Shoulder & Elbow Journal Scan

Arthroscopic repair of massive contracted rotator cuff tears: aggressive release with anterior and posterior interval slides do not improve cuff healing and integrity.

J Bone Joint Surg Am. 2013 Aug 21;95(16):1482-8

Authors: Kim SJ, Kim SH, Lee SK, Seo JW, Chun YM

Abstract
BACKGROUND: Few studies of large-to-massive contracted rotator cuff tears have examined the arthroscopic complete repair obtained by a posterior interval slide and whether the clinical outcomes or structural integrity achieved are better than those after partial repair without the posterior interval slide.
METHOD: The study included forty-one patients with large-to-massive contracted rotator cuff tears, not amenable to complete repair with margin convergence alone. The patients underwent either arthroscopic complete repair with a posterior interval slide and side-to-side repair of the interval slide edge (twenty-two patients; Group P) or partial repair with margin convergence (nineteen patients; Group M). The patient assignment was not randomized. The Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES) score, University of California at Los Angeles (UCLA) shoulder score, and range of motion were used to compare the functional outcomes. Preoperative and six-month postoperative magnetic resonance arthrography (MRA) images were compared within or between groups.
RESULTS: At the two-year follow-up evaluation, the SST, ASES score, UCLA score, and range of motion had significantly improved (p < 0.001 for all) in both groups. However, no significant differences were detected between groups. Even though the difference in preoperative tear size on

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Electromyographic analysis of reverse total shoulder arthroplasties.

J Shoulder Elbow Surg. 2013 Aug 14;

Authors: Walker D, Wright TW, Banks SA, Struk AM

Abstract
BACKGROUND: Understanding how reverse total shoulder arthroplasty (RTSA) affects muscle activation may help refine it. This study evaluated deltoid and upper trapezius activity during shoulder abduction, flexion, and external rotation in RTSA recipients.
METHODS: Fifty individuals were recruited for this study: 33 were ≥6 months postunilateral RSTA, and 17 comprised our control group. Control individuals easily performed all functional tasks and had no history of shoulder pathology or pain. RTSA participants were divided into 3 groups according to implant design. Participants performed weighted and unweighted abduction in the coronal plane, forward flexion in the sagittal plane, and unweighted external rotation. Electromyography activation of the anterior, lateral, and posterior aspects of the deltoid and the upper trapezius muscles was recorded bilaterally. Motion capture using passive reflective markers quantified 3-dimensional motions of both shoulders.

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Long-term clinical outcomes, motion, strength, and function after total claviculectomy.

J Shoulder Elbow Surg. 2013 Aug 10;

Authors: Rubright J, Kelleher P, Beardsley C, Paller D, Shackford S, Beynnon B, Shafritz A

Abstract
BACKGROUND: Total excision of the clavicle is rarely performed. No previous study has documented long-term outcomes with objective measurements of strength, motion, and patient-centered outcomes. We present the long-term consequences of total claviculectomy on shoulder girdle function, global upper extremity function, and overall general health.
METHODS: Five total claviculectomy patients were evaluated at 2 time points (2005 and 2010, mean 4.8 and 9.4 years postoperatively) by use of the DASH, SF-36, Simple Shoulder Test, ASES, UCLA, HSS, and Constant shoulder scores. Isokinetic strength, clinical range of motion, and kinematic analysis were performed on each limb pair.

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Acute lateral dislocated clavicular fractures: arthroscopic stabilization with TightRope.

J Shoulder Elbow Surg. 2013 Aug 9;

Authors: Motta P, Bruno L, Maderni A, Tosco P, Mariotti U

Abstract
HYPOTHESIS: Type IIA, IIB, and V lateral clavicular fractures (Craig modification of the Neer classification) are characterized by a constant displacement and are associated with a high rate of nonunion. The aim of this study is to verify whether the reduction and arthroscopic stabilization of these clavicular fractures with coracoclavicular cerclage provide stable fixation to allow for bone healing. To date, the treatment of these fractures is still controversial in young active patients in whom functional requirements are to be met.
METHODS: Fourteen male patients, with type IIA, IIB, and V lateral clavicular fractures (2 type IIA, 10 type IIB, and 2 type V) had been treated arthroscopically with a TightRope (Arthrex, Naples, FL, USA) and had a radiologic/clinical follow-up of at least 2 years.

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Limb function after excision of a deltoid muscle sarcoma.

J Shoulder Elbow Surg. 2013 Aug 9;

Authors: Mimata Y, Nishida J, Gotoh M, Akasaka T, Shimamura T

Abstract
BACKGROUND: Limb function after excision of deltoid muscle sarcomas has not been thoroughly investigated, although a large defect of soft tissue often causes some degree of dysfunction after wide excision. We formulated a hypothesis that the limb functional results depend on the volume of the excised deltoid muscle and examined the clinical outcomes in patients with a sarcoma in the deltoid muscle treated by surgical resection.
METHODS: The clinical outcomes of 8 patients with a malignant soft tissue tumor in the deltoid muscle were retrospectively reviewed. The following items were evaluated: type of excision of the deltoid muscle, including total excision, subtotal excision, and partial excision; surgical margins; reconstruction procedure used; postoperative complications; local recurrence; metastasis; survival; and functional results (determined by the Musculoskeletal Tumor Society scoring system).

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Shoulder arthroplasty for osteoarthritis secondary to glenoid dysplasia: an update.

J Shoulder Elbow Surg. 2013 Aug 9;

Authors: Allen B, Schoch B, Sperling JW, Cofield RH

Abstract
BACKGROUND: Glenoid component fixation is an issue in shoulder arthroplasty for glenoid dysplasia with osteoarthritis because of the small amount of bone available. In 2002, we described 6 patients (7 shoulders) undergoing shoulder arthroplasty for this condition. This report expands that experience to further understand the role of anatomic shoulder arthroplasty (both hemiarthroplasty and total shoulder arthroplasty), to outline results, and to identify complications and reoperations-all to better understand whether other treatment options need to be developed and explored. Our hypothesis is that treatment of this problem with anatomic arthroplasty is not ideal.
METHODS: Between 1980 and 2008, 20 patients (22 shoulders) underwent anatomic shoulder arthroplasty for treatment of osteoarthritis secondary to glenoid dysplasia. There were 8 hemiarthroplasties and 14 total shoulder arthroplasties. Average follow-up was 6 years (range, 0.4 to 23.1 years).

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Characteristics of small to medium-sized rotator cuff tears with and without disruption of the anterior supraspinatus tendon.

J Shoulder Elbow Surg. 2013 Aug 9;

Authors: Namdari S, Donegan RP, Dahiya N, Galatz LM, Yamaguchi K, Keener JD

Abstract
BACKGROUND: The purpose of this study was to examine the baseline function and results of arthroscopic cuff repair in shoulders with small and medium-sized full-thickness cuff tears with complete supraspinatus disruption compared with those with an intact anterior supraspinatus tendon.
METHODS: The study evaluated 112 subjects with small and medium-sized cuff tears. Subjects were grouped according to anterior supraspinatus integrity (83 shoulders intact, group 1; and 29 shoulders with anterior supraspinatus tendon disruption, group 2). Functional assessments included visual analogue scale for pain, American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test score, and Constant score. Repair integrity was assessed by ultrasound examination.
RESULTS: Group 2 shoulders had greater mean tear width, length, and area (P < .0001) and greater supraspinatus muscle degenerative changes (P < .0001) compared with shoulders with an intact anterior supraspinatus tendon. There were no differences in demographics or baseline function (ASES score: 45 group 1 vs 46 group 2, P = .79; Constant score: 56 group 1 vs 52 group 2, P = .29) before surgery. There were no differences in any

Biomechanical Evaluation of Anatomical Double-bundle Coracoclavicular Ligament Reconstruction Secured With Knot Fixation Versus Screw Fixation.

Orthopedics. 2013 Aug 1;36(8):e1047-52

Authors: Staron JS, Esquivel AO, Pandhi NG, Hanna JD, Lemos SE

Abstract

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Occupational injury among orthopaedic surgeons.

J Bone Joint Surg Am. 2013 Aug 7;95(15):e1071-6

Authors: Davis WT, Sathiyakumar V, Jahangir AA, Obremskey WT, Sethi MK

Abstract
BACKGROUND: Orthopaedic surgery is a physically demanding profession that requires many hours per week in body positions known to contribute to musculoskeletal injury and pain. Injuries to surgeons can affect the delivery of care and impose costs on the health care system. The aim of this study was to determine the prevalence and types of injuries sustained at the workplace during the career of an orthopaedic surgeon as well as the impact of such injuries on practicing surgeons.
METHODS: A survey was developed to assess occupational injury among orthopaedic surgeons. Electronic surveys were distributed via e-mail to all orthopaedic surgeons in Tennessee. Data were analyzed to determine statistical associations of demographic and workplace factors with the rate of injury.