Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Shoulder 154 articles


Open Surgical Treatment for Snapping Scapula Provides Durable Pain Relief, but so Does Nonsurgical Treatment

Martti Vastamäki MD, PhD, Heidi Vastamäki MD, PhD

Resection of the medial upper corner of the scapula is one option for treating patients with a painful chronic snapping scapula. However, the degree to which this procedure results in sustained relief of pain during long-term followup, and whether surgical treatment offers any compelling advantages over nonsurgical approaches at long-term followup, are not known.

Obesity is Not Associated with Increased Short-term Complications After Primary Total Shoulder Arthroplasty

Jimmy J. Jiang MD, Jason R. Somogyi MD, Pranay B. Patel MD, Jason L. Koh MD, Douglas R. Dirschl MD, Lewis L. Shi MD

Few studies have analyzed the association between elevated BMI and complications after total shoulder arthroplasty (TSA). Previous studies have not consistently arrived at the same conclusion regarding whether obesity is associated with a greater number of postoperative complications. We used a national surgical database to compare the 30-day complication profile and hospitalization outcomes after primary TSA among patients in different BMI categories.

No Differences in Early Results of a Hybrid Glenoid Compared With a Pegged Implant

Lawrence V. Gulotta MD, K. Lauchlan Chambers MD, Russell F. Warren MD, David M. Dines MD, Edward V. Craig MD, MPH

Glenoid component loosening after total shoulder arthroplasty is one of the most common causes of failure. A hybrid glenoid that uses peripherally cemented pegs and a central press-fit post may improve implant longevity.

Implant Design Variations in Reverse Total Shoulder Arthroplasty Influence the Required Deltoid Force and Resultant Joint Load

Joshua W. Giles PhD, G. Daniel G. Langohr MASc, James A. Johnson PhD, George S. Athwal MD

Reverse total shoulder arthroplasty (RTSA) is widely used; however, the effects of RTSA geometric parameters on joint and muscle loading, which strongly influence implant survivorship and long-term function, are not well understood. By investigating these parameters, it should be possible to objectively optimize RTSA design and implantation technique.

One-year Patient-reported Outcomes After Arthroscopic Rotator Cuff Repair Do Not Correlate With Mild to Moderate Psychological Distress

Michael Q. Potter MD, James D. Wylie MD, Erin K. Granger MPH, Patrick E. Greis MD, Robert T. Burks MD, Robert Z. Tashjian MD

Patients with shoulder and rotator cuff pathology who exhibit greater levels of psychological distress report inferior preoperative self-assessments of pain and function. In several other areas of orthopaedics, higher levels of distress correlate with a higher likelihood of persistent pain and disability after recovery from surgery. To our knowledge, the relationship between psychological distress and outcomes after arthroscopic rotator cuff repair has not been similarly investigated.

Posterior Glenoid Wear in Total Shoulder Arthroplasty: Eccentric Anterior Reaming Is Superior to Posterior Augment

Tim Wang MD, Geoffrey D. Abrams MD, Anthony W. Behn MS, Derek Lindsey MS, Nicholas Giori MD, Emilie V. Cheung MD

Uncorrected glenoid retroversion during total shoulder arthroplasty may lead to an increased likelihood of glenoid prosthetic loosening. Augmented glenoid components seek to correct retroversion to address posterior glenoid bone loss, but few biomechanical studies have evaluated their performance.

What Are Risk Factors for Intraoperative Humerus Fractures During Revision Reverse Shoulder Arthroplasty and Do They Influence Outcomes?

Eric R. Wagner MD, Matthew T. Houdek MD, Bassem T. Elhassan MD, Joaquin Sanchez-Sotelo MD, PhD, Robert H. Cofield MD, John W. Sperling MD, MBA

With the increase in shoulder arthroplasty rates, the number of perioperative complications, such as periprosthetic fractures, continues to be a rise; however, the risk factors and incidence of intraoperative complications, such as fractures, during revision reverse shoulder arthroplasty are not well established.

Latissimus Dorsi and Teres Major Transfer With Reverse Shoulder Arthroplasty Restores Active Motion and Reduces Pain for Posterosuperior Cuff Dysfunction

Lewis L. Shi MD, Kirk E. Cahill BA, Eugene T. Ek MBBS, PhD, Jeffrey D. Tompson MS, Laurence D. Higgins MD, Jon J. P. Warner MD

In patients with rotator cuff dysfunction, reverse shoulder arthroplasty can restore active forward flexion, but it does not provide a solution for the lack of active external rotation because of infraspinatus and the teres minor dysfunction. A modified L’Episcopo procedure can be performed in the same setting wherein the latissimus dorsi and teres major tendons are transferred to the lateral aspect of proximal humerus in an attempt to restore active external rotation.

Patients Undergoing Total Shoulder Arthroplasty on the Dominant Extremity Attain Greater Postoperative ROM

Gregory L. Cvetanovich MD, Peter N. Chalmers MD, Jonathan J. Streit MD, Anthony A. Romeo MD, Gregory P. Nicholson MD

Total shoulder arthroplasty (TSA) provides excellent functional outcomes and pain relief in appropriately selected patients. Although it is known to affect other shoulder conditions, the role of hand dominance after TSA has not been reported, to our knowledge.

What is the Best Clinical Test for Assessment of the Teres Minor in Massive Rotator Cuff Tears?

Philippe Collin MD, Thomas Treseder MD, PhD, Patrick J. Denard MD, Lionel Neyton MD, Gilles Walch MD, Alexandre Lädermann MD

Few studies define the clinical signs to evaluate the integrity of teres minor in patients with massive rotator cuff tears. CT and MRI, with or without an arthrogram, can be limited by image quality, soft tissue density, motion artifact, and interobserver reliability. Additionally, the ill-defined junction between the infraspinatus and teres minor and the larger muscle-to-tendon ratio of the teres minor can contribute to error. Therefore, we wished to determine the validity of clinical testing for teres minor tears.