Revision arthroscopic soft-tissue stabilization for failed coracoid transfer yields low recurrence and high sports return rates.

Background: The coracoid process transfer, such as the Bristow or Latarjet procedure, is standard procedure for cases of anterior shoulder instability with large bone defects. However, the revision surgery for failed coracoid transfer was challenging. The purpose of this study was to retrospectively assess the clinical outcomes after arthroscopic soft-tissue stabilization for failed coracoid transfer.

Better scapulohumeral rhythm is associated with superior patient-reported outcome measures in shoulders with semi-inlay type reverse shoulder arthroplasty.

Background: Shoulders capable of achieving active abduction greater than 90° following reverse total shoulder arthroplasty (rTSA) have been reported to exhibit better scapulohumeral rhythm (SHR) compared to those limited to less than 90 degrees of active abduction. This study aimed to calculate SHR in shoulders following semi-inlay rTSA and to investigate whether improved SHR is associated with better postoperative patient-reported outcome measures in shoulders achieving active abduction greater than 90°.

Methods: Twenty shoulders of 19 patients who underwent semi-inlay rTSA were analyzed.

Lateralized reverse shoulder arthroplasty shows similar scaption kinematics but greater scapular neck-insert distance during external rotation compared to Grammont prosthesis.

Background: Biomechanical differences between reverse shoulder arthroplasty (RSA) designs, specifically those with larger neck-shaft angles like the Grammont-type prosthesis and those with smaller neck-shaft angles such as lateralized humerus RSAs, have been analyzed in ex vivo studies. However, there are limited data on the differences in in vivo shoulder kinematics between these designs. The purpose of this study was to analyze in vivo kinematics of lateralized humerus RSA during active scaption and external rotation at the side, and to compare them to previously reported data for Grammont-type RSA.

The validity of radiographic measurements compared to 3-dimensional-surface model-based measurements in shoulders with reverse total shoulder arthroplasty.

Background: Postoperative assessment following reverse total shoulder arthroplasty (rTSA) typically involves plain radiographs to evaluate implant positioning parameters, such as humeral distalization and lateralization along with medialization and distalization of the center of rotation (COR). However, the precision of these radiographic measurements remains unclear. This study aimed to validate the accuracy of radiographic 2-dimensional (2D) measurements compared to 3-dimensional (3D) surface model-based measurements derived from computed tomography data for evaluating postoperative parameters in rTSA.

Greater distance from the glenosphere center to the acromion reduces risk of acromial impingement in semi-inlay reverse shoulder arthroplasty.

Background: Recently, the issue of subacromial notching, caused by acromial impingement has been reported. The purpose of this study was to assess the impact of differences in the distance between the glenosphere center and the greater tuberosity (DGT) and the distance between the glenosphere center and the acromion (DA) on the closest distance between the greater tuberosity and the acromion during active abduction in shoulders with reverse total shoulder arthroplasty (RSA).

Methods: Eleven shoulders with semiinlay RSA were analyzed.

Extracorporeal Shock Wave Therapy and the Handstand-Position Radiography for Proximal Humeral Epiphysiolysis in Elite Gymnasts: A Report of Two Cases.

We report two cases of proximal humeral epiphysiolysis in elite gymnasts. Both patients presented with shoulder pain during weight-bearing movements. The patient in case 1, treated with extracorporeal shock wave therapy (ESWT), exhibited rapid bone repair and pain relief, allowing an early return to competition.

Elasticity assessment of flexor pronator muscles using shear wave elastography.

Background: The flexor pronator muscles (FPMs) have been thought as a dynamic stabilizer to protect the ulnar collateral ligament (UCL) from valgus stress during throwing motion. Thus, evaluation of the FPMs is important for preventing UCL injuries. Shear wave ultrasound elastography (SWE) is an imaging modality that quantifies tissue elasticity.

Location and size of the reverse Hill-Sachs lesion in patients with traumatic posterior shoulder instability.

Background: In patients with traumatic posterior shoulder instability, little is known about the precise location and size of the reverse Hill-Sachs lesion.

Methods: Forty-nine shoulders of 47 patients with traumatic posterior instability were included in this study based on the following inclusion criteria: (1) a primary or recurrent traumatic posterior shoulder dislocation and (2) the initial event being caused by trauma. Patients were excluded if they had (1) no history of trauma, (2) prior shoulder surgery, (3) no computed tomographic (CT) examination, or (4) were seizure cases.

Fatty Degeneration of the Rotator Cuff Muscles Improves in Shoulders with Successful Arthroscopic Rotator Cuff Repair: A Prospective Study Using Quantitative T2 Mapping Techniques, with 2-Year Follow-up.

Background: There remain arguments regarding whether fatty degeneration of the rotator cuff muscles improves following rotator cuff repair. The purpose of this study was to prospectively investigate changes in fatty degeneration of the rotator cuff muscles, quantitatively measured on magnetic resonance imaging (MRI) with use of transverse relaxation time (T2) mapping techniques, and to assess the relationship between these changes and clinical outcomes.

Methods: Patients were included if they were scheduled for arthroscopic rotator cuff repair using the suture-bridge technique between June 2014 and December 2015, underwent preoperative MRI including the T2 mapping sequence, and consented to participate in the study.

Rotator Cuff Tears are Significantly More Frequent in Recurrent Shoulder Instability Patients With Initial Dislocation at Age 40 or Older.

Purpose: To investigate and compare the pathologies and clinical outcomes of patients with traumatic anterior shoulder instability who underwent arthroscopic stabilization at 40 years or older between shoulders with initial dislocation before age 40 years and at 40 years or after.

Methods: Shoulders that underwent arthroscopic stabilization for recurrent traumatic anterior shoulder instability at 40 years or older with a minimum of 2-year follow-up were included. The subjects were divided into 2 groups according to age at initial dislocation after propensity score matching to reduce potential bias: younger than 40 years (group 1) and 40 years or older (group 2).

Return to sports and physical work after anatomical and reverse shoulder arthroplasty.

Background: No consensus has been reached on the return to sports or physical work after shoulder arthroplasty due to a shortage of literature. The purpose of this study was to investigate return to sports or physical work after anatomical total shoulder arthroplasty (aTSA) and reverse shoulder arthroplasty (RSA), as well as the clinical and radiographic outcomes.

Methods: The inclusion criteria were as follows: 1) aTSA or RSA between 2012 and 2017, and 2) patients who preoperatively participated in sports or physical work.

Postoperative graft integrity affects clinical outcomes after superior capsule reconstruction using fascia lata autograft in posterior-superior rotator cuff tears: a multicenter study.

Background: Previous studies have postulated that graft thickness and graft healing may be important factors for optimizing clinical outcomes of superior capsule reconstruction (SCR) for patients with irreparable rotator cuff tears (RCTs). However, the relationship between postoperative graft integrity and clinical outcomes after SCR remains unclear. We aimed to assess the relationship between postoperative graft integrity, including graft thickness and size of graft tear, and clinical outcomes after SCR in patients with irreparable RCTs.

Arthroscopic Repair of Isolated Subscapularis Tears Show Clinical and Structural Outcome Better for Small Tears Than Larger Tears.

Purpose: To retrospectively investigate the mid-term outcomes after arthroscopic repair of isolated subscapularis tears with a relatively large number of patients and to compare them by tear size.

Methods: Medical records were reviewed for patients who underwent arthroscopic rotator cuff repair between 2010 and 2017 at our institute. The inclusion criterion was isolated subscapularis tears that underwent arthroscopic rotator cuff repair.

Incidence of teres minor muscle atrophy in young and middle-aged populations.

Background: Teres minor atrophy can be seen in shoulders both with and without a rotator cuff tear, even among the young population. The purpose of this study was to retrospectively investigate the incidence of teres minor atrophy in young and middle-aged patients with or without a rotator cuff tear.

Methods: Patient records were reviewed to identify 10-39-year-old patients (Group Y) and 60-69-year-old patients (Group O) who underwent MRI because of shoulder disorders.

Pathology and surgical outcomes of unstable painful shoulders.

Background: Boileau et al have reported on the unstable, painful shoulder (UPS), which was defined as painful shoulders without any recognized anteroinferior subluxations or dislocations that were associated with roll-over lesions (ie, instability lesions) on imaging or at arthroscopy. However, they included various pathologies, probably due to the ambiguity in their definitions of UPS. We redefined UPS as follows: (1) shoulder pain during daily or sports activities, (2) traumatic onset, (3) no complaint of shoulder instability, and (4) soft-tissue or bony lesions, such as Bankart or humeral avulsion of glenohumeral ligament lesion, confirmed by arthroscopy.

Assessment of the Preserved Biceps Tendon After Arthroscopic Rotator Cuff Repair in Patients ≤ 55 Years.

Purpose: We assessed hypertrophy of preserved long head of the biceps tendon (LHBT) and vascularity in the bicipital groove after arthroscopic rotator cuff repair in ≤55-year-old patients and compared postoperative pain between shoulders with or without vascularity in the bicipital groove.

Methods: Patients who underwent arthroscopic rotator cuff repair between 2015 and 2017 were reviewed. Inclusion criteria were arthroscopic rotator cuff repair and ≤55 years old.

Validation study of novel grading system for ulnar collateral ligament injury of the elbow with high-resolution magnetic resonance imaging.

Background: Recently, magnetic resonance imaging (MRI) classification of medial ulnar collateral ligament (UCL) tears has been introduced, but little is known about the relationship between MRI grading and medial joint laxity. It has been reported that microscopy coils could make it possible to achieve high-resolution images of upper extremities with a superior diagnostic ability to conventional MRI. However, there is no report that has compared the diagnostic reliability between microscopic and conventional MRI.

Clinical outcomes of anatomic total shoulder arthroplasty for primary shoulder osteoarthritis did not differ between elderly and younger Japanese patients.

Background: Few studies on the outcomes of anatomic total shoulder arthroplasty (aTSA) in Asian populations have been reported. In addition, approximately one-third of primary aTSA were performed for patients 80 years or older in Japan, but the indication of aTSA for the primary shoulder osteoarthritis in the elderly population remained unclear. The purposes of this study were (1) to investigate clinical outcomes of aTSA in Japanese patients with primary glenohumeral osteoarthritis and (2) to compare clinical outcomes between patients 80 years or older and 70 years or younger.

Relationship between the morphology of the greater tuberosity and radiological and clinical outcomes after arthroscopic rotator cuff repair.

Background: Degenerative greater tuberosity (GT) changes are often associated with rotator cuff tears. However, little is known about the impact of GT morphology on surgical outcomes. The aim of this study was to examine the relationship between clinical and radiological outcomes, after rotator cuff repair, and GT morphology.

Three-dimensional kinematics of reverse shoulder arthroplasty: a comparison between shoulders with good or poor elevation.

Background: Various factors may be related to outcomes of reverse shoulder arthroplasty (RSA) including patient and surgical factors. Differences in shoulder kinematics might be associated with poor function after RSA; however, kinematic differences between shoulders with good or poor elevation have not been elucidated. The purpose of this study was to compare RSA kinematics between shoulders with good or poor elevation.

Biceps tenotomy versus soft-tissue tenodesis in females aged 60 years and older with rotator cuff tears.

Background: Recently, to treat the long head of the biceps tendon lesions in addition to rotator cuff repair has been recommended. However, the differences in clinical outcomes between biceps tenotomy and tenodesis for middle-aged and elderly females remains unclear. The purpose of this study was to compare the outcomes of biceps tenotomy and soft-tissue tenodesis that were performed concurrently with arthroscopic rotator cuff repair in ≥60-year-old females.

Arthroscopic Soft Tissue Stabilization With Selective Augmentations for Traumatic Anterior Shoulder Instability in Competitive Collision Athletes.

Background: Many surgeons prefer bony stabilization including Bristow or Latarjet procedures for shoulder instability in collision athletes, even though several potential complications have been reported. There has been a limited number of studies on the midterm outcomes of arthroscopic soft tissue stabilization for anterior shoulder instability in competitive collision athletes.

Purpose: To assess the outcomes of arthroscopic soft tissue stabilization in combination with selective augmentation procedures for collision athletes with traumatic anterior shoulder instability.

In vivo measurement of distance between scapular neck and polyethylene insert during active external rotation in shoulders with Grammont type reverse prosthesis.

Background: Scapular notching is a frequently observed complication after reverse shoulder arthroplasty. Impingement of the humeral plastic insert against the scapular neck is believed to be the cause of notching. There have been no in vivo studies that analyzed the positional relationship between the scapular neck and humeral insert.