Glenoid track revisited.

The risk of Hill-Sachs lesion (HSL) to cause instability depends not only on the HSL but also on the glenoid size. Clinically, the only method to assess the risk of instability considering the dynamic interaction of both, the HSL together with the glenoid bone loss, is the glenoid track concept. Since it was introduced in a cadaveric study, its clinical efficacy and validity have been reported in the literature.

Operational strategies to deal with the COVID-19 emergency: recommendations from the Italian national society SIAGASCOT following the introduction of vaccines against the SARS-CoV-2 infection.

Background: This article aims to present the operational recommendations adopted by the Italian national society for orthopaedic surgery, arthroscopy, and sports medicine (SIAGASCOT) in managing patients eligible to undergo elective orthopaedic surgery during the COVID-19 pandemic after the beginning of a national vaccination campaign.

Materials And Methods: An extensive literature search, analysing medical databases and scientific societies protocols, was performed to support this document. A four-step approach was used: 1-definition of priorities; 2-definition of significant clusters of interventions; 3-extraction of recommendations from international literature; and 4-adaptation of the recommendations to the specific features of the Italian healthcare system.

Reverse shoulder arthroplasty: State-of-the-art.

The reverse shoulder arthroplasty conceived by Paul Grammont in 1985 has gradually gained popularity as a treatment for multiple shoulder diseases. Unlike previous reverse shoulder prosthesis characterized by unsatisfactory results and a high glenoid implant failure rate, the Grammont design has immediately shown good clinical outcomes. This semi constrained prosthesis solved the issues of the very first designs by medializing and distalizing the center of rotation with an increased stability of the replacement of the component.

Depression, fear of re-injury and kinesiophobia resulted in worse pain, quality of life, function and level of return to sport in patients with shoulder instability: a systematic review.

Introduction: Maladaptive psychological responses may hinder participation and return to pre-injury level in sport. The aim of this study was to investigate the psychological factors influence on pain, function, quality of life and time to return to sport in subjects with shoulder instability.

Evidence Acquisition: The research was conducted until the 15 of May 2022 in MEDLINE, CENTRAL, PEDro, and PubPSYCH regardless language, publication status or date.

The Role of the Trapezius in Stabilization of the Acromioclavicular Joint: A Biomechanical Evaluation.

Background: Acromioclavicular joint (ACJ) injuries are common, and many are adequately treated nonoperatively. Biomechanical studies have mainly focused on static ligamentous stabilizers. Few studies have quantified ACJ stabilization provided by the trapezius.

Depression and Anxiety Are Associated With Worse Subjective and Functional Baseline Scores in Patients With Frozen Shoulder Contracture Syndrome: A Systematic Review.

Purpose: To investigate whether psychological factors, such as avoidance behavior, fear, pain catastrophization, kinesiophobia, anxiety, depression, optimism, and expectation are associated with different subjective and functional baseline scores in patients with frozen shoulder contracture syndrome (FSCS).

Methods: Searches were conducted in MEDLINE, Cochrane Library (CENTRAL Database), PEDro, Pubpsych, and PsychNET.APA without restrictions applied to language, date, or status of publication.

The Use of Scapular Bone Flaps During Head-and-Neck Reconstruction: Functional, Orthopedic, and Quality of Life Analyses of Flap-Harvest-Related Deficits.

The authors sought correlations between harvesting of the scapular bone tip free flap used for head-and-neck reconstruction and any shoulder function deficit, particularly at the level of the rotator cuff. The flap permits reconstruction of large and diverse regions of the head and neck, but long-term harvest morbidity has not been investigated extensively. The authors analyzed the clinical records of all patients who underwent head-and-neck reconstructions using free scapular tip flaps in our department over the past 5 years.

New Trends in Shoulder Surgery from Biomechanics to the Operating Room.

After a rigorous peer review process, twelve papers were accepted and published [...

Limited Predictive Value of the Instability Severity Index Score: Evaluation of 217 Consecutive Cases of Recurrent Anterior Shoulder Instability.

Purpose: To review the existing variables and their ability to predict recurrence of shoulder instability as it relates to the Instability Severity Index Score (ISIS), as well as evaluate any other pertinent imaging and patient history variables that may impact risk of recurrent anterior instability after arthroscopic Bankart repair.

Methods: All consecutive patients with recurrent anterior shoulder instability and who had arthroscopic instability repair were identified. Exclusion criteria were prior surgery on the shoulder, posterior or multidirectional instability, instability caused by seizure disorder, or a rotator cuff tear.

Measuring Bone Loss in the Unstable Shoulder: Understanding and Applying the Track Concept.

An interesting international debate has been developed over the past 10 years (the last decade) surrounding the surgical procedure for recurrent anteroinferior instability and a definitive consensus is lacking on the factors which favor one technique over another, especially when bone loss is present (soft tissue vs. bone block). Glenoid bone loss is commonly observed in the shoulder with anterior instability, and it is difficult to evaluate the shape of the glenoid using plain radiograph, therefore, computed tomography or intraoperative observation is recommended for accurate assessment of glenoid bone loss and Hill-Sachs lesion.

Risk Factors for Recurrent Anterior Glenohumeral Instability and Clinical Failure Following Primary Latarjet Procedures: An Analysis of 344 Patients.

Background: Patients with a greater risk of recurrent instability and inferior clinical outcomes following a primary Latarjet procedure can be preoperatively identified on the basis of clinical, radiographic, and demographic criteria. The purpose of this study was to identify risk factors influencing the rates of recurrent anterior glenohumeral instability and clinical failure following a primary Latarjet procedure.

Methods: All patients who underwent a primary Latarjet procedure were prospectively enrolled and evaluated.

Biomechanical Analysis of Plate Fixation Compared With Various Screw Configurations for Use in the Latarjet Procedure.

Background: The biomechanical properties of coracoid fixation with a miniplate during the Latarjet procedure have not been described.

Purpose: To determine the biomechanical properties of miniplate fixation for the Latarjet procedure compared with various screw fixation configurations.

Study Design: Controlled laboratory study.

Glenoid Track Instability Management Score: Radiographic Modification of the Instability Severity Index Score.

Purpose: The purpose of this study is (1) to test the proposed treatment algorithm, the Glenoid Track Instability Management Score (GTIMS), which incorporates the glenoid track concept into the instability severity index score (ISIS), and (2) to compare treatment decision-making using either GTIMS versus ISIS in 2 cohorts of patients with operatively treated anterior instability.

Methods: A multicenter, retrospective review of two consecutive groups consisting of 72 and 189 patients treated according to ISIS and GTIMS, respectively, was conducted. Inclusion criteria for all patients were ≥2 confirmed traumatic anterior shoulder instability events and a physical examination demonstrating a positive anterior apprehension and relocation test.

Management of the Failed Latarjet Procedure: Outcomes of Revision Surgery With Fresh Distal Tibial Allograft.

Background: Patients with recurrent anterior glenohumeral instability after a failed Latarjet procedure remain a challenge to address. Complications related to this procedure include large amounts of bone loss, bone resorption, and issues with retained hardware that necessitate the need for revision surgery.

Purpose: To determine the outcomes of patients who underwent revision surgery for a recurrent shoulder instability after a failed Latarjet procedure with fresh distal tibial allograft.

The role of bone in glenohumeral stability.

Shoulder stability depends on several factors, either anatomical or functional. Anatomical factors can be further subclassified under soft tissue (shoulder capsule, glenoid rim, glenohumeral ligaments etc) and bony structures (glenoid cavity and humeral head).Normal glenohumeral stability is maintained through factors mostly pertaining to the scapular side: glenoid version, depth and inclination, along with scapular dynamic positioning, can potentially cause decreased stability depending on the direction of said variables in the different planes.

Update on unicompartmental knee arthroplasty: Current indications and failure modes.

Despite the excellent success rates of modern implants, unicompartmental knee arthroplasty (UKA) continues to show relatively high failure and revision rates, especially when compared with total knee arthroplasty (TKA).These higher rates of failure and revision are mainly observed during the early (< 5 years) post-operative period and are often due to incorrect indications and/or surgical errors.The correct clinical and radiological indications for UKA have therefore been analysed and correlated as far as possible with the principal mechanisms and timing of failures of UKA.

Hyaluronic Acid Intra-Articular Injections in Patients Affected by Moderate to Severe Glenohumeral Osteoarthritis: A Prospective Randomized Study.

 The aim of this study was to evaluate the efficacy and safety of intra-articular injection treatment with high molecular weight HA (Hyalubrix, 30 mg/2 mL, molecular weight > 1,500 kDa) in patients affected by moderate to severe glenohumeral osteoarthritis (OA).  Seventy-eight patients, affected by shoulder OA grade II-IV were randomized in two groups. Patients included in case group were treated with three intra-articular injections of HA and a specific physiotherapy program, whereas patients included in the control group received the only physical therapy.

Radiographic Analysis of the Hill-Sachs Lesion in Anteroinferior Shoulder Instability After First-Time Dislocations.

Purpose: To identify the relation between the Hill-Sachs (H-S) angle and arm position at the time of the initial dislocation, and to see if this correlates with the glenoid track.

Methods: A total of 102 patients (89 male patients, 87.2%), with a mean age of 32 years (range, 17 to 38 years), were divided into 2 groups, abduction (ABD) and adduction (ADD), dependent on the position of the arm at the time of the instability event.

The role of hyaluronic acid in patients affected by glenohumeral osteoarthritis.

Persistent shoulder pain is a highly prevalent problem, due to different pathologies, that is frequently associated with limited range of motion and decreased function. The correct diagnosis can lead to the best treatment for each pathology. In this study we tried to understand what could be the role of hyaluronic acid and its effective benefit in patients affected by mild-to-moderate glenohumeral osteoarthritis.

Glenohumeral translation in ABER position during muscle activity in patients treated with Latarjet procedure: an in vivo MRI study.

Purpose: The Latarjet procedure is frequently performed when treating traumatic anteroinferior shoulder instability. This procedure is supposed to have a triple effect: osseous, muscular and ligamentous. The main stabilizing mechanism in cadaver studies on fresh-frozen shoulders seems to be the sling effect produced by the subscapularis and the conjoint tendon.

Bipolar bone defect in the shoulder anterior dislocation.

In the anterior shoulder instability with glenoid bone loss among 25 % or more of the inferior glenoid diameter (inverted-pear glenoid), the consensus of recent authors is that glenoid bone grafting (Latarjet procedure) should be performed. The engaging Hill-Sachs lesion has been recognized as a risk factor for recurrent anterior shoulder instability. We have developed a method using radiographic and arthroscopic studies and the concept of the glenoid track to determine whether a Hill-Sachs lesion will engage the anterior glenoid rim, whether or not there is concomitant anterior glenoid bone loss.