Pub Date : 2024-03-05DOI: 10.1177/17585732241235631
A. M. Ifarraguerri, Alexander N. Berk, Allison J Rao, David P. Trofa, Christopher S. Ahmad, Anthony Martin, J. Fleischli, Bryan M Saltzman
This study aimed to analyze the effects of platelet-rich plasma (PRP) for partial ulnar collateral ligament (UCL) tears in athletes and predicted positive outcomes. The researchers systematically reviewed the PubMed, Cochrane CENTRAL, MEDLINE, Scopus, and Google Scholar databases to identify studies with clinical outcomes of PRP for partial UCL tears. They excluded studies that did not stratify data by tear type or included surgical management. Five studies with 156 patients were included. The timing, amount, platelet concentration, type, and number of PRP injections were highly variable among the studies. However, 75% (n = 97/127) of athletes returned to sport (RTS) at a weighted average of 82.1 days (37–84) after PRP injection. One study showed significant improvements in patient-reported outcomes. Two studies showed positive outcomes in the modified Conway scale, complete reconstitution of the UCL in 87% of patients on MRI, and significant improvement in the humeral-ulnar joint space after PRP injection via ultrasound. The Coleman methodology score (CMS) averaged 48/100, indicating an overall poor quality of evidence. This review demonstrates favorable RTS, clinical, and radiographic outcomes in patients receiving PRP for partial UCL tears, but the literature remains heterogeneous and of low quality. III
{"title":"A systematic review of the outcomes of partial ulnar collateral ligament tears of the elbow in athletes treated non-operatively with platelet-rich plasma injection","authors":"A. M. Ifarraguerri, Alexander N. Berk, Allison J Rao, David P. Trofa, Christopher S. Ahmad, Anthony Martin, J. Fleischli, Bryan M Saltzman","doi":"10.1177/17585732241235631","DOIUrl":"https://doi.org/10.1177/17585732241235631","url":null,"abstract":"This study aimed to analyze the effects of platelet-rich plasma (PRP) for partial ulnar collateral ligament (UCL) tears in athletes and predicted positive outcomes. The researchers systematically reviewed the PubMed, Cochrane CENTRAL, MEDLINE, Scopus, and Google Scholar databases to identify studies with clinical outcomes of PRP for partial UCL tears. They excluded studies that did not stratify data by tear type or included surgical management. Five studies with 156 patients were included. The timing, amount, platelet concentration, type, and number of PRP injections were highly variable among the studies. However, 75% (n = 97/127) of athletes returned to sport (RTS) at a weighted average of 82.1 days (37–84) after PRP injection. One study showed significant improvements in patient-reported outcomes. Two studies showed positive outcomes in the modified Conway scale, complete reconstitution of the UCL in 87% of patients on MRI, and significant improvement in the humeral-ulnar joint space after PRP injection via ultrasound. The Coleman methodology score (CMS) averaged 48/100, indicating an overall poor quality of evidence. This review demonstrates favorable RTS, clinical, and radiographic outcomes in patients receiving PRP for partial UCL tears, but the literature remains heterogeneous and of low quality. III","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140264512","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 : 2024-02-27DOI: 10.1177/17585732241232889
Reinier W. A. Spek, Michel P J van den Bekerom, P. Jutte, F. IJpma, R. Jaarsma, J. Doornberg
To (1) evaluate surgeon agreement on plating features (position and screw length) in virtual 3D planning software, (2) describe outcomes (fracture reduction, plate position, malpositioning of calcar screws and screw lengths) of plate fixations planned with routine pre-operative assessment (2D- and 3D CT imaging) and those planned with dedicated virtual 3D software of the same proximal humerus fracture. Fourteen proximal humerus fractures were retrospectively reduced and fixed with virtual planning software by eight attending orthopaedic surgeons and compared to the true surgical fixation with post-operative computed tomography (CT) scans. Reduction differences were quantified using CT micromotion analysis. Intraclass correlation for screw lengths was 0.97 (95% CI: 0.96–0.98) and 0.90 (95% CI: 0.79–0.96) for plate position. Mean difference in total fracture rotation of the head between the virtual and conventional group was 22.0°. Plate position in the virtual planning group was 3.2 mm more proximal. There were no differences in inferomedial quadrant calcar screw positioning and, apart from the superior posterior converging screw, no significant differences in screw lengths. Reproducibility on plate position and screw length with virtual planning software is adequate. Apart from fracture reduction, virtual planning yielded similar plate positions, screw malpositioning rates and lengths compared to routine pre-operative assessment.
{"title":"Pre-operative virtual three-dimensional planning for proximal humerus fractures: A proof-of-concept study","authors":"Reinier W. A. Spek, Michel P J van den Bekerom, P. Jutte, F. IJpma, R. Jaarsma, J. Doornberg","doi":"10.1177/17585732241232889","DOIUrl":"https://doi.org/10.1177/17585732241232889","url":null,"abstract":"To (1) evaluate surgeon agreement on plating features (position and screw length) in virtual 3D planning software, (2) describe outcomes (fracture reduction, plate position, malpositioning of calcar screws and screw lengths) of plate fixations planned with routine pre-operative assessment (2D- and 3D CT imaging) and those planned with dedicated virtual 3D software of the same proximal humerus fracture. Fourteen proximal humerus fractures were retrospectively reduced and fixed with virtual planning software by eight attending orthopaedic surgeons and compared to the true surgical fixation with post-operative computed tomography (CT) scans. Reduction differences were quantified using CT micromotion analysis. Intraclass correlation for screw lengths was 0.97 (95% CI: 0.96–0.98) and 0.90 (95% CI: 0.79–0.96) for plate position. Mean difference in total fracture rotation of the head between the virtual and conventional group was 22.0°. Plate position in the virtual planning group was 3.2 mm more proximal. There were no differences in inferomedial quadrant calcar screw positioning and, apart from the superior posterior converging screw, no significant differences in screw lengths. Reproducibility on plate position and screw length with virtual planning software is adequate. Apart from fracture reduction, virtual planning yielded similar plate positions, screw malpositioning rates and lengths compared to routine pre-operative assessment.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140425708","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 : 2024-02-22DOI: 10.1177/17585732241231758
Robert W Jordan, Imran Ahmed, Peter D’Alessandro, Jarret M. Woodmass, Peter B. MacDonald, S. Malik
Shoulder arthroplasty is a treatment option of the sequelae of native shoulder joint infections. However, the functional outcomes and re-infection rates are unknown. The aim of this review was to analyse the outcome of shoulder arthroplasty in patients with native shoulder infections. A review of the online databases MEDLINE and Embase was conducted according to PRISMA guidelines. The review was registered prospectively in the PROSPERO database. Studies reporting either primary or secondary infections of native shoulder joints treated with any form of arthroplasty were included and appraised using the methodological index for non-randomised studies (MINORS) tool. Fourteen studies were eligible for inclusion. Mean age ranged from 56 to 72 years and the mean follow-up from 20.5 months to 8.2 years. Primary shoulder infections were present in 50 patients and secondary infections in 86. 76 patients underwent a two stage: 46 patients a single-stage procedure whilst 14 refused second-stage surgery. Mean post-operative Constant score ranged from 38 to 56.2. The overall reported re-infection rate was 2.3% and complication rate was 26%. Shoulder arthroplasty in the management of either primary or secondary native shoulder infections has a high complication rate and low functional outcome but low re-infection rates at short-term follow-up.
{"title":"Shoulder arthroplasty in the management of native shoulder joint infections has a high complication rate and poor functional outcome – a systematic review","authors":"Robert W Jordan, Imran Ahmed, Peter D’Alessandro, Jarret M. Woodmass, Peter B. MacDonald, S. Malik","doi":"10.1177/17585732241231758","DOIUrl":"https://doi.org/10.1177/17585732241231758","url":null,"abstract":"Shoulder arthroplasty is a treatment option of the sequelae of native shoulder joint infections. However, the functional outcomes and re-infection rates are unknown. The aim of this review was to analyse the outcome of shoulder arthroplasty in patients with native shoulder infections. A review of the online databases MEDLINE and Embase was conducted according to PRISMA guidelines. The review was registered prospectively in the PROSPERO database. Studies reporting either primary or secondary infections of native shoulder joints treated with any form of arthroplasty were included and appraised using the methodological index for non-randomised studies (MINORS) tool. Fourteen studies were eligible for inclusion. Mean age ranged from 56 to 72 years and the mean follow-up from 20.5 months to 8.2 years. Primary shoulder infections were present in 50 patients and secondary infections in 86. 76 patients underwent a two stage: 46 patients a single-stage procedure whilst 14 refused second-stage surgery. Mean post-operative Constant score ranged from 38 to 56.2. The overall reported re-infection rate was 2.3% and complication rate was 26%. Shoulder arthroplasty in the management of either primary or secondary native shoulder infections has a high complication rate and low functional outcome but low re-infection rates at short-term follow-up.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139957568","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 : 2024-02-20DOI: 10.1177/17585732241232135
William Levitt, Chris Roche, J. Elwell, Oliver Donaldson
Optimal biomechanics in reverse total shoulder arthroplasty (rTSA) are still a topic of debate. Although larger glenospheres have been linked with a theoretical improvement in the range of movement, results from clinical studies are mixed. We hypothesised that matching glenosphere diameter to patient height would result in greater improvements in post-operative range of motion (ROM) and patient-reported outcomes (PROMs). An international database of rTSAs was analysed. After exclusions, 3318 rTSA patients were classified as short (<158 cm), average (158–173 cm) or tall(>173 cm). Outcomes were stratified for glenosphere size (small≤38 mm, large≥40 mm). Results were compared preoperatively and at 2 years. In short patients glenosphere diameter had no statistically significant impact on the degree of post-operative improvement for any ROM or PROM. Average height patients treated with small glenospheres had significantly more improvement in internal rotation (1.3 vs 1.0, p = 0.01), VAS pain (5.3 vs 4.8, p = 0.002), American Shoulder and Elbow Surgeons (47.8 vs 45.2, p = 0.03) and Shoulder Arthroplasty Smart (30.9 vs 28.2, p = 0.01) but significantly less improvement in constant score (31.7 vs 35.3, p = 0.009). Tall patients treated with small glenospheres had significantly more improvement in external rotation (21.2 vs 16.4, p = 0.01) and VAS pain scores (4.7 vs 4.3, p = 0.04). While most significant differences favoured small glenospheres, the magnitude of these differences was small. Overall, patients of all heights can expect similar clinical improvements irrespective of glenosphere size.
反向全肩关节置换术（rTSA）的最佳生物力学仍是一个争论不休的话题。虽然理论上较大的关节囊可改善活动范围，但临床研究的结果却不尽相同。我们的假设是，将关节盂直径与患者身高相匹配，将使术后活动范围（ROM）和患者报告结果（PROMs）得到更大的改善。我们对rTSAs的国际数据库进行了分析。经排除后，有3318名rTSA患者被归类为矮个子（173厘米）。结果按肾盂大小分层（小≤38毫米，大≥40毫米）。比较了术前和术后两年的结果。在矮个子患者中，关节囊直径对术后任何ROM或PROM的改善程度均无统计学意义。平均身高的患者接受小关节囊治疗后，在内旋转（1.3 vs 1.0，p = 0.01）、VAS疼痛（5.3 vs 4.8，p = 0.002）、美国肩肘外科医生（47.8 vs 45.2，p = 0.03）和肩关节成形术智能（30.9 vs 28.2，p = 0.01）方面的改善程度明显更高，但在恒定评分（31.7 vs 35.3，p = 0.009）方面的改善程度明显更低（31.7 vs 35.3，p = 0.009）。接受小型盂成形术的高个子患者在外侧旋转（21.2 vs 16.4，p = 0.01）和VAS疼痛评分（4.7 vs 4.3，p = 0.04）方面的改善幅度明显更大。虽然大多数明显的差异倾向于小关节球，但这些差异的幅度很小。总体而言，无论玻璃球大小如何，所有身高的患者都能获得相似的临床改善。
{"title":"Does matching glenosphere size to patient height improve outcomes following reverse total shoulder arthroplasty?","authors":"William Levitt, Chris Roche, J. Elwell, Oliver Donaldson","doi":"10.1177/17585732241232135","DOIUrl":"https://doi.org/10.1177/17585732241232135","url":null,"abstract":"Optimal biomechanics in reverse total shoulder arthroplasty (rTSA) are still a topic of debate. Although larger glenospheres have been linked with a theoretical improvement in the range of movement, results from clinical studies are mixed. We hypothesised that matching glenosphere diameter to patient height would result in greater improvements in post-operative range of motion (ROM) and patient-reported outcomes (PROMs). An international database of rTSAs was analysed. After exclusions, 3318 rTSA patients were classified as short (<158 cm), average (158–173 cm) or tall(>173 cm). Outcomes were stratified for glenosphere size (small≤38 mm, large≥40 mm). Results were compared preoperatively and at 2 years. In short patients glenosphere diameter had no statistically significant impact on the degree of post-operative improvement for any ROM or PROM. Average height patients treated with small glenospheres had significantly more improvement in internal rotation (1.3 vs 1.0, p = 0.01), VAS pain (5.3 vs 4.8, p = 0.002), American Shoulder and Elbow Surgeons (47.8 vs 45.2, p = 0.03) and Shoulder Arthroplasty Smart (30.9 vs 28.2, p = 0.01) but significantly less improvement in constant score (31.7 vs 35.3, p = 0.009). Tall patients treated with small glenospheres had significantly more improvement in external rotation (21.2 vs 16.4, p = 0.01) and VAS pain scores (4.7 vs 4.3, p = 0.04). While most significant differences favoured small glenospheres, the magnitude of these differences was small. Overall, patients of all heights can expect similar clinical improvements irrespective of glenosphere size.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140448366","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 : 2024-02-16DOI: 10.1177/17585732241229636
E. Kholinne, Hua Liu, Leonard Christianto Singjie, M. Anastasia, Jae-Man Kwak, In-ho Jeon
Coronoid fractures often occur with complex elbow dislocations, accounting for 15% of elbow fractures. The effectiveness of open reduction internal fixation (ORIF) versus arthroscopic-assisted reduction internal fixation (ARIF) surgeries for coronoid fractures remains uncertain. This study aimed to compare the outcomes of these two surgical approaches in treating varus posteromedial injuries. This study was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study protocol was registered with PROSPERO. The primary outcomes assessed in this study were the functional outcomes measured by the Mayo Elbow Performance Score (MEPS) and the complications associated with each surgical approach. Analysis of the data from 759 patients included in this study revealed that the mean postoperative MEPS score was higher in the ARIF group compared to the ORIF group (97.5 Vs. 90.7), with the mean improvement in MEPS was 16.6 points (19 for ORIF and 14.3 for ARIF). The complication rate in the ORIF group was 24.6%, while the ARIF group reported a complication rate of 6%. This study suggests that ARIF surgery can yield comparable and promising outcomes to ORIF surgery for coronoid fractures. IV
冠状面骨折常与复杂的肘关节脱位同时发生，占肘关节骨折的15%。对于冠状突骨折，开放复位内固定术（ORIF）与关节镜辅助复位内固定术（ARIF）的疗效仍不确定。本研究旨在比较这两种手术方法治疗后内侧变位损伤的效果。本研究按照《系统综述和元分析首选报告项目》指南进行和报告。研究方案已在 PROSPERO 注册。本研究评估的主要结果是梅奥肘关节功能评分（MEPS）所衡量的功能结果以及每种手术方法的相关并发症。对759名患者的数据分析显示，ARIF组术后MEPS平均得分高于ORIF组（97.5分VS 90.7分），MEPS平均提高16.6分（ORIF提高19分，ARIF提高14.3分）。ORIF 组的并发症发生率为 24.6%，而 ARIF 组的并发症发生率为 6%。这项研究表明，ARIF手术与ORIF手术治疗冠状面骨折的疗效相当，且前景广阔。四
{"title":"Surgical outcomes and complication rates of arthroscopic-assisted fixation versus open fixation for coronoid fractures: A systematic review and meta-analysis","authors":"E. Kholinne, Hua Liu, Leonard Christianto Singjie, M. Anastasia, Jae-Man Kwak, In-ho Jeon","doi":"10.1177/17585732241229636","DOIUrl":"https://doi.org/10.1177/17585732241229636","url":null,"abstract":"Coronoid fractures often occur with complex elbow dislocations, accounting for 15% of elbow fractures. The effectiveness of open reduction internal fixation (ORIF) versus arthroscopic-assisted reduction internal fixation (ARIF) surgeries for coronoid fractures remains uncertain. This study aimed to compare the outcomes of these two surgical approaches in treating varus posteromedial injuries. This study was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study protocol was registered with PROSPERO. The primary outcomes assessed in this study were the functional outcomes measured by the Mayo Elbow Performance Score (MEPS) and the complications associated with each surgical approach. Analysis of the data from 759 patients included in this study revealed that the mean postoperative MEPS score was higher in the ARIF group compared to the ORIF group (97.5 Vs. 90.7), with the mean improvement in MEPS was 16.6 points (19 for ORIF and 14.3 for ARIF). The complication rate in the ORIF group was 24.6%, while the ARIF group reported a complication rate of 6%. This study suggests that ARIF surgery can yield comparable and promising outcomes to ORIF surgery for coronoid fractures. IV","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139962205","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 : 2024-01-31DOI: 10.1177/17585732241229215
B. T. Seibold, Theodore Quan, Amy Y. Zhao, Philip M. Parel, Jacob D. Mikula, Frederick Mun, U. Srikumaran, Zachary R. Zimmer
Previous studies have shown that increased 5-item modified frailty index (mFI-5) scores are associated with poor surgical outcomes. This study seeks to determine whether the comorbidities comprising the mFI-5 were correlated with poor outcomes following revision total shoulder arthroplasty (TSA). Utilizing the National Surgical Quality Improvement Program database, a mFI-5 score was calculated for all patients 50 years and older who underwent revision TSA between 2013 and 2019. Pearson's Chi-squared tests and multivariable regression analysis were used to evaluate the association of the mFI score with various postoperative complications. Patients with a mFI-5 score of 2+ had significantly increased risk of readmission (OR 2.58), bleeding requiring transfusion (OR 3.66), extended length of stay (OR 2.43), and discharge to a non-home destination (OR 3.22) compared to patients with a mFI-5 score of 0. Relative to patients with a score of 1, those with a mFI-5 score of 2+ had an increased risk of postoperative transfusion (OR 2.46), extended length of stay (OR 2.16), and discharge to a non-home location (OR 2.84). The mFI-5 is a valuable tool that can stratify patients based on risk for postoperative complications following revision TSA.
{"title":"Higher modified frailty index score is associated with 30-day postoperative complications following revision total shoulder arthroplasty","authors":"B. T. Seibold, Theodore Quan, Amy Y. Zhao, Philip M. Parel, Jacob D. Mikula, Frederick Mun, U. Srikumaran, Zachary R. Zimmer","doi":"10.1177/17585732241229215","DOIUrl":"https://doi.org/10.1177/17585732241229215","url":null,"abstract":"Previous studies have shown that increased 5-item modified frailty index (mFI-5) scores are associated with poor surgical outcomes. This study seeks to determine whether the comorbidities comprising the mFI-5 were correlated with poor outcomes following revision total shoulder arthroplasty (TSA). Utilizing the National Surgical Quality Improvement Program database, a mFI-5 score was calculated for all patients 50 years and older who underwent revision TSA between 2013 and 2019. Pearson's Chi-squared tests and multivariable regression analysis were used to evaluate the association of the mFI score with various postoperative complications. Patients with a mFI-5 score of 2+ had significantly increased risk of readmission (OR 2.58), bleeding requiring transfusion (OR 3.66), extended length of stay (OR 2.43), and discharge to a non-home destination (OR 3.22) compared to patients with a mFI-5 score of 0. Relative to patients with a score of 1, those with a mFI-5 score of 2+ had an increased risk of postoperative transfusion (OR 2.46), extended length of stay (OR 2.16), and discharge to a non-home location (OR 2.84). The mFI-5 is a valuable tool that can stratify patients based on risk for postoperative complications following revision TSA.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140477638","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 : 2024-01-30DOI: 10.1177/17585732241227206
Luciano A Rossi, Ignacio Pasqualini, Salvatore J Frangiamore, Oke A. Anakwenze, Jonathan F Dickens, Christopher Klifto, E. Hurley
To perform a systematic review and meta-analysis to compare the results of the Latarjet procedure performed using screws (S) or suture-button for coracoid graft fixation. A systematic search in Pubmed, EMBASE, and The Cochrane Library databases was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Cohort studies comparing outcomes in the Latarjet procedure with screw fixation versus the Latarjet procedure with suture-button fixation were included. Five studies with 877 patients were included. There was a significantly lower rate of recurrent instability in those with S fixation compared to the suture-button fixation (1.5% vs 5%, p = 0.001). There was a significantly higher rate of reoperations with S fixation compared to suture-button fixation (4.3% vs 0%, p = 0.001). There were no significant differences between the groups regarding total complications (S: 7.5% vs suture-button: 3.6% p = 0.12) graft fracture (S: 0.8% vs suture-button: 0.5% p = 0.62) and symptomatic hardware (S: 2.7% vs suture-button: 0% p = 0.12). The Latarjet surgery was associated with favorable results and a low rate of complications regardless of the type of fixation used. Screw fixation was associated with a significantly lower rate of recurrences, but greater reoperations due to irritation or pain after surgery. Systematic review and meta-analysis, level III.
进行系统性综述和荟萃分析，比较使用螺钉（S）或缝合扣进行Latarjet手术的结果。根据《系统综述和荟萃分析首选报告项目》指南，在 Pubmed、EMBASE 和 Cochrane Library 数据库中进行了系统检索。纳入的队列研究比较了螺钉固定的 Latarjet 手术和缝合扣固定的 Latarjet 手术的疗效。共纳入了五项研究，877 名患者。采用螺钉固定的患者复发不稳定的比例明显低于采用缝合扣固定的患者（1.5% vs 5%，P = 0.001）。与缝合扣固定相比，S固定的再手术率明显更高（4.3% vs 0%，P = 0.001）。在总并发症（S：7.5% vs 缝合钮：3.6% p = 0.12）、移植物断裂（S：0.8% vs 缝合钮：0.5% p = 0.62）和无症状硬件（S：2.7% vs 缝合钮：0% p = 0.12）方面，两组间无明显差异。无论使用哪种固定方式，Latarjet 手术都能取得良好的效果，且并发症发生率较低。螺钉固定的复发率明显较低，但术后因刺激或疼痛导致的再次手术率较高。系统回顾和荟萃分析，III 级。
{"title":"Screw fixation versus suture-button fixation for the Latarjet procedure—a systematic review and meta-analysis","authors":"Luciano A Rossi, Ignacio Pasqualini, Salvatore J Frangiamore, Oke A. Anakwenze, Jonathan F Dickens, Christopher Klifto, E. Hurley","doi":"10.1177/17585732241227206","DOIUrl":"https://doi.org/10.1177/17585732241227206","url":null,"abstract":"To perform a systematic review and meta-analysis to compare the results of the Latarjet procedure performed using screws (S) or suture-button for coracoid graft fixation. A systematic search in Pubmed, EMBASE, and The Cochrane Library databases was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Cohort studies comparing outcomes in the Latarjet procedure with screw fixation versus the Latarjet procedure with suture-button fixation were included. Five studies with 877 patients were included. There was a significantly lower rate of recurrent instability in those with S fixation compared to the suture-button fixation (1.5% vs 5%, p = 0.001). There was a significantly higher rate of reoperations with S fixation compared to suture-button fixation (4.3% vs 0%, p = 0.001). There were no significant differences between the groups regarding total complications (S: 7.5% vs suture-button: 3.6% p = 0.12) graft fracture (S: 0.8% vs suture-button: 0.5% p = 0.62) and symptomatic hardware (S: 2.7% vs suture-button: 0% p = 0.12). The Latarjet surgery was associated with favorable results and a low rate of complications regardless of the type of fixation used. Screw fixation was associated with a significantly lower rate of recurrences, but greater reoperations due to irritation or pain after surgery. Systematic review and meta-analysis, level III.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140483820","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 : 2024-01-27DOI: 10.1177/17585732241229068
Hassan Farooq, Dane H Salazar, Jason E Meldau, T. Schoenfeldt, Nickolas G. Garbis
: The purpose of this study was to define the proximal humerus infraspinatus bare area in a human cadaveric model. : Ten fresh-frozen shoulder specimens were used. A deltopectoral approach was utilized for exposure. Following access to the glenohumeral joint, the bare area width was measured at the upper, middle, and lower limits using an electronic digital caliper. : Mean upper, middle, and lower limit widths of the infraspinatus bare area were 5.48 mm, 8.68 mm, and 10.78 mm, respectively. The infraspinatus bare area broadened as one evaluated the humeral head in a superior to inferior fashion.
{"title":"Describing the infraspinatus bare area of the proximal humerus: An anatomic cadaveric study","authors":"Hassan Farooq, Dane H Salazar, Jason E Meldau, T. Schoenfeldt, Nickolas G. Garbis","doi":"10.1177/17585732241229068","DOIUrl":"https://doi.org/10.1177/17585732241229068","url":null,"abstract":": The purpose of this study was to define the proximal humerus infraspinatus bare area in a human cadaveric model. : Ten fresh-frozen shoulder specimens were used. A deltopectoral approach was utilized for exposure. Following access to the glenohumeral joint, the bare area width was measured at the upper, middle, and lower limits using an electronic digital caliper. : Mean upper, middle, and lower limit widths of the infraspinatus bare area were 5.48 mm, 8.68 mm, and 10.78 mm, respectively. The infraspinatus bare area broadened as one evaluated the humeral head in a superior to inferior fashion.","PeriodicalId":507613,"journal":{"name":"Shoulder & Elbow","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140493064","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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