Journal of Shoulder and Elbow Surgery最新文献

{"title":"Comparative and predictive modelling of modern anatomic total shoulder arthroplasty revision rates in osteoarthritis with different polyethylene glenoid designs.","authors":"David R J Gill, Sophia Corfield, Peiyao Du, Dylan Harries, Richard S Page","doi":"10.1016/j.jse.2025.01.030","DOIUrl":"https://doi.org/10.1016/j.jse.2025.01.030","url":null,"abstract":"<p><strong>Background: </strong>The revision rates of four modern (currently used) polyethylene glenoid designs in anatomic total shoulder arthroplasty (stemmed and stemless) for osteoarthritis (OA) are compared from a national arthroplasty registry to model predictive variables.</p><p><strong>Materials and methods: </strong>The study period was 1^st January 2008 to 31^st December 2023. The study population included all primary anatomic total shoulder arthroplasty (aTSA) procedures undertaken for OA. We classified the designs of modern polyethylene glenoids (glenoid component types) into four cohort groups: cemented all polyethylene glenoids (CPG), polyethylene glenoids with modified central pegs (MCPG), non-modular metal backed glenoids (NMBG) and hybrid glenoids (HG). The cumulative percent revision (CPR) was defined using Kaplan-Meier estimates of survivorship and hazard ratios (HR) from Cox proportional hazard models adjusted for age, sex, humeral head size, humeral fixation, primary type (stemmed or stemless), and mean surgeon volume. Only prostheses with all known variables were analyzed. Possible interactions were examined. A sub-analysis was undertaken capturing additional patient demographics from 1 January 2017.</p><p><strong>Results: </strong>There were 9,332 primary aTSA procedures. The CPR at 8 years for CPG (n=5,048) was 5.5% (95% confidence interval (CI) 4.6, 6.4), 3.8% (95% CI 2.9, 5.1) for MCPG (n=2,217), and 9.4%(95% CI 7.4, 11.9) for HG (n=1,658). The NMBG (n=409) had a 2year CPR of 4.7% (95% CI 2.1, 10.1). The glenoid component type (CPG, MCPG, NMBG, HG) influenced the rate of revision of aTSA (p<0.001). There is evidence for interaction term between age and glenoid type (p=0.009), with a better model (Akaike Information Criterion (AIC) 6205.9) than main effects only (AIC 6211.5) There was no difference at sub-analysis, while the patient sex, type of primary, polyethylene type, ASA, BMI, glenoid fixation, glenoid morphology and mean surgeon volume were less predictive than glenoid component type alone.</p><p><strong>Conclusion: </strong>Modern aTSA outcome for OA is affected by the polyethylene glenoid design implanted, with the result only modified further by patient's age. Informed decision making about aTSA current prostheses survival is more accurate if age of the patient is included.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494558","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":"How important is the teres minor in reverse total shoulder arthroplasty combined with latissimus dorsi transfer?","authors":"Sung-Hyun Cho, Chan-Joo Park, Sang-Jae Kim, Kyoung-Geun Lee, Gyu Rim Baek, Ryan Lew, Aaron T Hui, Michelle H McGarry, Thay Q Lee, Jihoon Ok, Yang-Soo Kim","doi":"10.1016/j.jse.2025.01.028","DOIUrl":"https://doi.org/10.1016/j.jse.2025.01.028","url":null,"abstract":"<p><strong>Background: </strong>The utility of latissimus dorsi (LD) transfer combined with reverse total shoulder arthroplasty (rTSA) to restore external rotation (ER) strength is clinically well-established, but studies directly comparing LD and intact teres minor (TM) strength are lacking. Also, variations in eccentricity in the glenoid components have been under-estimated.</p><p><strong>Methods: </strong>We used eight fresh-frozen cadaveric shoulders in this study. LD transfer to the posterolateral aspect of the greater tuberosity was simulated using a cable pulley system. We explored six possible conditions: massive rotator cuff tears (RCTs) (supraspinatus and infraspinatus tears), massive RCTs with TM tears, massive RCTs with TM tears and LD transfer, and all three conditions complicated by centric and eccentric glenoid components. We measured the impingement-free range of motion (IFROM), the ER torque (N*m), the maximum abduction angle on successive loading of the middle deltoid (the abduction capacities), and the anterior dislocation forces.</p><p><strong>Results: </strong>Use of an eccentric glenosphere was associated with greater IFROM in all directions, but the differences in ER strength, abduction capability, and anterior dislocation force compared with a centric design were not significant. LD transfer with TM tears showed significantly greater ER strength than massive RCTs condition at 30° (P<0.05) and 60° (P<0.05) of abduction. TM tears, with or without LD transfer, had less anterior stability than an intact TM (P<0.05). Massive RCTs combined with TM tears tended to be associated with an increased abduction angle under the same deltoid load across all tested loads, revealing the key role played by the TM in joint stability and ER.</p><p><strong>Conclusions: </strong>LD transfer enhanced ER abduction strength in the absence of an intact TM, in contrast to a massive RCT with an intact TM. The TM was found to play a significant role in stability. Greater ROM in all directions was achieved with an eccentric than with a centric glenosphere.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484498","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":"Shear wave elastography ultrasound assessment of the ulnar collateral ligament in the elbow of college baseball players.","authors":"Jin Hyeok Lee, Kyosun Hwang, Seul Gi Kim, Dongik Song, Woong Kyo Jeong","doi":"10.1016/j.jse.2025.01.027","DOIUrl":"https://doi.org/10.1016/j.jse.2025.01.027","url":null,"abstract":"<p><strong>Background: </strong>The ulnar collateral ligament (UCL) stabilizes the elbow during overhead throwing activities. Repetitive throwing can cause valgus laxity even without injury. Shear-wave ultrasound elastography (SWE) is a novel imaging technique that assesses tissue elasticity. This study aimed to assess UCL elasticity in college baseball players using SWE under resting and valgus stress conditions.</p><p><strong>Methods: </strong>The study included 30 healthy male college baseball players (mean age 20.48 ± 1.34 years). The dominant and non-dominant arms of participants were examined, excluding those with a history of UCL injury. UCL thickness was measured using conventional ultrasound, and elastography was conducted at the same sites. Measurements were repeated under valgus stress, and the ulnohumeral joint gap was recorded. Participants were categorized into throwing and non-throwing arm groups. A subgroup analysis of the throwing arm was conducted based on joint laxity, defined as an increase of >1 mm in the ulnohumeral joint gap under valgus stress, which is associated with UCL injury and joint laxity. Correlations between UCL evaluation parameters and changes in ulnohumeral gap were analyzed.</p><p><strong>Results: </strong>Out of 54 elbows, 26 were classified as throwing and 28 as non-throwing. The throwing group had a significant increase in the ulnohumeral gap compared to the non-throwing group. The ulnohumeral gap under valgus stress increased from 0.59 to 0.72 cm (p=0.01). There was no significant difference in shear-wave velocity (SWV) between the two groups. Within the throwing group, 13 elbows were classified as lax arms and 15 as non-lax arms. The SWV of the lax arms (6.71 ± 4.59 m/s) was significantly lower than that of the non-lax arms (8.54 ± 5.17 m/s) (p=0.045). Multiple regression analysis showed that UCL thickness and SWV were independently correlated with the rate of change in the ulnohumeral gap (ß=0.335, p=0.018 and ß=-0.319, p=0.013, respectively).</p><p><strong>Conclusion: </strong>Valgus laxity of the elbow joint can be evaluated based on the elasticity of the UCL measured above the joint line using SWE at rest. Thickened UCL may exhibit a decrease in function; therefore, physicians should not evaluate the joint status solely on the basis of the structural properties on conventional ultrasound.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484501","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":"Glenohumeral Arthrodesis in Brachial Plexus Palsies: Open Surgery or Arthroscopy? A Retrospective Comparative Study.","authors":"Marie Fernandez, Antoine Bossée-Pilon, Thomas Williams, Frédéric Dubrana, Arthur Dellestable","doi":"10.1016/j.jse.2025.01.029","DOIUrl":"10.1016/j.jse.2025.01.029","url":null,"abstract":"<p><strong>Background: </strong>The indications for glenohumeral arthrodesis are severe lesions of the supra-clavicular brachial plexus. This is a demanding surgery with numerous complications. To reduce morbidity, a few rare arthroscopic techniques have been developed. We compared arthroscopic shoulder arthrodesis with open arthrodesis. Our hypothesis is that the results of arthroscopic arthrodesis would be at least as good as open arthrodesis in terms of strength and mobility, and better in terms of complications.</p><p><strong>Methods: </strong>Sixteen patients underwent arthrodesis for sequelae of complete brachial plexus palsy between 2008 and 2022. The procedures were performed in our university hospital by experienced surgeons. Six patients underwent open arthrodesis, and 10 arthroscopically. Data were collected retrospectively. A clinical assessment was carried out preoperative and monthly until bone fusion. Clinical examination included measurement of flexion, abduction and rotation amplitudes. Strength was assessed. Secondary endpoints included pain assessment, operative time, American Shoulder and Elbow Surgeons index, Disabilities of the Arm, Shoulder and Hand score and Simple Shoulder Test. Radiographs were analyzed at each consultation until bone fusion was acquired.</p><p><strong>Results: </strong>The average age of the patients was 28 years. Mean follow-up time after arthrodesis was 49.38 months. There was no statistically significant difference between the two groups on preoperative data. The vast majority of brachial plexus palsies were due to road traffic accidents. Patients underwent arthrodesis an average of 29 months after the accident. There was a statistically significant difference (p = 0.034) in the postoperative complication rate in favor of the arthroscopic group. There was no significant difference in mobility or strength. There were no significant differences in pain levels or scores, either pre- or postoperatively.</p><p><strong>Conclusion: </strong>The results of arthroscopic shoulder arthrodesis are at least as good as open arthrodesis in terms of strength and mobility, and better in terms of complications. The most frequent complications are pseudarthrodesis, humeral fractures, infection and pain. It would be interesting to carry out a multicenter, prospective study to confirm our results.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484493","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":"Bone graft augmentation of comminuted radial neck fractures improves the initial stability of plate fixation. A biomechanical study.","authors":"Jan P Hockmann, Vincent Heck, Niklas Theißen, Andreas Prescher, Tim Leschinger, Lars Peter Müller, Michael Hackl","doi":"10.1016/j.jse.2025.01.032","DOIUrl":"https://doi.org/10.1016/j.jse.2025.01.032","url":null,"abstract":"<p><strong>Purpose: </strong>Using modern implants, even complex radial head and neck fractures can often be reconstructed. However, metaphyseal comminution is associated with delayed bone healing and an increased risk for loss of reduction. Hence, this biomechanical in-vitro study intended to evaluate the mechanical stability of a bone graft from the ipsilateral proximal ulna in plate fixation of comminuted radial neck fractures.</p><p><strong>Methods: </strong>Osteotomies at the level of the radial neck with a 3 mm defect were created on 20 fresh-frozen proximal radius specimens to simulate metaphyseal comminution. Fixation was performed with a locking radial head plate in group A and with an additional structural bone graft from the ipsilateral ulna in group B. Cyclic loading from 5-100 N was performed and axial displacement and stiffness were evaluated.</p><p><strong>Results: </strong>The axial displacement was larger in group A (0.81 ± 0.24mm) than in group B (0.52 ± 0.27mm) (p=0.02). Group B had a higher axial stiffness compared to group A (300 (127 - 958)N/mm vs. 163 (82 - 209)N/mm, p=0.015).</p><p><strong>Conclusion: </strong>In the case of metaphyseal comminution of radial head/neck fractures, additional bone graft augmentation from the proximal ulna results in significantly increased stability of locking plate fixation. Future clinical research should focus on whether this leads to improved union rates of these challenging fractures.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477028","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":"Platelet-Derived Mitochondria Attenuate Muscle Atrophy Following Rotator Cuff Tears in a Rat Model.","authors":"Xin Wang, Xing Gao, Chunchu Deng, Ding Xu, Yuanyuan Chen, Jiaqi Huang, Xiao Li, Yulong Shi","doi":"10.1016/j.jse.2025.01.031","DOIUrl":"https://doi.org/10.1016/j.jse.2025.01.031","url":null,"abstract":"<p><strong>Background: </strong>Rotator cuff tears (RCTs) often result in muscle atrophy, compromising surgical outcomes and recovery. Mitochondrial dysfunction is implicated in this process, suggesting potential for mitochondria-based therapies. This study aimed to investigate the effects of platelet mitochondria (Plt-Mito) administration into the supraspinatus muscle (SSP) following RCTs.</p><p><strong>Methods: </strong>Seventy-two male Sprague-Dawley rats were allocated into three distinct groups: (1) a sham surgery group, (2) a group with RCTs treated with Plt-Mito, and (3) a group with RCTs treated with PBS. Treatments were administered every two weeks. After 12 weeks, the supraspinatus muscles were analyzed for wet muscle weight ratio, muscle fiber cross-sectional area (CSA), fibrosis, antioxidant activity, mitochondrial markers, capillary density and mitochondrial structure.</p><p><strong>Results: </strong>Plt-Mito successfully incorporated into SSP, maintaining functional integrity. Compared to the PBS group, Plt-Mito treatment significantly preserved wet muscle weight, increased mean muscle fiber CSA, promoted muscle regeneration, reduced fibrosis, enhanced antioxidant activity (increased superoxide dismutase activity and decreased malondialdehyde activity), improved muscle vascularity (increased CD31 and α-SMA), increased expression of mitochondrial markers (COX IV and UCP-1) and maintained mitochondrial density and structure.</p><p><strong>Conclusions: </strong>Our findings demonstrated Plt-Mito administration effectively halted muscle atrophy and fibrosis, while attenuating mitochondrial damage and dysfunction following RCTs.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477029","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":"Mismatched implants yield comparable outcomes in revision shoulder arthroplasty.","authors":"Monica Stadecker, Justin Givens, Christian M Schmidt, Josué G Layuno-Matos, Logan Kolakowski, Kaitlyn N Christmas, Peter Simon, Kevin J Cronin, Mark A Frankle","doi":"10.1016/j.jse.2025.02.003","DOIUrl":"10.1016/j.jse.2025.02.003","url":null,"abstract":"<p><strong>Background: </strong>Revision shoulder arthroplasty procedures pose unique challenges to shoulder surgeons. Efforts to mitigate bone loss, blood loss, operative time, and intraoperative complications may prompt the surgeon to consider retaining well-fixed components and combine them with components of a different manufacturer. This concept, known as mismatching, represents a viable solution to a dilemma encountered in the revision setting. The purpose of this study is to compare the clinical outcomes between patients treated with matched vs. mismatched implants in revision shoulder arthroplasty.</p><p><strong>Methods: </strong>All revision shoulder arthroplasty cases performed by a single surgeon between 2012 and 2022 were reviewed. Using radiographs and operative reports, 44 patients were identified as mismatches, defined by humeral and glenoid components made by 2 different manufacturers. Demographic data, preoperative and postoperative range of motion, and patient-reported outcomes measures (American Shoulder and Elbow Surgeons, visual analog scale, Simple Shoulder Test, and stability) were collected. A larger cohort of all revision arthroplasties by the same surgeon (n = 574) was then used to perform a matched cohort analysis based on indication for revision. Rate of re-revision and patient-reported outcomes were then compared using simple statistics.</p><p><strong>Results: </strong>Twenty-five of the 44 total mismatches had a minimum of 1-year follow-up. Indications for revision included 13 failed reverse shoulder arthroplasty, 9 failed anatomic total shoulder arthroplasty, and 3 failed hemiarthroplasty. All were revised to reverse shoulder arthroplasty. In the matched cohort analysis (n = 25 mismatches and n = 281 matches), there were no differences in mean American Shoulder and Elbow Surgeons score, visual analog scale pain score, or Simple Shoulder Test at 1 year postoperatively. However, stability was significantly higher for mismatches (5.9) than for matches (3.5) on a 0-10 scale, with 10 being most stable (P = .039). There was an 11% (n = 5) re-revision rate among mismatches, compared with 13% among matches in the total revision cohort. Of the 44 total manufacturer-mismatched cases, 11 were also size-mismatched (differing glenosphere and socket size), and none of these required re-revision within the available short-term follow-up period.</p><p><strong>Discussion: </strong>Patients treated with mismatched components in this study demonstrated similar clinical outcomes and revision rates to those treated with matched components in revision shoulder arthroplasty. Although promising, these results are limited by a small sample size and short-term follow-up. A more definitive conclusion about the practice of mismatching implants will require further research with larger data sets and longer follow-up.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473162","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":"Minimum 10-year clinical and functional outcomes after arthroscopic bony Bankart bridge for the treatment of bony Bankart lesions.","authors":"Maximilian Hinz, Bradley M Kruckeberg, Caleb S Davis, Mark E Cinque, Marilee P Horan, Amelia Drumm, Matthew T Provencher, Peter J Millett","doi":"10.1016/j.jse.2025.02.002","DOIUrl":"10.1016/j.jse.2025.02.002","url":null,"abstract":"<p><strong>Background: </strong>Shoulder dislocations may lead to anterior glenoid rim fractures. An all-arthroscopic double-row repair, referred to as the bony Bankart bridge (BBB), has been proposed with superior biomechanical properties when compared to single-row repair techniques. The aim of the present study was to evaluate the minimum 10-year clinical and functional outcomes following BBB.</p><p><strong>Methods: </strong>All consecutive patients who underwent arthroscopic BBB for the treatment of shoulder instability with an associated bony Bankart lesion by a single surgeon between December 2007 and February 2013 were eligible for inclusion. Preoperatively and minimum 10 years postoperatively, patient-reported outcome measures (American Shoulder and Elbow Surgeons score, short version of the Disabilities of the Arm, Shoulder, and Hand questionnaire, Single Assessment Numeric Evaluation, 12-Item Short-Form Health Survey Physical Component Summary, satisfaction with the postoperative result [1-10 scale with \"10\" indicating maximum satisfaction], and visual analog scale for pain), return to sport rates, and instability recurrence and revision surgery rates were evaluated.</p><p><strong>Results: </strong>Eleven patients (100% male) with a mean age at the time of surgery of 48.0 (interquartile range: 31.0-62.0) years were evaluated 14.0 (11.0-14.0) years postoperatively. At long-term follow-up, significant improvements in shoulder function (American Shoulder and Elbow Surgeons score: 74.9 [30.8-90.8] vs. 100 [98.3-100], P < .001; Quick Disabilities of the Arm, Shoulder, and Hand: 13.6 [10.0-63.6] vs. 0.0 [0.0-6.8], P = .002; Single Assessment Numeric Evaluation: 50.0 [19.0-90.0] vs. 96.0 [89.0-99.0], P = .002) and physical health (12-Item Short-Form Health Survey Physical Component Summary: 44.1 [35.1-55.7] vs. 57.3 [56.5-58.5], P < .001) were observed. Median satisfaction with the postoperative outcome was high (10 [5.0-10]). Pain levels were low (visual analog scale for pain: 0 [0-0]). Ten patients reported their postoperative sporting activity level with the majority patients reporting sporting activity levels equal to or above (70.0%) their preinjury level. One patient (9.1%) reported a shoulder redislocation during follow-up. No patients underwent further surgery for instability or post-traumatic osteoarthritis.</p><p><strong>Conclusion: </strong>The arthroscopic BBB for patients with bony Bankart lesions is associated with excellent shoulder function, low pain levels, and high return to sport rates at long-term follow-up. One patient suffered a shoulder redislocation, but did not require revision surgery. No patients underwent further surgery for post-traumatic osteoarthritis during follow-up.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473159","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":"Medial elbow torque during baseball hitting: considerations for return to play.","authors":"Ryan Lopez, Nabil Mehta, Nareena Imam, Christina Gambino, Aidan Farrell, Frank Alberta, Richard J Boergers, Brandon J Erickson","doi":"10.1016/j.jse.2025.02.001","DOIUrl":"10.1016/j.jse.2025.02.001","url":null,"abstract":"<p><strong>Background: </strong>Injuries to the ulnar collateral ligament are increasing among baseball players at all levels. Little is known about the loads experienced by the medial elbow during baseball hitting. The purpose of this study was to describe the stress experienced by the medial elbow of the trail arm during baseball hitting. We hypothesized that the biomechanical comparison of hitting will demonstrate greater elbow varus torque of the trail arm for wood vs. aluminum bat and inside vs. other swing locations.</p><p><strong>Methods: </strong>Thirteen healthy National Collegiate Athletics Association Division 1 baseball players were analyzed hitting plastic balls from a tee at 4 different swing locations (dry [no contact], inside, middle, and outside) using 2 different bats (wood and aluminum). Biomechanical models were generated for each subject from video motion capture data and the peak elbow varus torque and bat swing velocity were calculated for each trial.</p><p><strong>Results: </strong>The average peak elbow varus torque during hitting was 22.15 ± 4.79 N-m. There were no interactive effects between bat type and swing location type (P = .99) and no effect of bat type on peak elbow varus torque (P = .85) or swing velocity (P = .81). Swings to the outside location generated greater elbow varus torque than dry swings or swings to the inside location (P < .01). Greater swing velocities were observed for swings to the outside location compared to other locations (P < .01).</p><p><strong>Conclusion: </strong>The peak elbow varus torque on the trail arm during a baseball swing is lower than both the throwing and ultimate load to failure of the ulnar collateral ligament. Additionally, both elbow varus torque and swing velocity were greatest when swinging to the outside location.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469700","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":"Return to Sport and Performance Outcomes after Isolated Posterior Labral Repair in Professional Baseball Players.","authors":"Ryan W Paul, Usman Zareef, Andres Perez, William L Johns, Ryan Lopez, Steven B Cohen, Michael G Ciccotti, Stephen J Thomas, Brandon J Erickson","doi":"10.1016/j.jse.2025.01.024","DOIUrl":"https://doi.org/10.1016/j.jse.2025.01.024","url":null,"abstract":"<p><strong>Purpose: </strong>To report the return to sport (RTS) rate, RTS time, and performance outcomes in professional baseball pitchers and position players who underwent isolated posterior labrum repair.</p><p><strong>Methods: </strong>The MLB Health and Injury Tracking System (HITS) database was queried for all major league and minor league baseball players who underwent isolated posterior labrum repair from 2011-2022. Players were excluded if they underwent labrum débridement instead of repair, if they underwent concomitant SLAP or anterior labrum repair, or if they had multi-directional instability. Outcomes of interest included RTS rate, RTS time, workload statistics, and performance outcomes. Outcomes were compared between pitchers and position players, with further sub-analyses between starting vs. relief pitchers as well as between outfielders/infielders/catchers.</p><p><strong>Results: </strong>Overall, 133 professional baseball players including 78 pitchers and 55 position players were included. Position players were able to RTS at a higher rate than pitchers (91.0% vs. 74.5%, p=0.020) and were able to RTS sooner (251 days vs. 330 days, p<0.001) than pitchers. RTS rate did not differ between starting and relief pitchers (76.2% vs. 69.2%, respectively, p=0.719), however starting pitchers took longer to RTS than relief pitchers (348 days vs. 268 days, p=0.013). Position players who underwent repair of the throwing shoulder returned to sport 74 days later (296 days vs. 222 days, p<0.001) than position players who underwent repair of the non-throwing shoulder, and position players who underwent repair of the trail (facing the catcher) batting shoulder returned to sport 96 days later (317 vs. 221 days, p<0.001) than position players who underwent repair of the lead (facing the pitcher) batting shoulder. Pitching workload returned to baseline by the second season postoperatively.</p><p><strong>Conclusion: </strong>Professional baseball pitchers are able to return to sport less frequently and take longer to return to sport than professional baseball position players. Undergoing repair of the throwing or trail batting shoulder can delay return to sport by several months. Pitching workload returned to baseline by the second season postoperatively.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469715","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}