Short-Term Indwelling Foley Catheters Do Not Reduce the Risk of Postoperative Urinary Retention in Uncomplicated Primary THA and TKA: A Randomized Controlled Trial.

Background: The purpose of this randomized controlled trial was to determine whether a short-term Foley catheter (inserted in the operating room and removed upon arrival to the orthopaedic floor) would reduce the risk of postoperative urinary retention (POUR) in patients undergoing primary total hip (THA) and total knee arthroplasty (TKA).

Methods: Three hundred and eighty-eight patients undergoing inpatient primary TKA (n = 228) or THA (n = 160) with spinal anesthesia were randomized to receive a short-term Foley catheter (n = 194) or no Foley (n = 194). There were 143 male and 245 female patients.

Long-term outcomes and improved risk of revision following tumor endoprosthetic replacement of the distal femur: Single institutional results.

Purpose: This study assessed revision characteristics following distal femur tumor endoprosthetic replacement.

Methods: Fifty-seven procedures were performed between 2005 and 2019. The cumulative incidence of implant revision was calculated with death as a competing risk.

Conjoint Tendon Tenotomy for Glenoid Exposure in the Setting of Previous Coracoid Transfer.

Surgical exposure of the glenoid after previous coracoid process transfer is technically challenging as a result of distorted anatomy, obliterated soft-tissue planes, and adhesive scar tissue, which poses additional risk to adjacent neurovascular structures. The purpose of this article is to present a technique for glenoid exposure following coracoid transfer that involves tenotomy of the conjoint tendon to minimize the risk for neurovascular injury while leaving the well-healed coracoid bone graft in place.

Cost-Effectiveness of Arthroscopic Rotator Cuff Repair Versus Reverse Total Shoulder Arthroplasty for the Treatment of Massive Rotator Cuff Tears in Patients With Pseudoparalysis and Nonarthritic Shoulders.

Purpose: To determine the most cost-effective treatment strategy for patients with massive rotator cuff tears and pseudoparalysis of the shoulder without osteoarthritis of the glenohumeral joint (PP without OA). Specifically, we aimed to compare arthroscopic rotator cuff repair (ARCR) versus reverse total shoulder arthroplasty (RTSA) and investigate the effect of patient age on this decision.

Methods: A Markov decision model was used to compare 3 treatment strategies for addressing PP without OA: (1) ARCR with option to arthroscopically revise once, (2) ARCR with immediate conversion to RTSA on potential failure, and (3) primary RTSA.

Comprehensive Arthroscopic Management of Glenohumeral Osteoarthritis: Preoperative Factors Predictive of Treatment Failure.

Background: Patient selection is critical when choosing between arthroscopic joint preservation and total shoulder arthroplasty in young patients with glenohumeral osteoarthritis (GHOA).

Purpose: To identify prognostic factors predictive of early failure in patients undergoing comprehensive arthroscopic management (CAM) for GHOA.

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

Arthroscopic Double-Row Transosseous Equivalent Rotator Cuff Repair with a Knotless Self-Reinforcing Technique.

Background: Rotator cuff tears are a significant cause of shoulder morbidity. Surgical techniques for repair have evolved to optimize the biologic and mechanical variables critical to tendon healing. Double-row repairs have demonstrated superior biomechanical advantages to a single-row.

The Role of Platelet Rich Plasma (PRP) and Other Biologics for Rotator Cuff Repair.

Background: Surgical treatment of rotator cuff tears has consistently demonstrated good clinical and functional outcomes. However, in some cases, the rotator cuff fails to heal. While improvements in rotator cuff constructs and biomechanics have been made, the role of biologics to aid healing is currently being investigated.

Risk Factors, Pathobiomechanics and Physical Examination of Rotator Cuff Tears.

Background: It is important to appreciate the risk factors for the development of rotator cuff tears and specific physical examination maneuvers.

Methods: A selective literature search was performed.

Results: Numerous well-designed studies have demonstrated that common risk factors include age, occupation, and anatomic considerations such as the critical shoulder angle.

Irreparable Rotator Cuff Tears: Restoring Joint Kinematics by Tendon Transfers.

Background: Tendon transfers can be a surgical treatment option in managing younger, active patients with massive irreparable rotator cuff tears. The purpose of this article is to provide an overview of the use of tendon transfers to treat massive irreparable rotator cuff tears and to summarize clinical outcomes.

Methods: A selective literature search was performed and personal surgical experiences are reported.

Outcomes After Arthroscopic Pancapsular Capsulorrhaphy With Suture Anchors for the Treatment of Multidirectional Glenohumeral Instability in Athletes.

Background: Outcomes after arthroscopic pancapsular capsulorrhaphy (APC) with suture anchors for multidirectional instability (MDI) of the shoulder are not widely reported.

Purpose: To compare intraoperative findings and midterm outcomes of APC with suture anchors for MDI between female and male athletes and between a classic, atraumatic onset versus clinical onset of MDI after a traumatic event.

Study Design: Cohort study; Level of evidence, 3.

Survivorship and Patient-Reported Outcomes After Comprehensive Arthroscopic Management of Glenohumeral Osteoarthritis: Minimum 5-Year Follow-up.

Background: There are little data on midterm outcomes after the arthroscopic management of glenohumeral osteoarthritis (GHOA) in young active patients.

Purpose: To report outcomes and survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA at a minimum of 5 years postoperatively.

Study Design: Case series; Level of evidence, 4.

Arthroscopic Knotless, Double-Row, Extended Linked Repair for Massive Rotator Cuff Tears.

The management of massive rotator cuff tears remains a challenge for physicians, with failure rates being higher when compared with smaller tears. Many surgical treatment options exist including debridement with biceps tenodesis, complete repair, partial repair, repair with augmentation devices, superior capsule reconstruction, tendon transfer, and reverse total shoulder arthroplasty. The purpose of this article is to describe our preferred surgical technique for a complete arthroscopic repair using an extended linked, knotless, double-row construct.

Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears.

Massive irreparable rotator cuff tears in young patients are a particular challenge for the orthopaedic surgeon. Surgical treatment options include debridement, partial rotator cuff repair, patch-augmented rotator cuff repair, bridging rotator cuff reconstruction with graft interposition, tendon transfer, and reverse total shoulder arthroplasty. Recently, reconstruction of the superior glenohumeral capsule using a fascia lata autograft has been suggested to reduce superior glenohumeral translation and restore superior stability.

Clinical and Anatomic Predictors of Outcomes After the Latarjet Procedure for the Treatment of Anterior Glenohumeral Instability With Combined Glenoid and Humeral Bone Defects.

Background: The Latarjet procedure for the treatment of recurrent anterior shoulder instability is highly successful, but reasons for failure are often unclear. Measurements of the "glenoid track" have not previously been evaluated as potential predictors of postoperative stability.

Hypothesis: There are clinical and anatomic characteristics, including the glenoid track, that are predictive of outcomes after the Latarjet procedure.

Predictors for satisfaction after anatomic total shoulder arthroplasty for idiopathic glenohumeral osteoarthritis.

Introduction: The use of total shoulder arthroplasty (TSA) to treat primary glenohumeral osteoarthritis (GHOA) is increasing. Factors influencing patient satisfaction after surgery have not been well documented. The aim of this study was to determine demographic, radiologic, and surgical, factors predictive for satisfaction after TSA for GHOA.

Outcomes After Open Revision Repair of Massive Rotator Cuff Tears With Biologic Patch Augmentation.

Purpose: To assess minimum 2-year clinical outcomes after open revision biologic patch augmentation in patients with massive rotator cuff retears who had deficient rotator cuff tendons with healthy rotator cuff muscles.

Methods: Patients with massive posterosuperior rotator cuff retears who underwent open revision rotator cuff repair with patch augmentation were identified from a surgical registry. Outcomes data collected included American Shoulder and Elbow Surgeons; Quick Disabilities of the Arm, Shoulder and Hand; Single Assessment Numeric Evaluation; and Short Form-12 Physical Component Summary scores along with postoperative patient satisfaction, and activity modification.

Arthroscopically Assisted Anatomic Coracoclavicular Ligament Reconstruction Technique Using Coracoclavicular Fixation and Soft-Tissue Grafts.

Acromioclavicular joint injuries are common and are often seen in contact athletes. Good to excellent clinical results have been reported using soft-tissue grafts to reconstruct the coracoclavicular ligaments; however, complications remain. Some complications are unique to the surgical technique, particularly clavicle and coracoid fractures that are associated with drilling large or multiple bone tunnels.

Clinical Results After Conservative Management for Grade III Acromioclavicular Joint Injuries: Does Eventual Surgery Affect Overall Outcomes?

Purpose: To compare the clinical outcomes in patients with grade III acromioclavicular (AC) joint injuries in whom nonoperative therapy was successfully completed and those who had nonoperative therapy failure and who proceeded to undergo surgical reconstruction.

Methods: Forty-nine patients were initially treated nonoperatively for grade III AC joint injuries with physical therapy. Patients completed questionnaires at initial presentation and after a follow-up period of 2 years.

Chronic rupture of the long head of the biceps tendon: comparison of 2-year results following primary versus revision open subpectoral biceps tenodesis.

Introduction: The purpose of this study was to evaluate the clinical results of surgical repair for proximal long head of the biceps (LHB) tendon ruptures comparing chronic primary and postsurgical revision LHB tendon ruptures.

Materials And Methods: Patients who underwent subpectoral LHB tenodesis for chronic ruptures with a minimum of 2 years from surgery were identified. ASES and SF-12 PCS scores and surgical and demographic data were collected prospectively.

Patch-Augmented Latissimus Dorsi Transfer and Open Reduction-Internal Fixation of Unstable Os Acromiale for Irreparable Massive Posterosuperior Rotator Cuff Tear.

Latissimus dorsi transfer is a reasonable treatment option for massive posterosuperior rotator cuff tears that can substantially improve chronically painful and dysfunctional shoulders. This report and accompanying video describe the treatment of an active 43-year-old man with severe pain and weakness in the right shoulder after 3 failed rotator cuff repairs. Preoperative imaging showed a massive posterosuperior rotator cuff tear retracted to the glenoid as well as a hypermobile os acromiale likely causing dynamic impingement and recurrent rotator cuff tears.

The Comprehensive Arthroscopic Management Procedure for Treatment of Glenohumeral Osteoarthritis.

Younger, high-demand patients who are less suitable for joint replacement procedures are often affected by advanced glenohumeral osteoarthritis. There are several alternatives to total joint arthroplasty for the treatment of these patients. However, the outcomes of these procedures are less predictable and have limited durability.

Clinical outcomes after autograft reconstruction for sternoclavicular joint instability.

Background: Instability of the sternoclavicular (SC) joint is a rare condition. However, in some cases, SC joint instability may lead to persistent pain and impairment of shoulder function that requires surgical management. This study evaluated clinical outcomes after SC joint reconstruction with hamstring tendon autograft in patients with SC joint instability.

Alterations in Glenohumeral Kinematics in Patients With Rotator Cuff Tears Measured With Biplane Fluoroscopy.

Purpose: To quantitatively measure the 3-dimensional (3D) glenohumeral translations during dynamic shoulder abduction in the scapular plane, using a biplane fluoroscopy system, in patients with supraspinatus rotator cuff tears.

Methods: A custom biplane fluoroscopy system was used to measure the 3D position and orientation of the scapula and humerus of 14 patients with full-thickness supraspinatus or supraspinatus and infraspinatus rotator cuff tears and 10 controls as they performed shoulder abduction over their full range of motion. The 3D geometries of the scapula and humerus were extracted from a computed tomography scan of each shoulder.

Massive rotator cuff tears: pathomechanics, current treatment options, and clinical outcomes.

Rotator cuff tear size has an important effect on clinical outcomes after repair. Management options for massive rotator cuff tears are numerous, and selection of the most appropriate treatment method for individual patients can be a challenge. An understanding of the pathomechanics, treatment, and clinical outcomes in patients with massive rotator cuff tears can serve as a guide for clinical decision-making.

Two-Year Outcomes After Arthroscopic Rotator Cuff Repair in Recreational Athletes Older Than 70 Years.

Background: Outcomes after arthroscopic rotator cuff repair in recreational athletes older than 70 years are not widely reported.

Purpose: To evaluate clinical outcomes after arthroscopic repair of full-thickness rotator cuff tears in recreational athletes aged 70 years or older.

Study Design: Case series; Level of evidence, 4.