Tenascin C deletion impairs tendon healing and functional recovery after rotator cuff repair.

The biological factors that affect healing after rotator cuff repair (RCR) are not well understood. Genetic variants in the extracellular matrix protein Tenascin C (TNC) are associated with impaired tendon healing and it is expressed in rotator cuff tendon tissue after injury, suggesting it may have a role in the repair process. The purpose of the current study was to determine the role of TNC on tendon healing after RCR in a murine model.

Isolated humeral distalization in reverse total shoulder arthroplasty: a biorobotic shoulder simulator study.

Background: Humeral distalization is inherent to reverse total shoulder arthroplasty (rTSA) and is often produced with concomitant humeral lateralization via the level of the humeral head cut, implant positioning, implant neck shaft angle, and polymer insert thickness. Biomechanical data on the isolated effects of humeral distalization remain limited but could be important to consider when optimizing postoperative rTSA shoulder function. This study investigated the effects of isolated humeral distalization on shoulder biomechanics using a biorobotic shoulder simulator.

Editorial Commentary: Shoulder Minimal Clinically Important Difference and Patient Acceptable Symptomatic State Metrics Provide a Foundation for Interpreting Patient-Reported Outcomes.

Limited data have been previously published on the minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) after the treatment of shoulder instability. The MCID and PASS are useful in understanding how well one treatment performs against another and whether the differences in outcomes between treatments are clinically important to patients, supporting either treatment, performing power calculations for clinical studies and trials, and making an assessment as to whether a patient's final clinical state after treatment is reasonable. Anchor-based and distribution methods of MCID calculation have been performed for a variety of patient-reported outcome measures after the treatment of shoulder instability.

Patient, imaging, and surgical factors associated with supraspinatus re-tear pattern after rotator cuff repair.

Background: This study aimed to characterize patient, imaging, and surgical factors associated with re-tear patterns after rotator cuff repair, as well as to identify predictors of type 2 failure in a large patient cohort.

Methods: A retrospective case-control study was performed at a single urban academic institution. All patients who underwent an arthroscopic rotator cuff repair by 2 fellowship-trained shoulder and elbow surgeons between 2005 and 2022 and were subsequently found to have a symptomatic re-tear on magnetic resonance imaging were included.

Identification of rare genetic variants for rotator cuff tearing and repair in high-risk pedigrees.

Background: Common genetic variants with small effect sizes have been associated with rotator cuff tearing although very few rare, highly penetrant variants have been identified. The purpose of this pilot study was to identify dominant coding variants that segregated with affected individuals in pedigrees at high risk for rotator cuff tears (RCTs). We hypothesize that rare variants contribute to symptomatic RCTs and that they can be identified in related cases with a full-thickness tear requiring surgical management.

A transitional pain management program is associated with reduced opioid dependence after major shoulder surgery.

Background: Overprescription of opioids in the United States increases risks of opioid dependence, overdose, and death. Increased perioperative and postoperative opioid use during orthopedic shoulder surgery is a significant risk factor for long-term opioid dependence. The authors hypothesized that a multidisciplinary perioperative pain management program (Transitional Pain Service [TPS]) for major shoulder surgery would lead to a reduced amount of opioids required postoperatively.

Comparison of 3D computer-assisted planning with and without patient-specific instrumentation for severe bone defects in reverse total shoulder arthroplasty.

Background: Preoperative planning is an integral aspect of managing complex deformity in reverse shoulder arthroplasty (RSA). The purpose of this study was to compare the success of patient-specific instrumentation (PSI) and 3D computer-assisted planning with standard instrumentation (non-PSI) in achieving planned corrections of the glenoid among patients undergoing RSA with severe bony deformity requiring glenoid bone grafts.

Methods: A retrospective case-control study was performed, including all patients that underwent RSA with combined bone grafting procedures (BIO-RSA or structural bone grafting) for severe glenoid deformity by a single study between June 2016 and July 2023.

Hydrogen Peroxide May Reduce the Risk for Revision Surgery and Infection in Primary Shoulder Arthroplasty: Two-year Follow-up From a Prospective, Blinded, Controlled Trial.

Background: The purpose of this study was to determine whether the addition of hydrogen peroxide to the preoperative skin preparation for primary total shoulder arthroplasty is associated with a difference in patient-reported outcomes, risk for postoperative infection, and risk for revision surgery at a minimum of 2-year follow-up.

Methods: This was a prospective, blinded, and controlled trial, which included a consecutive series of patients undergoing primary shoulder arthroplasty. The control group underwent standard sterile skin preparation using ethyl alcohol and ChloraPrep applicators, and the peroxide group had the same preparation with the addition of hydrogen peroxide between the alcohol and ChloraPrep applications.

The effect of lateralization and distalization after Grammont-style reverse total shoulder arthroplasty.

Background: The purpose of this study was to evaluate the relationship between multiple radiographic measures of lateralization and distalization and clinical outcome scores after a reverse total shoulder arthroplasty (RTSA).

Methods: We retrospectively evaluated all RTSAs performed by the senior author between January 1, 2007, and November 1, 2017. We then evaluated the visual analog scale for pain (VAS pain), Simple Shoulder Test (SST), and American Shoulder and Elbow Surgeons (ASES) scores and complication and reoperation rates at a minimum of 2-year follow-up.

Three-month Delay in Rotator Cuff Repair: 2-year Follow-up.

Introduction: This study examined 2-year outcomes of patients who underwent delayed rotator cuff repair (RCR) compared with those who underwent RCR without delay.

Methods: In this prospective comparative study, two groups were formed: (1) patients planning RCR during a 6-week elective surgery ban and (2) patients undergoing RCR at least 6 weeks after the ban. The Simple Shoulder Test, American Shoulder and Elbow Surgeon score, and visual analog scale for pain were collected preoperatively and at 2 years postoperatively.

Biomechanical comparison of suture bridge rotator cuff repair with and without dermal allograft pledgets.

Background: One method to augment rotator cuff repair is to pass dermal allograft pledgets along the sutures that bridge from the medial to the lateral row. It remains unclear whether this augmentation method alters repair biomechanics.

Methods: This was a controlled laboratory study.

Common Complication From Routine Shoulder Surgery: Postoperative Stiffness After Rotator Cuff Repair.

Rotator cuff repair is commonly performed, and stiffness represents one of the most common complications. Unique characteristics of postoperative stiffness, including its natural history and pathoanatomy, differentiate it from other etiologies of shoulder stiffness. Patient risk factors that have been associated with postoperative stiffness should be reviewed to better help clinicians tailor their presurgical risk assessment.

Inlay vs. onlay humeral components in reverse total shoulder arthroplasty: a biorobotic shoulder simulator study.

Background: Both inlay and onlay humeral implants are available for reverse total shoulder arthroplasty (rTSA), but biomechanical data comparing these components remain limited. This study investigated the effects of inlay and onlay rTSA humeral components on shoulder biomechanics using a biorobotic shoulder simulator.

Methods: Twenty fresh-frozen cadaveric shoulders were tested before and after rTSA with either an inlay or onlay humeral implant.

Preoperative Planning Software Does Not Accurately Predict Range of Motion in Reverse Total Shoulder Arthroplasty.

Background: The purpose of this study was to determine whether preoperative planning software (PPS) accurately predicts clinical range of motion (ROM) in patients with reverse total shoulder arthroplasty 1 year postoperatively with preoperative and postoperative computed tomography (CT) scans.

Methods: This was a retrospective study of 16 reverse total shoulder arthroplasty patients with preoperative and postoperative (CT) scans obtained at least 1 year postoperatively. Clinical ROM was measured in abduction, external rotation at resting abduction, extension, and flexion at a minimum of 1 year postoperatively.

Estrogen and testosterone supplementation improves tendon healing and functional recovery after rotator cuff repair.

Failure of healing after rotator cuff repair (RCR) is common. The purpose of the current study was to evaluate the effect of systemic estrogen or testosterone supplementation on tendon healing after RCR. Seventy-two adult male mice were utilized for all experiments.

Revision Subpectoral Biceps Tenodesis Demonstrates a High Patient Satisfaction and Good Functional Outcomes.

Purpose: To clinically evaluate a subset of patients who underwent a revision subpectoral biceps tenodesis for a clinically failed proximal biceps tenodesis.

Methods: This is a retrospective case series of patients with at least 2-year follow-up who had undergone a revision biceps tenodesis after clinical failure of a proximal biceps tenodesis between January 2008 and February 2020 by a single surgeon. Patients who underwent concomitant procedures, such as revision cuff repair, were excluded.

Progression of symptomatic bilateral rotator cuff disease.

Background: Prior studies have demonstrated that conservatively treated rotator cuff tears and rotator cuff tendinopathy may continue to progress. It is unclear whether that rate of progression differs between sides in patients with bilateral disease. This study evaluated the likelihood of progression of rotator cuff disease as confirmed via magnetic resonance imaging (MRI) in individuals with symptomatic bilateral pathology, treated conservatively for a minimum of 1 year.

Abnormal Laboratory Values for Metabolic and Hormonal Syndromes Are Prevalent Among Patients Undergoing Rotator Cuff Repair.

Purpose: To determine the prevalence of systemic laboratory abnormalities among patients undergoing rotator cuff repair (RCR).

Methods: Patients who underwent RCR at the authors' institution for 1 year between October 2021 to September 2022 were retrospectively identified. Preoperative laboratory values, including serum sex hormones, vitamin D, hemoglobin A1C, and a lipid panel, were obtained as part of our routine practice during the study period.

Arthroscopic scapulothoracic bursectomy with and without superomedial angle scapuloplasty: a comparison of patient-reported outcomes.

Background: Operative treatment of scapulothoracic bursitis most commonly comprises arthroscopic scapulothoracic bursectomy with or without partial superomedial angle scapuloplasty. There is currently no consensus regarding whether or when scapuloplasty should be performed. Prior studies are limited to small case series, and optimal surgical indications are not yet established.

Adhesive Capsulitis.

Adhesive capsulitis, colloquially known as "frozen shoulder," is a relatively common disorder, affecting approximately 2% to 5% of the general population. The incidence may be higher as the condition can be relatively mild and self-limited and thus many patients who experience it may never present for treatment. It involves a pathologic process of gradual fibrosis of the glenohumeral joint that leads to limited active and passive range of motion, contracture of the joint capsule, and shoulder pain.