Self-powered, light-controlled, bioresorbable platforms for programmed drug delivery.

Degradable polymer matrices and porous scaffolds provide powerful mechanisms for passive, sustained release of drugs relevant to the treatment of a broad range of diseases and conditions. Growing interest is in active control of pharmacokinetics tailored to the needs of the patient via programmable engineering platforms that include power sources, delivery mechanisms, communication hardware, and associated electronics, most typically in forms that require surgical extraction after a period of use. Here we report a light-controlled, self-powered technology that bypasses key disadvantages of these systems, in an overall design that is bioresorbable.

Better Radiographic Reduction and Lower Complication Rates With Combined Coracoclavicular and Acromioclavicular Ligament Reconstruction Than With Isolated Coracoclavicular Reconstruction.

Purpose: To determine whether combined acromioclavicular (AC) ligament reconstruction and coracoclavicular (CC) ligament reconstruction without bone tunnels would improve radiographic reduction maintenance and complication rates for type III to V AC dislocations.

Methods: This single-institution retrospective study analyzed all patients who underwent a hybrid synthetic/graft wrap CC reconstruction without tunnels with additional AC reconstruction/repair from January 2013 to August 2019. This 26-patient cohort was compared with a 1:1 sex- and age-matched control group who underwent CC reconstruction without AC reconstruction.

High-Energy Proximal Humerus Fractures in Geriatric Patients: A Review.

High-energy proximal humerus fractures in elderly patients can occur through a variety of mechanisms, with falls and MVCs being common mechanisms of injury in this age group. Even classically low-energy mechanisms can result in elevated ISS scores, which are associated with higher mortality in both falls and MVCs. These injuries result in proximal humerus fractures which are commonly communicated via Neer's classification scheme.

The relationship of bilateral shoulder arthroplasty timing and postoperative complications.

Background: Though several case series have described bilateral shoulder arthroplasty results with range of motion, patient-reported outcomes, and complications, little guidance exists regarding the optimal interval timing between surgeries.

Methods: All patients from 2 insurance databases who underwent staged bilateral shoulder arthroplasty between 2005 and 2016 were identified. These patients were then stratified by elapsed time between surgeries into 4 study groups: (1) less than 3 months, (2) 3-6 months, (3) 6-9 months, and (4) 9-12 months.

Bundled Payment Plans Are Associated With Notable Cost Savings for Ambulatory Outpatient Total Shoulder Arthroplasty.

Introduction: Bundling of services, typically into a 90-day episode of care, is intended to facilitate cost reduction. The purpose of this study was to determine the impact of a private insurance bundling program on the costs of outpatient total shoulder arthroplasty (TSA) at a freestanding ambulatory surgery center.

Methods: A cost minimization analysis was done of patients who had anatomic TSA by a single surgeon at a single freestanding ambulatory surgery center, including line-by-line comparisons of demographic and comorbidity factors for all patients treated within the 90-day episode of care.

Safety and Cost-Effectiveness of Outpatient Unicompartmental Knee Arthroplasty in the Ambulatory Surgery Center: A Matched Cohort Study.

Using an age- and comorbidity-matched cohort, we compared patients who underwent unicompartmental knee arthroplasty in an ambulatory surgery center with those who underwent the procedure in a traditional hospital inpatient setting. Postoperatively, the ambulatory surgery center cohort had fewer major complications than the inpatient cohort. No ambulatory surgery center patients required acute hospital admission and none had major complications.

The effect of current and former tobacco use on outcomes after primary reverse total shoulder arthroplasty.

Background: The purpose of this study was to determine the influence of current and former tobacco use on minimum 2-year clinical and radiographic outcomes after reverse total shoulder arthroplasty (RTSA).

Methods: Review of primary RTSA patient data identified 186 patients with at least 2 years of follow-up. Patients were classified as nonsmokers (76 patients), former smokers (89 patients), or current smokers (21 patients).

Outcomes of Uncemented Versus Cemented Reverse Shoulder Arthroplasty for Proximal Humerus Fractures.

Reverse shoulder arthroplasty (RSA) for proximal humerus fractures (PHFs) is traditionally performed with cemented humeral fixation. The purpose of this study was to compare the clinical and radiographic outcomes of cemented and cementless RSA for PHF. Between 2010 and 2014, 38 acute PHFs were treated with RSA and followed for a minimum of 2 years (mean, 37 months; range, 24-66 months).

Younger patients report similar activity levels to older patients after reverse total shoulder arthroplasty.

Background: Younger patients who have undergone reverse total shoulder arthroplasty (RTSA) are believed to have higher activity levels that place higher stresses across the prosthesis, increasing the risk of failure, but there is little information to support or refute this supposition. The purposes of this study were to define the patient-reported activity levels of patients younger than 65 years and older than 65 years who underwent RTSA and to evaluate any differences between the groups.

Methods: Forty-six patients who underwent primary RTSA answered a questionnaire regarding their activity levels.

Advanced age diminishes tendon-to-bone healing in a rat model of rotator cuff repair.

Background: Advanced patient age is associated with recurrent tearing and failure of rotator cuff repairs clinically; however, basic science studies have not evaluated the influence of aging on tendon-to-bone healing after rotator cuff repair in an animal model. Hypothesis/

Purpose: This study examined the effect of aging on tendon-to-bone healing in an established rat model of rotator cuff repair using the aged animal colony from the National Institute on Aging of the National Institutes of Health. The authors hypothesized that normal aging decreases biomechanical strength and histologic organization at the tendon-to-bone junction after acute repair.

Rotator cuff injuries in professional and recreational athletes.

Professional and recreational athletes involved in contact sports and sports with repetitive overhead motion are at increased risk for rotator cuff tears. Shoulder anatomy, pathology, and biomechanics place unique stress on the rotator cuff tendons during sports activity. Athletes demand effective treatment to quickly return to elite competition.