Complications in Shoulder Arthroplasty: Why Do They Happen and How to Manage Them.

Complications occur with total shoulder arthroplasty (TSA), and they can be daunting to diagnose and treat. It is important to review common TSA-related complications and to summarize risk factors along with causes of these complications and how to avoid them. The orthopaedic surgeon should be knowledgeable about how to successfully manage complications to achieve good patient outcomes and the etiologies and management of the painful and stiff shoulder arthroplasty, subscapularis failure after anatomic TSA, instability after reverse shoulder arthroplasty, and acromion stress fractures in the setting of reverse TSA.

Performance of Two Artificial Intelligence Generative Language Models on the Orthopaedic In-Training Examination.

Background: Artificial intelligence (AI) generative large language models are powerful and increasingly accessible tools with potential applications in health care education and training. The annual Orthopaedic In-Training Examination (OITE) is widely used to assess resident academic progress and preparation for the American Board of Orthopaedic Surgery Part 1 Examination.

Materials And Methods: Open AI's ChatGPT and Google's Bard generative language models were administered the 2022 OITE.

Access to an Educational Video Preoperatively Has No Effect on Postoperative Opioid Use After Arthroscopic Partial Meniscectomy of the Knee: A Prospective Cohort Study.

Purpose: To determine whether access to a website with an educational video would decrease postoperative opioid use in patients undergoing arthroscopic partial meniscectomy.

Methods: Enrolled patients who underwent arthroscopic partial meniscectomy at a single center were randomized to either the intervention or control group prior to surgery. The intervention group received a card with access to an online educational video regarding opioids with their postoperative instructions; the control group did not.

Which pediatric supracondylar humerus fractures are high risk for conversion to open reduction?

Supracondylar humerus fractures are common pediatric injuries encountered by orthopedic surgeons. Displaced fractures are treated operatively with closed reduction and percutaneous pinning or open reduction of injuries that cannot be adequately closed reduced. The purpose of this study is to identify preoperative injury characteristics associated with open reduction.

Proximal humeral fracture-dislocations: which patterns can be reduced in the emergency department?

Background: Shoulder fracture-dislocations can represent a challenging management scenario in the emergency department (ED) because of concern for the presence of occult fractures that may displace during a reduction attempt. The alternative, a closed reduction attempt in the operating room, has the benefit of full paralysis but requires additional resource utilization. There is limited guidance in the literature about the risks of an initial reduction attempt in the ED as a function of fracture pattern to help guide physicians with this decision.

Elbow Ulnar Collateral Ligament Reconstruction Using the Novel Docking Plus Technique in 324 Athletes.

Background: This retrospective case series examined 324 athletes who received elbow ulnar collateral ligament (UCL) reconstruction by a single surgeon in a private practice over a 9-year period. The novel Docking Plus technique for elbow UCL reconstruction in 324 athletes provided good or excellent Conway score results in 88% of patients. The preponderance of previous studies examining UCL reconstruction outcomes were performed by surgeons at one of only three institutions (Andrews Institute, Hospital for Special Surgery, Kerlan Jobe Orthopedic Clinic).

A biomechanical cadaver comparison of suture button fixation to plate fixation for pubic symphysis diastasis.

Objectives: To determine whether suture button fixation of the pubic symphysis is biomechanically similar to plate fixation in the treatment of partially stable pelvic ring injuries.

Methods: Twelve pelvis specimens were harvested from fresh frozen cadavers. Dual-x-ray-absorptiometry (DXA) scans were obtained for all specimens.

Elbow Ulnar Collateral Ligament Reconstruction Using a 4-Strand Docking Plus Technique.

The "Docking Plus" technique for elbow ulnar collateral ligament (UCL) surgery is described in the following text and video. Depite the general success of UCL surgery, significant rates of retear and failure of return to competition persist. Hypothesized reasons for UCL surgery failure include insufficient graft strength (midsubstance tears), insufficient graft tensioning (functional UCL insufficiency, valgus extension overload), and insufficient healing of graft to bone (proximal avulsions).

Sports Injuries to the Latissimus Dorsi and Teres Major.

Injuries to the latissimus dorsi and teres major muscles, while rare, are debilitating. They are seen in a variety of sports, although disproportionately in the throwing shoulder of baseball pitchers. There have been 25 case reports and 2 case series published on the nonoperative and operative management of these injuries.