Automatic bicipital groove identification in arthritic humeri for preoperative planning: A Random Forest Classifier approach.

The bicipital groove is an important anatomical feature of the proximal humerus that needs to be identified during surgical planning for procedures such as shoulder arthroplasty and proximal humeral fracture reconstruction. Current algorithms for automatic identification prove ineffective in arthritic humeri due to the presence of osteophytes, reducing their usefulness for total shoulder arthroplasty. Our methodology involves the use of a Random Forest Classifier (RFC) to automatically detect the bicipital groove on segmented computed tomography scans of humeri.

The Kouvalchouk procedure vs. distal tibial allograft for treatment of posterior shoulder instability: the deltoid "hammock" effect exists.

Background: In 1993, Kouvalchouk described an acromial bone block with a pedicled deltoid flap for the treatment of posterior shoulder instability. This procedure provides a "double blocking" effect in that the acromial autograft restores posterior glenoid bone loss and the deltoid flap functions as a muscular "hammock" resembling the sling effect of the conjoint in the Latarjet procedure. The primary aim of this study was to compare the Kouvalchouk procedure to distal tibial allograft (DTA) reconstruction for the management of posterior shoulder instability with associated bone loss, while the secondary aim was to evaluate the deltoid hammock effect.

Bridge plating is an effective adjunct treatment for complex elbow instability.

Background: Managing persistent elbow instability and chronic dislocations presents challenges despite traditional treatments. Supplementary methods like immobilization and various fixations, though common, can carry high complication rates. This study assesses the efficacy of bridge plating in treating complex elbow instability through a retrospective review of patients.

An evidence-informed rehabilitation management framework for posterior shoulder tightness: A scoping review.

Objective: To systematically scope the literature on posterior shoulder tightness (PST) and define a therapist-instructed and therapist-administered management framework.

Design: Scoping review.

Literature Search: We searched MEDLINE, EMBASE, CINAHL, Scopus and Google Scholar from inception to December 2021.

Two-year minimum survivorship and radiographic analysis of a pressfit short humeral stem for total shoulder arthroplasty.

Background: Newer generation humeral stem designs in total shoulder arthroplasty (TSA) are trending towards shorter lengths and uncemented fixation. The goal of this study is to report a 2-yr minimum clinical and radiographic outcomes of an uncemented short-stem press-fit humeral stem in anatomic total shoulder arthroplasty (ATSA) and reverse total shoulder arthroplasty (RTSA).

Methods: A retrospective multicenter database review was performed of all patients who received an uncemented short-length press-fit humeral stem (Equinoxe Preserve humeral stem, Exactech, Inc.

Corrective Open-wedge Valgus Proximal Humerus Lengthening Osteotomy. Technique and Case Series.

Symptomatic varus malunion after proximal humeral fractures is associated with weakness and painful limitation of shoulder range of motion. When there is conformity of the articular surface and no avascular necrosis, a head-preserving procedure is best indicated. Arthroscopic arthrolysis, subacromial decompression, and tuberoplasty have been described for the treatment of mild deformity.

Implications of humeral short-stem diametral sizing on implant stability.

Background: Shoulder arthroplasty humeral stem design has evolved to include various shapes, coatings, lengths, sizes, and fixation methods. While necessary to accommodate patient anatomy characteristics, this creates a surgical paradox of choice. The relationship between the surgeon's selection of short-stem implant size and construct stiffness, resistance to subsidence and micromotion has not been assessed.

The effect of humeral head positioning and incomplete backside contact on bone stresses following total shoulder arthroplasty with a short humeral stem.

Background: The use of uncemented humeral stems in total shoulder arthroplasty (TSA) is known to be associated with stress shielding. This may be decreased with smaller stems that are well-aligned and do not fill the intramedullary canal; however, the effect of humeral head positioning and incomplete head backside contact has not yet been investigated. The purpose of this study was to quantify the effect of changes in humeral head position and incomplete head backside contact on bone stresses and expected bone response following reconstruction.

Balancing clinician and patient priorities for total shoulder replacement preoperative education programs.

Objective: To investigate patient and clinician preferences regarding a preoperative educational program for patients undergoing shoulder replacement surgery.

Methods: This study used a cross-sectional survey of patients awaiting shoulder replacement surgery and clinicians. The survey was comprised of 41 questions for patients and clinicians, regarding preferences for receiving information, content preferences and device preferences.

Arthroscopic tissue biopsy as a preoperative diagnostic test for periprosthetic shoulder arthroplasty infections: a systematic review and meta-analysis.

Background: The diagnosis of periprosthetic infection in shoulder arthroplasty remains a challenge. Conventional methods for evaluating periprosthetic joint infections are poor because of lower-virulence organisms affecting the shoulder. The aim of our systematic review was to evaluate the diagnostic accuracy of preoperative arthroscopic tissue cultures compared with tissue biopsy samples obtained at the time of revision surgery.

Indomethacin for heterotopic ossification prophylaxis following surgical treatment of elbow trauma: a randomized controlled trial.

Background: Heterotopic ossification is a frequent complication following surgical treatment of elbow trauma. The use of indomethacin to prevent heterotopic ossification is reported in the literature; however, its effectiveness is controversial. The purpose of this randomized, double-blind, placebo-controlled study was to determine whether indomethacin is effective in reducing the incidence and severity of heterotopic ossification after surgical management of elbow trauma.

Opioid use for a first-incident upper extremity fracture in 220,440 patients without recent prior use in Ontario, Canada: a retrospective cohort study.

Unlabelled: To describe opioid use for a first upper extremity fracture in a cohort of patients who did not have recent opioid use.

Design: Descriptive epidemiological study.

Setting: Emergency Department, Hospital.

Understanding individuals' perspectives and experiences of recovery following a proximal humerus fracture: an interpretive description.

Purpose: Proximal humerus fractures are common in older adults and optimizing their outcomes following this injury can be challenging. This study explored recovery from the perspective of individuals who experience proximal humerus fracture.

Materials And Methods: We conducted in-depth semi-structured interviews ( = 14) with participants (aged 45 and over) recruited from a hand clinic in London, Ontario using a purposive sampling technique.

The sizing and suitability of nonspherical ellipsoid humeral heads for total shoulder arthroplasty.

Background: Total shoulder arthroplasty (TSA) implants have evolved to include more anatomically shaped components that better replicate the native state. The geometry of the humeral head is nonspherical, with the frontal diameter of the base of the head being up to 6% larger than the sagittal diameter. Despite this, most TSA humeral head implants are spherical, meaning that the diameter must be oversized to achieve complete coverage, resulting in articular overhang, or portions of the resection plane will remain uncovered.

Preoperative Patient Education Programs for Orthopaedic Surgery: What Do the Programs Include? How Are They Delivered? What Are the Knowledge Gaps? A Scoping Review of 46 Studies.

Objectives: To (1) describe the nature and content of the current literature on preoperative education programs for patients preparing for orthopaedic surgery, (2) assess the completeness of reporting program descriptions, and (3) report gaps within the literature.

Design: Scoping review.

Literature Search: We searched the CINAHL, Embase, PubMed, Cochrane Reviews, PsycINFO, Web of Science, and Google Scholar databases for studies that (1) addressed preoperative education in elective orthopaedic surgery or (2) provided descriptions or evaluations of a preoperative program, including the content or outcomes of the program.

Humeral short stem varus-valgus alignment affects bone stress.

The use of uncemented humeral stems in total shoulder arthroplasty (TSA) is associated with stress shielding. Shorter length stems have shown to decrease stress shielding; however, the effect of stem varus-valgus alignment is currently not known. The purpose of this study was to quantify the effect of short stem distal humeral endosteal contact due to varus-valgus angulation on bone stresses after TSA.

Fracture profiles of a 4-year cohort of 266,324 first incident upper extremity fractures from population health data in Ontario.

Background: Understanding the profiles of different upper extremity fractures, particularly those presenting as a 1st incident can inform prevention and management strategies. The purpose of this population-level study was to describe first incident fractures of the upper extremity in terms of fracture characteristics and demographics.

Methods: Cases with a first adult upper extremity (UE) fracture from the years 2013 to 2017 were extracted from administrative data in Ontario.

Outcomes of radial head implants in total elbow arthroplasty.

Background: There is no consensus on the management of the radial head in total elbow arthroplasty (TEA). In 3-part TEA designs, options include radial head retention, excision, or arthroplasty. Biomechanical studies suggest improved varus-valgus stability with radial head implants in unlinked total elbows.

Arthroscopic Versus Mini-open Rotator Cuff Repair: A Randomized Trial and Meta-analysis.

Background: Patients with complete rotator cuff tears who fail a course of nonoperative therapy can benefit from surgical repair.

Purpose: This randomized trial compared mini-open (MO) versus all-arthroscopic (AA) rotator cuff repair.

Study Design: Randomized controlled trial; Level of evidence, 1.

Vancomycin is effective in preventing Cutibacterium acnes growth in a mimetic shoulder arthroplasty.

Background: Intra-incisional deposition of vancomycin powder is a strategy to limit Cutibacterium acnes infection after shoulder surgery. Unfortunately, limited research exists examining the effectiveness of vancomycin in a clinically relevant joint infection model. This basic science study investigated the efficacy of vancomycin administration as prophylaxis for C acnes growth in vitro using a mimetic shoulder arthroplasty.

Development of a Three-Dimensional Bioartificial Shoulder Joint Implant Mimetic of Periprosthetic Joint Infection.

Postsurgical infections of the shoulder joint involving are difficult to diagnose and manage. Despite the devastating clinical complications and costly health care burden of joint infections, the scarcity of joint infection models was identified as an unmet need by the 2019 International Consensus on Orthopedic Infections. In this study, we have developed a novel 3D shoulder joint implant mimetic (S-JIM) that includes a surgical metal surface and supports a co-culture of and patient-derived shoulder capsule fibroblasts.

The Unsalvageable Radial Head in Patients Aged 30 Years and Younger.

Purpose: Concern exists regarding the use of radial head arthroplasty (RHA) in younger patients. This study assessed clinical, functional, and radiographic outcomes of RHA in patients aged 30 years and younger.

Methods: A retrospective review identified 26 elbows that underwent a smooth stem modular RHA in patients aged 30 years and younger at a median follow-up of 3.