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Arthroscopy 2021 Jun 11. Epub 2021 Jun 11.

Istanbul Basaksehir Pine and Sakura City Training and Research Hospital, Istanbul, Turkey.

Purpose: To evaluate the effect of several shoulder anatomical parameters in the development of rotator cuff tear (RCT).

Methods: Between 2014 and 2018, all consecutive patients who underwent arthroscopic rotator cuff repair due to full-thickness rotator cuff tear with a minimum 2-year follow-up were identified. Inclusion criteria were (1) age>18 years, (2) patients with degenerative RCT, (3) full-thickness RCTs, (4) patients underwent arthroscopic RCR due to unresponsive conservative treatment, (5) minimum 2-year follow-up period. Read More

Front Neurol 2021 28;12:668370. Epub 2021 May 28.

Canadian Advances in Neuro-Orthopedics for Spasticity Congress, Victoria, BC, Canada.

Hemiplegic shoulder pain (HSP) is the most common pain disorder after stroke with incidence estimates of 30-70% and associated with reductions in function, interference with rehabilitation, and a reduced quality of life. Onset may occur as soon as a week after stroke in 17% of patients. Management of HSP represents a complex treatment pathway with a lack of evidence to support one treatment. Read More

Indian J Orthop 2021 May 6;55(Suppl 1):167-175. Epub 2020 Apr 6.

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351 South Korea.

Background: If osteomyelitis is confined to the proximal humerus, arthroscopic debridement with multiple punctures at the infected bone might be sufficient to eradicate the septic shoulder with bone involvement.

Materials And Methods: From 2005 to 2017, 15 patients received arthroscopic debridement with multiple punctures. We included patients with septic shoulder arthritis with proximal bone involvement and excluded patients with glenohumeral joint destruction or extension of bone involvement to the diaphysis of the humerus. Read More

J Shoulder Elbow Surg 2021 Jun 1. Epub 2021 Jun 1.

ICR - Institut de Chirurgie Réparatrice - Locomoteur & Sport, 7 av Durante, 06000 Nice, France. Electronic address:

Background: Recurrence of anterior instability after arthroscopic Bankart prevents return to sport and remains a surgical challenge.

Aim: To assess clinical and radiological outcomes after coracoid bone-block performed either open or under arthroscopy, for the management of failed arthroscopic Bankart.

Patients And Methods: fifty-nine consecutive patients with anterior instability recurrence after arthroscopic Bankart were revised with a Bristow or Latarjet procedure performed either open (25 cases) or under arthroscopy (34 cases). Read More

Biology (Basel) 2021 May 4;10(5). Epub 2021 May 4.

Institute of Biomedicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland.

Anomalies of fatty acid (FA) metabolism characterize osteoarthritis (OA) and rheumatoid arthritis (RA) in the knee joint. No previous study has investigated the synovial fluid (SF) FA manifestations in these aging-related inflammatory diseases in the shoulder. The present experiment compared the FA alterations between the shoulder and knee joints in patients with end-stage OA or end-stage RA. Read More

BMJ Case Rep 2021 May 25;14(5). Epub 2021 May 25.

Internal Medicine, University of Miami Health System, Miami, Florida, USA.

A 68-year-old woman presented for left shoulder pain, decreased range of motion (ROM) and fever 7 days following COVID-19 vaccination. Investigations showed a tender left deltoid mass, decreased shoulder ROM and elevated inflammatory markers. MRI demonstrated a large glenohumeral effusion with synovitis, and arthrocentesis confirmed septic arthritis (SA). Read More

Leuk Res Rep 2021 24;15:100242. Epub 2021 Apr 24.

Division of Hematology Mayo Clinic Rochester, MN, United States.

We report a case of smoldering multiple myeloma patient who developed signs and symptoms consistent with polyarthritis. A PET-CT demonstrated marked FDG activity in multiple joints, concerning for inflammatory arthritis. Arthrocentesis from the glenohumeral joint was consistent with inflammatory synovial fluid with no evidence for infection or crystals. Read More

J Orthop 2021 May-Jun;25:107-111. Epub 2021 Apr 27.

University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Orthopedic and Trauma Surgery, Kerpener Street 62, 50937, Cologne, Germany.

Purpose: Use of a relatively larger glenosphere with some larger overhang helps to minimize posterior impingement and some degree of glenoid lateralization is also beneficial in reverse shoulder arthroplasty (RSA). The optimal amounts of inferior overhang and lateralization are not agreed upon. The purpose of this in-vitro biomechanical study is to analyze the effect of glenosphere size and glenoid lateralization on deltoid load, focusing on differences in its three distinct heads. Read More

Clin Orthop Relat Res 2021 05 11. Epub 2021 May 11.

M. J. Hartwell, R. E. Harold, P. T. Sweeney, A. L. Seitz, G. Marra, M. D. Saltzman, Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Background: Fatty infiltration of the rotator cuff evaluated with CT has been associated with asymmetric glenoid wear and humeral head subluxation in patients with glenohumeral arthritis. The relationship between rotator cuff pathologic findings and abnormal glenoid wear plays an important role in determining the optimal surgical management of advanced glenohumeral osteoarthritis. Compared with CT, MRI has increased sensitivity for identifying rotator cuff conditions; therefore, prior studies using CT may have underestimated the association between fatty infiltration of the rotator cuff and abnormal glenoid wear. Read More

J Am Acad Orthop Surg 2021 07;29(13):e635-e645

From New England Baptist Hospital, Boston, MA (Jawa), Boston Sports and Shoulder Center, Waltham, MA (Jawa), and Tufts Medical Center, Boston, MA (Shields).

Our understanding of the pathology of and treatment for glenohumeral arthritis (GHA) has grown dramatically in the past few decades. Original observations regarding patterns of glenoid erosion, glenoid retroversion, and posterior humeral head subluxation in patients with primary GHA were documented in the 1980s and early 1990s. In the late 1990s, Walch et al proposed what is now the most widely used classification system to describe the characteristic pathology of GHA. Read More

JBJS Case Connect 2021 04 29;11(2). Epub 2021 Apr 29.

Steadman Philippon Research Institute, Vail, Colorado.

Case: A 41-year-old, former world-champion, mixed martial arts fighter presented with debilitating pain and loss of motion because of severe glenohumeral osteoarthritis (GHOA) in the setting of a previous shoulder instability stabilization procedure. Multiple conservative treatments failed to provide permanent relief, and he elected to undergo a comprehensive arthroscopic management (CAM) procedure for his GHOA.

Conclusion: At 2-year follow-up, the CAM procedure was effective in returning them to fighting at a professional level. Read More

J Shoulder Elbow Surg 2021 Apr 21. Epub 2021 Apr 21.

Department of Orthopaedic Surgery, The Rothman Orthopaedic Institute, Thomas Jefferson University Hospitals, Philadelphia, PA, USA. Electronic address:

Background: The benefit of rotator cuff repair (RCR) in patients with concurrent osteoarthritic changes remains unclear. RCR has the theoretical potential to increase the compressive force across the glenohumeral joint, further exacerbating osteoarthritis pain. The purpose of this study is to investigate pain relief and patient-reported outcomes of patients undergoing simultaneous RCR and microfracture of focal glenohumeral osteoarthritis. Read More

JBJS Case Connect 2021 04 22;11(2). Epub 2021 Apr 22.

The Division of Shoulder Surgery, Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, Maryland.

Case: We present a 62-year-old left-hand-dominant woman with history of renal failure, osteoporosis, and 4-part proximal humerus fracture malunion with subsequent post-traumatic arthritis of the left glenohumeral joint. After conservative treatments failed to relieve her symptoms, the patient underwent stemless total shoulder arthroplasty (TSA) because of concerns that her proximal humerus could not accommodate a stemmed implant. At 2 and a half-years postoperative, the patient demonstrated significant improvement of symptoms without signs of radiographic loosening. Read More

Clin J Sport Med 2021 Mar 1. Epub 2021 Mar 1.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota; Department of Orthopedic Surgery, Sierra Pacific Orthopedics, Fresno, California; and Department of Orthopedic Surgery, Pan Am Clinic, Winnipeg, MB, Canada.

Objective: To report the injury characteristics, radiographic findings, and long-term outcomes of nonoperative management for posterior shoulder instability (PSI).

Design: A retrospective review of 143 patients with PSI using a large geographic database.

Setting: Single county between January 1994 and July 2012. Read More

BMJ Case Rep 2021 Apr 13;14(4). Epub 2021 Apr 13.

Department of Emergency Medicine, Mount Sinai Medical Center, Miami Beach, Florida, USA.

Prompt recognition and treatment of septic arthritis are crucial to prevent significant morbidity and mortality in affected patients. During the current COVID-19 pandemic, anchoring bias may make an already challenging diagnosis like septic arthritis more difficult to diagnose quickly and efficiently. Musculoskeletal (MSK) point of care ultrasonography (POCUS) is an imaging modality that can be used to quickly and efficiently obtain objective findings that may help a clinician establish the diagnosis of septic arthritis. Read More

J Shoulder Elbow Surg 2021 Apr 1. Epub 2021 Apr 1.

Hôpital Privé Jean-Mermoz-GDS Ramsay, 24, Avenue Paul Santy, 69008, Lyon, France.

Background: An assessment of the pathoanatomic parameters of the arthritic glenohumeral joint (GHJ) has the potential to identify discriminating metrics to differentiate glenoid types in primary glenohumeral osteoarthritis (PGHOA). The aim was to identify the morphometric differences and threshold-values between glenoid types including normal and arthritic with the various types of the Walch-classification. We hypothesized that there would be clear morphometric discriminators between the various glenoid types, and that specific numeric threshold values would allow identification of each glenoid type. Read More

Surg Technol Int 2021 03 30;38. Epub 2021 Mar 30.

Department of Orthopaedic Surgery, Cleveland Clinic Sports Health Center, Garfield Heights, Ohio.

The incidence of patients undergoing total shoulder arthroplasty (TSA) for glenohumeral osteoarthritis has been steadily increasing in the United States. TSA with humeral head resurfacing with an inlay glenoid using OVO®/OVO® Motion (Arthrosurface, Inc., Franklin, Massachusetts) is an anatomic implant solution to shoulder arthritis. Read More

Expert Rev Med Devices 2021 Apr 30;18(4):407-411. Epub 2021 Mar 30.

Bhatia Hospital, Mumbai, India.

Background: We evaluated the imaging and functional outcomes of anatomic stemless shoulder arthroplasty (ECLIPSE) in elderly patients with primary osteoarthritis of the glenohumeral joint in Asian developing countries.

Methods: Thirty patients were treated using stemless TSA in 26 months period (years 2017 and 2019), and were followed for a minimum of 24 months. Functional outcomes were assessed using Constant and ASES scores. Read More

Arch Bone Jt Surg 2021 Jan;9(1):64-69

University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery and Biomedical Engineering, Memphis, Tennessee, USA.

Background: The purpose of this study was to compare the intraobserver and interobserver reliability of CT and T2-weighted MRI for evaluation of the severity of glenoid wear, glenohumeral subluxation, and glenoid version.

Methods: Sixty-one shoulders with primary osteoarthritis had CT and MRI scans before shoulder arthroplasty. All slices were blinded and randomized before evaluation. Read More

J Biol Regul Homeost Agents 2021 Mar-Apr;35(2):657-661

Dipartimento di Ortopedia, Concordia Hospital for "Special Surgery", Rome, Italy.

BMC Musculoskelet Disord 2021 Mar 15;22(1):279. Epub 2021 Mar 15.

Department of Orthopedic Surgery, Ordensklinikum Barmherzige Schwestern Linz, Vinzenzgruppe, Center of Orthopedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg, Seilerstätte 4, 4010, Linz, Austria.

Background: The transverse force couple (TFC) of the rotator cuff (subscapularis vs. infraspinatus and teres minor muscle) is an important dynamic stabilizer of the shoulder joint in the anterior-posterior direction. In patients with posterior static subluxation of the humeral head (PSSH), decentration of the humeral head posteriorly occurs, which is associated with premature arthritis. Read More

Mayo Clin Proc Innov Qual Outcomes 2021 Feb 6;5(1):204-209. Epub 2020 Nov 6.

Department of Radiology, Mayo Clinic, Rochester, MN.

Musculoskeletal injury is an uncommon but usually self-limited complication of vaccine administration. We present a case of progressive inflammatory monoarthritis of the shoulder characterized by bone erosion, bursitis, and severe synovitis caused by an influenza vaccine administered to the ipsilateral deltoid region. Clinical symptoms began within 2 hours of vaccination, with progressive decline in function over 6 weeks. Read More

Shoulder Elbow 2021 Feb 26;13(1):79-88. Epub 2019 Sep 26.

Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, GA, USA.

Background: Total shoulder arthroplasty has been demonstrated to be an effective treatment for arthritis of the glenohumeral joint. Prior studies have identified longer operative times as a risk factor for complications after numerous types of procedures. We hypothesized that increased operative time, in 20-min intervals, would be associated with complications following total shoulder arthroplasty. Read More

Ortop Traumatol Rehabil 2021 Feb;23(1):9-14

Department of Orthopaedics, Government Medical College, Srinagar, India.

Background: Acromioclavicular joint arthritis is a relatively common source of shoulder pain. The treatment options consist of conservative management and operative intervention depending on the severity and duration of the disease. Distal clavicle excision is the standard operative treatment and can be performed through either open or arthroscopic techniques. Read More

J Shoulder Elbow Surg 2021 Mar 4. Epub 2021 Mar 4.

Institut Locomoteur de l'Ouest, CHP St Grégoire, St Grégoire, France. Electronic address:

Background: This study aimed to describe the clinical outcomes and complications of 10 cases of pyrocarbon interposition shoulder arthroplasty (PISA).

Methods: The clinical and radiographic records of 10 patients who underwent PISA using the InSpyre shoulder prosthesis (Tornier-Wright) between July 2012 and March 2017 were reviewed. The mean age at surgery was 55 years. Read More

J Shoulder Elbow Surg 2021 Mar 3. Epub 2021 Mar 3.

Sir Charles Gairdner Hospital, Nedlands, WA, Australia.

Background: Accurate reproduction of humeral version is important in shoulder arthroplasty. Traditional referencing relative to the transepicondylar axis (TEA) is prone to error as it is absent on preoperative imaging and inaccurately reproduced intraoperatively. The bicipital groove is present on preoperative imaging and in the operative field and thus may be a useful landmark for accurate reproduction of humeral version. Read More

Int J Surg Case Rep 2021 Mar 15;80:105624. Epub 2021 Feb 15.

Graduate Medical Education, Orthopaedic Surgery Residency Program, Community Memorial Health System, Ventura, CA, USA.

Introduction: Septic arthritis is an orthopedic emergency that requires rapid diagnosis and treatment. It is typically caused by occult bacteremia which allows bacteria to seed the joint or local invasion of a soft tissue infection. Most cases of septic arthritis are caused by gram-positive bacteria, with the most common culprit being Staphylococcus Aureus. Read More

J Shoulder Elbow Surg 2021 Feb 23. Epub 2021 Feb 23.

Edinburgh Orthopaedics - Trauma Royal Infirmary of Edinburgh, Edinburgh, Midlothian, UK; Centre for Population and Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Midlothian, UK.

Background: The primary aim was to identify patient and injury factors independently associated with humeral diaphyseal fracture nonunion after nonoperative management. The secondary aim was to determine the effect of management (operative/nonoperative) on nonunion.

Methods: From 2008-2017, a total of 734 humeral shaft fractures (732 consecutive skeletally mature patients) were retrospectively identified from a trauma database. Read More

ANZ J Surg 2021 04 20;91(4):673-679. Epub 2021 Feb 20.

Melbourne Shoulder and Elbow Centre, Melbourne, Victoria, Australia.

Background: Currently, non-surgical treatments for glenohumeral osteoarthritis (GH-OA) mainly aim to reduce pain. Autologous conditioned serum (ACS), Orthokine, an interleukin-1 inhibitor from the patient's own blood has an anti-inflammatory effect. The objective was to determine whether intra-articular injections of this ACS improved symptoms in patients with GH-OA and delayed the need for a shoulder replacement. Read More

J Bone Joint Surg Am 2021 05;103(9):761-770

Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington.

Background: Publications regarding anatomic total shoulder arthroplasty (TSA) have consistently reported that they provide significant improvement for patients with glenohumeral arthritis. New TSA technologies that have been introduced with the goal of further improving these outcomes include preoperative computed tomography (CT) scans, 3-dimensional preoperative planning, patient-specific instrumentation, stemless and short-stemmed humeral components, as well as metal-backed, hybrid, and augmented glenoid components. The benefit of these new technologies in terms of patient-reported outcomes is unknown. Read More