Instability and the Anatomic Total Shoulder Arthroplasty.

Instability of the anatomic total shoulder arthroplasty is a challenging problem. With an incidence of 1% to 5% reported in the literature, it is critical for shoulder surgeons to understand and be capable of addressing this complication. Etiology is multifactorial and related to soft-tissue imbalance, osseous pathology, implant malposition, or more commonly, a combination of these various causes.

Posterolateral Rotatory Instability Develops Following the Modified Kocher Approach and Does Not Resolve Following Interval Repair.

Background: The modified Kocher and extensor digitorum communis (EDC)-splitting intervals are commonly utilized to approach the lateral elbow. Iatrogenic injury to the lateral ulnar collateral ligament may result in posterolateral rotatory instability (PLRI). in the present cadaveric study, we (1) evaluated lateral elbow stability following the use of these approaches and (2) assessed the accuracy of static lateral elbow radiographs as a diagnostic tool for PLRI.

Comparison of Tip- Versus Hub-Oscillating Saw Blade Control in a Total Knee Arthroplasty Model.

Background: Oscillating saws are commonly used for bone preparation in total knee arthroplasty but can cause injury to the posterior neurovascular bundle during tibial resection. Tip-oscillating saw blades are a recent innovation that could improve saw control due to decreased excursion; however, the tactile feedback to the surgeon is different.

Methods: To compare traditional hub and new tip-oscillating saw blades, 16 participants of varying levels of experience were video-recorded during composite tibial bone model resections to measure posterior saw blade plunge.

Sex-Based Differences in Patient-Reported Outcomes After Arthroscopic Rotator Cuff Repair.

Background: Rotator cuff repair is one of the most common surgical procedures performed on the shoulder. Previous studies have indicated that pain and disability can vary significantly between patients with similarly appearing rotator cuff tears on diagnostic imaging. Prior literature has compared functional outcomes between operative and nonoperative treatments as well as variability in surgical techniques.

Patient Satisfaction With Nonopioid Pain Management Following Arthroscopic Partial Meniscectomy and/or Chondroplasty.

Purpose: To evaluate the efficacy of nonopioid pain medication related to patient satisfaction with postoperative pain and identify potential risk factors for decreased patient satisfaction with nonopioid pain medications.

Methods: This was a prospective study conducted between January 2017 and April 2018 at a single institution. A power analysis was performed a priori, which determined an appropriate cohort size of 163 patients.

Clinical Outcomes Following the Latarjet Procedure in Contact and Collision Athletes.

Background: Few studies have evaluated the success of the Latarjet procedure for recurrent anterior glenohumeral instability in the contact or collision athlete. The purpose of this study was to evaluate the return-to-sport and functional results of the Latarjet procedure in this select group.

Methods: One hundred and nine consecutive contact or collision athletes (112 shoulders) treated with an open Latarjet procedure for recurrent anterior glenohumeral instability were retrospectively identified.

MRI Before Radiography for Patients With New Shoulder Conditions.

Purpose: To assess the patterns of Appropriate Criteria application among orthopedic specialists and other fields of medicine for use of MRI and radiography and the subsequent necessity for surgical intervention.

Methods: The hospital electronic medical record was used to identify all shoulder MRI studies at a single large urban teaching hospital between January 2, 2011, and June 30, 2011. For each study, variables collected included ordering department, patient age, patient gender, patient's self-reported race/ethnicity, whether the patient obtained surgery for an issue related to the MRI diagnosis, the type of MRI ordered, the date of pain onset, the date of x-ray (if any), and the date of the MRI.

The cost effectiveness of vancomycin for preventing infections after shoulder arthroplasty: a break-even analysis.

Background: Increasing methicillin resistance and recognition of Propionibacterium acnes as a cause of infection in shoulder arthroplasty has led to the adoption of local vancomycin powder application as a more effective method to prevent expensive periprosthetic infections. However, no study has analyzed the cost effectiveness of vancomycin powder for preventing infection after shoulder replacement.

Methods: Cost data for infection-related care of 16 patients treated for deep periprosthetic shoulder infection was collected from our institution for the break-even analysis.

Comparison of Glenoid Version and Posterior Humeral Subluxation in Patients With and Without Posterior Shoulder Instability.

Purpose: To evaluate glenoid version and humeral subluxation on preoperative multiplanar imaging of patients who underwent surgery for posterior glenohumeral instability compared with a matched group of patients who had shoulder surgery for other pathology.

Methods: All patients over a 2-year period who underwent surgery for posterior instability had preoperative magnetic resonance (MR) imaging or MR arthrogram reviewed. Patients undergoing shoulder surgery for reasons other than instability were identified as a control group and matched by sex, laterality, and age.

Traumatic full-thickness transtendinous rotator cuff tears: a case series.

Hypothesis: Our purpose was to describe an arthroscopic repair technique for and outcomes of traumatic transtendinous rotator cuff tears affecting the supraspinatus tendon.

Materials And Methods: A retrospective review was performed on a series of patients between January 2009 and January 2012. Demographic data, as well as preoperative and postoperative clinical data including strength, visual analog scale pain score, Subjective Shoulder Value, American Shoulder and Elbow Surgeons score, and Simple Shoulder Test score, were obtained.