clinical follow-up was carried out at a minimum of 2 years. Strength testing in 90° of abduction (ABD 90), in external rotation (ER) with the arm at the side, the Constant score, and the subjective shoulder value were recorded.</div></div><div><h3>Results</h3><div>Normalized preoperative deltoid volume, total muscle volume (deltoid, supraspinatus, infraspinatus, subscapularis, and teres minor), and combined deltoid + infraspinatus volume were strongly correlated with postoperative ABD 90 after rTSA (r = 0.69, r = 0.71, r = 0.72, respectively, all <em>P</em> &lt; .001). Preoperative normalized deltoid volume was the strongest predictor for ABD 90 (explained r² = 0.48, <em>P</em> &lt; .001). Preoperative infraspinatus was also moderately correlated with ER with the arm at the side strength (r = 0.51, <em>P</em> = .001). There was a weak correlation between deltoid volume and postoperative Constant score (r = 0.33, <em>P</em> = .04).</div></div><div><h3>Conclusion</h3><div>Preoperative measures of normalized deltoid and rotator cuff volume on planning computed tomography scans were strongly correlated with postoperative shoulder ABD strength, moderately correlated with ER strength, and weakly correlated with the Constant score. These findings are important to counsel patients preoperatively. They may also be useful in the comparison of different rTSA designs in future clinical studies.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1660-1667"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108781","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":"Apple farmers demonstrate a higher prevalence of rotator cuff tears: magnetic resonance imaging-based cross-sectional cohort study in a rural Japanese population","authors":"Daisuke Chiba MD, PhD ,&nbsp;Eitaro Sato MD ,&nbsp;Eiji Sasaki MD, PhD ,&nbsp;Takahiro Tsushima MD, PhD ,&nbsp;Ryo Tomita MD ,&nbsp;Tatsuya Mikami MD, PhD ,&nbsp;Yasuyuki Ishibashi MD, PhD","doi":"10.1016/j.jseint.2025.04.014","DOIUrl":"10.1016/j.jseint.2025.04.014","url":null,"abstract":"<div><h3>Background</h3><div>Limited data are available on how fruit tree farmers are at risk for rotator cuff tears (RCTs). Using mobile magnetic resonance imaging, this study aimed to clarify the prevalence of RCTs in a rural Japanese area where a large proportion of the population works is apple farming.</div></div><div><h3>Methods</h3><div>A total of 371 participants ≥40 years old were recruited (average age: 59.3 years, 225 females) and underwent dominant-side shoulder magnetic resonance imaging. RCT was defined as full-thickness tear on imaging. Shoulder function was evaluated by the Constant–Murley Score. Regarding the participation in apple farming, full-time farming was defined as participating 5 days or more per week; part-time farming was defined as participation less than 5 days per week; non-apple farming was defined as not participating in apple farming at all.</div></div><div><h3>Results</h3><div>Sixty-four participants (17.3%) had RCTs. The prevalence of RCTs was 2.8%, 7.8%, 25.0%, and 34.2% in individuals in their 40s, 50s, 60s, and ≥70 years old, respectively. The receiver operating characteristic curve revealed that 60 years was the optimal age cut-off to detect RCTs (area under the curve: 0.751, 95% confidence interval (CI): 0.690-0.812) Logistic regression analysis demonstrated that the prevalence of RCTs in farmers ≥60 years old was 6.7 times higher (95% CI: 3.3-13.3) than in those &lt;60 years old. Participants with RCTs showed a significantly worse Constant–Murley Score than those without. Twenty-nine farmers (7.8%) had full-time participation, 137 farmers (36.9%) had part-time participation, and 205 (55.3%) were non-apple farmers. Twelve full-time farmers (41.1%) had RCTs; the corresponding values for part-time and non-apple farmers were 26 (19.0%) and 26 (12.7%), respectively. Logistic regression analysis demonstrated that full-time farmers had a 3.8-times higher odds ratio of RCTs compared to non-apple farmers (95% CI of odds ratio: 1.4-10.0).</div></div><div><h3>Conclusion</h3><div>The prevalence of RCTs increased with age. Affected participants showed worse shoulder function than those without RCTs. Full-time farmers showed a higher odds ratio of RCTs compared to non-apple farmers. This indicates that frequent participation in fruit tree farming is associated with the development of full-thickness RCTs.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1487-1492"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108502","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 capsule reconstruction stabilizes the humeral head during scaption: in vivo 3-dimensional kinematic analysis using model–image registration","authors":"Hiroshige Hamada MD ,&nbsp;Keisuke Matsuki MD, PhD ,&nbsp;Hideki Kamijo MD, PhD ,&nbsp;Shota Hoshika MD, PhD ,&nbsp;Tomohiko Deguchi MD ,&nbsp;Norimasa Takahashi MD, PhD ,&nbsp;Hiroyuki Sugaya MD, PhD ,&nbsp;Scott A. Banks PhD","doi":"10.1016/j.jseint.2025.05.002","DOIUrl":"10.1016/j.jseint.2025.05.002","url":null,"abstract":"<div><h3>Background</h3><div>It has been proven that superior capsule reconstruction (SCR) improves the superior translation of the humeral head through cadaveric studies. However, there has been limited information on in vivo glenohumeral kinematics of shoulders with SCR. The purpose of this study was to compare pre- and postoperative glenohumeral kinematics in shoulders that underwent arthroscopic SCR using model–image registration techniques.</div></div><div><h3>Methods</h3><div>Patients who were planned for arthroscopic SCR using the fascia lata autograft due to irreparable massive rotator cuff tears were recruited for this study. The exclusion criteria were (1) preoperative active abduction &lt;60°, (2) massive graft failure on postoperative magnetic resonance imaging, and (3) low image quality. Fluoroscopic images were recorded during active scaption pre- and postoperatively. Computed tomography was performed to create three-dimensional models of the humerus and scapula. Using these fluoroscopic images and three-dimensional models, three-dimensional shoulder kinematics were measured using model–image registration techniques. Pre- and postoperative glenohumeral kinematics and scapulohumeral rhythm were statistically compared. Shoulder ranges of motion and the American Shoulder and Elbow Surgeons scores were also compared.</div></div><div><h3>Results</h3><div>Twenty-five shoulders were included in this study, and 10 shoulders were excluded: graft failure, 4 shoulders; insufficient shoulder elevation, 5 shoulders; low image quality, 1 shoulder. The subjects of this study were 15 shoulders (9 males and 6 females) with a mean age of 63 years (range, 53-70). Flexion and the American Shoulder and Elbow Surgeons score significantly improved after surgery (<em>P</em> = .03 and &lt; .001, respectively). There were no significant postoperative changes in glenohumeral rotations and scapulohumeral rhythm. The superior/inferior position of the humeral head from 10° to 90° of humeral abduction also showed no significant postoperative change; however, the change in humeral position from 30° was significantly smaller after surgery than before surgery (<em>P</em> = .03).</div></div><div><h3>Conclusion</h3><div>No significant changes were observed in glenohumeral rotations and scapulohumeral rhythm after arthroscopic SCR. The superior/inferior humeral translation at humeral abduction greater than 30° was significantly smaller after surgery. These findings suggest that SCR stabilizes the humeral superior/inferior translation without alteration of glenohumeral rotation kinematics.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1504-1510"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108503","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":"Postoperative angiotensin II receptor blocker use is associated with reduced 2-year reoperation rates in male patients undergoing arthroscopic rotator cuff repair","authors":"Scott Fong BA ,&nbsp;Nicholas J. Pettinelli MS ,&nbsp;Michael S. Lee BS ,&nbsp;James S. Macleod BS ,&nbsp;Stephen M. Gillinov AB ,&nbsp;Peter F. Monahan BS ,&nbsp;Jay Moran MD ,&nbsp;Anshu Jonnalagadda BS ,&nbsp;Ronak J. Mahatme BS ,&nbsp;John M. Apostolakos MD, MPH ,&nbsp;Andrew E. Jimenez MD","doi":"10.1016/j.jseint.2025.05.007","DOIUrl":"10.1016/j.jseint.2025.05.007","url":null,"abstract":"<div><h3>Background</h3><div>Angiotensin II receptor blockers (ARBs) antagonize the effects of transforming growth factor-β1, a cytokine mediator for fibrosis and fatty infiltration in skeletal muscle. The objective of this study was to determine (1) if postoperative ARB use is associated with reduced rates of secondary surgery 2 years following arthroscopic rotator cuff repair, and (2) whether there are differences in these outcomes within male-, female-, and non–sex-specific cohorts.</div></div><div><h3>Methods</h3><div>The TriNet X national database was queried to identify patients between 2015 and 2022 who were prescribed an ARB (losartan, valsartan, or olmesartan) within 3 months of arthroscopic rotator cuff repair. ARB patients were propensity matched 1:1 with a non-ARB control. Analyses were conducted to assess outcomes differences within male-, female-, and non–sex-specific cohorts. Two-year secondary surgery rates (manipulation under anesthesia, revision rotator cuff repair, conversion to reverse or anatomic total shoulder arthroplasty, and non-rotator cuff repair arthroscopic shoulder procedures) were evaluated and compared using odds ratios (OR).</div></div><div><h3>Results</h3><div>In total, 2,883 matched ARB and non-ARB rotator cuff repair patients were included, with a mean age of 62.5 years, and 42% female in each cohort. In the non–sex-specific analysis, within 2 years after surgery, the non-ARB cohort had similar rates of revision rotator cuff repair as the control. In the female-specific analysis, 1,228 matched ARB and non-ARB females were included, with an average age of 63.2 years, and there were no statistically significant differences in secondary surgery rates. In the male-specific analysis, 1,562 matched males were included, with an average of 62 years. The male non-ARB cohort reported significantly higher rates of undergoing revision rotator cuff repair (OR 1.33, 95% confidence interval [1.01-1.75], <em>P</em> = .039) and significantly higher rates of undergoing total non–rotator cuff repair arthroscopic shoulder procedures (OR 1.35, 95% [confidence interval] [1.04-1.75], <em>P</em> = .025) compared to the ARB male cohort.</div></div><div><h3>Conclusion</h3><div>The findings of this study suggest that ARB use may be associated with lower rates of secondary shoulder surgeries in patients undergoing rotator cuff repair, with the effects predominantly observed in male patients.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1517-1523"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108505","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":"Factors influencing recurrence rates and radiological outcomes after two-stage exchange arthroplasty for prosthetic joint infection utilizing a premade antibiotic loaded cement hemiarthroplasty","authors":"Adrik Da Silva BS,&nbsp;Michael A. Moverman MD,&nbsp;Chance L. McCutcheon BS,&nbsp;Silvia M. Soule BS,&nbsp;Christopher D. Joyce MD,&nbsp;Peter N. Chalmers MD,&nbsp;Robert Z. Tashjian MD","doi":"10.1016/j.jseint.2025.05.036","DOIUrl":"10.1016/j.jseint.2025.05.036","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The purpose of this study was to describe the rate of infection recurrence in a patient cohort undergoing placement of a prefabricated antibiotic spacer in the setting of two-stage management of shoulder prosthetic joint infection (PJI).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;All patients who underwent placement of a prefabricated antibiotic cement spacer for infection by three surgeons between 2019 and 2024 with a minimum of 3-month follow-up after spacer placement were retrospectively reviewed. Subsequent infection was defined as development of a sinus tract, purulent drainage, or subsequent revision surgery—planned or unplanned— associated with ≥2 tissue specimens with growth of the same bacterial species taken during a biopsy prior to the second stage if performed, at the second stage if performed, or after the second stage during revision of the second stage. Patients were characterized by the International Consensus Meeting 2018 criteria, and comparisons were performed between criteria and reinfection. Radiographic review was performed analyzing spacer loosening, fracture, and glenoid wear. Reinfection and nonreinfection groups were compared.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 55 shoulders (54 patients) met the inclusion criteria. The mean age and follow-up were 61.1 ± 11.1 years and 14.7 ± 10.8 months, respectively. Overall, 38.2% (21/55) of patients experienced reinfection. Five patients had clinically reinfected spacers, 7 had positive cultures on a planned prerevision biopsy, 7 had clinical reinfection after the second stage, and 2 had positive cultures at the time of second stage. Patients with a definite infection per International Consensus Meeting shoulder criteria demonstrated a 50% reinfection rate compared to 33% for probable, 23% for possible, and 33% for unlikely (&lt;em&gt;P&lt;/em&gt; = .349). Patients with reinfections were more likely to be younger patients (55.4 ± 11.7 vs. 64.6 ± 9.2; &lt;em&gt;P&lt;/em&gt; = .002) and have longer follow-up (19.5 ± 12.1 vs. 11.7 ± 8.9 months; &lt;em&gt;P&lt;/em&gt; = .015). The most common culture results were culture negative (26/55; 47.3%) and &lt;em&gt;Cutibacterium acnes&lt;/em&gt; (18/55; 32.7%). Only 14.3% (3/21) of patients that developed reinfection were found to have the same microbe on subsequent cultures. Radiographic factors including spacer fracture and glenoid wear pattern were not associated with recurrent infection (&lt;em&gt;P&lt;/em&gt; &gt; .05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Patients undergoing two-stage revision for PJI with a prefabricated antibiotic cement spacer demonstrate a high rate of recurrence (38.2%), using our conservative definition of recurrence and often become reinfected with a new bacterial species (85.7%). Patient factors are also important to consider given that recurrently infected patients were younger and had longer follow-up. A standardized definition of recurrent PJI is mandatory to accurately compare studies utilizing various treatment options.&lt;/div&gt;&lt;/div","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1754-1759"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108566","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":"How does a reduction in the radial bow, in addition to a rotational deformity of the radius, affect the range of motion of the forearm: an anatomical cadaver study","authors":"Yukie Metoki MD ,&nbsp;Koji Sukegawa MD, PhD ,&nbsp;Tomomi Mizuhashi ,&nbsp;Kohei Hirukawa MD ,&nbsp;Takuya Tada MD ,&nbsp;Kenji Onuma MD, PhD ,&nbsp;Yuya Otake MD ,&nbsp;Dai Iwase MD ,&nbsp;Kentaro Uchida PhD ,&nbsp;Motoyuki Ogawa MD, PhD ,&nbsp;Gen Inoue MD, PhD ,&nbsp;Masashi Takaso MD, PhD","doi":"10.1016/j.jseint.2025.04.023","DOIUrl":"10.1016/j.jseint.2025.04.023","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to investigate the anatomical effect of radial rotational deformity and reduced radial bow on the forearm range of motion (ROM) to improve outcomes in severe forearm diaphyseal fractures and malunion.</div></div><div><h3>Methods</h3><div>Twenty upper limbs of 10 fresh-frozen cadavers were amputated at the humerus and distally at the carpometacarpal joint and examined. Soft tissues, except the interosseous membrane, articular capsule, and pronator quadratus muscle, were removed. The deformity was modeled by cutting at the maximal bow of the radial diaphysis and fixing it with an external fixator. Radial deformities of 20° and 40° in pronation and supination were modeled to assess ROM. Thereafter, a model with a reduced radial bow was created, and ROM was evaluated in addition to the rotational deformities of 20° and 40° in pronation and supination. The cadavers were divided into the normal and reduced radial bow models, and the results were evaluated statistically.</div></div><div><h3>Results</h3><div>In both the normal and reduced radial bow models, malunion in the pronation model led to a loss of range of supination, whereas malunion in the supination model resulted in a loss of range of pronation. The reduced radial bow model showed a statistically significant 20% and 19% loss in forearm pronation and supination, respectively (<em>P</em> &lt; .05).</div></div><div><h3>Conclusion</h3><div>In addition to radial rotational deformity, a reduction in the radial bow contributes to reduced forearm rotation. Ensuring proper radial bow formation is crucial for achieving a good postoperative ROM when treating radial diaphysis fractures and malunion occurring at the maximum radius bow.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1813-1819"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108575","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":"Uncemented vs. cemented reverse total shoulder arthroplasty with latissimus dorsi and teres major transfer","authors":"Gaku Matsuzawa MD, PhD ,&nbsp;Taku Hatta MD, PhD ,&nbsp;Koichi Sasajima MD, PhD ,&nbsp;Eiji Itoi MD, PhD ,&nbsp;Toshitake Aizawa MD, PhD","doi":"10.1016/j.jseint.2025.05.033","DOIUrl":"10.1016/j.jseint.2025.05.033","url":null,"abstract":"<div><h3>Background</h3><div>Reverse total shoulder arthroplasty (rTSA) combined with latissimus dorsi and teres major (LD/TM) transfer is an effective treatment for massive rotator cuff tears associated with deficits in elevation and external rotation. The humeral components of rTSA can be implanted using either a cemented or uncemented technique; however, the impact of the fixation method on postoperative clinical outcomes remains unclear. The primary aim of this study was to compare the clinical outcomes of cemented or uncemented fixation of the humeral component in rTSA with LD/TM transfer with a minimum follow-up of 2 years. We hypothesized the fixation methods would influence the postoperative radiological findings but not the postoperative clinical outcomes.</div></div><div><h3>Methods</h3><div>A total of 32 shoulders with rotator cuff tear and deficits in elevation and external rotation underwent rTSA with LD/TM transfer with either cemented (C group) or uncemented (unC group) humeral component. Postoperative clinical outcomes were evaluated based on the range of motion, the American Shoulder and Elbow Surgeons score, and the Constant-Murley score. Clinical and radiological outcomes were compared between the groups, and their progression over time was analyzed.</div></div><div><h3>Results</h3><div>Both groups demonstrated significant postoperative improvements in range of motion, American Shoulder and Elbow Surgeons score, and Constant-Murley score, with no significant differences between the groups. However, bone resorption at the tendon insertion site was more prominent in the unC group than in the C group. Clinical outcomes stabilized after 6 months, and radiological findings showed no further changes beyond 12 months. No periprosthetic fractures were observed.</div></div><div><h3>Conclusion</h3><div>In patients treated with rTSA with LD/TM transfer, severe bone resorption at the tendon insertion site was more frequently observed in the patients treated with uncemented humeral implants than those with cemented ones.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1731-1738"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108620","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":"Hyperhidrosis increases the risk of postoperative infections after shoulder arthroplasty and rotator cuff repair","authors":"Seyedeh Zahra Mousavi BS ,&nbsp;Henry M. Fox MD ,&nbsp;Anagh Astavans BS ,&nbsp;Prasenjit Saha BA ,&nbsp;Daniel Badin MD ,&nbsp;Alexander R. Zhu BA ,&nbsp;Umasuthan Srikumaran MD, MBA, MPH","doi":"10.1016/j.jseint.2025.04.034","DOIUrl":"10.1016/j.jseint.2025.04.034","url":null,"abstract":"<div><h3>Background</h3><div>Hyperhidrosis (HH), or excessive sweating, has been associated with higher rates of infections. Despite being a relatively common condition, its impact on postoperative outcomes following orthopedic procedures in proximity to the axilla, such as rotator cuff repair (RCR) and shoulder arthroplasty (SA), remains unknown.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using the TriNetX globally federated database. Patients with and without HH who underwent either RCR or SA were matched based on patient demographics and comorbidities. A standard difference of &lt;0.1 was used to assess success of propensity score matching. Primary outcomes were 90-day postoperative superficial soft tissue infections (SSTIs), deep infections, and wound complications. Tests of significance and risk ratios (RR) with 95% confidence intervals were calculated.</div></div><div><h3>Results</h3><div>After matching, 2,941 patients who underwent RCR and 2,066 patients who underwent SA were identified in each cohort. HH patients undergoing RCR demonstrated a higher risk of SSTIs (RR = 1.81; <em>P</em> = .007), urinary tract infection (UTI; RR = 2.09; <em>P</em> &lt; .001), and emergency services usage (RR = 1.69; <em>P</em> &lt; .001). Similarly, HH patients undergoing SA were also at higher risk of SSTIs (RR = 1.87; <em>P</em> = .004), UTI (RR = 1.65; <em>P</em> = .003), and emergency services usage (RR = 1.54; <em>P</em> &lt; .001). There was no significant difference in the rates of deep soft tissue infections between the HH and non-HH groups for both RCR and SA.</div></div><div><h3>Discussion</h3><div>HH is associated with an increased risk for 90-day complications including SSTIs, UTIs, and emergency services usage following both RCR and SA. Additional strategies for optimizing surgical care of these patients should be investigated.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1623-1629"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108818","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":"Prior subacromial decompression is a significant risk factor for development of acromial stress fracture after reverse total shoulder arthroplasty","authors":"Patrick E. Saunders MD ,&nbsp;Clayton Hui BS ,&nbsp;Abhay Mathur MD ,&nbsp;Edward J. Quilligan BS ,&nbsp;Hafiz F. Kassam MD","doi":"10.1016/j.jseint.2025.05.014","DOIUrl":"10.1016/j.jseint.2025.05.014","url":null,"abstract":"<div><h3>Background</h3><div>As the use of reverse total shoulder arthroplasty (rTSA) has steadily increased since Food and Drug Administration approval in 2003, there have been a number of unique complications recognized, including postoperative acromial stress fractures (ASFs). The incidence of ASF after rTSA is rare; however, the impact on clinical outcomes and patient satisfaction can be devastating. Despite a growing body of literature exploring risk factors for ASF following rTSA, there has been minimal investigation into prior subacromial decompression/acromioplasty (SAD) as a risk factor. The purpose of this study was to review a large patient database to determine if prior SAD increases the risk for ASF after rTSA.</div></div><div><h3>Methods</h3><div>The PearlDiver database was used to perform a retrospective cohort study of patients undergoing primary rTSA between 2010 and 2022. International Classification of Diseases and Current Procedural Terminology codes were used to identify patients undergoing rTSA and determine the incidence of ASF. Demographic characteristics and independent risk factors, including prior SAD, were compared between patients with and without ASFs.</div></div><div><h3>Results</h3><div>A total of 106,599 patients undergoing primary rTSA were identified. The overall incidence of ASF was 0.90%. Prior SAD was identified as a significant independent risk factor with logistic regression analysis showing that prior SAD conferred a 26% higher risk of sustaining a postoperative ASF (odds ratio, 1.26 [95% confidence interval, 1.03-1.54]; <em>P</em> &lt; .01). Additional independent risk factors for ASF following rTSA included increased Charlson Comorbidity Index, history of a rotator cuff tear, osteoporosis and inflammatory arthropathy.</div></div><div><h3>Conclusion</h3><div>This study represents one of the largest cohorts of ASFs to date and is the first database study specifically investigating prior SAD as an independent risk factor for ASF after rTSA. Our results support that prior SAD is indeed an independent risk factor for ASF after rTSA. Further high quality, multicenter studies investigating prior SAD as a risk factor for ASF following rTSA are needed as our results supplement a sparse compendium of literature with mixed results pertaining to the hazard that SAD poses for development of this rare complication.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1678-1682"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108815","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":"Variability in ultimate humeral height of an inlay humeral stem does not impact outcomes following reverse shoulder arthroplasty","authors":"Max A. Saráchaga Mendoza MD ,&nbsp;Brian C. Werner MD ,&nbsp;Patrick J. Denard MD","doi":"10.1016/j.jseint.2025.04.017","DOIUrl":"10.1016/j.jseint.2025.04.017","url":null,"abstract":"<div><h3>Background</h3><div>In reverse shoulder arthroplasty, humeral components can be classified as either inlay or onlay implants. However, factors like the depth of seating and use of spacers can cause an inlay component to vary in height, functioning as an onlay component. It is unclear whether the positioning of an inlay humeral component as inlay or onlay position influences clinical outcomes. The aim of this study was to analyze the impact of humeral component position on clinical outcomes following reverse total shoulder arthroplasty.</div></div><div><h3>Methods</h3><div>This was a multicenter retrospective study analyzing radiographic and clinical data from reverse shoulder arthroplasties performed with the same 135° humeral component. Postoperative radiographs were examined to quantify the lateralization and distalization of the humeral component. The distance from the anatomical neck of the humerus to the glenosphere was measured to categorize the implantation as either inlay or onlay. Clinical data, including patient-reported outcomes and range of motion, were compared between groups. Linear regression was used to assess the association of angular measures and clinical outcomes during follow-up.</div></div><div><h3>Results</h3><div>A total of 194 patients with a mean age of 69.3 years (42-90) were included. Postoperative humeral position was classified as a true inlay in 25.3% and some degree of onlay in 74.7%. The modified distalization shoulder angle was greater in the inlay group, whereas the distance to the glenosphere was greater in the onlay group. Baseline patient-reported outcomes were similar, apart from a higher internal rotation at 90° in the onlay group. At 2-year follow-up, only the Western Ontario Osteoarthritis of the Shoulder index showed a statistically significant difference, with a higher score for the inlay group (88.9 ± 17 vs. 82.8 ± 18.1; <em>P</em> = .04). Linear regression analysis showed an association between the distance to the glenosphere and 0° and 90° external rotation, as well as the spinal level internal rotation. The complication rate was similar between groups.</div></div><div><h3>Conclusion</h3><div>Clinical outcomes following reverse shoulder arthroplasty with a 135° neck shaft angle designed inlay humeral implant are favorable, with either inlay or onlay implantation. Clinical outcomes were excellent, with minimal differences based on final humeral positioning. The inlay stem offers the advantage to be placed as either inlay or onlay, based on the surgeon’s preference or the patient’s needs. Patients’ characteristics and surgeon preference should be considered when deciding which configuration to use.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 5","pages":"Pages 1585-1593"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108874","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}