Shoulder brace has no detrimental effect on basic spatio-temporal gait parameters and functional mobility after arthroscopic rotator cuff repair.

Background: The risk of falls in patients undergoing orthopedic procedures is significant in terms of health and socioeconomic effects.

Research Question: Is there an influence of the shoulder abduction brace (SAB) on gait parameters in patients undergoing arthroscopic rotator cuff repair (ARCR)?

Methods: Thirty-five patients undergoing ARCR, who used a 15° SAB in the postoperative period, were included in a prospective study. Participants underwent gait analysis preoperatively (T), 24 h after surgery (T), 1 week (T), and 4 weeks after surgery (1 week after SAB removal) (T) by using a wearable inertial sensor (BTS G-Walk sensor).

Development of a Cadaveric Shoulder Motion Simulator with Open-Loop Iterative Learning for Dynamic, Multiplanar Motion: A Preliminary Study.

Ex vivo shoulder motion simulators are commonly used to study shoulder biomechanics but are often limited to performing simple planar motions at quasi-static speeds using control architectures that do not allow muscles to be deactivated. The purpose of this study was to develop an open-loop tendon excursion controller with iterative learning and independent muscle control to simulate complex multiplanar motion at functional speeds and allow for muscle deactivation. The simulator performed abduction/adduction, faceted circumduction, and abduction/adduction (subscapularis deactivation) using a cadaveric shoulder with an implanted reverse total shoulder prosthesis.

Does the osteoarthritic shoulder have altered rotator cuff vectors with increasing glenoid deformity? An in silico analysis.

Background: A transverse force couple (TFC) functional imbalance has been demonstrated in osteoarthritic shoulders by recent 3-dimensional (3D) muscle volumetric studies. Altered rotator cuff vectors may be an additional factor contributing to a muscle imbalance and the propagation of glenoid deformity.

Methods: Computed tomography images of 33 Walch type A and 60 Walch type B shoulders were evaluated.

High correlation between inner and outer glenoid circle diameters and its clinical relevance.

Purpose: The majority of methods for measuring glenoid bone loss in shoulder instability use the best-fit circle following the inferior glenoid rim. However, there is no precise method on how to draw this circle, particularly in case of a missing rim segment. Defining the radius is a source of substantial error.

What Is the Most Reliable Method of Measuring Glenoid Bone Loss in Anterior Glenohumeral Instability? A Cadaveric Study Comparing Different Measurement Techniques for Glenoid Bone Loss.

Background: Preoperative quantification of bone loss has a significant effect on surgical decision making and patient outcomes. Various measurement techniques for calculating glenoid bone loss have been proposed in the literature. To date, no studies have directly compared measurement techniques to determine which technique, if any, is the most reliable.

Salvage Procedures of the Shoulder: Glenohumeral Arthrodesis and Resection Arthroplasty.

Background: With the advances of modern medicine and technology there has been an increase of indications of shoulder reconstruction techniques and shoulder arthroplasty. Consequently, the number of complications and failures have increased in parallel. Not negligible number of cases are driven to an end-stage situation where salvage procedures, such as glenohumeral arthrodesis (GHA) and shoulder resection arthroplasty (SRA), are the only remaining solution.

Atraumatic Anterior Hip Dislocation as High Grade of Hip Instability: A Case Report.

Case: Fifty-year-old woman who presented an atraumatic anterior hip dislocation during a local traditional dance exhibition. The dislocation occurred during a dance step in which extreme hip position in extension and external rotation was held. After urgent closed reduction under general anesthesia, the patient underwent conservative management with a follow-up of 24 months.

Does the Walch type B shoulder have a transverse force couple imbalance? A volumetric analysis of segmented rotator cuff muscles in osteoarthritic shoulders.

Background: The etiology of the Walch type B shoulder remains unclear. We hypothesized that a scapulohumeral muscle imbalance, due to a disturbed transverse force couple (TFC) between the anterior and posterior rotator cuff muscles, may have a role in the pathogenesis of the type B morphology. The purpose of this study was to determine whether there is a TFC imbalance in the Walch type B shoulder using an imaging-based 3-dimensional (3D) volumetric and fatty infiltration assessment of segmented rotator cuff muscles.

Upper Limb Lengthening in Achondroplasia Using Unilateral External Fixation.

Purpose: The purpose of this study was to analyze the long-term results of humeral lengthening in achondroplastic patients and make suggestions on the most appropriate surgical technique to improve patient outcomes.

Methods: Fifty-four humeral lengthening procedures performed in 27 achondroplastic patients were reviewed. Elongations were performed by means of callotasis with unilateral external fixation.

Update on premature physeal closure. Diagnosis and treatment.

Purpose Of Review: Premature Physeal Closure (PPC) is the most common consequence of a mostly posttraumatic, physeal injury. They are of utmost importance because they can significantly alter physeal function and lead to disorders such as limb length discrepancies and angular deformities.

Recent Findings: The type of physeal fracture has not demonstrated a solid predictive value in the formation of PPC, especially in the knee where almost any type of fracture can produce it.

The unstable os acromiale: a cause of pain in the young athlete.

Purpose: Os acromiale is a common entity in the middle-age group, in whom it is frequently associated with rotator cuff tears. However, it can be a cause of shoulder pain in the young athletes. We want to increase awareness of this pathology that may occultly affect the young athlete as well as to present the results of a perfusion-preserving arthrodesis.

Impact of humeral and glenoid component variations on range of motion in reverse geometry total shoulder arthroplasty: a standardized computer model study.

Background: Multiple modifications of reverse total shoulder arthroplasty (RTSA) since the first Grammont design have developed to improve range of motion (ROM) and avoid notching. The effect of these changes in shoulder kinematics and the best compromise for ROM is still under debate. This computer simulation study evaluates the influence of humeral design, humeral neck-shaft angle (NSA), glenoid lateralization, and glenoid eccentricity on ROM of RTSA.

All-Arthroscopic, 270° Reconstruction of the Inferior Glenohumeral Ligament With Palmaris Longus Autograft.

Numerous factors play a role in anterior shoulder stability. The inferior glenohumeral ligament, especially the anterior band, is the main passive anterior stabilizer in the end range of motion. Surgical treatment of this pathology continues to be a challenge in patients with capsular deficiency, in whom the recurrence rate of soft-tissue arthroscopic repair increases significantly.

One-Stage Total Knee Arthroplasty Plus Corrective Osteotomy for Osteoarthritis Associated With Severe Extra-articular Deformity.

The mainstay for treatment of articular deformity caused by advanced tricompartmental osteoarthritis of the knee is total knee arthroplasty. When this is also associated with an extra-articular deformity, this also must be compensated or corrected. In this scenario, it is essential to achieve an optimal mechanical situation by restoring the anatomical and mechanical limb axes and an adequate soft-tissue balance.

Free Vascularized Fibular Graft for Reconstruction of the Lateral Clavicle: A Case Report and Review of the Literature.

Case: A 50-year-old female patient presented with significant (40%) bone loss of the lateral clavicle extending to the acromioclavicular (AC) joint, as a result of multiple, failed revision surgeries following a fracture-dislocation. She was treated with a free vascularized fibular graft and biplanar stabilization of the AC joint. At 4 years of follow-up, the patient had experienced resolution of painful symptoms with a Constant-Murley score of 72.

Lateral circumflex femoral artery false aneurysm as a complication of intertrochanteric hip fracture with displaced lesser trochanter.

We present a patient who suffered an unstable intertrochanteric hip fracture and underwent osteosynthesis with a trochanteric nail. During the postoperative period, he presented a pseudoaneurysm of the lateral circumflex branch of the deep femoral artery secondary to a displaced fracture of the lesser trochanter. With the suspected diagnosis due to indirect clinical and radiological signs and confirmation by Doppler ultrasound and computed tomography angiography, a transverse arterial embolization with resolution of the symptoms was carried out.

Update on treatment of adolescent Blount disease.

Purpose Of Review: Treatments available to correct adolescent Blount disease deformities differ in terms of features, advantages, and disadvantages. Each is indicated, therefore, for different scenarios of severity, physeal condition, and maturity. The purpose of this review is to update basic concepts, surgical treatments, and controversies concerning this disorder.

Simultaneous Ipsilateral Dislocation of the Hip and the Knee: A Case Report.

Case: A patient was struck by an agricultural vehicle and sustained ipsilateral hip and knee dislocations. Closed reduction of the hip was accomplished in the emergency department; the patient required general anesthesia in the operating room to reduce the knee dislocation. Nonoperative treatment was used for both injuries, with a good long-term outcome.