Glenoid bone loss and patient history influence surgical decision-making for bony Bankart lesion: A mid-term follow-up retrospective study.

Background: To analyze how patient history, glenoid bone loss (GBL), and the size of the residual glenoid bone fragment (GBF) influence the choice between arthroscopic Bankart repair and open Latarjet procedure in patients with anteroinferior glenohumeral instability and bony Bankart lesions.

Methods: Review of 290 patients with bony Bankart lesions treated for anterior glenohumeral instability was conducted and patients were categorized into three groups based on GBL and GBF: Group A (GBL < 10% and GBF <10%), Group B (GBL ≥ 10% and GBF <10%), and Group C (GBL ≥10%, GBF ≥10%). Number of preoperative dislocations, time from the first instability, Western Ontario Shoulder Index (WOSI) scores, Hill-Sachs lesion (HSL) location (central or peripheral), HSL track status, and Glenoid Track Instability Management Score (GTIMS) were analyzed.

The Latarjet Procedure for Recurrent Anterior Shoulder Instability in the Contact Athlete.

In young athletes, anterior shoulder instability is a prevalent condition. Because of high-energy traumas, contact athletes often suffer recurrent instability, bone loss and postoperative recurrences. Patients younger than 20 years, symptomatic for more than 6 months, with ≥ 2 dislocations, with off-track Hill-Sachs lesion, glenoid bone loss, ALPSA lesion, Instability Severity Index Score > 3, and Glenoid Track Instability Management Score > 3 are at higher risk of failure.

Optimizing Muscle-Tendon Lengths in Reverse Total Shoulder Arthroplasty: Evaluation of Surgical and Implant-Design-Related Parameters.

Background: Optimizing the function of muscles that cross the glenohumeral articulation in reverse total shoulder arthroplasty (RTSA) is controversial. The current study used a geometric model of the shoulder to systematically examine surgical placement and implant-design parameters to determine which RTSA configuration most closely reproduces native muscle-tendon lengths of the deltoid and rotator cuff.

Methods: A geometric model of the glenohumeral joint was developed and adjusted to represent small, medium, and large shoulders.

Glenoid track revisited.

The risk of Hill-Sachs lesion (HSL) to cause instability depends not only on the HSL but also on the glenoid size. Clinically, the only method to assess the risk of instability considering the dynamic interaction of both, the HSL together with the glenoid bone loss, is the glenoid track concept. Since it was introduced in a cadaveric study, its clinical efficacy and validity have been reported in the literature.

A high level of scientific evidence is available to guide treatment of primary shoulder stiffness: The SIAGASCOT consensus.

Purpose: Shoulder stiffness (SS) is a condition characterised by active and passive restricted glenohumeral range of motion, which can occur spontaneously in an idiopathic manner or be associated with a known underlying aetiology. Several treatment options are available and currently no consensus has been obtained on which treatment algorithm represents the best choice for the patient. Herein we present the results of a national consensus on the treatment of primary SS.

Operational strategies to deal with the COVID-19 emergency: recommendations from the Italian national society SIAGASCOT following the introduction of vaccines against the SARS-CoV-2 infection.

Background: This article aims to present the operational recommendations adopted by the Italian national society for orthopaedic surgery, arthroscopy, and sports medicine (SIAGASCOT) in managing patients eligible to undergo elective orthopaedic surgery during the COVID-19 pandemic after the beginning of a national vaccination campaign.

Materials And Methods: An extensive literature search, analysing medical databases and scientific societies protocols, was performed to support this document. A four-step approach was used: 1-definition of priorities; 2-definition of significant clusters of interventions; 3-extraction of recommendations from international literature; and 4-adaptation of the recommendations to the specific features of the Italian healthcare system.

Impact of reverse shoulder arthroplasty design and patient shoulder size on moment arms and muscle fiber lengths in shoulder abductors.

Background: Reverse shoulder arthroplasty (RSA) increases the moment arm of the deltoid; however, there is limited knowledge on the accompanying changes in muscle architecture that play a role in muscle force production. The purpose of this study was to use a geometric shoulder model to evaluate the anterior deltoid, middle deltoid, and supraspinatus regarding (1) the differences in moment arms and muscle-tendon lengths in small, medium, and large native shoulders and (2) the impact of 3 RSA designs on moment arms, muscle fiber lengths, and force-length (F-L) curves.

Methods: A geometric model of the native glenohumeral joint was developed, validated, and adjusted to represent small, medium, and large shoulders.

Reverse shoulder arthroplasty: State-of-the-art.

The reverse shoulder arthroplasty conceived by Paul Grammont in 1985 has gradually gained popularity as a treatment for multiple shoulder diseases. Unlike previous reverse shoulder prosthesis characterized by unsatisfactory results and a high glenoid implant failure rate, the Grammont design has immediately shown good clinical outcomes. This semi constrained prosthesis solved the issues of the very first designs by medializing and distalizing the center of rotation with an increased stability of the replacement of the component.

Depression, fear of re-injury and kinesiophobia resulted in worse pain, quality of life, function and level of return to sport in patients with shoulder instability: a systematic review.

Introduction: Maladaptive psychological responses may hinder participation and return to pre-injury level in sport. The aim of this study was to investigate the psychological factors influence on pain, function, quality of life and time to return to sport in subjects with shoulder instability.

Evidence Acquisition: The research was conducted until the 15 of May 2022 in MEDLINE, CENTRAL, PEDro, and PubPSYCH regardless language, publication status or date.

The Role of the Trapezius in Stabilization of the Acromioclavicular Joint: A Biomechanical Evaluation.

Background: Acromioclavicular joint (ACJ) injuries are common, and many are adequately treated nonoperatively. Biomechanical studies have mainly focused on static ligamentous stabilizers. Few studies have quantified ACJ stabilization provided by the trapezius.

Depression and Anxiety Are Associated With Worse Subjective and Functional Baseline Scores in Patients With Frozen Shoulder Contracture Syndrome: A Systematic Review.

Purpose: To investigate whether psychological factors, such as avoidance behavior, fear, pain catastrophization, kinesiophobia, anxiety, depression, optimism, and expectation are associated with different subjective and functional baseline scores in patients with frozen shoulder contracture syndrome (FSCS).

Methods: Searches were conducted in MEDLINE, Cochrane Library (CENTRAL Database), PEDro, Pubpsych, and PsychNET.APA without restrictions applied to language, date, or status of publication.

Bone Fragment Resorption and Clinical Outcomes of Traumatic Bony Bankart Lesion Treated With Arthroscopic Repair Versus Open Latarjet.

Background: Bony Bankart lesions can perpetuate chronic anterior glenohumeral instability. When surgical treatment is pursued, several factors need to be considered to obtain optimal outcomes.

Purpose: To (1) quantitatively describe patterns of bone fragment resorption and associated risk factors for developing glenoid bone loss (GBL) and (2) to compare clinical and radiological results of attritional bone loss treated with either the arthroscopic Bankart or the open Latarjet procedure.

The Use of Scapular Bone Flaps During Head-and-Neck Reconstruction: Functional, Orthopedic, and Quality of Life Analyses of Flap-Harvest-Related Deficits.

The authors sought correlations between harvesting of the scapular bone tip free flap used for head-and-neck reconstruction and any shoulder function deficit, particularly at the level of the rotator cuff. The flap permits reconstruction of large and diverse regions of the head and neck, but long-term harvest morbidity has not been investigated extensively. The authors analyzed the clinical records of all patients who underwent head-and-neck reconstructions using free scapular tip flaps in our department over the past 5 years.

New Trends in Shoulder Surgery from Biomechanics to the Operating Room.

After a rigorous peer review process, twelve papers were accepted and published [...

Evaluation and Management of Glenohumeral Instability With Associated Bone Loss: An Expert Consensus Statement Using the Modified Delphi Technique.

Purpose: To establish an international expert consensus, using the modified Delphi technique, on the evaluation and management of glenohumeral instability with associated bone loss.

Methods: A working group of 6 individuals generated a list of statements related to history and physical examination, imaging and specialized diagnostic tests, bone loss quantification and classification, treatment outcomes and complications, and rehabilitation for the management of glenohumeral instability associated with bone loss to form the basis of an initial survey for rating by a group of experts. The expert group (composed of 22 high-volume glenohumeral instability experts) was surveyed on 3 occasions to establish a consensus on the statements.

Limited Predictive Value of the Instability Severity Index Score: Evaluation of 217 Consecutive Cases of Recurrent Anterior Shoulder Instability.

Purpose: To review the existing variables and their ability to predict recurrence of shoulder instability as it relates to the Instability Severity Index Score (ISIS), as well as evaluate any other pertinent imaging and patient history variables that may impact risk of recurrent anterior instability after arthroscopic Bankart repair.

Methods: All consecutive patients with recurrent anterior shoulder instability and who had arthroscopic instability repair were identified. Exclusion criteria were prior surgery on the shoulder, posterior or multidirectional instability, instability caused by seizure disorder, or a rotator cuff tear.

Measuring Bone Loss in the Unstable Shoulder: Understanding and Applying the Track Concept.

An interesting international debate has been developed over the past 10 years (the last decade) surrounding the surgical procedure for recurrent anteroinferior instability and a definitive consensus is lacking on the factors which favor one technique over another, especially when bone loss is present (soft tissue vs. bone block). Glenoid bone loss is commonly observed in the shoulder with anterior instability, and it is difficult to evaluate the shape of the glenoid using plain radiograph, therefore, computed tomography or intraoperative observation is recommended for accurate assessment of glenoid bone loss and Hill-Sachs lesion.

Risk Factors for Recurrent Anterior Glenohumeral Instability and Clinical Failure Following Primary Latarjet Procedures: An Analysis of 344 Patients.

Background: Patients with a greater risk of recurrent instability and inferior clinical outcomes following a primary Latarjet procedure can be preoperatively identified on the basis of clinical, radiographic, and demographic criteria. The purpose of this study was to identify risk factors influencing the rates of recurrent anterior glenohumeral instability and clinical failure following a primary Latarjet procedure.

Methods: All patients who underwent a primary Latarjet procedure were prospectively enrolled and evaluated.

Biomechanical Analysis of Plate Fixation Compared With Various Screw Configurations for Use in the Latarjet Procedure.

Background: The biomechanical properties of coracoid fixation with a miniplate during the Latarjet procedure have not been described.

Purpose: To determine the biomechanical properties of miniplate fixation for the Latarjet procedure compared with various screw fixation configurations.

Study Design: Controlled laboratory study.

Editorial Commentary: Latarjet Mechanics and Biology: Thinking in Biodynamic Fashion.

Latarjet technique via open or arthroscopic approach is a very complex surgery that includes several steps. The coracoid placement that is performed at the end of this procedure represents the key point to avoid complications and attain the best clinical results. Mechanics and biology need to work as a whole to improve the integration of the graft on the glenoid neck.