Total Shoulder Arthroplasty is associated With Less Pain and Better Functional Outcomes, but Humeral Head Resurfacing may be Preferred in Younger, Higher Demand Patients: A Short-Term Outcomes Study in Patients with Glenohumeral Osteoarthritis.

Objectives: This study aimed to compare short-term outcomes following Total Shoulder Arthroplasty (TSA) and Humeral Head Resurfacing (HHR) in patients with glenohumeral osteoarthritis (GHOA).

Methods: A retrospective analysis included patients who had undergone either TSA or HHR for GHOA at a single institution. Baseline demographics, complications, range of motion (active forward flexion, FF and active external rotation, ER), visual analog scores (VAS), and Subjective Shoulder Values (SSV) were collected.

Defining Critical Humeral Bone Loss: Inferior Craniocaudal Hill-Sachs Extension as Predictor of Recurrent Instability After Primary Arthroscopic Bankart Repair.

Background: The glenoid track concept for shoulder instability primarily describes the medial-lateral relationship between a Hill-Sachs lesion and the glenoid. However, the Hill-Sachs position in the craniocaudal dimension has not been thoroughly studied.

Hypothesis: Hill-Sachs lesions with greater inferior extension are associated with increased risk of recurrent instability after primary arthroscopic Bankart repair.

Myotendinous junction tears of the pectoralis major are occurring more frequently and discrepancies exist between intraoperative and radiographic assessments.

Background: Pectoralis major (PM) tears have been shown to occur most frequently at the tendinous humeral insertion. However, no substantial updates on tear location have been published in 20 years or are based on relatively small sample sizes. The primary purpose of this study was to evaluate PM tear location based on magnetic resonance imaging (MRI).

Increased Failure Rates After Arthroscopic Bankart Repair After Second Dislocation Compared to Primary Dislocation With Comparable Clinical Outcomes.

Purpose: The purpose of this study was to compare rates of recurrent dislocation and postsurgical outcomes in patients undergoing arthroscopic Bankart repair for anterior shoulder instability immediately after a first-time traumatic anterior dislocation versus patients who sustained a second dislocation event after initial nonoperative management.

Methods: A retrospective chart review was performed of patients undergoing primary arthroscopic stabilization for anterior shoulder instability without concomitant procedures and minimum 2-year clinical follow-up. Primary outcome was documentation of a recurrent shoulder dislocation.

Distance to Dislocation and Recurrent Shoulder Dislocation After Arthroscopic Bankart Repair: Rethinking the Glenoid Track Concept.

Background: The "distance to dislocation" (DTD) calculation has been proposed as 1 method to predict the risk of recurrent dislocation after arthroscopic Bankart repair for an "on-track" shoulder. Rates of recurrent dislocation at specific DTD values are unknown.

Hypothesis: Among patients with "on-track" shoulder lesions who underwent primary arthroscopic Bankart repair, the rate of recurrent dislocation would increase as DTD values decrease.

Posterior Labral Tear Extension Concomitant With Shoulder Bankart Injuries Is not Uncommon.

Purpose: To identify the rate and risk factors of posterior labral involvement in operatively managed Bankart lesions and assess the effectiveness of MRI arthrogram for preoperative identification of such injury patterns.

Methods: A consecutive cohort of patients undergoing arthroscopic Bankart repair were retrospectively reviewed. All subjects underwent a prearthroscopy MRI arthrogram.

Predictive factors for failure of conservative management in the treatment of calcific tendinitis of the shoulder.

Background: Calcific tendinitis of the shoulder is a painful condition characterized by the presence of calcium deposits within the tendons of the rotator cuff (RTC). When conservative management fails, arthroscopic surgery for removal of the calcium may be considered. Surgical removal is often followed by RTC repair to address the resulting tendon defect.

On-Track Lesions with a Small Distance to Dislocation Are Associated with Failure After Arthroscopic Anterior Shoulder Stabilization.

Background: Off-track lesions are strongly associated with failure after arthroscopic Bankart repair. However, on-track lesions with a small distance-to-dislocation (DTD) value, or "near-track lesions," also may be at risk for failure. The purpose of the present study was to determine the association of DTD with failure after arthroscopic Bankart repair.

Liposomal bupivacaine infiltration in the surgical site for analgesia after rotator cuff repair: a randomized, double-blinded, placebo-controlled trial.

Introduction: Arthroscopic rotator cuff repair is among the most painful of orthopedic surgeries. Liposomal bupivacaine is Food and Drug Administration approved for administration into surgical sites to provide postsurgical analgesia and has been used to address postoperative pain after many types of surgery, including total shoulder arthroplasty. However, its efficacy for pain control after rotator cuff repair is unclear.

Humeral head resurfacing is associated with less pain and clinically equivalent functional outcomes compared with stemmed hemiarthroplasty at mid-term follow-up.

Purpose: Humeral head resurfacing (HHR) is a less invasive, anatomic alternative to the conventional stemmed hemiarthroplasty in patients in whom isolated humeral head replacement is preferred. It was hypothesized that, in a mid-term cross-sectional subjective outcome analysis, HHR would have equivalent patient-reported and functional outcomes to stemmed hemiarthroplasty (HA).

Methods: A total of 213 HHR and 153 HA procedures were performed at a single academic institution from 2000 to 2014.

Preoperative Comorbidities and Postoperative Complications Do Not Influence Patient-Reported Satisfaction Following Humeral Head Resurfacing: Mid- to Long-term Follow-up of 106 Patients.

Background: Humeral head resurfacing (HHR) has emerged as an alternative treatment for glenohumeral osteoarthritis. We investigated the outcomes of HHR using validated patient-reported outcome (PRO) measures.

Methods: A retrospective review was performed on 213 patients who underwent HHR.

The Rotator Cuff Organ: Integrating Developmental Biology, Tissue Engineering, and Surgical Considerations to Treat Chronic Massive Rotator Cuff Tears.

The torn rotator cuff remains a persistent orthopedic challenge, with poor outcomes disproportionately associated with chronic, massive tears. Degenerative changes in the tissues that comprise the rotator cuff organ, including muscle, tendon, and bone, contribute to the poor healing capacity of chronic tears, resulting in poor function and an increased risk for repair failure. Tissue engineering strategies to augment rotator cuff repair have been developed in an effort to improve rotator cuff healing and have focused on three principal aims: (1) immediate mechanical augmentation of the surgical repair, (2) restoration of muscle quality and contractility, and (3) regeneration of native enthesis structure.

The ability of preoperative factors to predict patient-reported disability following surgery for rotator cuff pathology.

Purpose: Minimal research has examined the prognostic ability of shoulder examination data or psychosocial factors in predicting patient-reported disability following surgery for rotator cuff pathology. The purpose of this study was to examine these factors for prognostic value in order to help clinicians and patients understand preoperative factors that impact disability following surgery.

Methods: Sixty-two patients scheduled for subacromial decompression with or without supraspinatus repair were recruited.

A biomechanical analysis of the native coracoclavicular ligaments and their influence on a new reconstruction using a coracoid tunnel and free tendon graft.

Purpose: To understand and characterize the kinematic properties of the 2 coracoclavicular ligaments and to evaluate the biomechanical performance of a new 3-tunnel reconstruction of the coracoclavicular ligaments by use of a free tendon graft.

Methods: Ten fresh-frozen cadaveric shoulders were tested. The kinematics and in situ forces of the coracoclavicular ligaments were tested with a robotic testing system.

Biomechanical evaluation of 2 arthroscopic biceps tenodeses: double-anchor versus percutaneous intra-articular transtendon (PITT) techniques.

Background: Recently, there is increasing interest in different arthroscopic biceps tenodesis techniques. However, little data have been published about the biomechanical properties of soft tissue tenodesis.

Purpose: This study was undertaken to evaluate the biomechanical properties of 2 different arthroscopic biceps tenodeses: the percutaneous intra-articular transtendon (PITT) technique and the suture-anchor technique.

Symptomatic os acromiale.

Os acromiale, the joining of the acromion to the scapular spine by fibrocartilaginous tissue rather than bone, is an anatomic variant that has been reported in approximately 8% of the population worldwide. It is more common in blacks and males than in whites and females. Although it is often an incidental finding, os acromiale has been identified as a contributor to shoulder impingement symptoms and rotator cuff tears.

Arthroscopic biceps tenodesis using the percutaneous, intra-articular trans-tendon technique: preliminary results.

The percutaneous intra-articular trans-tendon procedure relieved pain, increased or maintained strength and function, and did not cause a cosmetic deformity in this small consecutive series of patients.

Biomechanical rationale for development of anatomical reconstructions of coracoclavicular ligaments after complete acromioclavicular joint dislocations.

Background: Surgical treatments of complete acromioclavicular joint dislocations replace or reconstruct the coracoclavicular ligaments with a single structure and do not account for the anatomical variance of each ligament in the design.

Purpose: To evaluate the cyclic behavior and structural properties of an anatomic tendon reconstruction of the coracoclavicular ligament complex after a simulated acromioclavicular joint dislocation.

Study Design: Controlled laboratory study.

Internal impingement: findings on magnetic resonance imaging and arthroscopic evaluation.

Purpose: The purpose of this study was to examine preoperative shoulder magnetic resonance imaging (MRI) and intraoperative arthroscopic findings in throwing athletes with a clinical diagnosis of internal impingement.

Type Of Study: Retrospective review.

Methods: A retrospective review of the surgical indications for 769 shoulder arthroscopic procedures performed from 1997 to 2000 revealed 9 throwing athletes with a diagnosis of severe internal impingement.

Reflexive muscle activation alterations in shoulders with anterior glenohumeral instability.

Background: Patients with glenohumeral instability have proprioceptive deficits that are suggested to contribute to muscle activation alterations.

Hypothesis: Muscle activation alterations will be present in shoulders with anterior glenohumeral instability.

Study Design: Posttest-only control group design.

Biomechanical function of surgical procedures for acromioclavicular joint dislocations.

Purpose: Surgical procedures for treatment of acromioclavicular (AC) joint dislocation replace the coracoclavicular (CC) ligaments to minimize motion, allow scarring, and increase the subsequent stability of the joint. The purpose of this study was to evaluate the biomechanical function of the surgically repaired or reconstructed (CC Sling, Rockwood Screw [DePuy Orthopaedics, Warsaw, IN], and Coracoacromial [CA] Ligament Transfer Construct) AC joint after AC joint dislocation.

Type Of Study: A cadaver study using a convenience sample.

Arthroscopic biceps tenodesis using the percutaneous intra-articular transtendon technique.

Traditional management of end-stage pain and degeneration of the proximal biceps tendon has included open tenodesis of the biceps tendon. Several methods have been described. More recently, however, arthroscopic techniques have been developed.

Viscoelastic behavior and structural properties of the coracoclavicular ligaments.

During contact sports such as football, hockey or rugby, the coracoclavicular ligaments are commonly ruptured. Currently, the limited biomechanical data on the properties and function of these ligaments have led to debate on the "gold standard" treatment for these injuries. Therefore, the objective of this study was to characterize the geometry, viscoelastic behavior and structural properties of the coracoclavicular ligaments (n=11).

Joint compression alters the kinematics and loading patterns of the intact and capsule-transected AC joint.

High compressive loads are transmitted through the shoulder across the acromioclavicular (AC) joint to the axial skeleton during activities of daily living and can lead to early joint degeneration or instability. The objective of this study was to quantify the effect of joint compression on the biomechanics of the intact and capsule-transected AC joint during application of three loading conditions. A robotic/universal force-moment sensor testing system was utilized to apply an anterior, posterior or superior load of 70 N in combination with 10 or 70 N of joint compression to fresh-frozen cadaveric shoulders (n=12).