Journal of Shoulder and Elbow Surgery via MedWorm.com

Editorial Board

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:48 +0100

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Sponsoring Societies

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:48 +0100

(Source: Journal of Shoulder and Elbow Surgery)

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:48 +0100

(Source: Journal of Shoulder and Elbow Surgery)

Cell- and gene-based approaches to tendon regeneration

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:44 +0100

Repair of rotator cuff tears in experimental models has been significantly improved by the use of enhanced biologic approaches, including platelet-rich plasma, bone marrow aspirate, growth factor supplements, and cell- and gene-modified cell therapy. Despite added complexity, cell-based therapies form an important part of enhanced repair, and combinations of carrier vehicles, growth factors, and implanted cells provide the best opportunity for robust repair. Bone marrow–derived mesenchymal stem cells provide a stimulus for repair in flexor tendons, but application in rotator cuff repair has not shown universally positive results. The use of scaffolds such as platelet-rich plasma, fibrin, and synthetic vehicles and the use of gene priming for stem cell differentiation and local anabolic a...

Biomimetic scaffold design for functional and integrative tendon repair

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:43 +0100

Rotator cuff tears represent the most common shoulder injuries in the United States. The debilitating effect of this degenerative condition coupled with the high incidence of failure associated with existing graft choices underscores the clinical need for alternative grafting solutions. The 2 critical design criteria for the ideal tendon graft would require the graft to not only exhibit physiologically relevant mechanical properties but also be able to facilitate functional graft integration by promoting the regeneration of the native tendon-to-bone interface. Centered on these design goals, this review will highlight current approaches to functional and integrative tendon repair. In particular, the application of biomimetic design principles through the use of nanofiber- and nanocomposite...

Scaffold devices for rotator cuff repair

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:42 +0100

This article reviews the current basic science and clinical understanding of commercially available synthetic and extracellular matrix scaffolds for rotator cuff repair. Our review will emphasize the host response and scaffold remodeling, mechanical and suture-retention properties, and preclinical and clinical studies on the use of these scaffolds for rotator cuff repair. We will discuss the implications of these data on the future directions for use of these scaffolds in tendon repair procedures. (Source: Journal of Shoulder and Elbow Surgery)

Fiber-aligned polymer scaffolds for rotator cuff repair in a rat model

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:42 +0100

Conclusions: No adverse effect of surgical implantation of overlaid fiber-aligned scaffolds on structural properties of supraspinatus tendons in rat rotator cuff repair was demonstrated, validating this model as a platform for targeted delivery. (Source: Journal of Shoulder and Elbow Surgery)

The role of nitric oxide in tendon healing

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:41 +0100

Nitric oxide (NO) is a small free radical that is generated by a family of enzymes called the nitric oxide synthases (NOS). There are 3 isoforms of NOS: endothelial NOS (eNOS), brain or neuronal NOS (bNOS), and inducible NOS (iNOS). In experiments performed during the last 20 years, we have shown that NO is induced by all 3 isoforms of NOS after tendon injury and that NOS activity is upregulated in tendinopathy. In normal uninjured tendons, there is very little NOS activity. In injured rat and human tendons, NOS activity was found in healing fibroblasts in a temporal fashion. In animal models, competitive inhibition of NOS resulted in reduced tendon healing, whereas the addition of NO resulted in enhanced tendon healing. In cultured human cells, the addition of NO via chemical means and ad...

The role of mechanobiology in tendon healing

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:40 +0100

Mechanical cues affect tendon healing, homeostasis, and development in a variety of settings. Alterations in the mechanical environment are known to result in changes in the expression of extracellular matrix proteins, growth factors, transcription factors, and cytokines that can alter tendon structure and cell viability. Loss of muscle force in utero or in the immediate postnatal period delays tendon and enthesis development. The response of healing tendons to mechanical load varies depending on anatomic location. Flexor tendons require motion to prevent adhesion formation, yet excessive force results in gap formation and subsequent weakening of the repair. Excessive motion in the setting of anterior cruciate ligament reconstruction causes accumulation of macrophages, which are detrimenta...

Cytokines in rotator cuff degeneration and repair

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:40 +0100

The pathogenesis of rotator cuff degeneration remains poorly defined, and the incidence of degenerative tears is increasing in the aging population. Rates of recurrent tear and incomplete tendon-to-bone healing after repair remain significant for large and massive tears. Previous studies have documented a disorganized, fibrous junction at the tendon-to-bone interface after rotator cuff healing that does not recapitulate the organization of the native enthesis. Many biologic factors have been implicated in coordinating tendon-to-bone healing and maintenance of the enthesis after rotator cuff repair, including the expression and activation of transforming growth factor-β, basic fibroblast growth factor, platelet-derived growth factor-β, matrix metalloproteinases, and tissue inhibitors of m...

Potential of collagen cross-linking therapies to mediate tendon mechanical properties

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:39 +0100

Collagen cross-links are fundamental to the mechanical integrity of tendon, with orderly and progressive enzymatic cross-linking being central to healthy development and injury repair. However, the nonenzymatic cross-links that form as we age are associated with increased tendon brittleness, diminished mechanical resistance to injury, and impaired matrix remodeling. Collagen cross-linking thus sits at the center of tendon structure and function, with important implications to age, disease, injury, and therapy. The current review touches on these aspects from the perspective of their potential relevance to the shoulder surgeon. We first introduce the most well-characterized endogenous collagen cross-linkers that enable fibrillogenesis in development and healing. We also discuss the glycatio...

Metalloproteases and rotator cuff disease

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:38 +0100

The molecular changes occurring in rotator cuff tears are still unknown, but much attention has been paid to better understand the role of matrix metalloproteinases (MMP) in the development of tendinopathy. These are potent enzymes that, once activated, can completely degrade all components of the connective tissue, modify the extracellular matrix (ECM), and mediatethe development of painful tendinopathy and tendon rupture. To control the local activity of activated proteinases, the same cells produce tissue inhibitors of metalloproteinases (TIMP) that bind to the enzymes and prevent degradation. The balance between the activities of MMPs and TIMPs regulates tendon remodeling, whereas an imbalance produces a collagen dis-regulation and disturbances intendons. ADAMs (a disintegrin and metal...

Lessons we can learn from gene expression patterns in rotator cuff tears and tendinopathies

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:38 +0100

Persistently high failure rates that are reported after rotator cuff repairs have encouraged greater understanding of the pathophysiology that underlies rotator cuff tears. Biologic changes that contribute to the pathogenesis of rotator cuff tears and tendinopathies, as well as adaptation after these changes, have been well described. A subset of patients with a genetic predisposition to early onset of rotator cuff tears and earlier symptom and disease progression have been identified. Many biologic changes occurring at the gene level have been identified. Pathways that are believed to contribute to rotator cuff tendinopathies include extracellular matrix remodeling, angiogenesis, changes in metabolism, apoptosis, and stress-related genes. Metaplasia of rotator cuff cells is contributed to...

Biologic approaches to enhance rotator cuff healing after injury

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:37 +0100

Conclusions: Use of growth factors, stem cell therapy, and other tissue-engineering means serve to augment classical surgical rotator cuff repair procedures. The combination of stem cells and growth factors resulted in enhanced repair that emulated uninjured tissue, but the literature search reflected paucity of research in this field. Preclinical evidence from gene therapy and stem cell studies can be used as a start to move therapy from the experimental phase to clinical translation in patients.Level of evidence: Review Article. (Source: Journal of Shoulder and Elbow Surgery)

Mechanisms of fatty degeneration in massive rotator cuff tears

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:37 +0100

Fatty degeneration of chronically injured muscle is a commonly recognized consequence of massive rotator cuff tears. Current surgical treatments are unable to alter or reverse the progression of fatty degeneration and are associated with poor functional outcomes in these patients. Therefore, a better understanding of the pathophysiology of fatty degeneration is required. As such, recent discoveries in stem cell biology and new animal models have significantly advanced our understanding of the cellular and molecular basis of fatty degeneration. Future studies will facilitate development of novel treatments to prevent the progression of fatty degeneration and improve muscle regeneration in patients with massive rotator cuff tears. (Source: Journal of Shoulder and Elbow Surgery)

Muscle degeneration in rotator cuff tears

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:36 +0100

Rotator cuff tears are among the most common injuries seen by orthopedic surgeons. Although small- and medium-sized tears do well after arthroscopic and open repair, large and massive tears have been shown to develop marked muscle atrophy and fatty infiltration within the rotator cuff muscles. These pathologic changes have been found to be independent predictors of failed surgical repair with poor functional outcomes. To understand the pathophysiology of rotator cuff disease, we must first develop an understanding of the changes that occur within the cuff muscles themselves. The purpose of this review is to summarize the molecular pathways behind muscular degeneration and emphasize new findings related to the clinical relevance of muscle atrophy and fatty infiltration seen with rotator cuf...

Basic mechanisms of tendon fatigue damage

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:36 +0100

Pathologic processes intrinsic and extrinsic to the tendons have been proposed as the underlying cause of rotator cuff disease, but the precise etiology is not known. Tear formation is, in part, attributable to the accumulation of subrupture tendon fatigue damage. We review the molecular, mechanical, and structural changes induced in tendons subjected to controlled amounts of fatigue loading in an animal model of early tendinopathy. The distinct tendon responses to low and moderate levels of loading, as opposed to high levels, provide insight into the potential mechanisms for the therapeutic benefits of exercise in the treatment of rotator cuff tendinopathy. The progression of damage accumulation leading to fiber rupture and eventual tendon tearing seen with higher loading illustrates the ...

Measurement of in vivo tendon function

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:34 +0100

Chronic tendon pathologies (eg, rotator cuff tears, Achilles tendon ruptures) are common, painful, debilitating, and a significant source of medical expense. Treatment strategies for managing tendon pathologies vary widely in invasiveness and cost, with little scientific basis on which to base treatment selection. Conventional techniques for assessing the outcomes of physical therapy or surgical repair typically rely on patient-based assessments of pain and function, physical measures (eg, strength, range of motion, or stability), and qualitative assessments using magnetic resonance imaging or ultrasound. Unfortunately, these conventional techniques provide only an indirect assessment of tendon function. The inability to make a direct quantitative assessment of the tendon’s mechanical ca...

Editor’s note

Journal of Shoulder and Elbow Surgery — Sat, 14 Jan 2012 14:39:34 +0100

It is well established that secure healing between the rotator cuff tendon and bone after repair is often unpredictable and challenging to achieve. The normal tendon–bone insertion site is a highly specialized tissue, and the structure and composition of this native insertion site is not re-established after rotator cuff repair. This is likely due to deficiencies in both the biologic and biomechanical environment. The cellular and molecular signals that lead to formation of the native insertion site during embryogenesis and development are not recapitulated during tendon healing. This has led to the recent, intense interest in approaches to augment the biologic events that occur during tendon healing. (Source: Journal of Shoulder and Elbow Surgery)

Editorial Board

Journal of Shoulder and Elbow Surgery — Tue, 13 Dec 2011 17:33:26 +0100

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Sponsoring Societies

Journal of Shoulder and Elbow Surgery — Tue, 13 Dec 2011 17:33:26 +0100

(Source: Journal of Shoulder and Elbow Surgery)

Journal of Shoulder and Elbow Surgery — Tue, 13 Dec 2011 17:33:26 +0100

(Source: Journal of Shoulder and Elbow Surgery)

In Reply:

Journal of Shoulder and Elbow Surgery — Tue, 13 Dec 2011 17:33:26 +0100

The comments about our article, “A prospective analysis of interscalene brachial plexus blocks performed under general anaesthesia,” in their Letter to the Editor are in line with the standard teaching of anesthesia that has existed in recent years. However, we believe that there is no scientific basis for that position. The opposition to the performance of interscalene brachial plexus block (ISBPB) on patients under general anesthesia has been based on case reports in which complications have occurred in that setting. The presumption has been that the complications would not have occurred if the patient in each situation had been awake at the time of the block. We contend that there is no basis for that presumption because there has never been a comparative study that has demonstrated...

Peripheral nerve blockade under general anesthesia—benefits not shown to outweigh risk

Journal of Shoulder and Elbow Surgery — Tue, 13 Dec 2011 17:33:26 +0100

We have read the recent article by Misamore et al with great interest because performing peripheral nerve blocks in anesthetized patients is a controversial practice with a potential for severe injury. Although we applaud the authors for conducting a prospective study to further our understanding of the risks and benefits, we believe that much more research needs to be done before this practice can be recommended for routine use. (Source: Journal of Shoulder and Elbow Surgery)

Operative versus nonoperative treatment after primary traumatic anterior glenohumeral dislocation

Journal of Shoulder and Elbow Surgery — Mon, 14 Nov 2011 05:00:00 +0100

We thank the authors of the letter for their interest in our study regarding expected-value decision analysis of operative vs nonoperative treatment after primary traumatic anterior glenohumeral dislocation. We further thank the authors for performing probabilistic sensitivity analysis on our data. (Source: Journal of Shoulder and Elbow Surgery)

Journal of Shoulder and Elbow Surgery — Sun, 13 Nov 2011 16:26:40 +0100

(Source: Journal of Shoulder and Elbow Surgery)

Sponsoring Societies

Journal of Shoulder and Elbow Surgery — Sun, 13 Nov 2011 16:26:40 +0100

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Editorial Board

Journal of Shoulder and Elbow Surgery — Sun, 13 Nov 2011 16:26:40 +0100

(Source: Journal of Shoulder and Elbow Surgery)

Treatment of proximal humeral dysplasia epiphysealis hemimelica with custom hemiarthroplasty: a case report

Journal of Shoulder and Elbow Surgery — Sun, 13 Nov 2011 16:26:40 +0100

Dysplasia epiphysealis hemimelica is a rare disorder involving alterations in the growth of the epiphyses. It is more frequently encountered in the lower extremity, and shoulder girdle involvement is less common. Diagnosis is usually made by radiographically identifying epiphyseal lesions of varying size that alter joint size and shape. Often, these lesions progress to limit joint motion and can lead to pain. Presented here is a patient in whom epiphysiodesis failed and who underwent shoulder hemiarthroplasty after humeral head collapse. (Source: Journal of Shoulder and Elbow Surgery)

Implant sonication for the diagnosis of prosthetic elbow infection

Journal of Shoulder and Elbow Surgery — Sun, 13 Nov 2011 16:26:40 +0100

Conclusion: Culture of the implant by sonication is at least as sensitive as periprosthetic tissue culture to detect prosthetic elbow infection. (Source: Journal of Shoulder and Elbow Surgery)

A ten-year radiologic comparison of two-all polyethylene glenoid component designs: a prospective trial

Journal of Shoulder and Elbow Surgery — Sun, 13 Nov 2011 16:26:40 +0100

Conclusion: At 10 years there was no difference in the presence or progression of RRLs between a flat-back and a convex-back glenoid all-polyethylene design. Young age, hand dominance, and poor implantation technique influence glenoid RLLs and affect the clinical result of TSA. (Source: Journal of Shoulder and Elbow Surgery)

Editor's Note - We're on Facebook!

Journal of Shoulder and Elbow Surgery — Sun, 13 Nov 2011 16:26:40 +0100

Less than a decade ago, readers would have to check their mailbox for the latest issue of the Journal. The contents would be a surprise, and if one had a question for the author of an article, it would have to wait for the next Society meeting. Over the last few years, connectivity to the Internet has become ubiquitous and engendered a desire for immediate access to information. If one isn’t surfing the web from their home computer, they are accessing it from their mobile tablet or smart phone while on the street or in a plane. (Source: Journal of Shoulder and Elbow Surgery)

Diagnostic accuracy of five orthopedic clinical tests for diagnosis of superior labrum anterior posterior (SLAP) lesions

Journal of Shoulder and Elbow Surgery — Mon, 31 Oct 2011 04:00:00 +0100

Conclusion: There are a number of potential reasons for the poor utility in the 5 test findings. The heterogeneous sample included patients with a variety of shoulder disorders. The study was organized using very strict methodologic controls that should reduce the risk of bias, which normally overinflates the accuracy of a specific tool. The findings may truly reflect the stand-alone, diagnostic utility of the 5 tests, suggesting when used alone provides little usefulness toward decision making of the diagnostic clinician. (Source: Journal of Shoulder and Elbow Surgery)

Effects of surgical approach on functional outcomes of open reduction and internal fixation of intra-articular distal humeral fractures: a systematic review

Journal of Shoulder and Elbow Surgery — Fri, 21 Oct 2011 04:00:00 +0100

Fractures of the distal humerus are uncommon injuries, constituting between 0.5% and 7% of all fractures and 30% of all elbow fractures. Up to 96% of these injuries are intercondylar, or AO type C, distal humeral fractures involving the articular surface. These fractures are notoriously difficult to treat, presenting the surgeon with multiple challenges including the complex anatomy of the elbow joint itself, articular surface comminution, and frequently, osteopenic or osteoporotic bone stock. Anatomic reduction of the joint surface, restoration of the overall anatomic axes of the extremity, and stable fixation allowing for early elbow mobilization are keys to achieving a good surgical outcome. Early motion is critically important after open reduction and internal fixation (ORIF) of these ...

Etiology of rotator cuff tears in paraplegic patients: a case-control study

Journal of Shoulder and Elbow Surgery — Fri, 21 Oct 2011 04:00:00 +0100

Conclusion: The etiology of RCTs in paraplegic patients seems to be based on wear-and-tear mechanisms rather than aging. These results are important for our understanding of shoulder pathology in long-term paraplegic patients and show the impact of this problem. (Source: Journal of Shoulder and Elbow Surgery)

The first 20 years of the Journal of Shoulder and Elbow Surgery

Journal of Shoulder and Elbow Surgery — Fri, 21 Oct 2011 04:00:00 +0100

The first issue of the Journal of Shoulder and Elbow Surgery (JSES) appeared in January 1992. The issue you hold in your hands thus celebrates 20 years of publication of the JSES. JSES is very fortunate to have been led by just two editors during the first 17 years of its existence—the two Bobs—Cofield and Neviaser. Bob Cofield was the first editor and shepherded it through its first 5 years of existence, through 1996. Bob Neviaser then took over the leadership and was at the helm for 12 years, through 2008. I asked our two editors emeriti to lend us their thoughts on their years as editors-in-chief and the development of the JSES. They have been kind enough to do so and their comments are found in the following. We thank them both for this summary, but more importantly, for their work...

Responsiveness of the EQ-5D in patients with proximal humeral fractures

Journal of Shoulder and Elbow Surgery — Fri, 21 Oct 2011 04:00:00 +0100

Conclusion: The EQ-5D displayed good internal and external responsiveness in patients with proximal humeral fractures and can be recommended for use as a quality of life measure in patients with this particular injury. (Source: Journal of Shoulder and Elbow Surgery)

Triceps avulsion, radial head fracture, and medial collateral ligament rupture about the elbow: a report of 4 cases

Journal of Shoulder and Elbow Surgery — Mon, 17 Oct 2011 04:00:00 +0100

Triceps tendon rupture is a rare but well-reported entity. Three of these reports have documented the occurrence of a triceps avulsion with a radial head fracture. There have also been reports of triceps rupture with medial collateral ligament (MCL) avulsion or insufficiency. These reports did not describe a triceps avulsion with a radial head fracture and concomitant rupture of the MCL. (Source: Journal of Shoulder and Elbow Surgery)

Disorders of the long head of biceps tendon

Journal of Shoulder and Elbow Surgery — Mon, 17 Oct 2011 04:00:00 +0100

Disorders of the long head of the biceps (LHB) tendon can exist in conjunction with several other shoulder pathologies. Currently, the function of the LHB tendon remains unresolved. It is clear, however, that this tendon can be a significant source of shoulder pain and dysfunction. We have reviewed the anatomy, pathophysiology, classification, diagnosis, and treatment of disorders involving the LHB tendon. We also have reviewed the literature to help make treatment decisions. (Source: Journal of Shoulder and Elbow Surgery)

Can we improve the reliability of the Constant-Murley score?

Journal of Shoulder and Elbow Surgery — Mon, 17 Oct 2011 04:00:00 +0100

Conclusions: This study showed that the standardization of the items significantly improved both the intraobserver reliability and interobserver reliability of the CMS. The level of expertise of the observer has less of an effect on reliability when the score is applied with a higher level of standardization. (Source: Journal of Shoulder and Elbow Surgery)

Sequential ipsilateral glenohumeral arthrodesis and scapulothoracic fusion: a case report

Journal of Shoulder and Elbow Surgery — Mon, 10 Oct 2011 04:00:00 +0100

Glenohumeral arthrodesis is a well-established surgical procedure with a variety of indications, which include brachial plexus palsies and other paralytic disorders. Disorders requiring scapulothoracic fusion, however, are much less frequent, and scapulothoracic fusion is usually indicated for paralysis of the muscles controlling the scapulothoracic articulation, often the result of facioscapulohumeral dystrophy or occasional damage to the long thoracic nerve, the spinal accessory nerve, or the dorsal scapular nerve. (Source: Journal of Shoulder and Elbow Surgery)

Extremely rare synovial chondrosarcoma arising from the elbow joint: case report and review of the literature

Journal of Shoulder and Elbow Surgery — Mon, 10 Oct 2011 04:00:00 +0100

Primary synovial chondromatosis is benign disease of the mucosal membrane in the joint. This disease often affects the knee joint but rarely the elbow joint. Chondrosarcoma, however, is a common malignant bone tumor that usually arises from cartilaginous tissue but which can also arise de novo in extraskeletal tissues. Synovial chondrosarcoma arising from chondromatosis is one of the rarest types of chondrosarcoma. To our knowledge, only 31 patients with a malignant transformation of synovial chondromatosis have been reported (). (Source: Journal of Shoulder and Elbow Surgery)

Validation of a photography-based goniometry method for measuring joint range of motion

Journal of Shoulder and Elbow Surgery — Mon, 10 Oct 2011 04:00:00 +0100

Conclusions: Photography-based goniometry is accurate and reliable for measuring elbow ROM. The photography-based method relied less on observer expertise than clinical goniometry. This validates an objective measure of patient outcome without requiring doctor-patient contact at a tertiary care center, where most contracture surgeries are done. (Source: Journal of Shoulder and Elbow Surgery)

Treatment of persistent instability after posterior fracture-dislocation of the elbow: restoring stability and mobility by internal fixation and hinged external fixation

Journal of Shoulder and Elbow Surgery — Fri, 07 Oct 2011 04:00:00 +0100

Conclusion: Surgical restoration of the static stabilizers in combination with hinged external fixation leads to satisfactory results when performed within the first 6 weeks after injury. When definite surgical stabilization is delayed more than 6 weeks, the procedure can still restore stability but the functional results are often disappointing. (Source: Journal of Shoulder and Elbow Surgery)

Journal of Shoulder and Elbow Surgery — Thu, 22 Sep 2011 17:24:54 +0100

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Sponsoring Societies

Journal of Shoulder and Elbow Surgery — Thu, 22 Sep 2011 17:24:54 +0100

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Editorial Board

Journal of Shoulder and Elbow Surgery — Thu, 22 Sep 2011 17:24:54 +0100

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Cerebrovascular accident in a 19-year-old patient: a case report of posterior sternoclavicular dislocation

Journal of Shoulder and Elbow Surgery — Thu, 22 Sep 2011 17:24:54 +0100

Sternoclavicular (SC) injuries are rare, accounting for only 3% of shoulder girdle injuries. The dislocation can be either anterior or posterior, with the latter being less prevalent; fewer than 125 cases have been reported. Moreover, posterior dislocations are significantly more ominous because of the close anatomic relationship of the medial clavicle and superior mediastinum. Presenting symptoms of posterior dislocations may be as subtle as less fullness of the medial clavicle on the injured side than on the uninjured side. On the other hand, there have been reports of shortness of breath caused by tracheal injuries, dysphagia from esophageal injuries, vascular compromise from great vessel injuries, and upper extremity weakness due to brachial plexus injuries. To our knowledge, there has...

Objective evaluation of shoulder function using body-fixed sensors: a new way to detect early treatment failures?

Journal of Shoulder and Elbow Surgery — Thu, 22 Sep 2011 17:24:54 +0100

Conclusion: Kinematic scores add information to the regular outcome tools. They offer an effective way to measure the functional performance of patients with shoulder pathology and have the potential to detect early treatment failures. (Source: Journal of Shoulder and Elbow Surgery)

Magnetic resonance imaging in radial head fractures: most associated injuries are not clinically relevant

Journal of Shoulder and Elbow Surgery — Tue, 20 Sep 2011 04:00:00 +0100

Conclusion: Most injuries found with MRI in patients with radial head fractures are not symptomatic or of clinical importance in short-term follow-up. (Source: Journal of Shoulder and Elbow Surgery)

Osteoid osteoma of the coracoid masked as localized capsulitis of the shoulder

Journal of Shoulder and Elbow Surgery — Fri, 16 Sep 2011 04:00:00 +0100

Painful loss of range of motion is a common complaint among shoulder patients. Primary frozen shoulder is defined as significant restriction of active and passive range of motion in the absence of any identifiable intrinsic cause. It is a self-limiting disease characterized by the sequence of 3 phases: freezing, frozen, and thawing. In secondary frozen shoulder, underlying pathologies, such as rotator cuff lesions or calcifying tendinitis, induce the process of adhesive capsulitis. It is therefore of primary importance that the treating physician rule out such underlying diseases in patients with loss of range of motion. (Source: Journal of Shoulder and Elbow Surgery)

Path analysis of factors for functional outcome at one year in 463 proximal humeral fractures

Journal of Shoulder and Elbow Surgery — Fri, 16 Sep 2011 04:00:00 +0100

Conclusion: Prevention of local complications, in particular those leading to severe varus deviation, appears essential to improve shoulder function after a proximal humeral fracture. (Source: Journal of Shoulder and Elbow Surgery)

The effectiveness of therapeutic exercise for painful shoulder conditions: a meta-analysis

Journal of Shoulder and Elbow Surgery — Mon, 05 Sep 2011 04:00:00 +0100

Conclusion: Therapeutic exercise is an effective intervention for the treatment of painful shoulder conditions; however, subsequent research is necessary for translation into clinical practice. (Source: Journal of Shoulder and Elbow Surgery)

High-resolution 3-Tesla magnetic resonance neurography of musculocutaneous neuropathy

Journal of Shoulder and Elbow Surgery — Fri, 02 Sep 2011 04:00:00 +0100

The musculocutaneous nerve originates from the lateral cord of the brachial plexus, with contributions from the C5, C6, and C7 nerve roots. Once the musculocutaneous nerve leaves the lateral cord, it pierces the coracobrachialis muscle and then travels along the lateral aspect of the arm, coursing between the biceps brachii and brachialis muscles, and finally continuing in the forearm as the lateral antebrachial cutaneous nerve. It supplies the biceps brachii, brachialis, and coracobrachialis muscles and provides cutaneous innervations to the lateral forearm and lateral cubital region. (Source: Journal of Shoulder and Elbow Surgery)

Complex fracture-dislocations of the proximal ulna and radius in adults: a comprehensive classification

Journal of Shoulder and Elbow Surgery — Fri, 02 Sep 2011 04:00:00 +0100

Conclusion: We created a comprehensive classification of complex fracture-dislocations of the elbow. The classification appeared to be reproducible and may represent a useful tool for the management of such difficult injuries. (Source: Journal of Shoulder and Elbow Surgery)

Varicose veins at the spinoglenoidal notch: an unusual cause of suprascapular nerve compression

Journal of Shoulder and Elbow Surgery — Thu, 01 Sep 2011 04:00:00 +0100

Suprascapular neuropathy is assumed to be a relatively rare but significant cause of shoulder pain. Of all shoulder pain, only 1-2% is caused by entrapment of the suprascapular nerve (SSN). The main symptoms are pain, weakness, and atrophy of supra- and/or infraspinatus muscles. These symptoms are also present in other more common pathologies around the shoulder, making SSN entrapment classically a diagnosis of exclusion. There are several potential causes of SSN entrapment. It is typically due to compression or traction in association with other injuries. Along its course, the SSN is particularly vulnerable at the suprascapular and spinoglenoid notches. Additional extrinsic compression may be caused by adjacent ganglia or soft tissue masses. Traction neuropathy may occur following excessi...

Extranodal Rosai-Dorfman disease presenting as an isolated glenoid lesion in a high school athlete

Journal of Shoulder and Elbow Surgery — Mon, 29 Aug 2011 04:00:00 +0100

Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy (SHML), was first described as a clinical entity by Rosai and Dorfman in 1969. The first description of the disease reported a rare non-neoplastic disorder involving the proliferation of histiocytes predominantly involving the lymph nodes. “Sinus histiocytosis” refers to histiocytosis that occurs in the distended sinuses of lymph nodes, but since its initial description, RDD has been reported to involve a wide variety of organ systems and has been found in numerous locations throughout the body. (Source: Journal of Shoulder and Elbow Surgery)

Forearm pain associated with loose radial head prostheses

Journal of Shoulder and Elbow Surgery — Mon, 22 Aug 2011 04:00:00 +0100

Conclusion: The presence of proximal radial forearm pain in a patient with a radial head prosthesis is an indicator of symptomatic mechanical loosening. If the prosthesis has a textured surface for bone ingrowth, and was inserted without cement, we now consider this a strong indicator of loosening, even in the absence of radiographic signs. (Source: Journal of Shoulder and Elbow Surgery)

Radial head replacement with a bipolar system: a minimum 2-year follow-up

Journal of Shoulder and Elbow Surgery — Fri, 19 Aug 2011 04:00:00 +0100

Conclusion: This review demonstrates that a bipolar radial head prosthesis with a smooth stem and telescoping neck effectively restores stability to elbows with a comminuted radial head fracture and valgus instability. To date, this is the largest reported outcome analysis of bipolar radial head replacement in the literature. (Source: Journal of Shoulder and Elbow Surgery)

Editorial Board

Journal of Shoulder and Elbow Surgery — Fri, 12 Aug 2011 23:33:11 +0100

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Sponsoring Societies

Journal of Shoulder and Elbow Surgery — Fri, 12 Aug 2011 23:33:11 +0100

(Source: Journal of Shoulder and Elbow Surgery)

Journal of Shoulder and Elbow Surgery — Fri, 12 Aug 2011 23:33:11 +0100

(Source: Journal of Shoulder and Elbow Surgery)

Treatment of post-infection nonunion of the supracondylar humerus with Ilizarov external fixator

Journal of Shoulder and Elbow Surgery — Fri, 12 Aug 2011 23:33:00 +0100

Conclusion: Ilizarov treatment for post-infection nonunion of the supracondylar humerus was shown to be effective, reliable, and tolerated by the patients. (Source: Journal of Shoulder and Elbow Surgery)

Editor’s note

Journal of Shoulder and Elbow Surgery — Fri, 12 Aug 2011 23:32:59 +0100

She was a 46-year-old woman with shoulder pain secondary to an “overuse” injury at work who was sent to me for a second opinion. The original surgeon had recommended an arthroscopic acromioplasty, after several corticosteroid injections, none of which had helped. I listened to her story, examined her, checked out her radiographs and magnetic resonance images, and then told her my opinion. I really had no idea what was wrong with her shoulder, and told her the only diagnosis I could make was shoulder pain. Her pain was diffuse, nonclassic for rotator cuff tendinopathy, and in a million years I did not think an acromioplasty would improve her situation. I told her that, much more gently, of course, but it was obvious she thought I had 2 heads, neither of which had a brain in it, and went...

An anatomic and clinical study of the suprascapular and axillary nerve blocks for shoulder arthroscopy

Journal of Shoulder and Elbow Surgery — Fri, 12 Aug 2011 04:00:00 +0100

Conclusions: The SSNB and ANB were considered to provide safe and effective analgesia in terms of early postoperative pain in arthroscopic shoulder surgery. (Source: Journal of Shoulder and Elbow Surgery)

Arthroscopic management of heterotopic ossification of the subscapularis tendon in a patient with tuberculosis: a case report

Journal of Shoulder and Elbow Surgery — Thu, 11 Aug 2011 04:00:00 +0100

We describe the en bloc removal of a subscapularis tendon ossification by arthroscopy in a patient with tuberculosis (TB). (Source: Journal of Shoulder and Elbow Surgery)

Midterm outcomes after humeral head replacement with rotator cuff repair in patients with syringomyelia shoulder neuroarthropathy: a report on three cases

Journal of Shoulder and Elbow Surgery — Thu, 11 Aug 2011 04:00:00 +0100

Neuroarthropathy, known as a Charcot joint, is a severe, aggravated articulation associated with an underlying neurologic disorder in which a dysfunctional sensory mechanism severely induces joint overuse. As a result of this condition, articulation becomes unstable and deformed, with soft tissue swelling, intra-articular hemorrhage, para-articular debris, and osseous fragmentation. Neuroarthropathy has been associated with a number of disorders of the central and peripheral nervous systems, the most common of which are diabetic neuropathy, tabes dorsalis, and syringomyelia. (Source: Journal of Shoulder and Elbow Surgery)

Failed anterior shoulder stabilization

Journal of Shoulder and Elbow Surgery — Thu, 11 Aug 2011 04:00:00 +0100

Historically, arthroscopic transglenoid suture and bioabsorbable tack fixation techniques had higher rates of recurrent instability than open techniques, with a meta-analysis demonstrating a recurrence rate of 18% with bioabsorbable tacks, 23% with transglenoid sutures, and 10% with open surgery. Other studies have demonstrated even higher rates of recurrence with the use of arthroscopic tacks or transglenoid sutures. (Source: Journal of Shoulder and Elbow Surgery)

Rare complication of clavicular hook plate: clavicle fracture at the medial end of the plate

Journal of Shoulder and Elbow Surgery — Thu, 11 Aug 2011 04:00:00 +0100

We report a rare case of clavicle fracture at the medial end of the implant 40 days after the operation without a second significant injury. (Source: Journal of Shoulder and Elbow Surgery)

Reliability, agreement and validity of the 1988 version of the Rowe Score

Journal of Shoulder and Elbow Surgery — Thu, 11 Aug 2011 04:00:00 +0100

Conclusion: Results using the 1988 version of the Rowe score should be critically interpreted. (Source: Journal of Shoulder and Elbow Surgery)

Complete rupture through the short head of the biceps muscle belly: a case report

Journal of Shoulder and Elbow Surgery — Fri, 05 Aug 2011 04:00:00 +0100

Ruptures in the biceps brachii are common lesions. They are often seen in the elderly and generally involve the long head tendon. However, injuries to the biceps brachii muscle belly and distal tendons are rare. Statistics indicate 90-96% of all biceps brachii ruptures occur in the long head and 3-7% in the distal tendon. Muscle belly ruptures, particularly those in the short head, are extremely rare, and have most often involved military paratroopers. These injuries are typically caused by a direct blow to the upper extremity by static lines. To date, we have encountered 3 reported cases of isolated and complete rupture through the short head muscle belly. (Source: Journal of Shoulder and Elbow Surgery)

Comparison between the acromion index and rotator cuff tears in the Brazilian and Japanese populations

Journal of Shoulder and Elbow Surgery — Fri, 05 Aug 2011 04:00:00 +0100

Conclusion: The acromion index can be used as a predictive factor for RCTs in the Brazilian population but not in the Japanese population. (Source: Journal of Shoulder and Elbow Surgery)

Vacuum assist glenoid fixation: does this technique lead to a more durable glenoid component?

Journal of Shoulder and Elbow Surgery — Fri, 05 Aug 2011 04:00:00 +0100

Conclusion: If a cement technique is chosen to implant a glenoid component, the vacuum assist weep-hole technique is the most effective cementing technique to achieve durable fixation. (Source: Journal of Shoulder and Elbow Surgery)

Comparison of glenohumeral and subacromial steroid injection in primary frozen shoulder: a prospective, randomized short-term comparison study

Journal of Shoulder and Elbow Surgery — Fri, 05 Aug 2011 04:00:00 +0100

Conclusions: The GH steroid injection was not superior to a SA injection for patients with primary frozen shoulder even though injection at the GH joint led to earlier pain relief compared with the SA injection. SA steroid injection along with a GH injection is an alternative modality, and the treatment should be individualized and tailored appropriately. (Source: Journal of Shoulder and Elbow Surgery)

Ulnar collateral ligament tear and olecranon stress fracture nonunion in a collegiate pitcher

Journal of Shoulder and Elbow Surgery — Thu, 04 Aug 2011 04:00:00 +0100

Olecranon stress fractures may occur as part of the valgus extension overload (VEO) syndrome, which is a constellation of symptoms and physical findings that is commonly seen in the overhead athlete. They may occur in throwing athletes as a result of repetitive microtrauma due to posteromedial olecranon impingement within the olecranon fossa or due to excessive triceps tensile stress. In high-level adolescent throwing athletes with open physes, these repetitive stresses can result in symptomatic olecranon epiphyseal plate stress fractures. Alternatively, the physis may fail to fuse and be persistently patent in an asymptomatic individual. In an adult with a closed physis, these stresses can lead to a stress fracture related to the points of mechanical impingement of the proximal ulna and o...

Complication rates, dislocation, pain, and postoperative range of motion after reverse shoulder arthroplasty in patients with and without repair of the subscapularis

Journal of Shoulder and Elbow Surgery — Tue, 02 Aug 2011 04:00:00 +0100

Conclusion: Repairing the subscapularis has no appreciable effect on complication rate, dislocation events, or range of motion gains and pain relief. (Source: Journal of Shoulder and Elbow Surgery)

Biological glenoid resurfacing for glenohumeral osteoarthritis: a systematic review

Journal of Shoulder and Elbow Surgery — Tue, 02 Aug 2011 04:00:00 +0100

Young patients with glenohumeral joint arthritis are difficult to treat. Though total shoulder arthroplasty (TSA) and hemiarthroplasty provide reliable pain relief and restoration of function in this population, concerns regarding longevity, particularly of the glenoid component, persistent in active patients. Sperling et al have studied long-term outcomes of TSA and hemiarthroplasty in patients less than 50 years of age and have noted 68% rate of radiographic glenoid erosions in hemiarthroplasty and a 59% glenoid lucency rate in TSA. Most importantly, at minimum of 5 years, both treatment options had an unsatisfactory radiographic rating of more than 50%. As a result, some shoulder surgeons consider biological resurfacing of the glenoid as a potential means of pain relief, while preserv...

Inflammatory response to recombinant human bone morphogenetic protein-2 use in the treatment of a proximal humeral fracture: a case report

Journal of Shoulder and Elbow Surgery — Thu, 28 Jul 2011 04:00:00 +0100

Bone morphogenetic protein-2 (BMP-2) is an endogenous osteoinductive protein that plays a critical role in the initiation of fracture healing by stimulating differentiation of mesenchymal progenitor cells along the osteoblastic lineage. Recombinant human BMP-2 (rhBMP-2), 1 of 2 clinically available BMPs, received premarket approval from the U.S. Food and Drug Administration (FDA) in 2002 for single-level anterior lumbar interbody fusion in skeletally mature patients and in 2004 for open tibial fractures stabilized by intermedullary nailing within 14 days of injury. The benefit of rhBMP-2 in these settings is well supported by published randomized controlled studies. (Source: Journal of Shoulder and Elbow Surgery)

Erratum to: “The allograft sleeve: A case report of the surgical management of an interprosthetic fracture between a shoulder and elbow joint replacement” [J Shoulder Elbow Surg 2011, vol 20, no 3, pp e4-e9]

Journal of Shoulder and Elbow Surgery — Tue, 26 Jul 2011 04:00:00 +0100

In the abovementioned article, two author names printed incorrectly. The second author's name should appear as ‘Fraser Taylor.’ The last author’s name was incorrectly printed as “Bal.” The correct author name should be listed as “Craig M. Ball.” The editor, publisher, and production staff apologize for this error. (Source: Journal of Shoulder and Elbow Surgery)

Hemiarthroplasty versus nonoperative treatment of displaced 4-part proximal humeral fractures in elderly patients: a randomized controlled trial

Journal of Shoulder and Elbow Surgery — Mon, 25 Jul 2011 04:00:00 +0100

Conclusion: The results of the study demonstrated a significant advantage in quality of life in favor of HA, as compared to nonoperative treatment in elderly patients with a displaced 4-part fracture of the proximal humerus. The main advantage of HA appeared to be less pain while there were no differences in ROM. (Source: Journal of Shoulder and Elbow Surgery)

Accuracy of the biceps tendon sheath injection: ultrasound-guided or unguided injection? A randomized controlled trial

Journal of Shoulder and Elbow Surgery — Fri, 22 Jul 2011 04:00:00 +0100

Conclusion: Injection into the tendon sheath of the long head of the biceps brachii can be more accurately performed using ultrasound guidance than by the blind method. (Source: Journal of Shoulder and Elbow Surgery)

Response to “Literature review before questionnaire cross-cultural adaptation”

Journal of Shoulder and Elbow Surgery — Thu, 21 Jul 2011 04:00:00 +0100

We read with interest the letter, “Literature review before questionnaire cross-cultural adaptation” by Padua R et al., and are thankful for the opportunity to submit a response. (Source: Journal of Shoulder and Elbow Surgery)

Rotator cuff repair failure in vivo: a radiostereometric measurement study

Journal of Shoulder and Elbow Surgery — Thu, 21 Jul 2011 04:00:00 +0100

Conclusion: Most tendon marker movement was seen during the most intensive period of physiotherapy, in the second and third months after surgery. Significantly more movement was seen in the tendon markers of those patients in whom the repair failed. (Source: Journal of Shoulder and Elbow Surgery)

Corrective osteotomy for cubitus varus in middle-aged patients

Journal of Shoulder and Elbow Surgery — Wed, 20 Jul 2011 23:00:00 +0100

Conclusion: Cubitus varus in middle-aged patients can be treated by a closing wedge osteotomy and fixation with double plating. This provides satisfactory deformity correction, maintenance of the elbow motion, and good functional outcome, although healing of the osteotomy tends to be delayed. (Source: Journal of Shoulder and Elbow Surgery)

Magnetic resonance imaging study of glenohumeral relationships between genders

Journal of Shoulder and Elbow Surgery — Mon, 04 Jul 2011 04:00:00 +0100

Conclusion: We conclude that there are no significant differences in glenohumeral relationships between genders. (Source: Journal of Shoulder and Elbow Surgery)

Midshaft clavicular fractures: comparison of intramedullary pin and plate fixation

Journal of Shoulder and Elbow Surgery — Mon, 04 Jul 2011 04:00:00 +0100

Conclusion: Intramedullary pin fixation for acute, simple, or wedge-type midshaft clavicular fractures provides a safe and predictable alternative to plate and screw fixation. (Source: Journal of Shoulder and Elbow Surgery)

A cross-sectional study of demographic and morphologic features of rotator cuff disease in paraplegic patients

Journal of Shoulder and Elbow Surgery — Mon, 04 Jul 2011 04:00:00 +0100

Conclusions: Rotator cuff disease is common and correlates highly with age and duration of spinal cord injury, which underlines the theory of “wear and tear” in wheelchair-dependent patients. (Source: Journal of Shoulder and Elbow Surgery)

Long-term subscapularis strength assessment after Bristow-Latarjet procedure: isometric study

Journal of Shoulder and Elbow Surgery — Thu, 30 Jun 2011 04:00:00 +0100

Conclusion: L-shaped tenotomy in Bristow-Latarjet procedure has a weakening effect on the subscapularis and for these reasons we strongly recommend the muscle split approach for an optimal subscapularis function recovery. (Source: Journal of Shoulder and Elbow Surgery)

Glenoid component loosening due to deficient subscapularis: a case study of eccentric loading

Journal of Shoulder and Elbow Surgery — Thu, 30 Jun 2011 04:00:00 +0100

Total shoulder arthroplasty is an effective means of treating pain and loss of function associated with glenohumeral arthritis. The most common complication of this procedure is failure of the glenoid component, accounting for up to 59% of the unsatisfactory total shoulder arthroplasty results. Multiple studies to identify the factors associated with glenoid component failure have led to improvements in component design, bony preparation, and cement technique. (Source: Journal of Shoulder and Elbow Surgery)

Irreparable spontaneous deltoid rupture in rotator cuff arthropathy: the use of a reverse total shoulder replacement

Journal of Shoulder and Elbow Surgery — Thu, 30 Jun 2011 04:00:00 +0100

The spontaneous rupture of the origin of the middle deltoid muscle is a rare condition that appears to be associated with massive rotator cuff tears. Despite the non-infrequent incidence of massive rotator cuff tears, the literature only reports a handful of cases of spontaneous deltoid rupture in the absence of trauma or previous surgery. The management of this entity has not been established; repair of the deltoid and underlying cuff tear is typically not possible. Reverse total shoulder arthroplasty has been used for massive rotator cuff tears; however, significant deltoid dysfunction is said to be a contraindication and preclude its use. While acknowledging these concerns, we present the case of a reverse total shoulder replacement in this rare condition, with a good outcome. (Source: ...

Subscapularis tenotomy versus lesser tuberosity osteotomy during total shoulder replacement: a comparison of patient outcomes

Journal of Shoulder and Elbow Surgery — Thu, 30 Jun 2011 04:00:00 +0100

Conclusion: Our results indicate that in this single-surgeon sequential series, patients who underwent osteotomy of the lesser tuberosity during TSR for osteoarthritis had a better functional outcome than those who had a subscapularis tenotomy as assessed by the graded belly-press test. (Source: Journal of Shoulder and Elbow Surgery)

Prospective evaluation of arthroscopic rotator cuff repairs at 5 years: part II–prognostic factors for clinical and radiographic outcomes

Journal of Shoulder and Elbow Surgery — Wed, 29 Jun 2011 23:00:00 +0100

Discussion: Larger tears in older patients who undergo concomitant procedures are predictive of radiographic defects at 5 years; however, radiographic healing did not correspond to clinical results. Younger patients with single tendon tears are more likely to undergo spontaneous resolution of a radiographic defect. This information can be useful in counseling patients regarding the mid-term results of this procedure. (Source: Journal of Shoulder and Elbow Surgery)

Prospective evaluation of arthroscopic rotator cuff repairs at 5 years: part I - Functional outcomes and radiographic healing rates

Journal of Shoulder and Elbow Surgery — Wed, 29 Jun 2011 23:00:00 +0100

This study reports those results at 5 years.Materials and methods: The study enrolled 193 patients who underwent all-arthroscopic rotator cuff repairs. Patients were evaluated preoperatively and at 1, 2, and 5 years postoperatively. Outcome measurements included the American Shoulder and Elbow Surgeons (ASES) score, range of motion, manual muscle testing, and ultrasonography.Results: At 5-years, 106 patients completed follow-up, representing 55% of the patients originally enrolled but 77% of those who returned for evaluation at 1 year. ASES scores improved from 52.6 ± 23.2 preoperatively to 92.6 ± 14.8 at 5 years (P < .001). Paired analyses showed no differences between the ASES scores at 2 and 5 years, but the scores improved from 1 to 5 years (P = .002). Between years 2 and 5, passive ...

Principles of glenoid component design and strategies for managing glenoid bone loss in revision shoulder arthroplasty in the absence of infection and rotator cuff tear

Journal of Shoulder and Elbow Surgery — Sun, 26 Jun 2011 23:00:00 +0100

The number of total shoulder arthroplasty (TSA) cases continues to grow each year. With the increasing number of procedures being performed, there, in turn, will exist a greater need for revision procedures. Failure of a shoulder arthroplasty can result from soft-tissue problems, bony deficiencies, infection, and component wear or loosening. Component loosening and osseous deficiencies may occur on the humeral and/or glenoid side. Multiple studies have identified glenoid component loosening as one of the more common causes necessitating revision after TSA. Glenohumeral joint instability in the setting of rotator cuff deficiency is also a common cause of glenoid loosening. Eccentric loading of the glenoid from proximal humeral migration leads to increased stress at the bone-cement or bone-i...

Journal of Shoulder and Elbow Surgery — Mon, 20 Jun 2011 23:47:56 +0100

(Source: Journal of Shoulder and Elbow Surgery)

Sponsoring Societies

Journal of Shoulder and Elbow Surgery — Mon, 20 Jun 2011 23:47:56 +0100

(Source: Journal of Shoulder and Elbow Surgery)

Editorial Board

Journal of Shoulder and Elbow Surgery — Mon, 20 Jun 2011 23:47:56 +0100

(Source: Journal of Shoulder and Elbow Surgery)

Disclosure of conflict of interest

Journal of Shoulder and Elbow Surgery — Mon, 20 Jun 2011 23:47:50 +0100

Readers of articles published in medical journals are entitled to a full disclosure of all financial conflicts of interest of the authors of those articles. In the fall of 2010, after extensive study, the International Committee of Medical Journal Editors, as a part of their “Uniform Requirements for Manuscripts Submitted to Biomedical Journals,” approved a Form for Disclosure of Potential Conflicts of Interest (www.icmje.org; available at www.jshoulderelbow.org). Over the past few months, this form has been adopted by many medical journals throughout the world. (Source: Journal of Shoulder and Elbow Surgery)

Metallosis after hemiarthroplasty as a result of glenoid erosion causing contact with retained metallic suture anchors: a case series

Journal of Shoulder and Elbow Surgery — Wed, 08 Jun 2011 23:00:00 +0100

Metallosis is a well-documented cause of joint replacement failure. Metal-on-metal contact leads to increased numbers of metal ions, which form immune protein complexes. This hypersensitivity reaction can lead to aseptic loosening. Although most metallosis failures are described in metal-on-metal hip arthroplasties, it has also been reported in the knee, elbow, and wrist. (Source: Journal of Shoulder and Elbow Surgery)

Influence of prosthetic design on radiocapitellar concavity-compression stability

Journal of Shoulder and Elbow Surgery — Wed, 08 Jun 2011 23:00:00 +0100

Conclusion: The shape of the articular dish (depth, radius of curvature) of a monopolar radial head implant affects its contribution to radiocapitellar stability. An implant that mimics normal anatomy is more effective than a shallow radial head implant with a radius of curvature that is longer than normal. (Source: Journal of Shoulder and Elbow Surgery)

Locked bucket-handle tear of the anterior labrum causing persistent subluxation of a dislocated shoulder

Journal of Shoulder and Elbow Surgery — Sun, 05 Jun 2011 23:00:00 +0100

We present a case-report of persistent subluxation caused by a locked bucket-handle tear of the anterior labrum extending superiorly. This was treated arthroscopically with resection of the locked bucket-handle tear and biceps tenotomy, with immediate reduction of the shoulder. (Source: Journal of Shoulder and Elbow Surgery)

Incidence and implications of early postoperative wound complications after total elbow arthroplasty

Journal of Shoulder and Elbow Surgery — Sun, 05 Jun 2011 23:00:00 +0100

Conclusions: The overall incidence of serious wound complications was slightly less than anticipated; however, the significance was considerable. Patients with rheumatoid arthritis are most vulnerable. Persistent wound drainage showed a high correlation for deep infection and subsequent implant removal. Anticipation of potential problems and appropriate prophylactic management may avoid wound complications. (Source: Journal of Shoulder and Elbow Surgery)

Efficacy of preoperative home use of 2% chlorhexidine gluconate cloth before shoulder surgery

Journal of Shoulder and Elbow Surgery — Wed, 25 May 2011 23:00:00 +0100

Conclusion: Use of chlorhexidine impregnated cloths prior to shoulder surgery may be a useful adjunct to presently used infection prevention strategies. (Source: Journal of Shoulder and Elbow Surgery)

Full-thickness supraspinatus tears are associated with more synovial inflammation and tissue degeneration than partial-thickness tears

Journal of Shoulder and Elbow Surgery — Wed, 25 May 2011 23:00:00 +0100

Conclusion: Increased synovial inflammation and tissue degeneration correlate with the tear size of the supraspinatus tendon. A better understanding of the relationship between synovial inflammation and the progression of tendon degeneration can help in the design of novel and effective treatments to limit the advancement of rotator cuff disease and to improve their clinical outcomes. (Source: Journal of Shoulder and Elbow Surgery)

Effect of glenoid deformity on glenoid component placement in primary shoulder arthroplasty

Journal of Shoulder and Elbow Surgery — Mon, 23 May 2011 04:00:00 +0100

Conclusion: Traditional methods to correct moderate to severe glenoid deformity and place the glenoid component within 5° of the ideal position are not consistent. Optimal glenoid component placement can be achieved when there is minimal bone deformity. Retroversion greater or equal to 20° makes it difficult to place a pegged glenoid component perpendicular to the plane of the scapula by asymmetric reaming without center peg perforation. (Source: Journal of Shoulder and Elbow Surgery)

A cadaveric model for suprascapular nerve injury during glenoid component screw insertion in reverse-geometry shoulder arthroplasty

Journal of Shoulder and Elbow Surgery — Mon, 23 May 2011 04:00:00 +0100

Conclusion: Metaglene fixation with screws poses a significant risk to the suprascapular nerve. Caution should be used when inserting the posterior and superior screws in particular. Short locking screws may allow adequate fixation while minimizing the risk of neurologic injury. (Source: Journal of Shoulder and Elbow Surgery)

Resection arthroplasty of the shoulder as a salvage procedure for deep shoulder infection: does the use of a cement spacer improve outcome?

Journal of Shoulder and Elbow Surgery — Mon, 23 May 2011 04:00:00 +0100

Conclusion: Resection arthroplasty can be offered to patients with long-standing deep shoulder infection that was unresponsive to previous surgical treatment. Control of infection did not differ significantly between the groups. No improvement in outcome was demonstrated with the use of cement spacers. (Source: Journal of Shoulder and Elbow Surgery)

Bristow-Latarjet and Bankart: a comparative study of shoulder stabilization in 185 shoulders during a seventeen-year follow-up

Journal of Shoulder and Elbow Surgery — Mon, 23 May 2011 04:00:00 +0100

Conclusions: Results were better after the Bristow-Latarjet repair than after Bankart repairs done with anchors with respect to postoperative stability and subjective evaluation. Shoulders with original Bankart repair also seemed to be more stable than shoulders repaired with anchors. (Source: Journal of Shoulder and Elbow Surgery)

Essex-Lopresti lesion associated with an impacted radial neck fracture: interest of ulnar shortening in the secondary management of sequelae

Journal of Shoulder and Elbow Surgery — Sun, 22 May 2011 23:00:00 +0100

We describe 2 patients with an impacted fracture of the radial neck in whom the Essex-Lopresti lesion was not suspected until 6 weeks after the injury. (Source: Journal of Shoulder and Elbow Surgery)

Humeral fracture following subpectoral biceps tenodesis in 2 active, healthy patients

Journal of Shoulder and Elbow Surgery — Sun, 22 May 2011 23:00:00 +0100

Pathology involving the long head of the biceps tendon is a common and significant cause of shoulder pain. For active patients with refractory biceps tendinosis, tenodesis of the tendon to either soft tissue or the humerus is the preferred surgical treatment. Subpectoral biceps tenodesis to the humeral diaphysis with an interference screw has been gaining popularity as an effective method for treating biceps pathology, as clinical studies have demonstrated favorable outcomes with low rates of postsurgical complications with this technique. (Source: Journal of Shoulder and Elbow Surgery)

Shoulder arthroplasty in patients with dwarfism: a report of 2 cases

Journal of Shoulder and Elbow Surgery — Sun, 22 May 2011 23:00:00 +0100

Some skeletal dysplasias are characterized by abnormalities in the development and remodeling of cartilage and bone and may herald the early onset of osteoarthritis. The cumulative effects of abnormal cartilage synthesis, increased cartilage fibrosis, and weight bearing on an abnormal joint leads to progressive degeneration of the articular surface and loss of articular congruency. This is probably the reason why many osteochondrodysplasias evolve to osteoarthritis in early adulthood. (Source: Journal of Shoulder and Elbow Surgery)

Comminuted radial head fractures: aspects of current management

Journal of Shoulder and Elbow Surgery — Sun, 22 May 2011 23:00:00 +0100

The radial head articulates with the humerus at the radiocapitellar articulation and with the ulnar sigmoid notch at the proximal radioulnar articulation. The radiocapitellar articulation may transmit up to 60% of loads applied across the elbow, with the greatest force transmission occurring between 0° and 30°. The peripheral part of the radial head that articulates with the sigmoid notch is covered with thick hyaline cartilage, whereas a nonarticulating arc (106°-120°) is covered by thinner yellowish cartilage. The blood supply of the radial head is tenuous, in most cases via a single extra osseous intracapsular vessel that enters the radial head laterally via its nonarticulating bare area, giving rise to a transversely orientated subarticular plexus. An extra osseous extraarticular r...

Propionibacterium acnes infection of the elbow

Journal of Shoulder and Elbow Surgery — Sun, 22 May 2011 23:00:00 +0100

Isolated elbow joint infection is very rare, with little information in the literature on the causative organism and clinical sequelae. Propionibacterium acnes is a rare but recognized cause of osteomyelitis, septic arthritis, and prosthetic joint infection. There are no recorded cases of elbow joint sepsis due to P acnes after a local injection into the elbow joint. The only previous cases of osteomyelitis of the elbow caused by P acnes were described in 1977. Both individuals had significant comorbidities, including 70% burns and a puncture wound to the hand. (Source: Journal of Shoulder and Elbow Surgery)

Management of a periprosthetic fracture after humeral head resurfacing total shoulder replacement: a case report

Journal of Shoulder and Elbow Surgery — Sun, 22 May 2011 23:00:00 +0100

Shoulder arthroplasty is becoming an increasingly common procedure in the United Kingdom. With an aging population and higher prevalence of osteoporosis, there is an increased risk of periprosthetic fractures. Total shoulder arthroplasty (TSA) is indicated in patients with severe symptoms caused by glenohumeral joint pathology, most commonly osteoarthritis. Humeral stemmed and humeral head resurfacing systems have been shown to be comparable in outcome at long-term follow-up. (Source: Journal of Shoulder and Elbow Surgery)

Progressive osteolysis of the radius after distal biceps tendon repair with the bioabsorbable screw

Journal of Shoulder and Elbow Surgery — Sun, 22 May 2011 23:00:00 +0100

Discussion: No correlation was found between the volume of bone tunnel and the functional outcome. However, the results indicate that the use of a bioabsorbable screw in distal biceps tendon repair results in significant bone osteolysis. (Source: Journal of Shoulder and Elbow Surgery)

Outcome of local anconeus flap transfer to cover soft tissue defects over the posterior aspect of the elbow

Journal of Shoulder and Elbow Surgery — Thu, 19 May 2011 23:00:00 +0100

Conclusion: The LAPF is a reliable flap that could be used to cover chronic soft tissue defect around the posterior aspect of the elbow, with expected wound healing in all patients at an average of 3 weeks after surgery. (Source: Journal of Shoulder and Elbow Surgery)

Journal of Shoulder and Elbow Surgery — Thu, 19 May 2011 14:34:17 +0100

(Source: Journal of Shoulder and Elbow Surgery)

Sponsoring Societies

Journal of Shoulder and Elbow Surgery — Thu, 19 May 2011 14:34:17 +0100

(Source: Journal of Shoulder and Elbow Surgery)

Editorial Board

Journal of Shoulder and Elbow Surgery — Thu, 19 May 2011 14:34:17 +0100

(Source: Journal of Shoulder and Elbow Surgery)

Aberrant branch of the long head of the biceps tendon

Journal of Shoulder and Elbow Surgery — Thu, 19 May 2011 14:34:16 +0100

We present a case of a patient with an aberrant branch of the LHBT. Although the clinical relevance is not clear, we present this case because, to our knowledge, this report is the first to describe an aberrant branch of the LHBT within the shoulder joint. (Source: Journal of Shoulder and Elbow Surgery)

Shoulder heterotopic ossification after bilateral hemiarthroplasty: case report and review of the literature

Journal of Shoulder and Elbow Surgery — Thu, 19 May 2011 14:34:16 +0100

Proximal humeral fractures are the third most common fracture in the elderly population after hip and distal radial fractures. In 1970, Neer described excellent to satisfactory results after primary hemiarthroplasty for the treatment of displaced humeral head fractures. Subsequent studies have shown hemiarthroplasty provides good to excellent pain relief in 73% to 97% of patients. Functional outcomes have been variable, however, ranging from excellent to poor. One of the complications associated with poor functional outcomes is heterotopic ossification (HO) that can limit range of motion. (Source: Journal of Shoulder and Elbow Surgery)

Management of the radial head and linked total elbow arthroplasty

Journal of Shoulder and Elbow Surgery — Thu, 19 May 2011 14:34:13 +0100

Conclusions: Most often the radial head can be preserved with this linked prosthesis. Rheumatoid arthritis carries a higher prevalence of radial head disease, and hence requires attention more commonly, usually with simple debridement. If impingement symptoms of radial head develop, secondary resection yields good results. (Source: Journal of Shoulder and Elbow Surgery)

Cemented versus uncemented fixation of humeral components in total shoulder arthroplasty for osteoarthritis of the shoulder: a prospective, randomized, double-blind clinical trial—A JOINTs Canada Project

Journal of Shoulder and Elbow Surgery — Thu, 19 May 2011 14:34:10 +0100

Conclusions: These findings provide level I evidence that cemented fixation of the humeral component provides better quality of life, strength, and range of motion than uncemented fixation. (Source: Journal of Shoulder and Elbow Surgery)

Platelet rich plasma in arthroscopic rotator cuff repair: a prospective RCT study, 2-year follow-up

Journal of Shoulder and Elbow Surgery — Thu, 19 May 2011 14:34:10 +0100

Conclusion: The results of our study showed autologous PRP reduced pain in the first postoperative months. The long-term results of subgroups of grade 1 and 2 tears suggest that PRP positively affected cuff rotator healing. (Source: Journal of Shoulder and Elbow Surgery)

Charles Sumner Neer II 10 November 1917–28 February 2011

Journal of Shoulder and Elbow Surgery — Thu, 19 May 2011 14:34:09 +0100

Charles Sumner Neer II (Fig. 1), son of pioneer Oklahoma Territory surgeon Charles S. Neer and Pearl Brooke Neer, was born and raised in Vinita, Oklahoma. A graduate of Dartmouth College and the University of Pennsylvania Medical School, his residency training years were interrupted by military service in World War II as an orthopaedic surgeon. He served in 3 theaters as a Captain in the Army. Following the war he returned to Columbia-Presbyterian Medical Center in New York to complete his training and join the Orthopaedic Service of the Presbyterian Hospital and faculty of the College of Physicians & Surgeons of Columbia University. He eventually became Chief of both the Fracture Service and the Adult Reconstructive Service. It was a relationship that endured for 50 years. Until his pass...

Editor’s note

Journal of Shoulder and Elbow Surgery — Thu, 19 May 2011 14:34:09 +0100

In 1997, Lou Soslowsky was named Associate Editor for Basic Science Research for the Journal of Shoulder and Elbow Surgery (JSES). He has now served in that position for 14 years; but, as they must, all good things come to an end. Last fall, Lou and I spoke at the American Shoulder and Elbow Surgeons (ASES) meeting in Scottsdale, Arizona and agreed that he would step down from this position as of July 2011. So, officially, as you read this, he will soon no longer be holding that position. This is not to mean that his influence will not continue to be felt, as papers he has edited and starting reviewing will continue to appear in these pages for at least the next year. (Source: Journal of Shoulder and Elbow Surgery)

Result of a pyrocarbon prosthesis after comminuted and unreconstructable radial head fractures

Journal of Shoulder and Elbow Surgery — Mon, 02 May 2011 04:00:00 +0100

Conclusion: The results of treating Mason type III radial head fractures with additional elbow fractures and soft-tissue injuries with pyrocarbon radial head prostheses are satisfactory; nevertheless, long-term follow-up is still necessary. (Source: Journal of Shoulder and Elbow Surgery)

Regarding “Correlation of psychomotor findings and the outcome of a physical therapy program to treat scapular dyskinesis”

Journal of Shoulder and Elbow Surgery — Mon, 02 May 2011 04:00:00 +0100

To the Editors: I am delighted to see articles on rehabilitation in the Journal. (Source: Journal of Shoulder and Elbow Surgery)

Elastofibroma dorsi: diagnostic and therapeutic algorithm

Journal of Shoulder and Elbow Surgery — Fri, 29 Apr 2011 04:00:00 +0100

Conclusions: Magnetic resonance imaging can be used as a first-line investigation of the lesion, and biopsy is not necessary in most cases. We suggest that a conservative “wait-and-watch” attitude is reasonable and may be considered even when patients are symptomatic. (Source: Journal of Shoulder and Elbow Surgery)

Clinical success of biceps tenodesis with and without release of the transverse humeral ligament

Journal of Shoulder and Elbow Surgery — Fri, 29 Apr 2011 04:00:00 +0100

Conclusion: Biceps tenodesis techniques which do not release the biceps sheath or remove the tendon from the sheath have increased revision rates, compared to techniques that do. This may be supportive evidence for the theory that residual pain generating elements in the biceps groove is a cause of failure of proximal tenodesis methods. (Source: Journal of Shoulder and Elbow Surgery)

The impact of preoperative smoking habit on rotator cuff tear: cigarette smoking influences rotator cuff tear sizes

Journal of Shoulder and Elbow Surgery — Fri, 29 Apr 2011 04:00:00 +0100

Conclusions: There is a correlation between cigarette smoking habit, rotator cuff tear, and tear size. There was an increasing daily average number of cigarettes and a total number of cigarettes smoked in life across patients with increasing severity of tears. (Source: Journal of Shoulder and Elbow Surgery)

Reconstruction with constrained prosthesis after total scapulectomy

Journal of Shoulder and Elbow Surgery — Fri, 29 Apr 2011 04:00:00 +0100

Conclusion: Although there are limitations in the shoulder’s active motion, reconstruction with a scapular prosthesis can provide oncologic salvage and result in good postoperative function with a low rate of complications. (Source: Journal of Shoulder and Elbow Surgery)

Operative versus nonoperative treatment after primary traumatic anterior glenohumeral dislocation: expected-value decision analysis

Journal of Shoulder and Elbow Surgery — Fri, 29 Apr 2011 04:00:00 +0100

Conclusions: Arthroscopic stabilization was the preferred strategy after a primary anterior glenohumeral dislocation. In clinical settings where the likelihood of recurrent instability is low after nonoperative care or when an informed patient has an aversion to surgery, nonoperative treatment may be the preferred treatment strategy. (Source: Journal of Shoulder and Elbow Surgery)

The prevalence of shoulder osteoarthritis in the elderly Korean population: association with risk factors and function

Journal of Shoulder and Elbow Surgery — Thu, 28 Apr 2011 23:00:00 +0100

Conclusion: Primary shoulder OA is not as rare as previously reported. Our data also demonstrated that older age and knee OA were determining risk factors for shoulder OA, and shoulder OA was related to poor function. (Source: Journal of Shoulder and Elbow Surgery)

Suprapectoral or subpectoral position for biceps tenodesis: biomechanical comparison of four different techniques in both positions

Journal of Shoulder and Elbow Surgery — Thu, 14 Apr 2011 04:00:00 +0100

Hypothesis: The aim of this study was to compare different techniques for tenodesis of the long head of biceps tendon (LHB) in the suprapectoral and subpectoral position to test the hypothesis that using shorter screws at the subpectoral position would achieve a similar primary ultimate failure load (UFL) as the longer screws at the suprapectoral position, that both types of tenodesis screws achieve comparable UFL, and that knotless suture anchor techniques can be performed at the subpectoral position in cortical bone and reach a UFL similar to tenodesis screws.Methods: On 42 fresh frozen human cadavers divided into 6 groups, 4 different techniques for LHB tenodesis were performed localized 10 mm and 50 mm, respectively, distal to the entrance of the bicipital groove. Two techniques with t...

Accuracy of measurement of Hill-Sachs lesions with computed tomography

Journal of Shoulder and Elbow Surgery — Thu, 14 Apr 2011 04:00:00 +0100

Conclusions: The depth of Hill-Sachs lesions can be reliably assessed using CT scan. Observers consistently underestimated width in all imaging planes. Overall, sagittal- and axial-plane measurements are more accurate for evaluation of these defects than the coronal plane. Future studies using 3-dimensional CT may be helpful to further quantitatively assess the size of the Hill-Sachs lesion, including width and volume. (Source: Journal of Shoulder and Elbow Surgery)

The safe zone for avoiding suprascapular nerve injury during shoulder arthroscopy: an anatomical study on 500 dry scapulae

Journal of Shoulder and Elbow Surgery — Thu, 14 Apr 2011 04:00:00 +0100

We examined 500 dried scapulae, measuring 6 distances for each one, referring to the scapular body, glenoid, and the course of the suprascapular nerve, also catalogued according to gender and side. Differences due to gender were assessed comparing mean ± sd of each distance in males and females; paired t test was used to compare distances deriving from each couple. Successively, we calculated our safe zone and Pearson’s correlation.Results: We found nonsignificant differences between the right and left distances deriving from each couple; differences due to gender were stated. We defined 3 kinds of safe zones referring to: 500 scapulae; males (139 scapulae) and females (147 scapulae). The correlation indexes calculated between the axis of the scapular body and glenoid, and the posterosu...

Acromial base fractures after reverse total shoulder arthroplasty: report of five cases

Journal of Shoulder and Elbow Surgery — Thu, 14 Apr 2011 04:00:00 +0100

Conclusion: Acromial base fractures after rTSA are a painful and disabling complication. The outcomes appear different in this series than in other series describing acromial fractures. This may be a result of the different anatomic location of the fractures. Pain improves with fracture union, but functional returns are unpredictable. (Source: Journal of Shoulder and Elbow Surgery)

Accuracy of glenohumeral joint injections: comparing approach and experience of provider

Journal of Shoulder and Elbow Surgery — Thu, 14 Apr 2011 04:00:00 +0100

Conclusion: There was no statistically significant difference between the 3 approaches. The anterior approach was the most accurate, independent of the experience level of the provider. The posterior approach produced the lowest level of confidence regardless of experience. The experienced providers were not able to accurately predict the results of their injections, and were more likely to be overconfident with the anterior and supraclavicular approaches. (Source: Journal of Shoulder and Elbow Surgery)

Postoperative coracoid fracture after transcoracoid acromioclavicular joint reconstruction

Journal of Shoulder and Elbow Surgery — Tue, 12 Apr 2011 23:00:00 +0100

We report a postoperative coracoid fracture after AC joint reconstruction using a transcoracoid fixation technique. (Source: Journal of Shoulder and Elbow Surgery)

Revision total shoulder arthroplasty for painful glenoid arthrosis after humeral head replacement: the posttraumatic shoulder

Journal of Shoulder and Elbow Surgery — Tue, 12 Apr 2011 04:00:00 +0100

This study was conducted to test the hypothesis that patients would have improved pain and range of motion after conversion total shoulder arthroscopy but that overall outcome would be substantially affected by the need for removal of the humeral component and associated alterations of bony anatomy or soft tissue deficiencies.Materials and methods: Thirty-four patients (34 shoulders) with HHR after a proximal humeral fracture underwent revision total shoulder arthroplasty for painful glenoid arthrosis, with mean follow-up of 9.4 years (range, 2.3-20.4 years). After initial review, repeat analysis was performed based on the complexity of osseous (humeral stem revision) and soft tissue management, including rotator cuff tear, greater tuberosity resorption, malunion or nonunion, or instabilit...

Regarding “Observations on retrieved humeral polyethylene components from reverse total shoulder arthroplasty”

Journal of Shoulder and Elbow Surgery — Mon, 11 Apr 2011 04:00:00 +0100

This study provides some useful descriptions of the type and location of wear that can be found in patients treated with reverse total shoulder arthroplasty (RTSA). (Source: Journal of Shoulder and Elbow Surgery)

Magnetic resonance imaging-controlled results of the pectoralis major tendon transfer for irreparable anterosuperior rotator cuff tears performed with standard and modified fixation techniques

Journal of Shoulder and Elbow Surgery — Mon, 11 Apr 2011 04:00:00 +0100

Conclusion: As a salvage procedure, the pectoralis major tendon transfer provides good results in most cases. Sufficient in-growth of the transferred tissue is essential for the success of the procedure. This seems to be facilitated by both methods. (Source: Journal of Shoulder and Elbow Surgery)

Proximal humeral fracture classification systems revisited

Journal of Shoulder and Elbow Surgery — Mon, 11 Apr 2011 04:00:00 +0100

Conclusion: Overall interobserver κ values represented slight to moderate agreement. The most reliable interobserver scores were found with the Codman-Hertel classification, followed by elements of Resch’s trial system. The AO system had the lowest values. The higher interobserver reliability values for the Codman-Hertel system showed that is the only comprehensive fracture description studied, whereas the novel classification by Resch showed clear definition in respect to varus/valgus and impaction/distraction angulation. (Source: Journal of Shoulder and Elbow Surgery)

Locking plate versus nonsurgical treatment for proximal humeral fractures: better midterm outcome with nonsurgical treatment

Journal of Shoulder and Elbow Surgery — Mon, 11 Apr 2011 04:00:00 +0100

Conclusion: Nonsurgical treatment should have a more prominent role in the treatment of proximal humeral fractures. (Source: Journal of Shoulder and Elbow Surgery)

Plating versus intramedullary pin or conservative treatment for midshaft fracture of clavicle: a meta-analysis of randomized controlled trials

Journal of Shoulder and Elbow Surgery — Sun, 10 Apr 2011 23:00:00 +0100

Conclusion: The available evidence suggests that there are no differences in treatment effects between plating and intramedullary pinning, but plating is associated with more side effects. Plating is associated with improved treatment effects when compared with conservative treatment. (Source: Journal of Shoulder and Elbow Surgery)

Total shoulder arthroplasty in a patient with Paget’s Disease: case report and review of the literature

Journal of Shoulder and Elbow Surgery — Sun, 10 Apr 2011 23:00:00 +0100

Paget’s Disease is a chronic bone disorder characterized by alterations in bone resorption, bone formation, and bone remodeling. The pathologic process can cause pain, limb deformities, and subsequent aberrations in normal joint mechanics. These abnormalities, in turn, can lead to advanced degenerative joint disease. The severe bone alterations with increased vascularity create several technical challenges for optimal joint replacement. Because of this, a number of reports on total hip and total knee arthroplasty have been published that now guide preoperative, intraoperative, and postoperative management in patients with Paget’s Disease. To our knowledge, however, no reports on management of glenohumeral osteoarthritis associated with Paget’s disease exist. Therefore, this is the fi...

Tuberculosis of the shoulder

Journal of Shoulder and Elbow Surgery — Sun, 10 Apr 2011 23:00:00 +0100

Tuberculosis (TB) is a public health problem, especially in developing countries. Around 8 million new cases are diagnosed every year, with a worldwide prevalence rate of 33% of latent infection and approximately 2 million sufferers die every year. In Western Europe, the incidence of TB is overall stable in the European population, but increasing among immigrants and patients with HIV. (Source: Journal of Shoulder and Elbow Surgery)

Loss of visual acuity due to central serous retinopathy after steroid injection into the shoulder bursa

Journal of Shoulder and Elbow Surgery — Sun, 10 Apr 2011 23:00:00 +0100

We present a case report of a patient undergoing an ultrasound-guided subacromial bursal injection of steroid that coincided with a sudden loss of visual acuity caused by central serous retinopathy. (Source: Journal of Shoulder and Elbow Surgery)

Patient acceptance of long head of biceps brachii tenotomy

Journal of Shoulder and Elbow Surgery — Thu, 31 Mar 2011 04:00:00 +0100

Conclusions: Biceps tenotomy is well accepted by most patients with good overall results. Some adverse effects occur but appear to be mild and of little concern to patients. The procedure is tolerated in manually active populations. (Source: Journal of Shoulder and Elbow Surgery)

Journal of Shoulder and Elbow Surgery via MedWorm.com

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Contents

Cell- and gene-based approaches to tendon regeneration

Biomimetic scaffold design for functional and integrative tendon repair

Scaffold devices for rotator cuff repair

Fiber-aligned polymer scaffolds for rotator cuff repair in a rat model

The role of nitric oxide in tendon healing

The role of mechanobiology in tendon healing

Cytokines in rotator cuff degeneration and repair

Potential of collagen cross-linking therapies to mediate tendon mechanical properties

Metalloproteases and rotator cuff disease

Lessons we can learn from gene expression patterns in rotator cuff tears and tendinopathies

Biologic approaches to enhance rotator cuff healing after injury

Mechanisms of fatty degeneration in massive rotator cuff tears

Muscle degeneration in rotator cuff tears

Basic mechanisms of tendon fatigue damage

Measurement of in vivo tendon function

Editor’s note

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In Reply:

Peripheral nerve blockade under general anesthesia—benefits not shown to outweigh risk

Operative versus nonoperative treatment after primary traumatic anterior glenohumeral dislocation

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Treatment of proximal humeral dysplasia epiphysealis hemimelica with custom hemiarthroplasty: a case report

Implant sonication for the diagnosis of prosthetic elbow infection

A ten-year radiologic comparison of two-all polyethylene glenoid component designs: a prospective trial

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Diagnostic accuracy of five orthopedic clinical tests for diagnosis of superior labrum anterior posterior (SLAP) lesions

Effects of surgical approach on functional outcomes of open reduction and internal fixation of intra-articular distal humeral fractures: a systematic review

Etiology of rotator cuff tears in paraplegic patients: a case-control study

The first 20 years of the Journal of Shoulder and Elbow Surgery

Responsiveness of the EQ-5D in patients with proximal humeral fractures

Triceps avulsion, radial head fracture, and medial collateral ligament rupture about the elbow: a report of 4 cases

Disorders of the long head of biceps tendon

Can we improve the reliability of the Constant-Murley score?

Sequential ipsilateral glenohumeral arthrodesis and scapulothoracic fusion: a case report

Extremely rare synovial chondrosarcoma arising from the elbow joint: case report and review of the literature

Validation of a photography-based goniometry method for measuring joint range of motion

Treatment of persistent instability after posterior fracture-dislocation of the elbow: restoring stability and mobility by internal fixation and hinged external fixation

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Cerebrovascular accident in a 19-year-old patient: a case report of posterior sternoclavicular dislocation

Objective evaluation of shoulder function using body-fixed sensors: a new way to detect early treatment failures?

Magnetic resonance imaging in radial head fractures: most associated injuries are not clinically relevant

Osteoid osteoma of the coracoid masked as localized capsulitis of the shoulder

Path analysis of factors for functional outcome at one year in 463 proximal humeral fractures

The effectiveness of therapeutic exercise for painful shoulder conditions: a meta-analysis

High-resolution 3-Tesla magnetic resonance neurography of musculocutaneous neuropathy

Complex fracture-dislocations of the proximal ulna and radius in adults: a comprehensive classification

Varicose veins at the spinoglenoidal notch: an unusual cause of suprascapular nerve compression

Extranodal Rosai-Dorfman disease presenting as an isolated glenoid lesion in a high school athlete

Forearm pain associated with loose radial head prostheses

Radial head replacement with a bipolar system: a minimum 2-year follow-up

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Treatment of post-infection nonunion of the supracondylar humerus with Ilizarov external fixator

Editor’s note

An anatomic and clinical study of the suprascapular and axillary nerve blocks for shoulder arthroscopy

Arthroscopic management of heterotopic ossification of the subscapularis tendon in a patient with tuberculosis: a case report

Midterm outcomes after humeral head replacement with rotator cuff repair in patients with syringomyelia shoulder neuroarthropathy: a report on three cases

Failed anterior shoulder stabilization

Rare complication of clavicular hook plate: clavicle fracture at the medial end of the plate

Reliability, agreement and validity of the 1988 version of the Rowe Score

Complete rupture through the short head of the biceps muscle belly: a case report

Comparison between the acromion index and rotator cuff tears in the Brazilian and Japanese populations

Vacuum assist glenoid fixation: does this technique lead to a more durable glenoid component?

Comparison of glenohumeral and subacromial steroid injection in primary frozen shoulder: a prospective, randomized short-term comparison study

Ulnar collateral ligament tear and olecranon stress fracture nonunion in a collegiate pitcher

Complication rates, dislocation, pain, and postoperative range of motion after reverse shoulder arthroplasty in patients with and without repair of the subscapularis

Biological glenoid resurfacing for glenohumeral osteoarthritis: a systematic review

Inflammatory response to recombinant human bone morphogenetic protein-2 use in the treatment of a proximal humeral fracture: a case report

Erratum to: “The allograft sleeve: A case report of the surgical management of an interprosthetic fracture between a shoulder and elbow joint replacement” [J Shoulder Elbow Surg 2011, vol 20, no 3, pp e4-e9]