Noninvasive bracing of acromioclavicular joint dislocations is not superior to early functional rehabilitation and not inferior to surgical stabilization in Rockwood type III and V injuries.

Background: Treatment of acromioclavicular joint (ACJ) separations remains controversial. Yet, conservative treatment has become more common even for high-grade injuries. Available conservative treatment does currently however not address the loss of anatomical joint integrity in Rockwood (RW) III and V injuries.

Evaluation of the efficiency of an ultrasound-supported infiltration technique in patients with tennis elbow applying the ITEC medical device: a multicenter study.

Background: The treatment of lateral epicondylitis remains unsatisfactory in certain cases. The aim of this study is to investigate the efficiency of an ultrasound-guided infiltration combined with fenestration of the extensor tendon postulating a 50% reduction in pain on exertion within 6 months.

Methods: In a prospective, nonrandomized, multicenter study design, 68 patients with chronic lateral epicondylitis and symptoms lasted for at least 6 weeks were included.

Functional and Radiologic Outcomes of Degenerative Versus Traumatic Full-Thickness Rotator Cuff Tears Involving the Supraspinatus Tendon.

Background: Arthroscopic rotator cuff repair (ARCR) is among the most commonly performed orthopaedic procedures. Several factors-including age, sex, and tear severity-have been identified as predictors for outcome after repair. The influence of the tear etiology on functional and structural outcome remains controversial.

SECEC Didier Patte Prize 2023: the ABC classification of posterior shoulder instability.

Background: The ABC classification has recently been proposed as a comprehensive classification system for posterior shoulder instability (PSI). The purpose of this study was to analyze the comprehensiveness as well as inter-rater and intrarater reliability of the ABC classification.

Methods: All consecutive patients presenting with unidirectional PSI from June 2019 to June 2021 were included in a prospective study.

Pro-Resolving Mediators in Rotator Cuff Disease: How Is the Bursa Involved?

So far, tendon regeneration has mainly been analyzed independent from its adjacent tissues. However, the subacromial bursa in particular appears to influence the local inflammatory milieu in the shoulder. The resolution of local inflammation in the shoulder tissues is essential for tendon regeneration, and specialized pro-resolving mediators (SPMs) play a key role in regulating the resolution of inflammation.

Percutaneous elevation of radial head fractures without fixation - a promising technique.

The aim of the study is to describe the surgical technique and to report the outcomes of triceps reflecting anconeus pedicle (TRAP) approach for intercondylar fractures of the humerus. Twenty two patients with intercondylar fractures of the humerus were operated on by open reduction via the TRAP approach and internal fixation with dual precontoured locking plates. Data were collected on union time, postoperative complications, range of motion (ROM), triceps power, and objective clinical measurement.

Inter-Observer and Intra-Observer Reliability Assessment of the Established Classification Systems for Periprosthetic Shoulder Fractures.

This study evaluated the reliability and comprehensiveness of the Unified classification system (UCPF), Wright & Cofield, Worland and Kirchhoff classifications and related treatment recommendations for periprosthetic shoulder fractures (PPSFx). Two shoulder arthroplasty specialists (experts) and two orthopaedic residents (non-experts) assessed 20 humeral-sided and five scapula-sided cases of PPSFx. We used the unweighted Cohen's Kappa (κ) for measuring the intra-observer reliability and Krippendorff's alpha (α) for measuring the inter-observer reliability.

Arthroscopic Posterior Capsulolabral Repair With Suture-First Versus Anchor-First Technique in Patients With Posterior Shoulder Instability (Type B2): Clinical Midterm Follow-up.

Background: Isolated soft tissue injuries of the posterior capsulolabral complex can be addressed arthroscopically, with various anchor systems available for repair.

Purpose: To evaluate clinical and patient-reported outcomes after arthroscopic capsulolabral repair in patients with posterior shoulder instability (PSI) and to compare differences in outcomes between patients treated with a suture-first technique (PushLock anchor) and an anchor-first technique (FiberTak all-suture anchor).

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

[Infiltration therapies for lateral epicondylopathy].

The therapy of the lateral epicondylopathy (tennis elbow) includes drug injection into the extensor tendon insertion in chronic cases. The choice of medication and the type of injection is decisive for the success of therapy. Furthermore, accurate application is indispensable for therapy success (e.

Arthroscopic Posterior Articular Coverage and Shift (PACS) Procedure for Treatment of Preosteoarthritic Constitutional Static Posterior Shoulder Instability (Type C1).

Background: Different joint-preserving techniques for treatment of preosteoarthritic, constitutional static (type C1) posterior shoulder instability (PSI) have been proposed, including posterior glenoid open wedge osteotomy and bone graft augmentation. However, the techniques are demanding, the reported complication and reoperation rates are high, and posterior decentering cannot reliably be reversed.

Purpose: To assess the clinical and radiological longitudinal outcomes of patients with type C1 PSI after arthroscopic posterior articular coverage and shift (PACS) surgery.

Distal Radius Fracture with Ipsilateral Elbow Dislocation: A Rare but Challenging Injury.

Distal radius fractures are common and account for approximately 14% to 18% of all adult extremity injuries. On rare occasions, ipsilateral elbow dislocation can be observed additionally. However, this can be missed without careful examination, especially in patients experiencing altered mental status.

Clinical outcomes after refixation of subacute repaired distal biceps tendon ruptures.

Background: The aim of this study was to evaluate the clinical outcome and complication spectrum after delayed repair surgery of distal biceps tendon ruptures, postulating that satisfactory results are possible contrary to previous literature.

Methods: Forty-three of 92 patients with a full workup (= OPT in) undergoing primary distal biceps tendon repair were included in this study. The mean age of participants was 49.

Arthroscopic Bone Block Cerclage Technique Using a Tricortical Scapular Spine Autograft for Glenoid Reconstruction in Patients With Anterior Shoulder Instability.

In the treatment of anterior shoulder instability with glenoid bone loss, free bone graft transfers have proven to be a viable anatomic alternative to the commonly performed, nonanatomic Latarjet procedure. Implant-free fixation of the free bone grafts, in particular, has rendered excellent short- and long-term results. However, a drawback remains the source of the graft.

Subacromial Bursa: A Neglected Tissue Is Gaining More and More Attention in Clinical and Experimental Research.

The subacromial bursa has long been demolded as friction-reducing tissue, which is often linked to shoulder pain and, therefore, partially removed during shoulder surgery. Currently, the discovery of the stem cell potential of resident bursa-derived cells shed a new light on the subacromial bursa. In the meanwhile, this neglected tissue is gaining more attention as to how it can augment the regenerative properties of adjacent tissues such as rotator cuff tendons.

The Independent Double-Row (IDR) Bony Bankart Repair Technique.

A displaced anterior glenoid rim fracture, the so-called bony Bankart lesion, occurs after a traumatic shoulder dislocation resulting from a high energy trauma and is associated with recurrent shoulder instability. Different surgical techniques have been described in the literature to address this pathology, including open reduction and fixation, as well as arthroscopic transosseous, and single-row or double-row approaches with the use of suture anchors. However, there is currently no gold standard of treatment and the stability of fixation and the healing of the bony fragment are still a concern.

Failure Analysis in Multiple TKA Revisions-Periprosthetic Infections Remain Surgeons' Nemesis.

Background: The aim of this study was to categorize reasons for failure and to analyze the survivorship of multiple total knee arthroplasty (TKA) revisions.

Methods: The study retrospectively evaluated all multiple TKA revisions performed between 2005 and 2015 at the authors' institutions. Sixty-three patients (35 female, 28 male, age 64 ± 10 years, follow-up 55 ± 36 months) underwent a total of 157 re-revision TKA surgeries (range 2-5).

The inter-individual anatomical variation of the trochlear notch as a predisposition for simple elbow dislocation.

Purpose: Besides the multi-layered capsule-ligamentous complex of the elbow joint the high bony congruence in the ulnohumeral joint contributes to elbow stability. Therefore, we assume that specific anatomical configurations of the trochlear notch predispose to dislocation. In case of ligamentous elbow dislocation both conservative and surgical treatment is possible without a clear treatment algorithm.

Technical Note: Arthroscopic Resection of Snapping, Interponating Annular Ligament of the Elbow.

The indication for surgical treatment of lateral snapping elbow syndrome is recurrent joint blockage in combination with pain of the affected elbow joint. Different parts of the lateral synovial capsule sleeve complex, including the annular ligament itself, a hypertrophic synovial fold, or meniscus-like soft tissue interposition can lead to painful entrapment. Surgical treatment options can include an arthroscopic or open procedure.

Histological and molecular features of the subacromial bursa of rotator cuff tears compared to non-tendon defects: a pilot study.

Background: The role of the subacromial bursa in the development or healing of shoulder pathologies is unclear. Due to this limited knowledge, we aimed to understand specific reactions of the subacromial bursa according to rotator cuff (RC) pathologies compared to non-tendon defects of the shoulder. We hypothesized that the tissue composition and inflammatory status of the bursa are likely to vary between shoulder pathologies depending on the presence and the extent of RC lesion.

Bursa-Derived Cells Show a Distinct Mechano-Response to Physiological and Pathological Loading .

The mechano-response of highly loaded tissues such as bones or tendons is well investigated, but knowledge regarding the mechano-responsiveness of adjacent tissues such as the subacromial bursa is missing. For a better understanding of the physiological role of the bursa as a friction-reducing structure in the joint, the study aimed to analyze whether and how bursa-derived cells respond to physiological and pathological mechanical loading. This might help to overcome some of the controversies in the field regarding the role of the bursa in the development and healing of shoulder pathologies.

Arthroscopic Middle Trapezius Transfer for Treatment of Irreparable Superior Rotator Cuff Tendon Tears.

Irreparable supraspinatus tendon tears are challenging to treat, especially in a young and high-demanding patient population. Whereas interposition tendon grafting and partial repair are limited by the quality of the remaining rotator cuff tendons and muscles, superior capsular reconstruction and subacromial spacers do not provide the active biomechanical principle of a contracting supraspinatus. The purpose of this technical note is to introduce an arthroscopic middle trapezius transfer below the acromion to replace the former supraspinatus unit.

Middle trapezius transfer for treatment of irreparable supraspinatus tendon tears- anatomical feasibility study.

Purpose: The purpose of this study was to investigate the anatomical feasibility of a middle trapezius transfer below the acromion for treatment of irreparable supraspinatus tendon tears.

Methods: This study involved 20 human cadaveric shoulders in 10 full-body specimens. One shoulder in each specimen was dissected and assessed for muscle and tendon extent, force vectors, and distance to the neurovascular structures.

Does sonography allow an objective and reproducible distinction between stable, hypermobile, and unstable elbow joints?

Background: The diagnosis of residual or chronic elbow instability is often challenging. Sonography allows a dynamic examination of the elbow joint without any radiation exposure. The purpose of this prospective single-center study was to investigate the application of sonography for the evaluation of ligamentous instabilities of the elbow joint.