Archives of Bone and Joint Surgery-ABJS最新文献

{"title":"A Comparative Prospective Study Between Ligamentotaxis Versus Volar Plating in Displaced Intra-articular Fractures of Distal End Radius in Adults.","authors":"Sai Krishna Mada, Krishna Chaitanya Reddy Y, Siva Sai Kumar Reddy, Govardhan Reddy G","doi":"10.22038/ABJS.2025.87939.3982","DOIUrl":"10.22038/ABJS.2025.87939.3982","url":null,"abstract":"<p><strong>Objectives: </strong>The objectives of the study are to compare the efficacy of external fixator/ligamentotaxis and volar plating in the treatment of displaced intra-articular distal end radius fracture by comparing the functional outcome using the Green and O'Brien score and to assess the radiological outcome of displaced intra-articular distal end radius fracture treated with external fixator/ligamentotaxis and volar plate.</p><p><strong>Methods: </strong>This randomized study was done on 70 patients from August 2022 to May 2024 at GIMSR Medical College and Hospital. We enrolled 35 patients in the volar plating and 35 patients in the external fixation groups. Functional outcomes were assessed at 3 and 6 months using Cooney modification of Green and O'Brien scores, and radiological outcomes were evaluated using Sarmiento radiological score.</p><p><strong>Results: </strong>By 6 months, both groups had comparable functional outcomes. The volar plating group achieved excellent results in 71.4% of cases, compared to 48.5% in the external fixation group. Radiological parameters like palmar tilt, radial shortening, and deviation showed no significant differences. Complications were similar between groups. Superficial pin tract infections were found to be common in the external fixation group and surgical site infections in the volar plating group.</p><p><strong>Conclusion: </strong>Volar plating provided superior early functional outcomes, particularly in grip strength; however, both methods show comparable long-term results. Treatment choice should consider patient-specific factors, including bone quality and the need for early mobilization.</p><p><strong>Level of evidence: </strong>I.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 9","pages":"590-596"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13596990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026464","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":"Pelvico-Sacro-L1 Angle: An Index for Rapid Evaluation of Spinopelvic Sagittal Balance.","authors":"Mohammad Ayati Firoozabadi, Mohammadreza Razzaghof, Sina Esmaeili, Mohammad Zarei, Hesan Rezaee, Hamed Naghizadeh, Alireza Moharrami, Sm Javad Mortazavi","doi":"10.22038/ABJS.2025.84981.3868","DOIUrl":"10.22038/ABJS.2025.84981.3868","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the Pelvico-Sacro-L1 angle (PSLA) as a direct parameter for assessing PI-LL mismatch as a key determinant of sagittal balance.</p><p><strong>Methods: </strong>In this retrospective study, adult patients scheduled for total hip arthroplasty (THA) underwent spinopelvic lateral radiography. The pelvic sagittal line angle (PSLA) was defined as the angle between a line drawn from the center of the femoral head to the center of the superior endplate of S1 and the superior endplate of L1. The deviation from 90° was termed the modified PSLA, proposed as an alternative to the pelvic incidence-lumbar lordosis (PI-LL) mismatch. Two independent orthopaedic surgeons measured the spinopelvic parameters and repeated the assessments four weeks later to evaluate intraobserver reliability.</p><p><strong>Results: </strong>A total of 92 patients (average age: 57.4 ± 9.9 years, 50 females) were included. The Bland-Altman plot indicated no significant systematic difference between the two measurement sets, suggesting good agreement between methods. The intraclass correlation coefficient (ICC) for PSLA in both inter- and intraobserver reliability was greater than 0.9, indicating excellent agreement.</p><p><strong>Conclusion: </strong>The PSLA demonstrated a strong agreement with the PI-LL mismatch, confirming the reliability of this approach, which provides a more straightforward and easily interpretable measurement.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 6","pages":"394-400"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654281","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":"Epidural Gel-Foam Impregnated with Bupivacaine versus Paravertebral Intramuscular Bupivacaine for Postoperative Analgesia in Lumbar Spine Surgery: A Comparative Clinical Trial.","authors":"Peyman Gholipour, Chou-Yi Hsu, Ali Akbar Nasiri, A K Kareem, Abdullah Ali Alzahrani, Zahraa Al-Khafaji, Zuhair I Al-Mashhadani, Sami Najaf Bokhoor, Mohammad-Javad Peyvand, Behzad Kazemi Haki","doi":"10.22038/ABJS.2025.89179.4044","DOIUrl":"10.22038/ABJS.2025.89179.4044","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to compare the effect of epidural gel foam impregnated with bupivacaine and intramuscular paravertebral bupivacaine on analgesia after lumbar spine surgeries.</p><p><strong>Methods: </strong>In this single-blind clinical trial, 60 patients aged 18-65 years who underwent lumbar spine surgery under general anesthesia were randomly assigned to two groups. In the first group, a 1 × 5 cm strip of gel foam impregnated with 70 mg of 0.5% bupivacaine was placed in the epidural space. In contrast, in the second group, 70 mg of 0.5% bupivacaine was injected paravertebrally into the muscle. Pain scores based on the Visual Analogue Scale (VAS), analgesic prescriptions, time to first analgesic request, and total dosage during recovery and at 6, 12, and 24 hours postoperatively were recorded and compared between the groups.</p><p><strong>Results: </strong>No significant difference in average pain scores at different time points (recovery, 6, and 12 hours) was observed between the two groups (P > 0.05). However, at 24 hours postoperatively, a significant difference was found between the groups, with the VAS score in the bupivacaine-impregnated epidural gel foam group being significantly lower than that in the paravertebral intramuscular bupivacaine group (P = 0.04).</p><p><strong>Conclusion: </strong>Bupivacaine-impregnated epidural gel foam and paravertebral intramuscular bupivacaine provide similar analgesia during recovery and at 6 and 12 hours following spinal surgery. However, at 24 hours, the analgesia in the bupivacaine-impregnated epidural gel foam group is superior to that in the paravertebral intramuscular bupivacaine group.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 2","pages":"144-153"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870018","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":"Adjusted Internal Joint Stabilizer Implants as a Supplementary Management of Chronic Elbow Injury: A Preliminary Case Series.","authors":"Iman Widya Aminata, Salman Azis Nizami","doi":"10.22038/ABJS.2025.86117.3921","DOIUrl":"10.22038/ABJS.2025.86117.3921","url":null,"abstract":"<p><p>Chronic elbow injuries often cause instability and stiffness. The Internal Joint Stabilizer of Elbow (IJS-E), introduced in 2014, stabilizes the elbow and enables early mobilization. In resource-limited settings where the IJS-E is unavailable, an adapted radius T-plate technique has been developed. This study evaluated patients (n=11) with chronic elbow injuries, showing significant improvements in Mayo Elbow Performance Scores (MEPS) and range of motion (ROM). Despite challenges like implant rigidity and precise screw placement, the T-plate effectively maintained stability and allowed early ROM exercises. Limitations include the short follow-up period and the need for further studies; however, this approach holds promise for low-resource settings.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 3","pages":"228-231"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965218","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":"Partial Weight-Bearing after Lower Extremity Surgery: A Review of Current Standards, Innovations, and Patient Compliance.","authors":"Eric M Kunz, Devon T Foster, Pooya M Tehrany, Ashkan Sedigh, Amir R Kachooei","doi":"10.22038/ABJS.2025.88277.4000","DOIUrl":"10.22038/ABJS.2025.88277.4000","url":null,"abstract":"<p><p>Partial weight bearing (PWB) is a cornerstone of post-operative rehabilitation after lower extremity surgery (LES), balancing mechanical stimulation needed for bone, tendon, and cartilage healing with protection against excessive load that precipitates malunion, non-union, or joint dehiscence. This narrative review synthesizes literature to clarify current indications for PWB, evaluate traditional and emerging methods for prescribing and monitoring load, and identify factors influencing patient adherence. Hip, knee, ankle, and foot procedures commonly warrant PWB, yet optimal targets and progression schedules remain surgeon-dependent and inconsistently standardized. Household scales fail to replicate dynamic gait and are associated with poor long-term accuracy when compared to biofeedback devices, although these are the most widely adopted PWB adjuncts. Recent clinical trials demonstrate that wearable pressure-sensing insoles, audio or visual biofeedback, smartphone applications, telerehabilitation platforms, and virtual/augmented reality (VR/AR) or robotic off-loading devices markedly improve PWB precision, range of motion, muscle preservation, and functional scores without increasing complications. Nevertheless, widespread adoption is limited by cost, device sizing, battery life, and the requirement for continuous wear. Across studies that objectively quantified loading, adherence remains suboptimal, particularly among elderly and obese patients, underscoring the need for targeted educational interventions. Formal patient education, integrated into routine follow-up, may enhance understanding of PWB rationale, foster self-efficacy, and amplify the benefits of technology. Future research should prioritize high-quality randomized trials that combine sensor-derived compliance metrics with machine-learning analytics to individualize loading protocols, elucidate the drivers of non-adherence, and determine the cost-effectiveness of digital health solutions. Standardizing PWB guidelines while leveraging wearable, telehealth, and VR/AR technologies holds promise for accelerating recovery, reducing revision surgeries, and improving quality of life in an aging, fracture-prone population.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 1","pages":"16-23"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724363","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":"Orthopedic Residency Training Reform in Iran: A Competency-Based Approach.","authors":"Omid Salkhori, Nima Bagheri, Seyed Hadi Kalantar, Mohammad Ayati Firoozabadi, Hesan Rezaee, Aidin Arabzadeh, Poua Tabatabaei Irani, Mohammadreza Razzaghof, Hamed Naghizadeh, M Javad Mortazavi, Sadegh Saberi, Seyyed Saeed Khabiri","doi":"10.22038/ABJS.2025.88798.4030","DOIUrl":"10.22038/ABJS.2025.88798.4030","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to critically evaluate the time-based apprenticeship model currently dominating orthopedic residency training in Iran and to design a competency-based curriculum for the first two years that aligns with modern subspecialized practice while addressing trainee burnout and dissatisfaction.</p><p><strong>Methods: </strong>We conducted a narrative appraisal of existing Iranian training standards, synthesized resident-reported challenges from regional surveys, and reviewed competency-based frameworks implemented in North America, Europe, and Australasia. Based on these findings, we developed explicit milestones encompassing medical knowledge, technical skills, communication, professionalism, and wellness. An expert panel then iteratively refined the curriculum and aligned appropriate assessment tools with each milestone.</p><p><strong>Results: </strong>The proposed curriculum delineates 42 measurable competencies across five domains, replacing seniority-based rotation blocks with milestone-triggered progression. It incorporates weekly simulation laboratories, structured feedback, and mentor-led wellness sessions. Comparative analysis demonstrates superior alignment with international standards and suggests enhanced preparedness for fellowship-level practice. A pilot implementation at one academic center revealed increased resident satisfaction and a 30% reduction in reported burnout symptoms after six months.</p><p><strong>Conclusion: </strong>Transitioning to a competency-based, well-supported curriculum can better prepare Iranian orthopedic residents for contemporary clinical practice while enhancing their overall well-being. Nationwide implementation of this model is recommended.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 1","pages":"72-80"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724396","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":"Clinical Outcomes and Complications of Total knee Arthroplasty Following Previous Opening vs. Closing-Wedge High Tibial Osteotomy: A Systematic Review.","authors":"Mohammad Amin Khojastehnezhad, Mohammad H Ebrahimzadeh, Mohsen Dehghani, Maedeh Sharafoddin, Ali Moradi, Fateme Nikbakht, Nafiseh Jirofti","doi":"10.22038/ABJS.2026.95154.4275","DOIUrl":"10.22038/ABJS.2026.95154.4275","url":null,"abstract":"<p><strong>Objectives: </strong>Two frequently used surgical interventions for knee joint osteoarthritis include closing wedge high tibial osteotomy (CW-HTO) and opening wedge high tibial osteotomy (OW-HTO). Studies showed that, most to near all cases lead to failure, requiring a total knee arthroplasty (TKA). This systematic review aimed at answering this question: What are the outcomes of TKA following CW-HTO and OW-HTO?</p><p><strong>Methods: </strong>The main electronic databases were searched up to November 2025. Only studies that included comparative arms for both closing-wedge high tibial osteotomy (CW-HTO) and opening-wedge high tibial osteotomy (OW-HTO) were considered for further assessment. The primary outcomes included knee joint function scores, such as the International Knee Society (IKS) score and the Knee Society Score (KSS). A meta-analysis was not feasible because of heterogeneity in the reported data and follow-up periods. The Joanna Briggs Institute (JBI) critical appraisal tool was used to assess the methodological quality of each included study.</p><p><strong>Results: </strong>Of the 6,756 records identified and screened, three comparative clinical studies, including a total of 541 TKA cases, were included in this systematic review. Two studies reported no significant difference in KSS or range of motion after TKA between patients who had previously undergone CW-HTO and those who had undergone OW-HTO. However, one study reported improvements in walking ability in both groups after 80-90 months of follow-up. Post-operative complication rates were comparable between groups (OW-HTO: 12.3% vs. CW-HTO: 8.3%); however, one study noted a significantly higher incidence of specific complications, such as skin necrosis and nerve injury, in the CW-HTO cohort (12% vs. 6%, P<0.05). Intra-operative complications were rare, affecting 2.8% of cases with no significant between-group difference.</p><p><strong>Conclusion: </strong>The limited available evidence precludes definitive conclusions. Current data suggest potential benefits after TKA following either CW-HTO or OW-HTO, including earlier relief of joint loading, shorter recovery time, and improved clinical outcomes, with no significant differences in clinical outcomes and complications between the two HTO techniques.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 7","pages":"426-435"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664691","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":"Effects of Antibiotic-Loaded Bone Cement on the Risk of Periprosthetic Joint Infection in Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.","authors":"Mohammad Ali Tarahomjoy, Ali Khodashenas Haghighi, Afshin Taheriazam, Seyed Mohamad Sajjadi Dezfouli, Reza Heidari, Reza Mosaed, Hossein Fasihi, Mahdieh Soezi, Mohsen Chamanara, Mostafa Shahrezaee","doi":"10.22038/ABJS.2026.91856.4161","DOIUrl":"10.22038/ABJS.2026.91856.4161","url":null,"abstract":"<p><strong>Objectives: </strong>The use of antibiotic-loaded bone cement (ALBC) is a common strategy for preventing periprosthetic joint infection (PJI) after total knee arthroplasty (TKA); however, its effectiveness remains controversial. This study aimed to provide a clear, evidence-based recommendation regarding the use of ALBC versus plain bone cement (PBC) for the prevention of PJI after TKA.</p><p><strong>Methods: </strong>This systematic review and meta-analysis was conducted in accordance with the PRISMA 2020 reporting guidelines. PubMed, Embase, and Scopus were searched to identify relevant studies evaluating PJI in patients who received ALBC versus PBC. Eligible studies were screened, selected, and assessed for risk of bias using appropriate checklists. Random-effects meta-analyses were performed to calculate odds ratios (ORs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the I² statistic. The effects of antibiotic type and dose were examined through subgroup analyses. Meta-regression was performed to evaluate the effects of age, sex, follow-up duration, and diabetes mellitus on the occurrence of PJI.</p><p><strong>Results: </strong>Eighteen studies including 72,928 TKAs (20,201 in the ALBC group and 52,727 in the PBC group) were included. The overall analysis showed no significant difference in PJI rates between the ALBC and PBC groups (OR, 0.92; 95% CI, 0.67-1.27; p = 0.6). However, cefuroxime-loaded cement was associated with a significantly lower risk of PJI (p = 0.01). In contrast, cement containing gentamicin (p = 0.08), vancomycin (p = 0.3), or tobramycin (p = 0.6) did not show a similar protective effect. Antibiotic dose, age, sex, diabetes mellitus, and follow-up duration did not appear to influence the results.</p><p><strong>Conclusion: </strong>Most ALBC formulations were not associated with a significant reduction in the risk of PJI. Larger, dedicated trials are needed to further evaluate the effect of ALBC on PJI risk in selected patient populations.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 7","pages":"436-447"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13429145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663837","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":"Four-Corner Fusion Surgery for SLAC and SNAC of the wrist: Screw Versus Staple Fixation.","authors":"Nikita Golovachev, David Sylvester, Roya Khorram, Kassem Ghayyad, Abdo Bachoura, David Hirsch, Amir R Kachooei","doi":"10.22038/ABJS.2025.89889.4074","DOIUrl":"10.22038/ABJS.2025.89889.4074","url":null,"abstract":"<p><strong>Objectives: </strong>This study hypothesizes that, in patients undergoing four-corner fusion (4CF) surgery, the choice of fixation method-either headless compression screw (HCS) or staples (ST)-will not significantly impact postoperative complication rates, union rate, and functional outcomes.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on patients who underwent 4CF for scapholunate advanced collapse (SLAC) or scaphoid nonunion advanced collapse (SNAC) wrist at a single institution over thirteen years. Functional outcomes included postoperative complications, nonunion, subsequent surgery, wrist flexion-extension range of motion (ROM), Quick Disabilities of Arm, Shoulder & Hand (QuickDASH) score, and the 12-Item Short Form Survey (SF-12).</p><p><strong>Results: </strong>Thirty-seven patients were identified with an average follow-up of 9.1 months (range: 3-24 months). Nineteen patients were treated with HCS, and 18 were treated with ST. There were no significant differences in the complication rates between the HCS and ST groups (P=0.73). In the HCS group, the main complications were pain (n=4), subsequent surgeries for revision or hardware removal (n=3), and nonunion (n=2). For the ST group, these were pain (n=5), subsequent surgeries for revision or hardware removal (n=5), and hardware loosening (n=4). Postoperatively, wrist flexion and extension ROM did not significantly change in either group. QuickDASH improved postoperatively in both groups (P<0.005). Only the ST group improved in the SF-12 physical component postoperatively (P=0.01).</p><p><strong>Conclusion: </strong>In this small, retrospective case series with short follow-up, fixation choice between HCS and ST in 4CF for SLAC or SNAC did not significantly impact complication rates or functional recovery. Postoperative complications occurred at similar rates, with pain and the need for subsequent surgery being the most common.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 6","pages":"387-393"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653808","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":"Coracoacromial Ligament Release Improves Internal Rotation in Reverse Total Shoulder Arthroplasty; a Cadaver Study.","authors":"Feras Qawasmi, Abrar Abuhamdia, Logan M Andryk, Steven Grindel, Mustafa Yassin","doi":"10.22038/ABJS.2025.84191.3827","DOIUrl":"10.22038/ABJS.2025.84191.3827","url":null,"abstract":"<p><strong>Objectives: </strong>Evaluate the effect of Coracoacromial Ligament (CAL) release after Reverse shoulder arthroplasty (RSA) on range of motion (ROM), particularly on internal rotation (IR).</p><p><strong>Methods: </strong>Ten Fresh Frozen cadavers underwent RSA followed by CAL release by a fellowship-trained surgeon. Shoulder ROM was measured by a goniometer pre- and post-CAL release. The IR to the back was measured as the distance between the posterior-lateral acromion and the highest point of thumb elevation behind the back. Measurements of ROM before and after CAL release were compared using a paired sample t-test.</p><p><strong>Results: </strong>CAL release after RSA significantly increased ROM in all planes. The IR to the back improved by an average of four cm. Internal rotation in abduction, external rotation in abduction, external rotation at the side, forward elevation, abduction, and extension increased by 7°, 8°, 9°, 10°, 6°, 11°, respectively.</p><p><strong>Conclusion: </strong>The CAL release following RSA significantly improved IR to the back and all other ROM. CAL release post-RSA could be a potential solution to the ROM deficits, particularly IR, post-RSA. Clinical studies are needed to assess the clinical application of this technique.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"14 5","pages":"337-342"},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148200466","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}