Assessment of Inter- and Intrasurgeon Variability in Preoperative Planning of Reverse Shoulder Arthroplasty: A Multicenter Evaluation.

 To evaluate the intra and intersurgeon variability regarding the positioning and selection of implants in reverse shoulder arthroplasty.  A cross-sectional study assessed computed tomography images of the shoulder joint of patients diagnosed with degenerative joint diseases. The study team included seven specialists in shoulder surgery, representing six different institutions.

REASSESSMENT OF FATTY INFILTRATION BY MAGNETIC RESONANCE TEN YEARS AFTER ROTATOR CUFF INJURY REPAIR.

Unlabelled: Quantitative assessments of rotator cuff muscle changes after successful tendon repair are scarce. On the other hand, semiquantitative and subjective assessments are more abundant, but their findings are controversial. One hypothesis about this divergence is that there is an immediate decrease in the proportion of fatty infiltration after surgical repair.

Allograft-enhanced latissimus dorsi transfer is better than the conventional technique for irreparable posterosuperior rotator cuff tears. A retrospective matched cohort.

Purpose: Latissimus dorsi tendon (LDT) transfer (LDTT) to the greater tuberosity to treat irreparable posterosuperior rotator cuff tears (RCTs) in young active patients has been shown to have up to 36% of clinical failures, most of them happening because of either deltoid origin disruption or post-operative transfer rupture from the greater tuberosity. In an attempt to simultaneously prevent both complications, a modified technique includes the following adaptations to the original technique: reinforcement and augmentation of the LDT with a tendinous allograft, enabling the use of a single deltopectoral approach. The aim of this study is to compare mid-term outcomes of the traditional LDTT technique with this modified transfer.

Detection of in Tissue Samples from Primary Clean Shoulder Surgeries - Part I.

 The present study aimed to identify bacterial agents in shoulder surgery specimens from patients with no history of previous shoulder infection or surgery.  Tendon, bursa, and bone specimens were collected during surgery, stored in sterile dry bottles, and sent to a hospital-associated laboratory for culture growth analysis in media for aerobic and anaerobic agents. Findings from 141 samples from 47 shoulders were analyzed.

Comparative Clinical Evaluation of Two Techniques of Arthroscopic Treatment of Partial Articular Rotator Cuff Tears.

 To evaluate the clinical results of patients submitted to arthroscopic treatment of partial lesion of the articular part of the rotator cuff by transtendon suture techniques and after completing the lesion and to compare the postoperative recovery time of the two techniques.  Retrospective study based on the identification of all cases with partial lesion of the articular part of the rotator cuff submitted to arthroscopic treatment from October 1999 to December 2016 at the Shoulder and Elbow Group of our institution. Thirty-nine patients were included and divided into two groups: those who underwent the transtendon technique and those in whom the lesion was completed.

Current Options in Tendon Transfers for Irreparable Posterosuperior Rotator Cuff Tears.

Massive irreparable posterosuperior rotator-cuff tears are debilitating lesions that usually require surgical treatment. Even though there is no consensus regarding the best surgical technique, tendinous transfers around the shoulder are the most commonly performed procedures. The latissimus dorsi tendon remains the most commonly used, but different modifications to the original technique have been shown to minimize complications and to improve functional results and satisfaction.

Results of Latissimus Dorsi Transfer using a Tendinous Allograft through a Single Deltopectoral Approach for Irreparable Posterosuperior Rotator Cuff Tears.

 The primary aim of the present study is to evaluate the functional results of a modification to the latissimus dorsi (LD) transfer around the shoulder for irreparable posterosuperior rotator cuff tears. The secondary aim is to evaluate variables that might influence the outcomes.  Through a single deltopectoral approach, the LD tendon is detached, reinforced, and elongated with a tendinous allograft, transferred around the humerus, and fixed superolaterally to the greater tuberosity and anteriorly to the subscapularis.

Humeral Head Osteonecrosis: Outcomes of Hemiarthroplasty After Minimum 10-Year Follow-Up.

 To analyze long-term functional and radiographic results of partial shoulder replacement for humeral head osteonecrosis.  Retrospective review of thirteen cases, with a mean postoperative follow-up of 17 years (range 10 to 26 years). The findings from the last follow-up were compared to those in which the patients had one year of postoperative follow-up.

Latissimus Dorsi Tendon Transfer using Tendinous Allograft for Irreparable Rotator Cuff Lesions: Surgical Technique.

Latissimus dorsi transfer around the shoulder is the most frequently used surgical technique to treat young patients with irreparable posterosuperior rotator cuff lesions. This technique, as initially described and popularized by Gerber et al., has two main drawbacks that may predispose to complications and unsatisfactory functional results: 1) postoperative rupture of the origin of the deltoid, as its detachment from the acromion is necessary during the superior approach to the shoulder; and 2) postoperative rupture of the transferred tendon.

Articular reconstruction of the humeral head with autogenous allograft in the treatment of the osteonecrosis.

The authors describe a surgical biological reconstruction of the humeral head with frozen autogenous allograft technique for the treatment of young patients with focal osteonecrosis of the humeral head. This represents a possible alternative, maybe even definitive for some patients, when compared to hemiarthroplasty or total shoulder arthroplasty. The technique consists of the fixation of a frozen autogenous allograft with previously-molded articular cartilage from the humeral head, after cleansing the osteonecrotic focus.

Traumatic anterior instability of the shoulder.

The shoulder is the most unstable joint in the human body. Traumatic anterior instability of the shoulder is a common condition, which, especially in young patients, is associated with high recurrence rates. The effectiveness of non-surgical treatments when compared to surgical ones is still controversial.

Walch B0 glenoid: pre-osteoarthritic posterior subluxation of the humeral head.

The management of primary osteoarthritis of the shoulder has been well investigated. However, the etiology and management of posterior humeral head subluxation in the context of primary glenohumeral osteoarthritis remain controversial. The finding of static posterior subluxation of the humeral head before the development of posterior bone erosion of the glenoid in young men with radiographic findings of primary osteoarthritis has been described as arthrogenic posterior subluxation of the humeral head.

Evaluation of the functional results after rotator cuff arthroscopic repair with the suture bridge technique.

Objective: To evaluate the results of arthroscopic treatment of large and extensive rotator cuff injuries (RCI) that involved the supra and infraspinatus muscles using the suture bridge (SB) technique.

Methods: Between July 2010 and November 2014, 37 patients with RCI who were treated with SB technique were evaluated. The study included all patients with a minimum follow-up of 12 months who underwent primary surgery of the shoulder.

Obstetric paralysis: anterior arthroscopic release of the shoulder and transfer of the latissimus dorsi using a homologous graft.

Objective: Description of a new surgical technique for treating the shoulders of patients with sequelae of obstetric paralysis. Preliminary analysis on the results obtained from this technique.

Methods: Five consecutive patients underwent the proposed surgical procedure, consisting of arthroscopic anterior joint release followed by transfer of the latissimus dorsi tendon (elongated and reinforced with a homologous tendon graft) to the posterosuperior portion of the greater tubercle, using a single deltopectoral approach.

Brachial artery injury due to closed posterior elbow dislocation: case report.

An association between closed posterior elbow dislocation and traumatic brachial artery injury is rare. Absence of radial pulse on palpation is an important warning sign and arteriography is the gold-standard diagnostic test. Early diagnosis is essential for appropriate treatment to be provided.

Evaluation of the results from surgical treatment of the terrible triad of the elbow.

Objective: to evaluate the results from surgical treatment of the terrible triad of the elbow (fracture of the radial head, fracture of the coronoid process and elbow dislocation) and its complications.

Methods: between August 2002 and August 2010, 15 patients (15 elbows) with the terrible triad were treated by the Shoulder and Elbow Group of the Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo. Nine (60%) were male and six (40%) were female; their ages ranged from 21 to 66 years, with a mean of 41 years.