Kim's Lesion of the Shoulder: A Critical Analysis Review.

» Kim's lesion of the shoulder is characterized by incomplete tearing of the junction between the posteroinferior labrum and the glenoid, with the superficial labral tissue remaining intact, and generally requires arthroscopic evaluation for accurate confirmation.» Kim's lesion represents an under-reported subtype of posterior labral injury and a source of activity-related posterior shoulder discomfort and instability.» Kim's lesions are frequently observed in young, active individuals involved in overhead and contact sports, often resulting from traumatic mechanisms with the shoulder in flexion and adduction, as well as from repetitive microtrauma and overuse.

Is Acromial Morphology Different in Patients with Eccentric Glenohumeral Osteoarthritis?

Background: Acromial morphology has been implicated as a potential contributor to eccentric glenohumeral osteoarthritis (GHOA), leading to the development of novel procedures including scapular spine corrective osteotomies. However, there remains a substantial gap in knowledge on the relationship between acromial morphology and eccentric GHOA. This study utilized a comprehensive three-dimensional (3D) semi-automated analysis of acromial morphology to assess its association with eccentric GHOA patterns.

Adipose stromal cells in the human rotator cuff are resistant to fibrotic microenvironmental cues.

Rotator cuff tears are the most common upper extremity orthopaedic injury, causing degenerative changes within the bone, tendon, joint capsule, bursa and muscle. These degenerative changes are linked to poor rehabilitative and surgical outcomes, which has launched investigations into co-therapeutic biologics. Specifically, mesenchymal stem cells (MSCs) have shown promise in mitigating degenerative changes in animal models of rotator cuff tears, but reports of their impact on clinical outcomes remain mixed.

Midterm radiographic outcomes of anatomic total shoulder arthroplasty in biplanar glenoid deformities.

Background: Optimal management of retroversion in anatomic total shoulder arthroplasty (aTSA) remains controversial, and limited attention has been directed to the impact of glenoid inclination. Prior biomechanical study suggests that residual glenoid inclination generates shear stresses that may lead to early glenoid loosening. Combined biplanar glenoid deformities may complicate anatomic glenoid reconstruction and affect outcomes.

Incidence of and Risk Factors for Reoperation and Revision Following Total Elbow Arthroplasty with an Anatomic Convertible Prosthesis.

Background: Total elbow arthroplasty (TEA) remains a valuable tool for treating inflammatory, degenerative, and traumatic elbow conditions. This study aimed to understand the incidence of and risk factors for reoperation following TEA at a high-volume center utilizing an implant with a convertible linkage and the potential for anatomic lateral column reconstruction.

Methods: All patients undergoing primary TEA with the Latitude prosthesis (Stryker) from July 2001 to May 2020 were identified.

Clinical and Radiographic Outcomes and Graft Incorporation Rate Assessed by CT Scan After Reverse Shoulder Arthroplasty With Glenoid Structural Bone Graft Reconstruction.

Introduction: Reverse total shoulder arthroplasty (RTSA) with structural bone graft has been described as a technique in addressing glenoid bony defects. Studies have demonstrated acceptable outcomes with structural autograft or allograft. However, most of these studies are relatively small and rarely evaluate bone graft incorporation with CT scan.

Three-dimensional analysis of biplanar glenoid deformities: what are they and can they be virtually reconstructed with anatomic total shoulder arthroplasty implants?

Background: Descriptions of glenoid deformities in glenohumeral osteoarthritis (GHOA) have focused on the axial plane. Less is known regarding arthritic glenoids with higher amounts of superior inclination and little evidence exists to guide management of inclination or combined version-inclination deformity when performing anatomic total shoulder arthroplasty (aTSA). We hypothesized that biplanar deformities (BD) would be present in a higher proportion of GHOA patients than previously appreciated, and these deformities would be difficult to adequately reconstruct with contemporary aTSA implants.

Predictors of Internal Rotation after Reverse Shoulder Arthroplasty.

Objectives: Internal rotation (IR) remains unpredictable following reverse total shoulder arthroplasty (rTSA). This study aimed to determine if increasing IR limits range of motion in other planes, and to determine pre- and intra-operative factors associated with post-operative IR.

Methods: A retrospective analysis of a single surgeon's primary rTSA with a single implant was undertaken, excluding patients with acute fracture or infection.

Factors associated with genetic markers for rotator cuff disease in patients with atraumatic rotator cuff tears.

For atraumatic rotator cuff tears, genetics contributes to symptomatic tear risk and may influence rotator cuff healing after surgical repair. But little is known about how genetic factors influence rotator cuff tear patient characteristics at presentation. We collected saliva samples for genotyping from atraumatic rotator cuff tear patients.

Predictors of pain development for contralateral asymptomatic degenerative rotator cuff tears based on features of an ipsilateral painful cuff tear: a prospective longitudinal cohort study.

Background: Prior rotator cuff disease natural history studies have focused on tear-related factors that predict disease progression within a given shoulder. The purpose of this study was to examine both patient- and tear-related characteristics of a painful rotator cuff tear that predict future pain development and functional impairment in a shoulder with a contralateral asymptomatic cuff tear.

Methods: This was a prospective longitudinal cohort study of patients aged ≤65 years who underwent surgery for a painful degenerative rotator cuff tear and possessed an asymptomatic contralateral tear.

Revision of failed reverse total shoulder arthroplasty with reverse: short-term clinical outcomes.

Background: The prevalence of failed reverse total shoulder arthroplasty (rTSA) is increasing. This can often present a challenging clinical situation with substantial bone loss and limited reconstruction options. This study reports a single tertiary referral center's experience with revision of failed rTSA managed with revision rTSA of bone-interfacing components.

Evaluation of survivorship of asymptomatic degenerative rotator cuff tears in patients 65 years and younger: a prospective analysis with long-term follow-up.

Background: The purpose of this prospective study is to describe the mid- to long-term natural history of untreated asymptomatic degenerative rotator cuff tears in patients 65 years and younger.

Methods: Subjects with an asymptomatic rotator cuff tear in one shoulder and a contralateral painful cuff tear aged 65 years or younger were enrolled in a previously described prospective longitudinal study. Annual physical and ultrasonographic evaluations and surveillance for pain development were performed using independent examiners for the asymptomatic shoulder.

Rehabilitation after Shoulder Instability Surgery.

Shoulder instability can occur in any direction and presents across a broad spectrum including traumatic dislocations, repetitive microinstability events or subluxations, and global joint laxity. The development of pain, functional decline, and articular pathologic condition is a multifaceted process that is influenced by the underlying bony morphology, biology of the surrounding soft tissue structures, dynamic coordination of the periscapular musculature, and patient factors such as age, activity level, and associated injuries. This article will focus on the younger, active patient with instability due to deficiencies in the capsulolabral complex and dynamic stabilizers.

Clinical outcomes after reverse shoulder arthroplasty in patients 60 years old and younger; medium-term results.

Background: Reverse total shoulder arthroplasty (RTSA) has been well-described as a surgical solution to manage rotator cuff tear arthropathy in elderly, low demand paitents. As experience has increased along with improvements in technique and implant design, RTSA has become increasingly used to manage more varied pathologic conditions of the shoulder in younger, more active patients. This study evaluates outcomes in a consecutive series of patients aged 60 years old and younger after undergoing RTSA.

Anatomic shoulder arthroplasty in Walch type C glenoid deformity: mid- to long-term outcomes.

Background: Hypoplastic glenoid morphology in the setting of glenohumeral osteoarthritis is a rare yet complex surgical problem. Treatment of this patient population with anatomic total shoulder arthroplasty (aTSA) remains controversial. Furthermore, there is no gold-standard approach, with limited guidance for surgeons on the need for glenoid version correction in the setting of a dysplastic glenoid.

Active physical therapy does not improve outcomes after reverse total shoulder arthroplasty: a multi-center, randomized clinical trial.

Objective: To compare range of motion (ROM) and patient-reported outcomes (PROs) between a structured home exercise program (HEP) and active, supervised physiotherapy (PT) after primary Reverse total shoulder arthroplasty (RTSA) by performing a multicenter randomized clinical trial.

Methods: Patients undergoing primary RTSA at 2 centers were randomized to either a HEP group, in which they were given a handout and a rope pulley, or a PT group, in which they were given a standardized prescription. Surgical technique and implants were standardized.

Total shoulder arthroplasty in patients with a B2 glenoid addressed with corrective reaming: mean 8-year follow-up.

Background: The management of Walch B2 glenoid deformities in primary glenohumeral osteoarthritis is frequently debated. Previous literature has shown that the treatment of B2 glenoids with high-side reaming and anatomic total shoulder arthroplasty (aTSA) perform well in the short-term but is associated with an increased glenoid component failure rate in severe deformities. Therefore, many have explored alternative options, including augmented anatomic glenoid components and reverse shoulder arthroplasty.

My Reverse Has Failed: Top Five Complications and How to Manage Them.

Reverse total shoulder arthroplasty implantation has increased dramatically over the past 4 decades since it was first introduced in France in 1985. It has greatly improved the ability to treat patients with cuff tear arthropathy, proximal humeral fractures, and osteoarthritis with severe bone loss. However, with the increased implementation of reverse total shoulder arthroplasty, there has been a corresponding rise in complications.

Diagnosis and Management of Early Complications After Reverse Shoulder Arthroplasty.

Reverse shoulder arthroplasty has become the predominant shoulder arthroplasty procedure. Despite newer design modifications, complications still occur after reverse shoulder arthroplasty. Early complications include instability, acromial and scapular spine stress fractures, periprosthetic fractures, periprosthetic joint infections, and neurologic injury.

Occupational demands associated with rotator cuff disease surgery in the UK Biobank.

Objectives: Physically-demanding occupations may increase rotator cuff disease (RCD) risk and need for surgery. We linked a job-exposure matrix (JEM) to the UK Biobank cohort study to measure physical occupational exposures and estimate associations with RCD surgery.

Methods: Jobs and UK Standard Occupational Classification (SOC) codes were recorded during the UK Biobank verbal interview.

Trends in rotator cuff repair rates and comorbidity burden among commercially insured patients younger than the age of 65 years, United States 2007-2016.

Background: Prior US studies have shown increasing rotator cuff repair rates through 2009. We hypothesize that rotator cuff repair rates are continuing to increase and the comorbidity profiles of patients are becoming more complex over time.

Methods: We identified rotator cuff repairs in a large US cohort of people 18-64 years of age with ≥1 year of commercial insurance coverage.

Symptomatic aseptic loosening of a short humeral stem following anatomic total shoulder arthroplasty.

Introduction: The rate of aseptic humeral component loosening with standard-length stems is historically so low (0.3%) that presence of humeral loosening was given substantial weight in defining periprosthetic shoulder infection by the International Consensus Meeting (ICM) in 2018. This study aims to confirm that the historically low rate of humeral stem aseptic loosening is not affected by the adoption of a novel short humeral stem.

Identification of a Novel Genetic Marker for Risk of Degenerative Rotator Cuff Disease Surgery in the UK Biobank.

Background: While evidence indicates that familial predisposition influences the risk of developing degenerative rotator cuff disease (RCD), knowledge of specific genetic markers is limited. We conducted a genome-wide association study of RCD surgery using the UK Biobank, a prospective cohort of 500,000 people (40 to 69 years of age at enrollment) with genotype data.

Methods: Cases with surgery for degenerative RCD were identified using linked hospital records.