Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Shoulder 160 articles


The Anatomy of the Supraclavicular Nerve During Surgical Approach to the Clavicular Shaft

Tyler Nathe MD, Susan Tseng MD, Brad Yoo MD

Surgery for clavicular shaft fractures is becoming more common but incisional and chest wall numbness reportedly occurs in 10% to 29% of patients. This may be the result of iatrogenic injury to the supraclavicular nerve branches.

Erratum to: Shoulder Arthroplasties have Fewer Complications than Hip or Knee Arthroplasties in US Veterans

Edward V. Fehringer MD, Ted R. Mikuls MD, MSPH, Kaleb D. Michaud PhD, William G. Henderson PhD, James R. O’Dell MD

Does a Positive Neer Impingement Sign Reflect Rotator Cuff Contact with the Acromion?

Xiaofeng Jia MD, PhD, Jong Hun Ji MD, Vinodhkumar Pannirselvam MD, Steve A. Petersen MD, Edward G. McFarland MD

One possible cause of shoulder pain is rotator cuff contact with the superior glenoid (cuff-glenoid contact) with the arm in flexion, as occurs during a Neer impingement sign. It has been assumed that the pain with a Neer impingement sign on physical examination of the shoulder was secondary to the rotator cuff making contact with the anterior and lateral acromion.

Total Shoulder Arthroplasty in Older Patients: Increased Perioperative Morbidity?

Eric T. Ricchetti MD, Joseph A. Abboud MD, Andrew F. Kuntz MD, Matthew L. Ramsey MD, David L. Glaser MD, Gerald R. Williams MD

More elderly patients are becoming candidates for total shoulder arthroplasty with an increase in frequency of the procedure paralleling the rise in other total joint arthroplasties. Controversy still exists, however, regarding the perioperative morbidity of total joint arthroplasty in elderly patients, particularly those 80 years of age and older.

Does the Upward Migration Index Predict Function and Quality of Life in Arthroscopic Rotator Cuff Repair?

Peter C. Lapner MD, FRCSC, Yingua Su BSc (H), David Simon MD, Salah El-Fatori MD, Emilio Lopez-Vidriero MD, PhD

Although upward humeral head migration is a well-recognized phenomenon in patients with tears of the cuff, it is unclear whether it relates to patient function after cuff repair. The upward migration index (UMI) assesses proximal migration of the humeral head while controlling for patients’ bony morphologic features.

Bioabsorbable Tricalcium Phosphate Bone Cement Strengthens Fixation of Suture Anchors

Rayshad Oshtory MD MBA, Derek P. Lindsey MS, Nicholas J. Giori MD, PhD, Faisal M. Mirza MD, FRCSC

Failure of suture anchor fixation in rotator cuff repair can occur at different interfaces. Prior studies show fixation at the bone-anchor interface can be augmented using polymethylmethacrylate (PMMA) cement, and screw fixation into bone can be strengthened using bioabsorbable tricalcium phosphate cement.

Pain Relief, Motion, and Function after Rotator Cuff Repair or Reconstruction May Not Persist after 16 Years

Niclas Borgmästars MD, Mika Paavola MD, PhD, Ville Remes MD, PhD, Martina Lohman MD, PhD, Martti Vastamäki MD, PhD

Short- to medium-term rotator cuff repair reportedly relieves pain in 82% to 97% of patients and provides normal or almost normal shoulder function in 82% to 92%. However, it is unknown whether pain relief and function persist long term.

Hemiarthroplasty for Proximal Humerus Fractures in Patients with Parkinson’s Disease

Thomas J. Kryzak MD, John W. Sperling MD, MBA, Cathy D. Schleck BSc, Robert H. Cofield MD

Parkinson’s disease is a relatively common problem in geriatric patients with an annual incidence rate of 20.5 per 100,000. These patients are at increased risk for falls and resultant fractures. Several reports suggest total shoulder arthroplasty in patients with fractures has a relatively high rate of complications. Whether hemiarthroplasty reduces the rate of complications or improves pain or function is not known.

Radiographic Stability of Ingrowth Humeral Stems in Total Shoulder Arthroplasty

Thomas W. Throckmorton MD, Peter C. Zarkadas MD, John W. Sperling MD, Robert H. Cofield MD

Cemented and uncemented stem types are available for TSA. An early uncemented stem designed for bone ingrowth had radiographic loosening of approximately 10% at intermediate followup (mean 4.6 years). Subsequent stem modifications included circumferential metaphyseal porous coating to enhance ingrowth and reduce loosening rates.

Case Reports: Two Cases of Glenohumeral Chondrolysis after Intraarticular Pain Pumps

Okechukwu A. Anakwenze MD, Harish Hosalkar MD, MBMS(Orth), FCPS(Orth), DNB(Orth), G. Russell Huffman MD, MPH

Acute idiopathic chondrolysis in young adults is rare. The etiology often is unknown and outcomes can be devastating owing to rapid development of painful secondary osteoarthritis. There have been some recent reports of chondrolysis after arthroscopic shoulder procedures. Animal and laboratory data suggest chondrolysis is related to the use of intraarticular pain pumps, although there is no conclusive evidence that this is causative in patients.