Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Oct 2020
Comparative StudyA comparative study of arthroscopic débridement versus repair for Ellman grade II bursal-side partial-thickness rotator cuff tears.
We aimed to report the clinical outcomes of arthroscopic débridement vs. repair for Ellman grade II bursal-side partial-thickness rotator cuff tears. ⋯ Arthroscopic débridement and repair of Ellman grade II bursal-side partial-thickness rotator cuff tears achieved comparable clinical scores and low retear rates during 2 years of follow-up. However, débridement achieved better results, especially within 6 months postoperatively, and achieved a favorable prognosis up to 2 years postoperatively.
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J Shoulder Elbow Surg · Oct 2020
Comparative StudyCemented vs. uncemented glenoid fixation in total shoulder arthroplasty for osteoarthritis: a New Zealand Joint Registry study.
Total shoulder arthroplasty (TSA) is commonly performed for shoulder osteoarthritis (OA). Uncemented metal-backed (MB) glenoid components were introduced in an attempt to avoid glenoid loosening. New Zealand and Australian Joint Registry studies have shown significantly higher revision rates when uncemented MB glenoids are used. We used the New Zealand Joint Registry (NZJR) to compare all-cause revision rates and functional scores for TSA and investigated the trends of glenoid fixation used in New Zealand. ⋯ In the NZJR, primary TSAs undertaken for OA have a significantly higher all-cause revision rate when the glenoid component is uncemented. Uncemented glenoids have a 5.0 times higher revision rate. Excluding SMR L2 glenoids from the analysis, the significantly higher revision rate remained for uncemented glenoids. These data reaffirm that uncemented MB glenoids are associated with higher revision rates.
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J Shoulder Elbow Surg · Oct 2020
Biomechanical effects of superior capsular reconstruction in a rotator cuff-deficient shoulder: a cadaveric study.
Superior capsular reconstruction (SCR) has been gaining popularity as a treatment for irreparable rotator cuff tears (RCTs), especially in younger patients. This biomechanical study aimed to investigate how SCR affects functional abduction force, humeral head migration, and passive range of motion following an irreparable RCT. We hypothesized that SCR will restore these parameters to nearly intact shoulder levels. ⋯ In the setting of an irreparable SS tear, SCR restores key biomechanical parameters of the shoulder to intact levels. SCR should be considered for qualifying patients with irreparable RCTs.
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J Shoulder Elbow Surg · Sep 2020
Detection of traumatic elbow arthrotomies: computed tomography scan vs. saline load test.
Traumatic elbow arthrotomies are common injuries evaluated for by orthopedic services; however, failed identification of a traumatic arthrotomy leads to a high risk of developing septic arthritis. Currently these injuries are evaluated by either a saline load test or a computed tomography (CT) scan, yet there is little published evidence regarding detection of traumatic elbow arthrotomies. ⋯ After our study and based on the recommendations of the brief literature on this topic, we advise evaluating for traumatic elbow arthrotomies with a saline load test as the primary method of detection.
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J Shoulder Elbow Surg · Sep 2020
ReviewCutibacterium acnes: a threat to shoulder surgery or an orthopedic red herring?
Cutibacterium acnes is a lipophilic, anaerobic, gram-positive bacillus that mainly colonizes the pilosebaceous glands of human skin. It has been implicated as the leading cause of prosthetic joint infection (PJI) after shoulder arthroplasty. However, PJI caused by C acnes rarely manifests as overt clinical, laboratory, or imaging features. ⋯ C acnes is an important cause of shoulder PJI in some patients. However, there is a large body of literature that suggests other functions that need to be considered. Further research is needed to define the role of C acnes that is logically explained by all of the literature and not only some.