Two-year clinical outcomes and complication rates in anatomic and reverse shoulder arthroplasty implanted with Exactech GPS intraoperative navigation.

Introduction: We compared the 2-year clinical outcomes of both anatomic and reverse total shoulder arthroplasty (ATSA and RTSA) using intraoperative navigation compared to traditional positioning techniques. We also examined the effect of glenoid implant retroversion on clinical outcomes.

Hypothesis: In both ATSA and RTSA, computer navigation would be associated with equal or better outcomes with fewer complications.

Intersurgeon and intrasurgeon variability in preoperative planning of anatomic total shoulder arthroplasty: a quantitative comparison of 49 cases planned by 9 surgeons.

Background: Preoperative planning software is widely available for most anatomic total shoulder arthroplasty (ATSA) systems. It can be most useful in determining implant selection and placement with advanced glenoid wear. The purpose of this study was to quantify inter- and intrasurgeon variability in preoperative planning of a series of ATSA cases.

Assessment of surgeon variability in preoperative planning of reverse total shoulder arthroplasty: a quantitative comparison of 49 cases planned by 9 surgeons.

Background: Preoperative planning software is gaining utility in reverse total shoulder arthroplasty (RTSA), particularly when addressing pathologic glenoid wear. The purpose of this study was to quantify inter- and intrasurgeon variability in preoperative planning a series of RTSA cases to identify differences in how surgeons consider optimal implant placement. This may help identify opportunities to establish consensus when correlating plan differences with clinical data.

Subscapularis tenotomy versus lesser tuberosity osteotomy during total shoulder arthroplasty for primary osteoarthritis: a prospective, randomized controlled trial.

Background: There is no current consensus on subscapularis mobilization during total shoulder arthroplasty. The purpose of this prospective, randomized controlled trial was to compare functional and radiographic outcomes of the more traditional subscapularis tenotomy (ST) versus lesser tuberosity osteotomy (LTO).

Methods: This study enrolled 60 shoulders in 59 patients with primary osteoarthritis.

Academic characteristics of orthopedic team physicians affiliated with high school, collegiate, and professional teams.

We conducted a study to determine the academic involvement and research productivity of orthopedic team physicians at high school, college, and professional levels of sport. Through Internet and telephone queries, we identified 1054 team physicians from 362 institutions, including 120 randomly selected high schools and colleges and 122 professional teams (baseball, basketball, football, hockey). For all physicians included in the study, we performed a comprehensive search of the Internet and of a citation database to determine academic affiliations, number of publications, and h-index values.

Labrum and rotator cuff injuries in the throwing athlete.

The large amount of force imparted across the shoulder during the act of throwing makes the glenohumeral joint highly susceptible to injury in the athlete performing overhead throwing motions. The bony incongruity of the shoulder enables greater range of motion than any other joint in the body, but it also results in significant strain on the surrounding soft tissues during the throwing motion. Throwers can present with acute injuries, but more commonly they suffer from chronic overuse conditions resulting from repetitive overload.

The curveball as a risk factor for injury: a systematic review.

Context: The curveball is regarded by many as a potential risk factor for injury in youth baseball pitchers.

Objective: To critically evaluate the scientific evidence regarding the curveball and its impact on pitching biomechanics and the overall risk of arm injuries in baseball pitchers.

Study Type: Systematic review.

Mapping the articular contact area of the long head of the biceps tendon on the humeral head.

The purpose of this investigation was to calculate the contact surface area of the long head of the biceps (LHB) in neutral position and abduction. We sought to determine whether the LHB articulates with the humeral head in a consistent pattern comparing articular contact area in neutral position and abduction. Eleven fresh frozen matched cadaveric shoulders were analyzed.

A comprehensive approach to glenohumeral arthritis.

Arthritis of the glenohumeral joint is a common cause of debilitating shoulder pain, affecting up to one-third of patients older than 60 years. It is progressive in nature and characterized by irreversible destruction of the humeral head and glenoid articular surfaces. Inflammation of the surrounding soft tissues is often present and further contributes to the pain caused by the disease process.

Acromioclavicular osteoarthritis: a common cause of shoulder pain.

Osteoarthritis of the acromioclavicular joint is a frequent cause of shoulder pain and can result in significant debilitation. It is the most common disorder of the acromioclavicular joint and may arise from a number of pathologic processes, including primary (degenerative), posttraumatic, inflammatory, and septic arthritis. Patients often present with nonspecific complaints of pain located in the neck, shoulder, and/or arm, further complicating the clinical picture.

The Impact of Fatigue on the Kinematics of Collegiate Baseball Pitchers.

Background: Many factors are believed to contribute to throwing injuries in baseball pitchers, in particular overuse and poor throwing mechanics. The impact of fatigue on pitching biomechanics in live-game situations is not well understood.

Hypothesis: Pitchers will demonstrate significant deviation in their pitching motions with increasing levels of fatigue.

Sports reporting: a comprehensive review of the medical literature regarding North American professional sports.

Background: The increased physical demands of professional athletes predispose this patient population to a unique set of injuries typically not seen in the general population. This systematic literature review investigates the nature of injury reporting (both orthopedic and nonorthopedic conditions) in the medical literature of professional athletes in the National Football League (NFL), Major League Baseball (MLB), the National Basketball Association (NBA), and the National Hockey League (NHL). Rigorous reporting of sports injuries helps clinicians better understand disease mechanisms relevant to specific sports.

Influence of Rotator Cuff Tear Size and Repair Technique on the Creation and Management of Dog Ear Deformities in a Transosseous-Equivalent Rotator Cuff Repair Model.

Background: Redundancies in the rotator cuff tissue, commonly referred to as "dog ear" deformities, are frequently encountered during rotator cuff repair. Knowledge of how these deformities are created and their impact on rotator cuff footprint restoration is limited.

Purpose: The goals of this study were to assess the impact of tear size and repair method on the creation and management of dog ear deformities in a human cadaveric model.

Elbow arthroscopic surgery update for sports medicine conditions.

Elbow arthroscopic surgery can now effectively treat a variety of conditions that affect athletes. Advances in instrumentation, increased surgeon familiarity, and expanded indications have led to significant growth in elbow arthroscopic surgery in the past few decades. While positioning, portal placement, and specific instruments may vary among surgeons, anatomic considerations guide surgical approaches to minimize neurovascular compromise.

Characterizing bone tunnel placement in medial ulnar collateral ligament reconstruction using patient-specific 3-dimensional computed tomography modeling.

Background: Medial ulnar collateral ligament (MUCL) reconstruction is successful in restoring valgus elbow stability, but variability in bone tunnel characteristics exists among surgical techniques.

Hypothesis: Tunnel parameters such as diameter, drill angle, and starting location in MUCL reconstruction affect tunnel length and bone bridge size between tunnels.

Study Design: Descriptive laboratory study.

Radiographic outcomes of volar locked plating for distal radius fractures.

Purpose: To assess the ability of volar locked plating to achieve and maintain normal radiographic parameters for articular stepoff, volar tilt, radial inclination, ulnar variance, and radial height in distal radius fractures.

Methods: We performed a retrospective review of 185 distal radius fractures that underwent volar locked plating with a single plate design over a 5-year period. We reviewed radiographs and recorded measurements for volar tilt, radial inclination, ulnar variance, radial height, and articular stepoff.

A primer for physical examination of the elbow.

The elbow is a complex joint consisting of 3 separate but important articulations: the ulnohumeral, radiohumeral, and proximal radioulnar joints. The elbow assists in positioning the hand in space through 2 important motions, flexion-extension and pronation-supination. Although the elbow is not a weightbearing joint, it is subjected to significant loads, especially in overhead and throwing athletes.

Humeral head abrasion: an association with failed superior labrum anterior posterior repairs.

Hypothesis: An abrasion on the humeral head under the articulating portion of the biceps tendon has been observed in patients with pain and stiffness after superior labrum anterior posterior (SLAP) repair. This study examined this humeral head abrasion (HHA) and its association with various diagnoses involving pathology of the biceps-labral complex. We hypothesized that it would be more common in failed SLAP repairs than other diagnoses.

Preseason shoulder strength measurements in professional baseball pitchers: identifying players at risk for injury.

Background: The ability to identify pitchers at risk for injury could be valuable to a professional baseball organization. To our knowledge, there have been no prior studies examining the predictive value of preseason strength measurements.

Hypothesis: Preseason weakness of shoulder external rotators is associated with increased risk of in-season throwing-related injury in professional baseball pitchers.

Effects of wearing foot orthosis with medial arch support on the fifth metatarsal loading and ankle inversion angle in selected basketball tasks.

Study Design: Preintervention and post-intervention, repeated-measures experimental design.

Objectives: The objective was to investigate the effects of foot orthoses with medial arch support on ankle inversion angle and plantar forces and pressures on the fifth metatarsal during landing for a basketball lay-up and during the stance phase of a shuttle run.

Background: Proximal fractures of the fifth metatarsal, specifically the Jones fracture, are common in sports.

The use of suture anchors in repair of the ruptured patellar tendon: a biomechanical study.

Background: Rupture of the patellar tendon is a disabling injury that usually requires surgical treatment. The standard method of repair involves placing suture loops through transpatellar tunnels. The use of suture anchors in patellar tendon repair has not been previously described.