Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Shoulder 158 articles

Articles

Does Postoperative Glenoid Retroversion Affect the 2-Year Clinical and Radiographic Outcomes for Total Shoulder Arthroplasty?

Benjamin C. Service MD, Jason E. Hsu MD, Jeremy S. Somerson MD, Stacy M. Russ BA, Frederick A. Matsen MD

While glenoid retroversion and posterior humeral head decentering are common preoperative features of severely arthritic glenohumeral joints, the relationship of postoperative glenoid component retroversion to the clinical results of total shoulder arthroplasty (TSA) is unclear. Studies have indicated concern for inferior outcomes when glenoid components are inserted in 15° or more retroversion.

Does Humeral Component Lateralization in Reverse Shoulder Arthroplasty Affect Rotator Cuff Torque? Evaluation in a Cadaver Model

Kevin Chan MD, MSc, FRCSC, G. Daniel G. Langohr PhD, Matthew Mahaffy BESc, James A. Johnson PhD, George S. Athwal MD, FRCSC

Humeral component lateralization in reverse total shoulder arthroplasty (RTSA) may improve the biomechanical advantage of the rotator cuff, which could improve the torque generated by the rotator cuff and increase internal and external rotation of the shoulder.

What Are the Complications, Survival, and Outcomes After Revision to Reverse Shoulder Arthroplasty in Patients Older Than 80 Years?

Eduard Alentorn-Geli MD, Nicholas J. Clark MD, Andrew T. Assenmacher MD, Brian T. Samuelsen MD, Joaquín Sánchez-Sotelo MD, Robert H. Cofield MD, John W. Sperling MD

By the time patients with a failed shoulder arthroplasty require revision surgery, a substantial number are older than 80 years. The risk of complications of revision arthroplasty in this elderly population is largely unknown and needs to be considered when contemplating whether these patients are too frail for revision surgery.

Patients Older Than 40 Years With Unilateral Occupational Claims for New Shoulder and Knee Symptoms Have Bilateral MRI Changes

Tiffany C. Liu BA, Nina Leung PhD, Leonard Edwards BS, David Ring MD, PhD, Edward Bernacki MD, MPH, Melissa D. Tonn MD, MBA, MPH

Minor events that occur in the workplace sometimes are evaluated with MRI, which may reveal age-related changes in the symptomatic body part. These age-related changes are often ascribed to the event. However, evidence of similar or worse pathophysiology in the contralateral joint would suggest that the symptoms might be new, but the pathophysiology is not.

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.