Arthroscopic Medialization Partial Repair with Biologic Interposition Tuberoplasty for Large to Massive Irreparable Rotator Cuff Tear.

An irreparable rotator cuff tear is a challenging condition to treat, and various treatment modalities are being introduced. Medialization in the partial repair method has the limitation of exposing the tuberosity, while tension-free biologic interposition tuberoplasty using acellular dermal matrix has the limitation of exposing the humeral head. The authors believe that by combining these two techniques, it is possible to complement each other's limitations.

Proximal row carpectomy with interposition arthroplasty using both capsular flap and acellular human dermal matrix.

Background: In cases of wrist arthritis, proximal row carpectomy (PRC) has been widely utilized and shown favorable long-term outcomes. However, its applicability is limited in cases where arthritis extends to the lunate fossa or capitate. Recently, surgical approaches combining various methods of interposition arthroplasty have been introduced to overcome these drawbacks.

Combination of arthroscopic biologic tuberoplasty and bursal acromial reconstruction.

Background: Recently, among the various method for irreparable rotator cuff tears, the "tension-free allodermis graft technique" has been introduced as a method for arthroscopic biologic tuberoplasty(ABT) and bursal acromial reconstruction(BAR).The objective was to analyze the outcomes of ABT and BAR combination surgical technique.

Methods: Eighteen cases who underwent simultaneous ABT and BAR procedures were retrospectively recruited.

Correction to: Relation of Superficial and Deep Layers of Delaminated Rotator Cuff Tear to Supraspinatus and Infraspinatus Insertions.

[This corrects the article DOI: 10.1007/s43465-019-00020-6.].

Anterior cable reconstruction using the proximal biceps tendon for reinforcement of arthroscopic rotator cuff repair prevent retear and increase acromiohumeral distance.

Anterior cable reconstruction (ACR) using the long head of the biceps tendon (LHBT) was developed to place at the native superior capsule attachment site for large to massive rotator cuff tears (LMRCTs) with anterior cable disruption. In this study, we investigated whether ACR for reinforcement before ARCR prevented retear after arthroscopic rotator cuff repair (ARCR), especially in cases of LMRCTs with anterior cable disruption. A total of 125 patients who underwent arthroscopic rotator cuff repair (ARCR) for LMRCTs were retrospectively enrolled.

Assessment of the efficacy of the far cortical locking technique in proximal humeral fractures: a comparison with the conventional bi-cortical locking technique.

Background: Locking plate fixation is one of the treatment strategies for the management of proximal humeral fractures. However, stiffness after locking plate fixation is a clinical concern. The mechanical stiffness of the standard locking plate system may suppress the interfragmentary motion necessary to promote secondary bone healing by callus formation.

The anterior translation of the humeral head leads to a decrease in the coracohumeral distance in subscapularis tear.

Unlabelled: A total of 297 patients who classified as subscapularis (SC) tears through arthroscopic evaluation were retrospectively enrolled, and Fifty-seven patients with impingement syndrome were also enrolled as the control group for normal-population comparison. The coracohumeral distance (CHD) and humeral head anterior translation (HHAT) were measured on magnetic resonance imaging. Our study demonstrated that the anterior translation of the humeral head is related with a decrease in the coracohumeral distance in subscapularis tear.

Comparative analysis of a locking plate with an all-suture anchor versus hook plate fixation of Neer IIb distal clavicle fractures.

Background: The coracoclavicular fixation with suture anchors adds stability to type IIb distal clavicle fractures fixed with a plate and screws when loaded to failure. The purpose of this study was to compare the clinical and radiological outcomes between the use of a locking compression plate (LCP) with all-suture anchor fixation and hook LCP fixation of Neer IIb distal clavicle fractures.

Methods: A total of 82 consecutive patients who underwent plate fixation for Neer IIb distal clavicle fractures were included.

Relation of Superficial and Deep Layers of Delaminated Rotator Cuff Tear to Supraspinatus and Infraspinatus Insertions.

Background: It remains unclear whether the deep layer of the rotator cuff is an articular layer of the supraspinatus (SS) or infraspinatus (IS), rotator cable, or superior capsule. Therefore, this study aimed to analyse the relationship between occupation ratios and delamination patterns of rotator cuff tears (RCTs). We hypothesised that the deep layers are related to the occupation ratios of the deep SS and IS sections.

Comparison between hook plate fixation with and without coracoclavicular ligament suture for acute acromioclavicular joint dislocations.

Background: Hook plates are widely used for repair of acromioclavicular joint (ACJ) dislocations. However, it is unclear whether repair of torn coracoclavicular (CC) ligament is necessary. The purpose of this study was to evaluate the outcomes of the hook plate fixation with direct CC ligament repair for acute ACJ dislocation in comparison with the hook plate fixation without direct CC ligament repair.

Clinical outcomes of arthroscopic lateral ulnar collateral ligament repair with or without intra-articular fracture.

Background: The pathoanatomy and biomechanics of elbow instability have been previously reported; however, few researchers have dealt with the operative management and clinical consequence of recurrent elbow instability. Recent studies on arthroscopic lateral collateral ligament (LCL) complex repair have reported successful outcomes similar to those achieved by open repair. We aimed to determine the validity of arthroscopic repair of the LCL complex in elbows with unstable dislocation with or without intra-articular fracture.

Irreducible posterior fracture and dislocation of shoulder with massive rotator cuff tear due to incarceration of biceps tendon: A case report.

Acute traumatic posterior glenohumeral dislocation in association with a massive rotator cuff tear is rare. Moreover, only few cases with interposition of the long biceps head of the tendon has been described to prevent reduction in posterior dislocation of the shoulder. In addition, combined scapula fracture with posterior shoulder dislocation also extremely rare.

Restoration of supraspinatus and infraspinatus deep plane occupation ratios was greater in delaminated tears than in non-delaminated tears after rotator cuff repair.

Total 132 patients who underwent arthroscopic suture bridge repair were divided into two groups: group A, non-delaminated tears; group B, deep layer, more retracted, delaminated tears. In addition, group B were divided into two subgroups: group I (≤2-cm) and group II (>2-cm). Muscle volume was evaluated by measuring the occupation ratio and restoration of the rotator cuff muscle was defined as the difference between the preoperative and postoperative occupation ratios.

New predictors for subscapularis tear: Coraco-lesser tuberosity angle, lesser tuberosity angle, and lesser tuberosity height.

Background: The pathogenesis of degenerative subscapularis (SC) tear is not clear, several mechanisms are involved: intrinsic tendon degeneration or subcoracoid impingement. The aim of this study was to propose new radiographic markers, the coraco-lesser tuberosity angle (CLA), lesser tuberosity angle (LTA) and lesser tuberosity height (LTH). The hypothesis was that higher values of CLA, LTA, and LTH would be associated with a higher likelihood in detecting a SC tear.

Comparison of a novel hybrid hook locking plate fixation method with the conventional AO hook plate fixation method for Neer type V distal clavicle fractures.

Background: The conventional AO hook locking compression plate (LCP) (Synthes, Solothurn, Switzerland) has only three holes for lateral fragments; therefore it is not suitable for use during the fixation of small-comminuted fragments in some cases. Recently, a novel hybrid hook LCP (TDM, Seoul, Korea) was developed to overcome this limitation. Here, we evaluated the clinical and radiologic outcomes of a novel hybrid hook LCP for Neer type V distal clavicle fractures compared to the outcomes of a conventional AO hook plate.

Coracoid clavicular tunnel angle is related with loss of reduction in a single-tunnel coracoclavicular fixation using a dog bone button in acute acromioclavicular joint dislocation.

Purpose: Despite the high failure rates of techniques used to maintain the reduction of single-tunnel coracoclavicular (CC) fixation, analyses of the etiology of loss of reduction related to surgical techniques are limited. Therefore, it was hypothesized that the initial coracoclavicular tunnel angle was related to loss of reduction in the single-tunnel technique for AC joint dislocation. This study aimed to evaluate the clinical and radiological outcomes of arthroscopic single-tunnel CC suture button fixation according to the initial coracoclavicular tunnel angle.

Critical shoulder angle and greater tuberosity angle according to the partial thickness rotator cuff tear patterns.

Background: Current studies suggest that radiographic markers such as the critical shoulder angle (CSA) and the greater tuberosity angle (GTA) are associated with rotator cuff tears (RCTs). However, because the analysis of CSAs and GTAs according to the partial thickness rotator cuff tear patterns is limited, the purpose of the present study was to evaluate the relationship of CSAs and GTAs with partial thickness rotator cuff tear (PTRCT) patterns.

Method: This retrospective study included 1,069 patients from 2013 to 2017.

Greater tuberosity angle and critical shoulder angle according to the delamination patterns of rotator cuff tear.

The purpose was to evaluate the relationship between GTA, CSA, and the delamination patterns of RCTs. This study included 315 patients with RCTs from 2014 to 2018, retrospectively. The subjects were divided into 5 groups: Group A, control group; Group B, non-delaminated tear; Group C, delaminated tear with equally retraction of articular and bursal layer; Group D, articular layer more retracted delaminated tear, and Group E, bursal layer more retracted delaminated tear.

Clinical outcomes of dual 3.5-mm locking compression plate fixation for humeral shaft fractures: Comparison with single 4.5-mm locking compression plate fixation.

Background: Recently, several in vitro biomechanical studies that used dual small locking plate fixation for humeral shaft fractures have investigated. However, in vivo studies about dual plate fixation for humeral shaft fractures are limited. The purpose of our study was to report the outcomes of dual small plating for humeral shaft fractures in comparison with those of single large fragment plating.

The supraspinatus occupation ratios of both the ≥ 50% articular- and bursal-side partial-thickness rotator cuff tears were low and the infraspinatus occupation ratio of the ≥ 50% bursal-side partial-thickness rotator cuff tears was low.

Purpose: The purpose of this study was to analyze the relationship between the occupation ratio and partial-thickness rotator cuff tears.

Methods: The study included and retrospectively investigated 683 patients with partial-thickness rotator cuff tears between 2013 and 2017. Fifty patients with impingement syndrome were also enrolled as the control group for normal-population comparison.

Microfracture in Linear, Isolated, Narrow, Engaging Hill-Sachs Lesion.

Treatment of Hill-Sachs lesions is still controversial despite the frequent incidence in patients with recurrent shoulder dislocation. We report the use of arthroscopic microfracture for the treatment of recurrent shoulder dislocation with a linear, isolated, narrow, engaging Hill-Sachs lesion. Arthroscopic microfracture can be an alternative treatment option to obtain healing of defects and avoid external rotation limitation in young, active patients with recurrent dislocation with linear, isolated, narrow, engaging lesions.

Arthroscopic Acromioclavicular Fixation With Suture Tape Augmentation After Coracoclavicular Fixation With Dog Bone Button: Surgical Technique.

An arthroscopic technique for the surgical treatment of acute acromioclavicular (AC) joint injuries is presented in this study. This procedure aims to achieve both vertical and horizontal stability through the healing of both coracoclavicular (CC) and AC ligaments. As a routine maneuver, arthroscopic CC stabilization was applied using the dog bone button to obtain only vertical stability.

Effect of Surgical-Site, Multimodal Drug Injection on Pain and Stress Biomarkers in Patients Undergoing Plate Fixation for Clavicular Fractures.

Background: Surgical-site, multimodal drug injection has recently evolved to be a safe and useful method for multimodal pain management even in patients with musculoskeletal trauma.

Methods: Fifty consecutive patients who underwent plating for mid-shaft and distal clavicular fractures were included in the study. To evaluate whether surgical-site injections (SIs) have pain management benefits, the patients were divided into two groups (SI and no-SI groups).

Posterior Shoulder Instability in the Patients with Bilateral Congenital Absence of Long Head of Biceps Tendon: A Case Report.

Rare cases of a congenital absence of the long head of the biceps tendon (LHBT) have been reported, and its incidence is unknown. In a literature review of the congenital absence of the LHBT, only 1 case was associated with posterior shoulder instability and severe posterior glenoid dysplasia. This paper reports the first case of a patient with a bilateral congenital absence of the LHBT with posterior shoulder instability without glenoid dysplasia or posterior glenoid tilt.

Editorial Commentary: The Practical Goal of Arthroscopic Osteosynthesis for the Treatment of Unstable Scaphoid Nonunion.

Arthroscopic reduction with osteosynthesis using bone grafting has become a successful alternative to open techniques for the treatment of chronically unstable scaphoid nonunions. Several studies have demonstrated that arthroscopic techniques are safe and reproducible in addition to causing less soft tissue damage and providing promising short- and mid-term results. However, these techniques have limitations in restoring normal carpal alignment, especially in patients with unstable scaphoid nonunion and carpal collapse deformities, although this does not affect the recovery of clinical function.