Effect of interscalene nerve block on the inflammatory response in shoulder surgery: a randomized trial
Comparing techniques of general anesthesia and regional anesthesia in arthroscopic shoulder surgery, some studies have shown differences in the intensity of immediate postoperative pain and neuroendocrine response, but the inflammatory response when using balanced general anesthesia (BGA) vs. an ultrasound-guided (USG) single-dose interscalene block (SDIB) has not been compared. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 18, 2019 Category: Orthopaedics Authors: Gabriel Enrique Mej ía-Terrazas, Michell Ruíz-Suárez, Felipe Vadillo-Ortega, Rebecca Elizabeth Franco y Bourland, Eunice López-Muñoz Source Type: research

Outcomes of anatomic total shoulder arthroplasty in patients with excessive glenoid retroversion: a case-control study
Ideal management of severe glenoid retroversion during anatomic total shoulder arthroplasty (TSA) remains controversial, as previous reports have suggested that severe retroversion may negatively impact clinical outcomes. The purpose of this study was to evaluate the impact of severe glenoid retroversion on clinical and radiographic TSA outcomes using a standard glenoid component, as well as to compare outcomes among  patients with less severe retroversion. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 18, 2019 Category: Orthopaedics Authors: Paul DeVito, Kofi D. Agyeman, Hyrum Judd, Molly Moor, Derek Berglund, Andy Malarkey, Jonathan C. Levy Source Type: research

Low return-to-sports rate after elbow injury and treatment with radial head arthroplasty
The aim of this study was to analyze sports participation after radial head arthroplasty among recreational athletes. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 18, 2019 Category: Orthopaedics Authors: Matthias Jung, Corinna Groetzner-Schmidt, Felix Porschke, Paul A. Gr ützner, Thorsten Guehring, Marc Schnetzke Source Type: research

Brachioradialis muscle flap for posterior elbow defects: a simple and effective solution for the upper limb surgeon
Trauma, infection, and posterior surgical approach are the most frequent causes of soft tissue defects of posterior elbow. The brachioradialis (BR) muscle flap is a rotational muscular pedicled flap, and the dominant vascular pedicle arises from the radial recurrent artery in the proximal portion of the muscle. The aim of the study was to present the BR muscle flap as a simple, safe, and effective solution for the treatment of soft tissue defects of the posterior elbow. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 18, 2019 Category: Orthopaedics Authors: Frantzeska Zampeli, Sarantos Spyridonos, Emmanouil Fandridis Source Type: research

Management of infected shoulder arthroplasty: a comparison of treatment strategies
The study purpose was to determine whether 2-stage revision procedures result in superior outcomes and whether reverse shoulder arthroplasty produced superior outcomes to hemiarthroplasty or anatomic total shoulder arthroplasty at the time of reimplantation. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 14, 2019 Category: Orthopaedics Authors: Matthew Patrick, Heather K. Vincent, Kevin W. Farmer, Joseph J. King, Aimee M. Struk, Thomas W. Wright Tags: Original Article Source Type: research

Glenohumeral translation during active external rotation with the shoulder abducted in cases  with glenohumeral instability: a 4-dimensional computed tomography analysis
Although glenohumeral instability is common, the mechanism of instability remains unclear. The purpose of this study was to quantitatively evaluate humeral head translation during active external rotation with abduction in patients with glenohumeral instability by use of 4-dimensional computed tomography scans. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 13, 2019 Category: Orthopaedics Authors: Noboru Matsumura, Satoshi Oki, Naoto Fukasawa, Morio Matsumoto, Masaya Nakamura, Takeo Nagura, Yoshitake Yamada, Masahiro Jinzaki Source Type: research

Surgical approaches for total elbow arthroplasties using data from the Dutch Arthroplasty Register
Total elbow arthroplasty (TEA) is a relatively infrequently performed procedure. Therefore, nationwide databases help to provide more insight into factors that might influence implant survival, for example, the surgical approach used. Using data from the Dutch Arthroplasty Register, we aimed to reveal whether high-volume centers use different approaches than low-volume centers and whether the approach is implant specific. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 12, 2019 Category: Orthopaedics Authors: Ante Prki ć, Koen L.M. Koenraadt, Jetske Viveen, Liza van Steenbergen, Bertram The, Denise Eygendaal Source Type: research

The primary cost drivers of arthroscopic rotator cuff repair surgery: a cost-minimization analysis of 40,618 cases
This study examines the primary cost drivers of RCR surgery in the United States. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 12, 2019 Category: Orthopaedics Authors: Lambert Li, Steven L. Bokshan, Lauren V. Ready, Brett D. Owens Source Type: research

Mid- to long-term follow-up of shoulder arthroplasty for primary glenohumeral osteoarthritis in patients aged 60 or under
Shoulder arthroplasty in young patients with primary glenohumeral osteoarthritis is an area of continued controversy. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 12, 2019 Category: Orthopaedics Authors: Lionel Neyton, Jacob M. Kirsch, Philippe Collotte, Philippe Collin, Louis Gossing, Mikael Chelli, Gilles Walch Source Type: research

Modified frailty index predicts medical complications, length of stay, readmission, and mortality following total shoulder arthroplasty
The purpose of this study was to evaluate the 5-factor modified frailty index (mFI-5) as a predictor of postoperative complications in patients undergoing total shoulder arthroplasty (TSA). (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 12, 2019 Category: Orthopaedics Authors: Sophia A. Traven, Kathy M. McGurk, Russell A. Reeves, Zeke J. Walton, Shane K. Woolf, Harris S. Slone Tags: Original Article Source Type: research

The radiographic morphology of the greater tuberosity is associated with muscle degeneration in patients with symptomatic rotator cuff tears
Atrophy and fatty infiltration of the rotator cuff muscles portend poor findings in terms of postoperative function and the probability of retears. We assumed that sclerosis and spurs of the greater tuberosity (GT) on radiographs are associated with this rotator cuff muscle degeneration. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 12, 2019 Category: Orthopaedics Authors: Hao-Chun Chuang, Chih-Kai Hong, Kai-Lan Hsu, Fa-Chuan Kuan, Cheng-Li Lin, Wei-Ren Su Source Type: research

Glenoid component lucencies are associated with poorer patient-reported outcomes following anatomic shoulder arthroplasty
This study assesses the impact of radiolucent lines on function and patient-reported outcomes (PROs) following TSA. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 12, 2019 Category: Orthopaedics Authors: Bradley S. Schoch, Thomas W. Wright, Joseph D. Zuckerman, Charlotte Bolch, Pierre-Henri Flurin, Chris Roche, Joseph J. King Source Type: research

Is there a relationship between preoperative diagnosis and clinical outcomes in reverse shoulder arthroplasty? An experience in 699 shoulders
The influence of diagnosis on outcomes after reverse shoulder arthroplasty (RSA) is not completely understood. The purpose of this study was to compare clinical outcomes of different pathologies. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: Benjamin J. Lindbloom, Kaitlyn N. Christmas, Katheryne Downes, Peter Simon, Paul B. McLendon, A. Vincent Hess, Mark A. Mighell, Mark A. Frankle Source Type: research

Superior capsule reconstruction using dermal allograft: early outcomes and survival
This study analyzes early outcomes of SCRs in patients with massive irreparable rotator cuff tears. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: Jarret M. Woodmass, Eric R. Wagner, Kyle A. Borque, Michelle J. Chang, Kathryn M. Welp, Jon J.P. Warner Source Type: research

The Distress and Risk Assessment Method predicts postoperative narcotic use in patients undergoing rotator cuff repair
The Distress and Risk Assessment Method (DRAM) predicts poor outcomes in spine, hip, and knee surgery. Unlike other areas of orthopedic surgery, DRAM scores are not predictive of lower postoperative patient-reported outcomes after arthroscopic rotator cuff repair (RCR). (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: Jason S. Klein, Daniel E. Davis, Zach S. Wells, Liam T. Kane, Daniel Sholder, Surena Namdari, Joseph A. Abboud Source Type: research

Do preoperative radiographs help predict intraoperative challenges in revision surgery after previous shoulder hemiarthroplasty?
This study compares preoperative radiographic evaluation with intraoperative video and explant data in patients undergoing revision of a hemiarthroplasty. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: David E. O ’Briain, Peter Simon, Kaitlyn N. Christmas, Miguel A. Diaz, A. Vincent Hess, Eric G. Hernandez-Ortiz, Thomas Sellers, Paul B. McLendon, Mark A. Mighell, Mark A. Frankle Source Type: research

Early results of augmented anatomic glenoid components
Augmented glenoid components restore the native joint line and preserve bone in shoulders with posterior glenoid bone loss. The purpose of this study was to compare the clinical and radiographic outcomes of augmented total shoulder arthroplasties (TSAs) vs. case-matched shoulders with standard implants to assess the early performance of a full-wedge augmented glenoid component. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: Michael Priddy, Ali Zarezadeh, Kevin W. Farmer, Aimee M. Struk, Joseph J. King, Thomas W. Wright, Bradley S. Schoch Source Type: research

Proceedings from the 2018 International Consensus Meeting on Orthopedic Infections: management of periprosthetic shoulder infection
The Second International Consensus Meeting on Orthopedic Infections was held in Philadelphia, Pennsylvania, in July 2018. A multidisciplinary team of international experts from all 9 subspecialties of orthopedic surgery and allied fields of infectious disease, microbiology, and epidemiology was assembled to form the International Consensus Group. The following consensus proceedings from the International Consensus Meeting involve 30 questions pertaining to the management of periprosthetic shoulder infection. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: Grant E. Garrigues, Benjamin Zmistowski, Alexus M. Cooper, Andrew Green, ICM Shoulder Group Source Type: research

Proceedings from the 2018 International Consensus Meeting on Orthopedic Infections: evaluation of periprosthetic shoulder infection
The Second International Consensus Meeting on Orthopedic Infections was held in Philadelphia, Pennsylvania, in July 2018. More than 800 experts from all 9 subspecialties of orthopedic surgery and allied fields of infectious disease, microbiology, and epidemiology were assembled to form the International Consensus Group. The shoulder workgroup reached consensus on 27 questions related to culture techniques, inflammatory markers, and diagnostic criteria used to evaluate patients for periprosthetic shoulder infection. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: Grant E. Garrigues, Benjamin Zmistowski, Alexus M. Cooper, Andrew Green, ICM Shoulder Group Source Type: research

Proceedings from the 2018 International Consensus Meeting on Orthopedic Infections: prevention of periprosthetic shoulder infection
The Second International Consensus Meeting on Orthopedic Infections was held in Philadelphia, Pennsylvania, in July 2018. Over 800 international experts from all 9 subspecialties of orthopedic surgery and allied fields of infectious disease, microbiology, and epidemiology were assembled to form a consensus workgroup. The following proceedings on the prevention of periprosthetic shoulder infection come from 16 questions evaluated by delegates from the shoulder section. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: Grant E. Garrigues, Benjamin Zmistowski, Alexus M. Cooper, Andrew Green, ICM Shoulder Group Source Type: research

Proceedings from the 2018 International Consensus Meeting on Orthopedic Infections: the definition of periprosthetic shoulder infection
Research studies with evidence impacting clinical practice have used disparate definitions of shoulder periprosthetic joint infection, likely leading to variable and inconsistent conclusions about its diagnosis and management. In an effort to establish uniform guidelines for clinical decision making and research reporting, a clear definition of periprosthetic shoulder infection was established at the 2018 International Consensus Meeting on Orthopedic Infections. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: Grant E. Garrigues, Benjamin Zmistowski, Alexus M. Cooper, Andrew Green, ICM Shoulder Group Source Type: research

San Diego Shoulder Institute Fellows Symposium
It was a great honor and pleasure to host the American Shoulder and Elbow Surgeons Fellows  Symposium at the San Diego Shoulder Institute in June 2018. As with the first San Diego Shoulder Institute Fellows Symposium in 2017, many of the shoulder and elbow fellows presented papers based on their work during their fellowship. It was a great honor to be able to listen to all the wonderful presentations and then to see the best of them come to fruition with this issue of the Journal of Shoulder and Elbow Surgery. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: Felix H. “Buddy” Savoie Tags: Editorial Source Type: research

Does quality of life influence retear rate following arthroscopic rotator cuff repair?
The primary objective was to assess whether a patient's early postoperative quality of life (QOL) correlates with the retear rate following single-tendon double-row rotator cuff repair. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: Philip Zakko, Bastian Scheiderer, Knut Beitzel, Monica Shoji, Ariel Williams, Jessica DiVenere, Mark P. Cote, Augustus D. Mazzocca, Florian B. Imhoff Source Type: research

Three- and 4-part proximal humeral fracture fixation with an intramedullary cage: 1-year clinical and radiographic outcomes
Reverse total shoulder arthroplasty is a treatment option for 3- and 4-part proximal humeral fractures in elderly patients. However, arthroplasty has drawbacks in younger patients because of their greater activity level and more likely need for revision surgery. In such patients, an intramedullary cage may allow for reconstruction of the proximal humerus. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: Joshua L. Hudgens, Jessica Jang, Keith Aziz, Matthew J. Best, Uma Srikumaran Source Type: research

Proceedings from the 2018 International Consensus Meeting on Orthopedic Infections: rationale and methods of the shoulder subgroup
The Second International Consensus Meeting (ICM) on Orthopedic Infections was held in Philadelphia, Pennsylvania, in July 2018. Experts from all orthopedic subspecialties, including shoulder and elbow, as well as allied fields of infectious disease, microbiology, and epidemiology, were assembled to form the consensus workgroup. The delegates were tasked with updating guidelines and establishing new guidelines for the prevention, diagnosis, and treatment of musculoskeletal infection initially determined at the first ICM in 2013. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: Grant E. Garrigues, Benjamin Zmistowski, Alexus M. Cooper, Andrew Green Tags: Editorial Source Type: research

Shoulder periprosthetic joint infection: the current state of the art
It is with great pride and great humility that we submit the work of the shoulder section of the Second International Consensus Meeting (ICM) on Periprosthetic Joint Infection (PJI) —the first time shoulder PJI was included in the process. We feel “great pride” because of the quality of the product and extent of the effort that so many in our field and affiliated fields gave to codify the “state of the art” in our understanding of periprosthetic shoulder infection. Th e shoulder section included 73 delegates from multiple countries who toiled for over a year on 75 separate systematic reviews c...
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: Andrew (Andy) Green, Grant E. Garrigues Tags: Editorial Source Type: research

Introduction to this special issue
This is a special issue of the Journal of Shoulder and Elbow Surgery (JSES), which serves dual roles. The roles are different but they highlight where we are in the study of shoulder and elbow surgery, while at the same time we look to the future and the doctors and surgeons who we expect will take us to the next level. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: Bill Mallon Tags: Editorial Source Type: research

Variations of magnetic resonance imaging findings in asymptomatic elbows
Magnetic resonance imaging (MRI) findings in asymptomatic patients have been described for hips, knees, ankles, shoulders, and intervertebral disks. No such description exists for the elbow. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Authors: Sevag A. Bastian, Hithem Rahmi, John Crues, Shiv Bhanu, Collin Blout, Rajesh Rangarajan, Brian Lee, John Itamura Source Type: research

Editorial Board
(Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Source Type: research

Table of Contents
(Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Source Type: research

Sponsoring Societies
(Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - June 1, 2019 Category: Orthopaedics Source Type: research

Outpatient shoulder arthroplasty: outcomes, complications, and readmissions in 2 outpatient settings
There is currently a paucity of non-database studies looking at safety and outcomes after outpatient shoulder arthroplasty. The purpose of this study was to report our initial safety experience with outpatient shoulder arthroplasty including 90-day complications and readmissions. Our hypothesis was that the rate of early complications after outpatient shoulder arthroplasty would be low and similar to that of inpatient procedures regardless of outpatient setting. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - May 24, 2019 Category: Orthopaedics Authors: Michael D. Charles, Gregory Cvetanovich, Shelby Sumner-Parilla, Gregory P. Nicholson, Nikhil Verma, Anthony A. Romeo Source Type: research

Prospective evaluation of glenoid bone loss after first-time and recurrent anterior glenohumeral instability events
Introduction: Determining the amount of glenoid bone loss in patients following anterior glenohumeral instability events is critical to guiding appropriate treatment. One of the challenges in managing shoulder instability in young athletes is the absence of clear data showing the impact of each event. The purpose of this study was to prospectively determine the amount of bone loss associated with a single instability event, in the setting of both first-time and recurrent instability. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Jonathan F. Dickens, Sean E. Slaven, Kenneth L. Cameron, Adam M. Pickett, Matthew Posner, Scot E. Campbell, Brett D. Owens Source Type: research

Long-term results of the open Latarjet procedure for recurrent anterior shoulder instability in patients older than 40 years
Background: Age older than 40 years at surgery is known to be an independent risk factor for outcome after the Latarjet procedure. So far, no long-term results about the Latarjet procedure in elderly are available. It was the purpose to analyze long-term results of the open Latarjet procedure for recurrent anterior shoulder instability in patients older 40 years. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Lukas Ernstbrunner, Lara Wartmann, Stefan Zimmermann, Pascal Schenk, Karl Wieser, Christian Gerber Source Type: research

Return to sport following Latarjet versus distal tibia allograft for anterior shoulder instability: a matched cohort analysis
Introduction: The latarjet procedure is recognized as the gold standard for return to function in recurrent anterior instability patients by virtue of the triple-block effect with respect to increased articular arc, dynamic stability from the subscapularis split, and the sling effect from the conjoint tendon. However, anatomic glenoid reconstruction, most recently evaluated using distal tibial allograft (DTA), is an alternative modality that has recently demonstrated similar clinical outcomes, while lacking any donor site morbidity. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Joseph N. Liu, Anirudh K. Gowd, Grant H. Garcia, Brandon C. Cabarcas, Gregory P. Nicholson, Brian J. Cole, Nikhil N. Verma, Anthony A. Romeo Source Type: research

Management of the failed Latarjet procedure: outcomes of revision surgery with fresh distal tibial allograft
Introduction: A patient with recurrent instability after a failed Latarjet procedure remains a challenge to address. The vast majority of these result in large amounts of bone loss, resorption, and issues with retained hardware. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Andrew S. Bernhardson, Colin P. Murphy, Anthony Sanchez, Liam Peebles, Robert F. LaPrade, Matthew T. Provencher Source Type: research

Biomechanical analysis of plate fixation in the Latarjet procedure
Background: The Latarjet procedure has become the treatment of choice for the management of patients with anterior glenohumeral instability with clinically significant anterior glenoid bone loss. Multiple techniques for coracoid fixation have been described, all of which utilize a variety of screw constructs with varying screw sizes. Recently, the use of a mini-plate has been reported, with encouraging radiographic outcomes. The purpose of this study was to determine the biomechanical properties of mini-plate fixation for the Latarjet procedure, and to compare these findings to various screw fixation configurations. (Sourc...
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Rachel M. Frank, Nicole C. Fischer, Franziska Reifenschneider, Stefanie Ficht, Tim H übner, Coen A. Wijdicks, Alberto Costantini, Giovanni Di Giacomo, Anthony A. Romeo Source Type: research

Smart phone “selfies”—a reliable and accurate tool for measuring elbow range of motion
Introduction: It has been previously demonstrated that digital photography is an accurate and reliable tool for capturing elbow range of motion when patients are carefully positioned by orthopaedic surgeons. Our hypothesis was that self-taken photographs ( “selfies”), performed independently after instruction by video or illustrated handout, would be an accurate and reliable tool for capturing elbow range of motion in patients with elbow contractures. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Maegan N. Shields, Anthony M. Vaichinger, Shawn W. O'Driscoll Source Type: research

Safety of posterior endoscopic distal biceps repairs
Background: A prerequisite to restoring preinjury supination strength following a distal biceps rupture is tendon re-attachment to its footprint.1 An ECU / supinator muscle splitting approach reliability exposes the footprint, but iatrogenic injury to the supinator has been associated with decreased strength.1 Repairing the distal biceps tendon using endoscopy is a unique technique that minimizes supinator injury while providing the visualization required for an anatomic repair (Fig.  1).2 The goal of this study is to determine safe posterior endoscopy portals for distal biceps repair. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Christopher C. Schmidt, Joseph F. Styron, E.A. Lin, M.N. Scott Source Type: research

Indomethacin prophylaxis does not reduce the risk of heterotopic ossification following a two-incision distal biceps repair
Background: Use of heterotopic ossification (HO) prophylaxis remains controversial following a distal biceps repair. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Justin D. Hudson, Taylor R. Dunphy, Rebecca K. Butler, Daniel C. Acevedo, Raffy Mirzayan Source Type: research

Delayed management of distal biceps rupture: reconstruction with semitendinosis autograft versus primary repair
Background: Delayed presentation of distal biceps ruptures can make primary repair impossible, in which case reconstruction using a graft is an option. The current literature includes a variety of techniques with reconstruction studies reporting small patient numbers but no comparison to delayed direct repair has been made. The aim of this study was to compare functional outcomes, patient satisfaction and complications between delayed direct repair (>21 days) and reconstruction with a semitendinosis autograft. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Tym Frank, Anna Seltser, Ruby Grewal, Graham J.W. King, George S. Athwal Source Type: research

Asymptomatic MRI findings of the elbow predict injury and surgery in Major League Baseball pitchers
Background: Repetitive pitching produces significant stresses onto the elbow that produce structural abnormalities discernable on Magnetic Resonance Imaging (MRI) without causing symptoms. It is unknown whether these structural abnormalities pose any long term clinical significance. The purpose of this study is to determine whether there exists an association between subclinical MRI findings in asymptomatic elbows in major league baseball pitchers, and future placement on the disabled list or future surgery. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Grant H. Garcia, Anirudh K. Gowd, Brandon C. Cabarcas, Joseph N. Liu, Anthony A. Romeo, Nikhil N. Verma Source Type: research

Risk factors for ulnar collateral ligament injury in professional and amateur baseball players: a systematic review with meta-analysis
Background: Ulnar collateral ligament injury (UCLI) risk factors are unclear despite increasing injury rates. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Michael P. Reiman, Merritt D. Walker, Scott Peters, Elizabeth Kilborn, Charles Thigpen, Grant E. Garrigues Source Type: research

Reverse shoulder arthroplasty with and without concomitant latissimus dorsi and teres major transfer for shoulder pseudoparalysis with teres minor dysfunction: a prospective, randomized investigation
Introduction: Reverse shoulder arthroplasty (RSA) can restore active elevation in a cuff-deficient, pseudoparalytic shoulder. However, RSA alone does not restore active external rotation, which is impaired in patients with teres minor dysfunction. Persistent teres minor dysfunction, following RSA, has been associated with diminished functional outcomes and patient satisfaction, stemming from an inability to control spatial positioning of the arm. To address this concern, latissimus dorsi and teres major tendon transfers have been performed concurrently with RSA to restore both active elevation and external rotation. (Sourc...
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Bradley L. Young, Patrick M. Connor, Shadley C. Schiffern, Katherine M. Roberts, Nady Hamid Source Type: research

Impact of scapular notching on reverse total shoulder arthroplasty outcomes —5 year minimum follow-up
Introduction: Scapular notching is a well-documented phenomenon that occurs following reverse total shoulder arthroplasty (rTSA). Its frequency has been reported to occur variably with rates between 7% and 96% within the orthopedic literature. The impact of scapula notching on clinical outcomes is controversial as previous studies have differed in their determination of a significant effect on outcomes. Mallon et  al1 performed a power analysis on previous rTSA outcome studies and determined that four of the five largest rTSA outcome studies that concluded scapular notching did not have an impact on clinical outcomes ...
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Ryan W. Simovitch, Joseph D. Zuckerman, Thomas W. Wright, Pierre-Henri Flurin, Christopher Roche Source Type: research

Characteristics of patients who rate their subjective satisfaction as unchanged or worse after reverse total shoulder arthroplasty
Introduction: Patient reported outcome measures are an important determinant of surgical results as objective measures of function may not correlate with patient satisfaction. The prevalence of reverse total shoulder arthroplasty (rTSA) has increased over the past several years and for many surgeons now represents a majority of arthroplasty cases. It is important to understand who is at risk for unsatisfactory outcomes after rTSA so that surgeons can appropriately counsel patients as part of a shared decision-making process. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Ira M. Parsons, Howard D. Routman, Christopher Roche, Richard J. Friedman Source Type: research

Primary reverse shoulder arthroplasty using contemporary implants is associated with very low reoperation rates
Introduction: The early results of reverse shoulder arthroplasty (RSA) were influenced to some extent by the use of first generation implants as well as surgeons' learning curves, resulting in relatively high reoperation rates. As experience has been gained with the procedure and new implants have been introduced, reasons for reoperation and complication rates may have changed. The purpose of this study was to quantify the burden and identify the indications for reoperation after primary RSA using contemporary implants and techniques. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Joaquin Sanchez-Sotelo, Jason R. Kang, Matthew J. Dubiel, Robert H. Cofield, Scott P. Steinmann, Bassem T. Elhassan, Mark E. Morrey, John W. Sperling Source Type: research

Incidence of post-operative acromial fractures with onlay vs inlay reverse shoulder arthroplasty
Background: Acromial fractures in reverse shoulder arthroplasty (RSA) have been reported at rates up to 7%. Although these patients are reported to have improved function compared to their preoperative state, acromial insufficiency may negatively impact the final postoperative outcome in RSA compared to a cohort of patients without postoperative acromial complication. There are multiple implant systems used for reverse total shoulder arthroplasty. The purpose of this study was to retrospectively compare the rates of acromial fractures in two of such systems, using the outcomes of two surgeons at a single institution. (Sour...
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Ryan LeDuc, Dane H. Salazar, Nickolas G. Garbis Source Type: research

Persistent glenoid component retroversion is associated with radiolucency as measured with a minimal radiation technique after total shoulder arthroplasty
Introduction: Post-operative glenoid retroversion has been shown in biomechanical, finite element analysis, and clinical studies to be related to the development of radiolucency and component loosening, one of the most common causes of failure after total shoulder arthroplasty (TSA). We analyzed version correction after TSA and the associated risk of developing glenoid component radiolucency at minimum 2-year follow-up. A minimal radiation method was validated in a cadaveric model and utilized in a clinical series to measure post-operative glenoid component version using routine post-operative X-rays, pre-operative CT scan...
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: Manish Mehta, Brian Shiu, Laura A. Vogel, Elizabeth Dennis, Djuro Petkovic, William N. Levine, Charles M. Jobin Source Type: research

Quantification of cost savings from outpatient total shoulder arthroplasty
Introduction: Finding ways to contain costs in joint replacement surgery has become a central issue as the cost of healthcare continues to rise. High-volume arthroplasty centers have been shown to have lower costs and better outcomes. Outpatient arthroplasty has also been shown to help control healthcare costs, and recent studies suggest that outpatient total shoulder arthroplasty (TSA) is safe and effective for appropriately selected patients. However, specific costs associated with outpatient TSAs remain poorly studied. (Source: Journal of Shoulder and Elbow Surgery)
Source: Journal of Shoulder and Elbow Surgery - May 22, 2019 Category: Orthopaedics Authors: James M. Gregory, Alexander M. Wetzig, Colton D. Wayne, Ryan J. Warth, Lane Bailey Source Type: research