JSES International最新文献

{"title":"Utility of point-of-care ultrasound for the diagnosis of elbow fractures in the pediatric emergency department","authors":"Teresa Santamaria Barrena MD,&nbsp;Eva Ortiz de Mendivil Bernal MD,&nbsp;Iranzu Zabalza Gonzalez MD,&nbsp;Edurne Garcia Gordoa MD,&nbsp;Ana María Morata Lorente MD,&nbsp;Frederic Samson PhD","doi":"10.1016/j.jseint.2025.01.016","DOIUrl":"10.1016/j.jseint.2025.01.016","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric elbow injuries are a common pathology in the emergency department. Radiographic imaging is the reference test for diagnosing elbow fractures. However, ultrasonography is an imaging method with growing importance that has shown to be useful in musculoskeletal pathology. The aim of this study was to evaluate the precision of point-of-care ultrasound (POCUS) performed by pediatric emergency physicians compared with radiography for the detection of elbow fractures in pediatric patients, and to compare the interobserver concordance between the performer and an independent evaluator with wide experience in POCUS.</div></div><div><h3>Methods and settings</h3><div>This was a prospective, observational cohort study including pediatric patients under 14 years that visited the emergency department with elbow injuries and required radiographs. Before obtaining the radiographic image, an elbow ultrasonography was performed and interpreted as positive for fracture if an elevated posterior fat pad or lipohemearthrosis was detected. All patients got an elbow radiograph and clinical follow-up.</div></div><div><h3>Results</h3><div>One hundred and six patients were selected, from which 91 patients were electable for the study with a mean of age of 7.8 years. Twenty eight patients of the total (30.8%) had fracture. A sensitivity for POCUS positive result of 96.4% was obtained (95% confidence interval [CI] 81.7%-99.9%), with a specificity of 84.1% (95% CI 72.7%-92.1%). The positive predictive value was 74% (95% CI 61.6-83.4) and the negative predictive value 98.1% (95% CI 88.0-99.7). The POCUS took 14.2 (standard deviation 5.2) seconds to be performed. The interobserver concordance was almost perfect (ĸ = 0.89).</div></div><div><h3>Conclusion</h3><div>Elbow POCUS is a useful tool for the diagnosis of elbow fracture with a high sensitivity and negative predictive value and a very good interobserver concordance. It may be a useful safe alternative to optimize the evaluation and diagnosis of elbow trauma.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 907-911"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943145","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":"Preoperative hospital admission and complications following reverse total shoulder arthroplasty for proximal humerus fractures","authors":"Kenny Ling MD ,&nbsp;Dmitriy Butsenko MD ,&nbsp;James Gallagher MD ,&nbsp;Rachel Loyst BS ,&nbsp;Steven H. Liu BS ,&nbsp;David E. Komatsu PhD ,&nbsp;Edward D. Wang MD","doi":"10.1016/j.jseint.2024.11.023","DOIUrl":"10.1016/j.jseint.2024.11.023","url":null,"abstract":"<div><h3>Background</h3><div>Total shoulder arthroplasty is an increasingly popular surgical treatment for degenerative diseases of the shoulder. The expansion of indications for reverse total shoulder arthroplasty (rTSA) to include proximal humerus (PHFs) fractures has led to rTSA being performed in the inpatient setting, which potentially limits the time for preoperative patient optimization and management. The purpose of this study was to investigate the 30-day postoperative complications associated with rTSA performed on patients requiring preoperative inpatient admission.</div></div><div><h3>Methods</h3><div>The authors queried the American College of Surgeons National Surgical Quality Improvement Program database for all patients who underwent rTSA for PHF between 2015 and 2020. Patient demographics and comorbidities were compared between “admitted inpatient” and “from home” cohorts using bivariate logistic regression. Multivariate logistic regression, adjusted for all significantly associated patient demographics and comorbidities, was used to identify associations between admitted inpatient rTSA and postoperative complications.</div></div><div><h3>Results</h3><div>Patient demographics and comorbidities that were significantly associated with admitted inpatient rTSA for PHF were age≥ 75 (<em>P</em> &lt; .001), American Society of Anesthesiologists classification ≥3 (<em>P</em> &lt; .007), congestive heart failure (<em>P</em> = .001), open wound/wound infection (<em>P</em> &lt; .001), bleeding disorders (<em>P</em> &lt; .001), and transfusion prior to surgery (<em>P</em> &lt; .001). Multivariate analysis found admitted inpatient rTSA for PHF to be independently associated with blood transfusions (odds ratio 2.27, 95% confidence interval 1.66-3.09; <em>P</em> &lt; .001) and nonhome discharge (odds ratio 2.70, 95% confidence interval 2.16-3.38; <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>Patients who underwent inpatient rTSA for PHF while admitted had higher rates of bleeding disorders and preoperative transfusion. Postoperatively, inpatient rTSA for PHF was independently associated with higher rates of blood transfusions and nonhome discharge within the 30-day postoperative period, compared to rTSA performed for PHF in patients presenting from home.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 756-760"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943184","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":"Multiple acromion lengths and glenoid implant inclinations can result in the same critical shoulder angle with large differences in articular joint loading–a musculoskeletal study","authors":"Dan Soyeux MSc ,&nbsp;Margaux Peixoto MSc ,&nbsp;Patrice Tétreault MD ,&nbsp;Mickaël Begon PhD ,&nbsp;Nicola Hagemeister PhD","doi":"10.1016/j.jseint.2024.12.014","DOIUrl":"10.1016/j.jseint.2024.12.014","url":null,"abstract":"<div><h3>Background</h3><div>Glenoid implant loosening is the most common complication of anatomical total shoulder arthroplasty. It is caused by high glenohumeral shear forces and by an eccentric loading of the glenoid implant provoking its “rocking”. The critical shoulder angle (CSA) varies with the glenoid inclination and the acromion length. A higher CSA has been correlated with earlier radiological signs of glenoid loosening. However, the reliability of the CSA in predicting the risk factors of glenoid loosening has yet to be determined since the same CSA can result from multiple scapular anatomies.</div></div><div><h3>Methods</h3><div>An inverse-dynamic musculoskeletal model in <em>Anybody Modeling System</em> of the shoulder with anatomical implants allowing glenohumeral translations was used. The acromion length and the glenoid implant inclination were varied to create multiple CSA configurations. Muscle forces, the force, and the moment applied to the glenoid implant were simulated during a shoulder abduction to compare the risks of glenoid loosening.</div></div><div><h3>Results</h3><div>Increasing the CSA with an upward-tilted glenoid and a longer acromion led to more eccentric forces applied to the glenoid. The moment and shear applied to the glenoid implant increased with a higher CSA and were minimal for the smaller CSAs. Depending on the combination of inclination and acromion length, the shear and the moment were highly variable for the same CSA.</div></div><div><h3>Conclusion</h3><div>Measuring the CSA as a global indicator may be insufficient to accurately predict the risk of glenoid loosening. It suggests that the acromion length could be considered during surgical planning to determine the adequate glenoid implant inclination.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 798-806"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941822","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":"Reliability and reproducibility of teleconsultation for evaluation and treatment indication of rotator cuff syndrome: a cross-sectional outcomes-based diagnostic study","authors":"Rodrigo Alves Beraldo MD ,&nbsp;Mauro Emilio Conforto Gracitelli MD, PhD ,&nbsp;Jorge Henrique Assunção MD, PhD ,&nbsp;Fernando Brandão de Andrade e Silva MD, PhD ,&nbsp;Arnaldo Amado Ferreira Neto MD, PhD ,&nbsp;Henry Dan Kiyomoto PT, PhD ,&nbsp;Caio Santos Checchia MD, PhD ,&nbsp;Eduardo Angeli Malavolta MD, PhD","doi":"10.1016/j.jseint.2024.12.022","DOIUrl":"10.1016/j.jseint.2024.12.022","url":null,"abstract":"<div><h3>Background</h3><div>Telemedicine has enhanced medical practice by increasing accessibility for patients in remote areas. In orthopedics, its use in shoulder surgery is recent but promising. However, there is still a need for studies that evaluate its effectiveness specifically in the setting of rotator cuff disorders. To evaluate reliability and reproducibility of treatment indications using telemedicine for patients with rotator cuff syndrome. Secondary objectives were assessment of physical examination accuracy and level of patient satisfaction.</div></div><div><h3>Methods</h3><div>This diagnostic accuracy study included patients diagnosed with rotator cuff syndrome, who were randomized into two groups as follows: telemedicine and in-person consultations. Both groups underwent two appointments conducted by different orthopedic surgeons. The agreement between treatment indications (nonsurgical, surgical, or conservative, with the possibility of switching to surgery) was assessed using the Kappa coefficient. Additionally, physical examination tests and patient satisfaction were also evaluated.</div></div><div><h3>Results</h3><div>A total of 64 patients were evaluated, with 32 in each group. The reproducibility of teleconsultation for treatment indication was high in both groups, with Kappa values ranging from 0.82 to 0.93. For physical examination tests, reproducibility was high in the in-person group (Kappa between 0.63 and 1) but varied in the telemedicine group (Kappa between 0.11 and 1). The accuracy of the tests in the in-person group was high (sensitivity between 0.94 and 1; specificity between 0.66 and 1), whereas the telemedicine group showed greater variability (sensitivity between 0.60 and 1; specificity between 0.16 and 1). Patient satisfaction was high in both groups, with no significant differences (<em>P</em> &gt; .676).</div></div><div><h3>Conclusion</h3><div>Teleconsultation is a reliable tool for indicating treatment in patients with rotator cuff syndrome, demonstrating high reproducibility and high patient satisfaction. However, the variability in the accuracy of tests that require strength assessment highlights the need for improvements in telemedicine protocols to ensure more robust and accurate evaluations.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 709-714"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942938","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":"The association between tendon quality and clinical outcomes in rotator cuff repair","authors":"Silvia Soule BS ,&nbsp;Christopher Clinker BS ,&nbsp;Angela P. Presson PhD ,&nbsp;Chong Zhang MS ,&nbsp;Christopher Joyce MD ,&nbsp;Robert Z. Tashjian MD ,&nbsp;Peter N. Chalmers MD","doi":"10.1016/j.jseint.2024.12.023","DOIUrl":"10.1016/j.jseint.2024.12.023","url":null,"abstract":"<div><h3>Background</h3><div>Rotator cuff tendon injuries often necessitate surgical intervention to restore function and alleviate pain. The integrity of the tendon—specifically its quality, the extent of tendon loss, and the presence of delamination—may influence postoperative outcomes. The purpose of this study was to evaluate the association between these tendon characteristics and patient-reported outcomes (PROs) after rotator cuff tendon repair.</div></div><div><h3>Methods</h3><div>A retrospective chart review was performed for patients who underwent rotator cuff repair by a single surgeon at an academic institution between 2016 and 2022. This author recorded tendon quality, tendon loss, and tendon delamination on every single case immediately after it was performed. Tendon quality was graded as poor when sutures pulled through the tendon. Tendon loss was graded based upon tendon length remaining. PRO collected preoperatively and at a minimum of two-years postoperatively included the American Shoulder and Elbow Surgeons (ASES) score and the Subjective Shoulder Value (SSV) score.</div></div><div><h3>Results</h3><div>Of 424 patients (441 shoulders) who met inclusion criteria, 2-year outcomes were available for 77% (339/441). The cohort was 57 ± 10 years, had 39% female, with an average body mass index of 30 ± 5.7. Supraspinatus/infraspinatus tears were full thickness in 59% (202/339) and partial thickness in 34% (117/339), with 7% (23/339) having isolated subscapularis tears. PROs changed from ASES 51 ± 19, SSV 45 ± 20, and visual analog scale 4.7 ± 2.3 preoperatively to ASES 89 ± 15, SSV 89 ± 15, and visual analog scale 0.85 ± 1.6 postoperatively. Tendon quality was good in 83% (282/339), fair in 13% (44/339), and poor in 4% (13/339). Tendon loss was minimal in 86% (291/339) and substantial in 14% (48/339). Delamination was present in 16% (55/339). Multivariable analysis showed that poor tendon quality and substantial tendon loss (&lt;16 mm tendon length remaining) were independently associated with worse postoperative ASES scores (<em>P</em> = .019 and .005, respectively).</div></div><div><h3>Conclusion</h3><div>Substantial tendon loss and poor tendon quality should be considered as poor prognostic indicators in rotator cuff repair outcomes. In those patients with poor tendon quality or substantial tendon loss, surgeons could consider augmentation.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 715-719"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942939","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":"Transolecranon fracture dislocation and transolecranon basal coronoid fracture dislocation; results of standardized treatment in a retrospective cohort","authors":"Joaquín De la Paz MD ,&nbsp;Juan José Lecaros MD ,&nbsp;Andres Calvo MD ,&nbsp;Antonio Ariztia MD ,&nbsp;Cristian Aravena MD ,&nbsp;Felipe Reinares MD","doi":"10.1016/j.jseint.2024.11.019","DOIUrl":"10.1016/j.jseint.2024.11.019","url":null,"abstract":"<div><h3>Background</h3><div>Our understanding of transolecranon fracture dislocation (TOFD) has evolved to include associated ligament, coronoid, and radial head lesions impacting stability, rather than solely bone stability. Similarly, the understanding of coronoid fracture patterns has progressed. O’Driscoll et al state that basal subtype 2 coronoid fractures correspond to a TOFD, with a fracture passing through the base of the coronoid. In the literature, there is no clear differentiation between basal coronoid TOFD (BC-TOFD) and pure-TOFD outcomes. The main objective of this study is to evaluate the functional results and complications of TOFD using a standardized surgical technique. The secondary objectives are to describe the associated injuries and to compare the results between pure-TOFD and BC-TOFD.</div></div><div><h3>Methods</h3><div>This retrospective study included all patients with a TOFD treated with a standardized surgical procedure and rehabilitation protocol between 2013 and 2018 in a single trauma level 1 center. The surgical procedure mainly consisted of fixing the olecranon with a plate, using the same screws for coronoid fixation and coronoid plate if necessary. Radial head management involved either arthroplasty or screw fixation, with ligament repair performed as needed. Demographic data and the associated bone and ligament injuries were reviewed. The clinical outcomes (range of motion, Mayo Elbow Performance Score (MEPS), and Broberg and Morrey (B&amp;M) scores) were evaluated at the final follow-up, after a minimum of 2 years. Complications and reoperations were assessed.</div></div><div><h3>Results</h3><div>24 patients were included, and 75.0% were men. The average follow-up was 57.9 ± 22.0 months. The mean age was 42.0 ± 15.1 years. 18 (75.0%) were BC-TOFD and 6 (25.0%) were pure-TOFD. Ligament injuries requiring repair and radial head fracture were present in 8 (33.3%) and 11 (45.8%), respectively. The average range of motion were flexion 119.0° ± 17.6, extension deficit 20.4° ± 12.6°, pronation 68.9° ± 20.4°, and supination 63.1° ± 27.4°. MEPS and B&amp;M mean scores were 82.3 ± 16.5 and 82.0 ± 16.1, respectively. The reoperation rate was 33.3%. No significant differences were found between pure-TOFD and BC-TOFD. A significant distribution difference was found in MEPS (<em>P</em> = .001), B&amp;M (<em>P</em> = .002), range of flexion (<em>P</em> = .011), and extension deficit (<em>P</em> = .005) between patients who had reintervention and those who did not.</div></div><div><h3>Conclusion</h3><div>A standardized protocol for TOFD allows good to excellent functional results. There are no significant differences between pure-TOFD and BC-TOFD. One-third underwent reintervention. Patients with reintervention presented worse outcomes.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 878-884"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943088","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":"Glenoid morphology classification and computed tomography scanning prior to total shoulder arthroplasty: a population-level analysis from the Australian Orthopaedic Association National Joint Replacement Registry","authors":"Helen Ingoe MBBS, FRCS Eng ,&nbsp;Roberto Pareyon MD ,&nbsp;Mohammad N. Jomaa MD ,&nbsp;Marine Launay MEng ,&nbsp;Kristine Italia FPOA ,&nbsp;Jashint Maharaj FRSPH ,&nbsp;David RJ. Gill MBChB, FRACS, FAOrthA ,&nbsp;Carl Holder MBiostat ,&nbsp;Sarah L. Whitehouse PhD ,&nbsp;Kenneth Cutbush FRACS, FAOrthA ,&nbsp;Ashish Gupta MSc, FRACS, FAOrth","doi":"10.1016/j.jseint.2024.11.025","DOIUrl":"10.1016/j.jseint.2024.11.025","url":null,"abstract":"<div><h3>Background</h3><div>Evaluation of glenoid and humeral morphology is important prior to total shoulder arthroplasty and commonly measured on standard radiographs with further evaluation by computed tomography (CT). This study analyzed data from the Australian Orthopaedic Association National Joint Replacement Registry to assess the effect of glenoid morphology and preoperative CT scan on short-term implant survivorship.</div></div><div><h3>Methods</h3><div>The Australian Orthopaedic Association National Joint Replacement Registry identified all primary total stemless and stemmed anatomic total shoulder arthroplasties (aTSAs) and reverse total shoulder arthroplasties (rTSA) undertaken for all diagnoses during the period April 2004 to December 2022. The study population was grouped into glenoid morphology classified according to the Walch classification and to those with or without preoperative CT scan. The cumulative percent revision, which was defined using Kaplan-Meier estimates of survivorship to describe the time to the first revision, was calculated based upon glenoid morphology and CT scan availability. Hazard ratios from Cox proportional hazards models, adjusting for age and sex, were performed to compare the revision rates among groups.</div></div><div><h3>Results</h3><div>There were 4071 (10.7%) primary stemmed aTSA, 3196 (8.4%) stemless aTSA and 30,702 (80.9%) primary rTSA included. Of these, 2694 (77%), 2543 (88.6%) and 21,007 (83.8%) patients had a preoperative CT scan, respectively. There was no difference in the cumulative percent revision at any time point between glenoid type A or B for any arthroplasty type. Glenoid morphology (type A or B) alone and in conjunction with a preoperative CT scan (yes or no) did not affect the revision rate in any combination for any arthroplasty type based on hazard ratio.</div></div><div><h3>Conclusion</h3><div>Preoperative glenoid morphology and preoperative CT scanning does not affect the early rate of revision of stemmed or stemless aTSA and rTSA. Future evaluations of CT scanning in this setting should consider other performance indicators such as patient reported outcome measures.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 761-770"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943141","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":"Three-dimensional changes of scapulothoracic orientation in patients with acromioclavicular joint dislocations","authors":"Philipp Vetter MD ,&nbsp;Sophie Frege MD ,&nbsp;Alp Paksoy MD ,&nbsp;Doruk Akgün MD ,&nbsp;Markus Scheibel MD, PhD ,&nbsp;Philipp Moroder MD, PhD","doi":"10.1016/j.jseint.2025.01.012","DOIUrl":"10.1016/j.jseint.2025.01.012","url":null,"abstract":"<div><h3>Background</h3><div>Acromioclavicular joint (ACJ) dislocations have been linked to altered scapulothoracic orientation and scapula dyskinesis, but research on three-dimensional (3D) changes in scapulothoracic orientation after such injury in vivo has not been described before. The aim of our pilot study was to analyze scapulothoracic orientation changes in patients with ACJ dislocations using three-dimensional computed tomographic (CT) image reconstruction.</div></div><div><h3>Methods</h3><div>Patients with ACJ dislocations who underwent CT imaging were included retrospectively and consecutively. Minors and cases with spine, neurologic or systemic diseases, and shoulder girdle fractures were excluded. Each CT was performed in supine position with elbows rested on the scanning table and had to depict the complete shoulder girdle. After 3D image reconstruction, tilt, upward rotation, internal rotation, translation, and protraction of the scapula were measured based on three osseous landmarks: the glenoid (the deepest point of its concavity), the medial root of the scapular spine, and the inferior scapular angle. The healthy contralateral side was used as a paired control. ACJ dislocations were graded according to Rockwood (RW) on strict frontal CT image reconstruction, including the contralateral shoulder, where measurements were also performed to enable comparison. Cases were labeled as acute or chronic with a 3-week injury-to-diagnosis interval cut-off.</div></div><div><h3>Results</h3><div>The mean age of the 14 patients (11 males and 3 females) was 38.6 ± 15.6 years (range, 18-71). Ten cases were defined as acute (RW types II: 1; III: 3; V: 6) and four as chronic (II: 1; III: 2; V: 1). On the injured side, the scapula showed more internal rotation (46.2° ± 5.3° vs. 42.1° ± 4.4°; <em>P</em> = .003), more scapular tilt (20.2° ± 4.6° vs. 17.9° ± 3.5°; <em>P</em> = .022), and less upward rotation (10.1° ± 3.6° vs. 12.0° ± 4.8°; <em>P</em> = .043). No difference between sides was found for scapular translation (<em>P</em> = .342) and scapular protraction (<em>P</em> = .385). There was a trend toward more internal rotation for RW type V injuries (<em>P</em> = .097).</div></div><div><h3>Conclusion</h3><div>In this first 3D in vivo study, patients with ACJ dislocations displayed changes in scapulothoracic orientation in all planes. The scapula of the injured side was more internally rotated, forwardly tilted, and less upwardly rotated than on the healthy contralateral side.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 646-650"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942595","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":"Risk factors related to loss of reduction after anatomic repair of acromioclavicular joint dislocation in patients with acute traumatic acromioclavicular joint dislocation","authors":"Adinun Apivatgaroon MD ,&nbsp;Sorachat Sukkarnkosol MD ,&nbsp;Natsuda Chua Pukrittayakamee MD ,&nbsp;Ratirat Limjumroonrat ,&nbsp;Supapitchaya Boonyongsunchai ,&nbsp;Warisra Watcharaporn","doi":"10.1016/j.jseint.2024.12.020","DOIUrl":"10.1016/j.jseint.2024.12.020","url":null,"abstract":"<div><h3>Background</h3><div>Suspension stabilization is a commonly used surgical method for acute acromioclavicular (AC) joint dislocation. However, a failure rate of around 26% caused various emerging surgical techniques and recommendations. We aimed to identify the significance of postulated factors relevant to the radiographic success of AC joint stabilization.</div></div><div><h3>Methods</h3><div>The data of patients with acute AC joint dislocation treated with suspension stabilization in our institution from January 2012 to December 2022 were reviewed. Zanca views x-ray films of both AC joints were reviewed including the preoperative, immediate postoperative, and final follow-up film. Failure of stabilization was classified by coracoclavicular distance, AC joint subluxation ratio, and AC joint widening. Factors of interest were age, type of injury classified by Rockwood, K-wire augmentation, over-reduction, clavicular tunnels osteolysis, tunnel position, AC ligament repair, the timing of surgery, and stabilization technique. Univariate and multivariate logistic regression analysis was done for the factors contributing to each failure mode.</div></div><div><h3>Results</h3><div>There were 57 patients included in the study. Multivariate logistic regression analysis showed that AC ligament repair was significantly related to the success of stabilization using coracoclavicular distance criteria (odd ratio [OR] 0.22, <em>P</em> = .04). Age older than 40 years significantly related to the success of stabilization using AC subluxation ratio and by any type of failure (OR 0.23, <em>P</em> = .02 and OR 0.20, <em>P</em> = .049). Other factors failed to show their significance by any mean of failure criteria.</div></div><div><h3>Conclusion</h3><div>AC ligament repair is related to the success of AC joint stabilization, while additional of K-wire augmentation, direct tunnel position, over-reduction, and earlier surgery could not show their significance in maintaining the reduction.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 625-631"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942591","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":"Arthroscopic labral repair and shoulder stabilization in National Hockey League players are associated with decreased performance in the first year of return to play with return to baseline in the second year","authors":"Emmitt Hayes MD ,&nbsp;J Whitcomb Pollock MD ,&nbsp;Bogdan A. Matache MD, CM, FRCSC ,&nbsp;Michael Pickell MD","doi":"10.1016/j.jseint.2024.12.015","DOIUrl":"10.1016/j.jseint.2024.12.015","url":null,"abstract":"<div><h3>Background</h3><div>Few studies have assessed performance in National Hockey League players following shoulder labral repair and stabilization using advanced statistics. Our objective was to assess National Hockey League player performance following shoulder labral repair and stabilization</div></div><div><h3>Methods</h3><div>National Hockey League players who underwent surgical procedures for labral repair and stabilization between 2008 and 2022 were identified using a publicly available injury database. We obtained demographic and outcome data for one-year preinjury and two years postinjury. Our primary outcome was wins above replacement per 60 minutes played (WAR/60). A matched cohort based on position, draft year, and index season performance was established. Outcomes were compared between cases and controls with a paired <em>t</em>-test.</div></div><div><h3>Results</h3><div>We identified 94 eligible patients who underwent shoulder labral repair or stabilization. Preinjury, postinjury year one, and postinjury year two WAR/60 were 0.03, 0.02, and 0.03 compared to 0.03, 0.06, and 0.05 in controls (<em>P</em> = .33, .00, .07, respectively). Offensive performance was lower both one and two years postinjury when compared to controls (<em>P</em> = .00, <em>P</em> = .01, respectively).</div></div><div><h3>Conclusions</h3><div>Shoulder labral tears and glenohumeral instability requiring surgical management are associated with decreased overall performance one year postsurgery with return to baseline by postinjury year two. Offensive performance remained decreased at the second postinjury year.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 3","pages":"Pages 607-610"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942683","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}