JSES International最新文献

{"title":"Radiographic analysis of cartilage surface restoration in patients with pediatric capitellar osteochondritis dissecans lesions following osteochondral autologous transplantation","authors":"Jacqueline K. Kobayashi MD ,&nbsp;Alexandria J. Sherwood MD ,&nbsp;Benjamin Gundlach MD ,&nbsp;Conor S. Locke MS ,&nbsp;Tsz Kit Kevin Chan MD ,&nbsp;Eileen A. Crawford MD ,&nbsp;Kagan Ozer MD ,&nbsp;Adam C. Abraham PhD ,&nbsp;Jeffrey N. Lawton MD","doi":"10.1016/j.jseint.2025.10.008","DOIUrl":"10.1016/j.jseint.2025.10.008","url":null,"abstract":"<div><h3>Background</h3><div>Osteochondral autologous transplant (OAT) is an option in the treatment of pediatric capitellar osteochondritis dissecans (OCD). However, quantifying the improvement in the area of OCD defects contributing to the articular surface after an OAT procedure has not been well documented. The purpose of this study was to use magnetic resonance imaging (MRI) to evaluate changes in the defect area of capitellar OCD lesions in pediatric patients following an OAT procedure using a lateral femoral condyle autograft.</div></div><div><h3>Methods</h3><div>Pediatric patients with capitellar OCD lesions underwent an OAT from the lateral femoral condyle to the involved capitellum. MRI was obtained preoperatively, 3 months postoperatively, and 12 months postoperatively. Sagittal image slices of the capitellum were analyzed to measure the percentage area of articular cartilage defect compared with a best-fit circle simulating the ideal profile of the capitellum.</div></div><div><h3>Results</h3><div>Twelve patients met the inclusion criteria for this study. Preoperatively, the average percentage area of defect within each capitellar OCD lesion (compared to the ideal profile) was 16%. At 3 months postoperatively, the average area defect significantly improved to 3% (<em>P</em> &lt; .01) compared to preoperative imaging. One patient (8.3%) had complete filling of their cartilage defect, and 10 patients (83%) had ≤3% area of defect. One patient (8.3%) had subsidence of articular cartilage between their postoperative imaging at 3 months and 12 months. Despite this, there was no significant change in defect area between 3 months and 12 months postoperatively (<em>P</em> = .07).</div></div><div><h3>Conclusion</h3><div>This radiographic analysis of area restoration following an OAT procedure for pediatric capitellar OCD lesions demonstrates a significant decrease in defect area on the articular surface in postoperative MRI. This study provides further support for the utilization of an OAT procedure for the management of pediatric capitellar OCD lesions.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 1","pages":"Article 101406"},"PeriodicalIF":0.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is elastography feasible in torn rotator cuffs before surgery?","authors":"Mina Shenouda BS ,&nbsp;Nick Bouletos MD ,&nbsp;James Bilbrough MD ,&nbsp;Victor Chen ,&nbsp;Ala Hawa MD ,&nbsp;Christyon Hayek MD ,&nbsp;George A.C. Murrell MD, DPhil","doi":"10.1016/j.jseint.2025.10.004","DOIUrl":"10.1016/j.jseint.2025.10.004","url":null,"abstract":"<div><h3>Background</h3><div>Shear wave elastography (SWE) is a relatively recent ultrasound imaging technique that uses focused acoustic radiation forces to quantify the elasticity of biological tissues, commonly referred to as ‘elastographic stiffness’. Preliminary data suggest that the elastographic stiffness of a torn supraspinatus tendon may serve as an independent predictor of retear risk following surgical repair. However, the feasibility of obtaining accurate preoperative SWE measurements remains uncertain, as tendon retraction beneath the acromion can limit visualization and reliable assessment.</div></div><div><h3>Methods</h3><div>This was a prospective cohort study that recruited 60 consecutive patients who had received a diagnosis of supraspinatus tear. SWE imaging was conducted to determine the elastographic stiffness of each patient's torn supraspinatus tendon.</div></div><div><h3>Results</h3><div>SWE values of the edge of the torn supraspinatus were successfully measured in 59/60 (98%) of cases, resulting in a failure to measure rate of 2%. SWE measurements were not feasible in a single case where the anteroposterior or mediolateral tear lengths were greater than 28 mm. Tendon elastographic stiffness, measured as elasticity (kPa), was inversely correlated with anteroposterior tear length (R² −.51, <em>P</em> &lt; .001), mediolateral tear length (R² −.54, <em>P</em> &lt; .001), and patient age (R² −.27, <em>P</em> &lt; .05).</div></div><div><h3>Conclusion</h3><div>This study shows that preoperative SWE of the torn supraspinatus tendon is a feasible imaging methodology if the supraspinatus tear is &lt; 30 mm. Patients who had smaller tears and who were younger had greater SWE than older patients with larger tears.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 1","pages":"Article 101402"},"PeriodicalIF":0.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic total shoulder arthroplasty for osteoarthritis in patients who are 75 years or older. An analysis of revision rates and patient-reported outcome using data from the Danish shoulder arthroplasty registry","authors":"Carl Johan Queitsch BSc ,&nbsp;Marc R.K. Nyring MD, PhD ,&nbsp;Andreas Falkenberg Nielsen MD ,&nbsp;Marie Louise Jensen MD ,&nbsp;Bo S. Olsen MD, PhD ,&nbsp;Jeppe V. Rasmussen MD, PhD","doi":"10.1016/j.jseint.2025.10.003","DOIUrl":"10.1016/j.jseint.2025.10.003","url":null,"abstract":"<div><h3>Background</h3><div>Anatomic total shoulder arthroplasty (aTSA) has been proven effective in the treatment of painful end-stage osteoarthritis in patients with intact rotator cuff function. However, elderly patients may have an increased risk of revision, especially when it comes to the risk of revision due to loosening, rotator cuff pathology and periprosthetic fracture. The aim of this study was to investigate revision rates and patient-reported outcomes after aTSA for osteoarthritis in patients who are 75 years or older. We hypothesized that revision rates and patient-reported outcomes were similar for patients aged 55-74 years and 75 years or older.</div></div><div><h3>Methods</h3><div>This is a registry-based cohort study with data from the Danish Shoulder Arthroplasty Registry. For analysis, 1,884 aTSAs used for osteoarthritis between January 1, 2012, and December 31, 2019, were included. Patients were divided into 2 age groups: 55-74 years and 75 years or older. The Kaplan–Meier method was used to estimate unadjusted cumulative revision rates and a multivariate Cox regression model was used to determine hazard ratios. A multivariable linear regression model was used to compare the Western Ontario Osteoarthritis of the Shoulder Index (WOOS) 1 year postoperatively.</div></div><div><h3>Results</h3><div>There were 34 (2.5%) patients in the middle-aged group and 8 (1.6%) patients in the older age group who had revision surgery. The hazard ratio for revision was 0.67 for the older age group compared to the middle-aged group (95% confidence interval [CI] 0.31-1.47, <em>P</em> = .32). The unadjusted 2-year and 5-year cumulative revision rates were 2.3% (95% CI 1.4-3.2) and 3.6% (95% CI 2.3-4.9) in the middle-aged group and 1.7% (95% CI 0.4-3.0) and 2.2% (95% CI 0.6-3.8) in the older age group. The mean WOOS score was 84 (standard deviation = 20) in the middle-aged group and 85 (standard deviation = 20) in the older age group. The difference in WOOS between the 2 groups was 1.2 points (95% CI −1.5 to 3.8, <em>P</em> = .40).</div></div><div><h3>Conclusion</h3><div>We found low short-term revision rates and good patient-reported outcomes for both middle-aged and older patients treated for osteoarthritis using aTSA. The small differences in WOOS between the 2 age groups were not clinically relevant nor statistically significant. aTSA provides good and reliable outcomes in elderly patients with end-stage osteoarthritis, and age alone should not be a reason for opting out aTSA.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 1","pages":"Article 101401"},"PeriodicalIF":0.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring age-related differences in asymptomatic male shoulder kinematics using four-dimensional computed tomography","authors":"James C. Hunter PhD ,&nbsp;Ting-Yim Lee PhD, FCCPM ,&nbsp;George S. Athwal MD ,&nbsp;Emily A. Lalone PhD","doi":"10.1016/j.jseint.2025.10.007","DOIUrl":"10.1016/j.jseint.2025.10.007","url":null,"abstract":"<div><h3>Background</h3><div>Understanding age-related differences in shoulder glenohumeral and scapulothoracic motion has implications for the understanding, treatment, and management of shoulder injuries and diseases. Previous studies have investigated age-related differences, although statically and in single-plane motion. The shoulder, however, is a complex joint capable of a wide range of motion (ROM) and involves coordinated and synchronous movements from both the glenohumeral and scapulothoracic joints. Therefore, the objectives of this study were to measure age-related differences in kinematics of the glenohumeral and scapulothoracic joints during motion, as well as differences in the neutral positioning of the scapula and humerus.</div></div><div><h3>Methods</h3><div>Thirty-one male participants comprised 2 cohorts based on age (&lt;45 and ≥ 45 years). Participants performed 2 motions, forward elevation (FE) and internal rotation (IR) to the back, with 4-dimensional computed tomography scanning to dynamically track the bones. The kinematics of the humerus and scapula were calculated with 6 degrees of freedom. The neutral position of the scapula and humerus was also calculated based on a static computed tomography scan.</div></div><div><h3>Results</h3><div>During the FE motion, IR of the humerus was significantly greater (13°, <em>P</em> = .033) in the older cohort while the scapula had significantly more anterior translation (9 mm, <em>P</em> = .022) and medial rotation (9°, <em>P</em> = .021) in the younger cohort. Anterior translation of the humeral head during IR was significantly greater (1 mm, <em>P</em> = .05) in the younger cohort, while scapular superior translation was significantly greater (8 mm, <em>P</em> = .006) in the older cohort. When measuring humeral translation as a percentage of glenoid width rather than absolute translation, the older cohort exhibited significantly less translational ROM during FE (6%, <em>P</em> &lt; .001), (5%, <em>P</em> = .036), (5%, <em>P</em> = .009) and IR (6%, <em>P</em> &lt; .001), (6%, <em>P</em> &lt; .001), (4%, <em>P</em> &lt; .001) in the respective anterior, superior, and lateral directions. Furthermore, compared to the younger cohort, the older cohort had a neutral pose with significantly more superior translation (17 mm, <em>P</em> = .05), lateral rotation (8°, <em>P</em> = .009) and posterior tilting (10°, <em>P</em> &lt; .001) of the scapula, and a more anteriorly positioned humerus (2 mm, <em>P</em> = .007).</div></div><div><h3>Conclusion</h3><div>Overall, this study found age-related differences in kinematics and neutral positioning of the scapula and humerus, which may help improve understanding of age-related differences in subluxation, diseases, injuries, and ROM.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 1","pages":"Article 101405"},"PeriodicalIF":0.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative testosterone replacement therapy: a potential risk-factor for complications and reoperation after rotator cuff repair","authors":"Andrea H. Johnson MSN, CRNP,&nbsp;Ryan Friedman BS,&nbsp;Jane C. Brennan MS,&nbsp;Matthew A. Peterman DO,&nbsp;Jeffrey Gelfand MD,&nbsp;Daniel E. Redziniak MD,&nbsp;Cyrus Lashgari MD,&nbsp;Justin J. Turcotte PhD, MBA","doi":"10.1016/j.jseint.2025.10.002","DOIUrl":"10.1016/j.jseint.2025.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Prior studies have shown that testosterone replacement therapy (TRT) may be a risk-factor for complications after rotator cuff repair (RCR). This study evaluated complication rates among male RCR patients with and without a history of TRT preoperatively.</div></div><div><h3>Methods</h3><div>A retrospective review of 33,032 male patients undergoing RCR in the PearlDiver database was performed. Patients receiving TRT within 1-year of surgery were propensity score matched 1:3 to those not receiving TRT, 8,258 TRT, and 24,774 no-TRT patients were included. Univariate and multivariate analyses were performed to compare outcomes between groups.</div></div><div><h3>Results</h3><div>After controlling for decreased libido, benign prostatic hypertrophy, tobacco use, alcohol disorders, liver disease, rheumatologic disease, and preoperative steroid injections, TRT patients were more likely to be readmitted within 90 days (odds ratio [OR]: 1.26, <em>P</em> = .013). Within 2 years postoperatively, TRT patients were more likely to undergo (OR: 1.70, <em>P</em> &lt; .001) or revision RCR (OR: 1.53, <em>P</em> &lt; .001) and to have prolonged opioid use (OR: 1.32, <em>P</em> &lt; .001), frozen shoulder (OR: 1.37, <em>P</em> &lt; .001), and stroke/myocardial infarction (OR: 1.20, <em>P</em> &lt; .001). Patients whose last TRT fill was within 6 months prior to surgery had higher rates of 90-day readmission (2.1% vs. 1.3%; <em>P</em> = .048), prolonged opioid use at 2 years (66.6% vs. 62.1%; <em>P</em> = .002), revision RCR at 2 years (13.1% vs. 8.7%; <em>P</em> &lt; .001), and increased 2-year cost ($18,740 vs. $16,006; <em>P</em> &lt; .001) compared to those whose last fill was 6-12 months preoperatively.</div></div><div><h3>Conclusion</h3><div>TRT within 1 year of RCR appears to be a risk factor for multiple postoperative complications and subsequent shoulder surgery. Cessation of TRT prior to RCR should be considered on a patient-specific basis.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 1","pages":"Article 101400"},"PeriodicalIF":0.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histological features of the distal insertion of the middle glenohumeral ligament on the subscapularis tendon","authors":"Laurent Nové-Josserand MD ,&nbsp;Juliet Tantot MD ,&nbsp;Amandine Jost MD ,&nbsp;Charles-Henri Bretagne MD ,&nbsp;Arnaud Walch MD ,&nbsp;David Guillier MD, PhD ,&nbsp;Pierre Martz MD, PhD ,&nbsp;Thomas Chauvet MD","doi":"10.1016/j.jseint.2025.09.016","DOIUrl":"10.1016/j.jseint.2025.09.016","url":null,"abstract":"<div><h3>Background</h3><div>The middle glenohumeral ligament (MGHL) is the least well characterized glenohumeral ligament and its distal insertion remains matter of debate. The aim of this study was to describe the histological features of the distal insertion of the MGHL and its interactions with the subscapularis tendon. Our hypothesis was that the MGHL inserts distally on the articular surface of the subscapularis tendon.</div></div><div><h3>Methods</h3><div>Macroscopic and histological analysis of the insertion of the MGHL was performed in 16 shoulders obtained from 10 fresh cadaver dissections from a posterior approach. Macroscopic analysis involved observation of the distal insertion of the MGHL and measurement of its distance from the humerus. The distal insertion site was then extracted without bone, fixed in paraffin and stained with hematoxylin-eosin-saffron for histological analysis of longitudinal sections of the MGHL.</div></div><div><h3>Results</h3><div>The MGHL inserted macroscopically into the subscapularis tendon in all 16 shoulders, at a mean distance of 13 mm (range, 5-30 mm) from the humerus. Histological analysis revealed that the MGHL inserted on the deep layer (articular surface) of the subscapularis in all 16 shoulders, at a distance from the humerus. The junction angle was acute in all cases. Two different connection mechanisms were observed. While a majority of MGHL collagen fibers extended into the articular capsule, increasing its thickness, the remaining MGHL collagen fibers penetrated into the subscapularis tendon in the longitudinal direction of the ligament, mingling with the larger perpendicular collagen bundles of the subscapularis tendon. The junction was in some cases in the subscapularis tendon and in others in the subscapularis myotendinous junction.</div></div><div><h3>Conclusion</h3><div>The anatomically exceptional ligament-to-tendon distal insertion of the MGHL into the subscapularis was histologically confirmed in all. These findings support recent results indicating that the MGHL does not insert onto the humerus but into the articular surface of the subscapularis tendon, forming a blend of ligament fibers up to its terminal insertion on the lesser tuberosity. These results suggest that MGHL mechanical constraints are transferred into the subscapularis tendon rather than at the bony insertion on the lesser tuberosity.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 1","pages":"Article 101396"},"PeriodicalIF":0.0,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling surgeon belief updating under bias: a Bayesian simulation in shoulder arthroplasty","authors":"Mariano E. Menendez MD ,&nbsp;Michael A. Moverman MD ,&nbsp;Surena Namdari MD, MSc ,&nbsp;Frederick A. Matsen III MD ,&nbsp;David Ring MD, PhD","doi":"10.1016/j.jseint.2025.09.018","DOIUrl":"10.1016/j.jseint.2025.09.018","url":null,"abstract":"<div><h3>Background</h3><div>Shoulder surgeons often offer markedly different treatment recommendations for a given patient and pathophysiology within the context of a common body of evidence. Prior beliefs and cognitive bias may contribute to this variability. Using Bayesian decision theory informed by principles of behavioral science, we modeled how surgeons with different initial beliefs and degrees of bias update their treatment preferences in response to new evidence comparing anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) when making surgery recommendations for advanced primary glenohumeral osteoarthritis.</div></div><div><h3>Methods</h3><div>We developed a Bayesian simulation involving 3 hypothetical surgeons with distinct initial beliefs: aTSA Loyalist (90% belief aTSA is superior), Neutral Thinker (50%), and rTSA Advocate (10% belief aTSA is superior) and varying degrees of confirmation bias (eg, the selective discounting of evidence that contradicts one's current belief). Each surgeon was sequentially exposed to 10 simulated randomized trials modestly favoring rTSA, with belief trajectories updated after each trial under 2 conditions: (1) an unbiased scenario, in which all new evidence was weighted at face value, and (2) a biased scenario, in which disconfirming evidence was systematically downweighted.</div></div><div><h3>Results</h3><div>Under a condition simulating no confirmation bias, all surgeons gradually shifted toward lower belief in aTSA superiority as they reviewed the 10 rTSA-favoring trials: the aTSA Loyalist moved from about 90% to 25% confidence in aTSA, the Neutral Thinker from 50% to 2.0%, and the rTSA Advocate from 10% to 1.2%. Under biased conditions, belief change was markedly reduced for the aTSA Loyalist, who remained 64% confident in aTSA superiority despite consistent rTSA-favoring evidence. Changes for the rTSA Advocate (10%-1.2%) and Neutral Thinker (50%-2.3%) were largely unchanged.</div></div><div><h3>Conclusion</h3><div>This Bayesian simulation provides a practical framework to demonstrate how prior beliefs and cognitive bias can markedly influence the way shoulder surgeons interpret and act upon new evidence, contributing to unwarranted variation in care. When it comes to treatment recommendations, what surgeons believe at the outset may matter as much or more than the data itself. Implementing targeted strategies such as foundational principles based in behavioral ethics, evidence-based decision and debiasing aids, structured peer review, and routine performance feedback may help align treatment decisions more closely with a patient's values based on the best available evidence. The use of rTSA-favoring evidence in this simulation is solely for illustrative purposes and should not be interpreted as an endorsement of increased rTSA use in clinical practice.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 1","pages":"Article 101399"},"PeriodicalIF":0.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for postage stamp fracture following arthroscopic Bankart repair: a systematic review","authors":"Jakob Oury MD ,&nbsp;Srikanth Mudiganty MD ,&nbsp;Alexander Crowley MD ,&nbsp;Brian Godshaw MD","doi":"10.1016/j.jseint.2025.09.017","DOIUrl":"10.1016/j.jseint.2025.09.017","url":null,"abstract":"<div><h3>Background</h3><div>Postage stamp fractures are a rare but considerable complication after arthroscopic Bankart repair. Previous literature has implicated various patient- and technique-specific factors, but analyses often lacked comparison to the broader operative sample. The purpose of this study is to systematically review the literature on postage stamp fracture after arthroscopic Bankart repair, evaluate patient- and anchor-specific risk factors, and contextualize findings within the full operative sample.</div></div><div><h3>Methods</h3><div>A systematic review was conducted to identify studies reporting postage stamp fractures following arthroscopic Bankart repair using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Patient demographics, anchor characteristics, and surgical outcomes were extracted. Risk factor associations were evaluated descriptively, with emphasis on whether reported associations held true across the full sample of surgical cases in each study.</div></div><div><h3>Results</h3><div>A systematic search yielded 2,349 articles; after duplicate removal and screening, 7 studies met inclusion criteria (2 comparative, 5 noncomparative). Studies included a total of 1,264 patients aged 10-61, with fracture incidence in larger cohorts ranging from 1.58% to 5%. Most patients with fractures participated in sports, particularly contact or high-risk activities. Although male patients made up the majority of fracture cases, this reflected the underlying demographic of operative patients. Patients with fractures were often the same age or older than the overall sample. Anchor number, diameter, type, and material were variably reported. Average anchor count was not consistently higher in patients with fractures, and no study found a significant association between anchor quantity and fracture risk. Absorbable anchors were implicated in a higher proportion of fracture cases. Osteolysis was common among patients with fractures. Insertion angle and suture type (knotted vs. knotless) were inconsistently reported and not clearly linked to fracture incidence.</div></div><div><h3>Conclusion</h3><div>Male sex and younger age, previously identified as risk factors, were not associated with postage stamp fractures when contextualized within the full operative sample. Presence of osteolysis and athletic participation was consistently associated with postage stamp fracture and may represent meaningful risk factors. Contrary to earlier reports, higher anchor quantity was not associated with increased postage stamp fracture risk; instead, lower anchor counts may be linked to instability, which itself may predispose to postage stamp fracture. Use of absorbable anchors emerged as a potential contributor to fracture risk that warrants further research.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 1","pages":"Article 101397"},"PeriodicalIF":0.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative pain associated with rotator cuff tears correlates with synovitis severity in the rotator interval","authors":"Yuichi Nagase MD, PhD ,&nbsp;Kazuki Abe MD ,&nbsp;Kazuya Tamai MD, PhD ,&nbsp;Masashi Naito MD, PhD ,&nbsp;Hideaki Asai MD ,&nbsp;Masahiko Morishige MD ,&nbsp;Sakae Tanaka MD, PhD","doi":"10.1016/j.jseint.2025.09.013","DOIUrl":"10.1016/j.jseint.2025.09.013","url":null,"abstract":"<div><h3>Background</h3><div>The present study primarily aimed to investigate whether preoperative pain associated with rotator cuff tears correlates with the severity of synovitis in the rotator interval (RI) on arthroscopic findings retrospectively.</div></div><div><h3>Methods</h3><div>Between July 2017 and December 2022, 131 shoulders with arthroscopic rotator cuff repair were retrospectively investigated. The pain domain of the preoperative Constant Score and Shoulder36 were used to assess preoperative pain. Two examiners confirmed the degree of synovitis of RI in the arthroscopic findings.</div></div><div><h3>Results</h3><div>The mean patient age was 68.9 years. Synovitis in the RI was found in 118 shoulders (94%) assessed by arthroscopy. The pain domain of the Constant Score significantly correlated with synovitis in the RI assessed by arthroscopic findings (<em>P</em> &lt; .01), but the size and the number of rotator cuff tears did not.</div></div><div><h3>Conclusion</h3><div>The preoperative pain associated with rotator cuff tears significantly correlated with synovitis severity in the RI assessed by AS findings, highlighting the role of synovitis as a potential contributor to pain in patients with rotator cuff tears.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 1","pages":"Article 101393"},"PeriodicalIF":0.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Humeral retrotorsion corrected glenohumeral external rotation deficits are present in medial ulnar collateral ligament injured and uninjured college baseball players","authors":"Jacob E. Vasquez PT, DPT, OCS ,&nbsp;Frankie-Ann McCauley PT, DPT, SCS, CSCS ,&nbsp;Claire M. Reynolds PT, DPT, SCS ,&nbsp;Sean M. Kennedy PT, DPT, PhD, SCS, CSCS ,&nbsp;Jacob D. Jelmini PhD, ATC, CSCS ,&nbsp;Zachary A. Gehring ,&nbsp;J. Craig Garrison PT, PhD, SCS, ATC ,&nbsp;John E. Conway MD ,&nbsp;Natalie L. Myers PhD, ATC, PES","doi":"10.1016/j.jseint.2025.10.001","DOIUrl":"10.1016/j.jseint.2025.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Glenohumeral rotational motion should be interpreted within the context of relative humeral retrotorsion (rHRT). To date, no study has investigated shoulder rotational motion within the context of rHRT in a medial ulnar collateral ligament (MUCL)–injured population. Therefore, the purpose of this study was to determine if there were differences in HRT-corrected rotational motion between MUCL-injured and uninjured college baseball players.</div></div><div><h3>Methods</h3><div>Thirty-five baseball players diagnosed with an MUCL injury were matched with 35 uninjured controls. Glenohumeral external rotation (GER) and internal rotation (GIR), as well as anatomic HRT, were collected on both arms. Data reduction was performed for all objective rotational motions and anatomic HRT, which was used to quantify rHRT. rHRT was then used to calculate HRT-corrected GER and HRT-corrected GIR. Outcomes were compared between groups using multivariate analysis of covariance, controlling for baseline cohort differences.</div></div><div><h3>Results</h3><div>Results indicated no significant multivariate effects of cohort, body mass index, or level of competition on HRT-corrected GER or GIR (all Pillai's Trace <em>P</em> &gt; .05, partial η² ≤ 0.019). Adjusted estimated marginal means for HRT-corrected GER were –9.99° (standard error [SE] = 2.51) for the MUCL cohort and –5.45° (SE = 2.51) for the uninjured cohort; for HRT-corrected GIR, they were 5.01° (SE = 2.46) and 2.21° (SE = 2.46), respectively.</div></div><div><h3>Conclusion</h3><div>HRT-corrected GER deficits are more prevalent than HRT-corrected GIR deficits in both cohorts. These findings continue to highlight the importance of accounting for osseous adaptations in range of motion measurements, as GIR deficit is not as common as previously thought.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 1","pages":"Article 101398"},"PeriodicalIF":0.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}