European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"Outcomes of medial collateral ligament reconstruction with suture-augmented semitendinosus autograft.","authors":"John C Garside, Christopher P Bellaire, Dion G Birhiray, Kunal M Kirloskar, Evan H Argintar","doi":"10.1007/s00590-024-04129-9","DOIUrl":"https://doi.org/10.1007/s00590-024-04129-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates patient-reported outcomes among patients who underwent medial collateral ligament (MCL) reconstruction with suture-augmented semitendinosus autograft (SASA).</p><p><strong>Methods: </strong>Patients who underwent SASA MCL reconstruction between 2017 and 2022 participated in preoperative and postoperative surveys for patient-reported outcomes: Visual Analog Pain Scale (VAS), Knee Injury and Osteoarthritis Outcomes Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Single Assessment Numeric Evaluation (SANE), Marx Activity Rating Scale (MARS), and Veterans Rand 12 (VR-12). Paired t-tests were performed to compare preoperative and postoperative scores. Postoperative complications were analyzed for all patients.</p><p><strong>Results: </strong>A total of 19 operations were identified during the study period, and 16 patients were included in the study. Patients reported significant decreases in VAS (mean [95% CI] of -3.86 [-6.09, -1.63], p = 0.0022) and WOMAC (-24.87 [-40.30, -9.4], p = 0.0037) scores postoperatively. Patients also reported significant increases in KOOS (22.60 [9.79, 35.40], p = 0.0019), SANE (38.06 [18.83, 57.27], p = 0.0007), and VR-12 Physical (14.32 [6.38, 22.27], p = 0.0017) scores. Patients did not report significant changes in MARS (0.87 [-1.88, 3.63], p = 0.5081) or VR-12 Mental (-2.90 [-9.37, 3.56], p = 0.3516) scores after surgery. Four patients required reoperation for either arthrofibrosis (n = 3) or ACL reinjury following a multiligament procedure that did not require revision to the MCL reconstruction (n = 1).</p><p><strong>Conclusion: </strong>In this cohort of patients undergoing MCL reconstruction with SASA, patients reported significant improvement in functional outcomes and reduction in pain postoperatively. SASA is a safe and effective technique for MCL reconstruction.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"14"},"PeriodicalIF":1.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calcaneal lengthening osteotomy using ipsilateral fibular graft in the treatment of flexible flatfoot deformity: preliminary results.","authors":"Ahmed Afifi, Sari M Osman, Al-Munqith Al-Abri, Mohammed Heiba Hegazy, Ayman Shaheen, Ayman Mansour, Sherif Galal","doi":"10.1007/s00590-024-04139-7","DOIUrl":"https://doi.org/10.1007/s00590-024-04139-7","url":null,"abstract":"<p><strong>Purpose: </strong>Flexible flatfoot deformity is quite common among adolescents. This study aimed to report the preliminary results of calcaneal lengthening osteotomy using a fibular bone graft.</p><p><strong>Methods: </strong>This single-center, retrospective study included 28 patients (28 feet) with symptomatic flexible flatfoot deformity. The deformity was corrected with calcaneal lengthening osteotomy using an ipsilateral fibular graft. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot score at the final follow-up was selected as the primary outcome measure. Radiographic outcomes included the anteroposterior talo-first metatarsal (AP talo-MT1) angle, the lateral talo-first metatarsal (LAT talo-MT1) angle, the lateral calcaneal pitch (LCP), and the Goldberg scoring system (GSS) for fibular graft incorporation. The visual analogue scale (VAS) was used to assess pain over the ipsilateral fibula donor site.</p><p><strong>Results: </strong>The AOFAS ankle hindfoot score improved from a mean of 53.7 ± 22.4 to a mean of 81.1 ± 19.8, the AP talo-MT1 angle improved from a mean of 24.1° ± 15.6 to a mean of 12.9° ± 7.3, the LAT talo-MT1 angle improved from a mean of 22.3° ± 3.2 to a mean of 7.9° ± 2.3, and the LCP improved from a mean of 10.1° ± 7 to a mean of 24.4° ± 9.1. The GSS was seven points in all patients, which indicated complete radiographic union with an excellent reorganization of the fibular bone graft. The VAS for pain over the ipsilateral fibula donor site was zero at the final follow-up.</p><p><strong>Conclusion: </strong>The fibular bone autograft achieved excellent incorporation when used in calcaneal lengthening osteotomy with good improvement in the clinical and radiographic outcomes in patients with symptomatic flexible flatfoot deformity.</p><p><strong>Level of evidence: </strong>III, Therapeutic study.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"15"},"PeriodicalIF":1.4,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abnormal patella height may be an independent risk factor in meniscal tears: a retrospective study in paediatric patients.","authors":"Themistoklis Vampertzis, Panagiotis Sgardelis, Sonia Makvana, Athanasios Serlis, Ruqaiya Al-Habsi, Dimitrios Manoukian, Manoj Ramachandran","doi":"10.1007/s00590-024-04138-8","DOIUrl":"https://doi.org/10.1007/s00590-024-04138-8","url":null,"abstract":"<p><strong>Purpose: </strong>The literature on factors predisposing to meniscal tears in the paediatric population focuses on concomitant injuries such as anterior cruciate ligament rupture (ACL) or abnormal meniscus morphology such as discoid menisci. Patella alta has been associated with ACL ruptures but its association with meniscal tears has not been described. The purpose of our study was to evaluate whether abnormal patella height is associated with isolated meniscus tears in skeletally immature patients METHODS: We retrospectively analysed all patients under 16 years of age who had an isolated meniscal tear diagnosis confirmed on arthroscopic surgery. We examined data on demographics, meniscal morphology and patella height using the Insall-Salvati and Caton-Dechamp ratios. We compared the incidence of meniscal tears to a literature derived sex and age matched asymptomatic control group with normal patella heights.</p><p><strong>Results: </strong>A total of 39 patients with an isolated meniscal tear were identified (mean age 13.2years). Patella alta was present in 16 (41%). 21 had normal meniscus morphology, and 18 had a discoid meniscus. There was a significant association between patella alta and isolated meniscal tears compared to the control group (p = 0.001).</p><p><strong>Conclusions: </strong>Our analysis is the first to demonstrate an association between abnormal patella height and the incidence of isolated meniscal tears in skeletally immature patients. Further research of knee biomechanics is required to elicit the mechanism and quantify the risk which may be used to guide prevention strategies and management of patients who wish to participate in high-risk sporting activities.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"8"},"PeriodicalIF":1.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modular versus monobloc dual mobility components for primary cementless total hip arthroplasty: a systematic review and meta-analysis of implants' survival, complication rates, clinical and radiographic outcomes.","authors":"Vasileios Giovanoulis, Christos Koutserimpas, Eustathios Kenanidis, Eleftherios Tsiridis, Sébastien Lustig, Arnaud Dubory, Charles-Henri Flouzat-Lachaniette, Philippe Hernigou","doi":"10.1007/s00590-024-04136-w","DOIUrl":"10.1007/s00590-024-04136-w","url":null,"abstract":"<p><strong>Purpose: </strong>The dual mobility cup (DMC) reduces the dislocation rates in total hip arthroplasty (THA). DMC systems include anatomical (non-modular or monoblock) (ADM) and modular dual mobility (MDM) components (Stryker Orthopaedics, Mahwah, NJ, USA). This review aims to assess differences between these two types of DMC implants concerning dislocation and revision rates, as well as patient-reported outcomes.</p><p><strong>Methods: </strong>This systematic review and meta-analysis of studies reports data from patients undergoing primary THA using MDM and/or ADM implants. Following the PRISMA guidelines, we analyzed articles from Science Direct/Scopus, PubMed, and the Cochrane Database of Systematic Reviews. We compared dislocation rates, revisions for any reason, aseptic loosening, infections, fractures, and functional outcomes between ADM and MDM components.</p><p><strong>Results: </strong>Eleven studies were considered eligible for further analysis. A total of 3369 patients (mean age = 65.4 years) underwent primary THA, including 3386 DMC implants. The mean follow-up for the MDM and ADM groups was 2.9 years and 3.9 years, respectively. The study revealed one dislocation in the MDM and none in the ADM. By proportion metanalysis, the review did not show statistical differences in all-cause revisions (p = 0.93, [CI [0.01;0.02]) or periprosthetic fractures (p = 0.18, CI [0.01;0.02]).</p><p><strong>Conclusions: </strong>MDM and ADM systems, both, represent safe DM options regarding dislocation, all-causes revisions and functional outcomes.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"7"},"PeriodicalIF":1.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative outcomes of operative treatment for two and three-part proximal humerus fractures with or without ipsilateral shaft fractures and head-split patterns: intramedullary nail versus open reduction internal fixation.","authors":"Zachariah Whiting, Lucas Haase, Tyler Moon, Akash Raju, Robert Wetzel, John Sontich, George Ochenjele, Josh Napora","doi":"10.1007/s00590-024-04120-4","DOIUrl":"10.1007/s00590-024-04120-4","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether the outcomes, including union rates, complications, reoperations, blood loss, operative time, and range of motion, differed following intramedullary nailing (IMN) or open reduction internal fixation (ORIF) of two- and three-part proximal humerus fractures with or without ipsilateral shaft fractures and head-split patterns.</p><p><strong>Methods: </strong>This was a retrospective multicenter study at three community centers and one level 1 trauma center. Inclusion criteria were two- and three-part proximal humerus fracture treated with either IMN or ORIF from 2015 to 2022 with at least three months of postoperative follow-up.</p><p><strong>Results: </strong>228 patients. No significant differences in preoperative subject characteristics were observed. IMN was significantly more common with ipsilateral shaft fractures (p = 0.011). The number of fracture parts was significantly associated with treatment (p < 0.001). IMN had significantly less blood loss in two-part fractures (p = 0.016) and concomitant shaft fractures (p = 0.029), but operative time was not significantly less in any group. Union rates, complications, reoperation, postoperative humeral neck shaft angle, and postoperative range of motion were not significantly different.</p><p><strong>Conclusions: </strong>IMN and ORIF result in similar outcomes for proximal humerus fractures. Both treatments result in high union rates, the potential for near anatomic postoperative humeral neck shaft angles, and sufficient postoperative range of motion. IMN has lower blood loss than ORIF. IMN is a viable option for two-part proximal humerus fractures and may be effective in select three-part fractures as well. Concomitant humeral shaft fractures can be treated with either IMN or ORIF. Head-split patterns should be treated with ORIF.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"6"},"PeriodicalIF":1.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior cruciate ligament reconstruction with suture tape augmentation in the high-risk, young population.","authors":"John C Garside, Christopher P Bellaire, Eliana J Schaefer, Brian S Kim, Brian J Panish, Seleem H Elkadi, Denver B Kraft, Evan H Argintar","doi":"10.1007/s00590-024-04133-z","DOIUrl":"10.1007/s00590-024-04133-z","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated patient-reported outcome measures and reinjury rates in higher-risk adolescents and young adults aged 14-25 years old following Anterior Cruciate Ligament reconstruction using autograft with suture tape augmentation (SA ACLR).</p><p><strong>Materials and methods: </strong>We performed a retrospective case series of patients aged 14-25 who underwent SA ACLR by a single surgeon between 2016 and 2020. After a minimum of 2 years of follow-up, data was collected on reinjury and patient reported outcome measures, including Knee Injury and Osteoarthritis Outcome Score (KOOS), Marx Activity Rating Scale (MARS), Single Assessment Numeric Evaluation (SANE), and Visual Analog Pain Scale (VAPS).</p><p><strong>Results: </strong>27 patients were identified. 4 were lost to follow-up, and 23 met inclusion criteria (11 male, 12 female). Average age was 20, and average follow-up was 2.5 years. Failure rate was 8.7%, with two patients requiring revision ACL reconstruction. One patient required two additional meniscal operations with intraoperative findings demonstrating maintenance of an intact ACL. Postoperative patient-reported outcomes measures (PROMs) were obtained for the patients who did not require additional surgery (n = 20), and preoperative PROMs were available for 16 of these patients. Postoperatively, patients reported a mean VAPS of 0.74 ± 1.27, MARS of 8.05 ± 5.58, and SANE of 83.05 ± 16.47. Mean KOOS was 86.92 ± 11.77 with subscores Pain of 86.94 ± 12.94, Symptoms of 82.16 ± 14.96, ADL of 95.81 ± 8.10, Sport of 75.61 ± 21.52, and QOL of 70.64 ± 22.04. Paired t-tests demonstrated significant improvements in VAPS, SANE, and KOOS outcomes following surgery. Patients were significantly less active postoperatively as reported by the MARS. A multivariable regression analysis showed that increased age predicted poorer postoperative KOOS Pain outcomes, and female sex predicted inferior KOOS Pain and Sport outcomes.</p><p><strong>Conclusion: </strong>SA ACLR is a safe and effective surgical technique in the high failure risk young adult demographic, with a low reinjury rate and acceptable KOOS scores. Patients were active with minimal pain at minimum two years of follow-up. Female sex was a risk factor for poorer outcomes in this population.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"4"},"PeriodicalIF":1.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Femoral neck fractures: a cohort comparison of nonunion and complication rates after ballistic versus blunt mechanism fractures.","authors":"Jordan Cook Serotte, Julia Nascimben, Daniel Portney, Sara S Wallace, Mary Kate Erdman, Jason A Strelzow","doi":"10.1007/s00590-024-04143-x","DOIUrl":"10.1007/s00590-024-04143-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to review complications and union rates of ballistic femoral neck fractures when compared to their blunt counterparts. We hypothesize that gunshot injuries to the femoral neck may have higher rates of complications (nonunion, avascular necrosis [AVN], and implant failure) as a result of increasing comminution and disruption to the already tenuous blood supply through the femoral neck.</p><p><strong>Methods: </strong>Following the Institutional Review Board approval, a retrospective chart review was performed identifying femoral neck fractures at a single level 1 trauma center from 2018 to 2023. Inclusion criteria were age 16-45 years old with intracapsular femoral neck fractures. Exclusion criteria were absence of radiographic and clinical follow-up beyond 6 weeks, prior femur fractures, pathologic fractures, or primary surgery of total hip arthroplasty. Garden classification and Pauwels angle were reported. Clinical union was defined as the absence of pain with ambulation in the absence of radiographic changes. Radiographic union was defined using the validated Radiographic Union Score for Hip (RUSH) scoring system. Complication rates (deep and superficial infection, failure of fixation, and AVN) and subsequent surgery were recorded.</p><p><strong>Results: </strong>After exclusion, 12 ballistic and 16 blunt femoral neck fractures met inclusion criteria and were reviewed. The ballistic cohort had significant more Garden I fractures than the blunt cohort (4 [33%] vs. 0 [0%]), and significantly fewer Garden IV fractures than the blunt cohort (2 [17%] vs. 9 [56%]). Despite different Garden classification types of fracture patterns, the Pauwels angle between the two cohorts was similar (51° ballistic vs. 60° blunt, p = 0.16). The overall nonunion rate was 24.1%. Nonunion rates were similar between the two cohorts (3, 25% ballistic vs. 4, 25% blunt, p = 0.99). The mean final RUSH score between the two cohorts was similar (20.1 ballistic vs. 23.4 blunt [p = 0.05]). The total complication rate was 31% (9/28) consisting of 7 nonunions and 2 malunions across both cohorts.</p><p><strong>Conclusion: </strong>The current study found no difference in the union rates between blunt and ballistic femoral neck fractures. Although comparing these fractures using traditional classification systems (Garden and Pauwels) are difficult due to the inherent differences in mechanism and the applicability of these tools, both groups presented with high rates of nonunion and complications. We believe the similar RUSH scores and complication rates in both cohorts show these fractures fundamentally behave similarly and remain challenging injuries to manage with ORIF.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"3"},"PeriodicalIF":1.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative hip abductor strength predicts discharge destination after total hip arthroplasty.","authors":"Shusuke Nojiri, Azusa Kayamoto, Chiaki Terai, Shinya Tanaka, Yusuke Osawa, Yasuhiko Takegami","doi":"10.1007/s00590-024-04119-x","DOIUrl":"10.1007/s00590-024-04119-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to clarify the association between preoperative physical function and discharge destination after total hip arthroplasty (THA).</p><p><strong>Methods: </strong>This retrospective study included patients who underwent primary unilateral THA for hip osteoarthritis. Preoperative physical function was assessed via maximal isometric muscle strength (hip abduction and knee extension) and comfortable walking speed. The patients were divided into two groups according to the discharge destination (home or transfer to other facilities). Multivariate logistic regression analysis was used to identify preoperative physical function associated with discharge destination.</p><p><strong>Results: </strong>Of the 174 patients, 120 were discharged directly to home, and 54 were transferred to other facilities. Those transferred to other facilities were significantly older, more likely to live alone, and had a longer operation time. In addition, they demonstrated lower hip abductor strength on both sides and lower knee extensor strength on the operative side. Multivariate logistic regression analysis revealed that hip abductor strength on both sides, not knee extensor strength, was independently associated with the discharge destination. The largest area under the receiver operating characteristic curve was 0.668 for the hip abductor strength of the contralateral side. The optimal cutoff point was revealed to be 0.035 kgf·m/kg and 0.031 kgf·m/kg for the operative and contralateral sides, respectively.</p><p><strong>Conclusions: </strong>Preoperative hip abductor strength, particularly on the contralateral side with a cutoff value of 0.031 kgf·m/kg, could be a predictor of discharge destination after unilateral THA. Our findings would be useful in planning rehabilitation programs.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"5"},"PeriodicalIF":1.4,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of clinical outcomes and return to sport between unicortical versus bicortical button fixation techniques for subpectoral biceps tenodesis.","authors":"Nathan A Huebschmann, Zachary I Li, Amanda Avila, Guillem Gonzalez-Lomas, Kirk A Campbell, Michael J Alaia, Laith M Jazrawi, Eric J Strauss, Brandon J Erickson","doi":"10.1007/s00590-024-04134-y","DOIUrl":"10.1007/s00590-024-04134-y","url":null,"abstract":"<p><strong>Purpose: </strong>There is limited clinical outcome data comparing fixation methods for tenodesis of the long head of the biceps tendon (LHBT), particularly button fixation. The purpose of this study was to compare clinical outcomes, patient-reported outcomes, and return to sport (RTS) between patients undergoing LHBT with bicortical versus unicortical button technique. The authors hypothesized these fixation methods would be similar for all outcomes.</p><p><strong>Methods: </strong>Patients who underwent LHBT using unicortical or bicortical button fixation with minimum 2-year follow-up were identified. Postoperative outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) questionnaire and visual analogue scale (VAS) pain score. A sports activity survey was collected to assess baseline sport participation and ability to return to pre-injury activities. Continuous variables were analyzed using the Mann-Whitney-U test. Categorical variables were analyzed using Chi-squared tests. Multivariable logistic and linear regression were performed to determine predictors of RTS and time to RTS.</p><p><strong>Results: </strong>Sixty-four subjects (19 unicortical and 45 bicortical button fixation) were included (average follow-up 3.5 (range: 2.0-7.8) years). There were no significant differences found between button groups for VAS pain score (1.5 vs. 1.2; p = 0.876), VAS pain during sport score (1.6 vs. 1.1, p = 0.398), and ASES score (66 vs. 71; p = 0.294). There were no significant differences in rate of RTS (75.0 vs. 77.4%; p = 0.885) or average time to return to sport (11.7 ± 7.3 vs. 7.0 ± 4.0 months; p = 0.081) between groups.</p><p><strong>Conclusion: </strong>There were no significant differences in clinical outcomes, pain, or return to sport between patients who underwent LHBT with unicortical or bicortical button fixation.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"2"},"PeriodicalIF":1.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Surviving the dip\" after subacromial balloon spacer implantation for massive rotator cuff tear treatment: a retrospective case series.","authors":"Michael Sirignano, John Nyland, Ryan Krupp","doi":"10.1007/s00590-024-04140-0","DOIUrl":"https://doi.org/10.1007/s00590-024-04140-0","url":null,"abstract":"<p><strong>Background: </strong>Subacromial balloon spacer implantation (SBSI) attempts to decrease glenohumeral joint (GHJ) pain and improve function in patients with an irreparable rotator cuff tear (RCT) and minimal osteoarthritis. Between 12 and 26 weeks post-SBSI, gradual implant resorption may create a \"balloon dip\" that decreases GHJ function and increases pain. This retrospective cohort study attempted to delineate shoulder function, active mobility, strength, pain, and functional task impairment during the \"balloon dip\" period.</p><p><strong>Materials and methods: </strong>Sixty-five consecutive patients (55.9 ± 7 years of age, 42 men) with an irreparable RCT treated by the same fellowship-trained shoulder surgeon participated in this study. Outcome measurements pre-SBSI, during Phase I (early pain control ≤ 3 weeks post-SBSI), Phase II (early rehabilitation > 3-11 weeks post-SBSI), Phase III (advanced rehabilitation-early balloon resorption > 11-16 weeks post-SBSI), Phase IV (early strength training > 16-24 weeks post-SBSI), and Phase V (advanced strength training > 24 weeks post-SBSI) included the American Shoulder and Elbow Society (ASES) score for perceived bilateral shoulder function, visual analog scale (VAS) surgical shoulder pain score, active mobility, and shoulder manual muscle strength testing (p ≤ 0.05).</p><p><strong>Results: </strong>The mean final follow-up time was 40 weeks (range = 24.1-89.7 weeks). The surgical shoulder had higher ASES scores at Phase V than pre-SBSI. Surgical shoulder pain was less during Phase V than pre-SBSI. The surgical shoulder had greater flexion during Phase V than at Phase II or pre-SBSI, and greater external rotation (adducted) during Phases V-III than pre-SBSI. Peak shoulder internal rotation to level 12 (thoracic spinous process #10) occurred during Phase V. Peak shoulder flexor, external rotator, and internal rotator strength occurred during Phase V. During Phase I, most subjects were unable to sleep on their surgical shoulder, wash their back/do up their bra, reach a high shelf, or lift 10-lbs overhead. Tasks that were impaired during the \"balloon dip\" (between Phase III and V) were lifting 10-lbs overhead, reaching a high shelf, and doing normal work. By the end of Phase V, however, most subjects could perform each task with minimal or no difficulty.</p><p><strong>Conclusion: </strong>Surgical shoulder function improved and pain decreased, however, specific perceived functional task impairments remained. During the \"balloon dip\" phase, the perceived ability to lift 10 lbs above shoulder level, to reach a high shelf, and to do usual work activities were the most impaired tasks.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"1"},"PeriodicalIF":1.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}