No relationship between critical shoulder angle and glenoid erosion after shoulder hemiarthroplasty: a comparative radiographic study.

Introduction: Symptomatic glenoid erosion is one of the most common causes of functional impairment after shoulder hemiarthroplasty. A decrease in the critical shoulder angle (CSA) has been associated with the development of shoulder arthritis. The inter-observer reliability of the CSA and the relationship between CSA and symptomatic glenoid erosion after shoulder hemiarthroplasty were investigated.

Level of patient-physician agreement in assessment of change following conservative rehabilitation for shoulder pain.

Background: Assessment of health-related status has been shown to vary between patients and physicians, although the degree of patient-physician discordance in the assessment of the change in status is unknown.

Methods: Ninety-nine patients with shoulder dysfunction underwent a standardized physician examination and completed several self-reported questionnaires. All patients were prescribed the same physical therapy intervention.

Value on the Front End: Making the Effective Diagnosis for Optimal Treatment.

Much effort is being made to quantitate and improve the outcomes associated with medical treatment. These outcomes are defined as how the patient did after an intervention and may be termed "value on the back end" of the treatment process. The diagnosis guides the content and timing of the treatment, and may be considered the "value on the front end" that optimizes the treatment process.

Treatment of Symptomatic Acromioclavicular Joint Instability by a Docking Technique: Clinical Indications, Surgical Technique, and Outcomes.

Purpose: To report functional and objective outcomes resulting from surgical treatment of patients with symptomatic type III through V acromioclavicular (AC) joint injury by use of a modification of the anatomic AC joint reconstruction developed by Carofino and Mazzocca.

Methods: The study included all patients treated in 2009-2014 who presented with a history of direct trauma to the shoulder; deformity of the AC joint on clinical examination; radiographic findings that would classify the injury as a Rockwood type III, IV, or V injury; AC joint instability on clinical examination; and self-reported deficits of arm function on initial presentation, in whom a comprehensive and directed nonoperative program failed. The surgical procedure used an allograft with reinforcing internal sutures passed around the coracoid and through anatomically positioned clavicular holes for the coracoclavicular (CC) ligaments, used a docking technique for reconstruction of the superior AC ligaments, and included repair of the native AC ligaments.

Cross-cultural adaptation and validation of the Italian version of the Western Ontario Osteoarthritis of the Shoulder index (WOOS).

Background: The Western Ontario Osteoarthritis of the Shoulder index (WOOS) has been introduced as a disease-specific quality of life measurement in patients with glenohumeral arthritis. The aim of the present study was to perform a cross-cultural adaptation of the English version of the WOOS to Italian and to assess its validity, reliability and responsiveness in patients with glenohumeral joint osteoarthritis treated conservatively.

Material And Methods: The adaptation process was carried out following the simplified Guillemin criteria.

Volume-based Interval Training Program for Elite Tennis Players.

Background: A sport-specific conditioning program can help tennis players train for competition or return to play from injury. This study determined the actual tennis serve volume in elite play and used these data to construct an interval training program based on stroke volume.

Hypothesis: There will be no differences in serve volume between male and female tennis players at the professional and junior levels.

Obesity Has Minimal Impact on Short-Term Functional Scores After Reverse Shoulder Arthroplasty for Rotator Cuff Tear Arthropathy.

The potential adverse effect of body mass index (BMI) on shoulder function scores after reverse shoulder arthroplasty (RSA) has not been investigated. We conducted a study to examine outcomes of RSA performed for rotator cuff tear arthropathy (RCTA) across BMI categories (normal weight, overweight, obese). We hypothesized that, compared with normal-weight patients, obese patients would have worse shoulder function scores, worse mobility, and more complications.

ACUTE CHANGES IN PASSIVE GLENOHUMERAL ROTATION FOLLOWING TENNIS PLAY EXPOSURE IN ELITE FEMALE PLAYERS.

Background: Alterations in glenohumeral (GH) rotation especially internal rotation and total range of motion have been associated with altered GH kinematics and susceptibility to injury. Researchers have evaluated long-term change in baseball and tennis players, and short-term changes in baseball players. However, acute (short-term) changes in GH rotation have not been evaluated in tennis players.

The role of wound closure in total knee arthroplasty: a systematic review on knee position.

Purpose: Post-operative range of motion (ROM) is one of the most important parameters to assess, following total knee arthroplasty (TKA). The aims of the present systematic review were to analyse the available literature and determine if closing the knee in flexion or extension influences post-operative ROM, clinical outcomes, and complications following TKA.

Methods: A systematic review was performed using the keywords "total knee arthroplasty", "total knee replacement", and "wound closure" or "joint closure" or "extension" or "flexion" with no limit regarding the year of publication.

The Kinetic Chain Revisited: New Concepts on Throwing Mechanics and Injury.

The overhead throwing motion is a complex activity that is achieved through activation of the kinetic chain. The kinetic chain refers to the linkage of multiple segments of the body that allows for transfer of forces and motion. The lower extremities and core provide a base of support, generating energy that is transferred eventually through the throwing arm and hand, resulting in release of the ball.

Comparison of satisfied and dissatisfied patients 2 to 5 years after anatomic total shoulder arthroplasty.

Background: With an increasingly large number of patients undergoing total shoulder arthroplasty (TSA) combined with increased requirements for public reporting of patient outcomes, there is a greater need to better understand the underlying factors related to patient satisfaction. The purpose of this study was to compare patient demographics, nonorthopedic comorbidities, patient-reported outcome scores, and range of motion of patients who reported being either satisfied or dissatisfied with their procedure at midterm follow-up.

Methods: We identified 234 primary TSAs performed by a single surgeon for glenohumeral osteoarthritis with a minimum 2-year follow-up in a prospective shoulder arthroplasty registry.

Preoperative opioid use associated with worse outcomes after anatomic shoulder arthroplasty.

Background: Preoperative opioid use has been associated with worse clinical outcomes after orthopedic surgery. The purpose of this study was to evaluate the impact of preoperative opioid use on outcomes and patient satisfaction after anatomic total shoulder arthroplasty (TSA).

Methods: We identified 224 TSAs performed for primary glenohumeral joint osteoarthritis with 2- to 5-year follow-up in a prospective shoulder arthroplasty registry.

Current Practice for the Surgical Treatment of SLAP Lesions: A Systematic Review.

Purpose: To analyze current literature reporting surgical treatment of SLAP lesions to examine the consistency of reported surgical details (surgical indications, surgical technique, and postoperative rehabilitation) that are deemed important for best treatment outcomes and to try to establish a consensus regarding treatment.

Methods: A systematic review of papers reporting surgical treatment of a SLAP lesion was performed. Each paper was analyzed for the description of (1) the arthroscopic indications for surgery; (2) surgical aspects including type, location, and number of anchors and sutures; (3) description of criteria for determination of completeness of the repair; and (4) postoperative rehabilitation details.

RELIABILITY OF STRENGTH AND PERFORMANCE TESTING MEASURES AND THEIR ABILITY TO DIFFERENTIATE PERSONS WITH AND WITHOUT SHOULDER SYMPTOMS.

Background: Upper extremity physical performance measures exist but none have been universally accepted as the primary means of gauging readiness to return to activity following rehabilitation. Few reports have described reliability and/or differences in outcome with physical performance measures between individuals with and without shoulder symptoms.

Hypotheses/purpose: The purpose of this study was to establish the reliability of traditional upper extremity strength testing and the CKCUEST in persons with and without shoulder symptoms as well as to determine if the testing maneuvers could discriminate between individuals with and without shoulder symptoms.

Current Practice for the Diagnosis of a SLAP Lesion: Systematic Review and Physician Survey.

Purpose: To evaluate current practice reported in the literature for making a SLAP lesion diagnosis and compare the findings with a survey sent to experienced shoulder surgeons assessing how they make a SLAP diagnosis.

Methods: We performed a systematic review of articles reporting surgical repair of SLAP lesions, documenting the use of 4 diagnostic areas of evaluation: history, clinical examination, imaging, and diagnostic arthroscopy. A survey was distributed electronically to 175 surgeons with expertise in shoulder surgery.

Preseason Perceived Physical Capability and Previous Injury.

Context: Patient opinion about the ability to perform athletic maneuvers is important after injury; however, prospective assessment of self-perceived physical capability for athletes before the beginning of a season is lacking.

Objective: To perform a descriptive analysis of knee, shoulder, and elbow self-perceived measures of physical capability specific to athletics and to compare the measures between athletes with and without a history of injury.

Design: Cross-sectional study.

The role of the scapula in preventing and treating shoulder instability.

The shoulder is a closed-chain mechanism that balances the mobility required by the ranges of motion in normal activities with the stability required to act as a stable ball and socket base for those activities. The scapula plays key roles in the closed-chain mechanism by being mobile enough to place the glenoid in optimal relation to the humerus to facilitate concavity/compression and by being a stable base for coordinated muscle activation to compress the humerus into the glenoid. Scapular dyskinesis alters these roles and is frequently present in many types of glenohumeral instability.

Return to Preinjury Levels of Participation After Superior Labral Repair in Overhead Athletes: A Systematic Review.

Context: Athletes often preoperatively weigh the risks and benefits of electing to undergo an orthopaedic procedure to repair damaged tissue. A common concern for athletes is being able to return to their maximum levels of competition after shoulder surgery, whereas clinicians struggle with the ability to provide a consistent prognosis of successful return to participation after surgery. The variation in study details and rates of return in the existing literature have not supplied clinicians with enough evidence to give overhead athletes adequate information regarding successful return to participation when deciding to undergo shoulder surgery.

Lateral tibial plateau autograft in revision surgery for failed medial unicompartmental knee arthroplasty.

Purpose: Revision surgery for failed unicompartmental knee arthroplasty (UKA) with bone loss is challenging. Several options are available including cement augmentation, metal augmentation, and bone grafting. The aim of the present study was to describe a surgical technique for lateral tibial plateau autografting and report mid-term outcomes.

Bone block procedures in posterior shoulder instability.

Purpose: Posterior shoulder dislocation is often associated with bone defects. Surgical treatment is often necessary to address these lesions. The aim of the present systematic review was to analyse the available literature concerning bone block procedures in the treatment of bone deficiencies following posterior dislocation.

Characteristics of clinical shoulder research over the last decade: a review of shoulder articles in The Journal of Bone & Joint Surgery from 2004 to 2014.

Background: The purpose of this study was to determine characteristics and trends in published shoulder research over the last decade in a leading orthopaedic journal.

Methods: We examined all clinical shoulder articles published in The Journal of Bone & Joint Surgery from 2004 to 2014. The number of citations, authorship, academic degrees of the authors, country and institution of origin, topic, level of evidence, positive or nonpositive outcome, and inclusion of validated patient-reported outcome measures were assessed for each article.

Return to swimming protocol for competitive swimmers: a post-operative case study and fundamentals.

Unlabelled: A large percentage of swimmers report shoulder pain during their swimming career. Shoulder pain in swimmers has been attributed to duration of swim practice, total yardage, and break down in stroke technique. Rehabilitation programs are generally land-based and cannot adequately address the intricacies of the swimming strokes.

Preliminary development of a clinical prediction rule for treatment of patients with suspected SLAP tears.

Purpose: To use the clinical prediction rule process to identify patient variables, measured on initial clinical presentation, that would be predictive of failure to achieve satisfactory improvement, while following a rehabilitation program, in the modification of SLAP injury symptoms and dysfunction.

Methods: A cohort of patients received the clinical diagnosis of a SLAP lesion based on specific history and examination findings and/or magnetic resonance imaging. They underwent a physical examination of the kinetic chain and shoulder, including tests for labral injury.

Improvements in shoulder endurance following a baseball-specific strengthening program in high school baseball players.

Background: The posterior shoulder muscles play key roles in maintaining shoulder function in throwing. Arm fatigue has been identified as a risk factor for shoulder and elbow pain in youth baseball pitchers. However, endurance of the posterior shoulder muscles in overhead athletes is not routinely examined or conditioned.

Mechanics and pathomechanics in the overhead athlete.

Optimal performance of the overhead throwing task requires precise mechanics that involve coordinated kinetic and kinematic chains to develop, transfer, and regulate the forces the body needs to withstand the inherent demands of the task and to allow optimal performance. These chains have been evaluated and the basic components, called nodes, have been identified. Impaired performance and/or injury, the DTS, is associated with alterations in the mechanics that are called pathomechanics.