Pub Date : 2024-06-05DOI: 10.1177/17585732241258743
Mohammad Daher, Stephane Jabre, Jack C Casey, M. Fares, Peter Boufadel, Ryan Lopez, Jad Lawand, Jad Mansour, Joseph A. Abboud
Lifestyles advocating for proper health and fitness have been trending in recent years, and as such, sports like weightlifting have become very popular worldwide. While these sports improve physical fitness and cardiovascular health, they carry an inherent risk for physical injuries, mainly to the shoulder. In this review, we aimed to explore the epidemiology of shoulder injuries in weightlifting using a systematic search of the literature. The databases PubMed, Google Scholar (pages 1–20), Embase, and SPORTDiscus were queried using relevant search terms to extrapolate all studies pertaining to shoulder injuries in these two sports. Shoulder injuries turned out to be common in both sports with varying incidence rates and were shown to occur to athletes independent of gender and age. Anterior instability and overuse injuries were the most common injury types, and presentation varied with regards to symptoms and severity. Both intrinsic and extrinsic factors can contribute to shoulder injuries in the setting of these two sports, including incorrect implementation of techniques, age, vulnerable positioning of the shoulder during the lift, and overtraining which leads to overuse injuries.
{"title":"Shouldering the load: A scoping review of incidence, types, and risk factors of shoulder injuries in weight-lifting athletes","authors":"Mohammad Daher, Stephane Jabre, Jack C Casey, M. Fares, Peter Boufadel, Ryan Lopez, Jad Lawand, Jad Mansour, Joseph A. Abboud","doi":"10.1177/17585732241258743","DOIUrl":"https://doi.org/10.1177/17585732241258743","url":null,"abstract":"Lifestyles advocating for proper health and fitness have been trending in recent years, and as such, sports like weightlifting have become very popular worldwide. While these sports improve physical fitness and cardiovascular health, they carry an inherent risk for physical injuries, mainly to the shoulder. In this review, we aimed to explore the epidemiology of shoulder injuries in weightlifting using a systematic search of the literature. The databases PubMed, Google Scholar (pages 1–20), Embase, and SPORTDiscus were queried using relevant search terms to extrapolate all studies pertaining to shoulder injuries in these two sports. Shoulder injuries turned out to be common in both sports with varying incidence rates and were shown to occur to athletes independent of gender and age. Anterior instability and overuse injuries were the most common injury types, and presentation varied with regards to symptoms and severity. Both intrinsic and extrinsic factors can contribute to shoulder injuries in the setting of these two sports, including incorrect implementation of techniques, age, vulnerable positioning of the shoulder during the lift, and overtraining which leads to overuse injuries.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141385331","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}
Pub Date : 2024-06-03DOI: 10.1177/17585732241255679
David R Annison, Neil Smith, Emma Salt, Tim Noblet, Amar Rangan, C. McDaid
The utility of the suprascapular nerve block (SSNB) in the non-surgical management of shoulder pain continues to be explored, whilst its associated physical harms have not. This systematic review aims to report the physical harms associated with the SSNB in the non-surgical management of shoulder pain. A search was undertaken of AMED, CINAHL, Cochrane Library, EMBASE, Medline, Pubmed, and Scopus databases. Studies were included if they reported the presence or absence of harm following a SSNB intervention (injection, pulsed radiofrequency, ablation) in the non-surgical management of acute or chronic shoulder pain. Excluded studies were those which utilised SSNB for peri, intra, or post-surgical intervention. The McMaster tool for assessing quality of harms assessment and reporting was utilised. A total of 111 studies were included in this review of which 168 episodes of harm were reported across 4142 participants. Harm severity ranged from pneumothorax (n = 5) to local pain and bruising (n = 50). The quality of harms assessment and reporting across all studies was poor. Despite heterogeneity in SSNB intervention, and low-quality evidence, SSNB carries a low risk of physical harm. Further work is needed in addressing the poor quality of harms assessment and reporting in SSNB studies.
{"title":"Physical harms associated with suprascapular nerve block interventions in the non-surgical management of acute and chronic shoulder pain: A systematic review","authors":"David R Annison, Neil Smith, Emma Salt, Tim Noblet, Amar Rangan, C. McDaid","doi":"10.1177/17585732241255679","DOIUrl":"https://doi.org/10.1177/17585732241255679","url":null,"abstract":"The utility of the suprascapular nerve block (SSNB) in the non-surgical management of shoulder pain continues to be explored, whilst its associated physical harms have not. This systematic review aims to report the physical harms associated with the SSNB in the non-surgical management of shoulder pain. A search was undertaken of AMED, CINAHL, Cochrane Library, EMBASE, Medline, Pubmed, and Scopus databases. Studies were included if they reported the presence or absence of harm following a SSNB intervention (injection, pulsed radiofrequency, ablation) in the non-surgical management of acute or chronic shoulder pain. Excluded studies were those which utilised SSNB for peri, intra, or post-surgical intervention. The McMaster tool for assessing quality of harms assessment and reporting was utilised. A total of 111 studies were included in this review of which 168 episodes of harm were reported across 4142 participants. Harm severity ranged from pneumothorax (n = 5) to local pain and bruising (n = 50). The quality of harms assessment and reporting across all studies was poor. Despite heterogeneity in SSNB intervention, and low-quality evidence, SSNB carries a low risk of physical harm. Further work is needed in addressing the poor quality of harms assessment and reporting in SSNB studies.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141270453","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}
Pub Date : 2024-05-21DOI: 10.1177/17585732241255947
Ivan Perez Kalejman, Ignacio Pasqualini, Catalina Larrague, Federico Gallego, I. Tanoira, M. Ranalletta, L. A. Rossi
Prolonged work absence following arthroscopic rotator cuff repair (ARCR) is a major concern, yet factors influencing return to work are poorly understood. The primary aim of this study is to retrospectively assess the proportion of patients who successfully resume equivalent occupational demands after ARCR, along with the time taken for their return to work. Eighty-three patients underwent ARCR. Work intensity and worker's compensation status were recorded. Patients were interviewed at ≥12 months to determine return to work rate and timing. In total, 83 patients were included, with a median age of 58.7 (±8.36) and a follow-up of at least 12 months. 98.8% returned to work at a median of eight weeks. Heavy manual labor significantly delayed return to work compared to light work (HR 0.15 95% CI). Receiving worker's compensation was associated with delayed return to work (HR 0.26 95% CI). This study found that nearly all patients returned to work following ARCR, but high-intensity manual labor and worker compensation status significantly delayed their return to work. Patients with physically demanding jobs and those receiving workers’ compensation had a 60–85% lower likelihood of returning to work at any given time point compared to light work and noncompensated patients.
{"title":"Factors affecting return to work following arthroscopic rotator cuff repair","authors":"Ivan Perez Kalejman, Ignacio Pasqualini, Catalina Larrague, Federico Gallego, I. Tanoira, M. Ranalletta, L. A. Rossi","doi":"10.1177/17585732241255947","DOIUrl":"https://doi.org/10.1177/17585732241255947","url":null,"abstract":"Prolonged work absence following arthroscopic rotator cuff repair (ARCR) is a major concern, yet factors influencing return to work are poorly understood. The primary aim of this study is to retrospectively assess the proportion of patients who successfully resume equivalent occupational demands after ARCR, along with the time taken for their return to work. Eighty-three patients underwent ARCR. Work intensity and worker's compensation status were recorded. Patients were interviewed at ≥12 months to determine return to work rate and timing. In total, 83 patients were included, with a median age of 58.7 (±8.36) and a follow-up of at least 12 months. 98.8% returned to work at a median of eight weeks. Heavy manual labor significantly delayed return to work compared to light work (HR 0.15 95% CI). Receiving worker's compensation was associated with delayed return to work (HR 0.26 95% CI). This study found that nearly all patients returned to work following ARCR, but high-intensity manual labor and worker compensation status significantly delayed their return to work. Patients with physically demanding jobs and those receiving workers’ compensation had a 60–85% lower likelihood of returning to work at any given time point compared to light work and noncompensated patients.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141113044","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}
Pub Date : 2024-05-20DOI: 10.1177/17585732241255952
D. Gonzalez-Morgado, Carlos Mendoza-Aguilo, I. Gallardo-Calero, Pablo Martínez-Collado, Andres Bustos-Mardones, Julia Bargallo-Granero, A. Lluch-Bergadà, Ignacio Esteban-Feliu
Fixation of radial head fractures with neck involvement presents challenges. It remains unclear whether the outcomes of head-to-neck screw fixation are similar to those of arthroplasty in this scenario. We conducted a retrospective cohort study to evaluate the clinical outcomes of these two methods for treating such fractures. Demographic data, fracture type, number of fragments, and concomitant injuries were recorded. Range of motion, Visual Analogue Scale for pain, Mayo Elbow Performance Score, and Quick-Disabilities of the Arm, Shoulder, and Hand at three-year follow-up, complications, and reintervention were compared. A total of 14 patients underwent fixation with head-to-neck screws, and 15 an arthroplasty. Baseline characteristics between groups were similar ( P > .05). Satisfactory range of motion (arc > 100°) was achieved in nine patients (64%) in the fixation group, and eight patients (53%) in the arthroplasty group ( P = .55). The mean Visual Analogue Scale, Mayo Elbow Performance Score, and Quick-Disabilities of the Arm, Shoulder, and Hand were 1.2 ± 1.2, 91.7 ± 10.7, and 9.1 ± 1, respectively, ( P = .651, P = .651, and P = .155). Three patients (21%) in the fixation group underwent a reintervention and three (20%) in the arthroplasty group ( P = .639). Head-to-neck screw fixation and radial head arthroplasty result in similar postoperative outcomes for low-comminuted radial head fractures with neck involvement.
颈部受累的桡骨头骨折的固定是一项挑战。在这种情况下，头颈螺钉固定与关节成形术的疗效是否相似仍不清楚。我们进行了一项回顾性队列研究，以评估这两种方法治疗此类骨折的临床效果。研究记录了患者的人口统计学数据、骨折类型、碎片数量以及合并损伤情况。比较了患者三年随访时的活动范围、疼痛视觉模拟量表、梅奥肘关节表现评分、手臂、肩部和手部快速残疾评分、并发症和再干预情况。共有14名患者接受了头颈螺钉固定术，15名患者接受了关节成形术。两组患者的基线特征相似（P > .05）。固定组中有9名患者（64%）达到了满意的活动范围（弧度大于100°），关节置换组中有8名患者（53%）达到了满意的活动范围（P = .55）。视觉模拟量表（Visual Analogue Scale）、梅奥肘关节功能评分（Mayo Elbow Performance Score）和手臂、肩部和手部快速残疾评分（Quick-Disabilities of the Arm, Shoulder, and Hand）的平均值分别为 1.2 ± 1.2、91.7 ± 10.7 和 9.1 ± 1（P = .651、P = .651 和 P = .155）。固定组有三名患者（21%）接受了再介入治疗，关节成形组有三名患者（20%）接受了再介入治疗（P = .639）。对于颈部受累的低粉碎性桡骨头骨折，头颈螺钉固定和桡骨头关节成形术的术后效果相似。
{"title":"Head-to-neck screw fixation and radial head arthroplasty result in similar postoperative outcomes for low-comminuted radial head fractures with neck involvement","authors":"D. Gonzalez-Morgado, Carlos Mendoza-Aguilo, I. Gallardo-Calero, Pablo Martínez-Collado, Andres Bustos-Mardones, Julia Bargallo-Granero, A. Lluch-Bergadà, Ignacio Esteban-Feliu","doi":"10.1177/17585732241255952","DOIUrl":"https://doi.org/10.1177/17585732241255952","url":null,"abstract":"Fixation of radial head fractures with neck involvement presents challenges. It remains unclear whether the outcomes of head-to-neck screw fixation are similar to those of arthroplasty in this scenario. We conducted a retrospective cohort study to evaluate the clinical outcomes of these two methods for treating such fractures. Demographic data, fracture type, number of fragments, and concomitant injuries were recorded. Range of motion, Visual Analogue Scale for pain, Mayo Elbow Performance Score, and Quick-Disabilities of the Arm, Shoulder, and Hand at three-year follow-up, complications, and reintervention were compared. A total of 14 patients underwent fixation with head-to-neck screws, and 15 an arthroplasty. Baseline characteristics between groups were similar ( P > .05). Satisfactory range of motion (arc > 100°) was achieved in nine patients (64%) in the fixation group, and eight patients (53%) in the arthroplasty group ( P = .55). The mean Visual Analogue Scale, Mayo Elbow Performance Score, and Quick-Disabilities of the Arm, Shoulder, and Hand were 1.2 ± 1.2, 91.7 ± 10.7, and 9.1 ± 1, respectively, ( P = .651, P = .651, and P = .155). Three patients (21%) in the fixation group underwent a reintervention and three (20%) in the arthroplasty group ( P = .639). Head-to-neck screw fixation and radial head arthroplasty result in similar postoperative outcomes for low-comminuted radial head fractures with neck involvement.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141121565","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}
Pub Date : 2024-05-20DOI: 10.1177/17585732241254693
Joseph Cutteridge, Joe Dixon, Pierre Garrido, Nicholas Peckham, Carolyn Smith, Alex Woods, Steve Gwilym
The most appropriate management following primary traumatic anterior shoulder dislocation in young adults is unclear. This systematic review and meta-analysis evaluated operative versus non-operative management. The primary outcome measure was re-dislocation rate, in contrast to the often reported ‘recurrent instability’, which includes subjective instability. Our review was prospectively registered with PROSPERO (CRD42022322600) and reported as per PRISMA guidelines. Selection criteria included mean age of participants between 15 and 25 and minimum follow-up of 1 year. 21 studies meet the inclusion criteria with 5142 patients included. The mean age of patients was 23, with 87% male. There was a median of 54 patients per study and a mean follow up of 46 months per study. The mean re-dislocation rate was 16.08% in the operative group and 24.84% in the non-operative group. In the subgroup meta-analysis, including only RCTs, comparing arthroscopic stabilisation vs non-operative there was an odds ratio of 0.09, strongly favouring intervention. This systematic review found the literature available supports surgical intervention in patients under the age of 25, in order to reduce re-dislocation. However, there is a lack of cost-effectiveness data to support these findings, and this should be an area of future research.
{"title":"A systematic review and meta-analysis of operative versus non-operative management for first time traumatic anterior shoulder dislocation in young adults","authors":"Joseph Cutteridge, Joe Dixon, Pierre Garrido, Nicholas Peckham, Carolyn Smith, Alex Woods, Steve Gwilym","doi":"10.1177/17585732241254693","DOIUrl":"https://doi.org/10.1177/17585732241254693","url":null,"abstract":"The most appropriate management following primary traumatic anterior shoulder dislocation in young adults is unclear. This systematic review and meta-analysis evaluated operative versus non-operative management. The primary outcome measure was re-dislocation rate, in contrast to the often reported ‘recurrent instability’, which includes subjective instability. Our review was prospectively registered with PROSPERO (CRD42022322600) and reported as per PRISMA guidelines. Selection criteria included mean age of participants between 15 and 25 and minimum follow-up of 1 year. 21 studies meet the inclusion criteria with 5142 patients included. The mean age of patients was 23, with 87% male. There was a median of 54 patients per study and a mean follow up of 46 months per study. The mean re-dislocation rate was 16.08% in the operative group and 24.84% in the non-operative group. In the subgroup meta-analysis, including only RCTs, comparing arthroscopic stabilisation vs non-operative there was an odds ratio of 0.09, strongly favouring intervention. This systematic review found the literature available supports surgical intervention in patients under the age of 25, in order to reduce re-dislocation. However, there is a lack of cost-effectiveness data to support these findings, and this should be an area of future research.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141122032","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}
Pub Date : 2024-05-05DOI: 10.1177/17585732241249959
Ignacio Pasqualini, Oguz A Turan, E. Hurley, Salvatore J. Frangiamore, Jay M. Levin, Jonathan F Dickens, Christopher S. Klifto, L. A. Rossi
The purpose of this study was to systematically review the rate and time frame to return to sports in collision athletes following arthroscopic Bankart repair. A systematic literature search based on Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, utilizing the EMBASE, MEDLINE, and The Cochrane Library Databases was performed. Manuscripts were included if they studied collision or contact athletes, reported on return to play rates or percentages, underwent arthroscopic Bankart repair, published in a peer-reviewed journal, and published in English. The study characteristics and clinical outcomes were extracted. A total of 19 studies with 1077 patients were included. Among collision athletes undergoing arthroscopic Bankart repair, the overall rate of return to sports was 89.8% (range 72%–100%). The mean time to return to sports was 5 months (range 3–6). The overall rate of returning to the same level of play was 80.8% (range 71.1%–100%). There were high return to sports rates among all collision sports. Specific return-to-play criteria were reported in most of the studies (95%), with time to return to sport being the most reported item (89.4%). Although overall return to sport among collision athletes following arthroscopic Bankart repair remains high, the proportion of athletes returning to their preoperative level of play was substantially lower.
{"title":"Return to sports following arthroscopic Bankart repair in collision athletes: A systematic review","authors":"Ignacio Pasqualini, Oguz A Turan, E. Hurley, Salvatore J. Frangiamore, Jay M. Levin, Jonathan F Dickens, Christopher S. Klifto, L. A. Rossi","doi":"10.1177/17585732241249959","DOIUrl":"https://doi.org/10.1177/17585732241249959","url":null,"abstract":"The purpose of this study was to systematically review the rate and time frame to return to sports in collision athletes following arthroscopic Bankart repair. A systematic literature search based on Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, utilizing the EMBASE, MEDLINE, and The Cochrane Library Databases was performed. Manuscripts were included if they studied collision or contact athletes, reported on return to play rates or percentages, underwent arthroscopic Bankart repair, published in a peer-reviewed journal, and published in English. The study characteristics and clinical outcomes were extracted. A total of 19 studies with 1077 patients were included. Among collision athletes undergoing arthroscopic Bankart repair, the overall rate of return to sports was 89.8% (range 72%–100%). The mean time to return to sports was 5 months (range 3–6). The overall rate of returning to the same level of play was 80.8% (range 71.1%–100%). There were high return to sports rates among all collision sports. Specific return-to-play criteria were reported in most of the studies (95%), with time to return to sport being the most reported item (89.4%). Although overall return to sport among collision athletes following arthroscopic Bankart repair remains high, the proportion of athletes returning to their preoperative level of play was substantially lower.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141011908","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}
Pub Date : 2024-04-24DOI: 10.1177/17585732241248835
Ghiath Ismayl, Catherine Ogbechie, Samuel Goundry, Luke Budworth, Ikechukwu Ejiofor, Hassaan Sheikh, Paul McCormack, Charlotte Tunstall, Mark Philipson, Paul Cowling
Literature demonstrates variability in the amount of displacement of isolated greater tuberosity (GT) fractures and measurement techniques that orthopaedic surgeons deem warrant surgical intervention. This study aims to assess the intra and interobserver reliability for classifying and measuring the displacement amount for isolated GT fractures. Eight surgeons, consisting of four shoulder specialists and four trainee surgeons, reviewed 25 plain radiographs on two separate occasions, 3 months apart. They were required to morphologically classify the GT fracture, measure the displacement distance on anteroposterior and axillary views, calculate the GT displacement ratio, and state whether they would offer surgical treatment. There was a lack of good reliability for the classification of the depression and avulsion fracture types. There was good intraobserver but poor interobserver consistency in classifying the split-type fractures. The measurement of the displacement distance showed good intraobserver reliability, but not as good interobserver agreement. Also, the displacement ratio calculated revealed poor consistency. We found good agreement between and within the raters for the treatment decision. No significant difference was noted when comparing the senior surgeons to the junior surgeons. This study has revealed ongoing inconsistency in the classification and measurement of isolated GT fractures.
{"title":"Classification and measurement of displacement of isolated greater tuberosity fractures: Intra and interobserver reliability","authors":"Ghiath Ismayl, Catherine Ogbechie, Samuel Goundry, Luke Budworth, Ikechukwu Ejiofor, Hassaan Sheikh, Paul McCormack, Charlotte Tunstall, Mark Philipson, Paul Cowling","doi":"10.1177/17585732241248835","DOIUrl":"https://doi.org/10.1177/17585732241248835","url":null,"abstract":"Literature demonstrates variability in the amount of displacement of isolated greater tuberosity (GT) fractures and measurement techniques that orthopaedic surgeons deem warrant surgical intervention. This study aims to assess the intra and interobserver reliability for classifying and measuring the displacement amount for isolated GT fractures. Eight surgeons, consisting of four shoulder specialists and four trainee surgeons, reviewed 25 plain radiographs on two separate occasions, 3 months apart. They were required to morphologically classify the GT fracture, measure the displacement distance on anteroposterior and axillary views, calculate the GT displacement ratio, and state whether they would offer surgical treatment. There was a lack of good reliability for the classification of the depression and avulsion fracture types. There was good intraobserver but poor interobserver consistency in classifying the split-type fractures. The measurement of the displacement distance showed good intraobserver reliability, but not as good interobserver agreement. Also, the displacement ratio calculated revealed poor consistency. We found good agreement between and within the raters for the treatment decision. No significant difference was noted when comparing the senior surgeons to the junior surgeons. This study has revealed ongoing inconsistency in the classification and measurement of isolated GT fractures.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140663707","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}
Pub Date : 2024-04-24DOI: 10.1177/17585732241249079
Timon H. Geurkink, Bart W Oudelaar, C. Overbeek, Jorrit Jasper, Rob GHH Nelissen, J. Nagels
To investigate the outcome of open subscapularis (SSC) repair in terms of complete relief of symptoms, regaining functional range of motion ((ROM), i.e. minimum ROM to complete all tasks of daily living) and retear rate. Sixty-one patients who underwent open SSC repair between 2012 and 2019 were included in a retrospective cohort study. Primary outcome measures (complete relief of symptoms, obtaining functional ROM, SSC retears), were assessed at minimum 1-year follow-up. Prognostic factors for these outcome measures were identified. At final follow-up, 44 patients (72%) reported complete relief of symptoms. Pre-operatively, 23 patients (40%) had a functional ROM, which increased to 33 patients (54%) post-operatively. Eight Patients (13%) had a retear after a median follow-up of 21 months (range: 3-35). Lafosse type IV tears were associated with having persisting symptoms (OR 5, 95 confidence interval (CI) 1.2–17.9, p = 0.024) and retears (OR 7, 95 CI 1.9–37.7, p = 0.031). The majority of patients reported complete relief of symptoms after SSC repair; however, only 54% obtained a functional ROM. Measuring outcome in terms of complete relief symptoms and regaining functional ROM is useful for the surgeon to evaluate the effect of surgical intervention and provides tangible information for patients.
{"title":"Open repair of subscapularis tendon tears leads to complete relief of symptoms in the majority of patients, but often fails to restore functional range of motion","authors":"Timon H. Geurkink, Bart W Oudelaar, C. Overbeek, Jorrit Jasper, Rob GHH Nelissen, J. Nagels","doi":"10.1177/17585732241249079","DOIUrl":"https://doi.org/10.1177/17585732241249079","url":null,"abstract":"To investigate the outcome of open subscapularis (SSC) repair in terms of complete relief of symptoms, regaining functional range of motion ((ROM), i.e. minimum ROM to complete all tasks of daily living) and retear rate. Sixty-one patients who underwent open SSC repair between 2012 and 2019 were included in a retrospective cohort study. Primary outcome measures (complete relief of symptoms, obtaining functional ROM, SSC retears), were assessed at minimum 1-year follow-up. Prognostic factors for these outcome measures were identified. At final follow-up, 44 patients (72%) reported complete relief of symptoms. Pre-operatively, 23 patients (40%) had a functional ROM, which increased to 33 patients (54%) post-operatively. Eight Patients (13%) had a retear after a median follow-up of 21 months (range: 3-35). Lafosse type IV tears were associated with having persisting symptoms (OR 5, 95 confidence interval (CI) 1.2–17.9, p = 0.024) and retears (OR 7, 95 CI 1.9–37.7, p = 0.031). The majority of patients reported complete relief of symptoms after SSC repair; however, only 54% obtained a functional ROM. Measuring outcome in terms of complete relief symptoms and regaining functional ROM is useful for the surgeon to evaluate the effect of surgical intervention and provides tangible information for patients.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140658835","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}
Pub Date : 2024-04-17DOI: 10.1177/17585732241244722
E. Burden, T. Batten, William Thomas, J. P. Evans, Christopher D. Smith
This feasibility trial aims to assess the practicality of, and obtain preliminary data to inform, a definitive randomised controlled trial (RCT) of total elbow arthroplasty (TEA) versus distal humeral hemiarthroplasty (HA) in patients over the age of 65 years with unreconstructible distal humeral fractures (DHF). 17 patients met the inclusion criteria during the 18-month recruitment period from December 2020 until June 2022, and 15 (88%) consented to be randomised (recruitment rate: 0.7/month). Two patients withdrew from the study prior to surgery leaving 13 patients for analysis (retention rate: 87%). Seven patients were randomised to TEA and six patients to HA. 100% of patients were available for 12-month follow-up. A 10-point difference in favour of HA in DASH (44.5 vs. 54.2) and OES (31.6 vs. 21.3) was seen during 6-week follow-up, while no difference in patient-reported outcome measures was seen at 3- or 12-month follow-up. This study demonstrates feasibility of undertaking an RCT of TEA versus HA in patients over the age of 65 with unreconstructible DHF. Preliminary data corroborate with the ongoing clinical equipoise and support the requirement for a larger adequately powered RCT. This trial is registered in the US Clinical Trials Registry (https://clinicaltrials.gov/study/NCT04646798?cond=distal%20humeral%20fracture&rank=6) Clinical Trial ID: NCT04646798.
{"title":"Hemiarthroplasty or total elbow arthroplasty for unreconstructible distal humeral fractures in the elderly (hot elbow): A feasibility study","authors":"E. Burden, T. Batten, William Thomas, J. P. Evans, Christopher D. Smith","doi":"10.1177/17585732241244722","DOIUrl":"https://doi.org/10.1177/17585732241244722","url":null,"abstract":"This feasibility trial aims to assess the practicality of, and obtain preliminary data to inform, a definitive randomised controlled trial (RCT) of total elbow arthroplasty (TEA) versus distal humeral hemiarthroplasty (HA) in patients over the age of 65 years with unreconstructible distal humeral fractures (DHF). 17 patients met the inclusion criteria during the 18-month recruitment period from December 2020 until June 2022, and 15 (88%) consented to be randomised (recruitment rate: 0.7/month). Two patients withdrew from the study prior to surgery leaving 13 patients for analysis (retention rate: 87%). Seven patients were randomised to TEA and six patients to HA. 100% of patients were available for 12-month follow-up. A 10-point difference in favour of HA in DASH (44.5 vs. 54.2) and OES (31.6 vs. 21.3) was seen during 6-week follow-up, while no difference in patient-reported outcome measures was seen at 3- or 12-month follow-up. This study demonstrates feasibility of undertaking an RCT of TEA versus HA in patients over the age of 65 with unreconstructible DHF. Preliminary data corroborate with the ongoing clinical equipoise and support the requirement for a larger adequately powered RCT. This trial is registered in the US Clinical Trials Registry (https://clinicaltrials.gov/study/NCT04646798?cond=distal%20humeral%20fracture&rank=6) Clinical Trial ID: NCT04646798.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140690312","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}
Pub Date : 2024-04-17DOI: 10.1177/17585732241246560
Teja Yeramosu, William L. Johns, Gabriel I. Onor, Mariano E Menendez, S. Namdari, Sommer Hammoud
The rising prominence of artificial intelligence in healthcare has revolutionized patient access to medical information. This cross-sectional study sought to assess if ChatGPT could satisfactorily address common patient questions about total shoulder arthroplasty (TSA). Ten commonly encountered questions in TSA practice were selected and posed to ChatGPT. Each response was assessed for accuracy and clarity using the Mika et al. scoring system, which ranges from “excellent response not requiring clarification” to “unsatisfactory response requiring substantial clarification,” and a modified DISCERN score. The readability was further evaluated using the Flesch Reading Ease Score and the Flesch-Kincaid Grade Level. The mean Mika et al. score was 2.93, corresponding to an overall subjective rating of “satisfactory but requiring moderate clarification.” The mean DISCERN score was 46.60, which is considered “fair.” The readability analysis suggested that the responses were at a college-graduate level, higher than the recommended level for patient educational materials. Our results suggest that ChatGPT has the potential to supplement the collaborative decision-making process between patients and experienced orthopedic surgeons for TSA-related inquiries. Ultimately, while tools like ChatGPT can enhance traditional patient education methods, they should not replace direct consultations with medical professionals.
{"title":"ChatGPT is capable of providing satisfactory responses to frequently asked questions regarding total shoulder arthroplasty","authors":"Teja Yeramosu, William L. Johns, Gabriel I. Onor, Mariano E Menendez, S. Namdari, Sommer Hammoud","doi":"10.1177/17585732241246560","DOIUrl":"https://doi.org/10.1177/17585732241246560","url":null,"abstract":"The rising prominence of artificial intelligence in healthcare has revolutionized patient access to medical information. This cross-sectional study sought to assess if ChatGPT could satisfactorily address common patient questions about total shoulder arthroplasty (TSA). Ten commonly encountered questions in TSA practice were selected and posed to ChatGPT. Each response was assessed for accuracy and clarity using the Mika et al. scoring system, which ranges from “excellent response not requiring clarification” to “unsatisfactory response requiring substantial clarification,” and a modified DISCERN score. The readability was further evaluated using the Flesch Reading Ease Score and the Flesch-Kincaid Grade Level. The mean Mika et al. score was 2.93, corresponding to an overall subjective rating of “satisfactory but requiring moderate clarification.” The mean DISCERN score was 46.60, which is considered “fair.” The readability analysis suggested that the responses were at a college-graduate level, higher than the recommended level for patient educational materials. Our results suggest that ChatGPT has the potential to supplement the collaborative decision-making process between patients and experienced orthopedic surgeons for TSA-related inquiries. Ultimately, while tools like ChatGPT can enhance traditional patient education methods, they should not replace direct consultations with medical professionals.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140693445","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}
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