Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Shoulder 160 articles


Scapular Notching: Recognition and Strategies to Minimize Clinical Impact

Gregory P. Nicholson MD, Eric J. Strauss MD, Seth L. Sherman MD

Scapular notching is a unique complication of Grammont-style reverse total shoulder arthroplasty. While reverse total shoulder arthroplasty has revolutionized the treatment of pseudoparalysis secondary to cuff tear arthropathy, the implications of scapular notching with regard to patient function and implant stability remain unclear.

Scapular Notching in Reverse Shoulder Arthroplasty: Is It Important to Avoid It and How?

Christophe Lévigne MD, Jérome Garret MD, Pascal Boileau MD, Ghassan Alami MD, Luc Favard MD, Gilles Walch MD

Scapular notching, erosion of the scapular neck related to impingement by the medial rim of the humeral cup during adduction, is a radiographic sign specific to reverse shoulder arthroplasty (RSA). Its clinical and radiological consequences remain unclear.

Where to Tenodese the Biceps: Proximal or Distal?

David M. Lutton MD, Konrad I. Gruson MD, Alicia K. Harrison MD, James N. Gladstone MD, Evan L. Flatow MD

The best location for biceps tenodesis is controversial as surgeons have begun to question whether tenodesis location affects the incidence of residual bicipital postoperative pain. An open distal tenodesis technique has been previously proposed to eliminate remaining symptoms at the bicipital groove.

Functional Recovery Period after Arthroscopic Rotator Cuff Repair: Is it Predictable Before Surgery?

Tomoya Manaka MD, Yoichi Ito MD, Isshin Matsumoto MD, Kunio Takaoka MD, Hiroaki Nakamura MD

Several studies have reported functional recovery of the shoulder after arthroscopic rotator cuff repair (ARCR). Preoperative estimation of the time required for functional recovery is important for determining surgical indications and for planning timing of the surgery and an appropriate postoperative physical therapy.

What Are the Instability and Infection Rates After Reverse Shoulder Arthroplasty?

George J. Trappey MD, Daniel P. O’Connor PhD, T. Bradley Edwards MD

A concern regarding reverse shoulder arthroplasty (RSA) is the possibly higher complication rate compared with conventional unconstrained shoulder arthroplasty.

Is Reverse Shoulder Arthroplasty a Reasonable Alternative for Revision Arthroplasty?

Luke Austin MD, Benjamin Zmistowski BS, Edward S. Chang MD, Gerald R. Williams MD

Reverse shoulder arthroplasty (RSA) improves function in selected patients with complex shoulder problems. However, we presume patient function would vary if performed primarily or for revision and would vary with other patient-specific factors.

Reverse Total Shoulder Arthroplasty Improves Function in Cuff Tear Arthropathy

Betsy M. Nolan MD, Elizabeth Ankerson BS, J. Michael Wiater MD

Early failure due to glenoid loosening with anatomic total shoulder arthroplasty in patients with severe rotator cuff deficiency led to the development of the reverse ball-and-socket shoulder prosthesis. The literature reports improved short-term pain and function scores following modern reverse total shoulder arthroplasty (RTSA) in patients with cuff tear arthropathy (CTA).

Outcomes of Nonoperatively Treated Displaced Scapular Body Fractures

Apostolos Dimitroulias MD, Kenneth G. Molinero DO, Daniel E. Krenk DO, Matthew T. Muffly MS, Daniel T. Altman MD, Gregory T. Altman MD

Displaced scapular body fractures most commonly are treated conservatively. However there is conflicting evidence in the literature regarding the outcomes owing to retrospective design of studies, different classification systems, and diverse outcome tools.

Greater Strength Increase with Cyst Decompression and SLAP Repair than SLAP Repair Alone

Gita Pillai MD, Jason R. Baynes MD, James Gladstone MD, Evan L. Flatow MD

Treatment of symptomatic spinoglenoid cysts has been controversial with options ranging from observation, to open excision, to arthroscopic decompression with or without labral repair. It has recently been suggested that isolated repair of SLAP lesions without cyst decompression can restore function in patients with spinoglenoid cysts and SLAP lesions.

Can Reverse Shoulder Arthroplasty be Used with Few Complications in Rheumatoid Arthritis?

Anders Ekelund MD, PhD, Ragnhild Nyberg PT

Many patients with rheumatoid arthritis develop superior migration of the humeral head because of massive cuff tears, causing loss of active motion. Reverse shoulder arthroplasty could potentially restore biomechanical balance but a high incidence of glenoid failure has been reported. These studies do not, however, typically include many patients with rheumatoid arthritis (RA) and it is unclear whether the failure rates are similar.