Primary Open Latarjet Procedure Versus Revision to Open Latarjet Procedure for Anterior Shoulder Instability.

Background: Although the Latarjet operation may be performed as a revision surgery for anterior shoulder instability, the high recurrence rate of anterior shoulder instability after arthroscopic Bankart repair (ABR) has led some to advocate for performing the Latarjet procedure as a primary stabilization surgery. The purpose of this study was to compare the intermediate-term outcomes after primary open Latarjet (PLJ) and revision to open Latarjet (RLJ).

Materials And Methods: This was a single-institution retrospective analysis of patients who underwent either PLJ or RLJ procedures for anterior shoulder instability between 2014 and 2023.

Risk factors associated with atraumatic posterolateral rotatory instability.

Background: Traumatic posterolateral rotatory instability after elbow dislocation or fracture dislocation has been well described. However, few reports cover atraumatic posterolateral rotatory instability as a cause of lateral-sided elbow pain. We assessed the risk factors and epidemiology of atraumatic posterolateral rotatory instability in a case-control study.

Preoperative tendon retraction, not smoking, is a risk factor for failure with continuity after rotator cuff repair.

Background: Smoking is a poor prognostic factor for healing after rotator cuff repair and is associated with inferior results. We hypothesized that smokers would have higher recurrent tear rates and more postoperative myotendinous junction (MTJ) retraction in healed repairs than nonsmokers three months postoperatively.

Methods: Rotator cuff repairs (RCRs) were retrospectively reviewed over a 2-year period.

Risk Factors for Cerebral Desaturation Events During Shoulder Surgery in the Beach Chair Position.

Purpose: The goals of this study were 2-fold: (1) to determine the risk factors for cerebral desaturation events (CDEs) after implementation of a comprehensive surgical and anesthetic protocol consisting of patient risk stratification, maintenance of normotensive anesthesia, and patient positioning in a staged fashion, and (2) to assess for subclinical neurologic decline associated with intraoperative ischemic events through cognitive testing.

Methods: One hundred patients undergoing shoulder surgery in the beach chair position were stratified for risk of CDE based on Framingham stroke criteria, body mass index (BMI), and history of cerebrovascular accidents. Cerebral oxygen saturation was monitored with near-infrared spectroscopy.

Prevalence and risk factors for kidney stones in fibrodysplasia ossificans progressiva.

The worldwide prevalence and risk factors for kidney stones in patients with fibrodysplasia ossificans progressiva (FOP) are unknown. We conducted a survey of 383 patient-members of the International Fibrodysplasia Ossificans Progressiva Association, comprising the entire global membership of the international FOP community. Two hundred seven patients from 31 nations and 6 continents (54%) responded.

Arthroscopic Cortical Button Stabilization of Isolated Acute Neer Type II Fractures of the Distal Clavicle.

Neer type II distal clavicle fractures are inherently unstable. The purpose of this study was to review the outcome of Neer type II distal clavicle fractures arthroscopically treated using a suspensory cortical button technique. Between 2008 and 2012, a total of 17 Neer type IIB fractures were managed operatively at the authors' institution.

The timing of retears after arthroscopic rotator cuff repair.

Background: Little is known about the time dependence of the failure rate of surgically repaired rotator cuffs. Retears are significant, as they are common and may lead to less satisfactory outcomes and additional operations. Their timing is critical foundational information for understanding failure mechanisms.

Biceps tenotomy in the presence of a supraspinatus tear alters the adjacent intact tendons and glenoid cartilage.

A rotator cuff tear is a common injury in athletes and workers who repeatedly perform overhead movements, and it is not uncommon for this demographic to return to activity shortly after treatment. A biceps tenotomy is often performed in the presence of a rotator cuff tear to help reduce pain and improve joint function. However, the effect of this procedure on the surrounding tissues in the glenohumeral joint is unknown.

The development and application of a risk stratification index system for outpatient shoulder arthroscopy patient management-a single academic center's experience.

Background: Our goal was to develop a risk stratification index (RSI) that could guide management of our patients. We hypothesized that the risks of unexpected overstay admission (OS) and emergency department (ED) transfer are predictable on the basis of patient factors for elective outpatient shoulder arthroscopic surgery.

Methods: We first identified 124,860 subjects who received shoulder arthroscopic surgery in the Healthcare Cost and Utilization Project database.

Is there a dose response of dexamethasone as adjuvant for supraclavicular brachial plexus nerve block? A prospective randomized double-blinded clinical study.

Study Objective: The study objective is to examine the analgesic effect of 3 doses of dexamethasone in combination with low concentration local anesthetics to determine the lowest effective dose of dexamethasone for use as an adjuvant in supraclavicular brachial plexus nerve block.

Design: The design is a prospective randomized double-blinded clinical study.

Setting: The setting is an academic medical center.

Glenoid perforation with pegged components during total shoulder arthroplasty.

A subset of patients undergoing primary total shoulder arthroplasty (TSA) have a medialized joint line secondary to glenoid wear. In some cases, the central pegs or peripheral pegs of a peg design glenoid component may violate the medial cortex of the glenoid vault. It is unknown whether this leads to early failure.

Disruption of the anterior-posterior rotator cuff force balance alters joint function and leads to joint damage in a rat model.

The rotator cuff assists in shoulder movement and provides dynamic stability to the glenohumeral joint. Specifically, the anterior-posterior (AP) force balance, provided by the subscapularis anteriorly and the infraspinatus and teres minor posteriorly, is critical for joint stability and concentric rotation of the humeral head on the glenoid. However, limited understanding exists of the consequences associated with disruption of the AP force balance (due to tears of both the supraspinatus and infraspinatus tendons) on joint function and joint damage.

Biceps detachment decreases joint damage in a rotator cuff tear rat model.

Background: Pathology in the long head of the biceps tendon often occurs in patients with rotator cuff tears. Arthroscopic tenotomy is the most common treatment. However, the role of the long head of the biceps at the shoulder and the consequences of surgical detachment on the remaining shoulder structures remain unknown.

Addressing glenoid bone deficiency and asymmetric posterior erosion in shoulder arthroplasty.

Glenoid bone deficiency and eccentric posterior wear are difficult problems faced by shoulder arthroplasty surgeons. Numerous options and techniques exist for addressing these issues. Hemiarthroplasty with concentric glenoid reaming may be a viable alternative in motivated patients in whom glenoid component failure is a concern.

Returning to overuse activity following a supraspinatus and infraspinatus tear leads to joint damage in a rat model.

Large rotator cuff tears (supraspinatus and infraspinatus) are common in patients who perform overhead activities (laborers, athletes). In addition, following large cuff tears, these patients commonly attempt to return to pre-injury activity levels. However, there is a limited understanding of the damaging effects on the uninjured joint tissues when doing so.

Scapula fractures: interobserver reliability of classification and treatment.

Objectives: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment.

Effect of return to overuse activity following an isolated supraspinatus tendon tear on adjacent intact tendons and glenoid cartilage in a rat model.

Rotator cuff tears are common conditions that can alter shoulder mechanics and may lead to damage of intact joint tissues. These injuries are of particular concern in populations who perform tasks requiring repetitive overhead activity (e.g.

Glenoid cartilage mechanical properties decrease after rotator cuff tears in a rat model.

Rotator cuff repairs are commonly performed to reduce pain and restore function. Tears are also treated successfully without surgical intervention; however, the effect that a torn tendon has on the glenohumeral cartilage remains unknown. Clinically, a correlation between massive rotator cuff tears and glenohumeral arthritis has often been observed.

Intra-articular changes precede extra-articular changes in the biceps tendon after rotator cuff tears in a rat model.

Hypothesis: Biceps tendon pathology is common with rotator cuff tears. The mechanisms for biceps changes, and therefore its optimal treatment, are unknown. Our objective was to determine the effect of rotator cuff tears on regional biceps tendon pathology.

Decreased loading after rotator cuff tears leads to improved biceps tendon properties in a rat model.

Background: The purpose of this study was to elucidate the mechanism of biceps tendon changes after rotator cuff tears. We hypothesized that increased loading on the biceps tendon after rotator cuff tears will result in further detrimental changes whereas decreased loading will result in increased organization and more normal tendon composition. In addition, we hypothesized that changes with altered loading will begin at the proximal insertion into bone and progress along the tendon length at later time points.

Restoration of anterior-posterior rotator cuff force balance improves shoulder function in a rat model of chronic massive tears.

The rotator cuff musculature imparts dynamic stability to the glenohumeral joint. In particular, the balance between the subscapularis anteriorly and the infraspinatus posteriorly, often referred to as the rotator cuff "force couple," is critical for concavity compression and concentric rotation of the humeral head. Restoration of this anterior-posterior force balance after chronic, massive rotator cuff tears may allow for deltoid compensation, but no in vivo studies have quantitatively demonstrated an improvement in shoulder function.

Biceps tendon properties worsen initially but improve over time following rotator cuff tears in a rat model.

Damage to the biceps tendon is often seen in conjunction with rotator cuff tears. However, controversy exists regarding its role in the shoulder and its optimal treatment. A previous study determined that biceps tendons were detrimentally affected in the presence of rotator cuff tears in the rat model and this damage worsened over time.

Total shoulder arthroplasty in older patients: increased perioperative morbidity?

Background: More elderly patients are becoming candidates for total shoulder arthroplasty with an increase in frequency of the procedure paralleling the rise in other total joint arthroplasties. Controversy still exists, however, regarding the perioperative morbidity of total joint arthroplasty in elderly patients, particularly those 80 years of age and older.

Questions/purposes: We asked whether perioperative complications and mortality, transfusion requirements, inpatient length of stay, and discharge disposition after total shoulder arthroplasty were similar in patients 80 years and older compared with those in younger patients.

The effect of altered loading following rotator cuff tears in a rat model on the regional mechanical properties of the long head of the biceps tendon.

Biceps tendon pathology is a common clinical problem often seen in conjunction with rotator cuff tears. A previous study found detrimental changes to biceps tendons in the presence of rotator cuff tears in a rat model. Therefore, the objective of this study was to utilize this model along with models of altered loading to investigate the effect of altered loading on the initiation of these detrimental changes.