Management of Failed Proximal Biceps Surgery: Clinical Outcomes After Revision to Subpectoral Biceps Tenodesis.

Background: The preferred surgical technique to manage biceps-superior labral pathology is often debated, and rates of revision and persistence of pain vary widely according to surgical technique and patient characteristics.

Purpose: To evaluate the clinical and functional outcomes of patients undergoing revision subpectoral tenodesis after failed primary tenodesis or tenotomy of the long head of the biceps.

Study Design: Case series; Level of evidence, 4.

Inferior outcomes and higher complication rates after shoulder arthroplasty in workers' compensation patients.

Background: Outcomes of shoulder surgery in workers' compensation (WC) patients have generally been inferior to those in non-WC patients. The purpose of this study was to compare the complication rates and clinical outcomes after shoulder arthroplasty in WC patients and control non-WC patients.

Methods: An institutional shoulder arthroplasty database was queried for patients with minimum 2-year follow-up who underwent total shoulder arthroplasty, reverse total shoulder arthroplasty, or hemiarthroplasty.

Good functional outcomes expected after shoulder arthroplasty irrespective of body mass index.

Background: This study evaluated how body mass index (BMI) factors into functional outcomes and complications after shoulder arthroplasty.

Methods: A retrospective analysis was performed of age-matched patients with a minimum 2-year follow-up after total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA), or hemiarthroplasty (HA). Patient-reported outcome (PRO) scores, range of motion (ROM), and complications were assessed.

Arthroscopic Intramuscular Side-to-Side Repair of an Isolated Infraspinatus Tear.

Intramuscular, full-thickness rotator cuff tears are uncommon and present a challenging clinical scenario for repair because traditional suture anchor or transosseous repair techniques are less feasible. The goal of repair is to achieve a tension-free reduction of both ends of the muscle to allow for adequate healing over time. Intramuscular tears of the infraspinatus specifically have rarely been reported.

Single-Incision Anatomic Repair Technique for Distal Biceps Tendon Rupture Using Tunneling Device.

Distal biceps tendon ruptures are uncommon and generally occur in men aged 30 to 50 years in their dominant arm as a result of a strong eccentric load. Numerous surgical exposures and methods of fixation exist for repair of a ruptured distal biceps tendon. The goal of surgical management is to restore the anatomic footprint of the biceps tendon on the radial tuberosity to maximize flexion strength, supination strength, and muscle endurance.

Biomechanical evaluation of distal biceps tendon repair using tension slide technique and knotless fixation technique.

Background: Acute distal biceps tendon ruptures are uncommon injuries that often affect young active males, typically resulting from an eccentric load on their dominant extremity. The purpose of this study was to compare pullout strength and tendon gapping in the tension slide technique (TST) versus a knotless fixation technique (KFT).

Methods: Two sets of experiments were performed using cadaveric elbow specimens.

Humeral head sizing using extra-articular landmarks on conventional radiographs.

Purpose: Proper humeral head (HH) sizing is critical to success in anatomic shoulder replacement for management of glenohumeral arthritis. In this study, we evaluate the accuracy and reliability of using non-articular landmarks on conventional radiographs for HH templating.

Methods: Anatomic HH replacement was performed on five non-arthritic shoulders, from fresh adult cadavers.

Glenoid version and size: does gender, ethnicity, or body size play a role?

Introduction: Variations in glenoid morphology among patients of different gender, body habitus, and ethnicity have been of interest for surgeons. Understanding these anatomical variations is a critical step in restoring normal glenohumeral structure during shoulder reconstruction surgery.

Methods: Retrospective review of 108 patient shoulder CT scans was performed and glenoid version, AP diameter and height were measured.

Survey study suggests that reverse total shoulder arthroplasty is becoming the treatment of choice for four-part fractures of the humeral head in the elderly.

Purpose: The role of reverse total shoulder arthroplasty (RTSA) for three and four-part proximal humerus fractures is evolving. However, there does not appear to be a clear consensus amongst surgeons. The purpose of this study is to further define the standard of care, assessing surgeon preference and treatment considerations for management of such fractures.

Technical Errors May Affect Accuracy of Torque Limiter in Locking Plate Osteosynthesis.

In locking plate osteosynthesis, proper surgical technique is crucial in reducing potential pitfalls, and use of a torque limiter makes it possible to control insertion torque. We conducted a study of the ways in which different techniques can alter the accuracy of torque limiters. We tested 22 torque limiters (1.

Scapular Winging: Evaluation and Treatment: AAOS Exhibit Selection.

Scapular winging is a rare, underreported, and debilitating disorder that produces abnormal scapulothoracic kinematics, which can lead to shoulder weakness, decreased range of motion, and substantial pain. Although there are numerous underlying etiologies, injuries to the long thoracic nerve or spinal accessory nerve are the most common, with resultant neuromuscular imbalance in the scapulothoracic stabilizing muscles. Early diagnosis followed by initiation of a treatment algorithm is important for successful outcomes.

When Is It Safe to Return to Driving After Spinal Surgery?

Study Design Prospective study. Objective Surgeons' recommendations for a safe return to driving following cervical and lumbar surgery vary and are based on empirical data. Driver reaction time (DRT) is an objective measure of the ability to drive safely.

National trends and perioperative outcomes in primary and revision total shoulder arthroplasty: Trends in total shoulder arthroplasty.

Introduction: Total shoulder arthroplasty (TSA) is a highly successful procedure for management of glenohumeral arthritis, fractures and rotator cuff tears. The purpose of this study was to evaluate patient demographics, perioperative outcomes and assess recent national trends in both primary and revision TSA.

Methods: The National Hospital Discharge Survey database was searched for patients admitted to US hospitals for primary and revision TSA from 2001 to 2010.

Trends in the surgical treatment of lumbar spine disease in the United States.

Background Context: There is a lack of agreement among spine surgeons as to the best surgical treatment modality for many degenerative lumbar diseases. Although there are many studies examining trends in spinal surgery, specific studies reporting the variations in surgical treatment in the United States for these diseases are lacking.

Purpose: The aim of this study was to analyze trends in lumbar spinal fusion methods for common lumbar pathologies in the United States.

Distribution of high-conductance calcium-activated potassium channels in rat vestibular epithelia.

Voltage- and calcium-activated potassium channels (BK) are important regulators of neuronal excitability. BK channels seem to be crucial for frequency tuning in nonmammalian vestibular and auditory hair cells. However, there are a paucity of data concerning BK expression in mammalian vestibular hair cells.