The scapula spine may not be a suitable source of bone graft for glenoid reconstruction in critical bone loss.

Background: The hypothesis is that the scapula spine can provide a graft of suitable dimensions for use in cases of shoulder instability with critical bone loss. We aimed to investigate its utility with grafts of differing sizes.

Methods: The scapula spine was measured on computed tomography scans of 50 patients who had undergone anterior stabilization.

CT methods for measuring glenoid bone loss are inaccurate, and not reproducible or interchangeable.

Aims: Glenoid bone loss is a significant problem in the management of shoulder instability. The threshold at which the bone loss is considered "critical" requiring bony reconstruction has steadily dropped and is now approximately 15%. This necessitates accurate measurement in order that the correct operation is performed.

Tripod Technique to Augment Transosseous Equivalent Rotator Cuff Repair.

The transosseous-equivalent Speedbridge™ technique is commonly used during rotator cuff repair; however, the soft bone of the lateral humerus may result in toggling of the lateral row anchors with subsequent de-tensioning of the repair. The technique presented here uses an additional third-row anchor, in a tripod fashion, that reduces the forces on the lateral humerus anchors and protects the repair.

Superior Capsule Reconstruction Is a Viable Option for Patients with Symptomatic, Isolated, and Irreparable Supraspinatus Tears.

Purpose: To evaluate the outcome of superior capsular reconstruction for isolated subscapularis tears using a decellularized porcine allograft as a superior capsular reconstruction.

Methods: Patients who had symptomatic tears of supraspinatus who had failed to improve a conservative rehabilitation program were included. Previous surgery to the shoulder was not a bar to inclusion.

Elbow arthroplasty is safe for the management of simple open distal humeral fractures.

Background: Elbow arthroplasty (EA) is an established technique for the treatment of select distal humeral fractures, yet little data exists regarding the safety and outcome of EA in the presence of an open distal humeral fracture where the risk of periprosthetic infection is an even greater concern. We hypothesized that EA does not carry an increased risk of infection or other postoperative complications when performed for simple open distal humeral fractures.

Methods: Seventeen patients underwent total EA (n = 9) or hemiarthroplasty (n = 8) for an open distal humeral fracture.

Arthroscopic Iliac Crest Bone Graft Augmentation Using All-Suture Anchors for Shoulder Instability Caused by Glenoid Bone Loss.

Augmentation of the anterior glenoid with bone graft is an established treatment for recurrent anterior instability due to critical glenoid bone loss. Both open and arthroscopic techniques have been described. Fixation with metal screws through an open approach is the most common technique, but the risk of metal screw-related complications remains a concern.

Reporting of glenoid bone loss measurement in clinical studies and the need for standardization : a systematic review.

Aims: The amount of glenoid bone loss is an important factor in deciding between soft-tissue and bony reconstruction when managing anterior shoulder instability. Accurate and reproducible measurement of glenoid bone loss is therefore vital in evaluation of shoulder instability and recommending specific treatment. The aim of this systematic review is to identify the range methods and measurement techniques employed in clinical studies treating glenoid bone loss.

Catching the second wave: clinical characteristics and nosocomial infection rates in major trauma and orthopaedic patients during the COVID-19 pandemic.

Aims: The new COVID-19 variant was reported by the authorities of the UK to the World Health Organization (WHO) on 14 December 2020. We aim to describe the clinical characteristics and nosocomial infection rates in major trauma and orthopaedic patients comparing the first and second wave of COVID-19 infection.

Methods: A retrospective analysis of a prospectively collected trauma database was reviewed at a level 1 major trauma centre from 1 December 2020 to 18 February 2021 looking at demographics, clinical characteristics, and nosocomial infections and compared to our previously published first wave data (26 January 2020 to 14 April 2020).

Two-year results of arthroscopic conjoint tendon transfer procedure for the management of failed anterior stabilization of the shoulder.

Background: Management of failed anterior stabilization is difficult. There are two main options for revision either a revision labral repair which has published high failure rates because of poor quality capsulolabral tissues or a bone block/Latarjet procedure with associated morbidity and complication rates. On this background, the senior author (D.

Radiological outcomes of iliac crest bone graft augmentation for glenoid bone loss using an open all-suture anchor and washer fixation technique.

Background: Many of the complications related to bone block augmentation for recurrent shoulder instability are related to metal screw fixation. Alternative fixation techniques using suspensory fixation have been described with good results, although they require an additional posterior incision to manage the button. It was postulated that the use of an all-suture anchor would remove the requirement for a posterior incision, whilst providing equivalent union rates.

What are the risk factors and presenting features of premature physeal arrest of the distal radius? A systematic review.

Introduction: Premature physeal arrest (PPA) of the distal radius is considered a rare complication of physeal wrist fractures. Standardised guidelines for duration of follow up do not exist. The aim of this review is to recognise the risk factors of PPA and guide follow up protocols.

Procedure-Specific Arthroscopic Simulation Using 3-Dimensional Printing.

Surgical simulation offers a solution to the problems of reduced training time and surgical exposure by allowing trainees to develop surgical skills outside of the operating room in a safe, cost-effective environment. We developed a highly detailed, procedure-specific shoulder arthroscopy simulator using 3-dimesional printing with the aim of providing greater access to cost-effective simulation support to trainees.

40 days and 40 nights: Clinical characteristics of major trauma and orthopaedic injury comparing the incubation and lockdown phases of COVID-19 infection.

Aims: The first death in the UK caused by COVID-19 occurred on 5 March 2020. We aim to describe the clinical characteristics and outcomes of major trauma and orthopaedic patients admitted in the early COVID-19 era.

Methods: A prospective trauma registry was reviewed at a Level 1 Major Trauma Centre.

Paediatric olecranon fractures: a systematic review.

The optimal management and long-term outcomes of olecranon fractures in the paediatric population is not well understood. This systematic review aims to analyse the literature on the management of paediatric olecranon fractures and the long-term implications.A systematic review of several databases was conducted according to PRISMA guidelines.

The influence of age and unreported symptoms on the Oxford Shoulder Score.

Background: One potential limitation of interpreting the Oxford Shoulder Score (OSS) in longitudinal studies is that the observed score may be influenced by age and other variables, which may change over time. The purpose of the present study was to investigate the influence of increasing age and unreported non-shoulder upper limb and neck symptoms on the OSS.

Methods: We collected OSS data from a sample of our ethnically diverse local population.

Clavicle fracture nonunion in the paediatric population: a systematic review of the literature.

Aims: Clavicle fracture nonunions are extremely rare in children. The aim of this systematic review was to assess what factors may predispose children to form clavicle fracture nonunions and evaluate the treatment methods and outcomes.

Methods: We performed a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aiming to find papers reporting clavicle fracture nonunion in children under the age of 18 years.

Quantification of the articular view of the elbow afforded by standard portals using 30° arthroscopy.

Background: The present study quantifies the field of view (FOV) from standard arthroscopy portals and aims to identify anatomical regions where the FOV is limited.

Methods: Eleven cadaveric elbows were examined through standard anteromedial, anterolateral and posterior portals. The FOV was marked with dye using a spinal needle.

Construct Validity, Assessment of the Learning Curve, and Experience of Using a Low-Cost Arthroscopic Surgical Simulator.

Objective: We have developed a low-cost, portable shoulder simulator designed to train basic arthroscopic skills. This study aimed to establish the construct validity of the simulator by determining which parameters discriminated between experience levels and to assess the experience of using the simulator.

Design: Participants were given an introductory presentation and an untimed practice run of a 6-step triangulation task using hooks and rubber bands.

Arthroscopic Conjoint Tendon Transfer: A Technique for Revision Anterior Shoulder Stabilization.

Revision anterior stabilization of the shoulder presents a challenge to the surgeon and carries a higher risk of recurrent dislocation than primary repair. The Latarjet procedure may be more reliable than revision soft-tissue repair but may not be indicated in patients without significant glenoid bone loss. We describe an arthroscopic technique of conjoint tendon transfer using a combination of suspensory and interference screw fixation for patients without significant glenoid bone loss (<15%).

Is computed tomography an accurate and reliable method for measuring total knee arthroplasty component rotation?

Purpose: Computed tomography (CT) is widely used to assess component rotation in patients with poor results after total knee arthroplasty (TKA). The purpose of this study was to simultaneously determine the accuracy and reliability of CT in measuring TKA component rotation.

Methods: TKA components were implanted in dry-bone models and assigned to two groups.

Clinical assessment of the glenoid labrum.

Background: The glenoid labrum is integral to shoulder stability and can be difficult to assess clinically. Whilst it is a single anatomical structure, damage to different regions results in very different clinical manifestations. A large number of provocative tests have been described, all of which initially purport to have excellent diagnostic accuracy.