JSES International最新文献

{"title":"Short humeral stem in total shoulder arthroplasty does not jeopardize primary implant stability","authors":"Giulia Galteri MSc,&nbsp;Sara Montanari PhD,&nbsp;Giacomo Dozza BSc,&nbsp;Marco Palanca PhD,&nbsp;Luca Cristofolini PhD","doi":"10.1016/j.jseint.2024.09.021","DOIUrl":"10.1016/j.jseint.2024.09.021","url":null,"abstract":"<div><h3>Background</h3><div>The trend of the modern humeral components in total shoulder arthroplasty is toward shorter and shorter humeral stems. However, the question remains whether short uncemented stems can provide the same implant stability as long stems. This study aimed to evaluate and compare the torsional primary stability and the pull-out extraction force of both a long and a short version of the same stem.</div></div><div><h3>Materials and methods</h3><div>Ten humeral components (five long stems and five short stems) were press-fitted into ten synthetic composite humeri. A torsional load was applied to generate the most critical loading condition. The specimens were loaded with 100 cycles between 2 Nm and 10 Nm, at 1 Hz. A 3D Digital Image Correlation system was used to measure the relative displacement between the prosthesis and the host bone during the test. After completing the torsional test, the pull-out force was measured. Differences between the long and short stem on the biomechanical parameters (permanent migrations, inducible micromotion, and extraction force) were tested with the nonparametric Mann-Whitney test (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>The main rotational inducible micromotion was around the craniocaudal axis. No significant differences were found between the rotational permanent migrations of the long and short stem around the craniocaudal (<em>P</em> = .421), anteroposterior (<em>P</em> = .841), and mediolateral axes (<em>P</em> = .452). No significant differences were found between the rotational inducible micromotions of the long and short stem around the craniocaudal (<em>P</em> = .222), anteroposterior (<em>P</em> = .420), and mediolateral axes (<em>P</em> = .655). No significant differences were found between the permanent translations of the long and short stem along the craniocaudal (<em>P</em> = .341), anteroposterior (<em>P</em> = .420), and mediolateral (<em>P</em> = .429) directions. No significant differences were found between the translations of the long and short stem in terms of inducible translation in the craniocaudal (<em>P</em> = .547), anteroposterior (<em>P</em> = .999), and mediolateral axes (<em>P</em> = .285). Similar extraction force (<em>P</em> = .35) was found.</div></div><div><h3>Discussion and Conclusion</h3><div>No statistically significant difference was found between the long-stem and short-stem implants. These results show that short uncemented stems can provide adequate primary mechanical stability. As the long-stem version of this stem is already clinically used, the present findings suggest that the short version can be reasonably expected to deliver similar outcomes in terms of implant stability.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 212-218"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081151","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":"Deltoid reconstruction using iliotibial band autograft following deltoid detachment: a case report","authors":"Nikita Golovachev BS,&nbsp;Kassem Ghayyad MD,&nbsp;Adam J. Money MD,&nbsp;G. Russell Huffman MD, MPH, FAAOS","doi":"10.1016/j.jseint.2024.09.014","DOIUrl":"10.1016/j.jseint.2024.09.014","url":null,"abstract":"","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 136-140"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081315","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":"An in-vitro biomechanical comparison of annular ligament repair and reconstructions to restore radial head stability in anterior Monteggia fractures","authors":"Kirk Vannitamby MD ,&nbsp;Cole T. Fleet MESc ,&nbsp;Carlos Prada MD, MSc, FEBHS ,&nbsp;James A. Johnson PhD ,&nbsp;Graham J.W. King MD, MSc, FRCSC","doi":"10.1016/j.jseint.2024.12.002","DOIUrl":"10.1016/j.jseint.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Persistent or recurrent instability of the radial head (RH) remains a challenge in treating anterior Monteggia fractures despite anatomic restoration of the ulna. RH instability may be caused by the pull of the biceps muscle with rupture of the annular ligament and other soft tissue stabilizers of the proximal radius. Currently, the optimal method to stabilize the proximal radius is unknown. The purpose of this study was to compare annular ligament repair with three different ligament reconstructions in restoring anterior RH stability.</div></div><div><h3>Methods</h3><div>Eight cadaveric upper extremities were mounted on an elbow simulator in 90 degrees of flexion with the forearm in neutral rotation. Simulated sequential biceps loading was applied in 10 N increments up to a maximum biceps load of 150 N to generate an anteriorly directed force to the RH. Testing was first conducted in the native state with all soft tissue intact, followed by sectioning the central interosseous membrane, the proximal interosseous membrane, and annular and quadrate ligaments. This was followed by the randomized evaluation of an annular ligament repair and three different ligament reconstructions, including a Bell Tawse reconstruction with triceps fascia (Bell Tawse reconstruction), a free tendon annular ligament reconstruction (Itadera reconstruction), and a free tendon anatomic annular ligament reconstruction (anatomic reconstruction). An optical tracking system was used to determine RH kinematics relative to the humerus. For all test states, the anterior translation of the RH relative to the capitellum was quantified as a measure of subluxation.</div></div><div><h3>Results</h3><div>Sectioning the soft tissue stabilizers of the proximal radius produced a significant increase in anterior RH subluxation relative to the intact state (<em>P</em> &lt; .001). The annular ligament repair was most effective at reducing anterior radial subluxation (<em>P</em> = 1.000). The Itadera reconstruction was the next most effective procedure at reducing anterior RH subluxation (<em>P</em> = 1.000) and was followed by the anatomic reconstruction (<em>P</em> = .192) and the Bell Tawse reconstructions (<em>P</em> = .015), respectively.</div></div><div><h3>Conclusion</h3><div>Annular ligament repair was most effective in restoring normal RH stability; however, repair of this structure may not always be feasible as the tissues are often compromised by the injury and may not be reparable. The Itadera reconstruction was the most effective reconstruction technique at restoring RH stability and should be considered over alternative procedures when annular ligament repair is not feasible. These data also suggest that careful rehabilitation will be important postoperatively as residual RH instability can occur even with an anatomic reduction of the ulna and annular ligament repair or reconstruction.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 313-319"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081133","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":"Which muscle is the external rotation compensator after superior capsular reconstruction?","authors":"Nattakorn Mahasupachai MD ,&nbsp;Nobuyuki Yamamoto MD, PhD ,&nbsp;Atsushi Arino MD ,&nbsp;Jun Kawakami MD, PhD ,&nbsp;Rei Kimura MD ,&nbsp;Toshimi Aizawa MD, PhD","doi":"10.1016/j.jseint.2024.09.010","DOIUrl":"10.1016/j.jseint.2024.09.010","url":null,"abstract":"<div><h3>Background</h3><div>Superior capsular reconstruction (SCR) is a surgical option for massive irreparable rotator cuff tears, particularly involving the supraspinatus and infraspinatus. In this procedure, the torn infraspinatus is not repaired or reconstructed. However, an improvement in postoperative external rotation (ER) angle and strength is observed. There is a lack of studies explaining how ER is restored after SCR. The aim of this study is to identify the ER compensator by assessing the muscle volume of the posterior deltoid and teres minor.</div></div><div><h3>Methods</h3><div>Sixty-eight patients with massive rotator cuff tears underwent SCR during 2016-2021. Of these patients, 28 who met the following inclusion criteria were retrospectively reviewed: (1) massive rotator cuff tears, including the supraspinatus and infraspinatus, (2) severe muscle atrophy and fatty change, (3) intact or reparable subscapularis tendon, and (4) Hamada of grade 3 or lower. Posterior deltoid and teres minor volume were measured using open-source medical image processing software preoperatively and 1-year postoperatively. The percentage of the posterior deltoid and teres minor muscle volume change was compared between patients with 1-year postoperative ER manual muscle testing (MMT) of grade 5 and of grade &lt; 5. The relationship between grade of fatty change, percentage of the muscle volume change, and ER angle and strength were evaluated.</div></div><div><h3>Results</h3><div>There was a significant increase in the 1-year postoperative teres minor volume compared with the preoperative volume (24.6 ± 10.3 cm³ vs. 20.9 ± 8.3 cm³, <em>P</em> &lt; .000), while the posterior deltoid volume remained unchanged (178.1 ± 48.3 cm³ vs. 178.8 ± 47 cm³). Patients with ER MMT of grade 5 had a greater teres minor volume change compared to those with an ER MMT grade of less than 5 (22.3% vs. 9.4%), although this difference was not significant (<em>P</em> = .074, 95% CI = −1.3 to 27.0). The posterior deltoid volume showed no significant change. The percentage of teres minor volume change had a weak positive correlation with ER strength (r = 0.308, <em>P</em> = .055, 95% CI = −0.02 to 1.0). There was a significant negative correlation between ER strength and the severity of both preoperative and postoperative fatty changes in the teres minor (r = −0.258, <em>P</em> = .065, 95% CI = −1.0 to −0.042 and r = −0.323, <em>P</em> = .028, 95% CI = −1.0 to −0.113, respectively). The pre and postoperative fatty changes in the teres minor were negatively correlated with the percentage of teres minor volume change (r = −0.298, <em>P</em> = .062, 95% CI = −1.0 to 0.031 and r = −0.413, <em>P</em> = .015, 95% CI = −1.0 to −0.1, respectively).</div></div><div><h3>Conclusion</h3><div>The teres minor may serve as a potential compensator for ER in patients with massive rotator cuff tears following SCR.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 123-129"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081348","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":"Superior suspensory complex of the shoulder reconstruction for acute and chronic acromioclavicular joint dislocations: the Queensland Unit for Advanced Shoulder Research 3-tunnel technique","authors":"Helen Ingoe MBBS, FRCS Eng, MD, MSc, PGCert ,&nbsp;Jashint Maharaj MBBS, MPHTM, FRSPH ,&nbsp;Nagmani Singh MBBS, MS ,&nbsp;Kathir Azhagan Stalin MBBS, MS, MRCS, DNB ,&nbsp;Kristine Italia MD, FPOA ,&nbsp;Roberto Pareyon MD ,&nbsp;Mohammad N. Jomaa MD ,&nbsp;Kenneth Cutbush MBBS, FRACS, FAOrthA ,&nbsp;Ashish Gupta MBBS, MSc, FRACS","doi":"10.1016/j.jseint.2024.09.004","DOIUrl":"10.1016/j.jseint.2024.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Management of acromioclavicular joint (ACJ) injuries have wide variety of classification systems, surgical indications and operative techniques. Our study describes the Queensland Unit for Advanced Shoulder Research (QUASR) 3-Tunnel Technique with Ligament Augmentation and Reconstruction System (LARS; Surgical Implants and Devices, Arc sur Tille, France) artificial ligament to reconstruct the superior shoulder suspensory complex in acute, chronic, and revision ACJ dislocations and lateral clavicle fractures.</div></div><div><h3>Methods</h3><div>Our prospective cohort series of patients undergoing the QUASR 3-Tunnel Technique using LARS artificial ligament. This technique reconstructs the superior shoulder suspensory complex using 2 4-mm clavicle tunnels, 1 acromion tunnel, and is arthroscopically assisted to pass the artificial ligament under the coracoid. The ligament is secured with braided composite sutures and no interference screw is used. Preoperative and postoperative functional outcome scores were compared in patients with minimum 12-months follow-up.</div></div><div><h3>Results</h3><div>Of 26 patients in this series, 7 (27%) were operated within 4 weeks of injury, 2 (8%) were revision cases, and 6 (23%) were lateral clavicle fractures. Mean time to surgery was 14 weeks (2-650). Mean postoperative scores with associated 95% confidence interval were Specific Acromioclavicular Score 87.38 (confidence interval 75.38-99.37), American Shoulder and Elbow Surgeons score 94.60 (87.85-101.35), Constant 79.47 (71.87-87.07), simple shoulder test 85.44 (72.34-98.54) and visual analog score 0.50 (−0.15 to 1.15). There were 2 infections and 1 atraumatic loss of reduction; however, there were no tunnel fractures.</div></div><div><h3>Conclusion</h3><div>The QUASR 3-Tunnel Technique with LARS artificial ligament is a safe and efficient technique for both acute and chronic ACJ reconstruction, lateral clavicle fractures with coracoclavicular ligament disruption and complex revision cases with favorable outcomes at the mid-term follow-up.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 31-39"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081157","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":"Medial elbow approaches for coronoid fractures: risk to the ulnar nerve","authors":"Olawale A. Sogbein MD, MSc, FRCSC ,&nbsp;Shav Rupasinghe MBChB, FRACS ,&nbsp;Yibo Li MD, FRCSC ,&nbsp;Yousif Atwan MD, MSc, FRCSC ,&nbsp;Armin Badre MD, MSc, FRCSC ,&nbsp;Thomas Goetz MD, FRCSC ,&nbsp;Graham J.W. King MD, MSc, FRCSC","doi":"10.1016/j.jseint.2024.09.001","DOIUrl":"10.1016/j.jseint.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Coronoid fractures often require open reduction internal fixation (ORIF) to restore elbow stability. The flexor pronator split, flexor carpi ulnaris (FCU) split, and Taylor and Scham (T&amp;S) approaches are frequently used medial approaches to access the coronoid. The ulnar nerve can be released or transposed when performing these exposures. The optimal medial surgical approach and management of the ulnar nerve has not been clearly defined. The purpose of this study was to compare postoperative ulnar nerve complications in coronoid fractures undergoing ORIF following a medial surgical approach and ulnar nerve release or transposition.</div></div><div><h3>Methods</h3><div>A retrospective review of 91 patients with coronoid fractures treated with ORIF using a medial approach from 2004 to 2022 was performed at three academic medical centers. Patients ≥ 18 years of age who sustained coronoid fractures with or without associated injuries were included. Patient charts and perioperative imaging were reviewed. Patient demographics, fracture classification, associated injuries, surgical approaches, ulnar nerve management, and postoperative complications were recorded. Primary outcomes assessed were signs and symptoms of postoperative ulnar nerve neuropathy.</div></div><div><h3>Results</h3><div>The mean age of the cohort was 45 ± 16 years, 71% were males, with a mean length of follow-up of 16 ± 22 months. Of the 91 coronoid fractures, 69 were anteromedials, eight were tips, and 14 were basal types. The incidence of preoperative ulnar neuropathy was 5% (n = 5). The incidence of postoperative ulnar neuropathy was 33% (n = 30) of which 55% (n = 16) completely resolved by final follow-up. The rate of postoperative ulnar neuropathy was not significantly different between in situ release 30% (n = 9) or transposition of the ulnar nerve 34% (n = 20), (<em>P</em> = .64). There was a significantly higher rate of postoperative resolution with transposition (70%) versus in situ release (22%), (<em>P</em> = .045). The rate of postoperative ulnar neuropathy was not significantly different between the FCU, T&amp;S, or flexor pronator split approaches, (<em>P</em> = .331). Finally, the rate of neuropathy resolution was not significantly different between medial approaches (<em>P</em> = .46).</div></div><div><h3>Conclusion</h3><div>There was no statistical difference in the incidence of postoperative ulnar nerve complications with ulnar nerve transposition or in situ release following coronoid fixation. However, transposing the nerve resulted in a higher rate of neuropathy resolution. While the incidence of postoperative ulnar nerve dysfunction is high following coronoid fixation when using a medial surgical approach, it was similar with the FCU, T&amp;S, and flexor pronator split approaches. Larger cohorts and randomized clinical trials are needed to confirm these findings.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 250-254"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079936","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":"Analyzing practice pattern in treating partial-thickness rotator cuff tears: a dual perspective from national database and American Shoulder and Elbow Surgeons PARCIAL research group","authors":"H. Mike Kim MD ,&nbsp;Emily Leary PhD ,&nbsp;Champ L. Baker 3rd MD ,&nbsp;Leslie A. Barnes MD ,&nbsp;R. Alexander Creighton MD ,&nbsp;Frances Cuomo MD ,&nbsp;Matthew J. DiPaola MD ,&nbsp;Abdullah Foad MD ,&nbsp;James M. Gregory MD ,&nbsp;Brian F. Grogan MD ,&nbsp;Scott G. Kaar MD, MBA ,&nbsp;Eitan M. Kohan MD ,&nbsp;Sumant G. Krishnan MD ,&nbsp;Eddie Y. Lo MD ,&nbsp;John T. Moor MD","doi":"10.1016/j.jseint.2024.08.196","DOIUrl":"10.1016/j.jseint.2024.08.196","url":null,"abstract":"<div><h3>Background</h3><div>Partial-thickness rotator cuff tears (PTRCTs), often considered less severe than full-thickness rotator cuff tears (FTRCTs), can be equally symptomatic. Despite the prevalence of PTRCTs, scholarly attention has predominantly focused on FTRCTs, resulting in a relative neglect of PTRCTs. This study aimed to assess the incidence of surgical repairs for PTRCTs in the United States (U.S.) using the Nationwide Ambulatory Surgery Sample (NASS) database and delineate practice patterns among a group of American Shoulder and Elbow Surgeons (ASES) members.</div></div><div><h3>Methods</h3><div>The NASS database, representing approximately 67% of U.S. ambulatory surgical encounters, was queried to obtain the incidence of PTRCT and FTRCT repairs for the year 2019. Data on patient sex, hospital location, setting, teaching affiliation and size, and primary payor were also obtained. Separately, a retrospective chart review was conducted by 13 ASES research group members, collecting data on rotator cuff repairs performed from July 2021 to June 2022 at their individual institutions. Collected data included age, sex, extent and type of rotator cuff tears, duration of symptoms prior to surgical repair, and type and duration of nonoperative treatment.</div></div><div><h3>Results</h3><div>The NASS database showed that PTRCT repairs accounted for at least 23% of the 187,787 rotator cuff repairs performed in 2019, with potential underestimation due to unspecified tear categorization. The retrospective chart review of the ASES research group revealed that PTRCT repairs constituted 27.8% of all rotator cuff repairs with substantial variability among institutions (8.6%-67.1%), that nonoperative measures were commonly employed, with a mean 12-month duration before surgical repair, and that the most common type of nonoperative treatment was supervised physical therapy combined with corticosteroid injection (37.7%).</div></div><div><h3>Discussion</h3><div>This study revealed approximately one-fourth of all rotator cuff repairs conducted in the U.S. were attributed to PTRCTs with substantial variability in proportion of PTRCT repairs across individual orthopedic practices. The overall duration of nonoperative treatment was consistent with the existing literature. This study provides insights into the landscape of PTRCT repairs and associated practice patterns. Further investigation into factors influencing treatment decisions is warranted.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 91-97"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081185","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":"Arthroscopic lateral collateral ligament imbrication for the treatment of posterolateral rotatory elbow instability","authors":"Christos Koukos MD, PhD ,&nbsp;Nikolaos Platon Sachinis MD, PhD ,&nbsp;Konstantinos Sidiropoulos MD ,&nbsp;Michael Kotsapas MD ,&nbsp;Kerem Bilsel MD, PhD ,&nbsp;Fredy Montoya MD, PhD","doi":"10.1016/j.jseint.2024.09.024","DOIUrl":"10.1016/j.jseint.2024.09.024","url":null,"abstract":"<div><h3>Hypothesis</h3><div>Posterolateral rotatory instability (PLRI) of the elbow is commonly treated with open lateral collateral ligament (LCL) reconstruction techniques. This cohort study evaluates the efficacy of a less invasive arthroscopic LCL imbrication technique for reducing grade I or II PLRI.</div></div><div><h3>Methods</h3><div>Forty-three patients with stage 1 or 2 PLRI, unresponsive to conservative therapy, were included. Diagnoses were based on chronic post-traumatic pain (11 patients), chronic atraumatic lateral elbow pain (20), and previous open tennis elbow surgery (12). Following clinical and arthroscopic diagnosis confirmation, the LCL imbrication technique was performed. The Mayo Elbow Performance Score and range of motion (ROM) were assessed preoperatively and postoperatively using the Shapiro-Wilk test and Wilcoxon signed rank test, respectively, with a minimum 12-month follow-up (range 12-48 months).</div></div><div><h3>Results</h3><div>The Mayo Elbow Performance Score increased significantly from a median of 45 points preoperatively to 90 (range 80-100) at 3 months and 95 (range 80-100) at 12 months follow-up (<em>P</em> &lt; .001). Postoperative median flexion reached 140°, and extension was 0°. At 12 months, 2 patients experienced a 10° extension deficit; 95.3% (41 of 43) achieved full ROM. Knot irritation occurred in 4 patients (out of the first 10 of this cohort, 9.3%), 3 of them requiring knot removal. Switching to a polydioxanone 1 suture eliminated this complication. One patient underwent arthroscopic arthrolysis for adhesions after 14 months.</div></div><div><h3>Conclusion</h3><div>Arthroscopic LCL imbrication offers favorable outcomes for grade I or II PLRI from the third postoperative month with minimal complications. A slight restriction in ROM and transient knot discomfort were the main issues, the latter resolved by switching to a thinner polydioxanone suture.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 255-259"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081218","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":"A dual-phase biologic augmentation of rotator cuff healing in a preclinical rat model using interleukin-17F and low-dose lithium","authors":"Manisha R. Mistry MD, MSc ,&nbsp;Yufa Wang MD, MSc ,&nbsp;Cari M. Whyne PhD ,&nbsp;David M. Phillips MSc ,&nbsp;Wendy Oakden PhD ,&nbsp;Paul Marks MD ,&nbsp;Jimmy Tat MD, MSc ,&nbsp;Diane Nam MD, MSc","doi":"10.1016/j.jseint.2024.11.015","DOIUrl":"10.1016/j.jseint.2024.11.015","url":null,"abstract":"<div><h3>Background</h3><div>Rotator cuff tendon tears are a common cause of shoulder dysfunction in adults. Yet, impaired healing continues to result in higher failure rates after surgical repair resulting in patient dysfunction and prolonged recovery. This has spurred increased investigation of biologic augmentation to improve tendon healing. This study examines the outcome of peritendinous interleukin-17F (IL-17F) administration and oral low-dose lithium carbonate (Li) on rotator cuff healing following acute surgical repair in a rat model.</div></div><div><h3>Methods</h3><div>Treatment group included an open supraspinatus peel and repair followed by a local injection of IL-17F at the bone–tendon interface and a 7-day course of oral Li. Control rats received no additional intervention before surgical closure. Evaluation of healing was then preformed using MRI imaging, biomechanical testing, and histological analysis at the bone–tendon interface.</div></div><div><h3>Results</h3><div>Eighteen rats (9 control, 9 experimental) underwent complete testing. Combined treatment of peritendinous IL-17F and oral low-dose Li after rotator cuff repair improved rotator cuff healing in all outcomes when compared to controls. MRI imaging in the treatment group showed complete healing of all supraspinatus tendons across the anatomic footprint after repair. We also found significant increases in biomechanical stiffness compared to controls (<em>P</em> &lt; .01). At the histological level, treatment groups also had decreased osteoclasts (<em>P</em> &lt; .001), and increased histologic organization of fibroblasts compared to controls. These findings are consistent with an increase in biomechanical stiffness.</div></div><div><h3>Conclusion</h3><div>We demonstrated that the combined treatment of IL-17F and oral low-dose lithium improved rotator cuff tendon healing quality following acute surgical repair in a rat model.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 306-312"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081123","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":"Relationship between glenohumeral horizontal abduction angle and scapular internal rotation angle at maximum shoulder external rotation during baseball pitching","authors":"Yuki Nomura PhD, PT ,&nbsp;Hajime Toda PhD, PT, JSPO-AT ,&nbsp;Masaki Katayose PhD, PT, JSPO-AT ,&nbsp;Shun Watanabe MSc ,&nbsp;Masahiro Yoshida PhD, PT, JSPO-AT ,&nbsp;Makoto Yoshida PhD, PT, JSPO-AT ,&nbsp;Keizo Yamamoto PhD","doi":"10.1016/j.jseint.2024.08.190","DOIUrl":"10.1016/j.jseint.2024.08.190","url":null,"abstract":"<div><h3>Background</h3><div>Increased scapulothoracic (ST) internal rotation at maximum external rotation (MER) during baseball pitching can decrease glenohumeral (GH) horizontal adduction, leading to excessive GH horizontal abduction. However, few studies have examined this direct relationship, and none have investigated the ST internal rotation angle at stride foot contact (FC) and MER. This study investigated the relationships between GH horizontal adduction and ST internal rotation angles at MER and between ST internal rotation angles at FC and MER.</div></div><div><h3>Methods</h3><div>We recruited 15 asymptomatic collegiate baseball pitchers and assessed the ST internal rotation angle at FC and MER and GH horizontal adduction angle at MER during pitching using an optical motion tracking system. Pearson’s correlation coefficients determined the relationships between GH horizontal adduction and ST internal rotation angles at MER and between ST internal rotation angles at FC and MER.</div></div><div><h3>Results</h3><div>The GH horizontal adduction angle at MER was significantly related to the ST internal rotation angle at MER (r = −0.58, <em>P</em> = .022). The ST internal rotation angle at FC was significantly related to the ST internal rotation angle at MER (r = 0.53, <em>P</em> = .045).</div></div><div><h3>Conclusions</h3><div>The GH horizontal adduction angle at MER is associated with the ST internal rotation angle at MER in asymptomatic collegiate baseball pitchers, and the ST internal rotation angle at FC is related to the ST internal rotation angle at MER. Thus, the scapula and humerus should be controlled from FC to MER during pitching to reduce internal impingement risk in asymptomatic baseball pitchers.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 1","pages":"Pages 12-17"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081202","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}