JSES International最新文献

{"title":"Subcutaneous tissue disinfection is more effective than the use of electrocautery in reducing Cutibacterium acnes burden in open shoulder surgery","authors":"Nicolas Gallusser MD ,&nbsp;Bertrand Léger PhD ,&nbsp;Caroline Passaplan MD ,&nbsp;Stéphane Emonet MD ,&nbsp;Beat Kaspar Moor PD","doi":"10.1016/j.jseint.2025.101408","DOIUrl":"10.1016/j.jseint.2025.101408","url":null,"abstract":"<div><h3>Background</h3><div><em>Cutibacterium acnes</em> (<em>C</em>. <em>acnes</em>) is a pathogen linked to infections following shoulder surgery. Exposure can occur during surgical dissection and spread in the surgical field through the surgeon's gloves and instruments. Disinfection of the subcutaneous tissue has been shown to reduce its contamination. No evidence has been provided for a decrease in the transmission rate when the dissection is performed with an electrocautery. The aim of this study was to ascertain whether disinfection of subcutaneous tissue can reduce the <em>C</em>. <em>acnes</em> rate in primary open shoulder surgery in comparison with dissection performed with electrocautery. We also wanted to compare the contamination rate of the operating field after electrocautery dissection with those found in the literature.</div></div><div><h3>Methods</h3><div>All patients who qualified for primary open shoulder surgery via a deltopectoral approach were prospectively included in our single-blinded, two-arm randomized clinical trial. For every patient, a skin swab from the surgical area was taken before the standard preparation of the skin. In the disinfection group, the subcutaneous layer was treated with povidone iodine solution after exposure of the deltoid fascia. The cautery group underwent subcutaneous tissue dissection using an electrocautery. After fully exposing the proximal humerus, 5 swabs were collected from various locations for microbiological analysis, following a rigorous protocol. All cultures were incubated for 14 days under both aerobic and anaerobic conditions.</div></div><div><h3>Results</h3><div>Between February 2020 and July 2021, 210 shoulders were enrolled in 2 groups (140 disinfection vs. 70 cautery). The 2 groups showed no significant differences in terms of sex, age, body mass index, or diabetes prevalence. The subcutaneous disinfection protocol led to a significant decrease in the overall positive culture rate of the operating field for all bacteria (<em>P</em> = .001) and specifically for <em>C</em>. <em>acnes</em> (<em>P</em> = .021). The reduction of positive swabs for <em>C</em>. <em>acnes</em> was significant for both the surgeon's gloves (<em>P</em> = .004) and for the subcutaneous tissue (<em>P</em> = .009). <em>C</em>. <em>acnes</em> contamination rate was noted in 26% of patients in the electrocautery group and 13% in the disinfection group after exclusion of the outside scalpel blade sample, which was removed from the scrub nurse's instrument table and therefore no longer used during the procedure.</div></div><div><h3>Conclusion</h3><div>Disinfection of the subcutaneous tissue reduces the contamination rate of <em>C</em>. <em>acnes</em> by a factor of 2 during open shoulder surgery compared with an approach performed with electrocautery and could limit the contamination of the operating field.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101408"},"PeriodicalIF":0.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904067","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":"Mitochondria dysfunction and increased expression of WNT5A and BNIP3 in tenocytes obtained from patients with tendinopathy","authors":"Yusuke Nakagawa MD, PhD ,&nbsp;Yuki Okazaki MD, PhD ,&nbsp;Camila B. Carballo PT, PhD ,&nbsp;Susumu Wada MD, PhD ,&nbsp;Daniel Nemirov MD ,&nbsp;Elizabeth R. Selvaggio MD ,&nbsp;Amir H. Lebaschi MD ,&nbsp;Xiang-Hua Deng MD ,&nbsp;Miguel Otero PhD ,&nbsp;Michelle L. Delco DVM, PhD ,&nbsp;Lisa A. Fortier DVM, PhD ,&nbsp;Scott A. Rodeo MD","doi":"10.1016/j.jseint.2025.101417","DOIUrl":"10.1016/j.jseint.2025.101417","url":null,"abstract":"<div><h3>Background</h3><div>Tendinopathy is a significant source of pain and functional impairment, with contributions from various extrinsic and intrinsic factors. Prior studies have demonstrated the role of mitochondria (MT) dysfunction in a murine model of supraspinatus tendinopathy, with improvement in tendon structure following treatment with the mitochondrial protectant agent Szeto-Schiller-31 (elamipretide). However, there is very little information available on mitochondrial function in human tendinopathy. The purpose of this study is to compare MT function in human tenocytes obtained from pathologic tendons of patients with tendinopathy and normal tendons and to identify potential target genes for the treatment of tendinopathy.</div></div><div><h3>Methods</h3><div>Samples of degenerative tendons from the upper extremity (biceps tendon [n = 7], rotator cuff [n = 4], and extensor carpi radialis brevis tendon [n = 2]; total n = 13) and normal tendons from the lower extremity (hamstring [n = 4], patellar [n = 3], and quadriceps [n = 2]; total n = 9) were collected during surgeries. Cell viability, ultrastructural morphology (using transmission electron microscopy), differentiation potential (adipogenesis and osteogenesis), MT membrane polarity, production of reactive oxygen species, and gene expression profile (using NanoString and quantitative real-time polymerase chain reaction (qRTPCR)) were analyzed.</div></div><div><h3>Results</h3><div>Tenocytes from normal tendons exhibited higher colony formation potential (<em>P</em> = .026) and cell viability (<em>P</em> = .017) compared to those from the degenerative group. Transmission electron microscopy revealed degeneration of MT in degenerative tenocytes, with ingestion by phagosomes. The degenerative group showed higher adipogenic potential than the normal group (<em>P</em> = .025). MT membrane potential was significantly decreased in the degenerative group (<em>P</em> &lt; .0001). No gene reached statistical significance when an adjusted <em>P</em> value &lt;.05 was used as the threshold in the NanoString analysis. However, several genes showed upregulation in the degenerative group compared with the normal group (listed in order of smallest <em>P</em> value with log2 fold change, log2FC): IDH2 (<em>P</em> = .0014, log2FC = 0.69), vascular endothelial growth factor (<em>P</em> = .0017, log2FC = 0.63), BNIP3 (BCL2/adenovirus E1B 19 kDa protein-interacting protein 3) (<em>P</em> = .0021, log2FC = 0.70), FGF2 (<em>P</em> = .0026, log2FC = 0.99),WNT5A (Wingless-type MMTV integration site family member 5A) (<em>P</em> = .0027, log2FC = 2.2). WNT5A and BNIP3 upregulation was also confirmed by qRT-PCR.</div></div><div><h3>Conclusion</h3><div>Our results confirm MT dysfunction in the degenerative group, as reported in previous studies. The upregulation of the WNT5A and BNIP3 expression was confirmed by both Nanostring and qRT-PCR.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101417"},"PeriodicalIF":0.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904068","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 new-onset anxiety and depression after arthroscopic shoulder stabilization surgery","authors":"David C. Lutati BS,&nbsp;Jane C. Brennan MS,&nbsp;Andrea H. Johnson MSN, CRNP,&nbsp;Matthew A. Peterman DO,&nbsp;Daniel E. Redziniak MD,&nbsp;Cyrus J. Lashgari MD,&nbsp;Justin J. Turcotte PhD, MBA","doi":"10.1016/j.jseint.2025.101413","DOIUrl":"10.1016/j.jseint.2025.101413","url":null,"abstract":"<div><h3>Background</h3><div>Shoulder instability is a common shoulder pathology, especially in young athletes involved in contact sports, sometimes requiring surgical intervention. In this retrospective database study, we aimed to identify the incidence of new-onset anxiety or depression (NOAD) after arthroscopic shoulder stabilization surgery, identify risk factors for the development of NOAD, evaluate the effect of NOAD on postoperative complications, and examine whether psychiatric interventions have a protective effect against adverse outcomes.</div></div><div><h3>Methods</h3><div>A retrospective analysis of the PearlDiver national database was completed. Included patients had no prior diagnosis of depression/anxiety or prior utilization of antidepressant medication before shoulder stabilization surgery and had at least 1 year of postoperative follow-up. The primary outcome was the development of NOAD within 1 year postoperatively. Multivariate logistic regression was used to assess predictors of NOAD. Postoperative outcomes were compared between patients who did and did not develop NOAD after propensity score matching. A subgroup comparison of outcomes across various NOAD treatments was performed.</div></div><div><h3>Results</h3><div>Of the 38,388 patients, 1,950 (5.1%) were diagnosed with NOAD within 1 year postoperatively. Increased age (odds ratio [OR]: 0.98, 95% confidence interval [CI]: 0.98-0.98; <em>P</em> &lt; .001), increased Charlson Comorbidity Index score (OR: 1.07, 95% CI: 1.01-1.12; <em>P</em> = .012), female sex (OR: 1.72, 95% CI: 1.56-1.89; <em>P</em> &lt; .001), hypermobility (OR: 2.17, 95% CI: 1.33-3.38; <em>P</em> = .001), headaches/migraines (OR: 1.33, 95% CI: 1.20-1.47; <em>P</em> &lt; .001), obesity (OR: 1.49; 95% CI: 1.31-1.70; <em>P</em> &lt; .001), preoperative opioid use (OR: 3.68, 95% CI: 3.34-4.05; <em>P</em> &lt; .001), tobacco use (OR: 2.25, 95% CI: 1.99-2.53; <em>P</em> &lt; .001), and alcohol disorders (OR: 2.13, 95% CI: 1.70-2.64; <em>P</em> &lt; .001) were all associated with a higher risk of developing NOAD. Postoperatively, the NOAD group had a 9.52 times increased risk of 90-day readmission (<em>P</em> &lt; .001), a 1.58-times increased risk of prolonged opioid use (<em>P</em> &lt; .001) at 1 year, increased total cost ($11,107 ± 12,317 vs. $7,695 ± 8,840; <em>P</em> &lt; .001), and a 1.48-times increased risk of revision at 2 years (<em>P</em> &lt; .001). Patients with NOAD undergoing psychotherapy had lower rates of postoperative opioid use.</div></div><div><h3>Conclusion</h3><div>The postoperative development of NOAD is an understudied but relatively common complication of arthroscopic shoulder stabilization surgery, occurring in approximately 5% of patients. The current study highlights a variety of risk factors that may be used to identify at-risk patient populations. Further work is needed to identify interventions that can mitigate the adverse outcomes associated with NOAD.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101413"},"PeriodicalIF":0.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078872","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":"Longitudinal analysis of rotator cuff repair: joint kinematics and clinical outcomes","authors":"Sujata Khandare PhD ,&nbsp;Rebekah L. Lawrence PT, PhD ,&nbsp;Alena Jalics MS ,&nbsp;Roger Zauel MS ,&nbsp;Vasilios Moutzouros MD ,&nbsp;Eric C. Makhni MD, MBA ,&nbsp;Stephanie Muh MD ,&nbsp;Michael J. Bey PhD","doi":"10.1016/j.jseint.2025.101421","DOIUrl":"10.1016/j.jseint.2025.101421","url":null,"abstract":"<div><h3>Background</h3><div>Rotator cuff repair is a common surgical procedure, but postoperative outcomes can be highly variable, and postoperative repair tissue healing remains a significant clinical challenge. Furthermore, the biomechanical effects of rotator cuff repair are not fully understood.</div></div><div><h3>Methods</h3><div>Twenty-two participants scheduled for arthroscopic rotator cuff repair were evaluated preoperatively and at 3, 12, and 24 months postsurgery. The following data were recorded at each time point: glenohumeral and scapulothoracic kinematics, shoulder strength, and patient-reported measures of pain and function. Postoperative repair integrity was assessed via magnetic resonance imaging at 3 months and 24 months postsurgery.</div></div><div><h3>Results</h3><div>At 3 months postsurgery, 5 of 20 patients were identified as having a recurrent tear. An additional 4 patients had a recurrent tear at 24 months postsurgery. The center of contact of the humerus on the glenoid gradually shifted superiorly on the glenoid during the 24 month follow-up period (<em>P</em> &lt; .01). There were subtle changes in scapulothoracic upward rotation at 3 months postsurgery compared to presurgery (<em>P</em> ≤ .01), but these differences did not persist at 12 or 24 months postsurgery. Compared to presurgery, there were significant increases in flexion and internal rotation strength at 12 months postsurgery (<em>P</em> &lt; .01) and significant increases in flexion, abduction, external rotation, and internal rotation strength at 24 months postsurgery (<em>P</em> &lt; .01). Patient-reported measures of pain and function improved significantly over the 24 month follow-up period (<em>P</em> &lt; .01).</div></div><div><h3>Conclusion</h3><div>Surgical rotator cuff repair was associated with decreased pain and improved subjective assessments of function within the first 3 months after surgery, and increased shoulder strength over 12- 24 months postsurgery. The study also found subtle changes over time in glenohumeral joint and scapulothoracic motion.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101421"},"PeriodicalIF":0.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941284","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":"The efficacy of platelet-rich plasma compared to corticosteroids for partial-thickness rotator cuff tears: a randomized controlled trial","authors":"Mohammad Reza Guity MD ,&nbsp;Mahdi Sahebi MD, MPH ,&nbsp;Mohammad Pourfarzaneh MD ,&nbsp;Omid Salkhori MD ,&nbsp;Mahdieh Ghiasi PhD ,&nbsp;Nima Bagheri MD","doi":"10.1016/j.jseint.2025.101409","DOIUrl":"10.1016/j.jseint.2025.101409","url":null,"abstract":"<div><h3>Background</h3><div>Management of partial-thickness rotator cuff tears (PTRCTs) remains debated, especially when conservative treatments fail. Corticosteroid (CS) and platelet-rich plasma (PRP) injections are frequently used, but their comparative effectiveness remains unclear. This study compares PRP and CS injections in improving shoulder range of motion, pain, and patient-reported outcomes in an Iranian population.</div></div><div><h3>Methods</h3><div>A double-blind, randomized controlled trial was conducted with PTRCT patients receiving ultrasound-guided PRP or CS injections. Assessments included shoulder range of motion, visual analog scale for pain, Simple Shoulder Test, Constant–Murley Score, and Oxford Shoulder Score at baseline, 3 months, and 6 months postinjection.</div></div><div><h3>Results</h3><div>Out of 208 patients screened, 107 were analyzed (39 PRP, 68 CS). Baseline measures were similar except for external rotation, which was higher in the PRP group (<em>P</em> &lt; .05). The CS group showed significantly lower visual analog scale scores at 3 and 6 months (<em>P</em> &lt; .001). No significant differences were found in forward flexion, abduction, or internal rotation (<em>P</em> &gt; .05). External rotation remained greater in the PRP group throughout (<em>P</em> &lt; .001). Simple Shoulder Test and Constant–Murley Scores were significantly higher, and Oxford Shoulder Score significantly lower, in the CS group at both follow-ups (<em>P</em> &lt; .001). Both groups showed significant improvement from baseline, except for internal rotation in the PRP group at 6 months (<em>P</em> = .248).</div></div><div><h3>Conclusion</h3><div>Both injections improve clinical outcomes in PTRCT, but CS injections provide superior short- and medium-term pain relief and patient-reported outcomes. CS is preferable for patients prioritizing rapid pain reduction. Further long-term studies are needed to assess sustained effects and safety.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101409"},"PeriodicalIF":0.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188558","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":"Total resection and reconstruction of collateral ligaments in severe elbow stiffness induced by heterotopic ossification: a novel approach and review of the literature","authors":"Mehmet Fatih Güven MD ,&nbsp;Muhammed Yusuf Afacan MD, FEBOT, PhD ,&nbsp;Erdem Şahin MD ,&nbsp;Göker Utku Değer MD","doi":"10.1016/j.jseint.2025.101418","DOIUrl":"10.1016/j.jseint.2025.101418","url":null,"abstract":"<div><h3>Background</h3><div>Post-traumatic elbow stiffness poses a complex challenge, often attributed to intrinsic and extrinsic factors. Heterotopic ossification (HO) is a significant extrinsic contributor, leading to contracture and entrapment syndromes. This study explores the pioneering strategy of total resection and reconstruction of the ossified and contracted collateral ligament in managing extensive HO-induced elbow stiffness. Our goal was to show that complete collateral ligament excision and reconstruction result in a wide range of motion and no long-term HO or elbow instability.</div></div><div><h3>Methods</h3><div>Six patients with severe elbow stiffness underwent HO resection and extensive soft tissue release. Two of them underwent a single fraction of radiotherapy, receiving a dose of 7 gray within the 24 hours preceding the surgery. Five patients with extensive medial HO underwent medial collateral ligament reconstruction using palmaris longus autografts in four of them and tensor fascia lata autograft in one of them, and one patient underwent lateral collateral ligament reconstruction with palmaris longus autograft after lateral collateral ligament sacrifice. Anterior transposition of the ulnar nerve was carried out for all patients to prevent postoperative ulnar nerve symptoms. Evaluations included preoperative and postoperative elbow flexion/extension arcs and Mayo Elbow Performance Score.</div></div><div><h3>Results</h3><div>The study included six patients with stiff elbows (five males, 1 female), aged 17- 45 years (mean age: 30 years). Injury patterns included three nonvehicle traffic accidents and three trauma-related injuries. The trauma-to-surgery interval ranged from 6 to 288 months, with a mean of 79.17. Three patients required intensive care unit stays before surgery, while the other three did not, suggesting varying causes of HO development. After an average follow-up of 3 years, patients exhibited improved flexion/extension arcs (122.5°) from a mean preoperative 20°. The mean Mayo Elbow Performance Score improved from 21.67 preoperatively to 98.33 postoperatively. None of the patients reported varus or valgus instability.</div></div><div><h3>Conclusion</h3><div>Our study demonstrates that excision and reconstruction of the ligament with HO can be a viable and reliable solution for elbow joint stiffness, particularly when the wide HO involves collateral ligaments and loosening procedures are deemed insufficient. Our approach proves cost-effectiveness compared to alternatives involving suture anchors or external fixators, with the added advantage of facilitating more flexion and extension postoperatively to preserve the achieved range of motion.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101418"},"PeriodicalIF":0.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941282","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":"Effect of combined version on impingement-free rotational range-of-motion in three different implant types in reverse shoulder arthroplasty","authors":"Midhat Patel MD ,&nbsp;Charles J. Cogan MD ,&nbsp;Jose A. Rodriguez MD ,&nbsp;Chao Zhang BS ,&nbsp;Bong Jae Jun PhD ,&nbsp;Jason C. Ho MD ,&nbsp;Vahid Entezari MD, MMSc ,&nbsp;Joseph P. Iannotti MD, PhD ,&nbsp;Eric T. Ricchetti MD","doi":"10.1016/j.jseint.2025.101414","DOIUrl":"10.1016/j.jseint.2025.101414","url":null,"abstract":"<div><h3>Background</h3><div>The influence of combined humeral and glenoid component version on impingement-free range-of-motion (ROM) has not previously been evaluated in reverse total shoulder arthroplasty (rTSA). The purpose of this study was to determine the effects of combinations of humeral and glenoid component version on ROM in 3 different rTSA designs. We hypothesized that increased combined retroversion would decrease ROM.</div></div><div><h3>Methods</h3><div>Nine patients with posterior glenoid bone loss indicated for rTSA underwent preoperative computed tomography of the shoulder. Virtual templating was performed using 3 different rTSA designs: medial glenoid-medial humerus, medial glenoid-lateral humerus (MG-LH), and lateral glenoid-medial humerus (LG-MH). Each implant was placed in different combinations of glenoid (10°, 0°, −10°, −20°) and humeral component version (0°, −10°, −20°, −30°, −40°). Virtual simulations of glenohumeral ROM were performed at 0°, 30°, and 90° abduction, with impingement-free internal rotation (IR), external rotation (ER), and combined IR and ER measured. A scapular contact mesh was created to determine impingement locations. A linear mixed effects model was used to assess the association between implant type and ROM. Chi-square tests were used to evaluate differences in impingement locations between implant types.</div></div><div><h3>Results</h3><div>Total (IR and ER) ROM decreased with increasing combined component retroversion. ER ROM increased with more combined retroversion version until 30°, while the contrary was found for IR ROM. In the linear mixed effects model, implant type, glenoid version, and humeral version were significantly associated with total ROM. Compared to the LG-MH implant, the MG-LH implant was associated with increased ROM, and the medial glenoid-medial humerus implant was associated with decreased ROM. Changes in glenoid version were significantly associated with IR ROM but not ER ROM, while changes in humeral version significantly impacted both IR and ER ROM. The most common locations of bony impingement were the posterior scapular neck and anterior/posterior glenoid at 0° abduction; the anterior/posterior glenoid at 30° abduction; and the superior glenoid, coracoid, and acromion at 90° abduction. There were significant differences in impingement locations between implant types at all abduction positions (<em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>This study demonstrates that total impingement-free ROM in rTSA decreases with combined component version greater than 30° of retroversion. The study also demonstrates increased total ROM with implant designs that create a more lateralized center of rotation (MG-LH, LG-MH). Impingement location changes with implant design, with less scapular neck impingement found with the LG-MH design. The study is limited by not being able to account for scapulothoracic motion or soft tissue considerations.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101414"},"PeriodicalIF":0.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904066","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":"“Fighter’s shoulder” part I: impact on shoulder motion and scapular movement in judo and jiu-jitsu athletes","authors":"Wagner Castropil MD, PhD,&nbsp;Juliana Mauad MD,&nbsp;Giovanna Medina MD, PhD,&nbsp;Breno Schor MD, PhD","doi":"10.1016/j.jseint.2025.101416","DOIUrl":"10.1016/j.jseint.2025.101416","url":null,"abstract":"<div><h3>Background</h3><div>Martial arts athletes, such as judo and jiu-jitsu, often develop musculature asymmetry due to repetitive movements over the years of practice. Common injuries include strains, sprains, and fractures, with shoulder and upper-arm injuries being particularly prevalent. The objective of this study was to identify potential changes in the shoulder range of motion (ROM) of martial arts athletes and to associate these changes with years of practice, belt graduation, and scapular dyskinesis. The scapular dyskinesis was evaluated and classified according to the Kibler classification.</div></div><div><h3>Methods</h3><div>A cross-sectional study including martial arts athletes. The shoulder ROM was evaluated using a goniometer through elevation and internal and external rotation at 0° and 90° of abduction. The analysis was performed on both shoulders. The Kibler classification was used to classify scapular dyskinesis.</div></div><div><h3>Results</h3><div>Among 133 belt-ranked combat athletes (54% black belts; mean age 27.8 years), 73% showed scapular dyskinesis (predominantly type I). Years of practice independently predicted reduced dominant-shoulder ROM: anterior elevation −0.320°/year, external rotation at 0° −0.556°/year, and at 90° −0.612°/year (all <em>P</em> &lt; .001). Internal rotation decreased −0.612°/year plus −5.5° in international competitors (<em>P</em> = .030).</div></div><div><h3>Conclusion</h3><div>Years of sustained judo/jiu-jitsu practice were associated with progressive loss of dominant-shoulder ROM, with a concurrent trend toward scapular dyskinesis. These time-linked biomechanical and anatomical adaptations suggest a distinct entity named “Fighter's shoulder.” Clarifying its causes and chronology through longitudinal studies is essential to guide targeted screening, preventive programming, and sport-specific rehabilitation.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101416"},"PeriodicalIF":0.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078870","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":"Electromyography analysis of rotator cuff activation while driving","authors":"Megan C. Paulus MD ,&nbsp;Brent B. Wiesel MD ,&nbsp;Lauren W. Bierman MD ,&nbsp;Tom C. Galetti BA ,&nbsp;Shaan S. Nagda ,&nbsp;Kevin F. Fitzpatrick MD ,&nbsp;Sameer H. Nagda MD","doi":"10.1016/j.jseint.2025.101411","DOIUrl":"10.1016/j.jseint.2025.101411","url":null,"abstract":"<div><h3>Background</h3><div>A common concern of patients after rotator cuff repair is when they can drive. The purpose of this study is to evaluate the activation of the rotator cuff while driving to help guide surgeon recommendations.</div></div><div><h3>Methods</h3><div>A computerized driving simulator was used by 16 volunteers who performed a series of turns with their hands in different positions on the steering wheel. Muscle activity of the supraspinatus, infraspinatus, and biceps was recorded using electromyography. Muscle activity was also recorded while closing the door, fastening the seat belt, and turning a key in the ignition and quantified by a board-certified electromyographer.</div></div><div><h3>Results</h3><div>For the right supraspinatus, infraspinatus, and biceps muscles, there was statistically significant higher level of activation when the right hand was in the 12 o'clock position and the 3 o'clock position as compared with the 6 o'clock positions. This was the same for the left side with the left hand in the 12 o'clock and 9 o'clock positions compared to the 6 o'clock positions (<em>P</em> &lt; .003). Activity of all muscles was minimal when the car door was closed with the opposite hand. Fastening the seat belt and turning the key in the ignition also demonstrated rotator cuff activation.</div></div><div><h3>Conclusion</h3><div>Rotator cuff activity during driving can be minimized by closing the door using the nonoperative arm and driving with the nonoperative arm in the 12 o'clock position with the operative arm at the side and holding the wheel at the 6 o'clock position.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101411"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145941248","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":"Interest in computer-assisted surgery on the glenoid implant positioning in the context of navigated or planned total shoulder arthroplasties","authors":"Yannis Yahiaoui MD,&nbsp;Cyril Lazerges MD, MSc,&nbsp;Michel Chammas MD, PhD,&nbsp;Bertrand Coulet MD, PhD","doi":"10.1016/j.jseint.2025.06.003","DOIUrl":"10.1016/j.jseint.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Three-dimensional planning and intraoperative navigation are beneficial for glenoid implant positioning in total shoulder arthroplasty (TSA). The respective benefits of these two techniques are still being evaluated. The aim of this study was to evaluate the contribution of intraoperative navigation to glenoid implant positioning, compared with planning alone. Our hypothesis is that the use of intraoperative navigation can help to come closer to the planned positioning of the implant, compared with standard instrumentation.</div></div><div><h3>Methods</h3><div>This monocentric, ongoing study included 205 shoulders (197 patients) operated between 2018 and 2024 for a TSA, anatomic or reverse. All patients benefited from preoperative planning (Equinoxe Planning App; Exactech, Gainesville, FL, USA), enabling the collection of native glenoid parameters. Postoperatively, these were assessed using the same method via the planning software. One hundred fifty-three TSA were included, and we identified 2 groups: 101 navigated TSA (navigated planned arthroplasties [NAV] group) and 52 planned TSA (planned arthroplasties [PLA] group), comparable in all respects (68% women, mean age 72.5 years). Version and inclination were compared, as well as the difference between planned and postoperative.</div></div><div><h3>Results</h3><div>The average native glenoid parameters measured and planned were similar between the two groups. The average postoperative version was respectively −2.5° (±4.7°) vs. −1.6° (±6.2°) in the NAV group (<em>P</em> = .259), and the postoperative inclination was respectively 3.8° (±4.9°) vs. 2.0° (±8.1°) in the NAV group (<em>P</em> = .312). The average postoperative deviation from planning in version was 3.0° (±2.9°) in the NAV group vs. 3.7° (±3.0) (<em>P</em> = .157). Regarding inclination, the mean deviation was 4.2° (±3.5°) vs. 6.5° (±5.1°) in the PLA group (<em>P</em> = .004). There was a reduction in the proportion of mispositioned implant in the NAV group, both in version (6.9% vs. 13.5%) and in inclination (9.9% vs. 19.3%). In the revered TSA subgroup, we found a significant reduction of the postoperative deviation from planning in the NAV group.</div></div><div><h3>Discussion</h3><div>Our study highlights the benefits of preoperative planning. We found a reduction in the deviation from planning for reverseTSA, as well as a reduction in the proportion of mispositioned implants. Our series is limited by the absence of randomization. Further studies are needed on clinical improvement after navigation-assisted surgery.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"9 6","pages":"Pages 2030-2036"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468645","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}