Good functional outcome but high rates of instability recurrence after posterior open-wedge glenoid osteotomy for the treatment of posterior shoulder instability with increased glenoid retroversion at mid-term follow-up.

Purpose: To evaluate clinical, functional and radiological mid-term outcomes following posterior open-wedge glenoid osteotomy (POWGO) for the treatment of posterior shoulder instability (PSI) associated with increased glenoid retroversion.

Methods: Patients who underwent POWGO for the treatment of symptomatic PSI with glenoid retroversion >10° and participated in a previous study assessing short-term outcomes were included after a minimum follow-up of 5 years. Clinical (Rowe score and physical examination) and functional outcomes (Oxford Shoulder Instability Score [OSIS] and visual analogue scale [VAS] for pain) were assessed.

Glenolabral Articular Disruption (GLAD) Is Not Associated with Worse Outcomes or Higher Instability Recurrence after Arthroscopic Bankart Repair-A Matched-Pair Analysis.

This study aimed to compare clinical outcomes and recurrence of instability after arthroscopic Bankart repair (ABR) in patients with anterior shoulder instability, with and without a GLAD lesion, while distinguishing between primary and recurrent instability. Consecutive patients who underwent isolated ABR between January 2012 and December 2021 were included. Patients with a concomitant GLAD lesion were matched in with patients without a GLAD lesion according to the following criteria: age, sex, BMI, follow-up time, and primary versus recurrent instability.

Demographic-, Radiographic-, and Surgery-Related Factors Do Not Affect Functional Internal Rotation Following Reverse Total Shoulder Arthroplasty: A Retrospective Comparative Study.

Purpose: This study aimed to identify the demographic-, radiographic-, and surgery-related factors influencing postoperative functional internal rotation (fIR) following reverse total shoulder arthroplasty (RTSA).

Methods: In this retrospective cohort study, patients who underwent RTSA between June 2013 and April 2018 at a single institution were assigned to two groups ("IROgood" or "IRObad"). Patients were classified as having good fIR (≥8 points in the Constant-Murley score (CS) and fIR to the twelfth thoracic vertebra or higher) or poor fIR (≤2 points in the CS and fIR to the twelfth thoracic vertebra or lower) after RTSA with a single implant model.

Superior Capsular Reconstruction Using an Acellular Dermal Xenograft or Allograft Improves Shoulder Function but Is Associated with a High Graft Failure Rate.

The purpose of the present study was to evaluate clinical and functional outcomes, graft integrity rate and progression of osteoarthritis after superior capsular reconstruction (SCR) at short-term follow-up. Consecutive patients that underwent SCR using an acellular dermal xeno- or allograft between May 2018 and June 2020 for the treatment of irreparable posterosuperior rotator cuff tears were included. Shoulder function (American Shoulder and Elbow Surgeons [ASES] score), pain (Visual Analog Scale [VAS] for pain) and active shoulder range of motion (ROM) were evaluated preoperatively and after a minimum of 24 months postoperatively.

Intact revision rotator cuff repair stabilizes muscle atrophy and fatty infiltration after minimum follow up of two years.

Background: The extent of fatty infiltration and rotator cuff (RC) atrophy is crucial for the clinical results after rotator cuff repair (RCR). The purpose of this study was to evaluate changes in fatty infiltration and RC atrophy after revision RCR and to correlate them with functional outcome parameters.

Methods: Patients who underwent arthroscopic revision RCR for symptomatic recurrent full-thickness tear of the supraspinatus tendon between 2008 and 2014 and were retrospectively reviewed with a minimum follow up of 2 years.

Physiological Tensioning During Lower Trapezius Transfer for Irreparable Posterosuperior Rotator Cuff Tears May Be Important for Improvement in Shoulder Kinematics.

Background: Lower trapezius transfer (LTT) has been proposed for restoring the anteroposterior muscular force couple in the setting of an irreparable posterosuperior rotator cuff tear (PSRCT). Adequate graft tensioning during surgery may be a factor critical for sufficient restoration of shoulder kinematics and functional improvement.

Purpose/hypothesis: The purpose was to evaluate the effect of tensioning during LTT on glenohumeral kinematics using a dynamic shoulder model.

Superior Capsular Reconstruction Partially Restores Native Glenohumeral Joint Loads in a Dynamic Biomechanical Shoulder Model.

Purpose: To evaluate the effect of an irreparable posterosuperior rotator cuff tear (PSRCT) on glenohumeral joint loads and to quantify improvement after superior capsular reconstruction (SCR) using an acellular dermal allograft.

Methods: Ten fresh-frozen cadaveric shoulders were tested using a validated dynamic shoulder simulator. A pressure mapping sensor was placed between the humeral head and glenoid surface.

Management of Irreparable Posterosuperior Rotator Cuff Tears-A Current Concepts Review and Proposed Treatment Algorithm by the AGA Shoulder Committee.

Posterosuperior rotator cuff tears range among the most common causes of shoulder complaints. While non-operative treatment is typically reserved for the elderly patient with low functional demands, surgical treatment is considered the gold standard for active patients. More precisely, an anatomic rotator cuff repair (RCR) is considered the most desirable treatment option and should be generally attempted during surgery.

A shallow morphology of the intertubercular groove is associated with medial and bilateral but not lateral pulley lesions.

Purpose: To investigate the influence of intertubercular groove (IG) morphology on the development of different types of biceps reflection pulley (BRP) injuries.

Methods: A consecutive cohort of 221 patients with ventral shoulder pain and a preoperative diagnosis suspecting BRP injury, who underwent arthroscopy, was retrospectively reviewed. The presence or absence as well as type of pulley injury (medial, lateral or bilateral) was confirmed arthroscopically.

Current concepts in acromioclavicular joint (AC) instability - a proposed treatment algorithm for acute and chronic AC-joint surgery.

Background: There exists a vast number of surgical treatment options for acromioclavicular (AC) joint injuries, and the current literature has yet to determine an equivocally superior treatment. AC joint repair has a long history and dates back to the beginning of the twentieth century.

Main Body: Since then, over 150 different techniques have been described, covering open and closed techniques.

A 3-Dimensional Classification for Degenerative Glenohumeral Arthritis Based on Humeroscapular Alignment.

Background: Seminal classifications of degenerative arthritis of the shoulder (DAS) describe either cuff tear arthropathy in the coronal plane or primary osteoarthritis in the cross-sectional plane. None consider a biplanar eccentricity.

Purpose/hypothesis: The purpose of this study was to investigate humeroscapular alignment (HSA) of patients with DAS in both the anteroposterior (A-P) and superoinferior (S-I) planes on computed tomography (CT) after 3-dimensional (3D) reconstruction and develop a classification based on biplanar HSA in 9 quadrants.

The Morphology of the Acromioclavicular Joint Does Not Influence the Postoperative Outcome Following Acute Stabilization-A Case Series of 81 Patients.

Purpose: To specifically evaluate the influence of the acromioclavicular (AC)-joint morphology on the outcome after arthroscopically assisted coracoclavicular (CC) stabilization surgery with suspensory fixation systems and to investigate whether an additional open AC-joint reduction and AC cerclage improves the clinical outcome for patients with certain morphologic AC-joint subtypes.

Methods: Patients with an acute acromioclavicular joint injury, who underwent arthroscopically assisted CC stabilization with suspensory fixation systems with or without concomitant AC cerclage between January 2009 and June 2017 were identified and included in this retrospective cohort analysis. AC-joint morphology was assessed on preoperative radiographs and categorized as "flat" or "non-flat" ("oblique"/"curved") subtypes.

Biomechanical comparison of lower trapezius and latissimus dorsi transfer for irreparable posterosuperior rotator cuff tears using a dynamic shoulder model.

Background: In the setting of irreparable posterosuperior rotator cuff tears (PSRCTs), lower trapezius transfer (LTT) may be anatomically better positioned for restoring the muscular force couple compared with latissimus dorsi transfer (LDT). The purpose of the study was to evaluate the effect of LTT and LDT on glenohumeral kinematics using a dynamic shoulder model.

Methods: Ten fresh-frozen cadaveric shoulders (mean age: 56.

Low rate of substantial loss of reduction immediately after hardware removal following acromioclavicular joint stabilization using a suspensory fixation system.

Purpose: To evaluate immediate loss of reduction in patients undergoing hardware removal after arthroscopically assisted acromioclavicular (AC) joint stabilization using a high-tensile suture tape suspensory fixation system and to identify risk factors associated with immediate loss of reduction.

Materials And Methods: Twenty-two consecutive patients with a mean age of 36.4 ± 12.

Influence of sportive activity on functional and radiographic outcomes following reverse total shoulder arthroplasty: a comparative study.

Background: The purpose of the present study was to compare the functional and radiographic outcomes following reverse total shoulder arthroplasty (RTSA) in a senior athletic and non-athletic population.

Material And Methods: In this retrospective cohort study, patients who underwent RTSA between 06/2013 and 04/2018 at a single institution were included. Minimum follow-up was 2 years.

[Arthroscopic superior capsule reconstruction using a 6 mm thick acellular dermal allograft for irreparable posterosuperior rotator cuff tears].

Objective: Implantation of an acellular dermal allograft between glenoid and humerus to restore a stable glenohumeral center of rotation in cases of irreparable posterosuperior rotator cuff tears.

Indications: Irreparable posterosuperior rotator cuff tears with low-grade cuff tear arthropathy (Hamada grade 1 and 2) and isolated pseudoparesis for flexion.

Contraindications: Absolute: Infection, nerve lesions (brachial plexus, axillary nerve), concomitant irreparable subscapularis tendon tear, anterosuperior subluxation of the humeral head ("anterosuperior escape").

Minimum 10-Year Clinical Outcomes After Arthroscopic 270° Labral Repair in Traumatic Shoulder Instability Involving Anterior, Inferior, and Posterior Labral Injury.

Background: Current literature reports highly satisfactory short- and midterm clinical outcomes in patients with arthroscopic 270° labral tear repairs. However, data remain limited on long-term clinical outcomes and complication and redislocation rates in patients with traumatic shoulder instability involving anterior, inferior, and posterior labral injury.

Purpose: To investigate, at a minimum follow-up of 10 years, the clinical outcomes, complications, and recurrent instability in patients with 270° labral tears involving the anterior, inferior, and posterior labrum treated with arthroscopic stabilization using suture anchors.

Reliable Clinical and Sonographic Outcomes of Subpectoral Biceps Tenodesis Using an All-Suture Anchor Onlay Technique.

Purpose: To evaluate the clinical outcomes and structural integrity of primary subpectoral biceps tenodesis using an all-suture anchor onlay technique for long head of the biceps (LHB) tendon pathology.

Methods: We conducted a retrospective case series with prospectively collected data of patients who underwent primary, isolated subpectoral biceps tenodesis with a single all-suture anchor onlay fixation between March 2017 and March 2019. Outcomes were recorded at a minimum follow-up of 12 months based on assessments of the American Shoulder and Elbow Surgeons (ASES) score, LHB score, and elbow flexion strength and supination strength measurements.

Biconcave glenoids show 3 differently oriented posterior erosion patterns.

Background: Posterior glenoid wear remains a challenge in anatomic and reverse total shoulder arthroplasty (rTSA) because of an asymmetric erosion with altered retroversion. The purpose of this study was to assess glenoid morphology and evaluate the influence of acromial orientation in posterior glenoid erosion patterns by using 3-dimensional (3D) models.

Material And Methods: Computed tomographic (CT) shoulder scans from 3 study centers of patients awaiting rTSA between 2017 and 2018 were converted into 3D models and analyzed by 2 observers.

LUCL reconstruction of the elbow: clinical midterm results based on the underlying pathogenesis.

Purpose: Traumatic and atraumatic insufficiency of the lateral ulnar collateral ligament (LUCL) can cause posterolateral rotatory instability (PLRI) of the elbow. The influence of the underlying pathogenesis on functional outcomes remains unknown so far. The objective of this study was to determine the impact of the initial pathogenesis of PLRI on clinical outcomes after LUCL reconstruction using an ipsilateral triceps tendon autograft.

Comparison of Different Fixation Techniques of the Long Head of the Biceps Tendon in Superior Capsule Reconstruction for Irreparable Posterosuperior Rotator Cuff Tears: A Dynamic Biomechanical Evaluation.

Background: In the past decade, superior capsular reconstruction has emerged as a potential surgical approach in young patients with irreparable posterosuperior rotator cuff tears (RCT) and absence of severe degenerative changes. Recently, the use of locally available and biological viable autografts, such as the long head of the biceps tendon (LHBT) for SCR has emerged, with promising early results.

Purpose/hypothesis: The purpose of this study was to investigate the effect of using the LHBT for reconstruction of the superior capsule on shoulder kinematics, along with different fixation constructs in a dynamic biomechanical model.

[Irreparable rotator cuff tear-reverse shoulder arthroplasty and alternative procedures].

Irreparable rotator cuff tears represent a significant everyday clinical challenge. A high degree of tendon retraction and muscle degeneration means that a direct reconstruction is impossible. Patients often suffer from pain and pseudoparalysis.