Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Nov 2014
Upregulation of transforming growth factor-β signaling in a rat model of rotator cuff tears.
Muscle atrophy, fatty infiltration, and fibrosis of the muscle have been described as important factors governing outcome after rotator cuff injury and repair. Muscle fibrosis is also thought to have a role in determining muscle compliance at the time of surgery. The transforming growth factor-β (TGF-β) pathways are highly conserved pathways that exert a potent level of control over muscle gene expression and are critical regulators of fibrosis in multiple organ systems. It has been shown that TGF-β can regulate important pathways of muscle atrophy, including the Akt/mammalian target of rapamycin pathway. The purpose of this study was to evaluate the expression of TGF-β and its downstream effectors of fibrosis after a massive rotator cuff tear (RCT) in a previously established rat model. ⋯ TGF-β signaling is significantly upregulated in rat supraspinatus muscles after RCTs.
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J Shoulder Elbow Surg · Nov 2014
Nationwide shoulder arthroplasty rates and revision burden in Germany: analysis of the national hospitalization data 2005 to 2006.
The aim of this study was to provide nationwide shoulder arthroplasty rates in Germany based on the national hospitalization file and to estimate the revision burden for shoulder arthroplasty and its determinants. ⋯ We found more than 2-fold higher primary rates for HA than for TSA and up to 3-fold higher shoulder arthroplasty rates for women than for men. TSA had a 3-fold higher relative burden of revision than HA.
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J Shoulder Elbow Surg · Nov 2014
The effects of medial ulnar collateral ligament reconstruction on Major League pitching performance.
Medial ulnar collateral ligament (MUCL) reconstruction is commonly performed on Major League Baseball (MLB) pitchers. Previous studies have reported that most pitchers return to presurgical statistical performance levels after MUCL reconstruction. ⋯ MUCL reconstruction allows most players to return to pitching at the major league level. However, after MUCL reconstruction, there is a statistically significant decline in pitching performance. There appears to be a statistically significant decline in pitching performance the year before reconstructive surgery, and this decline is also a risk factor for requiring surgery. In addition, there is an increased risk of MUCL reconstruction for pitchers who enter the major leagues at a younger age.
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J Shoulder Elbow Surg · Nov 2014
Arthroscopic anatomic glenoid reconstruction using an autologous iliac crest bone grafting technique.
Open bone block procedures for glenohumeral stabilization have been used for a long time. With the advancement of arthroscopic techniques and the development of sophisticated instruments and implants, the insertion of the bone block can be performed by an all-arthroscopic approach. The purpose of this study was to evaluate the clinical and radiologic results after an arthroscopic anatomic glenoid reconstruction using an all-arthroscopic, autologous tricortical iliac crest bone grafting technique. ⋯ The arthroscopic reconstruction of anteroinferior glenoid defects re-creates the pear-shaped anatomy of the anteroinferior glenoid and leads to good to excellent early clinical results.
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J Shoulder Elbow Surg · Oct 2014
Morbid obesity in total shoulder arthroplasty: risk, outcomes, and cost analysis.
A rate of obesity in the US population and the rate of total shoulder arthroplasty (TSA) has increased over the past decade. Little information exists concerning the number of morbidly obese patients undergoing TSA or how these patients compare with their non-obese counterparts. The goal of this study was to determine whether morbidly obese patients exhibit greater rates of postoperative in-hospital complications, mortality, or utilization of resources. ⋯ Obese patients tend to have longer hospital stays, an increased risk of postoperative respiratory complications, and higher costs. Although there was a trend toward an increased early postoperative mortality rate, obesity was not associated with an increased incidence of most complications. These findings should be supplemented with further research to assist patient counseling and risk adjustment for obese patients undergoing TSA.