Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears Yields Good Clinical Outcomes for Patients With and Without Diabetes Mellitus.

Purpose: To compare the clinical outcomes after superior capsule reconstruction (SCR) for irreparable rotator cuff tears (RCTs) in patients with and without diabetes mellitus (DM).

Methods: Patients who underwent SCR using fascia lata autograft for irreparable RCTs between 2012 and 2020 with a minimum 2-year follow-up were divided into non-DM and DM groups. Propensity score matching was used to select controls matched for patients' characteristics.

Clinical outcomes of arthroscopic superior capsule reconstruction in patients aged over 70 with irreparable rotator cuff tears.

Background: Arthroscopic superior capsule reconstruction (SCR) was developed to restore superior shoulder stability, muscle balance, and function after irreparable posterior-superior rotator cuff tears. The purpose of this study was to investigate whether favorable clinical outcomes after SCR for irreparable rotator cuff tears would be obtained in patients aged more than 70 years.

Methods: A total of 173 consecutive shoulders in 162 patients who underwent arthroscopic SCR using autografts of fascia lata for irreparable rotator cuff tears were allocated to 3 groups according to patient age at the time of surgery: Group 1, <55 years old (11 shoulders); Group 2, 55-70 years old (85 shoulders); and Group 3, > 70 years old (77 shoulders).

Location and size of the reverse Hill-Sachs lesion in patients with traumatic posterior shoulder instability.

Background: In patients with traumatic posterior shoulder instability, little is known about the precise location and size of the reverse Hill-Sachs lesion.

Methods: Forty-nine shoulders of 47 patients with traumatic posterior instability were included in this study based on the following inclusion criteria: (1) a primary or recurrent traumatic posterior shoulder dislocation and (2) the initial event being caused by trauma. Patients were excluded if they had (1) no history of trauma, (2) prior shoulder surgery, (3) no computed tomographic (CT) examination, or (4) were seizure cases.

Biomechanical Characterization of a New Locking Loop Stitch for Graft Fixation versus Krackow Stitch.

Background: The purpose of this study was to quantify and compare the biomechanical characteristics of a new locking loop stitch (LLS), developed utilizing the concepts of both running locking stitch and needleless stitch, to the traditional Krackow stitch.

Methods: The Krackow stitch with No.2 braided suture and the LLS with 1.

Editorial Commentary: Superior Capsule Reconstruction: Acellular Allograft at 45° of Glenohumeral Abduction Improves Glenohumeral Stability, but Fascia Lata Autograft Remains Superior.

Originally, fascia lata autograft was used for superior capsule reconstruction (SCR) to restore glenohumeral stability in irreparable rotator cuff tears. Consistently excellent clinical outcomes with low graft tear rates have been reported, without repair of tears in the supraspinatus and infraspinatus tendons. On the basis of our experience and studies published in the 15 years since the first SCR using fascia lata autograft in 2007, we can say that this technique is the gold standard.

Postoperative graft integrity affects clinical outcomes after superior capsule reconstruction using fascia lata autograft in posterior-superior rotator cuff tears: a multicenter study.

Background: Previous studies have postulated that graft thickness and graft healing may be important factors for optimizing clinical outcomes of superior capsule reconstruction (SCR) for patients with irreparable rotator cuff tears (RCTs). However, the relationship between postoperative graft integrity and clinical outcomes after SCR remains unclear. We aimed to assess the relationship between postoperative graft integrity, including graft thickness and size of graft tear, and clinical outcomes after SCR in patients with irreparable RCTs.

Structural and clinical outcomes after superior capsule reconstruction using an at least 6-mm-thick fascia lata autograft including the intermuscular septum.

Background: Superior capsule reconstruction (SCR) is a viable treatment option for irreparable rotator cuff tears. However, graft tear rate is highly variable in the previous studies, and the impact of graft tears on clinical outcomes after arthroscopic SCR remains controversial. We aimed to investigate the graft tear rate, timing of graft tear, and the impact of graft tears on clinical outcomes after arthroscopic SCR using an at least 6-mm-thick fascia lata autograft including the intermuscular septum.

Relationship between the Hamada Grade and underlying pathological conditions in the rotator cuff and long head of biceps in symptomatic patients with rotator cuff tears.

Background: This study aimed to investigate the relationship between Hamada Grade and rotator cuff and long head of the biceps (LHB) pathologies in symptomatic patients with rotator cuff tears (RCTs).

Methods: We retrospectively reviewed 376 patients (156 men and 220 women; mean age, 68.4 years) who had undergone surgery for complete RCTs.

Histologic changes during healing with autologous fascia lata graft after superior capsule reconstruction in rabbit model.

Background: Superior capsule reconstruction (SCR) has been developed to improve shoulder function and relieve pain in the treatment of irreparable rotator cuff tears. Previous studies have reported that graft healing can enhance favorable outcomes after SCR. On the other hand, graft tears often lead to less desirable outcomes and sometimes require additional surgical procedures.

Superior Capsule Reconstruction Using Fascia Lata Allograft Compared With Double- and Single-Layer Dermal Allograft: A Biomechanical Study.

Purpose: To biomechanically characterize superior capsule reconstruction (SCR) using fascia lata allograft, double-layer dermal allograft, and single-layer dermal allograft for a clinically relevant massive irreparable rotator cuff tear involving the entire supraspinatus and 50% of the infraspinatus tendons.

Methods: Eight cadaveric specimens were tested in 0°, 30°, and 60° abduction for (1) intact, (2) massive rotator cuff tear, (3) SCR using fascia lata, (4) SCR using double-layer dermis, and (5) SCR using single-layer dermis. Superior translation and subacromial contact pressure were measured.

Biomechanical assessment of docking ulnar collateral ligament reconstruction after failed ulnar collateral ligament repair with suture augmentation.

Background: Ulnar collateral ligament (UCL) repair with single-strand suture augmentation has been introduced as a viable surgical option for throwers with acute UCL tears. For the original single-strand suture augmentation construct, revision UCL reconstructions can be challenging owing to the bone loss at the site of anchor insertion in the center of the sublime tubercle. This biomechanical study assessed a small-diameter (1.

Relationship between humeral retroversion and baseball positions during elementary and junior-high school.

Background: Humeral retroversion is greater in the dominant shoulder than in the nondominant shoulder in baseball players. However, the effect of different baseball positions during childhood on humeral retroversion remains unknown. The purpose of this study was to investigate the following: (1) the relationship between humeral retroversion and baseball positions played during elementary and junior-high schools; (2) the association between humeral retroversion and the prevalence of pain during the medical checkup and self-reported history of injuries in the dominant shoulder or elbow.

Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears: Comparison of Clinical Outcomes With and Without Subscapularis Tear.

Background: Arthroscopic superior capsule reconstruction (SCR) was developed to restore shoulder superior stability, muscle balance, and function in patients with irreparable posterior-superior rotator cuff tears.

Purpose: To assess the effects of concomitant subscapularis tendon tear, which may reduce glenohumeral stability and force coupling, on clinical outcomes of SCR for irreparable posterior-superior rotator cuff tears.

Study Design: Cohort study; Level of evidence, 3.

Does the timing of surgical intervention impact the clinical outcomes and overall duration of symptoms in frozen shoulder?

Background: The optimal timing of arthroscopic capsular release in patients with frozen shoulder is controversial. Some surgeons delay surgery in the belief that early surgical intervention results in a poorer prognosis. However, whether early surgical intervention causes inferior clinical outcomes and a longer duration of symptoms in frozen shoulder remains unclear.

Arthroscopic superior capsule reconstruction with Teflon felt synthetic graft for irreparable massive rotator cuff tears: clinical and radiographic results at minimum 2-year follow-up.

Background: Superior capsule reconstruction (SCR) was developed to improve shoulder function and relieve pain in patients with irreparable rotator cuff tears. Here, we investigated the clinical and radiographic outcomes and postoperative complications of SCR using a Teflon graft for reconstruction.

Methods: Thirty-five consecutive patients with irreparable rotator cuff tears underwent SCR with Teflon grafts.

Partial-Thickness Rotator Cuff Tear by Itself Does Not Cause Shoulder Pain or Muscle Weakness in Baseball Players.

Background: Partial-thickness rotator cuff tears are common shoulder injuries in baseball players. For some tears, the symptoms can be relieved through physical therapy or debridement without rotator cuff repair.

Purpose: To assess whether partial-thickness rotator cuff tear by itself causes shoulder pain and muscle weakness in baseball players.

Humeral Retroversion and Injury Risk After Proximal Humeral Epiphysiolysis (Little Leaguer's Shoulder).

Background: The increased humeral retroversion on the dominant side of throwing athletes is thought to result from repetitive throwing motion. Little Leaguer's shoulder-a rotational stress fracture of the proximal humeral epiphyseal plate-may influence the risk of humeral retroversion and injury of the shoulder or elbow joint.

Purpose: To investigate the effect of Little Leaguer's shoulder on humeral retroversion and the rates of shoulder and elbow injuries.

Five-Year Follow-up of Arthroscopic Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears.

Background: Arthroscopic superior capsule reconstruction was developed to restore superior stability, muscle balance, and function in the shoulder joint after an irreparable rotator cuff tear. Our objective was to assess the functional and radiographic results of superior capsule reconstruction after 5 years of follow-up.

Methods: Thirty patients who underwent arthroscopic superior capsule reconstruction using fascia lata autograft were enrolled in this study.

Posterior shoulder tightness can be a risk factor of scapular malposition: a cadaveric biomechanical study.

Background: Scapular malposition and posterior shoulder tightness are key pathologic processes in the shoulder of throwing athletes. The objective of this study was to investigate the effects of posterior capsule tightness, posterior rotator cuff muscle tightness, or both on scapular position.

Methods: Ten shoulders from 5 fresh frozen cadaveric male torsos were tested in maximum internal, neutral, and maximum external shoulder rotations at 0°, 45°, and 90° of shoulder abduction.

Editorial Commentary: Superior Capsule Reconstruction: Grafts for Superior Capsular Reconstruction Must Be Thick and Stiff.

To achieve a good functional outcome, including minimal graft tear, after superior capsule reconstruction, surgeons should carefully compare the biomechanical properties of all graft materials under consideration. In particular, graft stiffness affects postoperative stability in the glenohumeral joint, acromiohumeral distance, and graft healing. In my experience, a sufficiently stiff fascia lata graft is 6- to 8-mm thick and includes suture reinforcement and/or an augmentation patch.

Ulnar collateral ligament insufficiency affects cubital tunnel syndrome during throwing motion: a cadaveric biomechanical study.

Background: In throwing athletes, cubital tunnel syndrome and insufficiency of the ulnar collateral ligament (UCL) are common pathologic processes of the elbow. The objective of this study was to investigate the effect of UCL tears on ulnar nerve elongation in the simulated throwing position.

Methods: Eight fresh frozen cadaveric upper limbs were tested at the simulated late cocking to acceleration phase in the throwing motion using an elbow testing system.

Subacromial bone erosion due to suture-knots in arthroscopic rotator cuff repair: A report of two cases.

Knot impingement can cause shoulder-joint motion pain after rotator-cuff repair. Previous studies have revealed only subacromial effusion in magnetic resonance imaging (MRI) evaluations of knot impingement. We report two cases of patients with symptomatic knot impingement.