Predictors of Internal Rotation after Reverse Shoulder Arthroplasty.

Objectives: Internal rotation (IR) remains unpredictable following reverse total shoulder arthroplasty (rTSA). This study aimed to determine if increasing IR limits range of motion in other planes, and to determine pre- and intra-operative factors associated with post-operative IR.

Methods: A retrospective analysis of a single surgeon's primary rTSA with a single implant was undertaken, excluding patients with acute fracture or infection.

Rehabilitation after Shoulder Instability Surgery.

Shoulder instability can occur in any direction and presents across a broad spectrum including traumatic dislocations, repetitive microinstability events or subluxations, and global joint laxity. The development of pain, functional decline, and articular pathologic condition is a multifaceted process that is influenced by the underlying bony morphology, biology of the surrounding soft tissue structures, dynamic coordination of the periscapular musculature, and patient factors such as age, activity level, and associated injuries. This article will focus on the younger, active patient with instability due to deficiencies in the capsulolabral complex and dynamic stabilizers.

Current Concepts in Upper-Extremity Motion Analysis: Room To Grow?

Kinematic motion analysis (KMA) is well established in the assessment of gait and lower-extremity kinematics; however, its application to upper-extremity (UE) pathology has been limited. This review provides a concise overview of information related to the KMA technology that is pertinent to the clinician. Advantages of KMA for UE assessment are discussed, along with barriers to implementation.

Management of Adult Brachial Plexus Injuries.

Adult brachial plexus injuries result in profound functional deficits, debilitating pain, substantial mental health implications, and extensive economic impacts. Their initial evaluation includes a detailed physical examination, electrodiagnostic studies, advanced imaging, and patient counseling. A team-based approach, led by a peripheral nerve surgeon and including hand therapists, electrodiagnosticians, mental health experts, and pain-management specialists, is used to provide optimal longitudinal care during the lengthy recovery process.

Factors Associated With Distal Femoral Osteotomy Survivorship: Data From the California Office of Statewide Health Planning and Development (OSHPD) Registry.

Background: Malalignment of the lower extremity can lead to early functional impairment and degenerative changes. Distal femoral osteotomy (DFO) can be performed with arthroscopic surgery to correct lower extremity malalignment while addressing intra-articular abnormalities or to help patients with knee osteoarthritis (OA) changes due to alignment deformities.

Purpose: To examine survivorship after DFO and identify the predictors for failure.

Elastic fibers in orthopedics: Form and function in tendons and ligaments, clinical implications, and future directions.

Elastic fibers are an essential component of the extracellular matrix of connective tissues. The focus of both clinical management and scientific investigation of elastic fiber disorders has centered on the cardiovascular manifestations due to their significant impact on morbidity and mortality. As such, the current understanding of the orthopedic conditions experienced by these patients is limited.

Severity of Glenohumeral Osteoarthritis Does Not Correlate With Patient-Reported Outcomes.

Background: Patient pain and clinical function are important factors in decision-making for patients with glenohumeral osteoarthritis (GHOA). The correlation between radiographic severity of arthritis and demographic factors with modern patient-reported outcome measures has not yet been well defined.

Methods: This cross-sectional study included 256 shoulders in 246 patients presenting with isolated GHOA.

High Tibial Osteotomy Survivorship: A Population-Based Study.

Background: High tibial osteotomy (HTO) was developed to treat early medial compartment osteoarthritis in varus knees.

Purpose: To evaluate the midterm and long-term outcomes of HTO in a large population-based cohort of patients.

Study Design: Case-control study; Level of evidence, 3.

Discharge Destination After Shoulder Arthroplasty: An Independent Risk Factor for Readmission and Complications.

Introduction: Postdischarge disposition after shoulder replacement lacks uniform guidelines. The goal of this study was to identify complication and readmission rates by discharge disposition and determine whether disposition was an independent risk factor for adverse events, using a statewide database.

Methods: Data from the California Office of Statewide Health Planning and Development discharge database were used.

Redefining Zone II: Anatomy of the Flexor Digitorum Superficialis Insertion.

Background: Flexor zone II is defined as the region spanning the proximal aspect of the A1 pulley to the insertion of the flexor digitorum superficialis (FDS) tendon. Descriptions of the FDS insertion are inconsistent in the literature, but zones of injury are frequently determined with reference to superficial landmarks. The purpose of this study was to describe the footprint of the FDS insertion and define its relationship to the proximal interphalangeal (PIP) skin crease.

Strategies for complying with the HIPAA security rule.

In response to the HIPAA privacy and security rules, organizations are taking steps to set up and clean up access controls, and explore possible changes to audit controls and termination procedures. They are facing the practical issues of implementing security policies that are compliant, efficient to administer, and not disruptive to users. Organizations are also setting up new users' system access according to role-based schemes and examining the ways they are terminating access for departing employees.