The Iowa orthopaedic journal最新文献

{"title":"Outcomes of Gluteus Maximus Transfer and the High Prevalence of Lumbar Spine Pathology: A Potential Etiology of Abductor Failure.","authors":"Bryan M Song, Cameron Foreman, Sarah Namrow, Michael D Harris, Cecilia Pascual-Garrido","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Gluteus maximus tendon transfer has been described as a salvage treatment option for irreparable abductor tendon tears. Current literature has demonstrated favorable short term outcomes, yet strength and gait abnormalities persist. The purpose of this study was to evaluate the impact of gluteus maximus tendon transfer on patient reported outcomes (PROs) over two consecutive time points and determine the prevalence of concomitant lumbosacral pathology.</p><p><strong>Methods: </strong>A retrospective review of 17 patients who underwent gluteus maximus transfer for irreparable abductor insufficiency was performed. The mean age was 71 years (range, 61 to 83), and 88% (15/17) were women. Clinical outcomes were obtained from follow-up visits, and modified Harris Hip Scores (mHHS) and Visual Analog Scale (VAS) pain scores were obtained at 24.9 ± 8.4 months (range, 13 to 42) and 47.1 ± 9.4 months (range, 31 to 65) postoperatively.</p><p><strong>Results: </strong>Mean mHHS (46.3 vs. 66.1, P<0.01), VAS at rest (3.1 vs. 0.9, P<0.01), and VAS with activity (5.9 vs. 1.9, P<0.01) improved between preoperative and 24.9 months postoperatively. Between 24.9 months and 47.1 months, mean mHHS (66.1 vs. 53.7, P<0.01) and VAS with activity (1.9 vs. 4.4, P<0.01) declined, and there was no difference in VAS at rest (0.9 vs. 2.1, P=0.09). Compared to the preoperative state, there was maintained improvement in mHHS (46.3 vs. 53.7, P=0.03) but no difference in VAS scores. Lumbar spine pathology or lumbar spine instrumentation was present in 76% (13/17) of patients.</p><p><strong>Conclusion: </strong>Patients undergoing gluteus maximus transfer for irreparable abductor deficiency demonstrate improved PROs at 2 years postop-eratively. These improvements persist to a variable degree at 4 years. There was a high prevalence of associated lumbar spine pathology suggesting a key etiologic factor explaining why these patients exhibit severe fatty degeneration of the abductor musculature while preserving gluteus maximus function.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"171-176"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564378","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":"At-Home Shoulder Exercises or Supervised Physical Therapy for Adhesive Capsulitis: A Retrospective Comparative Cohort Study.","authors":"Austin M Gartner, Vafa Behzadpour, Rosalee E Zackula, Harry A Morris, Bernard F Hearon","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to determine if the clinical outcomes of patients with adhesive capsulitis were influenced by the type of shoulder exercise regimen prescribed.</p><p><strong>Methods: </strong>This was a retrospective, comparative cohort, therapeutic outcomes study of patients with primary or secondary systemic adhesive capsulitis who were initially treated with either a doctor-directed home-based exercise program (HEP) or the HEP supplemented with supervised physical therapy (SPT). Study participants were treated by one of two orthopaedists at a single institution between 2012 and 2022. Demographic and disease-specific data extracted from electronic medical records during the period of observation were compiled in an electronic database. Primary outcomes included shoulder range of motion (ROM) measures and treatment failures leading to operative intervention. Data were analyzed using the Friedman test and the Mann-Whitney U exact test.</p><p><strong>Results: </strong>There were 124 patients who met eligibility criteria, 81 in the HEP cohort and 43 in the SPT group. Intra-cohort comparisons showed significant increases in shoulder ROM in all planes between baseline and follow-up encounters (p<0.001), indicating clinical improvement with either shoulder rehabilitation method. However, inter-cohort comparisons demonstrated shoulder flexion and abduction were significantly greater in the HEP group than in the SPT group at both 8-week and final follow-up evaluations (p<0.001). While there were no treatment failures in the HEP cohort, 10 of 43 cases (23%) failed the SPT protocol, wherein an unconscious framing bias regarding treatment expectations and early operative intervention may have contributed to the high failure rate. Good clinical outcomes were obtained in all 10 cases with shoulder manipulation under anesthesia, arthroscopic global capsulotomy, and continued supervised physiotherapy.</p><p><strong>Conclusion: </strong>Patients with adhesive capsulitis should be treated initially with at-home shoulder stretching exercises, reserving more costly supervised physical therapy or operative intervention for recalcitrant cases.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"119-126"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440627","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":"Postoperative Outcomes with Unrestricted or Restricted Immediate Weight Bearing Status After Operatively Treated Unstable Pelvic Ring Injuries.","authors":"Jillian V Johnson, Alexander Cm Chong, Anthony N Brown","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The functional recovery of unstable pelvic ring injuries patients relies heavily on their ability to mobilize post-operatively and immobility is associated with a multitude of negative outcomes. The purpose of this study was to examine the restricted (NWB) and unrestricted (WB) immediate postoperative weight bearing protocols for patients who have undergone unstable pelvic ring injury fixation and evaluate trends in postoperative outcomes.</p><p><strong>Methods: </strong>A retrospective review of medical charts and radiographs were performed on adult patients from 1/2012 through 6/2022 at a level one trauma center. Outcomes examined time to fracture healing, time to full weight bearing, postoperative complications, and reoperation between groups.</p><p><strong>Results: </strong>151 patients (50 females, 101 males) met the eligibility criteria. Eighty-six patients (mean age 46 years, 71% men) were designated NWB group, and 65 patients (mean age 46 years, 62% men) were designated WB group. The most common injury mechanism was motor vehicle collision (MVC) (n=60, 40%) followed by fall from height (n=29, 19%). The most common injury patterns were lateral compression (n=87, 58%), followed by anteroposterior compression (n=47, 31%) and vertical shear (n=17, 11%). 54 (36%) patients who had postoperative complications with seven (5%) patients having both fracture-related and no-fracture-related complications noted. The NWB group had a mean fracture healing time of 17 weeks, 14 fracture related complications, 21 nonfracture related complications, 23 reoperations, and a mean full weight bearing time of 12 weeks. The WB group had a mean fracture healing time of 16 weeks, 14 fracture related complications, 13 non-fracture related complications, 15 reoperations, and a mean full weight bearing time of nine weeks. The mean duration of the initial weight bearing restriction for the NWB group was 9.7±3.4 weeks. No statistically significant difference found between these two groups (healing time: p=0.73; fracture related complication: p=0.41; non-fracture related complication: p=0.38; reoperation: p=0.61; full weight bearing time: p=0.73).</p><p><strong>Conclusion: </strong>This study shows unrestricted postoperative weight bearing protocols achieved similar postoperative outcomes as restricted postoperative weight bearing protocols. The choice of restricted or unrestricted postoperative weight bearing protocols after surgical treated unstable pelvic ring injuries patients could not significantly affect the postoperative outcomes.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"287-292"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440561","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":"Pediatric Achilles Tendon Ruptures in the United States: an Evaluation of National Practice Patterns, Management Trends, Complications and 2-Year Failure Rates.","authors":"Harmon S Khela, Monty S Khela, Margaret A Bowen, Alexandra M Olson, Akbar N Syed, Kathleen J Maguire, J Todd R Lawrence","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Achilles tendon ruptures, though uncommon in the pediatric population, present significant clinical challenges due to the unique biomechanical and physiological characteristics of developing tissues. While adult management is well studied, the optimal pediatric approach remains unclear, with limited large-scale studies on this topic. This study aims to evaluate national trends in the incidence and management of pediatric Achilles tendon ruptures in the United States and compare short-term complication rates and longterm outcomes between operative and nonoperative approaches.</p><p><strong>Methods: </strong>A retrospective cohort study using the PearlDiver database identified pediatric patients (ages 0-18) diagnosed with Achilles tendon ruptures from 2016 to 2022. Patients were stratified by rupture type (open vs. closed) and management (operative vs. nonoperative). Population-normalized incidence rates were assessed by age group. A subset with a minimum 2 years of follow-up was analyzed for complications, including 90-day infection, nerve injury, and wound complication rates, as well as two-year ankle fracture and failure rates. Statistical analyses included Student's t-tests, chisquare tests, and linear regression.</p><p><strong>Results: </strong>A total of 18,441 pediatric patients with Achilles tendon ruptures were identified. Most injuries (88.0%) were in the 10-18 year age group with an even distribution of males and females (50% each). Most ruptures were closed (99.2%) and managed nonoperatively (97.4%), with nonoperative treatment more common in closed vs. open ruptures (97.6% vs. 71.5%, p<0.001). From 2016 to 2022, rupture incidence declined across all age groups (p<0.05), most notably in ages 1014 (p=0.004). The distribution of operative vs. nonoperative management remained unchanged. Complication rates were higher in the operative cohort compared to the nonoperative cohort: infections (5.07% vs. 0.32%), nerve injuries (0.68% vs. 0.03%), wound complications (1.01% vs. 0.04%), two-year failure (5.74% vs. 0.10%), and ankle fracture (1.69% vs. 0.75%), though statistical comparison was limited by low event counts.</p><p><strong>Conclusion: </strong>The incidence of pediatric Achilles tendon ruptures has declined significantly over the past decade. Nonoperative management remains the dominant treatment approach and is associated with low complication and failure rates. These findings highlight the importance of careful patient selection for operative intervention.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"95-106"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564366","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":"Operative Treatment of Pediatric Supracondylar Humerus Fractures Using Mini C-Arm Fluoroscopy.","authors":"Tyler R Mange, Anna M Acosta, Amy K Williams","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Supracondylar humerus (SCH) fractures comprise about 20% of pediatric fractures. Displaced SCH fractures require reduction and percutaneous pinning, most commonly making use of conventional C-arm (CCA) fluoroscopy. Many authors have proposed the use of mini C-arm (MCA) in the upper extremity, given multiple proposed benefits including decreased radiation. We investigated the utility of MCA in the operative treatment of pediatric SCH fractures.</p><p><strong>Methods: </strong>Patients who underwent operative fixation of SCH fractures using MCA from 20202022 were reviewed. Demographic, surgical, and radiographic data were collected, along with clinical outcomes through final follow-up. Data were analyzed to assess rates of fluoroscopy use depending on various patient and fracture characteristics. Complication rates were quantified to assess the safety and efficacy of MCA for this procedure.</p><p><strong>Results: </strong>171 patients were included with an average age of 5.5 years. 55% of fractures were Gartland type 3/4, and most were treated with three lateral pins (69%). The median fluoroscopy time per case was 113 seconds with 61 images taken. Fluoroscopy use increased both with fracture severity and number of pins used. The overall complication rate was 2% with only one patient requiring reoperation (0.6%).</p><p><strong>Conclusion: </strong>Utilizing MCA fluoroscopy in the treatment of SCH fractures is associated with a low rate of complications, consistent with previously reported rates when using CCA. We report a higher rate of fluoroscopy use compared to CCA which does not necessarily translate to an increase in radiation exposure. Utilizing MCA to surgically treat SCH fractures may have benefits over CCA, especially in certain practice settings.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"275-280"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564320","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":"Demographic Drivers of Operative Time in Short and Long Cephalomedullary Nail Fixation.","authors":"Jared J Hill, Michael C Willey, Yumeng Gao, Matthew Hogue, J Lawrence Marsh, Matthew D Karam","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Cephalomedullary nails (CMNs) are commonly used for femoral fracture fixation; however, operative times may vary based on patient-specific factors. Characterizing the influence of these factors provides important context for understanding the variability in procedure time. This study aimed to evaluate the relationship between patient demographics and operative time in CMN fixation for both long and short nail cohorts.</p><p><strong>Methods: </strong>A retrospective review of femoral CMN cases was performed, excluding bilateral procedures. Patient demographics, including BMI, sex, and age, as well as procedure time, were collected. Procedure time was compared between short and long cohorts, and associations between procedure time and demographic variables were evaluated using nonparametric statistical methods.</p><p><strong>Results: </strong>744 CMN cases (421 long and 323 short) were evaluated. Procedure time was greater for long CMNs (median: 104 min, IQR: 81-133 min) compared to short (median: 62 min, IQR: 51-76 min, p<0.001). In short CMNs, obese individuals (median: 66 min, IQR: 58-86 min) had longer procedure times than overweight (median: 59 min, IQR: 49-73 min, p=0.028), and normal weight individuals (median: 61 min, IQR: 49-73 min, p=0.011). In long CMNs, obese individuals (median: 112 min, IQR: 89-148 min) had longer procedure times compared to normal weight patients (median: 97 min, IQR: 79-128 min, p=0.005), and men (median: 108 min, IQR: 88137 min) had longer procedure times than women (median: 98 min, IQR: 78-128 min, p=0.002).</p><p><strong>Conclusion: </strong>Procedure time for CMN fixation was influenced by BMI, sex, and age. Obesity consistently contributed to increased procedure time independent of nail length. Sex and age demonstrated smaller, nail-specific associations with operative duration. Patient demographic factors should be considered when interpreting variability in operative time for CMN fixation.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"241-246"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564148","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":"Outcomes of Uncemented Hemiarthroplasty for Intracapsular Femoral Neck Fracture: A Retrospective Comparison of Trauma Fellowship-Trained Orthopaedists and Chief Resident Surgeons.","authors":"Seth L Carder, Michael T Nguyen, Brian G Dean, Zachary S Donoviel, Rosalee E Zackula, Bradley R Dart","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to evaluate the influence of primary surgeon fellowship training on the outcomes of uncemented hemiarthroplasty for femoral neck fractures with emphasis on intraoperative and postoperative complications.</p><p><strong>Methods: </strong>This was a retrospective comparative cohort study of patients who underwent uncemented hemiarthroplasty for intracapsular femoral neck fractures from 2010 to 2024 at a single institution. The study cohorts were defined according to whether the primary surgeon was a trauma fellowship-trained orthopaedist or a nonfellowship-trained chief (PGY-5) orthopaedic resident. Demographic, operative, and complication data were extracted from the medical records of patients meeting study eligibility criteria and were compiled in an electronic database. Categorical data were compared using chi-square or Fisher's Exact tests, whereas continuous variables were compared using Mann-Whitney U tests for skewed data.</p><p><strong>Results: </strong>A total of 395 patients were studied, 130 (32.9%) operated on by trauma fellowship-trained surgeons and 265 (67.1%) by non-trauma fellowship-trained chief orthopaedic surgery residents. There were no statistically significant differences between groups for intraoperative calcar fracture, postoperative infection, implant dislocation, or reoperation. Although patient survival at final follow-up was significantly higher in the fellowship-trained group, this result is likely multifactorial and should be interpreted with caution.</p><p><strong>Conclusion: </strong>Uncemented hemiarthroplasty was associated with low complication rates regardless of surgeon fellowship training status. Our findings suggest that uncemented hemiarthroplasty can be safely and effectively performed by both trauma fellowship-trained orthopaedists and non-fellowship-trained chief orthopaedic surgery residents.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"281-285"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13359791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440590","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":"High Rate of Vascular Injury and Mortality for Acute Total Knee Arthroplasty Dislocations: A Case Series.","authors":"Alex J Demers, Michael C Marinier, Victoria C Tappa, Caleb McCabe, Ana V Figueroa, Jacob M Elkins","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Acute dislocations following total knee arthroplasty (TKA) represent a rare and devastating complication frequently leading to loss of function and mortality. Literature regarding management, risk factors, and mechanisms for acute TKA dislocation is limited to case reports and systematic reviews, thus necessitating the need for further data to better understand these injuries. This case series aims to present our institution's experience with acute TKA dislocations while highlighting risk factors, rates of vascular injury, mortality, and intensive care utilization.</p><p><strong>Methods: </strong>Retrospective review was performed to identify patients presenting to a Level I Academic Trauma center from 2016 to 2021 with radiographic evidence of an acute TKA dislocation. Patient charts were reviewed for past medical history, arthroplasty course, injury characteristics, and course after dislocation.</p><p><strong>Results: </strong>Records review identified 6 patients managed for an acute TKA dislocation. 5/6 patients were female with an average body mass index of 45.1 ±18.2 and average age of 69.2 ± 5.6 years. All patients had a ground level fall as mechanism of injury. Four patients sustained a vascular injury requiring intervention, 5/6 patients required intensive care unit admission, and 5/6 implants were cruciate-retaining (CR). This series was associated with a 50% 30-day mortality rate and 33.3% rate of above knee amputation.</p><p><strong>Conclusion: </strong>This case series demonstrates a high rate of vascular injury, morbidity, and mortality for acute TKA dislocations, emphasizing the importance of multidisciplinary care and neurovascular monitoring. Most patients sustaining dislocation were female, obese, multiply comorbid, with a high rate of subsequent intensive care unit admission.</p><p><strong>Level of evidence: </strong>V.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"43-48"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440615","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":"Characterizing Material Properties of Rotator Cuff Tendons Relevant in Reverse Total Shoulder Arthroplasty Using Video-Based Strain Measures.","authors":"Joshua E Johnson, Vijay N Permeswaran, M James Rudert, Carolyn M Hettrich, Donald D Anderson, Jessica E Goetz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The material behavior of rotator cuff tendons that remain intact in patients indicated for reverse total shoulder arthroplasty influences the compressive stability of the reconstructed joint. However, the literature provides insufficient information about those material property definitions to accurately incorporate cuff tendons in computational stress (finite element) analysis of reverse total shoulder arthroplasty. Therefore, the goal of this study was to characterize the material properties of rotator cuff tendons relevant in reverse total shoulder arthroplasty.</p><p><strong>Methods: </strong>Tensile testing was performed on the subscapularis (superior; inferior), infraspinatus (superior; inferior), and teres minor tendons in whole bone-tendon constructs acquired from two cadaveric shoulder specimens. Force and displacement outputs measured from the materials testing system and from two tissue-specific video-based strain measurement methods were used to derive stress-strain curves and associated elastic modulus values. Tendon elastic modulus values were statistically compared between analysis methods.</p><p><strong>Results: </strong>Average elastic modulus values measured from the materials testing system (49 ± 8 MPa) were significantly lower than those measured using either video-based method (method 1: 217 ± 135 MPa and method 2: 186 ± 84 MPa; p<0.001 for both). Except for one teres minor specimen, no differences in individual tendon elastic modulus values were found between the video-based measurement methods.</p><p><strong>Concluion: </strong>The data demonstrate that rotator cuff tendon elastic modulus values are underestimated by studies that only use materials testing system-based measurement, and any video-based measurement yields more relevant data.</p><p><strong>Clinical relevance: </strong>Elastic modulus values determined in this study can be used to assign cuff tendon material behavior in finite element analysis of reverse total shoulder arthroplasty.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"135-142"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13389644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564209","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":"Implant Survivorship, Radiographic Evaluation, and Clinical Outcomes of Radial Head Arthroplasty Using The Depuy Synthes Radial Head Replacement System.","authors":"Kate A Spitzley, Kenneth P Butters, Julie M Embree, Tessa K Kirkpatrick, Cindy Headlee, Ellie DeLoretto, Daniel C Fitzpatrick","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Radial head arthroplasty (RHA) implants are designed either to promote osseo-integration with an anatomic stem or function as a loose-fitting spacer. Anatomic implants have shown painful loosening leading to revision or removal, making the loose-fitting design an appealing alternative. This study evaluates short-term survivorship and clinical, radiographic, and patient reported outcomes following RHA using the DePuy Synthes monoblock loose fit radial head replacement system.</p><p><strong>Methods: </strong>Nineteen patients (mean age 54 SD 17 years), who underwent RHA were enrolled, with a mean follow-up of 14.9 SD 6.8 months. Fractures were classified using Mason and Regan-Morrey systems. Fifteen patients returned for in-person evaluation with x-rays, physician and physical therapist examination and patient reported outcome (PRO) questionnaires. Four remote participants completed PROs only.</p><p><strong>Results: </strong>The cohort consisted of 8 females and 11 males, with 10 patients sustaining associated elbow dislocations and 13 with concurrent coronoid fractures. No patient had the implant removed or revised. PROs indicated excellent functional outcomes: Mayo Elbow Performance Score of 90 SD 12, QuickDash of 13 SD 9 (minor disability) and EQ-5D of 0.77 SD 0.18 (mild disability). Grip strength in the operative limb was 90% SD 14% of the non-operative and range of motion was greater than 90% of the non-operative side. Heterotopic bone formation was noted in 7 patients but did not limit motion. Mild periprosthetic radiolucency around the stem was noted in 14 patients. Moderate capitellar erosion was noted in one patient with an Essex-Lopresti injury.</p><p><strong>Conclusion: </strong>The DePuy Synthes radial head replacement system demonstrated excellent shortterm outcomes in terms of survivorship, functional recovery and patient satisfaction. Although mild radiographic lucencies and heterotopic ossification were observed, they did not impact functional outcome. These findings support the safety and efficacy of this implant, though longer-term follow-up is necessary to assess its durability and performance.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":94233,"journal":{"name":"The Iowa orthopaedic journal","volume":"46 1","pages":"267-273"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13361574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440613","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}