A validated algorithm using current literature to judge the appropriateness of anatomic total shoulder arthroplasty utilizing the RAND/UCLA appropriateness method.

Background: Currently, appropriateness criteria evaluating when to perform total shoulder arthroplasty (TSA) is lacking. In the absence of society guidelines and limited quality evidence, the RAND/University California in Los Angeles (UCLA) method provides a suitable alternative to evaluate appropriateness and assist in clinical decision making. Given the rise in utilization, appropriateness criteria for TSA have the potential to be an extremely powerful tool for improving quality of care and controlling costs.

Arthroscopic-Assisted Coracoclavicular Ligament Reconstruction: Clinical Outcomes and Return to Activity at Mean 6-Year Follow-Up.

Purpose: To report clinical and functional outcomes including return to preinjury activity level following arthroscopic-assisted coracoclavicular (CC) ligament reconstruction (AA-CCR) and to determine associations between return to preinjury activity level, radiographic outcomes, and patient-reported outcomes following AA-CCR.

Methods: A institutional registry review of all AA-CCR using free tendon grafts from 2007 to 2016 was performed. Clinical assessment included Single Assessment Numeric Evaluation (SANE) score and return to preinjury activity level at final follow-up.

Scapular Ring Preservation: Coracoacromial Ligament Transection Increases Scapular Spine Strains Following Reverse Total Shoulder Arthroplasty.

Background: Scapular fractures following reverse total shoulder arthroplasty (RSA) are devastating complications with substantial functional implications. The role of the coracoacromial ligament (CAL), which is often transected during surgical exposure for RSA, is not fully known. We hypothesized that the CAL contributes to the structural integrity of the "scapular ring" and that the transection of this ligament during RSA alters the scapular strain patterns.

Influence of implant design and parasagittal acromial morphology on acromial and scapular spine strain after reverse total shoulder arthroplasty: a cadaveric and computer-based biomechanical analysis.

Background: The purpose was to analyze the influence of deltoid lengthening due to different implant designs and anatomic variations of the acromion and scapular spine (SS) in the parasagittal plane on strain patterns after reverse shoulder arthroplasty (RSA).

Methods: Ten cadaveric shoulders with strain rosettes placed on the surface of the acromial body (Levy II) and SS (Levy III) were tested using a shoulder simulator. RSA using humeral onlay (+3, +5, +8, +10, +13 mm) and glenosphere lateralization (0, +6 mm) was performed.

Acromioclavicular joint injuries in overhead athletes: a concise review of injury mechanisms, treatment options, and outcomes.

Purpose Of The Review: To review the relevant literature surrounding acromioclavicular (AC) joint injuries particularly pertaining to overhead athletes.

Recent Findings: The AC joint is a unique anatomic and biomechanical portion of the shoulder that can be problematic for athletes, particularly throwers, when injured. Treatment of these injuries remains a topic in evolution.