Journal of Shoulder and Elbow Surgery最新文献

{"title":"Arthroscopic retrograde disimpaction of reverse Hill-Sachs lesions in acute posterior shoulder dislocation type A2 leads to good clinical outcome and close to anatomic reconstruction of the articular surface of the humeral head.","authors":"Christian Festbaum, Agahan Hayta, Alp Paksoy, Rony-Orijit Dey Hazra, Doruk Akgün, Philipp Moroder","doi":"10.1016/j.jse.2024.07.024","DOIUrl":"10.1016/j.jse.2024.07.024","url":null,"abstract":"<p><strong>Background: </strong>Posterior shoulder dislocation frequently results in a centrally located impression fracture of the anterior humeral head, known as reverse Hill-Sachs lesion (RHSL). Depending on its size and location, the RHSL can lead to engagement with the posterior glenoid rim and subsequently redislocation of the shoulder joint. The objective of this study was to present the clinical and radiologic outcomes of anatomic reconstruction of the humeral articular surface using arthroscopically assisted disimpaction in patients with acute posterior shoulder dislocation and an engaging RHSL.</p><p><strong>Methods: </strong>As part of a retrospective analysis, 9 shoulders in 9 patients (1 female, 8 males) with engaging RHSL following acute posterior shoulder dislocation (type A2 according to the ABC classification) who underwent arthroscopically assisted disimpaction of the RHSL between 2016 and 2023 were identified. Eight patients were included, because 1 patient refused to participate. In all patients, a radiologic analysis of the RHSL was accomplished on preoperative and postoperative cross-sectional imaging including the alpha, beta, and gamma angle as well as depth measurements. The clinical examination included an assessment of the active range of motion, instability tests, and patient-reported outcome measures, such as the Western Ontario Shoulder Instability (WOSI) Index, the Constant Score, and the Subjective Shoulder Value (SSV).</p><p><strong>Results: </strong>The mean follow-up period for all 8 patients was 34.4 ± 38 months (range: 6-102 months). The mechanisms of injury included falls (n = 6), traffic accident (n = 1), and convulsive episode (n = 1). The average time from injury to surgery was 6.8 ± 4.7 days (range: 2-16). Patient-reported outcomes at the final follow-up indicated an average WOSI Index of 77.8% ± 17%, a mean Constant Score of 88.3 ± 11 points, and a mean SSV of 87% ± 16%. None of the patients experienced recurrent dislocations during the follow-up period. Post-traumatically, the mean absolute defect depth was 8.4 ± 2.2 mm and the mean gamma angle was 115.8° ± 13°. In the radiologic follow-up, the RHSL depth measurements showed a significant reduction in the mean defect depth from 8.4 ± 2 mm to 1.2 ± 1 mm resulting in an average reduction of the RHSL by 7.1 mm (P < .001). In 3 of the 8 patients (37.5%), the RHSL was not identifiable any more at follow-up and in 5 patients barely identifiable.</p><p><strong>Conclusion: </strong>Arthroscopically assisted disimpaction of acute RHSLs leads to close to anatomic reduction of RHSL, achieving a stable shoulder and good clinical outcomes.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of combined all-arthroscopic Latarjet with Hill-Sachs remplissage for significant bipolar glenohumeral bone loss.","authors":"Pascal Boileau, Riccardo Ranieri, Vincent Lavoué, David Saliken","doi":"10.1016/j.jse.2024.07.030","DOIUrl":"10.1016/j.jse.2024.07.030","url":null,"abstract":"<p><strong>Background: </strong>Arthroscopic Latarjet using suture-button fixation has shown good clinical results and low recurrent instability in patients with significant glenoid bone loss. However, the presence of an associated Hill-Sachs lesion (HSL) is a risk factor for recurrent instability after isolated Latarjet. The aim of the study was to report clinical and radiologic results following all-arthroscopic Latarjet combined with Hill-Sachs remplissage (HSR).</p><p><strong>Methods: </strong>Monocentric prospective study including 41 patients (mean age 28 ± 7 years) who underwent the combined procedure between 2014 and 2019 with minimum 2 years' follow-up (mean 40 ± 13 months). Indications were glenoid bone loss >10% (mean 23.9% ± 7.5%) and large, deep HSL (Calandra 3). Five (13%) patients had signs of osteoarthrosis stage I preoperatively, 4 (10%) had previous stabilization surgery (3 cases isolated Bankart and 1 case Bankart combined with HSR), and 4 (13%) were epileptic. The HSR was performed first followed by guided Latarjet procedure. Primary outcome measures included shoulder stability and function represented by Walch-Duplay and Rowe scores, and Subjective Shoulder Value (SSV) for daily life/sports. Secondary outcome measures included coracoid graft position and union, and glenohumeral osteoarthritis using radiographs and computed tomography.</p><p><strong>Results: </strong>Three patients (7%) had recurrent instability: 1 due to seizure, 1 following fall, and 1 related to graft osteolysis. Two patients were revised because of recurrence with arthroscopic distal clavicle autograft. There were no infections, neurologic complications, or hardware failures. The Walch-Duplay score was 90 (95% CI 76.8-93.2), and the Rowe score 95 (95% CI 77.2-92.2). The median SSV averaged 96% (95% CI 87.5-97.0) for daily life and 90% (95% CI 75.7-90.2) for sports. Mean external rotation with the arm at the side was 60° (95% CI 59°-70°) with a median loss 10° (95% CI 3°-17°) compared to the contralateral side. Among patients playing sport preoperatively, 36 (95%) were able to return to sport: 25 (67%) at the same level and 7 (18%) at a lower level, whereas 4 had to change sport. The coracoid graft was flush with the glenoid surface in 96% of cases and subequatorial in 89%. The graft developed nonunion in 11% and fractured in 5%. Seven patients (18%) had radiographic signs of grade I osteoarthritis.</p><p><strong>Conclusion: </strong>Combined arthroscopic Latarjet and HSR is an efficient solution for dealing with significant bipolar glenohumeral bone loss. The combined procedure deserves consideration in high-risk patients including combined bone loss, recurrent anterior instability after failed stabilization procedures and/or seizure.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparable low revision rates of stemmed and stemless total anatomic shoulder arthroplasties after exclusion of metal-backed glenoid components: a collaboration between the Australian and Danish national shoulder arthroplasty registries.","authors":"Marc R K Nyring, Jeppe V Rasmussen, David R J Gill, Dylan Harries, Bo S Olsen, Richard S Page","doi":"10.1016/j.jse.2024.03.022","DOIUrl":"10.1016/j.jse.2024.03.022","url":null,"abstract":"<p><strong>Background: </strong>The stemmed anatomic total shoulder arthroplasty is the gold standard in the treatment of glenohumeral osteoarthritis. However, the use of stemless total shoulder arthroplasties has increased in recent years. The number of revision procedures are relatively low, and therefore it has been recommended that national joint replacement registries should collaborate when comparing revision rates. Therefore, we aimed to compare the revision rates of stemmed and stemless TSA used for the diagnosis of glenohumeral osteoarthritis using data from both the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) and the Danish Shoulder Arthroplasty Registry (DSR).</p><p><strong>Methods: </strong>We included all patients who were registered in the AOANJRR and the DSR from January 1, 2012, to December 2021 with an anatomic total shoulder arthroplasty used for osteoarthritis. Revision for any reason was used as the primary outcome. We used the Kaplan-Meier method to illustrate the cumulative revision rates and a multivariate cox regression model to calculate the hazard ratios. All analyses were performed separately for data from AOANJRR and DSR, and the results were then reported using a qualitative approach.</p><p><strong>Results: </strong>A total of 13,066 arthroplasties from AOANJRR and 2882 arthroplasties from DSR were included. The hazard ratio for revision of stemmed TSA with stemless TSA as reference, adjusted for age and gender, was 1.67 (95% confidence interval [CI] 1.34-2.09, P < .001) in AOANJRR and 0.57 (95% CI 0.36-0.89, P = .014) in DSR. When including glenoid type and fixation, surface bearing (only in AOANJRR), and hospital volume in the cox regression model, the hazard ratio for revision of stemmed TSA compared to stemless TSA was 1.22 (95% CI 0.85-1.75, P = .286) in AOANJRR and 1.50 (95% CI 0.91-2.45, P = .109) in DSR. The adjusted hazard ratio for revision of total shoulder arthroplasties with metal-backed glenoid components compared to all-polyethylene glenoid components was 2.54 (95% CI 1.70-3.79, P < .001) in AOANJRR and 4.1 (95% CI 1.92-8.58, P < .001) in DSR.</p><p><strong>Conclusion: </strong>Based on data from 2 national shoulder arthroplasty registries, we found no significant difference in risk of revision between stemmed and stemless total shoulder arthroplasties after adjusting for the type of glenoid component. We advocate that metal-backed glenoid components should be used with caution and not on a routine basis.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overexpression of PRDM16 improves muscle function after rotator cuff tears.","authors":"He Zhang, Aboubacar Wague, Agustin Diaz, Mengyao Liu, Luke Sang, Alex Youn, Sankalp Sharma, Nesa Milan, Hubert Kim, Brian Feeley, Xuhui Liu","doi":"10.1016/j.jse.2024.05.037","DOIUrl":"10.1016/j.jse.2024.05.037","url":null,"abstract":"<p><strong>Background: </strong>Muscle atrophy, fibrosis, and fatty infiltration are commonly seen in rotator cuff tears (RCTs), which are critical factors that directly determine the clinical outcomes for patients with this injury. Therefore, improving muscle quality after RCT is crucial in improving the clinical outcome of tendon repair. In recent years, it has been discovered that adults have functional beige/brown adipose tissue (BAT) that can secrete batokines to promote muscle growth. PRDM16, a PR-domain-containing protein, was discovered with the ability to determine the brown fat cell fate and stimulate its development. Thus, the goal of this study was to discover the role of PRDM16 in improving muscle function after massive tendon tears using a transgenic mouse model with an elevated level of PRDM16 expression.</p><p><strong>Methods: </strong>Transgenic aP2-driven PRDM16-overexpressing mice and C57BL/6J mice underwent unilateral supraspinatus (SS) tendon transection and suprascapular nerve transection (TTDN) as described previously (n = 8 in each group). DigiGait was performed to evaluate forelimb function at 6 weeks post the TTDN injury. Bilateral SS muscles, interscapular brown fat, epididymal white fat, and inguinal beige fat were harvested for analysis. The expression of PRDM16 in adipose tissue was detected by Western blot. Masson Trichrome staining was conducted to evaluate the muscle fibrosis, and Oil Red O staining was used to determine the fat infiltration. Muscle fiber type was determined by major histocompatibility complex (MHC) expression via immunostaining. All data were presented in the form of mean ± standard deviation. t test and 2-way analysis of variance was performed to determine a statistically significant difference between groups. Significance was considered when P < .05.</p><p><strong>Results: </strong>Western blot data showed an increased expression of PRDM16 protein in both white and brown fat in PRDM16-overexpressing mice compared with wild-type (WT) mice. Even though PRDM16 overexpression had no effect on increasing muscle weight, it significantly improved the forelimbs function with longer brake, stance, and stride time and larger stride length and paw area in mice after RCT. Additionally, PRDM16-overexpressing mice showed no difference in the amount of fibrosis when compared to WT mice; however, they had a significantly reduced area of fatty infiltration. These mice also exhibited abundant MHC-IIx fiber percentage in the supraspinatus muscle after TTDN.</p><p><strong>Conclusion: </strong>Overexpression of PRDM16 significantly improved muscle function and reduced fatty infiltration after rotator cuff tears. Promoting BAT activity is beneficial in improving rotator cuff muscle quality and shoulder function after RCT.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of the in-season athlete with an anterior shoulder dislocation.","authors":"Garwin Chin, Matthew J Kraeutler, Alexis Batiste, Cleveland McCarty, Eric C McCarty","doi":"10.1016/j.jse.2024.05.052","DOIUrl":"10.1016/j.jse.2024.05.052","url":null,"abstract":"<p><strong>Background: </strong>Management of the in-season athlete presenting with an anterior shoulder dislocation is a nuanced process that continues to be refined. Options and pathways between nonoperative and operative treatment have undergone many iterations over a century of orthopedic research and advancement. It requires an understanding of sport-specific demands and the individual athlete's goals. The orthopedic surgeon must have mastery of the natural history, treatment options, and outcomes of anterior shoulder dislocations. Balance of these factors is delicate and highly individualized for each athlete, and is why management of the in-season athlete with an anterior shoulder dislocation remains an art for the orthopedic surgeon.</p><p><strong>Materials and methods: </strong>A narrative review of the literature regarding the in-season athlete with anterior shoulder dislocation was conducted of the PubMed, Embase, and Cochrane databases. The findings are summarized in this article.</p><p><strong>Results: </strong>Multiple studies have investigated management of the in-season athlete with anterior shoulder dislocation. Treatment is highly individualized for each athlete and their respective circumstances. Nonoperative treatment remains the only option for athletes that seek to return to play in the same season, however with a high risk of recurrence. Operative treatment has a track record of success in terms of returning to high level of play and lower recurrence, but would preclude a return to competition in the same season.</p><p><strong>Conclusions: </strong>Management of the in-season athlete with anterior shoulder dislocation remains a challenging issue without consensus recommendation among shoulder surgeons. Much has been done to understand the pathology and delineate indications for nonoperative treatment and surgical management. Although recurrence and return to play rates have improved with each iteration, recurrent instability and revision surgery continue to occur at high rates. Therefore, additional work remains to optimize return to play as well as long-term outcomes for athletes.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and radiographic outcomes of primary vs. revision arthroscopic anatomic glenoid reconstruction with distal tibial allograft for anterior shoulder instability with bone loss.","authors":"Jillian Karpyshyn, Ryland Murphy, Sara Sparavalo, Jie Ma, Ivan Wong","doi":"10.1016/j.jse.2024.04.005","DOIUrl":"10.1016/j.jse.2024.04.005","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to assess the clinical and radiographic outcomes of arthroscopic anatomic glenoid reconstruction (AAGR) used for primary vs. revision surgery for addressing anterior shoulder instability with bone loss.</p><p><strong>Methods: </strong>We performed a retrospective review on consecutive patients who underwent AAGR from 2012 to 2020. Patients who received AAGR for anterior shoulder instability with bone loss and had a minimum follow-up of 2 years were included. Exclusion criteria included patients with incomplete primary patient-reported outcome scores (PROs), multidirectional instability, glenoid fracture, nonrigid fixation and concomitant humeral avulsion of the glenohumeral ligament, or rotator cuff repair. Our primary outcome was measured using the Western Ontario Shoulder Instability Index (WOSI) scores. Secondary outcomes included postoperative Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) scores, complications, recurrence of instability and computed tomographic (CT) evaluation of graft position, resorption, and healing.</p><p><strong>Results: </strong>There were 73 patients (52 primary and 21 revision) finally included. Both groups had comparable demographics and preoperative WOSI and DASH scores. The primary group had significantly better postoperative WOSI and DASH scores at final follow-up when compared to the revision group (WOSI: 21.0 vs. 33.8, P = .019; DASH: 7.3 vs. 17.2, P = .001). The primary group also showed significantly better WOSI scores than the revision group at the 6-month, 1-year, and 2-year time points (P = .029, .022, and .003, respectively). The overall complication rate was 9.6% (5 of 52) in the primary group and 23.8% (5 of 21) in the revision group. Both groups showed good graft healing and placement in the anterior-to-posterior and mediolateral orientation and had a similar rate of graft resorption and remodeling. There was no difference between the groups in the remainder of the CT measurements.</p><p><strong>Conclusion: </strong>Functional outcome scores and stiffness were significantly worse in patients undergoing an AAGR procedure after a failed instability surgery when compared with patients undergoing primary AAGR. There were no differences in postoperative recurrence of instability or radiographic outcomes. As a result, AAGR should be considered as a primary treatment option within current treatment algorithms for shoulder instability.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social media use and patient ratings in shoulder and elbow surgeons: how many \"likes\" for five stars?","authors":"Cara Busheme, Payton Yerke Hansen, Ajay Desai, Jessica V Baran, Clyde Fomunung, Garrett R Jackson, Vani J Sabesan","doi":"10.1016/j.jse.2024.04.015","DOIUrl":"10.1016/j.jse.2024.04.015","url":null,"abstract":"<p><strong>Background: </strong>Social media plays an important role in healthcare and physician selection by facilitating direct communication with patients and impacting physician ratings. A concern however is the increased online scrutiny and negative impact on patient satisfaction with these connections. This study aimed to investigate whether social media activity by fellowship-trained shoulder and elbow surgeons impacts patient's perceptions and ratings on physician review websites (PRWs).</p><p><strong>Methods: </strong>The American Shoulder and Elbow Surgeons physician directory was used to identify currently practicing shoulder and elbow surgeons in the United States. Physician ratings were collected from Healthgrades, Google reviews, and Vitals. The surgeons were divided into two groups: social media users (SMU) and non- SMU (NSMU). The association of social media use with online physician ratings was evaluated using simple and multilinear regressions.</p><p><strong>Results: </strong>A total of 385 American Shoulder and Elbow Surgeons surgeons were included and 21.3% were SMU. SMU were younger (mean age, 48 years) compared to NSMU (mean age, 51 years) (P = .01), all other demographics were comparable including sex (P = .797), medical degree (P = .114), and geographic location within the United States (P = .49). SMU had significantly higher ratings on Healthgrades (P < .001) and Vitals (P < .001). However, social media use did not impact the total number of ratings on PRWs. Additionally, surgeons who utilized Facebook had higher physician ratings and number of website reviews on Healthgrades (P = .028 and P = .014, respectively). In addition, surgeons who used Twitter had higher ratings on Healthgrades (P < .001) and Vitals (P = .001). Surgeons with a greater average number of likes per post on Twitter had significantly higher average ratings across all three sites (P = .004). Surgeons with a greater number of Twitter followers and greater average number of likes per post had significantly higher average ratings on Healthgrades (P = .052 and P = .005, respectively) while surgeons with a greater average number of likes per post had significantly higher average ratings on Vitals (P = .006). Finally, surgeons with a greater average posting frequency on Instagram had significantly higher average ratings across all websites (P = .029).</p><p><strong>Conclusion: </strong>Shoulder and elbow surgeons who use Twitter and Facebook had significantly higher online ratings. However, the increased use of these platforms in terms of postcontent, postfrequency, comments, and number of followers was not as influential on PRWs. This suggests that social media is an important marketing and outreach method for orthopedic surgeons to improve their ratings and patient reviews.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing postoperative proprioception of the glenohumeral joint between the open and the arthroscopic Latarjet procedure.","authors":"Geoffroi Lallemand, Madu N Soares, Erica Lante, Arno A Macken, Agathe Kling, Laurent Lafosse, Geert A Buijze, Thibault Lafosse","doi":"10.1016/j.jse.2024.09.002","DOIUrl":"10.1016/j.jse.2024.09.002","url":null,"abstract":"<p><strong>Background: </strong>Shoulder proprioception, in which the anterior glenohumeral capsule plays a major role, is critical to the functioning of the shoulder. Consequently, most surgeons either do not resect or reinsert the anterior capsule in shoulder stabilization surgery. In the original open Latarjet procedure (OLP), the anterior capsule is preserved. However, in the all-arthroscopic Latarjet procedure (ALP), complete anterior capsule resection is recommended for better view and access to the coracoid. This raises the question if there is a postoperative difference in proprioception between these 2 procedures. Therefore, the aims of this study are (1) to assess the difference in postoperative proprioception between the operated and healthy sides after the OLP and ALP and (2) to compare the difference in postoperative proprioception on the operated side between the OLP and ALP.</p><p><strong>Methods: </strong>We conducted a retrospective analysis including all patients who underwent a proprioception test after an OLP or ALP at our center. Collected baseline characteristics included sex, age at surgery, operated side, hand dominance, presence of a Hill-Sachs lesion, and time between surgery and the proprioception test. For the test, patients were positioned 1 meter from a wall. They were blindfolded and had to point at a target with a laser pointer taped to their index finger. The laser point was marked and the errors were measured horizontally and vertically and categorized as <4 cm, 4-8 cm, 8-16 cm, and >16 cm.</p><p><strong>Results: </strong>Between April 2022 and April 2024, a total of 91 cases were identified, of which 24 underwent an OLP and 67 underwent an ALP. No significant difference was found in error distribution between the healthy and operated side after both the OLP (P = .30 horizontally, P = .67 vertically) and ALP (P = .20 horizontally, P = .34 vertically). Moreover, there was no significant difference in error distribution between the operated sides after the OLP vs. ALP (P = .52 horizontally; P = .61 vertically).</p><p><strong>Conclusion: </strong>Our data suggest that postoperative proprioception is not significantly different between the operated and healthy sides after both the OLP and ALP, nor between the operated sides after the OLP vs. after the ALP. This might imply that completely resecting the anterior glenohumeral capsule does not have a detrimental effect on shoulder proprioception. However, these results are multifactorial and prospective studies are needed to better understand the regeneration potential of glenohumeral capsule mechanoreceptors and the importance of the anterior capsule for shoulder proprioception.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between the elasticity of the forearm flexor-pronator muscles and elbow valgus torque in young baseball pitchers: a descriptive laboratory study.","authors":"Akira Saito, Kyoji Okada, Yusuke Namiki, Kazuyuki Shibata, Hiromichi Sato, Yoshino Terui","doi":"10.1016/j.jse.2024.05.027","DOIUrl":"10.1016/j.jse.2024.05.027","url":null,"abstract":"<p><strong>Background: </strong>The forearm flexor-pronator muscles act as a dynamic elbow stabilizer against elbow valgus load during baseball pitching. The elasticity of these muscles increases with pitching. However, it is unclear whether increased muscle elasticity is associated with greater elbow valgus torque during pitching. This study aimed to determine the relationship between the elasticity of the forearm flexor-pronator muscles and elbow valgus torque during pitching in young baseball pitchers.</p><p><strong>Methods: </strong>We recruited 124 young baseball pitchers aged 9 to 12 years. The exclusion criteria included current pain with pitching, history of surgery on the tested extremity, or injuries on the tested extremity within the past 12 months. Before the examination, participants completed a questionnaire about their age, height, weight, dominant arm, and practice time per week. The strain ratios of flexor carpi ulnaris (FCU), flexor digitorum superficialis (FDS), and pronator teres as the index of muscle elasticity were measured using ultrasound strain elastography. Participants pitched 3 fastballs at a distance of 16 m (52 ft 6 in) with maximum effort while wearing a sensor sleeve that recorded the elbow valgus torque. A multiple linear regression analysis was conducted to examine the association between muscle elasticity and elbow valgus torque, adjusting for age, height, weight, and practice time.</p><p><strong>Results: </strong>The final analysis included 107 pitchers. After adjusting for covariates, increased strain ratio of the FCU was significantly associated with greater elbow valgus torque (coefficients = 0.038, 95% confidence interval, 0.016-0.059, P < .001). Similarly, increased strain ratio of the FDS was significantly associated with greater elbow valgus torque (coefficients = 0.027, 95% confidence interval, 0.013-0.042, P < .001).</p><p><strong>Conclusion: </strong>The high elasticities of the FCU and FDS were associated with greater elbow valgus torque during pitching in young baseball pitchers. The high elasticity of these muscles is a protective response and may be necessary for young baseball pitchers with greater elbow valgus torque during pitching. Among young baseball pitchers with greater elbow valgus torque, those who are unable to produce the higher elasticities of these muscles could have greater elbow valgus load during pitching and be at a higher risk for elbow injuries. The measurement of the elasticities of the FCU and FDS may be useful for identifying young baseball pitchers at risk of sustaining elbow injuries.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iatrogenic radial nerve injury caused by metal shaving: a case report.","authors":"Akari Mori, Kaoru Tada, Mika Akahane, Soichiro Honda, Sho Horie, Satoru Demura","doi":"10.1016/j.jse.2024.05.048","DOIUrl":"10.1016/j.jse.2024.05.048","url":null,"abstract":"","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}