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
{"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}
David V Ivanov, Jacob E Voelkel, Hugo Giambini, Joaquin Sanchez-Sotelo, Jaydev K Dave, Tobias Kummer
{"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}
Isabella C Klarenbeek, Anne C van der Eijk, Esther Rc Janssen, Freek Hollman, Paul C Willems, Okke Lambers Heerspink
{"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 CO<sub>2</sub>-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 CO<sub>2</sub> 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}
Akshar P Thakkar, Samuel G Reyes, Shaheen Jadidi, Sanjeev Bhatia, Aaron A Bare
{"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}
Bryan Sun, Vetri Thangavelu, Rose Yakubov, Clare Sun, Moin Khan, Sumit Chaudhari, Ujash Sheth
{"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}
Christopher W Haff, Justin T Childers, Jessica M Forbes, Benjamin T Lack, Garrett R Jackson, Vani J Sabesan
{"title":"Gender influence on career trajectory as a shoulder and elbow surgeon.","authors":"Christopher W Haff, Justin T Childers, Jessica M Forbes, Benjamin T Lack, Garrett R Jackson, Vani J Sabesan","doi":"10.1177/17585732241310513","DOIUrl":"10.1177/17585732241310513","url":null,"abstract":"<p><strong>Background: </strong>Women continue to make up a minority of orthopedic surgeons, especially shoulder and elbow surgeons. There exists no study that investigates the effect of gender on one's academic career as a shoulder and elbow orthopedic surgeon, which was the purpose of this cross-sectional study.</p><p><strong>Methods: </strong>The American Shoulder and Elbow Surgeons website was used to identify surgeons. Demographics, education, and current professional roles were obtained using the websites of institutions, hospital employers, physicians, LinkedIn, and Doximity. Research productivity metrics were obtained using SCOPUS and Google Scholar. Outcome measures included current academic/leadership roles, and research productivity. Statistical analysis was performed using the Chi-squared test and Mann-Whitney <i>U</i> test.</p><p><strong>Results: </strong>Totally, 893 surgeons were identified, 60 being female (6.7%). Males had a significantly higher average <i>h</i>-index (<i>P </i>= 0.003), total number of publications (<i>P </i>= 0.019), citations (<i>P </i>= 0.03) and ASES membership ranks than female surgeons (<i>P </i>= 0.037; <i>P </i>= 0.004). There were no significant differences between genders in current professional or leadership roles.</p><p><strong>Discussion: </strong>Female surgeons had a significantly lower number of citations, publications, and <i>h</i>-index but equal leadership positions such as fellowship director, residency director, chief of service, and department chair compared to their male counterparts.</p><p><strong>Level of evidence: </strong>Level III, cross-sectional study.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241310513"},"PeriodicalIF":1.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047921","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}
Brandon T Fisher, Alexander Cm Chong, Kevin P Feltz, Howard T Berglund, Jason L Hurd
{"title":"Outcomes of utilizing double-incision technique with combination of cortical button and interference screw fixation for distal biceps rupture: A case series.","authors":"Brandon T Fisher, Alexander Cm Chong, Kevin P Feltz, Howard T Berglund, Jason L Hurd","doi":"10.1177/17585732241312212","DOIUrl":"10.1177/17585732241312212","url":null,"abstract":"<p><strong>Background: </strong>Distal biceps tendon rupture is an injury that causes a significant reduction in strength and endurance. Combined cortical button and interference screw fixation has been utilized via single-incision technique. There are limited data describing this technique utilizing a double-incision approach. This study describes patient outcomes for primary distal biceps repair with combined cortical button and interference screw fixation via double-incision approach.</p><p><strong>Methods: </strong>This is a case series analysis of patients within a single Midwest institution between January 2006 and February 2020. We examined patient demographics, intraoperative efficiency variables, patient outcomes, and postoperative complications.</p><p><strong>Results: </strong>Sixty-two cases were included (62 males; 44 acute complete ruptures, 1 acute partial rupture, 8 chronic complete ruptures, 9 chronic partial ruptures). Average operative time was 48 ± 23 min. Nonformal manner postoperative range of motion (ROM) results show 89%-92% within satisfactory elbow ROM parameters. There were two reported postoperative complications, but no instances of neurapraxia, wound dehiscence, synostosis, proximal radius fracture, or fixation failure.</p><p><strong>Conclusion: </strong>The findings of this study demonstrate that the described technique is safe, reliable, and effective. This will help surgeons determine the best method of fixation and approach with the goal of minimizing postoperative complications in patients with distal biceps ruptures.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241312212"},"PeriodicalIF":1.5,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047922","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}
Felipe de Souza Serenza, Marília Manuella Simões Augusto Rizzato, Fernando Vieira, Kevin James McQuade, Anamaria Siriani de Oliveira
{"title":"Assessment of upper extremity functional capacity in following osteosynthesis for upper limb fractures using a novel method for determining total reachable workspace.","authors":"Felipe de Souza Serenza, Marília Manuella Simões Augusto Rizzato, Fernando Vieira, Kevin James McQuade, Anamaria Siriani de Oliveira","doi":"10.1177/17585732241313363","DOIUrl":"10.1177/17585732241313363","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess reachable workspace (RWS) in patients post-osteosynthesis of shoulder, elbow, or wrist fractures and explore correlations with self-reported function and kinesiophobia.</p><p><strong>Design: </strong>An observational case-control study compared patients with fractures to a control group, utilizing questionnaires and 3D kinematic data.</p><p><strong>Participants: </strong>The sample included 66 individuals who had undergone osteosynthesis: 21 with shoulder fractures, 10 with elbow fractures, and 22 with wrist fractures. A control group of 23 participants without upper limb pathologies was also established. Inclusion criteria were ages 18-80 and recent surgery; exclusions were previous upper limb surgeries, cervical pathologies, systemic diseases or nerve injuries.</p><p><strong>Main outcome measure: </strong>RWS, the three-dimensional volume the hand can reach, was measured with participants standing. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia (TKS), and physical disability and pain were measured using the DASH questionnaire and the Numeric Pain Rating Scale (NPRS).</p><p><strong>Results: </strong>Fracture groups exhibited significant RWS reductions (62-85%) compared to the control group, with no significant differences among the fracture types. RWS showed a high correlation with TKS (R = 0.77) and a moderate correlation with DASH (R = 0.52).</p><p><strong>Conclusion: </strong>RWS is a promising biomechanical parameter for assessing upper limb function post-fracture, aiding in refining rehabilitation protocols.</p>","PeriodicalId":36705,"journal":{"name":"Shoulder and Elbow","volume":" ","pages":"17585732241313363"},"PeriodicalIF":1.5,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030022","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}