Glenoid Bone Loss in Shoulder Instability: Superiority of Three-Dimensional Computed Tomography over Two-Dimensional Magnetic Resonance Imaging Using Established Methodology.

Backgroud: Recent literature suggests that three-dimensional magnetic resonance imaging (3D MRI) can replace 3D computed tomography (3D CT) when evaluating glenoid bone loss in patients with shoulder instability. We aimed to examine if 2D MRI in conjunction with a validated predictive formula for assessment of glenoid height is equivalent to the gold standard 3D CT scans for patients with recurrent glenohumeral instability.

Methods: Patients with recurrent shoulder instability and available imaging were retrospectively reviewed.

Clinical utility of immediate postoperative radiographs following uncomplicated primary reverse shoulder arthroplasty.

Background: It is common practice to order an immediate postoperative radiograph in the postanesthesia care unit (PACU) following reverse shoulder arthroplasty (RSA). However, with a growing emphasis on value-based care and cost-effectiveness, we question the necessity for immediate postoperative radiographs following uncomplicated, primary RSA.

Methods: From 2014-2020, patients undergoing primary RSA at a single institution by one of 3 surgeons were included in this cohort.

Short-term outcomes associated with drain use in shoulder arthroplasties: a prospective, randomized controlled trial.

Background: This study examined the immediate outcomes during the perioperative period associated with drains in the setting of total shoulder arthroplasty or reverse shoulder arthroplasty. We hypothesized that drain use would result in lower postoperative hemoglobin and hematocrit levels that would increase transfusion rates and longer hospital stays that would increase hospital costs.

Methods: The study prospectively randomized 100 patients (55% women; average age, 69.

Quality of Life and Functional Outcomes after Multiligament Knee Reconstruction.

We aimed to determine factors that affect the quality of life of patients undergoing a standardized surgical and postoperative management protocol for knee dislocations. A total of 31 patients (33 knees) were included in this study. We contacted patients at a minimum of 12 months postoperatively (mean: 38 months; range, 12-111 months) and administered the previously validated Multiligament Quality of Life questionnaire (ML-QOL), 2000 International Knee Documentation Committee Subjective Knee Form (IKDC), and Lysholm Knee Scoring Scale.

Effect of charted mental illness on reperfusion therapy in hospitalized patients with an acute myocardial infarction in Florida.

Patients with mental illness carry risk factors that predispose them to excess cardiovascular mortality from an acute myocardial infarction (AMI) compared to the general population. The aim of this study was to determine if patients with AMI and charted mental illness (CMI) received less reperfusion therapy following an AMI, compared to AMI patients without CMI in a recent sample population from Florida.A secondary analysis of data was conducted using the Florida Agency for Health Care Administration (FL-AHCA) hospital discharge registry.

Pronator Teres Myotendinous Tear.

Pronator teres muscle strain is a rare sporting injury reported thus far only in cricket and golf players. The injury appears to occur when the sporting club or racket strikes the ground during a forceful swing and causes the elbow to experience an eccentric force during resisted elbow flexion and pronation. On initial presentation, this injury can be mistaken for injury to the medial ulnar collateral ligament, or exacerbation of medial epicondylitis.

Measurement of Clavicle Fracture Shortening Using Computed Tomography and Chest Radiography.

Background: Nonoperative management of midshaft clavicle fractures has resulted in widely disparate outcomes and there is growing evidence that clavicle shortening poses the risk of unsatisfactory functional outcomes due to shoulder weakness and nonunion. Unfortunately, the literature does not clearly demonstrate the superiority of one particular method for measuring clavicle shortening. The purpose of this study was to compare the accuracy of clavicle shortening measurements based on plain radiographs with those based on computed tomography (CT) reconstructed images of the clavicle.

Valgus Extension Overload in Baseball Players.

Repetitive throwing, such as in baseball pitching, applies massive stress on the elbow. This can often lead to a predictable constellation of elbow injuries, such as valgus extension overload syndrome (VEO). The following review of VEO provides an understanding of relevant anatomy, explanation of pathomechanics, key aspects to clinical evaluation, effective treatment options, and indications for surgery.

Radiographic Landmarks for Identifying the Anterolateral Ligament of the Knee.

Purpose: To identify the radiographic position of the origin and insertion of the anterolateral ligament (ALL) of the knee on a lateral radiograph.

Methods: Twelve unpaired, fresh-frozen cadaveric knees were dissected to expose the ALL. The origin and insertion of the ALL on each cadaver were then tagged using 2-mm radiopaque beads.

Complication rate and implant survival for reverse shoulder arthroplasty versus total shoulder arthroplasty: results during the initial 2 years.

Background: The use of reverse total shoulder arthroplasty (RTSA) has significantly increased in recent years. However, there is large variance in reported complication rates and sparse data on implant survival. This study used a statewide patient database to investigate complication rates and implant survival for RTSA.

Acute Compartment Syndrome after Non-Contact Peroneus Longus Muscle Rupture.

This case demonstrates a rare variation in the pattern of injury and the presentation of acute lateral compartment syndrome of the leg. Although uncommon, lateral compartment syndrome of the leg after an ankle inversion leading to peroneus longus muscle rupture has been previously documented. This case was unusual because there was no overt ankle injury and the patient was able to continue physical activity, in spite of a significant rupture of the peroneus longus muscle that was determined later.

A Comparison of Rehabilitation Methods After Arthroscopic Rotator Cuff Repair: A Systematic Review.

Context: Despite the significant attention directed toward optimizing arthroscopic rotator cuff repair, there has been less focus on rehabilitation after rotator cuff repair surgery.

Objective: To determine the effect of different rehabilitation protocols on clinical outcomes by comparing early versus late mobilization approaches and continuous passive mobilization (CPM) versus manual therapy after arthroscopic rotator cuff repair.

Data Sources: PubMed was searched for relevant articles using the keywords rotator cuff, rotator, cuff, tears, lacerations, and rehabilitation to identify articles published from January 1980 to March 2014.

Subacromial volume and rotator cuff tears: Does an association exist?

Background: Rotator cuff pathology occurs commonly and its cause is likely multifocal in origin. The development and progression of rotator cuff injury, especially in relation to extrinsic shoulder compression, remain unclear. Traditionally, certain acromial morphologies have been thought to contribute to rotator cuff injury by physically decreasing the subacromial space.

Surgical anatomy of the lower trapezius tendon transfer.

Background: The precise surgical anatomy of the lower trapezius tendon transfer has not been well described. A precise anatomic description of the different trapezius segments and the associated neurovascular structures is crucial for operative planning and execution. We aimed (1) to establish a reliable demarcation between the middle and lower trapezius, (2) to establish the precise relationship of the main neurovascular pedicle to the muscle belly, and (3) to evaluate the utility of the relationships established in (1) and (2) by using the results of this study to perform cadaveric lower trapezius tendon harvest.

Combined Glenoid and Humeral Head Reconstruction with Allografts: A Report of Two Cases and the Midterm Outcomes.

Case: We present two cases of anterior glenohumeral instability in which both the humeral head and the glenoid were reconstructed concurrently with use of allografts; we discuss the midterm outcomes at four and one-half and five years of follow-up, respectively.

Conclusion: In our experience, concomitant glenoid and humeral head allograft reconstruction for anterior glenohumeral instability with severe combined humeral head and glenoid pathology yielded good midterm clinical, functional, and radiographic outcomes. This treatment approach may be a viable option for young and active patients presenting with severe combined glenoid and humeral pathology and warrants additional investigation.

Does patient sex affect the anatomic relationships between the sternoclavicular joint and posterior vascular structures?

Background: Despite increased concern for injury during surgical reconstruction of the sternoclavicular joint, to our knowledge there are few studies detailing the vascular relationships adjacent to the joint.

Questions/purposes: We investigated sex differences in the following relationships for sternoclavicular joint reconstruction: (1) safe distance from the posterior surface of the medial clavicle's medial and lateral segments to the major vessels, (2) length of the first costal cartilage and safe distance from the first rib to the internal mammary artery, (3) minimum distance medial to the sternoclavicular joint for optimal hole placement, and (4) safe distance from the manubrium to the great vessels.

Methods: Fifty normal postcontrast CT scans of the chest were reviewed.

Prevalence of Abnormal Vitamin D Levels Among Division I NCAA Athletes.

Background: Up to 1 billion people have insufficient or deficient vitamin D levels. Despite the well-documented, widespread prevalence of low vitamin D levels and the importance of vitamin D for athletes, there is a paucity of research investigating the prevalence of vitamin D deficiency in athletes.

Hypothesis: We investigated the prevalence of abnormal vitamin D levels in National Collegiate Athletic Association (NCAA) Division I college athletes at a single institution.

Serum interleukin-6 as a marker of periprosthetic shoulder infection.

Background: Infection after shoulder arthroplasty can be a devastating complication, and subacute and chronic low-grade infections have proven difficult to diagnose. Serum marker analyses commonly used to diagnose periprosthetic infection are often inconclusive. The purpose of this study was to evaluate the effectiveness of serum interleukin-6 (IL-6) as a marker of periprosthetic shoulder infection.

3.0-Tesla MRI and arthroscopy for assessment of knee articular cartilage lesions.

The purpose of this study was to evaluate the ability of 3.0-Tesla magnetic resonance imaging (MRI) to accurately assess knee articular cartilage lesions. Sixteen patients who had knee 3.

Tension band plating of a nonunion anterior tibial stress fracture in an athlete.

The authors present a rare technique of tension band plating of the anterior tibia in the setting of a nonunion stress fracture. Surgical management with an intramedullary nail is a viable and proven option for treating such injuries. However, in treating elite athletes, legitimate concerns exist regarding the surgical disruption of the extensor mechanism and the risk of anterior knee pain associated with intramedullary nail use.

Latissimus dorsi tendon transfer for irreparable rotator cuff tears: a modified technique using arthroscopy.

Latissimus dorsi transfer is a well-established method for the treatment of posterosuperior massive irreparable rotator cuff tears. We propose using an arthroscopically assisted technique that avoids insult to the deltoid. With the patient in the lateral decubitus position, an L-shaped incision is made along the anterior belly of the latissimus muscle and then along the posterior axillary line.

Fresh osteochondral allograft for the treatment of cartilage defects of the talus: a retrospective review.

Background: Osteochondral lesions of the talar dome can cause substantial functional impairment and present a difficult treatment dilemma. Interest has recently focused on fresh osteochondral allografts as a promising treatment alternative. The purpose of this study was to evaluate the clinical outcome of osteochondral lesions of the talus treated with a fresh osteochondral allograft.