Intraoperative Electrical Nerve Stimulation as a Prognostic Tool in Patients Undergoing Peripheral Nerve Neurolysis.

Purpose: Functional recovery from peripheral nerve injuries remains unpredictable and continues to pose a major clinical challenge to surgeons. This study sought to investigate the utility of intraoperative nerve stimulation following neurolysis surgery as a prognostic indicator of functional recovery.

Methods: A retrospective chart review of adult patients who underwent peripheral nerve neurolysis between September 2021 and December 2022 was performed.

Reconstruction of the Coracoclavicular Ligament Complex Utilizing an All-Suture Tape Cerclage Technique.

Current techniques for the operative management of acromioclavicular joint separation injuries are plagued by a high rate of postoperative complications. Loss of fixation has been the most difficult challenge to overcome, with a recent meta-analysis finding postoperative subluxation in over 20% of cases. No gold-standard surgical treatment has been established despite over 100 unique procedures having been described in the literature.

Definitional differences in "outpatient" surgery can influence study outcomes related to total shoulder arthroplasty.

Background: Numerous studies have investigated the outcomes of outpatient total shoulder arthroplasty (TSA). However, some patients originally planned for outpatient surgery may unexpectedly require inpatient hospital stay, which can obscure the distinction of "outpatient" and "inpatient" cases. Ultimately, this inconsistent classification of "outpatient" surgery may influence study results.

Outcomes after revision total shoulder arthroplasty with pectoralis major transfer.

Background: Irreparable tears of the subscapularis muscle pose a difficult problem to patients and the treating physician. Pectoralis major transfers (PMTs) are often used in patients with irreparable tears of the subscapularis muscle with good outcomes. Similarly, PMT used in conjunction with shoulder arthroplasty has been proposed for patients with deficient subscapularis muscles and end stage glenohumeral arthritis.

Tendon Inversion Improves Tendon-to-Bone Healing in a Rat Bicep Tenodesis Model.

Purpose: Tendon-to-bone repair remains a surgical challenge. Although bone tunnel fixation is a common surgical technique whereby soft tissue is expected to heal against a bone tunnel interface, contemporary methods have yet to recapitulate biomechanical similarity to the native enthesis. In this study, we aimed to understand how inside-out longitudinal tendon inversion affects bone tunnel healing with the hypothesis that inversion removes the gliding epitenon surface to facilitate interface healing.

Anatomic total shoulder arthroplasty in the 7th decade of life demonstrates superior long-term maintenance than in older patients.

Background: Anatomic total shoulder arthroplasty (aTSA) is often delayed due to concerns about a more rapid loss of postoperative improvements in younger, more active patients. This retrospective study investigated the effects of patient age on activity-specific functional outcomes at a minimum of 10 years following aTSA.

Methods: A retrospective review of a shoulder arthroplasty database was performed.

Demographic and training descriptive analysis of National and American Hockey League team physicians.

Aims/objective: Assess the demographic/education backgrounds of team physicians (TPs) in the National Hockey League (NHL) and American Hockey League (AHL).

Materials/methods: Orthopedic Surgeon (O) and Primary Care (PC) TPs for each NHL and AHL team were recorded based on an internet search. Age, sex, and race were collected.

Reverse shoulder arthroplasty with isolated latissimus-dorsi transfer/additional teres-major transfer for combined loss of elevation and external rotation: A systematic review and meta-analysis.

Background: The relative clinical advantages of reverse shoulder arthroplasty (RSA) with latissimus dorsi transfer (LDT) in direct comparison to RSA with latissimus dorsi and teres major (LD and TM) transfer for the treatment of combined loss of elevation and external rotation (CLEER) are not well understood. The objective of this study was to conduct a systematic review and meta-analysis to compare the two surgeries with regards to (1) preoperative severity/indications, (2) range of motion (ROM) outcomes, (3) functional and patient-reported outcomes (PROs), and (4) complications.

Methods: Following screening of three databases in accordance with PRISMA guidelines, 13 studies were included, consisting of 91 and 115 shoulders having received RSA with LDT and with LD and TM, respectively.

Can ChatGPT reliably answer the most common patient questions regarding total shoulder arthroplasty?

Background: Increasingly, patients are turning to artificial intelligence (AI) programs such as ChatGPT to answer medical questions either before or after consulting a physician. Although ChatGPT's popularity implies its potential in improving patient education, concerns exist regarding the validity of the chatbot's responses. Therefore, the objective of this study was to evaluate the quality and accuracy of ChatGPT's answers to commonly asked patient questions surrounding total shoulder arthroplasty (TSA).

Comparison of analgesic efficacy of continuous perineural catheter, liposomal bupivacaine, and dexamethasone as an adjuvant for interscalene block in total shoulder arthroplasty: a triple-blinded randomized controlled trial.

Background: Interscalene catheters (ISC) are considered as the gold standard for perioperative pain control after total shoulder arthroplasty. Liposomal bupivacaine (LB) for interscalene blocks (ISBs) and the addition of dexamethasone to ISBs have both presented as additional options for extended analgesia. We aimed to compare the efficacy of LB to a single-shot ISB (SISB) with added dexamethasone to an ISC.

Anatomic total shoulder arthroplasty for B2 glenoids treated with asymmetric reaming has equivalent survivorship and patient outcomes compared with type A glenoids at a mean 9-year follow-up.

Background: Walch B2 glenoids can present a challenge to shoulder arthroplasty surgeons. Short-term studies have demonstrated that corrective reaming to 10° of retroversion in anatomic total shoulder arthroplasty (aTSA) can result in good outcomes; however, there is little data reporting the long-term outcomes in this cohort. B2 glenoids treated with high-side reaming present a theoretical risk of early glenoid component failure as one may ream into the subchondral bone.

Glenosphere Size Does Not Matter in Reverse Total Shoulder Arthroplasty.

 There are few studies to date reporting on outcomes following reverse total shoulder arthroplasty with cohorts stratified by glenosphere size. The purpose of this study is to investigate the role that glenosphere size has on postoperative outcomes.  Patients who underwent reverse TSA between 1987 with minimum of 2.

Multimodal pain management and postoperative outcomes in inpatient and outpatient shoulder arthroplasties: a population-based study.

Introduction: Multimodal analgesia has been associated with reduced opioid utilization, opioid-related complications, and improved recovery in various orthopedic surgeries; however, large sample size data is lacking for shoulder surgery.

Methods: A retrospective review using the Premier Healthcare Database of patients who underwent inpatient or outpatient (reverse, total, partial) shoulder arthroplasty from 2010 to 2019. Opioid-only analgesia was compared with multimodal analgesia, categorized into 1, 2, or >2 additional analgesic modes, with/without a nerve block.

Surgical treatment of displaced proximal humerus fractures is associated with decreased 1-year mortality in patients aged 65 years and older: a retrospective study of Medicare patients.

Background: Proximal humerus fracture (PHF) is a risk factor for 1-year mortality. This study aimed to determine if surgery is associated with lower mortality compared to nonoperative treatment following PHF in older patients.

Methods: This retrospective cohort study used the Medicare Limited Data set.

Effect of patient-reported allergies on reverse total shoulder arthroplasty outcomes at over two years follow-up.

Background/aims: Understanding the factors that lead to poor outcomes after reverse total shoulder arthroplasty (rTSA) is important to appropriate patient counseling. While patient-reported allergies (PRAs) have been shown to be associated with poorer outcomes after both TKA and THA, their effect on rTSA outcomes remains unclear. This study investigated the effect of zero, one, and two or more preoperative PRAs on clinical outcomes after rTSA at over two years follow-up in a cohort of fifty-two patients from our institution.

Cemented vs. press-fit humeral stems: a matched cohort analysis at a mean follow-up of 10 years.

Background: Although cementation of humeral stems has long been considered the gold standard for anatomic shoulder arthroplasty (aTSA), cementless, or press-fit, fixation offers a relatively cheaper and less demanding alternative, particularly in the setting of a revision procedure. However, this approach has been accompanied by concerns of implant loosening and high rates of radiolucency. In the present study, we performed a propensity-matched comparison of clinical and patient-reported outcomes between cemented and cementless fixation techniques for aTSA.

Most cited articles involving lacrosse since 1990 primarily focus on concussion and traumatic brain injury.

Objectives: The purpose of this study was to identify the 50 most-cited publications relating to lacrosse since 1990 and conduct a bibliometric analysis of the identified studies.

Methods: Clarivate Analytics Web of Science database was queried to identify all publication titles, abstracts, and keywords for the term 'lacrosse' on 9 June 2023. The resulting articles were sorted by total number of citations.

The 50 most-cited articles in reverse shoulder arthroplasty.

Background: Citation analyses have been used to understand the impact that a group of publications has on its field. As the techniques and indications of reverse total shoulder arthroplasty (RTSA) continue to expand, it is important to identify articles that can orient readers to the history, evolution, and current status of the body of RTSA literature. The purpose of this study was to identify and analyze the 50 most-cited articles related to RTSA.

Impact of Surgeon Case Volume on Outcomes After Reverse Total Shoulder Arthroplasty.

Introduction: Despite a rapid increase in utilization of reverse total shoulder arthroplasty (rTSA), volume-outcome studies focusing on surgeon volume are lacking. Surgeon-specific volume-outcome studies may inform policymakers and provide insight into learning curves and measures of efficiency with greater case volume.

Methods: This retrospective cohort study with longitudinal data included all rTSA cases as recorded in the Centers for Medicare & Medicaid Services Limited Data Set (2016 to 2018).

Improved functional, radiographic and patient-reported outcomes at midterm follow-up for shoulder arthroplasty patients 75 years and older.

Background: Current discussion centers around the appropriateness of shoulder arthroplasty in elderly patients, and whether anatomic and reverse total shoulder arthroplasty yield acceptable results in this population. The purpose of this study was to examine midterm outcomes in patients 75 years and older who underwent either procedure.

Methods: A retrospective review was performed on patients who underwent anatomic total shoulder arthroplasty (aTSA) or reverse total shoulder arthroplasty (rTSA) between 2000 and 2018.

Mid-term outcomes following reverse total shoulder arthroplasty.

Purpose: The utilization of reverse total shoulder arthroplasty now exceeds the incidence of anatomic shoulder arthroplasty. Previous mid-to-long-term studies on rTSA have reported a decrease in shoulder function as follow-up increased. The purpose of this study was to provide data on mid-term outcomes and implant survival in a series focusing on reverse total shoulder arthroplasty.

Impact of tobacco usage on readmission and complication rates following shoulder replacement surgery: A study of 164,527 patients.

Background: Tobacco carcinogens have adverse effects on bone health and are associated with inferior outcomes following orthopedic procedures. The purpose of this study was to assess the impact tobacco use has on readmission and complication rates following shoulder arthroplasty.

Methods: The 2016-2018 National Readmissions Database was queried to identify patients who underwent anatomical, reverse, and hemi-shoulder arthroplasty.

Does humeral fixation technique affect long-term outcomes of total shoulder arthroplasty?

Background: For anatomic total arthroscopic repair, cementless humeral fixation has recently gained popularity. However, few studies have compared clinical, radiographic, and patient-reported outcomes between cemented and press-fit humeral fixation, and none have performed follow-up for longer than 5 years. In this study, we compared long-term postoperative outcomes in patients receiving a cemented versus press-fit humeral stem anatomic arthroscopic repair.

Evaluating the effects of age on the long-term functional outcomes following anatomic total shoulder arthroplasty.

Background: In the past decade, the number of anatomic total shoulder arthroplasty (aTSA) procedures has steadily increased. Patients over 65 years of age comprise the vast majority of recipients, and outcomes have been well documented; however, patients are opting for definitive surgical treatment at younger ages.We aim to report on the effects of age on the long-term clinical outcomes following aTSA.