Synovial fluid leukocytes as diagnostic marker in periprosthetic shoulder infection.

Background: Limited data exist regarding the diagnostic accuracy of synovial fluid leukocyte count (SFLC) in diagnosing periprosthetic shoulder infection (PSI). The main objective of this study was to determine the diagnostic value of leukocyte count at a common threshold of 3 cells/nL and the optimal cut-off value.

Methods: Patients who underwent shoulder arthroplasty revision surgery and aspiration with SFLC between 2012 and 2023 were retrospectively included.

Mid- to Long-Term Outcomes of Two-Stage Revision Arthroplasty for Periprosthetic Joint Infection of the Shoulder.

: Periprosthetic joint infection (PJI) after shoulder arthroplasty is often treated with a two-stage approach, but the data on the mid- to long-term outcomes remain scarce. This study aimed to evaluate the clinical outcomes of two-stage revision arthroplasty for shoulder PJI with a minimum follow-up of five years. : This retrospective study identified 59 shoulders in 58 patients who underwent the first stage of a two-stage revision arthroplasty for shoulder PJI at our institution between 2007 and 2018.

Mid- to long-term outcome of reverse total shoulder arthroplasty as revision procedure for failed hemiarthroplasty after proximal humerus fracture.

Background: Insufficient tuberosity healing is the most common reason for poor outcome after treatment of proximal humerus fractures (PHFs) using hemiarthroplasty (HA). In these cases, revision to reverse total shoulder arthroplasty (RTSA) can improve function and reduce pain in the short term, however, long-term results remain scarce. Aim of this study was to evaluate the clinical and radiological mid- to long-term results in patients with a revision RTSA after failed HA for PHF.

Intraoperative Doppler flowmetry evaluation of humeral head perfusion after proximal humerus fracture.

Background: Understanding vascularity and assessing the risk of post-traumatic avascular necrosis are crucial for predicting outcomes and identifying optimal treatment options in proximal humerus fractures (PHFs). Until now, Hertel et al have been the only researchers to evaluate the intraoperative perfusion of the humeral head after fracture using Doppler flowmetry in a central single drill hole within the head. This pilot study aims to standardize the evaluation of intraoperative perfusion measurements in different areas of the humeral head in patients with PHF.

Outcome of Endoprosthetic Hip Reconstruction Following Resection of Malignant Bone Tumors.

Introduction: Over the past few decades, tumor arthroplasty has evolved into an established therapeutic approach for addressing bone defects following tumor resection in the extremities. As the diagnosis has a significant impact on patients' lives, it is important to give clear expectations for functional recovery. Therefore, we investigated both the functional outcomes and the quality of life (QoL) after tumor arthroplasty for malignant hip tumors.

Augmented reality-assisted intraoperative navigation increases precision of glenoid inclination in reverse shoulder arthroplasty.

Background: Reverse total shoulder arthroplasty (RTSA) is the standard of care for patients with glenohumeral osteoarthritis and rotator cuff deficiency. Preoperative RTSA planning based on medical images and patient-specific instruments has been established over the last decade. This study aims to determine the effects of using augmented reality-assisted intraoperative navigation (ARIN) for baseplate positioning in RTSA compared to preoperative planning.

MicroRNA expression analysis in peripheral blood and soft-tissue of patients with periprosthetic hip infection.

Aims: Current diagnostic tools are not always able to effectively identify periprosthetic joint infections (PJIs). Recent studies suggest that circulating microRNAs (miRNAs) undergo changes under pathological conditions such as infection. The aim of this study was to analyze miRNA expression in hip arthroplasty PJI patients.

The Global Track Concept for Assessment of Engaging Hill-Sachs Defects in Anterior Shoulder Instability.

Background: The glenoid track concept is used to determine preoperatively whether a Hill-Sachs defect is engaging or not. Currently, the glenoid track concept relies on measurements of bony structures as well as on the confines and elasticity of the rotator cuff as a reference point, which varies extensively among individuals and therefore limits the reliability and accuracy of this concept.

Purpose: To evaluate the reliability of the global track concept, which determines the angular distance of the Hill-Sachs defect from the center of the articular surface of the humeral head as a new reference point with the help of an automated image analysis software and 3-dimensional analysis of the humeral head.

The latissimus dorsi creates a dynamic track for the inferior angle of the scapula during arm abduction in humans.

Background: The importance of several scapulothoracic muscles, including trapezius and serratus anterior, in maintaining physiological scapula kinematics has been highlighted in the past. However, the relationship between the scapula and the latissimus dorsi muscle remains unclear. Our clinical surgical observation is that the latissimus dorsi does not directly attach but rather runs superficial to the inferior angle of the scapula.

Differences in Osseous Shoulder Morphology, Scapulothoracic Orientation, and Muscle Volume in Patients With Constitutional Static Posterior Shoulder Instability (Type C1) Compared With Healthy Controls.

Background: Constitutional static posterior humeral decentering (type C1 according to ABC Classification) has been recognized as a pre-osteoarthritic deformity that may lead to early-onset posterior decentering osteoarthritis at a young age. Therefore, it is important to identify possible associations of this pathologic shoulder condition to find more effective treatment options.

Purpose: To perform a comprehensive analysis of all parameters reported to be associated with a C1 shoulder-including the osseous shoulder morphology, scapulothoracic orientation, and the muscle volume of the shoulder girdle in a single patient cohort.

Reliability of Manual Measurements Versus Semiautomated Software for Glenoid Bone Loss Quantification in Patients With Anterior Shoulder Instability.

Background: The presence of glenoid bone defects is indicative in the choice of treatment for patients with anterior shoulder instability. In contrast to traditional linear- and area-based measurements, techniques such as the consideration of glenoid concavity have been proposed and validated.

Purpose: To compare the reliability of linear (1-dimensional [1D]), area (2-dimensional [2D]), and concavity (3-dimensional [3D]) measurements to quantify glenoid bone loss performed manually and to analyze how automated measurements affect reliability.

Functional and Radiologic Outcomes of Degenerative Versus Traumatic Full-Thickness Rotator Cuff Tears Involving the Supraspinatus Tendon.

Background: Arthroscopic rotator cuff repair (ARCR) is among the most commonly performed orthopaedic procedures. Several factors-including age, sex, and tear severity-have been identified as predictors for outcome after repair. The influence of the tear etiology on functional and structural outcome remains controversial.

SECEC Didier Patte Prize 2023: the ABC classification of posterior shoulder instability.

Background: The ABC classification has recently been proposed as a comprehensive classification system for posterior shoulder instability (PSI). The purpose of this study was to analyze the comprehensiveness as well as inter-rater and intrarater reliability of the ABC classification.

Methods: All consecutive patients presenting with unidirectional PSI from June 2019 to June 2021 were included in a prospective study.

Position of scapula and clavicle in acute acromioclavicular joint dislocations: depressed scapula or elevated distal clavicle?

Background: Increased coracoclavicular distance due to acute acromioclavicular joint (ACJ) instability is often described as a pseudoelevation of the clavicle due to inferior hanging of the scapula, while the distal clavicle remains in its position. The aim of this study was to analyze whether the elevation of the distal clavicle, depression of the scapula, or both are associated with vertical instability and to evaluate the impact of weighted stress radiographs on the clavicle and scapular position in acute ACJ instabilities.

Methods: The cohort consisted of 505 patients (f = 52, m = 453; mean age 46 years) which presented to our emergency department or outpatient clinic and treated in our institution from 2006 to 2019 displaying an acute ACJ injury.

Prosthetic Joint Infection in Mega-Arthroplasty Following Shoulder, Hip and Knee Malignancy-A Prospective Follow-Up Study.

Introduction: The risk of prosthetic joint infection (PJI) in mega-prosthesis for malignancy is increased compared with non-tumor cases. While several studies describe PJI in tumor-related arthroplasty, prospective studies comparing infection characteristics among different joints are limited. The present study analyzes mega-arthroplasty for hip, knee, and shoulder malignancy and compares the epidemiology, diagnosis, microbe spectrum, treatments, and outcomes between the different entities.

Effects of the clathrin inhibitor Pitstop-2 on synaptic vesicle recycling at a central synapse .

Four modes of endocytosis and subsequent synaptic vesicle (SV) recycling have been described at the presynapse to ensure the availability of SVs for synaptic release. However, it is unclear to what extend these modes operate under physiological activity patterns . The coat protein clathrin can regenerate SVs either directly from the plasma membrane (PM) via clathrin-mediated endocytosis (CME), or indirectly from synaptic endosomes by SV budding.

Arthroscopic Posterior Articular Coverage and Shift (PACS) Procedure for Treatment of Preosteoarthritic Constitutional Static Posterior Shoulder Instability (Type C1).

Background: Different joint-preserving techniques for treatment of preosteoarthritic, constitutional static (type C1) posterior shoulder instability (PSI) have been proposed, including posterior glenoid open wedge osteotomy and bone graft augmentation. However, the techniques are demanding, the reported complication and reoperation rates are high, and posterior decentering cannot reliably be reversed.

Purpose: To assess the clinical and radiological longitudinal outcomes of patients with type C1 PSI after arthroscopic posterior articular coverage and shift (PACS) surgery.

Clinical outcomes after refixation of subacute repaired distal biceps tendon ruptures.

Background: The aim of this study was to evaluate the clinical outcome and complication spectrum after delayed repair surgery of distal biceps tendon ruptures, postulating that satisfactory results are possible contrary to previous literature.

Methods: Forty-three of 92 patients with a full workup (= OPT in) undergoing primary distal biceps tendon repair were included in this study. The mean age of participants was 49.

Arthroscopic Bone Block Cerclage Technique Using a Tricortical Scapular Spine Autograft for Glenoid Reconstruction in Patients With Anterior Shoulder Instability.

In the treatment of anterior shoulder instability with glenoid bone loss, free bone graft transfers have proven to be a viable anatomic alternative to the commonly performed, nonanatomic Latarjet procedure. Implant-free fixation of the free bone grafts, in particular, has rendered excellent short- and long-term results. However, a drawback remains the source of the graft.

The Independent Double-Row (IDR) Bony Bankart Repair Technique.

A displaced anterior glenoid rim fracture, the so-called bony Bankart lesion, occurs after a traumatic shoulder dislocation resulting from a high energy trauma and is associated with recurrent shoulder instability. Different surgical techniques have been described in the literature to address this pathology, including open reduction and fixation, as well as arthroscopic transosseous, and single-row or double-row approaches with the use of suture anchors. However, there is currently no gold standard of treatment and the stability of fixation and the healing of the bony fragment are still a concern.