Shoulder/Elbow News

Results showed glenohumeral internal rotation loss, glenohumeral external rotation gain and total rotational motion deficit may be related to increased medial ulnar collateral ligament injury risk among baseball pitchers.

Superior capsule reconstruction is a new treatment option for massive, irreparable posterosuperior rotator cuff tears (Figure 1). The treatment goals for massive tears are to reduce pain, restore shoulder function and delay the development of cuff tear arthropathy. Superior capsule reconstruction is an exciting and promising new procedure that can achieve these goals. Moreover, superior capsule reconstruction can be performed arthroscopically, which minimizes the complication risk. Superior capsule reconstruction uses a bridging graft that is attached at the superior glenoid and at the greater tuberosity to re-stabilize and re-center the humeral head. Teruhisa Mihata, MD, who is credited with inventing the procedure, recently reported on 100 patients who underwent superior capsule reconstruction with fascia lata autografts at a minimum of 2-years follow-­up. In that series, the American Shoulder and Elbow Surgeons score improved significantly from 36 preoperatively to 92 postoperatively and MRI follow-up showed 95% of patients had intact capsule reconstructions.

According to recently published results, there was a large variation of about 25 points in the 6-month risk-adjusted American Shoulder and Elbow Surgeons performance difference across the highest performing surgeons and the lowest performing surgeons who perform rotator cuff repair.

In an evaluation of related factors for rotator cuff tears, results showed rotator cuff tears were more affected by heel-type osteophytes than critical shoulder angle.

Patients with medium- to large-sized rotator cuff tears treated with a biocomposite medial-row anchor experienced a decrease in the incidence and severity of peri-anchor cysts at 18 months postoperatively, according to published results.

Shoulder Club International is an international group focused on education regarding shoulder and sports medicine. It includes several international shoulder experts from the United States, Netherlands, Kosovo, United Kingdom, Korea, Italy, France and Turkey.

Reverse total shoulder arthroplasty was introduced in 1987 in Europe and nearly 20 years later in the United States. Since then, the number of reverse TSAs performed annually has increased worldwide. In 2015, the number of reverse TSAs performed surpassed that of hemiarthroplasties in the health care system. Conventional shoulder arthroplasty places the implant cup into the shoulder glenoid and the metal ball into the humerus. In reverse TSA, both parts of the implant are switched.

LAS VEGAS — At the American Academy of Orthopaedic Surgeons Annual Meeting, Leesa M. Galatz, MD, discussed a study that looked at patient satisfaction after total shoulder arthroplasty. She said functional outcomes are most important to patients after surgery; however, patient satisfaction did not correlate with functional outcome scores.

LAS VEGAS — At the American Academy of Orthopaedic Surgeons Annual Meeting, Jon J.P. Warner, MD, discussed a study that compared patient-reported outcomes between superior capsular reconstruction and tendon transfers. He said there was no difference between treatments with regard to the process of recovery or patient-reported outcomes at a 2-year minimum follow-up.

Despite complications, surgical treatment of terrible triad injuries of the elbow that involve slight modifications of the Pugh standard surgical protocol may yield good to excellent outcomes, according to results published in Medicine.