Journal of Shoulder and Elbow Surgery最新文献

{"title":"Utilization Trends of the ExactechGPS® Computer-Assisted Navigation System in Total Shoulder Arthroplasty.","authors":"Jacquelyn J Xu, Brian O Molokwu, Roban Shabbir-Hussain, François Boux de Casson, Josie Elwell, Sandrine V Polakovic, Charles L Myerson, Joseph D Zuckerman, Mandeep S Virk","doi":"10.1016/j.jse.2025.01.015","DOIUrl":"https://doi.org/10.1016/j.jse.2025.01.015","url":null,"abstract":"<p><strong>Background: </strong>Guidance technology in total joint arthroplasty has gained popularity over the last few decades. Computer-assisted navigation (CAN) was recently introduced for glenoid implantation in total shoulder arthroplasty (TSA). However, utilization trends of CAN TSA are not currently known. This study aims to determine the prevalence and trends of CAN usage in TSA from its introduction in 2017 until 2023.</p><p><strong>Methods: </strong>A retrospective review was performed of all TSAs (anatomic TSA [aTSA] or reverse TSA [rTSA]) implanted using a single computer navigation shoulder system (ExactechGPS; Gainseville, FL, USA). Intraoperative navigation was performed for the glenoid component only. Utilization of CAN was reported per year to determine trends in the prevalence of CAN cases, number of users, new users, dropped users, high-volume users (>50 CAN cases/year), and the number of cases completed by high-volume users. The data was also stratified by type of TSA (aTSA vs. rTSA) and type of glenoid component used (augmented or non-augmented).</p><p><strong>Results: </strong>From 2017 to 2023, navigated TSAs increased from 654 to 9777 cases per year, with a greater increase in navigated rTSA than aTSA volume. The number of CAN cases using augmented implants grew 1435% while non-augmented implants grew 1352%. By 2023, the overall number of CAN users increased from 79 to 667 users. High-volume CAN surgeons increased to 50 users by 2023. Over this period, the number of CAN TSA performed by high-volume surgeons increased more rapidly than the actual number of high-volume surgeons per year.</p><p><strong>Conclusions: </strong>This study demonstrates an exponential increase in the use of CAN for TSA in the last eight years. This increase is driven by progressive growth in both the volume of new users as well as CAN TSAs performed by existing users by several hundred folds. These upwards trends in utilization of guidance technology for TSA are likely to continue in future.</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":"143469720","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 Superior Labrum Anterior to Posterior (SLAP) Repair in Professional Baseball Players.","authors":"Ryan W Paul, Andres Perez, William L Johns, Ryan Lopez, Alim Osman, Steven B Cohen, Michael G Ciccotti, Stephen J Thomas, Brandon J Erickson","doi":"10.1016/j.jse.2025.01.025","DOIUrl":"https://doi.org/10.1016/j.jse.2025.01.025","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 SLAP 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 SLAP repair without treatment of the biceps from 2011-2022. Outcomes of interest included RTS rate, time until RTS, 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, 53 professional baseball players comprised of 36 pitchers and 17 position players were included with 49 (92.5%) players at the Minor League Baseball level and a mean age of 24±3 years. All pitchers underwent surgery of the pitching shoulder, and only one position player underwent surgery of the non-throwing shoulder. Position players and pitchers RTS at a similar rate (82.4% vs. 80.6%, respectively, p=1.000) and RTS in a similar amount of time (280 vs. 327 days, p=0.120) after surgery. No statistical changes in pitching performance statistics (ERA, WHIP, batting average) or offensive performance statistics (batting average, OBP, SLG, OPS) were observed across the study timeline (all p>0.05).</p><p><strong>Conclusion: </strong>Professional baseball pitchers and position players RTS at 82% vs. 81%, respectively after SLAP repair. They require approximately an average of 9 to 11 months to RTS after SLAP repair. Pitchers and position players do not experience significant changes in their performance statistics after surgery.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460460","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":"Voluntary Activation is impaired in Subacromial Pain Syndrome but improves with pain relief and exercise.","authors":"Kshamata M Shah, Daniel Safford, Kathleen Madara, Jennifer Cooper, Brett Sweitzer, Andrew Karduna, Philip W McClure","doi":"10.1016/j.jse.2025.01.020","DOIUrl":"https://doi.org/10.1016/j.jse.2025.01.020","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Shoulder exercise and subacromial injection are the first line of treatment for patients with subacromial pain syndrome (SAPS) and have been shown to be effective in about 70% of patients. Weakness is common in these patients although its true source is uncertain. The purpose of this study is to determine the changes in rotator cuff voluntary activation (VA), i.e. central drive and force, immediately after a pain-relieving subacromial injection, and following a 6-week exercise program and examine baseline differences in patients with SAPS and healthy controls.</p><p><strong>Methods: </strong>Voluntary Activation, peak normalized External Rotation (ER) Torque, pain and self-report function were assessed in 43 patients with positive shoulder impingement. Subjects were tested at baseline (T1), immediately after a pain-relieving injection (T2), and after 6 weeks of exercise (T3). Forty-four matched controls were tested at baseline (T1). Participants received two stimuli on their infraspinatus, one while contracting maximally and one at rest, to determine the VA.</p><p><strong>Results: </strong>Subjects with SAPS demonstrated lower ER normalized torque, 27.3% lower compared to controls, P=0.005, and lower infraspinatus VA, median 0.99 in controls and 0.71 in patients, P<0.001. As expected, the VA increased (P=0.004) from T1 to T2 and remained unchanged at T3 as compared to T2. ER normalized torque increased across all time points. Pain (P<0.001) decreased with the injection and exercise and function (P<0.001) improved from baseline to discharge.</p><p><strong>Discussion: </strong>Understanding neural adaptations with exercise is critical to learning how to best modify the system and optimize current rehabilitation strategies, for example including exercises focused on motor-control training, biofeedback or neuromuscular electric stimulation.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460461","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":"Assessment and comparison of artificial intelligence-generated information regarding shoulder arthroplasty from multiple interfaces.","authors":"Suhasini Gupta, Brett D Haislup, Anisha Tyagi, Suleiman Y Sudah, Ryan A Hoffman, Anand M Murthi","doi":"10.1016/j.jse.2024.12.048","DOIUrl":"10.1016/j.jse.2024.12.048","url":null,"abstract":"<p><strong>Background: </strong>This study aims to analyze and compare the quality, accuracy, and readability of information regarding anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) provided by various AI interfaces (Open AI's ChatGPT and Microsoft's CoPilot).</p><p><strong>Methods: </strong>Thirty commonly asked questions (categorized by Rothwell criteria into Fact, Policy, and Value) by patients were inputted into ChatGPT 3.5 and CoPilot. Responses were assessed with the DISCERN scale, Journal of the American Medical Association (JAMA) benchmark criteria, and Flesch-Kincaid Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL). The sources of citations provided by CoPilot were further analyzed.</p><p><strong>Results: </strong>Both AI interfaces generated DISCERN scores >50 (aTSA and rTSA ChatGPT: 57 [Fact], 61 [Policy], 58 [Value]; aTSA and rTSA CoPilot: 68 [Fact], 72 [Policy], 70 [Value]), demonstrating \"good\" quality of information provided, except for the Policy questions by CoPilot, which were scored as \"excellent\" (>70). CoPilot's higher JAMA score (3 vs. 0) and FRES scores >30 indicated more reliable, accessible responses, which required a minimum of 12th-grade education to read the same. In comparison, the ChatGPT generated more complex texts, with the majority of the FRES scores <20, and FKGL score signifying complexity of academic level text. Finally, CoPilot provided citations and demonstrated the highest percentage of academic sources (31.1% for rTSA and 26.7% for aTSA), suggesting reliable sources of information.</p><p><strong>Conclusion: </strong>Overall, the information provided by both AI interfaces ChatGPT and CoPilot was scored as a \"good\" source of information for commonly asked patient questions regarding shoulder arthroplasty. But the answers to questions pertaining to shoulder arthroplasty provided by CoPilot proved to be more reliable (P = .0061), less complex, easier to read (P = .0031), and referenced information from reliable resources including academic sources, journal articles, and medical sites. Although answers provided by CoPilot were \"easier\" to read, they still required a 12th-grade education, which may be too complex for most patients, posing a challenge for patient comprehension. There were a substantial amount of nonmedical media sites, and commercial sources that were cited for both aTSA and rTSA questions by CoPilot. Critically, answers from both AI interfaces should serve as supplementary resources rather than primary sources on perioperative conditions pertaining to shoulder arthroplasty.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460417","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":"Sponsoring Societies","authors":"","doi":"10.1016/S1058-2746(25)00037-0","DOIUrl":"10.1016/S1058-2746(25)00037-0","url":null,"abstract":"","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":"34 3","pages":"Page A10"},"PeriodicalIF":2.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143429566","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":"What are We Matching On and Why?: A Systematic Review of Matched Study Designs in Shoulder Arthroplasty.","authors":"Nathan H Varady, Benjamin R Wesorick, Michael L Garenani, Audrey Wimberly, Samuel A Taylor, Joshua S Dines, Michael C Fu, Gabriella E Ode, David M Dines, Lawrence V Gulotta, Christopher M Brusalis","doi":"10.1016/j.jse.2025.01.021","DOIUrl":"https://doi.org/10.1016/j.jse.2025.01.021","url":null,"abstract":"<p><strong>Background: </strong>Establishing patient-matched cohorts can be a valuable technique for minimizing selection bias in outcomes research pertaining to shoulder arthroplasty. This systematic review evaluated the variety and inconsistency with which matching techniques are employed in matched studies assessing outcomes following shoulder arthroplasty.</p><p><strong>Methods: </strong>The PubMed, EMBASE, and Cochrane computerized databases were queried from their inception through December 2023 to identify clinical outcome studies of shoulder arthroplasty that employed a matched study design. Study quality was assessed via the Methodological Index for Non-Randomized Studies criteria. Matching techniques, covariates included, and covariate justification were aggregated.</p><p><strong>Results: </strong>Among 110 studies encompassing 483,738 shoulder arthroplasties, 82 (74.6%) studies employed direct matching and 28 (25.5%) employed propensity score matching. Seventy-four distinct covariates were used in at least one study, with 86 unique combinations of covariates employed. Studies used a median of 4 covariates (range 1-27). The most common covariates were age (94.5%), sex (89.1%), body mass index (26.4%), smoking (19.1%), and follow-up duration (19.1%). Only 16 (14.6%) studies reported justification for the covariates included.</p><p><strong>Conclusions: </strong>There are marked methodological discrepancies among studies using covariate matching methods in the shoulder arthroplasty literature. Future matched studies in shoulder arthroplasty should provide justification for included covariates and properly account for matching in their statistical analyses to enhance the validity of study findings. When patient matching is deemed appropriate, key variables to consider for matching may include patient age, sex, comorbidity burden and, when analyzing multiple clinical conditions, surgical indication.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460464","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":"Hawkins Award 2024: Free bone graft transfer versus Latarjet procedure for treatment of anterior shoulder instability with glenoid bone loss: 5-year follow-up of a prospective randomized trial.","authors":"Eva Schulz, Julian Diepold, Paul Siegert, Guido Wierer, Nicholas Matis, Thomas Hoffelner, Alexander Auffarth, Herbert Resch, Peter Habermeyer, Mark Tauber, Philipp Moroder","doi":"10.1016/j.jse.2025.01.017","DOIUrl":"https://doi.org/10.1016/j.jse.2025.01.017","url":null,"abstract":"<p><strong>Background: </strong>Free bone graft transfer (FBGT) and the Latarjet procedure are two competing techniques for the treatment of anterior shoulder instability with glenoid bone loss. In the current literature, there are no mid- to long-term prospective randomized comparative studies comparing both surgical methods.</p><p><strong>Methods: </strong>This prospective, bi-center, randomized study enrolled 60 patients with anterior shoulder instability and more than 15% glenoid bone loss. The study cohort was randomly assigned in a 1:1 ratio to either an open FBGT surgery (J-bone graft technique) or an open Latarjet procedure. Clinical data, including Western Ontario Shoulder Index, Rowe Score, Subjective Shoulder Value, Visual Analogue Scale, satisfaction with the operation, sports and work limitations, range of motion and strength, as well as the extent of instability arthropathy were collected preoperatively and at 6, 12, 24, and 60 months postoperatively. The 5-year follow-up rate was 63.3% for the FBGT group and 66.6% for the Latarjet group.</p><p><strong>Results: </strong>The primary outcome parameter (WOSI) showed no significant differences at the 5-year follow-up (J-Span 221 ±186, Latarjet 201±239; p= 0.529) and other time points. The secondary clinical scores also showed no significant differences between the two groups (Rowe score p= 0.596, Subjective Shoulder Value p= 0.368, Visual Analogue Scale p= 0.238, ASSOS score p= 0.594). Comparable results were observed regarding strength and motion, except for significantly better internal rotation in the FBGT group at all time points, including the 5-year follow-up (p= 0.004). A single recurrence of instability was observed in 3 patients of the FBGT group and 1 patient of the Latarjet group (p= 0.342). Postoperative hypesthesia at the iliac crest was reported in 3.3% of the FBGT patients. The degree of instability arthropathy showed a comparable increase in both cohorts (p= 0.154).</p><p><strong>Conclusion: </strong>None of the two surgical methods showed clinical superiority at the 5-year follow-up, except for statistically better internal rotation in the FBGT group. Both cohorts showed comparable success in joint stabilization, but neither could prevent the progression of instability arthropathy.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460419","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":"Morrey Award 2024: If I replace these bushings, how long will they last? An analysis of 58 isolated Coonrad-Morrey bushing exchanges with 21-year average follow-up.","authors":"Tristan B Weir, Christopher M Hart, Kristin E Yu, Micah J Nieboer, Bernard F Morrey, Shawn W O'Driscoll, Joaquin Sanchez-Sotelo, Mark E Morrey","doi":"10.1016/j.jse.2025.02.004","DOIUrl":"10.1016/j.jse.2025.02.004","url":null,"abstract":"<p><strong>Background: </strong>Reports of bushing exchange (BE) with retention of all other components (isolated BE) after Coonrad-Morrey total elbow arthroplasty (TEA) are limited to small case series. The purpose of this study was to determine the survival of isolated BE after primary or revision TEA. Secondary aims were to determine the survival of the humeral and ulnar stems, the risk factors for failure, and the complications and outcomes after 1 or more BEs.</p><p><strong>Methods: </strong>Our Total Joint Registry database was queried to identify all elbows that underwent revision of a primary or revision Coonrad-Morrey TEA between 1981 and 2021. After excluding reoperations for infection, cancer, or inadequate records, 43 patients with 58 isolated BEs with retention of both the humeral and ulnar components were included. The mean age at the time of the initial TEA was 51 ± 12 years and 63% were female. A single BE was performed in 31 patients, while 12 had a revision BE. The mean follow-up was 21 years (range, 7-35 years).</p><p><strong>Results: </strong>The median time to the first isolated BE was significantly longer than the time to revision BE (11.0 vs. 7.6 years; P = .036). Following the first isolated BE, Kaplan-Meier survivorship free of revision BE was 95% at 2 years, 87% at 5 years, 78% at 10 years, and 60% at 15 and 20 years. A \"triceps on\" approach during the index TEA was a risk factor (hazard ratio [HR], 27.0) for requiring a revision BE. The survivorship free of any revision was 78% at 5 years, 63% at 10 years, and 49% at 15 and 20 years. A \"triceps on\" approach during the index TEA (HR, 5.4) and post-traumatic arthritis or osteoarthritis (HR, 2.8) were risk factors for any revision. The overall survival of the humeral and ulnar stems was 73% at 20 years following the index TEA. The overall revision (28%) and complication (19%) rates, Mayo Elbow Performance Score (85 points), pain (1.5 points), and arc of motion (110°) were similar for single and multiple BEs.</p><p><strong>Conclusions: </strong>While isolated BE is a relatively rare procedure, it should be considered in patients with substantial bushing wear and stable implants. Patients may experience relatively high revision and complication rates following isolated BE, but more than half retain their bushings and implants at long-term follow-up. Surgical and patient factors may increase the risk of revision following isolated BE, but patients can expect good clinical outcomes.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460424","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":"MEDIUM-TERM OUTCOMES FOLLOWING MATHYS AFFINIS SHORT STEMLESS ANATOMIC TOTAL SHOULDER REPLACEMENT: CLINICAL AND RADIOLOGIC FINDINGS (MINIMUM 5-YEAR FOLLOW-UP).","authors":"J E Dixon, I A Rankin, N C Sciberras, L A K Khan, S L Barker, D A Cairns, K Kumar","doi":"10.1016/j.jse.2025.01.016","DOIUrl":"https://doi.org/10.1016/j.jse.2025.01.016","url":null,"abstract":"<p><strong>Background: </strong>Stemless anatomic total shoulder arthroplasty (aTSA) use has increased in recent years. Despite evidence to suggest good mid-term results at 2-year follow-up, there is a paucity of evidence for longer term follow-up. This study aimed to investigate outcomes at a minimum of 5 years postoperatively following primary stemless aTSA.</p><p><strong>Methods: </strong>An observational cohort study using prospectively collected data was performed for all patients that underwent a Mathys Affinis stemless aTSA procedure at our institution. The study period ranged from July 2010 to August 2018 (minimum 5-year follow-up). Clinical outcome measures included revision rate, range of motion, and patient reported outcomes (Oxford Shoulder Score and Numerical Satisfaction Score). Radiological outcome was an assessment of radiolucency using Lazarus grading.</p><p><strong>Results: </strong>A total of 105 stemless TSAs were implanted during the trial period. Following exclusions, seventy-five aTSA's were included in the final cohort for analysis of 5-year outcomes. Five patients underwent revision (4.8%). Median follow-up time was 6.1 years. Median age was 69 years old and 81% were female. Oxford shoulder score showed a range of 18 to 48, with a median score of 47. Satisfied or very Satisfied was selected in 94.4%. Median range of motion assessments showed forward elevation 160°, abduction 150°, external rotation 40°, and mode internal rotation was to the lumbar spine. No glenoid lucency was present in 79.7%. There were 9.5% with Lazarus Grade 1 lucency, 5.4% with Lazarus Grade 2, and 5.4% Lazarus Grade 3. No humeral lucency was observed.</p><p><strong>Conclusions: </strong>This cohort study represents the largest minimum 5 year follow-up data for the Mathys Affinis stemless anatomic total shoulder arthroplasty, demonstrating excellent clinical and radiological outcomes.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460421","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 can Predict Stiffness of Supraspinatus Musculotendinous Unit earlier than fatty infiltration in a rat chronic rotator cuff tear model.","authors":"Akihisa Koga, Yoshiaki Itoigawa, Hirohisa Uehara, Daichi Morikawa, Katsuhiko Maezawa, Yuichiro Maruyama","doi":"10.1016/j.jse.2025.01.019","DOIUrl":"https://doi.org/10.1016/j.jse.2025.01.019","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare extensibility changes in the rotator cuff musculotendinous unit after a surgically induced rotator cuff tear by correlating tendon retraction size, and fatty infiltration of the muscle and shear wave elastography (SWE) measures of rotator cuff muscle stiffness, using a rat model of chronic rotator cuff tear.</p><p><strong>Methods: </strong>This study used Sprague-Dawley rats (n = 24). In the right shoulders, treated as chronic rotator cuff tear (cRCT) group, the supraspinatus and infraspinatus tendons were detached from the greater tuberosity. Then, an L-shaped resin was fixed firmly on the greater tuberosity with a 3-0 nylon suture to prevent cuff reattachment and scar tissue formation. In the left shoulders, treated as control group, rotator cuff tendon was not detached. The rats were euthanized at 1, 2, 4 and 8 weeks after the surgery. The resin was removed, and the length of the retraction of the supraspinatus tendon end from the greater tuberosity was measured. Thereafter, the whole rotator cuff muscle, scapula, and humerus were harvested from the shoulder of the cRCT and control groups, and were frozen immediately at -80°C. The specimens were thawed at room temperature. SWE measurement was performed initially, and the SSP muscle stiffness value was measured. Next, the medial edge of the scapula and supraspinatus tendon edge were fastened, and the tension based on the tensile test was applied in the mediolateral direction of the SSP muscle. The supraspinatus muscle specimens were processed from frozen sections and stained with Oil Red O. The ratio of fat area in the central third of the muscle was measured. The association between the supraspinatus muscle extensibility in the tensile test and other measurements was examined.</p><p><strong>Result: </strong>The rotator cuff maintained the tear without attachment to the humerus on all cRCT sides. The correlation values between extensibility and other measurements were as follows: SWE value - R = 0.573, P < 0.001; retraction length - R = 0.186, P = 0.384; and fatty infiltration ratio - R = 0.139, P = 0.518. Hence, the SWE value had the highest correlation.</p><p><strong>Conclusion: </strong>SWE can detect rotator cuff stiffness in the early stages of rotator cuff tear in this rat model. Further, SWE values have the strongest correlation with rotator cuff extensibility in the tensile test. Thus, SWE has the potential to be used in presurgical planning to predict difficulty due to decreased extensibility of the rotator cuff musculotendinous unit.</p>","PeriodicalId":50051,"journal":{"name":"Journal of Shoulder and Elbow Surgery","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450821","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}