Editorial Commentary: Combined Single-Anchor Fixation of Subscapularis and Biceps Pathology Leads to Improved Clinical Outcomes.

Upper-edge subscapularis tendon tears associated with biceps instability are a cause of anterior shoulder pain and disability. At shoulder arthroscopy, the incidence of subscapularis pathology was noted to be 27%, with 47% of these being combined lesions involving the medial reflection pulley. The anatomic location of the upper subscapularis and biceps allows for combined fixation techniques.

Rotator Cuff Augmentation: Its Role and Best Practices.

Rotator cuff tears are a common source of pain and impairment in the shoulder. Healing of the rotator cuff tendons following repair has been associated with improved patient outcomes. While there have been many technical improvements in surgical techniques for rotator cuff repair, failure rates are still surprisingly high.

Editorial Commentary: Rotator Cuff Tendon Healing May Be Enhanced With a Blanket.

After rotator cuff repair, the regeneration of the anatomic enthesis may be beneficial. Although many cell and growth factor studies have been performed, none have shown a consistent regeneration of this structure. The use of bone marrow vents in the greater tuberosity has been associated with improved healing.

Editorial Commentary: What's Hamada With Partial Rotator Cuff Repair?

Early repair of acute traumatic rotator cuff tears has been shown to restore functional range of motion, whether or not there is complete healing. The ability to predict those cuff tears that can achieve only a partial repair can help with preoperative patient counseling. The Hamada classification can be predictive in determining outcomes in the treatment of massive rotator cuff tears.

Editorial Commentary: Avoid Passive Acceptance of Early Active Range of Motion After Arthroscopic Rotator Cuff Repair.

Following arthroscopic rotator cuff repair there is a balance between allowing reliable tendon healing and regaining range of motion. Common rehabilitation philosophy requires time for shoulder immobilization combined with passive range of motion to avoid shoulder stiffness yet maximize tendon healing.

Editorial Commentary: Treating Hidden Lesions Using Hidden Data: Isolated Lesions of the Shoulder Biceps Pulley.

In a study evaluating a rare condition (isolated lesions of the shoulder biceps pulley), retrospective analysis of a comprehensive, prospective surgical database allows authors to determine the results for the surgical management of this uncommon pathology. The creation and use of a comprehensive surgical database can help surgeons evaluate their own data to help improve patient outcomes. The authors present favorable data on the effectiveness of open subpectoral biceps tenodesis to treat isolated biceps reflection pulley lesions.

Suture spanning augmentation of single-row rotator cuff repair: a biomechanical analysis.

Background: This in vitro study evaluated the biomechanical benefit of adding spanning sutures to single-row rotator cuff repair.

Methods: Mechanical testing was performed to evaluate 9 pairs of cadaveric shoulders with complete rotator cuff repairs, with a single-row technique used on one side and the suture spanning technique on the other. The spanning technique included sutures from 2 lateral anchors securing tendon near the musculotendinous junction, spanning the same anchor placement from single-row repair.

Arthroscopic posterior labral repair and capsular shift with a lateralized posterior portal.

Arthroscopic techniques for posterior shoulder subluxation with labral injuries in athletes have shown good results. The difficulty with the procedure is gaining appropriate access to the posteroinferior quadrant of the glenoid at a steep enough angle that allows for safe anchor placement. Various portals have been described that can be used as accessory portals for anchor placement.

Tension level during preconditioning influences hamstring tendon graft properties.

Background: Hamstring tendon grafts used for anterior cruciate ligament reconstruction are preconditioned to reduce the influence of viscoelasticity on the stiffness and tension.

Hypothesis: Increasing the tension applied during preconditioning will decrease the loss of tension and stiffness due to viscoelasticity.

Study Design: Controlled laboratory study.

In vitro comparison of tension and stiffness between hamstring tendon and patella tendon grafts.

Following anterior cruciate ligament reconstruction, grafts relax and warm from the temperature of the operating room to body temperature. The current study compared graft tension and stiffness between patella tendon and hamstring tendon grafts. Six quadruple strand hamstring tendon grafts and six patella tendon grafts were preconditioned and loaded to 105 N while at 20 degrees C.

Assessment of pain relief provided by interscalene regional block and infusion pump after arthroscopic shoulder surgery.

Purpose: This study was performed to evaluate the efficacy of interscalene regional blocks and infusion pumps for postoperative pain control after arthroscopic subacromial decompression with or without arthroscopic rotator cuff repair.

Methods: Seventy-six patients were included in the prospective study. Participants were randomized into 4 treatment groups: (1) interscalene regional block, (2) infusion pump with 0.

Elbow function after repair of the distal biceps brachii tendon with a two-incision approach.

A modified Boyd-Anderson 2-incision approach is commonly used to repair the distal biceps tendon after avulsion from the radial tuberosity. Using suture anchors for fixation instead of a bone trough simplifies the procedure. This retrospective study enrolled 32 patients who underwent surgical repair of the distal biceps tendon with a 2-incision approach and 2 suture anchors.

Viscoelasticity and temperature variations decrease tension and stiffness of hamstring tendon grafts following anterior cruciate ligament reconstruction.

Background: Hamstring tendon grafts used for anterior cruciate ligament reconstruction are typically harvested early in the surgical procedure and are preconditioned prior to reimplantation. Postoperatively, the grafts undergo stress relaxation and warm from the temperature of the operating room to body temperature. The hypothesis of this study was that the tension within semitendinosus and gracilis tendon grafts and the stiffness of the grafts significantly decrease postoperatively because of both stress relaxation and an increase in temperature.

Locking plates improve torsional resistance in the stabilization of three-part proximal humeral fractures.

This study quantified the torsional resistance provided by locking plates and angled blade plates used to stabilize proximal humeral fractures. Three-part proximal humeral fractures were created in 6 pairs of cadaveric humeri. One specimen of each pair was reconstructed with a proximal humeral locking plate, whereas the other specimen was reconstructed with an angled blade plate.

Structural properties of lateral collateral ligament reconstruction at the fibular head.

Background: Anatomical reconstruction of a ruptured lateral collateral ligament using allograft tissue secured within the fibular head with an interference screw has been described.

Hypothesis: Interference fixation at the fibular head does not reproduce the strength of the intact ligament.

Study Design: Controlled laboratory study.

Simplified arthroscopic suture passing using a suture loop.

Arthroscopic procedures for shoulder pathology are becoming more popular. Passing braided nonabsorbable suture for repair of intra-articular tissue can be technically difficult because advancing this suture through tissue is a 2-step process. The use of a suture loop with Spectrum suture hooks (Linvatec, Largo, FL) simplifies braided suture passing, and eliminates the use of expensive suture shuttles.