Revision rotator cuff repair versus primary repair: an assessment of longitudinal outcomes in revision rotator cuff repair.

Background: Information about outcomes after revision rotator cuff repair (RCR) is limited. A more thorough investigation of pain, range of motion (ROM), strength, and functional outcomes is needed. Comparing outcomes between primary and revision rotator cuff repair patients can help surgeons guide patient expectations of the revision procedure.

Anatomy of the Lateral Antebrachial Cutaneous Nerve: Landmarks for Procedures in the Cubital Fossa.

Purpose: The research outlines anatomical landmarks that may help surgeons in identifying the lateral antebrachial cutaneous nerve (LABCN) to minimize nerve damage during procedures in the cubital fossa.

Methods: Twenty-eight fresh cadaveric upper extremities were dissected. The course of the LABCN was followed from the emerging point at the biceps brachii tendon (BT) to the mid-forearm.

Conjoint tendon lengthening improves internal rotation following reverse total shoulder arthroplasty: a cadaveric study.

Background: Reverse shoulder arthroplasty (RSA) is a common procedure for treating a variety of shoulder pathologies. However, many patients struggle with postoperative internal rotation (IR) deficits, which often hinder their activities of daily living. The conjoint tendon provides an anatomic barrier that can impede the postoperative IR of the shoulder, and this study aims to evaluate the effect of a conjoint tendon lengthening on the glenohumeral range of motion (ROM) following RSA.

Revision reverse shoulder arthroplasty has similar outcomes to primary reverse shoulder arthroplasty at 5 Year average follow-up.

Background: Shoulder arthroplasty is a successful procedure that provides pain relief and improvements in function and range of motion. Anatomic and reverse shoulder arthroplasty are both effective procedures, and their indications continue to expand. We look at the outcomes of revision reverse total shoulder arthroplasty and compare it to the outcomes of primary reverse and anatomic total shoulder arthroplasty.

Biomechanical Comparison of Two Surgical Repair Techniques of the Distal Biceps Tendon.

Purpose: This study aimed to characterize the relationship between the distal biceps tendon force and the supination and flexion rotations during the initiation phase and to compare the functional efficiency of anatomic versus nonanatomic repairs.

Methods: Seven matched pairs of fresh-frozen cadaver arms were dissected to expose the humerus and elbow while preserving the biceps brachii, elbow joint capsule, and distal radioulnar soft tissue complex. For each pair, the distal biceps tendon was severed with a scalpel and then repaired with bone tunnels placed at either the anterior (anatomic) or the posterior (nonanatomic) aspect of the bicipital tuberosity on the proximal radius.

Assessment of 2 distinct anatomical landmarks for suprascapular nerve injection: a cadaveric study.

Background: The suprascapular nerve block (SSNB) is a commonly used procedure for the management of pain in various shoulder pathologies. Both image-guided and landmark-based techniques have been utilized successfully for SSNB, though more consensus is needed regarding the optimal method of administration. This study aims to evaluate the theoretical effectiveness of a SSNB at 2 distinct anatomic landmarks and propose a simple, reliable way of administration for future clinical use.

Reverse shoulder arthroplasty in upper extremity ambulators: a matched-cohort analysis.

Background: Upper extremity ambulators (UEAs) who require prolonged use of assistive devices for mobility have a high incidence of shoulder pathology secondary to increased stress across the shoulder joint with upper extremity weight-bearing. Reverse shoulder arthroplasty (RSA) for rotator cuff arthropathy has historically been associated with increased complications in UEA, but more recent studies have shown more promising outcomes. The objective of this study is to evaluate clinical outcomes and complication rates between these 2 groups to define the relative risk of RSA in the UEA population and identify opportunities to improve treatment outcomes.

Is the radial groove a myth? Is the radial nerve in direct contact with the posterior humerus?

Background: The radial groove is known as a sulcus on the posterior humerus and protects the radial nerve from adjacent muscle and soft tissue. In the literature, there exists heterogeneity regarding the presence of an actual radial groove and the radial nerve's interaction with the periosteum of the humerus. This study aimed to determine if there is a real radial groove, "sulcus," and define the relationship between the radial nerve and the periosteum of the posterior humerus.

Rotator cuff repair in upper extremity ambulators: an assessment of longitudinal outcomes.

Background: Individuals who rely on wheelchairs, walkers, and crutches for ambulation have an increased incidence of rotator cuff tears due to altered shoulder biomechanics and increased force transmission across the shoulder joint. The purpose of our study is to review our longitudinal outcomes treating upper extremity ambulators to guide patient expectations and identify risk factors for rotator cuff repair failure.

Methods: A total of fifteen patients were included after a cohort of thirty-nine patients were identified.

Entrapment of the Extensor Indicis Proprius Tendon after Open Reduction and Internal Fixation of Distal Ulna: Case Report and Discussion of the Diagnosis and Surgical Result.

Entrapment of the extensor indicis proprius (EIP) after open reduction and internal fixation (ORIF) of the distal ulna with a plate and screw construct is rare. By literature review, we found evidence of such complication associated with distal radius fracture, but no past reports relating to the distal ulna. ORIF of the distal ulna is a common procedure for both fracture treatment and deformity correction.

Shoulder complex kinematics pre- and post- rotator cuff repair.

This study investigated shoulder complex joint kinematics and functional outcomes before and after full-thickness supraspinatus rotator cuff repair. Nine adults (mean age 63.4 ± 6.

Influence of preoperative opioid use on postoperative outcomes and opioid use after arthroscopic rotator cuff repair.

Background: Recent orthopedic research has questioned the effect of opioid use on surgical outcomes. This study investigated this in the context of arthroscopic rotator cuff repair. We hypothesized that preoperative opioid use would be associated with inferior outcomes and greater postoperative opioid requirements.

Outcomes of shoulder replacement in humeral head avascular necrosis.

Background: This retrospective review evaluated 25 patients with 29 shoulders treated with arthroplasty for humeral head avascular necrosis (HHAVN) between 2004 and 2015. We hypothesized that regardless of implant, radiographic stage, or etiology, patients would appreciate significant improvement in pain, range of motion, and shoulder functionality after surgical intervention.

Methods: Data were obtained by record review on all patients meeting inclusion criteria.

Pre-operative corticosteroid injections improve functional outcomes in patients undergoing arthroscopic repair of high-grade partial-thickness rotator cuff tears.

Background: Subacromial corticosteroid injections (CSI's) are a common non-surgical treatment for rotator cuff tears. Few studies have assessed the effects of pre-operative CSI's on postoperative functional outcomes.

Methods: A retrospective analysis was conducted of 132 patients with high-grade, partial-thickness rotator cuff tears (PTRCT's).

Assessment of Kinematics and Electromyography Following Arthroscopic Single-Tendon Rotator Cuff Repair.

Background: The increasing demand for rotator cuff (RC) repair patients to return to work as soon as they are physically able has led to exploration of when this is feasible. Current guidelines from our orthopedic surgery clinic recommend a return to work at 9 weeks postoperation. To more fully define capacity to return to work, the current study was conducted using a unique series of quantitative tools.

High-Grade Articular, Bursal, and Intratendinous Partial-Thickness Rotator Cuff Tears: A Retrospective Study Comparing Functional Outcomes After Completion and Repair.

We conducted a study to assess the impact of tear location on functional outcomes in high-grade partial-thickness rotator cuff tears (PTRCTs) after arthroscopic completion and repair. Retrospectively, we evaluated the preoperative and postoperative findings of 60 patients who underwent arthroscopic completion and repair of Ellman grade 3 partial-thickness tears of the supraspinatus. The 60 patients were grouped by tear subtype (20 articular, 20 bursal, 20 intratendinous) as identified by preoperative imaging and confirmed at time of surgery.

Ultrasound Imaging Improves Identification of Prominent Hardware in the Surgical Treatment of Distal Radius Fractures: A Cadaveric and Prospective Clinical Study.

Background Volarly applied locking plates are one of several current treatment options for displaced fractures of the distal radius. Presently, surgeons use intraoperative depth gauges and fluoroscopy to select and confirm proper screw length. The contour of the dorsal cortex beneath the extensor compartments along with fracture comminution may limit the accuracy of screw length selection.

The "Thumbs-up" sign and trapeziometacarpal joint injection: a useful clinical indicator.

Background: Several clinical studies investigating the accuracy and efficacy of trapeziometacarpal injection exist. Some studies utilize anatomical landmarks for proper injection placement while others utilize modalities including ultrasound and fluoroscopy. The changes of limb position that occur at the time of intra-articular injection can provide valuable visual and tactile feedback to the clinician.

Biomechanical evaluation of locking plate radial shaft fixation: unicortical locking fixation versus mixed bicortical and unicortical fixation in a sawbone model.

Purpose: Compression plating is a commonly accepted technique for treating diaphyseal forearm fractures. The purpose of this study was to evaluate the stabilizing effects of two hybrid fixations that replace the end screws of a locked unicortical fixation with bicortical (locked or unlocked) screws and to compare these hybrid fixations to an unlocked bicortical fixation.

Methods: Sixteen composite radius sawbones were equally divided into 4 groups.

Biomechanical comparison of fixed-angle volar plate versus fixed-angle volar plate plus fragment-specific fixation in a cadaveric distal radius fracture model.

Purpose: To test the hypothesis that combining orthogonal fragment-specific fixation with volar fixed-angle fixation provides markedly higher interfragment stability and construct strength compared with volar fixed-angle fixation alone.

Methods: Eight matched pairs of fresh cadaveric hand and forearm specimens were potted upright in cement. Flexor and extensor tendons were isolated at insertion sites and sutured into a looped bundle for loading in flexion and extension, respectively (up to 61 N).