JSES reviews, reports, and techniques最新文献

{"title":"Acute pectoralis major tendon tear repair with semitendinosus augmentation: case series","authors":"Giovanna Medina MD, PhD, Luiz Henrique Boraschi Vieira Ribas MD, Breno Schor MD, PhD, Juliana R. Mauad MD, Antonio Guilherme Padovani Garofo MD","doi":"10.1016/j.xrrt.2025.100653","DOIUrl":"10.1016/j.xrrt.2025.100653","url":null,"abstract":"","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100653"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078594","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":"External hinged fixation vs. internal joint stabilization for elbow instability: a systematic review and meta-analysis of functional outcomes and surgical complications","authors":"Areeb Ahmad BS ,&nbsp;Kassem Ghayyad MD ,&nbsp;Alaina Mitchell BS ,&nbsp;Daryl C. Osbahr MD ,&nbsp;G. Russell Huffman MD, MPH ,&nbsp;Luke S. Oh MD, MS ,&nbsp;Amir R. Kachooei MD, PhD ,&nbsp;Rothman Florida Elbow Experts (ROFLEX) Group","doi":"10.1016/j.xrrt.2025.100638","DOIUrl":"10.1016/j.xrrt.2025.100638","url":null,"abstract":"<div><h3>Background</h3><div>Traumatic elbow instability can be managed with hinged external fixator (HEF) or internal joint stabilizer (IJS). While prior studies report device-related complications with both devices, a comprehensive analysis comparing range of motion (ROM), patient-reported outcome measures, and surgical complications is limited. This study aims to evaluate these outcomes to guide treatment decisions for complex elbow instability.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search was performed in Google Scholar and PubMed from January 1, 2000, to February 20, 2025. Level I-IV studies were included if they reported on postoperative ROM, patient-reported outcome measure, or surgical complications as outcome measures in patients treated with HEF or IJS for elbow instability.</div></div><div><h3>Results</h3><div>Of the 2,041 articles identified, 38 studies met inclusion criteria for quantitative synthesis, including 27 of moderate quality and 11 of high quality based on the Newcastle–Ottawa Scale classification. Across the 29 retrospective studies, 8 prospective studies, and 1 randomized control trial, 500 patients underwent treatment with HEF, while 263 patients were treated with IJS. Disabilities of the Arm, Shoulder, and Hand scores were significantly better in the HEF group compared to IJS (9.8 vs. 23; <em>P</em> &lt; .001). No significant differences were found between HEF and IJS in postoperative ROM, Mayo Elbow Performance Index, visual analog scale for pain, heterotopic ossification, or nerve injury rates.</div></div><div><h3>Conclusion</h3><div>HEF and IJS showed comparable rates of postoperative ROM, Mayo Elbow Performance Index, visual analog scale, heterotopic ossification, and nerve injury. However, Disabilities of the Arm, Shoulder, and Hand scores were 13.2 points lower in the HEF group, exceeding the minimal clinically important difference of 10.8 and indicating a clinically meaningful functional advantage of the upper extremity. This difference may be influenced by the less invasive nature of hardware removal with HEF compared to IJS. These findings should be interpreted with caution, given the overall lower level of evidence and heterogeneity across studies. Future prospective investigations with standardized rehabilitation protocols, longer follow-up, and stratification by injury chronicity, limb dominance, and preoperative motion are needed to better define optimal indications for each technique.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100638"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078562","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":"A biomechanical comparison of hook plate vs. superolateral locking plate with coracoclavicular suture fixation for distal third clavicle fractures with coracoclavicular ligament disruption","authors":"Alexander A. Hysong MD ,&nbsp;Jonathan Day MD ,&nbsp;Manaswini Chennoju MS ,&nbsp;Gabriel J. Yohe MS ,&nbsp;Pooyan Abbasi MSc ,&nbsp;Christopher L. Forthman MD ,&nbsp;Aviram M. Giladi MD, MS","doi":"10.1016/j.xrrt.2025.100645","DOIUrl":"10.1016/j.xrrt.2025.100645","url":null,"abstract":"<div><h3>Background</h3><div>Unstable distal third clavicle fractures involving coracoclavicular (CC) ligament disruption are prone to nonunion and often require surgical fixation. While hook plates (HPs) and superolateral locking plate (SLP) with CC suture augmentation are both commonly used, biomechanical comparisons are limited.</div></div><div><h3>Methods</h3><div>Eighteen fresh-frozen adult cadaveric shoulders (9 contralateral matched pairs) were randomized to receive either HPs or SLP with CC suture fixation constructs after simulated Neer type IIb distal clavicle fractures. Constructs were cyclically loaded at 70 N for 500 cycles, followed by load-to-failure testing. Displacement and failure modes were recorded and statistically analyzed using paired <em>t</em>-tests (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>At 50 N and 70 N, SLP with CC suture fixation demonstrated significantly less displacement than HPs (<em>P</em> &lt; .05) across all measured cycles. Comparisons were made using a paired <em>t</em>-test. Mean displacement at 70 N at cycle 500 was 5.5 mm (HPs) vs. 3.0 mm (SLP with CC suture fixation). SLP with CC suture fixation constructs also had significantly higher load to failure (364.8 N vs. 281.9 N, <em>P</em> &lt; .05). Failure modes differed. HPs typically failed by hook bending and screw pullout, while SLP with CC suture fixation failed primarily via suture rupture or anchor pullout.</div></div><div><h3>Conclusion</h3><div>SLP with CC suture fixation constructs provide superior biomechanical stability compared to HPs in Neer type IIb fractures, with less displacement and greater failure strength under load. These results support the clinical use of SLP with CC suture fixation as a robust alternative to traditional hook plating.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100645"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078564","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 humeral computed tomography may be a useful indicator of low bone mineral density in patients undergoing rotator cuff repair","authors":"Yuki Matsui MD, PhD ,&nbsp;Yusuke Menjo MD ,&nbsp;Yoshihiro Hojo MD, PhD ,&nbsp;Daisuke Momma MD, PhD ,&nbsp;Norimasa Iwasaki MD, PhD","doi":"10.1016/j.xrrt.2025.100624","DOIUrl":"10.1016/j.xrrt.2025.100624","url":null,"abstract":"<div><h3>Background</h3><div>Bone fragility can compromise rotator cuff repair, particularly in patients with osteoporosis. Although previous studies have demonstrated correlations between systemic bone mineral density (BMD) and bone quality, only a few have focused on the anchor-relevant regions in patients with rotator cuff tears. We hypothesized that preoperative computed tomography (CT)-based Hounsfield unit (HU) values at anchor-relevant areas in the proximal humerus could be used to estimate systemic BMD in these patients.</div></div><div><h3>Methods</h3><div>This retrospective study included 58 patients (62 shoulders) who underwent arthroscopic rotator cuff repair and had both preoperative shoulder CT and dual energy X-ray absorptiometry scans. HU values were measured in 4 regions of interest within the proximal humerus: medial, central, lateral, and greater tuberosity (GT). Systemic BMD was assessed using femoral neck and lumbar spine T-scores and BMD values. Pearson correlation coefficients were used to evaluate the association between the HU values and systemic T-score/BMD. Multivariate linear regression analyses were performed using HU values at the GT after adjusting for age, sex, and rotator cuff tear size.</div></div><div><h3>Results</h3><div>HU values were significantly lower in the lateral and GT regions than in the medial and central regions (<em>P</em> &lt; .01). Among regions, the HU values at the GT showed the highest correlations with the systemic T-scores and BMD (all moderate): femoral neck T-score (r = 0.57), lumbar spine T-score (r = 0.55), femoral neck BMD (r = 0.60), and lumbar spine BMD (r = 0.56) (all <em>P</em> &lt; .01). Multivariate regression confirmed that GT values were independently associated with both femoral and lumbar T-score/BMD (adjusted R² = 0.37-0.45, <em>P</em> &lt; .001), even after controlling age, sex, and tear size.</div></div><div><h3>Conclusion</h3><div>Preoperative CT-derived HU values, particularly at the GT, have a moderate correlation with systemic T-scores and BMD in patients with rotator cuff tears. Given the lower HU values observed at the anchor insertion sites (GT and lateral regions), clinicians should consider the risk of bone fragility during surgical planning.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100624"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145898154","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":"Management of a proximal humerus nonunion with an extramedullary calcar replacing iliac crest autograft: surgical technique and review of the literature","authors":"Bradley W. Fossum MD,&nbsp;Daniel Z. You MD, MSc, FRCSC,&nbsp;Samuel S. Rudisill MD,&nbsp;Joaquin Sanchez-Sotelo MD, PhD","doi":"10.1016/j.xrrt.2025.100626","DOIUrl":"10.1016/j.xrrt.2025.100626","url":null,"abstract":"","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100626"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979621","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":"Outcomes of reverse total shoulder arthroplasty vs. other surgical fixation methods for proximal humerus fractures in elderly patients","authors":"Julie Mekhail MS ,&nbsp;Ryan Mullan BS ,&nbsp;James L. Cross BS ,&nbsp;Om Jahagirdar MS ,&nbsp;Xuan Luo MD ,&nbsp;Motasem Salameh MD","doi":"10.1016/j.xrrt.2025.100644","DOIUrl":"10.1016/j.xrrt.2025.100644","url":null,"abstract":"<div><h3>Background</h3><div>Proximal humerus fractures (PHFs) are among the most common osteoporotic injuries in elderly patients, typically resulting from low-energy mechanisms such as ground-level falls. Multiple surgical options exist, including reverse total shoulder arthroplasty (rTSA), open reduction and internal fixation (ORIF), and hemiarthroplasty (HA), but the optimal treatment remains debated. This up-to-date systematic review and meta-analysis aimed to evaluate the comparative effectiveness of rTSA, HA, and ORIF for treating PHFs in the geriatric population.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed (MEDLINE), EMBASE, and Web of Science were searched through January 2025. Eligible studies included randomized controlled trials or cohort studies comparing rTSA with HA and/or ORIF in patients aged ≥ 65 years. Two reviewers independently screened studies using predefined inclusion criteria. The primary outcome was postoperative functional scores; secondary outcomes included: complication rates, revision surgery rates, shoulder range of motion, and quality of life metrics.</div></div><div><h3>Results</h3><div>Twenty studies met the inclusion criteria. rTSA demonstrated significantly better Constant–Murley Scores (standardized mean difference [SMD] = 0.67, <em>P</em> &lt; .001), visual analog scale pain scores (SMD = −0.36, <em>P</em> = .034), forward flexion (SMD = 0.95, <em>P</em> &lt; .001), abduction (SMD = 0.90, <em>P</em> &lt; .001), and complication rates (risk ratio = 0.79, <em>P</em> = .047) than HA. Compared to ORIF, rTSA was associated with significantly lower revision rates (risk ratio = 0.31, <em>P</em> &lt; .001), with no difference in functional outcomes or complication rates. No significant differences in mortality rates were observed between rTSA and either HA or ORIF.</div></div><div><h3>Conclusion</h3><div>rTSA offers superior functional outcomes and complication rates compared to HA and a more favorable revision profile than ORIF in elderly patients with PHFs. These findings support the growing preference for rTSA as the primary surgical treatment in this population, though further high-quality, long-term studies are needed to guide individualized decision-making.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100644"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183716","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":"Use of locking humeral stems in reverse total shoulder arthroplasty for complex proximal humerus fractures: a scoping review","authors":"Victor Cardona-Perez BS ,&nbsp;Elyette Lugo BS ,&nbsp;Alberto R. Rivera MD ,&nbsp;Umasuthan Srikumaran MD, MBA, MPH","doi":"10.1016/j.xrrt.2025.100625","DOIUrl":"10.1016/j.xrrt.2025.100625","url":null,"abstract":"<div><div>The use of locked humeral stems in reverse total shoulder arthroplasty (rTSA) has emerged as an alternative fixation strategy for treating complex proximal humerus fractures (PHFs). This scoping review synthesizes the available literature evaluating clinical outcomes, radiographic findings, and complications associated with interlocking humeral stems in rTSA for PHFs. Nine studies, encompassing 434 patients, were identified, of whom 308 underwent rTSA with a locking humeral stem. The mean patient age was 75.7 ± 5.1 years, with a mean follow-up of 20.0 ± 8.9 months, and at least 54% of patients were female. Postoperative functional outcomes demonstrated a mean forward flexion of 120° ± 13.2°, abduction of 101° ± 2.3°, external rotation of 29.3° ± 8.9°, and internal rotation to the lumbar spine. Patient-reported outcomes showed a mean Quick Disabilities of the Arm, Shoulder, and Hand score of 31.4 ± 4.2 and a Constant-Murley Score of 65.4 ± 10.7. Tuberosity healing was observed in 76% of cases. The overall complication rate was 13.0%, with locking screw -related complications occurring in 1.6% of cases, accounting for 12.5% of all reported complications. These findings suggest that locked humeral stems provide reliable diaphyseal fixation with a low incidence of screw-related complications in rTSA for complex PHFs. Long-term success depends on achieving stable metaphyseal fixation and osteointegration; cemented or press-fit stems without screws remain viable alternatives. Further prospective, comparative studies are needed to clarify long-term outcomes and optimize implant selection.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100625"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145979619","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":"A modern advanced analytic approach to cost and performance loss analysis of ulnar collateral ligament surgery to Major League Baseball teams","authors":"Michael A. Mastroianni MD,&nbsp;Ritt R. Givens MD,&nbsp;Dongyeon J. Kim MD,&nbsp;Matthew R. LeVasseur MD,&nbsp;Andrew J. Luzzi MD,&nbsp;Frank J. Alexander MS, ATC,&nbsp;Christopher S. Ahmad MD","doi":"10.1016/j.xrrt.2025.100651","DOIUrl":"10.1016/j.xrrt.2025.100651","url":null,"abstract":"<div><h3>Background</h3><div>Ulnar collateral ligament (UCL) surgery has become increasingly prevalent among Major League Baseball (MLB) pitchers. While its clinical implications have been extensively studied, the economic and performance impact on MLB teams remains incompletely understood.</div></div><div><h3>Methods</h3><div>Cost analysis on all MLB pitchers who underwent UCL reconstruction between 2014 and 2024 was conducted. Pitchers were identified, and data were collected using public databases affiliated with MLB and used in previous studies. Economic losses were calculated using 2 primary components: (1) salary cost of recovery (COR), which quantified salaries paid to injured players during recovery, and (2) performance cost, a metric we defined using common FanGraphs wins above replacement (fWAR) conversions to estimate lost player contributions.</div></div><div><h3>Results</h3><div>During the study period, a total of 276 UCL surgeries were performed from 2014 to 2024. Over the past 5 seasons (2020-2024), the number of UCL reconstructions in MLB pitchers has significantly increased to an average of 29.0 ± 4.7 surgeries per year compared to 21.8 ± 4.3 surgeries per year the 6 seasons prior (2014-2019; <em>P</em> = .05), with a peak of 35 surgeries in 2023. From 2014 to 2024, the COR salary losses adjusted for inflation totaled over $1.26 billion, with an increase in average COR over the past 5 seasons ($141 million ± 72 million) compared to the 6 seasons prior ($92 million ± 52 million; <em>P</em> = .14). The estimated COR per player for starters, relievers, and closers was $7.3 million, $2.3 million, and $11.5 million, respectively. The average cumulative fWAR lost per pitcher was 1.9, translating to an estimated annual market loss of $14.3 million per player. The total cumulative fWAR loss across all players was 452.8. Using the conversion of 1 fWAR is equal to approximately $7.5 million in salary, an estimated $3.4 billion worth of performance value was lost for the entire study period.</div></div><div><h3>Conclusion</h3><div>UCL injuries that require surgery impose an increasingly significant financial burden on MLB teams, leading to the loss of $1.26 billion dollars in salary paid out to injured players and likely over $3 billion worth of performance value lost to injury to teams over 10 years. Players also struggle to provide the same value in fWAR as they did prior to injury. This study shows that investing in UCL prevention and recovery efforts can potentially save teams, players, and local communities millions of dollars.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100651"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079008","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":"Allograft strut–screw construct in the management of total elbow periprosthetic fractures: a surgical technique with high complication rate","authors":"Julia C. Mastracci MD ,&nbsp;Nainisha Chintalapudi MD ,&nbsp;James Tyler Frix MD ,&nbsp;R. Glenn Gaston MD ,&nbsp;Bryan J. Loeffler MD","doi":"10.1016/j.xrrt.2025.100627","DOIUrl":"10.1016/j.xrrt.2025.100627","url":null,"abstract":"","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100627"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145929077","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":"Severe glenohumeral ankylosis following revision reverse shoulder arthroplasty","authors":"Artem Klimov MD ,&nbsp;Florian Freislederer MD ,&nbsp;Alexander Pieringer MD ,&nbsp;Markus Scheibel MD","doi":"10.1016/j.xrrt.2025.100647","DOIUrl":"10.1016/j.xrrt.2025.100647","url":null,"abstract":"","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100647"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078560","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}