Shoulder and Elbow最新文献

{"title":"Epidemiology of acromioclavicular joint separations presenting to emergency departments in the United States between 2004 and 2023.","authors":"Peter Boufadel, Mohamad Y Fares, Mohammad Daher, Ryan Lopez, Adam Z Khan, Joseph A Abboud","doi":"10.1177/17585732251320015","DOIUrl":"10.1177/17585732251320015","url":null,"abstract":"<p><strong>Introduction: </strong>Acromioclavicular (AC) joint separation is a common injury that results from direct or indirect trauma to the shoulder. The purpose of this study was to explore the incidence, demographic variations, and injury mechanisms of AC joint separations in the United States from 2004 to 2023.</p><p><strong>Methods: </strong>The National Electronic Injury Surveillance System database was queried to identify all patients who visited participating emergency departments between 2004 and 2023 and were diagnosed with an AC joint separation. Examined variables included age, sex, year, and injury mechanisms. National injury estimates were calculated using sample weights. Annual incidence rates were calculated using U.S. Census population estimates.</p><p><strong>Results: </strong>A total of 4163 AC joint separations were recorded, representing an estimated 196,983 injuries. The overall incidence rate was 3.1 per 100,000 person-years. The highest incidence of AC joint separations was among patients aged 10 to 30 years (47.6%), and the majority of patients were male (83.9%). Sports-related injuries had a significantly greater incidence rate compared to transportation-related and fall-related injuries (p < 0.001). The most common injury mechanisms involved bicycles (15.9%), football (10.5%), stairs/steps (6.0%), and snowboarding (5.8%).</p><p><strong>Conclusion: </strong>The incidence of AC joint separations has increased over the past two decades, with the majority caused by sports-related and transportation-related injuries.<b>Level of Evidence:</b> III.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251320015"},"PeriodicalIF":1.5,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450505","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":"Stress shielding influences shoulder function after reverse shoulder arthroplasty using a short stem at minimum 2 years follow-up and can be predicted using a preoperative planning software: A retrospective cohort study.","authors":"Edoardo Franceschetti, Pietro Gregori, Alice Laudisio, Chiara De Andreis, Giovanni Perricone, Giancarlo Giurazza, Michele Paciotti, Umile Giuseppe Longo, Rocco Papalia","doi":"10.1177/17585732251314386","DOIUrl":"10.1177/17585732251314386","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to assess if 3D CT-scan-based planification of distal filling ratio (DFR) is accurate when compared to postoperative DFR calculated on plain X-rays. A secondary aim was to investigate if an association between clinical outcomes and the degree of stress shielding (SS) exists.</p><p><strong>Methods: </strong>Fifty patients with short-stem reverse shoulder arthroplasties, preoperative CT scans, and a minimum 24-month radiographic follow-up were included in the study. At 24 months follow-up, all patients were evaluated by assessing the postoperative filling ratios, the 3D DFRs, the simple shoulder test, Constant-Murley score, and visual analogue scale through a prospectively data collection and statistically analyzed.</p><p><strong>Results: </strong>A correlation between the 3D DFR and SS onset (r_s 0.54; <i>P</i> < 0.001), and between postoperative DFR and SS (r_s 0.71; <i>P</i> < 0.001), was found. The 3D DFR and the postoperative DFR were correlated (r_s 0.89; <i>P</i> < 0.0001). SS negatively affects the postoperative range of motion, decreasing the forward elevation of the shoulder.</p><p><strong>Conclusion: </strong>The calculation of DFR based on 3D CT planning is a good predictor of humeral SS after short-stem RTAs. The presence of SS decreases clinical outcomes by lowering the anterior elevation of the shoulder.</p><p><strong>Level of evidence: </strong>Case series.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251314386"},"PeriodicalIF":1.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383861","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":"Patterns of management for post-traumatic elbow stiffness: A comparative study of open and arthroscopic approaches.","authors":"Apurvakumar Patel, Kerollos G Ibrahim, Olamide Oshikoya, Matthew Conlon, Jason Epstein, Amir R Kachooei","doi":"10.1177/17585732251316466","DOIUrl":"10.1177/17585732251316466","url":null,"abstract":"<p><strong>Background: </strong>Post-traumatic elbow stiffness (PTES) often results in significant functional impairment. Open elbow arthrolysis (OEA) and arthroscopic elbow arthrolysis (AEA) are two surgical management options. This study aimed to compare the incidence, demographics, and treatment patterns of patients with PTES undergoing OEA and AEA from 2014 to 2023.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using the TriNetX database. Patients diagnosed with elbow stiffness (ICD-10 codes M25.621, M25.622, M25.629) were included. Rates of OEA (CPT 24149, 24006) and AEA (CPT 29837, 29838) were identified. Demographic characteristics and simultaneous surgical procedures were assessed.</p><p><strong>Results: </strong>A total of 30,624 patients were diagnosed with PTES, with 848 undergoing OEA (2.8%) and 361 undergoing AEA (1.2%). The mean age for OEA patients was 44.3 ± 17.6 years, while AEA patients had a mean age of 37.9 ± 18.9 years. OEA was more common in males (61.2%) and non-Hispanic/Latino patients (68.3%). AEA showed higher rates in younger patients and non-Hispanic/Latino individuals (72.7%).</p><p><strong>Discussion: </strong>The study highlights a preference for OEA in older patients with complex conditions, while AEA is more common in younger patients. Despite the growing trend toward minimally invasive techniques, OEA remains prevalent. Further research is needed to understand the drivers of these trends.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251316466"},"PeriodicalIF":1.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383859","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 rotator cuff repair with bioinductive patch achieves equivalent patient-reported outcomes and retear rate at 1 year.","authors":"Joshua P Castle, Johnny K Kasto, Eric X Jiang, Michael A Gaudiani, Trevor D Wolterink, Taylor Timoteo, Jacob Best, Shariff K Bishai, Patricia A Kolowich, Stephanie J Muh","doi":"10.1177/17585732251317954","DOIUrl":"10.1177/17585732251317954","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to evaluate the safety and efficacy of a bioinductive patch augmentation following arthroscopic rotator cuff repair (RCR) in terms of patient-reported outcomes, motion, and complications stratified by tear size.</p><p><strong>Methods: </strong>A retrospective review of patients undergoing primary RCR with and without bioinductive bovine collagen patch augmentation for supraspinatus/infraspinatus tears from 2014 to 2022 at two centers was performed. Exclusion criteria included: age <18 years, revisions, or lack of 6-month postoperative follow-up. Patients were propensity-score matched 2:1 to patch-augmented patients based on age, sex, BMI, and tear size. Outcomes were compared between the patch and control groups after being stratified by tear size.</p><p><strong>Results: </strong>A total of 125 patients patch augmented RCRs were matched to 250 controls. No significant differences in demographics or comorbidities between groups. Following stratification by tear size, VAS for partial and small/medium tears in the patch cohorts were lower (<i>p</i> = 0.02) at 3 months. Functional scores were not statistically different. Patch-augmented partial and small/medium tears showed increased forward elevation (<i>p</i> < 0.05) at 1-year follow-up. Retear rates were statistically similar.</p><p><strong>Conclusions: </strong>Bioinductive patch augmentation demonstrates equivalent outcomes for pain and function, retear rate, but is associated with improved forward elevation up to 1-year for partial and small/medium tears.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251317954"},"PeriodicalIF":1.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383858","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":"Response to the Letter-to-the-Editor by Dr H Duansuperwong and Prof. V Wiwanitkit.","authors":"Umar Ghilzai","doi":"10.1177/17585732251317590","DOIUrl":"10.1177/17585732251317590","url":null,"abstract":"","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251317590"},"PeriodicalIF":1.5,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11791947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256942","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":"ChatGPT and common shoulder pathology.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1177/17585732251317503","DOIUrl":"10.1177/17585732251317503","url":null,"abstract":"","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251317503"},"PeriodicalIF":1.5,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190805","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":"Shear wave elastography of the deltoid muscle in healthy volunteers - quantifying age-dependent normal values.","authors":"David V Ivanov, Jacob E Voelkel, Hugo Giambini, Joaquin Sanchez-Sotelo, Jaydev K Dave, Tobias Kummer","doi":"10.1177/17585732251315952","DOIUrl":"10.1177/17585732251315952","url":null,"abstract":"<p><strong>Introduction: </strong>Reverse shoulder arthroplasty (RSA) is performed for various shoulder pathologies. Inadequate tensioning of the deltoid muscle can lead to complications, highlighting the need for optimization. Preoperative quantification of deltoid health may improve operative execution and outcomes. Shear wave elastography (SWE) quantifies stiffness as a marker for muscle health and tensioning. This study establishes normal reference values for the deltoid in healthy individuals.</p><p><strong>Methods: </strong>40 participants were enrolled, 10 in each 18-30, 31-40, 41-55, and 55 + age groups. Two operators performed SWE in 3 deltoid regions, and the intra- and inter-operator agreement was assessed.</p><p><strong>Results: </strong>Mean values were 23.2 ± 4.6, 26.4 ± 5.6, and 17.9 ± 5.2 kPa for the anterior, lateral, and posterior regions. The posterior region did not show any age dependency. However, there were significant differences between the age groups of 18-30 and 55 + years in the anterior (19.7 ± 3.7 vs. 26.7 ± 5.3 kPa) and lateral (22.0 ± 5.4 vs. 30.2 ± 8.8 kPa). Intra-operator reliability ranged from 0.45 to 0.60, and inter-reader agreement from 0.57 to 0.85.</p><p><strong>Conclusion: </strong>This study provides reference values of deltoid stiffness which could serve as a comparison with clinical measurements for RSA operative planning and execution and prediction of surgical outcomes.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251315952"},"PeriodicalIF":1.5,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190808","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":"Life cycle assessment and optimisation of surgical instrument trays for reverse shoulder arthroplasty.","authors":"Isabella C Klarenbeek, Anne C van der Eijk, Esther Rc Janssen, Freek Hollman, Paul C Willems, Okke Lambers Heerspink","doi":"10.1177/17585732251315424","DOIUrl":"10.1177/17585732251315424","url":null,"abstract":"<p><strong>Objectives: </strong>Shoulder arthroplasty has a large environmental impact. Part of the environmental impact is caused by the sterilisation of surgical instruments. This study examines the effect of optimising surgical instrument trays for reverse shoulder arthroplasty (RSA), to reduce the environmental impact.</p><p><strong>Methods: </strong>An adjusted LEAN 5s method was used to optimise the number of instruments of shoulder arthroplasty specific trays. A Life Cycle Assessment was performed to calculate the CO₂-eq.</p><p><strong>Results: </strong>After careful selection, 139 of the 254 (55%) instruments were removed from the original RSA trays. Out of the 139 removed instruments, 19 were placed in a supplemental tray. The number of base trays was reduced with 3 trays. The estimated impact by reducing these trays from the standard pre-operative setup is a reduction of 28% of the environmental impact annually (524 kg CO₂ equivalent).</p><p><strong>Discussion: </strong>This study confirms the feasibility of optimising instrument trays for RSA, offering a straightforward method to reduce the environmental impact of shoulder arthroplasty. Our results show that strategic instrument selection can contribute to lowering the environmental impact of orthopaedic surgery.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251315424"},"PeriodicalIF":1.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080949","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":"Trends in anterior shoulder instability procedures over the last decade in the United States.","authors":"Akshar P Thakkar, Samuel G Reyes, Shaheen Jadidi, Sanjeev Bhatia, Aaron A Bare","doi":"10.1177/17585732241303874","DOIUrl":"10.1177/17585732241303874","url":null,"abstract":"<p><strong>Background: </strong>The treatment algorithm for traumatic shoulder instability has evolved, emphasizing the significance of glenoid bone loss and the glenoid track, addressing humeral, and glenoid vault bone deficiencies. This study examines trends and demographics of anterior shoulder instability procedures in the United States from 2010 to 2020.</p><p><strong>Methods: </strong>PearlDiver database was queried for patients who underwent traumatic anterior shoulder instability procedures. Student <i>t</i> and multiple regression analysis tests were used for statistical comparisons and trends analysis (<i>P </i>< 0.05 significant).</p><p><strong>Results: </strong>Arthroscopic anterior labral repair showed an annual decline of approximately 10% compared to the substantial growth of Latarjet coracoid transfer procedures in the first half of the decade (2010-2015), followed by a plateau in the second half (2016-2020). Arthroscopic anterior labral repair was most prevalent in the 15 to 19 age range, while Latarjet was most prevalent in the 20 to 24 age group. Latarjet procedures were three times more common in males than females, whereas arthroscopic anterior labral repairs occurred approximately twice as frequently in males compared to females.</p><p><strong>Discussion: </strong>Latarjet procedures showed a general increase in annual growth rate, while arthroscopic anterior labral repairs have consistently declined. Open anterior capsulorrhaphy with bone block, open capsular shift, and open capsulolabral repairs have shown a steady decrease in incidence.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241303874"},"PeriodicalIF":1.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059115","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":"The impact of preexisting psychiatric disorders on patient outcomes following primary total shoulder arthroplasty: A systematic review and quantitative synthesis.","authors":"Bryan Sun, Vetri Thangavelu, Rose Yakubov, Clare Sun, Moin Khan, Sumit Chaudhari, Ujash Sheth","doi":"10.1177/17585732251314130","DOIUrl":"10.1177/17585732251314130","url":null,"abstract":"<p><strong>Purpose: </strong>To summarize complication rates, reoperation rates, length-of-stay (LOS), patient-reported outcome measures (PROMs), and range of motion following total shoulder arthroplasty (TSA) in patients with preexisting psychiatric disorders (PDs) compared to controls.</p><p><strong>Methods: </strong>Three databases (MEDLINE, PubMed, and EMBASE) were searched from inception to 4 March 2024 to identify studies comparing outcomes between patients undergoing anatomic (aTSA) or reverse TSA (rTSA) with or without a preexisting psychiatric condition. The authors adhered to the preferred reporting items for systematic reviews and meta-analyses and revised assessment of multiple systematic review guidelines. Data on demographics, as well as postoperative complication rates, reoperation rates, LOS, PROMs, and range of motion were extracted from included studies. PROMs included the American Shoulder and Elbow Surgeons (ASESs) score, and visual analogue scale (VAS) pain score. Meta-analyses were conducted for outcomes reported by multiple studies, with odds ratios (ORs) and mean differences (MDs) as effect measures for continuous and dichotomous outcomes, respectively.</p><p><strong>Results: </strong>Thirteen studies were included in this review, comprising a total of 820,831 TSA patients. The PD group (71.0% female) consisted of 150,432 patients (mean age: 67.6 ± 9.9) with a mean follow-up time of 34.1 ± 30.1 months. The control group (58.1% female) consisted of 670,399 patients (mean age: 69.4 ± 10.7) with a mean follow-up time of 39.1 ± 36.0 months. The PD group had significantly higher rates of complications and reoperation. The PD group also reported significantly lower postoperative ASES scores, higher postoperative VAS scores, and inferior postoperative abduction. There were no significant differences in postoperative LOS, forward flexion, internal rotation, or external rotation.</p><p><strong>Conclusion: </strong>Patients with preexisting PDs may have a one-and-a-half times higher odds of postoperative complication or reoperation, as well as significantly worse postoperative pain and PROMs. Identification of at-risk individuals with preexisting psychiatric conditions and preoperative referral to a mental health specialist to optimize psychiatric conditions may benefit this patient cohort ahead of their shoulder arthroplasty procedure.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732251314130"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047926","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}