Shoulder OA

Glenohumeral biomechanics after rotator cuff (RC) tears have not been fully elucidated. This study aimed to investigate the muscle compensatory mechanism in weight-bearing shoulders with RC tears and asses the induced pathomechanics (i.e., glenohumeral translation, joint instability, center of force (CoF), joint reaction force). An experimental, glenohumeral simulator with muscle-mimicking cable system was used to simulate 30° scaption motion. Eight fresh-frozen shoulders were prepared and mounted in the simulator...

BACKGROUND: The decision to treat shoulder osteoarthritis definitively with shoulder arthroplasty (SA) is multifactorial, considering objective findings, subjective information, and patient goals. The first goal of this study was to determine if Patient Reported Outcome Measurement Information System (PROMIS) measures correlated with patients with shoulder osteoarthritis (OA) who underwent SA within 1 year. The second goal of this study was to determine if score cut-offs in PROMIS domains could further discriminate which shoulder OA patients underwent SA within 1 year...

Due to first promising long term outcome data, reverse shoulder arthroplasty experienced an immense increase of usage during the past decade. Moreover, the initial Grammont concept has constantly been refined and adapted to current scientific findings. Therefore, clinical and radiological problems like scapular notching and postoperative instability were constantly addressed but do still remain an area of concern.This article summarises current concepts in reverse shoulder arthroplasty and gives an overview of actual indications like cuff tear arthropathy, severe osteoarthritis, proximal humerus fractures, tumours, fracture sequelae as well as revision surgery and their corresponding clinical and radiological results...

BACKGROUND: The purpose of this study was to evaluate the influence of humeral position of Affinis short implant in stemless anatomic total shoulder arthroplasties (STSA) on clinical and radiological results and mid- to long-term survival in the treatment of primary osteoarthritis (OA) of the shoulder. METHODS: 80 patients treated with a stemless shoulder arthroplasty for OA of the shoulder were evaluated with a mean follow-up (FU) of 92 ± 14 months (range 69 to 116 months) by Constant (CS)-Score, Disability of Shoulder, Arm and Hand (DASH)-Score and active range of motion (ROM)...

Background  The thumb carpometacarpal joint (CMCJ) osteoarthritis is one of the most common pathologies in the hand with controversial treatment options. Description of Technique  Describe the use of arthroscopic technique for thumb CMCJ arthrodesis and the clinical outcome. Patients and Methods  Cases with Eaton III thumb CMCJ osteoarthritis treated with arthroscopic arthrodesis were reviewed. Patient evaluations include: grip strength, pinch strength, range of motion, Kapandji score, Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and the visual analog scores for pain...

BACKGROUND: Constitutional static posterior humeral decentering (type C1 according to ABC Classification) has been recognized as a pre-osteoarthritic deformity that may lead to early-onset posterior decentering osteoarthritis at a young age. Therefore, it is important to identify possible associations of this pathologic shoulder condition to find more effective treatment options. PURPOSE: To perform a comprehensive analysis of all parameters reported to be associated with a C1 shoulder-including the osseous shoulder morphology, scapulothoracic orientation, and the muscle volume of the shoulder girdle in a single patient cohort...

BACKGROUND: Researchers have attempted to understand the underlying mechanism of the Latarjet procedure; however, its effects on shoulder kinematics have not been well studied. PURPOSE/HYPOTHESIS: The purpose was to analyze shoulder kinematics after the Latarjet procedure. It was hypothesized that the nonanatomic transfer of the coracoid process during the procedure would affect normal shoulder kinematics. STUDY DESIGN: Controlled laboratory study...

BACKGROUND: Reverse total shoulder arthroplasty (RSA) has been increasingly utilized for a variety of shoulder pathologies that are difficult to treat with anatomical shoulder arthroplasty (TSA). Few studies have compared the outcomes of TSA versus RSA in patients with cuff intact GHOA and poor preoperative forward elevation. This study aimed to determine whether there is a difference in functional outcomes and postoperative ROM between TSA and RSA in these patients. METHODS: This retrospective cohort study included 116 patients who underwent RSA or TSA between 2013 and 2022 for the treatment of rotator cuff intact primary osteoarthritis with restricted preoperative forward flexion (FF) and a minimum 1-year follow-up...

BACKGROUND: Arthroscopic superior capsular reconstruction (ASCR) and reverse shoulder arthroplasty (RSA) have both shown favorable outcomes in patients with irreparable rotator cuff tears (IRCTs). PURPOSE: To (1) compare the clinical outcomes of ASCR versus RSA in patients aged ≥65 years with IRCTs and (2) compare serial changes in clinical outcomes between treatment groups. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: This study included patients with IRCTs without glenohumeral osteoarthritis who underwent either ASCR or RSA between March 2013 and December 2020 and had at least 2 years of follow-up data...

BACKGROUND: Anatomic and reverse total shoulder arthroplasty (TSA) are effective treatment options for end-stage glenohumeral osteoarthritis. However, consideration for pre-existing conditions must be taken into account. Factor V Leiden (FVL), the most common inherited thrombophilia, is one such condition that predisposes to a prothrombotic state and may affect perioperative and longer-term outcomes following TSA. METHODS: Adult patients undergoing primary TSA for osteoarthritis indication were identified in the 2010 through October 2021 PearlDiver M157 database...

PURPOSE: The purpose of this study was to compare outcomes of patients that underwent rotator cuff repair (RCR) with concomitant biceps tenodesis to those that underwent an isolated RCR. METHODS: Exclusion criteria included prior ipsilateral shoulder surgery, irreparable rotator cuff tears, rotator cuff arthropathy, calcific tendinitis, adhesive capsulitis requiring a capsular release or advanced osteoarthritis of the glenohumeral joint. Patients were indicated for biceps tenodesis if they had any degree of tendon tearing, moderate to severe tenosynovitis, instability, or a significant degenerative SLAP tear...

BACKGROUND: An increased or decreased critical shoulder angle (CSA) is a known risk factor for osteoarthritis, lesions, and re-ruptures in the rotator cuff. A CSA greater than 35° correlates with degenerative rotator cuff tears, while a CSA of less than 30° correlates with osteoarthritis in the glenohumeral joint. The diagnostic gold standard for its determination is X-ray or MRI. OBJECTIVES: The primary objective of this research was to assess the viability of utilizing sonography imaging as a diagnostic tool to determine the modified critical shoulder angle (mCSA)...

PURPOSE: Various surgical treatments have been described for the treatment of reverse Hill-Sachs lesions (rHSls) sized between 20% and 50% in the case of posterior shoulder dislocation. The aim of this systematic review is to report the clinical and radiological outcomes of subscapularis or lesser tuberosity transfer (McLaughlin and modified procedures) compared to bone or osteochondral autograft or allograft. METHODS: A systematic review was performed on five medical databases up to December 2022...

BACKGROUND: Four-dimensional computerized tomographies (4D-CTs) or motion CTs in elbow disorders have several potential advantages over conventional static imaging such as a reduction of misdiagnoses, a more targeted surgical approach, better patient understanding of their condition and potentially faster operative times. However, the radiation dose is higher than conventional static CT scans so this should be used judiciously. Our study reviews the current literature for 4D-CTs in dynamic elbow disorders and provides a technical note describing radiation-reduced targeted elbow 4D-CTs (te4D-CT) with two exemplar cases alongside our recommendations for when te4D-CTs are indicated...

BACKGROUND: Machine learning algorithms are finding increasing use in prediction of surgical outcomes in orthopedics. Random forest is one of such algorithms popular for its relative ease of application and high predictability. In the process of sample classification, algorithms also generate a list of variables most crucial in the sorting process. Total shoulder arthroplasty (TSA) is a common orthopedic procedure after which most patients are discharged home. The authors hypothesized that random forest algorithm would be able to determine most important variables in prediction of nonhome discharge...

BACKGROUND: This review aims to describe the origin and development of critical shoulder angle (CSA) and its correlation with different shoulder pathologies. Current literature is inconclusive in characterizing the role of CSA in predicting pathology and surgical outcomes. METHODS: A literature search of both historical and more contemporary research articles on CSA was conducted to compare data points on the impact of CSA on shoulder pathology and postoperative clinical outcomes...

BACKGROUND: The minimal clinically important difference (MCID) is defined as the smallest meaningful change in a health domain that a patient would identify as important. Thus, an improvement that exceeds the MCID can be used to define a successful treatment for the individual patient. AIM: To quantify the rate of clinical improvement following anatomical total shoulder arthroplasty for glenohumeral osteoarthritis. METHODS: Patients were treated with the Global Unite total shoulder platform arthroplasty between March 2017 and February 2019 at Herlev and Gentofte Hospital, Denmark...

PURPOSE OF THE STUDY: The critical shoulder angle (CSA) is formed by the combination of glenoid inclination and acromial index and has been shown related to rotator cuff tears and glenohumeral osteoarthritis. SLAP lesions today have an important place among bicipitolabral pathologies that cause intensive shoulder pain. We aimed to investigate the relationship between CSA and glenoid depth and SLAP lesions. MATERIAL AND METHODS: Between March 2017 and January 2022, 279 consecutive shoulder arthroscopy patients' MRI images were retrospectively examined...

The shoulder joint has a complex anatomy and biomechanics. It is a ball and socket joint made by the articulation surface of the humeral head (ball) and glenoidal fossa (socket) of the scapula. Shoulder arthroplasty is done when parts of the shoulder joint are severely affected and damaged beyond repair. The damaged parts are replaced with artificial parts. Prosthetic implants are typically made of metal or plastic material. Implants come in various sizes and shapes. There are three types of surgical arthroplasty: total shoulder arthroplasty, partial shoulder arthroplasty, and reverse arthroplasty...

PURPOSE: To determine, from a sizable cohort of reverse shoulder arthroplasty (RSA), whether the deltopectoral (DP) or anterosuperior (AS) approach grant better outcomes at a minimum follow-up of 24 months. METHODS: The authors reviewed 743 RSAs in patients with primary osteoarthritis (OA) with or without rotator cuff lesions and secondary OA due to rotator cuff tears. The DP approach was used in 540 and the AS approach in 203. Pre- and post-operative constant scores (CSs) and shoulder range of motion were recorded...