Mid-term outcomes of microfracture for the treatment of focal, full-thickness cartilage defects isolated to the humeral head.

Background: While microfracture has been shown to be an effective treatment for chondral lesions in the knee, evidence to support its use for chondral defects in the shoulder is limited to short-term outcomes studies. The purpose of this study is to determine if microfracture provides pain relief and improved shoulder function in patients with isolated focal chondral defects of the humeral head at a minimum 5-year follow-up.

Methods: Patients who underwent microfracture procedure for isolated focal chondral defects of the humeral head with a minimum follow-up of 5 years between 02/2006 and 08/2016 were included.

Does glenoid version and its correction affect outcomes in anatomic shoulder arthroplasty? A systematic review.

Background: Correction of glenoid retroversion is commonly performed in anatomic total shoulder arthroplasty (TSA) to increase component contact area and decrease eccentric loading of the glenoid component. Despite demonstrated biomechanical advantages, limited information exists on the clinical benefit of correcting glenoid retroversion. The purpose of this systematic review is to critically evaluate the existing literature on the effect of preoperative and postoperative glenoid retroversion on clinical functional and radiologic outcomes in patients who underwent anatomic TSA.

Biomechanical Analysis of Meniscotibial Ligament Tenodesis to Treat Meniscal Extrusion in the Setting of Posterior Medial Meniscus Root Repair.

Background: Meniscal extrusion often persists after a medial meniscus root repair. If the meniscus is extruded, the function of the meniscus as a load-sharing device and secondary knee stabilizer is compromised.

Hypothesis: It was hypothesized that repairing the meniscotibial ligament (MTL) would decrease meniscal extrusion in the settings of both an isolated MTL tear and a repaired medial meniscus root while also improving medial compartment contact mechanics.

Patient-reported outcomes of arthroscopic repair for partial or full-thickness upper third subscapularis tendon tears with open sub-pectoral biceps tenodesis: minimum 10-year outcomes.

Background: Although short-term results are promising, there are limited data for long-term results of arthroscopic subscapularis (SSC) repair. The purpose of this study is to report minimum 10-year outcomes of primary arthroscopic repair of isolated partial or full-thickness tears of the upper third of the SSC tendon.

Methods: Patients who underwent arthroscopic repair of isolated upper third SSC tears, Lafosse type I (>50% of tendon thickness) or type II were included.

Arthroscopic Labral Repair and Pancapsular Shift With Knotless All-Suture Anchors in the Setting of Multidirectional Instability of the Shoulder.

In the management of multidirectional type of shoulder instability (MDI), arthroscopic surgical stabilization is a preferred treatment option after failed conservative therapy regimens because of the ability to easily access all aspects of the capsule with one surgical procedure. As arthroscopic techniques have evolved, factors critical to postoperative success have been elucidated. Currently, optimal arthroscopic treatment of MDI involves circumferentially restoring labral integrity, a tailored, patient-specific surgical reduction of capsular volume, and adequately managing potential lesions of the biceps anchor.

Sternoclavicular Joint Reconstruction With Gracilis Tendon Autograft.

Clinical instability of the sternoclavicular (SC) joint is a challenging problem. Recurrent subluxation and pain can lead to significant functional limitations. Although many patients respond positively to conservative treatment, chronic dislocations often require operative intervention.

Effects of Fisetin Treatment on Cellular Senescence of Various Tissues and Organs of Old Sheep.

Fisetin has been shown to be beneficial for brain injury and age-related brain disease via different mechanisms. The purpose of this study was to determine the presence of senescent cells and the effects of fisetin on cellular senescence in the brain and other vital organs in old sheep, a more translational model. Female sheep 6-7 years old (N = 6) were treated with 100 mg/kg fisetin or vehicle alone on two consecutive days a week for 8 weeks.

Minimum 10-Year Outcomes After Arthroscopic Repair of Partial-Thickness Supraspinatus Rotator Cuff Tears.

Background: The prevalence of partial-thickness rotator cuff tears (PTRCTs) has been reported to be 13% to 40% within the adult population, accounting for 70% of all rotator cuff tears. Approximately 29% of PTRCTs will progress to full-thickness tears if left untreated. The long-term clinical course after arthroscopic repair of PTRCTs is not well known.

Treatment options for massive irreparable rotator cuff tears: a review of arthroscopic surgical options.

While functional reconstruction of massive irreparable rotator cuff tears remains a challenge, current techniques aimed at recentering and preventing superior migration of the humeral head allow for clinical and biomechanical improvements in shoulder pain and function. Recentering of the glenohumeral joint reduces the moment arm and helps the deltoid to recruit more fibers, which compensates for insufficient rotator cuff function and reduces joint pressure. In the past, the concept of a superior capsular reconstruction with a patch secured by suture anchors has been used.

Arthroscopic Posterior Labral Repair and Capsular Closure via Single Working Portal for Posterior Shoulder Instability.

Posterior shoulder instability (PSI) is a relatively less common form of instability that frequently affects young overhead or contact athletes. The etiology of PSI may be traumatic or atraumatic, with establishment of the diagnosis being more difficult in cases of atraumatic instability. Surgical management of PSI has evolved from open techniques to arthroscopic techniques.

Arthroscopic Treatment of Snapping Scapula Syndrome With Scapulothoracic Bursectomy and Partial Scapulectomy.

Snapping scapula syndrome (SSS) is a painful and debilitating condition that occurs as a result of disruption of normal scapulothoracic articulation and inflammation of numerous soft tissue and bursal structures that function to facilitate scapulothoracic motion. Historically, when nonoperative management of SSS failed, patients progressed to open surgical management. However, as arthroscopic techniques have evolved, the condition has been increasingly treated arthroscopically because of the minimally invasive nature, periscapular muscle-preserving approach with decreased risk to surrounding neurovascular structures, better intraoperative visualization, and quicker patient recovery and rehabilitation.

Anatomic safe zones for arthroscopic snapping scapula surgery: quantitative anatomy of the superomedial scapula and associated neurovascular structures and the effects of arm positioning on safety.

Background: Neurovascular anatomy has not been previously quantified for the arthroscopic snapping scapula approach with the patient in the most frequent patient position ("chicken-wing" position). The purposes of this study were (1) to determine anatomic relationships of the superomedial scapula and neurovascular structures at risk during arthroscopic surgical treatment of snapping scapula syndrome (SSS), (2) to compare these measurements between the arm in the neutral position and the arm in the chicken-wing position, and (3) to establish safe zones for arthroscopic treatment of SSS.

Methods: Eight fresh-frozen cadaveric hemi-torsos (mean age, 55.

Editorial Commentary: Current Indications for Lateral Acromioplasty Include Patients With Elevated Critical Shoulder Angle Plus Subacromial Impingement With Rotator Cuff Pathology or Previous Rotator Cuff Repair.

The critical shoulder angle (CSA) reflects the lateral extent of the acromion and the inclination of the glenoid. In 2013, CSA was first introduced and its association with rotator cuff (RC) tears and glenohumeral osteoarthritis (GHOA) was shown. It was speculated that with a high CSA, there was an increased superior force vector from the deltoid and that this superior force led to RC tears.