Does Functional Bracing of the Unstable Shoulder Improve Return to Play in Scholastic Athletes? Returning the Unstable Shoulder to Play.

Background: Functional bracing is often used as an adjunct to nonoperative treatment of anterior shoulder instability, but no study has evaluated the effectiveness of in-season bracing. The purpose of this study was to examine successful return to play in a nonoperative cohort of adolescent athletes with in-season shoulder instability and compare those athletes treated with bracing to those who were not.

Hypothesis: The use of functional bracing will improve success rates in a cohort of athletes treated nonoperatively for in-season shoulder instability.

The Nonoperative Instability Severity Index Score (NISIS): A Simple Tool to Guide Operative Versus Nonoperative Treatment of the Unstable Shoulder.

Background: The management of the adolescent athlete after initial shoulder instability remains controversial.

Hypothesis: Individual risk factors in athletes with shoulder instability who are managed nonoperatively can be integrated into a scoring system that can predict successful return to sport.

Study Design: Retrospective cohort study.

Subscapularis Repair Is Unnecessary After Lateralized Reverse Shoulder Arthroplasty.

Background: Controversy exists as to whether the subscapularis should be repaired after reverse shoulder arthroplasty. The purpose of the present study was to evaluate the utility of repairing the subscapularis after reverse shoulder arthroplasty with regard to complications, objective findings, and patient-reported outcome measures.

Methods: We retrospectively reviewed the records for 99 patients who had undergone a lateralized reverse shoulder arthroplasty with (n = 58) or without (n = 41) subscapularis repair.

Clinical outcomes of suprascapular nerve decompression: a systematic review.

Background: Suprascapular neuropathy is an uncommon clinical diagnosis. Although there have been a number of case series reporting on this pathologic process, to date there has been no systematic review of these studies. This study aimed to synthesize the literature on suprascapular neuropathy with regard to clinical outcomes.

The incidence and effect of fatty atrophy, positive tangent sign, and rotator cuff tears on outcomes after total shoulder arthroplasty.

Background: Treatment choices for total shoulder arthroplasty (TSA) in the absence of full-thickness rotator cuff tears (RCTs) are not clearly defined in current literature. This study investigated the prevalence and effect of preoperative partial-thickness RCTs and muscular degenerative changes on postoperative outcomes after TSA.

Methods: Medical records and magnetic resonance imaging studies were reviewed for patients who underwent TSA for primary glenohumeral osteoarthritis with minimum 2-year follow-up to determine preoperative tear classification, Goutallier grade, and supraspinatus tangent sign.

Liposomal bupivacaine versus indwelling interscalene nerve block for postoperative pain control in shoulder arthroplasty: a prospective randomized controlled trial.

Background: Pain management strategies following shoulder arthroplasty vary significantly. Liposomal bupivacaine (LB) is an extended-release delivery of a phospholipid bilayer encapsulating bupivacaine that can result in drug delivery up to 72 hours. Prior studies in lower extremity surgery demonstrated efficacy of LB in comparison to a single-shot peripheral nerve block; however, no study has investigated LB in a total shoulder arthroplasty population.

Preparedness of orthopaedic surgeons for modern battlefield surgery.

Over 220 U.S. Army orthopaedic surgeons have deployed during the Global War on Terrorism (GWOT).

Comparison of the split stacked versus the split achilles allograft for dual femoral tunnel posterior cruciate ligament reconstruction.

Background: Cadaveric testing has shown that double-bundle reconstruction better replicates the native anatomy of the posterior cruciate ligament. With the current trend toward allograft Achilles posterior cruciate ligament reconstructions, the need to determine a graft configuration with the highest tensile and pull-out strength has become paramount.

Hypothesis: The split stacked Achilles allograft construct provides greater graft material to traverse the notch and provides increased load to failure at the tibial point of fixation compared with a standard monoblock Achilles allograft construct.

Tobramycin-impregnated calcium sulfate prevents infection in contaminated wounds.

Open fractures often are associated with increased rates of infection and nonunion, multiple surgical procedures, and delayed return to preinjury activity. Antimicrobial bone graft substitutes used as an alternative to antibiotic cement beads and/or delayed autologous bone grafting may provide a useful adjunct in patients with open fractures. A stable, unicortical defect was created and contaminated with 30 microL of 5 x 10 colony-forming units/mL of Staphylococcus aureus in the proximal tibial metaphysis of Spanish goats.