JSES International最新文献

{"title":"Functional impact and risk factors for humeral implant migration in stemless RSA","authors":"M. Antoni , G. Nourissat , M. Azar","doi":"10.1016/j.jseint.2025.101488","DOIUrl":"10.1016/j.jseint.2025.101488","url":null,"abstract":"","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101488"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147538881","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":"Shoulder arthroplasty following a previous Latarjet procedure","authors":"Matthias Biner MD,&nbsp;Bettina Hochreiter MD,&nbsp;Philipp Kriechling MD,&nbsp;Karl Wieser MD, eMBA","doi":"10.1016/j.jseint.2025.101609","DOIUrl":"10.1016/j.jseint.2025.101609","url":null,"abstract":"<div><h3>Background</h3><div>Shoulder arthroplasty in patients with prior Latarjet procedures is technically challenging due to altered anatomy and soft tissue changes. This study aimed to compare clinical outcome measures, complications, and implant survival in primary hemiarthroplasty (HA), anatomic total shoulder arthroplasty (aTSA), and reverse total shoulder arthroplasty (rTSA) in patients with previous Latarjet surgery vs. matched cohorts.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted including a total of 69 patients, comparing 23 post-Latarjet patients (4 HA, 6 aTSA, 13 rTSA) with a 2:1 matched control group. Outcomes included range of motion, functional scores (absolute and relative Constant-Murley Score [aCS and rCS], Subjective Shoulder Value), complications, revisions, and radiographic findings. Kaplan–Meier survival analysis evaluated reintervention-free survival.</div></div><div><h3>Results</h3><div>Demographics were not significantly different between the post-Latarjet and matched cohorts. Patients who underwent HA following a Latarjet demonstrated significantly less improvement in flexion (Δ −10° vs. 50°), abduction (Δ 5° vs. 70°), and external rotation (Δ −15° vs. 30°) compared to their matched controls (all <em>P</em> &lt; .05). Moreover, the improvement in aCS was significantly lower in the post-Latarjet HA group (13.5 vs. 36 points; <em>P</em> = .042). In the rTSA subgroup, flexion improvement was also significantly reduced in post-Latarjet patients compared to the matched cohort (Δ −10° vs. 37.5°; <em>P</em> = .018). Other functional outcomes (aCS, rCS, Subjective Shoulder Value) were comparable across groups. Complication rates were 75% (HA), 33.3% (aTSA), and 15.4% (rTSA) in the post-Latarjet group, compared to 25% (HA), 33.3% (aTSA), and 11.5% (rTSA) in the matched cohorts. Reintervention-free survival at 60 months was lowest for HA (25%), intermediate for aTSA (66.7%), and highest for rTSA (84.6%), with rTSA showing significantly better survival than HA (<em>P</em> = .009).</div></div><div><h3>Conclusion</h3><div>While clinical outcomes were largely comparable between post-Latarjet patients and matched cohorts, rTSA may offer the most reliable results with lower complication and revision rates than aTSA and HA. It appears to be the preferred option in this complex setting, although post-Latarjet patients showed reduced range of motion.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101609"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Humeral head in rotator cuff tear arthropathy shows reduced cartilage damage and uniform subchondral bone osteoporosis: a histomorphometric analysis","authors":"Shingo Maesako MD ,&nbsp;Takashi Tasaki MD, PhD ,&nbsp;Kohei Uekama MD ,&nbsp;Seiya Yokoyama PhD ,&nbsp;Shingo Maeda MD, PhD ,&nbsp;Ikumi Kitazono MD, PhD ,&nbsp;Noboru Taniguchi MD, PhD ,&nbsp;Akihide Tanimoto MD, PhD","doi":"10.1016/j.jseint.2025.101435","DOIUrl":"10.1016/j.jseint.2025.101435","url":null,"abstract":"<div><h3>Background</h3><div>This study histologically assessed alterations in the articular cartilage, subchondral bone, and trabecular bone in patients with rotator cuff tear arthropathy (CTA) versus those with osteoarthritis (OA) of the humeral head.</div></div><div><h3>Methods</h3><div>This retrospective study evaluated 59 humeral heads (37 CTA and 22 OA cases) resected during shoulder arthroplasty and 7 shoulder specimens from cadaveric controls. Bone density was evaluated by computed tomography. Histological evaluations were analyzed semiquantitatively for Osteoarthritis Research Society International scores, articular cartilage thickness, subchondral bone plate thickness, and trabecular bone mass and distribution, using standard staining techniques.</div></div><div><h3>Results</h3><div>CTA cases showed significantly lower Hounsfield units in the trabecular and metaphyseal bones on the affected side than on the healthy side. In contrast, no significant difference in Hounsfield units was observed in OA cases. A histological analysis showed lower Osteoarthritis Research Society International scores in CTA than in OA, which indicated moderate cartilage degeneration. Subchondral trabecular bone in CTA cases was uniformly thinned, whereas OA cases showed variable trabecular morphology, with areas of both thickening and thinning. Consequently, the humeral head bone volume was smaller in CTA than in OA.</div></div><div><h3>Conclusion</h3><div>CTA is characterized by moderate cartilage degeneration and uniform subchondral trabecular bone loss, which may underlie complications associated with reverse shoulder arthroplasty. These findings may serve as a foundation for further studies of appropriate surgical strategies and preoperative interventions for osteoporosis.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101435"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079044","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":"Efficacy of 3D-printed surgical guides in the correction of pediatric cubitus varus deformity: a systematic review and meta-analysis","authors":"Omid Salkhori MD ,&nbsp;Nima Bagheri MD ,&nbsp;Seyyed Saeed Khabiri MD ,&nbsp;Aidin Arabzadeh MD ,&nbsp;Seyyed Hadi Kalantar MD ,&nbsp;Elham Poorghasem MD ,&nbsp;Pouya Tabatabei Irani MD ,&nbsp;Alireza Talebi MD ,&nbsp;Seyed Mohammadjavad Mortazavi MD ,&nbsp;Hamed Naghizadeh MD","doi":"10.1016/j.jseint.2025.101604","DOIUrl":"10.1016/j.jseint.2025.101604","url":null,"abstract":"<div><h3>Background</h3><div>Cubitus varus is a frequent post-traumatic deformity in children, typically resulting from malunion of supracondylar humeral fractures. Despite the availability of various osteotomy techniques, achieving precise and reproducible correction remains challenging. Recently, 3-dimensional (3D) printing–guided osteotomy has gained attention for improving surgical accuracy and outcomes. This study aimed to systematically evaluate the clinical effectiveness and safety of 3D-guided corrective osteotomy in pediatric cubitus varus in comparison with conventional surgical techniques.</div></div><div><h3>Methods</h3><div>We performed a systematic review and meta-analysis of studies published between 2000 and 2025 that investigated the use of 3D printing–assisted, patient-specific instrumentation in corrective osteotomy for pediatric cubitus varus. Databases searched included PubMed, Scopus, and Web of Science. Both single-arm and comparative studies reporting clinical, radiographic, and operative outcomes were included. Methodological quality was assessed using the Methodological Index for Non-Randomized Studies (MINORs) criteria.</div></div><div><h3>Results</h3><div>Twelve studies involving 206 pediatric patients were included, comprising 2 prospective and 10 retrospective studies. In the single-arm meta-analysis, 81.9% of patients achieved excellent outcomes, with a pooled complication rate of 7.8%. A comparative analysis revealed a significantly higher likelihood of excellent outcomes in the 3D group compared to conventional techniques (risk ratio = 1.33; 95% confidence interval: 1.05-1.69), while complication rates and humerus–elbow–wrist angle correction were similar between the groups.</div></div><div><h3>Conclusion</h3><div>3D printing–guided corrective osteotomy appears to offer high success rates and low complication rates in treating pediatric cubitus varus, with potential advantages over conventional techniques. Further prospective studies are needed to confirm these findings and guide clinical adoption.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101604"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356281","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":"Length ratios of the distal triceps tendon: an anatomical study for the assessment of tendon length in chronic defect situations","authors":"Christopher Wahlers Dr med ,&nbsp;Kai Hoffeld Dr med ,&nbsp;Martin Scaal Prof Dr rer nat ,&nbsp;Tim Leschinger PD, Dr med ,&nbsp;Lars Peter Müller Prof Dr med ,&nbsp;Michael Hackl Prof Dr med","doi":"10.1016/j.jseint.2025.101434","DOIUrl":"10.1016/j.jseint.2025.101434","url":null,"abstract":"<div><h3>Background</h3><div>Chronic triceps tendon ruptures are rare but challenging to treat due to limited muscle mobilization and difficulty in accurately assessing tendon length. Proper tendon length restoration is essential for maintaining physiological muscle tension, as excessive tendon length may lead to weakness and extension lag with reduced functional stability during elbow extension, whereas insufficient length can restrict elbow flexion and alter joint kinematics. This study aimed to examine the length ratios of the distal triceps tendon and aponeurosis in relation to bony landmarks to provide an intraoperative reference for tendon length assessment in chronic defect situations.</div></div><div><h3>Methods</h3><div>A total of 54 embalmed cadaveric upper limbs (male: 54%, female: 46%) were dissected. The following anatomical parameters were measured: the length of the distal triceps tendon from the olecranon (OL) tip to the musculotendinous junction, the lengths of the medial and lateral distal triceps aponeurosis, the length of the ulna (UL) and radius (RA), and the width of the OL and the distal humerus (intercondylar width). Pearson correlation coefficients were used to analyze relationships between tendon/aponeurosis lengths and bony landmarks.</div></div><div><h3>Results</h3><div>The mean length of the distal triceps tendon was 40 ± 15 mm, while the medial and lateral triceps aponeurosis measured 150 ± 17 mm and 115 ± 18 mm, respectively. Moderate correlations were observed between the distal triceps tendon length and both the width of the distal humerus (r = 0.42, <em>P</em> = .002) and the width of the OL (r = 0.36, <em>P</em> = .007). The lateral aponeurosis length showed strong correlations with UL length (r = 0.64, <em>P</em> &lt; .001), RA length (r = 0.54, <em>P</em> &lt; .001), and distal humerus width (r = 0.51, <em>P</em> &lt; .001), while a moderate correlation was found with OL width (r = 0.41, <em>P</em> = .002). The medial aponeurosis length strongly correlated with the OL width (r = 0.54, <em>P</em> &lt; .001) and UL length (r = 0.52, <em>P</em> &lt; .001), and moderately with the RA length (r = 0.49, <em>P</em> &lt; .001) and distal humerus intercondylar width (r = 0.44, <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>This study demonstrates that the lateral aponeurosis length correlates strongly with UL length, making it a particularly reliable reference for estimating the physiological triceps length in chronic defect situations. These findings provide an important anatomical basis for achieving precise triceps length restoration, which is essential for optimal clinical outcomes in reconstructive surgery.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101434"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189122","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":"Electromyography analysis of rotator cuff activation while driving","authors":"Megan C. Paulus MD ,&nbsp;Brent B. Wiesel MD ,&nbsp;Lauren W. Bierman MD ,&nbsp;Tom C. Galetti BA ,&nbsp;Shaan S. Nagda ,&nbsp;Kevin F. Fitzpatrick MD ,&nbsp;Sameer H. Nagda MD","doi":"10.1016/j.jseint.2025.101411","DOIUrl":"10.1016/j.jseint.2025.101411","url":null,"abstract":"<div><h3>Background</h3><div>A common concern of patients after rotator cuff repair is when they can drive. The purpose of this study is to evaluate the activation of the rotator cuff while driving to help guide surgeon recommendations.</div></div><div><h3>Methods</h3><div>A computerized driving simulator was used by 16 volunteers who performed a series of turns with their hands in different positions on the steering wheel. Muscle activity of the supraspinatus, infraspinatus, and biceps was recorded using electromyography. Muscle activity was also recorded while closing the door, fastening the seat belt, and turning a key in the ignition and quantified by a board-certified electromyographer.</div></div><div><h3>Results</h3><div>For the right supraspinatus, infraspinatus, and biceps muscles, there was statistically significant higher level of activation when the right hand was in the 12 o'clock position and the 3 o'clock position as compared with the 6 o'clock positions. This was the same for the left side with the left hand in the 12 o'clock and 9 o'clock positions compared to the 6 o'clock positions (<em>P</em> &lt; .003). Activity of all muscles was minimal when the car door was closed with the opposite hand. Fastening the seat belt and turning the key in the ignition also demonstrated rotator cuff activation.</div></div><div><h3>Conclusion</h3><div>Rotator cuff activity during driving can be minimized by closing the door using the nonoperative arm and driving with the nonoperative arm in the 12 o'clock position with the operative arm at the side and holding the wheel at the 6 o'clock position.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101411"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941248","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 of sarcopenia with surgical outcomes and complications following reverse total shoulder arthroplasty: a matched cohort study with comparative analysis against anatomic total shoulder arthroplasty","authors":"Majd Mzeihem MD ,&nbsp;Ali Rteil MD, Msc ,&nbsp;Roma Fe Mabanag MD ,&nbsp;Jason Koh MD ,&nbsp;Farid Amirouche PhD","doi":"10.1016/j.jseint.2025.101431","DOIUrl":"10.1016/j.jseint.2025.101431","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenia, defined as age-related loss of skeletal muscle mass and function, has been linked to poor outcomes postoperatively. While anatomic total shoulder arthroplasty (aTSA) relies on rotator cuff integrity, reverse total shoulder arthroplasty (rTSA) depends primarily on deltoid function. This retrospective cohort study aims to evaluate the association of sarcopenia with postoperative outcomes following total shoulder arthroplasty.</div></div><div><h3>Methods</h3><div>This study utilized TriNetX to analyze data from a cohort of 24,566 patients who underwent total shoulder arthroplasty. One-to-one exact matching was done to control variables across the control rTSA, sarcopenia rTSA, and sarcopenia aTSA cohorts. Postoperative outcomes were assessed at 3 and 6 months and at 1, 2, and 3 years. Independent <em>t-</em>tests and chi-square analyses were done for continuous and categorical variables.</div></div><div><h3>Results</h3><div>Postoperatively the sarcopenic rTSA group demonstrated significantly higher odds of surgical complications (odds ratio [OR]: 2.22, <em>P</em> = .03 at 3 months; OR: 1.87, <em>P</em> = .06 at 6 months) and pain (OR: 2.22, <em>P</em> &lt; .001 at 3 months; OR: 2.34, <em>P</em> &lt; .001 at 6 months), as well as prosthetic joint infection (<em>P</em> = .002 at 3 months), postoperative blood transfusion (OR: 2.10, <em>P</em> = .03 at 3 months), and readmission (OR: 1.68, <em>P</em> &lt; .001 at 3 months). By 1 year, the sarcopenic group also showed significantly higher odds of revision (OR: 1.25, <em>P</em> = .04) and postoperative opioid abuse/dependence (OR: 2.46, <em>P</em> = .004 at 1 year). Notably, sarcopenic rTSA patients had increased rates of prosthetic complications at 3 years (OR: 1.54, <em>P</em> = .002). Overall, no significant differences in complication rates were observed between sarcopenic patients undergoing rTSA and aTSA, with both procedures demonstrating comparable outcomes through two years.</div></div><div><h3>Conclusion</h3><div>Sarcopenia has been identified as a significant factor affecting patient outcomes following shoulder arthroplasty. Sarcopenic patients demonstrated higher rates of surgical complications, pain, prosthetic joint infection, postoperative blood transfusion, and readmission, as well as long-term complications and higher odds of revision, postoperative opioid abuse, and prosthetic complications. The slightly higher early complication rates in the rTSA sarcopenic cohort compared to the aTSA sarcopenic cohort may be attributable to patients selected for rTSA being generally more comorbid rather than to the procedure itself. Given that sarcopenia has been associated with adverse postoperative outcomes, early identification and further investigation into targeted postoperative interventions may help clarify its potential role in recovery.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101431"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078861","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 for new-onset anxiety and depression after arthroscopic shoulder stabilization surgery","authors":"David C. Lutati BS,&nbsp;Jane C. Brennan MS,&nbsp;Andrea H. Johnson MSN, CRNP,&nbsp;Matthew A. Peterman DO,&nbsp;Daniel E. Redziniak MD,&nbsp;Cyrus J. Lashgari MD,&nbsp;Justin J. Turcotte PhD, MBA","doi":"10.1016/j.jseint.2025.101413","DOIUrl":"10.1016/j.jseint.2025.101413","url":null,"abstract":"<div><h3>Background</h3><div>Shoulder instability is a common shoulder pathology, especially in young athletes involved in contact sports, sometimes requiring surgical intervention. In this retrospective database study, we aimed to identify the incidence of new-onset anxiety or depression (NOAD) after arthroscopic shoulder stabilization surgery, identify risk factors for the development of NOAD, evaluate the effect of NOAD on postoperative complications, and examine whether psychiatric interventions have a protective effect against adverse outcomes.</div></div><div><h3>Methods</h3><div>A retrospective analysis of the PearlDiver national database was completed. Included patients had no prior diagnosis of depression/anxiety or prior utilization of antidepressant medication before shoulder stabilization surgery and had at least 1 year of postoperative follow-up. The primary outcome was the development of NOAD within 1 year postoperatively. Multivariate logistic regression was used to assess predictors of NOAD. Postoperative outcomes were compared between patients who did and did not develop NOAD after propensity score matching. A subgroup comparison of outcomes across various NOAD treatments was performed.</div></div><div><h3>Results</h3><div>Of the 38,388 patients, 1,950 (5.1%) were diagnosed with NOAD within 1 year postoperatively. Increased age (odds ratio [OR]: 0.98, 95% confidence interval [CI]: 0.98-0.98; <em>P</em> &lt; .001), increased Charlson Comorbidity Index score (OR: 1.07, 95% CI: 1.01-1.12; <em>P</em> = .012), female sex (OR: 1.72, 95% CI: 1.56-1.89; <em>P</em> &lt; .001), hypermobility (OR: 2.17, 95% CI: 1.33-3.38; <em>P</em> = .001), headaches/migraines (OR: 1.33, 95% CI: 1.20-1.47; <em>P</em> &lt; .001), obesity (OR: 1.49; 95% CI: 1.31-1.70; <em>P</em> &lt; .001), preoperative opioid use (OR: 3.68, 95% CI: 3.34-4.05; <em>P</em> &lt; .001), tobacco use (OR: 2.25, 95% CI: 1.99-2.53; <em>P</em> &lt; .001), and alcohol disorders (OR: 2.13, 95% CI: 1.70-2.64; <em>P</em> &lt; .001) were all associated with a higher risk of developing NOAD. Postoperatively, the NOAD group had a 9.52 times increased risk of 90-day readmission (<em>P</em> &lt; .001), a 1.58-times increased risk of prolonged opioid use (<em>P</em> &lt; .001) at 1 year, increased total cost ($11,107 ± 12,317 vs. $7,695 ± 8,840; <em>P</em> &lt; .001), and a 1.48-times increased risk of revision at 2 years (<em>P</em> &lt; .001). Patients with NOAD undergoing psychotherapy had lower rates of postoperative opioid use.</div></div><div><h3>Conclusion</h3><div>The postoperative development of NOAD is an understudied but relatively common complication of arthroscopic shoulder stabilization surgery, occurring in approximately 5% of patients. The current study highlights a variety of risk factors that may be used to identify at-risk patient populations. Further work is needed to identify interventions that can mitigate the adverse outcomes associated with NOAD.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101413"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of reverse shoulder arthroplasty and glenohumeral arthrodesis for end-stage shoulder instability","authors":"Ayham Jaber MD ,&nbsp;Tyler J. Uppstrom MD ,&nbsp;Marilee P. Horan MPH ,&nbsp;Christopher J. Hawryluk MBS ,&nbsp;Yazan Jaber MD ,&nbsp;Matthew T. Provencher MD, MBA ,&nbsp;Peter J. Millett MD, MSc","doi":"10.1016/j.jseint.2025.101429","DOIUrl":"10.1016/j.jseint.2025.101429","url":null,"abstract":"<div><h3>Hypothesis</h3><div>End-stage multidirectional recurrent shoulder instability (RSI) that is unresponsive to nonoperative treatment is a puzzling pathology, with no consensus on standard of care. The purpose is to report and compare outcomes of glenohumeral arthrodesis (GHA) and reverse total shoulder arthroplasty (rTSA). We hypothesized that both treatment options would be acceptable, but rTSA patients would have better function and higher patient satisfaction.</div></div><div><h3>Methods</h3><div>Patients who underwent primary GHA or rTSA for isolated RSI by a single surgeon were included. Failure was defined as a conversion surgery or major component exchange. Patient-reported outcome measures (American Shoulder and Elbow Surgeons, Single Assessment Numerical Evaluation, Quick Disabilities of the Arm, Shoulder and Hand, 12-item Short Form) were assessed preoperatively and postoperatively. Persistent instability and patient satisfaction were reported.</div></div><div><h3>Results</h3><div>Thirteen shoulders in 11 patients with end-stage RSI underwent either GHA (n = 8) or rTSA (n = 5) with a mean age was 29.7 ± 11.8 years. Ehlers-Danlos syndrome was present in 5 patients. Follow-up rate was 93% (12/13). One GHA patient required conversion to rTSA. One GHA patient underwent hardware removal and a varus-producing osteotomy for scapular pain. No persistent instability was reported. No significant differences were found in demographics or preoperative patient-reported outcomes. American Shoulder and Elbow Surgeons (GHA: 64.4 ± 15.4; rTSA: 89.6 ± 12.6, <em>P</em> = .016) and Single Assessment Numerical Evaluation (GHA: 60 ± 24; rTSA: 85.2 ± 20.9, <em>P</em> = .040) scores were higher at follow-up in the rTSA group. Quick Disabilities of the Arm, Shoulder and Hand scores were significantly lower (<em>P</em> = .026) in the rTSA group, indicating less disability. Both groups reported high median satisfaction on a 1–10 scale [GHA: 8 (range: 3–10), rTSA: 10 (range: 5–10), <em>P</em> = .156].</div></div><div><h3>Conclusion</h3><div>rTSA and GHA are viable options in treating end-stage RSI. rTSA resulted in better function and lower revision surgery rates, suggesting rTSA provides better shoulder mobility while maintaining stability.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101429"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079042","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":"Subcutaneous tissue disinfection is more effective than the use of electrocautery in reducing Cutibacterium acnes burden in open shoulder surgery","authors":"Nicolas Gallusser MD ,&nbsp;Bertrand Léger PhD ,&nbsp;Caroline Passaplan MD ,&nbsp;Stéphane Emonet MD ,&nbsp;Beat Kaspar Moor PD","doi":"10.1016/j.jseint.2025.101408","DOIUrl":"10.1016/j.jseint.2025.101408","url":null,"abstract":"<div><h3>Background</h3><div><em>Cutibacterium acnes</em> (<em>C</em>. <em>acnes</em>) is a pathogen linked to infections following shoulder surgery. Exposure can occur during surgical dissection and spread in the surgical field through the surgeon's gloves and instruments. Disinfection of the subcutaneous tissue has been shown to reduce its contamination. No evidence has been provided for a decrease in the transmission rate when the dissection is performed with an electrocautery. The aim of this study was to ascertain whether disinfection of subcutaneous tissue can reduce the <em>C</em>. <em>acnes</em> rate in primary open shoulder surgery in comparison with dissection performed with electrocautery. We also wanted to compare the contamination rate of the operating field after electrocautery dissection with those found in the literature.</div></div><div><h3>Methods</h3><div>All patients who qualified for primary open shoulder surgery via a deltopectoral approach were prospectively included in our single-blinded, two-arm randomized clinical trial. For every patient, a skin swab from the surgical area was taken before the standard preparation of the skin. In the disinfection group, the subcutaneous layer was treated with povidone iodine solution after exposure of the deltoid fascia. The cautery group underwent subcutaneous tissue dissection using an electrocautery. After fully exposing the proximal humerus, 5 swabs were collected from various locations for microbiological analysis, following a rigorous protocol. All cultures were incubated for 14 days under both aerobic and anaerobic conditions.</div></div><div><h3>Results</h3><div>Between February 2020 and July 2021, 210 shoulders were enrolled in 2 groups (140 disinfection vs. 70 cautery). The 2 groups showed no significant differences in terms of sex, age, body mass index, or diabetes prevalence. The subcutaneous disinfection protocol led to a significant decrease in the overall positive culture rate of the operating field for all bacteria (<em>P</em> = .001) and specifically for <em>C</em>. <em>acnes</em> (<em>P</em> = .021). The reduction of positive swabs for <em>C</em>. <em>acnes</em> was significant for both the surgeon's gloves (<em>P</em> = .004) and for the subcutaneous tissue (<em>P</em> = .009). <em>C</em>. <em>acnes</em> contamination rate was noted in 26% of patients in the electrocautery group and 13% in the disinfection group after exclusion of the outside scalpel blade sample, which was removed from the scrub nurse's instrument table and therefore no longer used during the procedure.</div></div><div><h3>Conclusion</h3><div>Disinfection of the subcutaneous tissue reduces the contamination rate of <em>C</em>. <em>acnes</em> by a factor of 2 during open shoulder surgery compared with an approach performed with electrocautery and could limit the contamination of the operating field.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101408"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904067","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}