Clinical Orthopaedics and Related Research ®

A Publication of The Association of Bone and Joint Surgeons ®

Shoulder 158 articles


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.

Deltoid Tuberosity Index: A Simple Radiographic Tool to Assess Local Bone Quality in Proximal Humerus Fractures

Christian Spross MD, Nicola Kaestle MD, Emanuel Benninger MD, Jürgen Fornaro MD, Johannes Erhardt MD, Vilijam Zdravkovic MD, Bernhard Jost Prof, MD

Osteoporosis may complicate surgical fixation and healing of proximal humerus fractures and should be assessed preoperatively. Peripheral quantitative CT (pQCT) and the Tingart measurement are helpful methods, but both have limitations in clinical use because of limited availability (pQCT) or fracture lines crossing the area of interest (Tingart measurement). The aim of our study was to introduce and validate a simple cortical index to assess the quality of bone in proximal humerus fractures using AP radiographs.

Scapular Bracing is Effective in Some Patients but Symptoms Persist in Many Despite Bracing

Martti Vastamäki MD, PhD, Veera Pikkarainen MD, Heidi Vastamäki MD, Leena Ristolainen PT, DSc

A scapular-protecting brace is one option for treating patients with a winging scapula in isolated serratus palsy. However, outcomes after brace treatment have been reported in only a few studies, and to our knowledge, none has results reported at long-term beyond 10 years.

Does Rotator Cuff Repair Improve Psychologic Status and Quality of Life in Patients With Rotator Cuff Tear?

Chul-Hyun Cho MD, PhD, Kwang-Soon Song MD, Ilseon Hwang MD, Jon J. P. Warner MD

Recently, psychological status, patient-centered outcomes, and health-related quality of life (HRQoL) in patients with scheduled or who underwent orthopaedic surgeries have been emphasized. The relationship between preoperative psychological status and postoperative clinical outcome in patients with rotator cuff repair has not yet been investigated.

Future Patient Demand for Shoulder Arthroplasty by Younger Patients: National Projections

Eric M. Padegimas MD, Mitchell Maltenfort PhD, Mark D. Lazarus MD, Matthew L. Ramsey MD, Gerald R. Williams MD, Surena Namdari MD, MSc

The outcomes of shoulder arthroplasties in younger patients (55 years or younger) are not as reliable compared with those of the general population. Greater risk of revision and higher complication rates in younger patients present direct costs to the healthcare system and indirect costs to the patient in terms of quality of life. Previous studies have suggested an increased demand for shoulder arthroplasties overall, but to our knowledge, the demand in younger patients has not been explored.

The Effect of Granulocyte-colony Stimulating Factor on Rotator Cuff Healing After Injury and Repair

David Ross MD, Tristan Maerz MS, Michael Kurdziel MS, Joel Hein MD, Shashin Doshi MD, Asheesh Bedi MD, Kyle Anderson MD, Kevin Baker PhD

The failure rate of tendon-bone healing after repair of rotator cuff tears remains high. A variety of biologic- and cell-based therapies aimed at improving rotator cuff healing have been investigated, and stem cell-based techniques have become increasingly more common. However, most studies have focused on the implantation of exogenous cells, which introduces higher risk and cost. We aimed to improve rotator cuff healing by inducing endogenous stem cell mobilization with systemic administration of granulocyte-colony stimulating factor (G-CSF).

What Are Risk Factors for 30-day Morbidity and Transfusion in Total Shoulder Arthroplasty? A Review of 1922 Cases

Chris A. Anthony MD, Robert W. Westermann MD, Yubo Gao PhD, Andrew J. Pugely MD, Brian R. Wolf MD, MS, Carolyn M. Hettrich MD, MPH

Total shoulder arthroplasty (TSA) is an effective treatment for end-stage glenohumeral joint pathology with good long-term results. Previous descriptions of morbidity and blood transfusion in TSA are limited by preoperative risk factors and postoperative complications considered and single-center studies.