Percutaneous Coracohumeral Release for Patients with Adhesive Capsulitis: Two-Year Results from a Randomized Control Crossover Study.

Background: Adhesive capsulitis (AC) causes a variety of symptoms, including but not limited to pain, stiffness, and a gradual restriction of active and passive range of motion (ROM). The coracohumeral ligament (CHL) plays an important role in this disease process, and percutaneous CHL release (PCHLR) has demonstrated efficacy in treating manifestations of this disorder that are refractory to pain medication, physical therapy, and local injections. Our previous study demonstrated one-year efficacy and durability, and this study examines 2-year data from our original randomized control crossover cohort.

Missed Short-term Follow-up After Arthroscopic Rotator Cuff Surgery: Analysis of Surgical and Demographic Factors.

Introduction: Few current studies have examined loss to follow-up after rotator cuff-related shoulder arthroscopy. Understanding the demographic and surgical factors for missed follow-up would help identify patients most at risk and potentially mitigate the onset of complications while maximizing clinical outcomes.

Methods: A retrospective review of consecutive rotator cuff arthroscopic procedures with a minimum of 12-month follow-up done by a single, fellowship-trained surgeon was undertaken from February 2016 through January 2022.

Allergic Contact Dermatitis (ACD) to Topical Products in Orthopedic Surgery: Clinical Characteristics and Treatment Strategies.

The potential for many of the commonly used surgical site wound adhesives, skin antiseptic solutions, topical antibiotics, and suture materials to sensitize and subsequently result in allergic contact dermatitis (ACD) has become increasingly recognized within orthopedic surgery. Particularly with subsequent exposure to the offending allergen, the cutaneous allergic reaction may present in a similar fashion to cellulitis, thus making early differentiation between the two etiologies to initiate the appropriate and timely treatment crucial. Recognition of the characteristic appearance and severity of ACD surrounding a surgical wound often drives the initial management.

Prevalence and Risk Factors for Missed Short-term Follow-up After Primary Total Shoulder Arthroplasty.

Introduction: The importance of consistent postoperative follow-up has been established for collecting patient-reported outcomes and surveilling for potential complications. Despite this, the prevalence of and risk factors for missed short-term follow-up after elective shoulder arthroplasty remain limited.

Methods: A retrospective review of consecutive primary anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty cases with a minimum of 12-month follow-up performed by a single, fellowship-trained shoulder surgeon was undertaken from January 2015 to December 2021.

Does Morbid Obesity (BMI ≥40 kg/m2) Impact Operative Time, Blood Loss, Length of Stay, or Complications Following Anatomic Total Shoulder Arthroplasty?

Objectives: There have been conflicting reports regarding the effects of obesity on both surgical time and blood loss following anatomic shoulder arthroplasty. Varying categories of obesity has made comparison amongst existing studies difficult.

Methods: A retrospective review of consecutive anatomic shoulder arthroplasty cases (aTSA) was undertaken.

Accuracy and Reliability of Computerized Surgical Planning Software in Anatomic Total Shoulder Arthroplasty.

Purpose: The primary purpose of this study was to assess the concordance between preoperatively determined implant parameters using CT-based planning software and surgically implanted prostheses. Secondarily, we sought to evaluate the agreement between preoperative plans performed by surgeons at different levels of training.

Methods: Patients with primary glenohumeral osteoarthritis who underwent anatomic total shoulder arthroplasty (aTSA) and had a preoperative CT scan according to Blueprint (Stryker, Mahwah, NJ) protocol to be used for preoperative planning were included.

Musculoskeletal Literacy in Orthopedics: Associated Factors, Effects on Patient-Physician Communication and Intervention Strategies.

Health literacy is defined as the degree to which an individual obtains and processes basic health information and services so as to make appropriate and informed health decisions. Limited health literacy (LHL), as assessed by various validated instruments, remains prevalent amongst older adult patients, non-Caucasian ethnicities, and those of lower socioeconomic backgrounds. Of concern, LHL has been associated with decreased medical knowledge, disuse of preventative medical services, worse chronic disease control and increased use of emergency services.

A Comparison of Operative Time and Intraoperative Blood Volume Loss Between Stemless and Short-stem Anatomic Total Shoulder Arthroplasty: A Single Institution's Experience.

Introduction: There has been increasing interest in the use of stemless humeral implants for total shoulder arthroplasty when compared with both short-stem (SS) and standard-length implants. Although evidence for decreased surgical time and blood loss exists for stemless versus standard-length stems, far less literature exists comparing these clinical parameters for stemless versus SS implants.

Methods: A retrospective review of consecutive anatomic total shoulder arthroplasty (aTSA) cases conducted by a single, fellowship-trained shoulder surgeon was undertaken from January 2016 through January 2022 with the exception of March 2020 through January 2021 secondary to the COVID-19 pandemic.

Incidence and Risk Factors for Patient-related Short-term Cancellation of Elective Arthroscopic Surgery: A Case-matched Study.

Introduction: Short-term cancellation of elective ambulatory orthopaedic surgery can result in disruption to the process flow of the operating room, with resultant negative financial implications for the health system. The risk factors for patient-related short-term cancellations within 24 hours of the surgical date have not been well defined.

Methods: A retrospective review of a single orthopaedic surgery electronic internal database was done to identify all cancellations from January 1, 2016, through December 31, 2019, which were made within 24 hours of the surgical date.

Perioperative management of patients with hip fractures and COVID-19: A single institution's early experiences.

• Good perioperative outcomes seen in patients with COVID-19 that underwent hip fracture repair after 48 hours of admission. • Short cephalomedullary nailing should be strongly considered over long nail for symptomatic COVID-19 patients. • Regional anesthesia is preferred over general anesthesia in COVID-19 patients with hip fracture.

Advances in the development of gene therapy, noncoding RNA, and exosome-based treatments for tendinopathy.

Tendinopathy is a common musculoskeletal disorder characterized by chronic low-grade inflammation and tissue degeneration. Tendons have poor innate healing ability and there is currently no cure for tendinopathy. Studies elucidating mechanisms underlying the pathogenesis of tendinopathy and mechanisms mediating the genesis of tendons during development have provided novel targets and strategies to enhance tendon healing and repair.

The critical shoulder angle (CSA) in glenohumeral osteoarthritis: Does observer experience affect measurement reliability on plain radiographs?

Background: The critical shoulder angle (CSA) has been associated with full-thickness rotator cuff tears both in the presence and absence of glenohumeral arthritis. It is unclear whether the CSA can be reliably measured from plain radiographs of concentric glenohumeral osteoarthritis amongst examiners at differing levels of training.

Methods: We retrospectively reviewed the radiographs of consecutive patients who underwent shoulder arthroplasty for glenohumeral osteoarthritis.

Patient Preferences for Plain Radiographs in the Setting of Atraumatic Shoulder Pain: Which Factors Influence Their Decision?

Introduction: Plain radiographs of the shoulder are routinely obtained for patients presenting with atraumatic shoulder pain, although the diagnostic utility of this imaging modality is unclear. Despite this, patients often prefer to obtain radiographs and may associate them with a more satisfactory visit.

Methods: New patients presenting with atraumatic shoulder pain were provided with information regarding the potential advantages and disadvantages of plain radiographs as part of their visit.

Reducing Lateral Femoral Cutaneous Nerve Palsy in Obese Patients in the Beach Chair Position: Effect of a Standardized Positioning and Padding Protocol.

Introduction: To report on the effectiveness of a standardized patient positioning and padding protocol in reducing lateral femoral cutaneous nerve (LFCN) palsy in obese patients who have undergone shoulder surgery in the beach chair position.

Methods: We retrospectively reviewed the medical records of 400 consecutive patients with a body mass index (BMI) of ≥30 kg/m who underwent either open or arthroscopic shoulder surgery in the beach chair position by a single surgeon. Before June 2013, all patients were placed in standard beach chair positioning with no extra padding.

Routine Plain Radiographs in the Setting of Atraumatic Shoulder Pain: Are They Useful?

Introduction: Plain radiographs of the shoulder are routinely obtained for patients presenting with atraumatic shoulder pain. The diagnostic utility of these radiographs is debatable.

Methods: Patients presenting for the first time to a shoulder clinic with atraumatic shoulder pain received a plain radiographic series.

Prevalence and Risk Factors for Lateral Femoral Cutaneous Nerve Palsy in the Beach Chair Position.

Purpose: To report on the prevalence of lateral femoral cutaneous nerve (LFCN) palsy in patients who had undergone shoulder surgery in the beach chair position and to identify patient and surgical risk factors for its development.

Methods: We retrospectively reviewed the medical records of 397 consecutive patients who underwent either open or arthroscopic shoulder surgery in the beach chair position by a single surgeon. Patient demographic and surgical data including age, gender, weight, body mass index (BMI), diabetes, procedure duration, and anesthesia type (general, regional, regional/general) were recorded.

Glenohumeral Joint Sepsis Caused by Streptococcus mitis: A Case Report.

Septic arthritis of the shoulder girdle remains relatively uncommon, with Staphylococcus aureus and β-hemolytic streptococci the typical offending organisms in adult patients. Rare cases of Streptococcus viridans, an oral bacterium with low virulence, have been reported in the setting of septic arthritis, mostly involving the knee joint or the sternoclavicular joint. In this article, we report a case of Streptococcus mitis infection of the glenohumeral joint that likely resulted from hematogenous spread after oral trauma in a patient with poor underlying dentition.

Outcomes of intramedullary nailing for acute proximal humerus fractures: a systematic review.

Background: While proximal humerus fractures remain common within the elderly population, the optimal treatment method remains controversial. Intramedullary nailing has been advocated as an effective and less invasive surgical technique. The purpose of this study is to elucidate the demographics, outcomes, and complications of intramedullary nailing for acute, displaced proximal humerus fractures.

Tension Pneumothorax After Ultrasound-Guided Interscalene Block and Shoulder Arthroscopy.

Interscalene brachial plexus anesthesia is commonly used for outpatient arthroscopic shoulder procedures. Ultrasound guidance has helped to minimize the cardiac, neurologic, and pulmonary complications associated with this block. Although rarely reported, pneumothorax may occur as a result of direct lung injury and even in a delayed fashion.

Reducing Postoperative Fracture Displacement After Locked Plating of Proximal Humerus Fractures: Current Concepts.

The incidence of proximal humerus fractures in the elderly has been rising. Concomitantly, operative fixation with use of locking plates has been increasing. Postoperative complications of locking plate fixation, particularly in the setting of osteoporotic bone, include screw penetration of the articular surface, progressive fracture displacement, and avascular necrosis.