Shoulder and Elbow

Latest journal articles about shoulder and elbow from Journal of Shoulder and Elbow Surgery, The Bone & Joint Journal, Journal of Bone and Joint Surgery, Clinical Orthopaedics and Related Research, Acta Orthopaedica, Orthopedic Clinics of North, America, Journal of Orthopaedic Surgery and Research, Orthopedics

Related Articles Preliminary evaluation of a robotic apparatus for the analysis of passive glenohumeral joint kinematics. J Orthop Surg Res. 2013;8(1):24 Authors: Rosso C, Müller AM, Entezari V, Dow WA, McKenzie B, Stanton SK, Li D, Cereatti A, Ramappa AJ, Deangelis JP, Nazarian A, Della Croce U Abstract BACKGROUND: The shoulder has the greatest range of motion of any joint in the human body. This is due, in part, to the complex interplay between the glenohumeral (GH) joint and the scapulothoracic (ST) articulation. Currently, our ability to study shoulder kinematics is limited, because existing models isolate the GH joint and rely on manual manipulation to create motion, and have low reproducibility. Similarly, most established techniques track shoulder motion discontinuously with limited accuracy. METHODS: To overcome these problems, we have designed a novel system in which the shoulder girdle is studied intact, incorporating both GH and ST motions. In this system, highly reproducible trajectories are created using a robotic actuator to control the intact shoulder girdle. High-speed cameras are employed to track retroreflective bone markers continuously.

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Related Articles Medial scapular muscle detachment: clinical presentation and surgical treatment. J Shoulder Elbow Surg. 2013 Jul 15; Authors: Kibler WB, Sciascia A, Uhl T Abstract BACKGROUND: This study describes the clinical presentation and preliminary outcomes in a cohort of patients treated for detachment of the medial scapular stabilizing muscles. METHODS AND METHODS: The study included 72 patients who underwent reattachment of the lower trapezius and rhomboid muscles. Patients presented with a history of a high level of medial scapular border pain during activity and inability to perform overhead or forward flexion activities. Clinical examination demonstrated palpable tenderness along the medial scapular border, palpable defect along the medial border muscles, scapular dyskinesis, decreased scapular/rotator cuff strength, and modification of symptoms by manual scapular repositioning. Surgical exploration revealed detachment of the lower trapezius muscle or rhomboid muscles, requiring muscle reattachment to the scapula. Clinical outcomes were measured by the American Shoulder and Elbow Surgeons (ASES) self-report form, with comparisons made between the overall scores and subcomponents obtained at initial evaluation, discharge from active care, and postdischarge follow-up. RESULTS: Time from injury to treatment averaged 52 months, and time from surgery to discharge was 7.4 months. ASES scores significantly improved from initial

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Related Articles MRI of the Elbow: Techniques and Spectrum of Disease: AAOS Exhibit Selection. J Bone Joint Surg Am. 2013 Jul 17;95(14):e991-13 Authors: Dewan AK, Chhabra AB, Khanna AJ, Anderson MW, Brunton LM Abstract BACKGROUND: Magnetic resonance imaging (MRI) of the elbow allows for high-resolution evaluation of osseous and soft-tissue structures, including ligaments, tendons, nerves, and muscles. Multiple imaging techniques and pulse sequences exist. The purpose of this article is to update orthopaedic surgeons on current MRI techniques and illustrate the spectrum of elbow pathology detectable by MRI. METHODS: We searched MEDLINE with use of the keywords "MRI" and "elbow" for studies less than five years old evaluating MRI techniques. These papers, our experience, and textbooks reviewing elbow MRI provided the information for this article. RESULTS: We discuss the essentials and applications of the following techniques: (1) conventional, non-gadolinium-enhanced MRI; (2) gadolinium-enhanced MRI; and (3) magnetic resonance arthrography. The classic MRI appearances of occult fractures, loose bodies, ulnar collateral ligament injuries, lateral collateral ligament complex injuries, biceps tendon injuries, triceps tendon injuries, lateral epicondylitis, medial epicondylitis, septic arthritis, osteomyelitis, osteochondritis dissecans, compression neuropathies, synovial disorders, and various soft-tissue masses are reviewed.

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Related Articles Update on the state of outcome measurement in total elbow arthroplasty research: identifying a need for consensus. J Bone Joint Surg Am. 2013 Jul 17;95(14):e971-8 Authors: Riedel K, Beaton DE Abstract BACKGROUND: There is little consensus for a standard set of metrics to express outcome after total elbow arthroplasty. In order to set the stage for future work toward a core set of measurement tools, our goal was to gather a complete view of the outcomes used in total elbow arthroplasty research, the concepts of their focus, and their quality as measures of the target concept. METHODS: We reviewed the outcome measures for total elbow arthroplasty presented in the literature from 2004 to 2011 in terms of the instruments used and their concepts of focus. We reviewed the reliability, validity, and responsiveness of the prevailing measurement tools.

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Related Articles Interscalene brachial plexus block for arthroscopic shoulder surgery: a systematic review. J Bone Joint Surg Am. 2013 Jul 17;95(14):1318-24 Authors: Hughes MS, Matava MJ, Wright RW, Brophy RH, Smith MV PMID: 23864181 [PubMed - in process]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23864181?dopt=Abstract

Related Articles Reverse total shoulder arthroplasty for primary glenohumeral osteoarthritis in patients with a biconcave glenoid. J Bone Joint Surg Am. 2013 Jul 17;95(14):1297-304 Authors: Mizuno N, Denard PJ, Raiss P, Walch G Abstract BACKGROUND: The biconcave glenoid in patients with primary glenohumeral osteoarthritis represents a surgical challenge because of the associated static posterior instability of the humeral head and secondary posterior glenoid erosion. The purpose of the present study was to evaluate the clinical and radiographic results of reverse total shoulder arthroplasty for the treatment of primary osteoarthritis in patients with a biconcave glenoid without rotator cuff insufficiency.

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Related Articles Clinical and radiographic outcomes of total shoulder arthroplasty with bone graft for osteoarthritis with severe glenoid bone loss. J Bone Joint Surg Am. 2013 Jul 17;95(14):1290-6 Authors: Sabesan V, Callanan M, Ho J, Iannotti JP Abstract BACKGROUND: Glenohumeral osteoarthritis may be associated with severe posterior glenoid bone loss and glenoid retroversion. Treatment with total shoulder arthroplasty and autologous bone graft obtained from the humeral head has been infrequently reported in the peer-reviewed literature. METHODS: The clinical and radiographic results of primary total shoulder replacement with an all-polyethylene glenoid component and autologous humeral head graft augmentation performed by a single surgeon in thirteen consecutive patients were evaluated.

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Related Articles Evaluation of the role of glenosphere design and humeral component retroversion in avoiding scapular notching during reverse shoulder arthroplasty. J Shoulder Elbow Surg. 2013 Jul 12; Authors: Berhouet J, Garaud P, Favard L Abstract BACKGROUND: Scapular notching is a common observation during radiological follow-up of reverse shoulder arthroplasty. The purpose of this study was to evaluate the effect of glenosphere design and humeral component retroversion on movement amplitude in the scapular plane and inferior scapular impingement. MATERIALS AND METHODS: The Aequalis Reversed Shoulder Prosthesis (Tornier) was implanted into 40 cadaver shoulders. On the glenoid side, 8 different combinations were tested: 36-mm glenosphere: centered (standard), eccentric, with an inferior tilt, or with the center of rotation (COR) lateralized by 5 or 7 mm; and 42-mm centered glenosphere: used alone or with the COR lateralized by 7 or 10 mm. The humeral component was positioned in 0°, 10°, 20°, 30°, and 40° of retroversion. Maximum adduction and abduction were measured when inferior impingement and superior impingement, respectively, were detected.

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Related Articles Diagnostic value of patient characteristics, history, and six clinical tests for traumatic anterior shoulder instability. J Shoulder Elbow Surg. 2013 Jul 12; Authors: van Kampen DA, van den Berg T, van der Woude HJ, Castelein RM, Terwee CB, Willems WJ Abstract BACKGROUND: It is unknown which combination of patient information and clinical tests might be optimal for the diagnosis of traumatic anterior shoulder instability. This study aimed to determine the diagnostic value of individual clinical tests and to develop a prediction model that combined patient characteristics, history, and clinical tests for diagnosis of traumatic anterior shoulder instability. MATERIALS AND METHODS: This prospective cohort study included 169 consecutive patients with shoulder complaints who were examined at an orthopaedic outpatient clinic. One experienced clinician conducted 25 clinical tests; of these, 6 were considered to be specific for testing of traumatic anterior shoulder instability (apprehension, relocation, release, anterior drawer, load and shift, and hyperabduction tests). Magnetic resonance arthrography was used to determine the final diagnosis. A prediction model was developed by logistic regression analysis.

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Related Articles Investigating minimal clinically important difference for Constant score in patients undergoing rotator cuff surgery. J Shoulder Elbow Surg. 2013 Jul 12; Authors: Kukkonen J, Kauko T, Vahlberg T, Joukainen A, Aärimaa V Abstract BACKGROUND: The minimal clinically important difference (MCID) is increasingly used to evaluate treatment effectiveness. The MCID for the Constant score has not been previously reported. MATERIALS AND METHODS: A prospectively collected cohort of 802 consecutive shoulders with arthroscopically treated partial- or full-thickness rotator cuff tears was analyzed. The Constant score was measured preoperatively and at 3 months and 1 year postoperatively. At follow-up visits, the patients were asked a simple 2-stage question: Is the shoulder better or worse after the operation compared with the preoperative state? This single 2-level question was used as an indicator of patient satisfaction and as an anchor to calculate the MCID for the Constant score. RESULTS: At 1 year, 781 (97.4%) patients (474 men, 307 women) were available for follow-up. The preoperative Constant score was 53.1 (SD 17.2) in all patients, 56.2 (SD 17.4) in male patients, and 48.2 (SD 15.6) in female patients. Postoperatively at 3 months, the scores were 61.7 (SD 16.4) in all patients, 65.1 (SD 16.1) in male patients, and 56.8 (SD 15.5) in female patients. At 1 year, the scores were 75.9 (SD 15.2) in all patients, 79.0 (SD 14.9) in

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