Long head of biceps tendon autograft is effective in the management of large to massive rotator cuff tear: a systematic review.

Purpose: The aim of this systematic review is to review the functional, clinical and radiological outcomes of patients undergoing large to massive rotator cuff repair with long head of biceps tendon (LHBT) autograft, as well as compare these to standard arthroscopic cuff repair.

Methods: A review of the online Medline database was conducted on 20 October 2022 according to PRISMA guidelines and registered prospectively on the PROSPERO database. Clinical studies assessing patients with large to massive rotator cuff tears undergoing LHBT autograft repair were included.

Are displaced distal clavicle fractures associated with inferior clinical outcomes following nonoperative management? A systematic review.

Background: Management of displaced distal clavicle fractures remains a topic of discussion because of notoriously high nonunion rates, but there is little documented in the literature as to what effect this may have on patient-reported function. The aim of this systematic review was to look at nonoperative management following displaced distal clavicle fractures to determine union rates, complications, and patient-reported outcome measures.

Methods: A review of the online databases MEDLINE and Embase was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.

Arthroscopic superior capsular reconstruction with dermal allograft for primary and recurrent rotator cuff tears.

Background: The aim of this study was to compare the clinical outcomes and retear rate of arthroscopic superior capsular reconstruction (SCR) with dermal allograft following structural failure of a previous rotator cuff repair, with a cohort of primary SCRs.

Methods: This was a retrospective comparative study with a study group comprising 22 patients who were followed up at a minimum of 24 (mean, 41; range, 27-65) months after SCR with dermal allograft performed for structural failure of a previous rotator cuff repair. The control group included 13 patients who previously underwent a primary SCR using dermal allograft and were followed up for 24 months.

Two cases of sternoclavicular joint replacement arthroplasty: A case report. A novel prosthesis and surgical technique for recalcitrant instability, arthropathy of the sternoclavicular joint with medial clavicular bone loss.

Instability arthropathy of the sternoclavicular joint is most commonly managed by rehabilitation, injection, and either arthroscopic or open debridement with or without interposition arthroplasty. When these options fail to achieve symptom relief, excision arthroplasty is an option. This is associated with a risk of persistent instability and incomplete pain relief.

Graft Healing Is More Important Than Graft Technique: Superior Capsular Reconstruction Versus Bridging Grafts-A Prospective Randomized Controlled Trial.

Purpose: To compare superior capsular reconstruction (SCR) versus bridging graft (BG) for massive irreparable rotator cuff tears (RCTs).

Methods: A prospective double-blind randomized study was conducted to compare SCR versus BG for massive irreparable RCTs. Fifty patients (mean age: 60.

Arthroscopic revision rotator cuff repair of large and massive retears using an interpositional bridging dermal allograft.

Background: The purpose of this study was to report the clinical outcomes and retear rate following arthroscopic interpositional bridging dermal allograft for revision rotator cuff repair of large and massive retears.

Methods: Twenty-three patients were retrospectively reviewed at a minimum follow-up of 24 (mean, 47; range, 24-77) months after revision rotator cuff repair using an interpositional bridging dermal allograft. There were 17 males and 6 females with a mean age of 56 (range, 40-74) years.

Arthroscopic Anterior Glenoid Reconstruction Using a Distal Tibial Allograft Positioned With an Intra-Articular Guide and Secured With Double-Button Fixation.

Recurrent shoulder instability and its role in bone loss from the anterior glenoid is well recognized throughout the literature. This technique paper presents an all-arthroscopic technique that uses distal tibial allograft and double-button suture fixation to address anterior recurrent shoulder instability. With the patient in the lateral decubitus position, we use the posterior portal to position the double-barrel drill guide tangential to the face of the glenoid, while viewing through the anterosuperolateral portal.

Isolated Bioinductive Arthroscopic Repair of Partial-Thickness Rotator Cuff Tears Using a Resorbable Collagen Implant.

Unlabelled: Over 300,000 rotator cuff repairs are performed annually in the United States, where the annual financial burden of managing shoulder pain has been estimated to be $3 billion. Despite advances in surgical techniques, retear rates range from 39% to 94%. Partial-thickness tears are approximately twice as common as full-thickness tears and can lead to considerable pain and loss of function.

Optimal Management of Partial Thickness Rotator Cuff Tears: Clinical Considerations and Practical Management.

Partial thickness rotator cuff tears have been diagnosed with increased frequency due to heightened awareness and an improvement in diagnostic modalities. When >50% of the tendon thickness has ruptured, intra-tendinous strain of the residual tendon increases. Surgery is generally confined to patients who have failed non-operative measures and have persistent symptoms.

Management of the failed rotator cuff repair.

Rotator cuff repair is increasingly being performed, and this is likely to continue to given the ageing population. An improvement in functional outcome can be achieved, with the best results noted in those tendons that go on to heal. Failure of repair following surgery can be associated with debilitating symptoms that are not always amenable to non-operative measures, so further surgery may be indicated for these patients.

Day case shoulder arthroplasty: needed now more than ever.

The demand for total shoulder arthroplasty has grown over the years and is set to continue in a similar trend because of the ageing population. Following a global reduction in elective orthopaedic treatment and an exponential rise in surgical waiting times, innovative strategies are desperately needed to mitigate against the harmful effects of delaying vital operations on both patients and the wider society. Day case shoulder arthroplasty is a safe alternative to a traditional inpatient approach, with evidence supporting substantial cost savings, improved outcomes and fewer complications.

Arthroscopic Compaction Bone Grafting for Uncontained Bone Defects of the Greater Tuberosity Associated With a Rotator Cuff Retear.

Revision rotator cuff repair is a technically demanding procedure that can be complicated by the presence of large peri-implant cysts. When multiple suture anchors are encountered, massive bone defects may need to be addressed to ensure that tendon-bone fixation and healing can be optimized. This Technical Note discusses arthroscopic compaction bone grafting for massive uncontained bone defects of the greater tuberosity associated with revision rotator cuff repair.

Protocol for a Retrospective Comparative Study to Determine the Effect of Two Different Biocomposite Suture Anchors on the Occurrence of Bony Ingrowth and Implant Reabsorption Following Arthroscopic Rotator Cuff Repair.

Introduction: Surgical treatment of rotator cuff tears commonly entails reattachment of the ruptured tendon to its bony insertion using suture anchors. Suture anchor design has evolved from solid metal anchors to vented biocomposite anchors with potentially biologic consequences. Few studies have investigated the differences between different modern anchor design and materials, making it difficult to justify their use or cost.

Rotator cuff repair techniques: Current concepts.

Arthroscopic rotator cuff repair is being performed by an ever-increasing number of surgeons. With an ageing population and growing patient expectations it is crucial that clinical outcomes are optimised. Anatomical reduction of the tendon back to its footprint with minimal tension contributes to this, but this can only be achieved if key biomechanical factors are taken into consideration.

Characterisation of the tensile properties of Demineralised Cortical Bone when used as an anterior cruciate ligament allograft.

Background: Graft choice in anterior cruciate ligament (ACL) reconstruction remains controversial and some grafts fail due to inadequate osteointegration. Demineralised cortical bone (DCB) is an osteoinductive collagen-based scaffold. The aim of this study was to measure the tensile properties of DCB from different locations and from different ages, and determine its compatibility with current ACL fixation systems.

Revision shoulder arthroplasty for failed humeral head resurfacing hemiarthroplasty.

Background: The purpose of the present study was to analyze and report the clinical outcomes following revision shoulder arthroplasty for failed humeral head resurfacing hemiarthroplasty (HHRH).

Methods: All patients who underwent revision shoulder arthroplasty for failed HHRH at our institution were retrospectively reviewed. Twenty-two shoulders in 20 patients were available for analysis.

The biomechanics of proximal humeral fractures: Injury mechanism and cortical morphology.

Background: The aim of this study was to examine the effect of arm position on proximal humerus fracture configuration and to determine whether cortical thinning would predispose to fracture propagation and more complex patterns of injury.

Methods: A drop test rig was designed to simulate falls onto an outstretched arm ('parachute reflex'). Thirty-one cadaveric specimens underwent computer tomography scanning and cortical thicknesses mapping.

Cortical thickness analysis of the proximal humerus.

Background: Structural changes within the proximal humerus influence the mechanical properties of the entire bone and predispose to low-energy fractures with complex patterns. The aim of the present study was to measure the cortical thickness in different regions of the proximal humerus.

Methods: Thirty-seven proximal humeri were analyzed using novel engineering software to determine cortical thickness in 10 distinct anatomical zones.

Simulation of bone-determined range of motion in proximal humeral fractures.

Background: Predicting the outcome following fractures of the proximal humerus is an important consideration when effectively counselling patients and planning treatment. The purpose of the present study was to analyze different proximal humeral fracture configurations, using a computerized simulation model, aiming to predict the range of motion (ROM).

Methods: The computer tomography scans of 79 proximal humeral fractures were analyzed using a customized software system that simulated the range of movement at the glenohumeral joint.

Application of a Demineralized Cortical Bone Matrix and Bone Marrow-Derived Mesenchymal Stem Cells in a Model of Chronic Rotator Cuff Degeneration.

Background: The success of rotator cuff repair is primarily dependent on tendon-bone healing. Failure is common because weak scar tissue replaces the native enthesis, rendering it prone to reruptures. A demineralized bone matrix (DBM) consists of a network of collagen fibers that provide a sustained release of growth factors such as bone morphogenetic proteins.

Glenohumeral arthrodesis for late reconstruction of flail shoulder in patients with traumatic supraclavicular brachial plexus palsy.

Background: Flail shoulder can occur following a brachial plexus injury and is characterized by painful subluxation of the glenohumeral joint and the inability to independently position the hand in space. The present study aimed to report the clinical outcomes following glenohumeral arthrodesis for late reconstruction of flail shoulder in patients with traumatic supraclavicular brachial plexus palsy.

Methods: Seven patients were included in the present study and were followed-up for a mean of 98 months (range 27 months to 197 months).

Anatomical shoulder arthroplasty in epileptic patients with instability arthropathy and persistent seizures.

Purpose: Epileptic seizures can cause shoulder dislocation, recurrent instability and eventually arthritis. The purpose of this study was to report the results, complications and rate of revision surgery following anatomical shoulder arthroplasty in epileptic patients with instability arthropathy.

Methods: A consecutive series of eight patients with epilepsy underwent anatomical shoulder arthroplasty for recurrent shoulder instability and were retrospectively reviewed after a mean of 4.

Supraspinatus detachment causes musculotendinous degeneration and a reduction in bone mineral density at the enthesis in a rat model of chronic rotator cuff degeneration.

Background: To evaluate biological strategies that enhance tendon-bone healing in humans, it is imperative that suitable animal models accurately reproduce the pathological changes observed in the clinical setting following a tear. The purpose of the present study was to investigate rotator cuff degeneration in a rat, as well as assess the development of osteopenia at the enthesis following tendon detachment.

Methods: Eighteen female Wistar rats underwent unilateral detachment of the supraspinatus tendon.

The effectiveness of demineralized cortical bone matrix in a chronic rotator cuff tear model.

Background: The purpose of this study was to assess the effect of demineralized bone matrix (DBM) on rotator cuff tendon-bone healing. The hypothesis was that compared with a commercially available dermal matrix scaffold, DBM would result in a higher bone mineral density and regenerate a morphologically superior enthesis in a rat model of chronic rotator cuff degeneration.

Methods: Eighteen female Wistar rats underwent unilateral detachment of the supraspinatus tendon.

Glenohumeral arthrodesis for recurrent types II and III shoulder instability.

Background: This study reports the clinical outcome after glenohumeral arthrodesis for recurrent type II (atraumatic structural) and type III (muscle patterning nonstructural disorder) shoulder instability.

Methods: A retrospective review was conducted at a single facility. Eight consecutive patients (7 women and 1 man) with recurrent shoulder instability underwent arthrodesis and were monitored for a mean of 57 months (range, 24-123 months).