Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Shoulder 154 articles

Articles

Matrix Metalloproteases 1 and 3 Promoter Gene Polymorphism Is Associated With Rotator Cuff Tear

Jorge H. Assunção MD, Alexandre L. Godoy-Santos PhD, Maria Cristina L. G. Santos PhD, Eduardo A. Malavolta PhD, Mauro E. C. Gracitelli PhD, Arnaldo A. Ferreira Neto PhD

Studies suggest that the collagen degeneration and disordered arrangement of collagen fibers in rotator cuff tears are associated with an increase in activity of matrix metalloproteases 1 and 3 (MMP-1 and MMP-3), and that MMP activity may be in part genetically mediated. The degree to which this might be clinically relevant in patients with rotator cuff tears has not been well characterized.

What Influence Does Progression of a Nonhealing Rotator Cuff Tear Have on Shoulder Pain and Function?

Yoon Sang Jeon MD, Rag Gyu Kim MD, Sang-Jin Shin MD

There have been numerous reports of clinical outcomes associated with tendon healing after repair that suggest a nonhealed tendon has a negative effect on postoperative clinical outcomes. However, to our knowledge, there has been no report on the relationship between tear size progression of nonhealed tendons and clinical outcomes.

Does the Critical Shoulder Angle Correlate With Rotator Cuff Tear Progression?

Peter N. Chalmers MD, Dane Salazar MD, Karen Steger-May MA, Aaron M. Chamberlain MD, Ken Yamaguchi MD, MBA, Jay D. Keener MD

The critical shoulder angle (CSA) has been reported to be associated with rotator cuff disease and has been suggested as an etiology for cuff tears. However, it is unclear whether acromial morphologic characteristics such as CSA are a cause or effect because all studies to date have been retrospective.

What Does a Shoulder MRI Cost the Consumer?

Robert W. Westermann MD, Cameron Schick MD, Christopher M. Graves MD, Kyle R. Duchman MD, Stuart L. Weinstein MD

More than 100 MRIs per 1000 inhabitants are performed in the United States annually, more than almost every other country. Little is known regarding the cost of obtaining an MRI and factors associated with differences in cost.

Perioperative Risk Adjustment for Total Shoulder Arthroplasty: Are Simple Clinically Driven Models Sufficient?

David N. Bernstein MA, Aakash Keswani BA, David Ring MD, PhD

There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and high blood urea nitrogen (BUN) are associated with adverse events, whereas patients on antihypertensive medications were more likely to have an unplanned readmission. Many surgeons rely on their knowledge and intuition when assessing the risk of a procedure. Comparing clinically driven with statistically derived risk models of total shoulder arthroplasty (TSA) offers insight into potential gaps between common practice and evidence-based medicine.

What Factors are Associated With Clinically Important Improvement After Shoulder Hemiarthroplasty for Cuff Tear Arthropathy?

Jeremy S. Somerson MD, Patrick Sander MD, Kamal Bohsali MD, Ryan Tibbetts MD, Charles A. Rockwood MD, Michael A. Wirth MD

In selected patients with a desire to maintain activity levels greater than those recommended after reverse total shoulder arthroplasty, hemiarthroplasty remains an option for treatment of cuff tear arthropathy (CTA). However, given the relatively small case series that have been reported to date, little is known regarding which patients will show functional improvement after this surgery.

Corticosteroid Injections Give Small and Transient Pain Relief in Rotator Cuff Tendinosis: A Meta-analysis

Amin Mohamadi MD, MPH, Jimmy J. Chan MD, Femke M. A. P. Claessen MD, David Ring MD, PhD, Neal C. Chen MD

The ability of injection of corticosteroids into the subacromial space to relieve pain ascribed to rotator cuff tendinosis is debated. The number of patients who have an injection before one gets relief beyond what a placebo provides is uncertain.

Economic Decision Model Suggests Total Shoulder Arthroplasty is Superior to Hemiarthroplasty in Young Patients with End-stage Shoulder Arthritis

Suneel B. Bhat MD, Mark Lazarus MD, Charles Getz MD, Gerald R. Williams MD, Surena Namdari MD, MSc

Young patients with severe glenohumeral arthritis pose a challenging management problem for shoulder surgeons. Two controversial treatment options are total shoulder arthroplasty (TSA) and hemiarthroplasty. This study aims to characterize costs, as expressed by reimbursements for episodes of acute care, and outcomes associated with each treatment.