Is there value in the routine practice of discarding the incision scalpel from the surgical field to prevent deep wound contamination with Cutibacterium acnes?

Background: Cutibacterium acnes is found in skin flora of the shoulder and is the most common microbe identified in periprosthetic shoulder infections. The purpose of this study is to determine if there is C acnes present on the incision scalpel in patients undergoing shoulder arthroplasty despite extensive skin preparation techniques to prevent wound contamination.

Methods: The authors collected a consecutive case series of patients meeting inclusion criteria.

Blinded Ultrasound Examination of the Subscapularis Following Anatomic Shoulder Arthroplasty.

Background: The subscapularis tendon is commonly released during shoulder arthroplasty, and its integrity and repair postoperatively have been shown important to help maximize patient function. However, diagnosing subscapular tendon failure can be difficult with magnetic resonance imaging secondary to metal artifact as well as very costly.

Purpose: The purpose of this study was to assess the utility of ultrasound imaging in evaluating subscapularis integrity at specific time points following shoulder arthroplasty, in a blinded fashion.

An Anatomic and Biomechanical Comparison of Bankart Repair Configurations.

Background: Suture anchor repair for anterior shoulder instability can be performed using a number of different repair techniques, but none has been proven superior in terms of anatomic and biomechanical properties. Purpose/Hypothesis: The purpose was to compare the anatomic footprint coverage and biomechanical characteristics of 4 different Bankart repair techniques: (1) single row with simple sutures, (2) single row with horizontal mattress sutures, (3) double row with sutures, and (4) double row with labral tape. The hypotheses were as follows: (1) double-row techniques would improve the footprint coverage and biomechanical properties compared with single-row techniques, (2) horizontal mattress sutures would increase the footprint coverage compared with simple sutures, and (3) repair techniques with labral tape and sutures would not show different biomechanical properties.

The Effect of Early Range of Motion on Quality of Life, Clinical Outcome, and Repair Integrity After Arthroscopic Rotator Cuff Repair.

Purpose: To compare the effect of early versus delayed motion protocols on quality of life, clinical outcomes, and repair integrity in patients who have undergone arthroscopic single-tendon rotator cuff repair.

Methods: This was a prospective, randomized, investigator-blinded clinical trial. Seventy-three patients from a single surgeon's practice who underwent arthroscopic repair of a single-tendon rotator cuff tear were randomized to either an early motion protocol (starting 2 to 3 days after surgery) or a delayed motion protocol (starting 28 days after surgery).

Comparison of Time to Recurrence of Instability After Open and Arthroscopic Bankart Repair Techniques.

Background: The results of open and arthroscopic instability repairs have been shown to be equivalent in recent literature.

Purpose: To compare the time to recurrence (TTR) of instability and disease-specific outcome measures in patients undergoing open and arthroscopic Bankart repair.

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

Anatomic and Biomechanical Comparison of Traditional Bankart Repair With Bone Tunnels and Bankart Repair Utilizing Suture Anchors.

Background: Traditional Bankart repair using bone tunnels has a reported failure rate between 0% and 5% in long-term studies. Arthroscopic Bankart repair using suture anchors has become more popular; however, reported failure rates have been cited between 4% and 18%. There have been no satisfactory explanations for the differences in these outcomes.

A biomechanical analysis of gap formation and failure mechanics of a xenograft-reinforced rotator cuff repair in a cadaveric model.

Hypothesis: Failure rates of rotator cuff repairs are reported to be as high as 90%, in part because of gap formation at the repair site that occurs before healing. The purpose of this study was to evaluate whether the application of an extracellular matrix (ECM) graft (Conexa; Tornier, Edina, MN, USA) to a rotator cuff repair will decrease the gap formation at the tendon-bone interface and increase the ultimate load to failure over control specimens by mechanically sharing load with the repair in a cadaveric model.

Methods: Six pairs of human cadaveric shoulders were used to test ECM-reinforced and unreinforced rotator cuff repairs for repair-site gapping, ultimate load, failure mode, and load-sharing capabilities of the ECM patch under both cyclic and monotonic loading.

Inter-rater agreement of the Goutallier, Patte, and Warner classification scores using preoperative magnetic resonance imaging in patients with rotator cuff tears.

Purpose: The purpose of this study was to determine the interobserver reliability of 3 commonly used classification systems in describing preoperative magnetic resonance imaging (MRI) studies of patients undergoing surgery for full-thickness rotator cuff tears.

Methods: Thirty-one patients who underwent arthroscopic rotator cuff repair and had preoperative MRI studies available were selected over a 2-year period. Three board-certified shoulder surgeons independently reviewed these images.

Human tendon cell response to 7 commercially available extracellular matrix materials: an in vitro study.

Purpose: To evaluate the response of human tenocytes in culture to 7 commercially available extracellular matrix (ECM) patches.

Methods: Four samples of each ECM were incubated in human tenocyte cultures by use of standard methods. Cell adhesion, cell proliferation, and cellular production of type I and type III collagen, decorin, and scleraxis were measured for each sample according to established experimental methods.

Biomechanical and radiographic analysis of partial coracoclavicular ligament injuries.

Background: A spectrum of acromioclavicular joint injuries may exist between type II acromioclavicular joint disruption (coracoclavicular strain) and type III acromioclavicular joint injuries (coracoclavicular disruption). This may help explain the variability in outcomes seen in patients with type II acromioclavicular injuries.

Hypothesis: Injury to either the conoid or trapezoid ligaments would lead to instability of the acromioclavicular joint after complete acromioclavicular joint injury.

The use of intra-articular hylan G-F 20 in the treatment of symptomatic osteoarthritis of the shoulder: a preliminary study.

Background: While hylan G-F 20 is an approved therapy for the treatment of knee osteoarthritis, there are few reports of its use in shoulder osteoarthritis.

Hypothesis: Hylan G-F 20 can reduce pain and improve function in patients with glenohumeral osteoarthritis.

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