JSES reviews, reports, and techniques最新文献

{"title":"2025 Acknowledgment of Reviewers","authors":"","doi":"10.1016/j.xrrt.2026.100663","DOIUrl":"10.1016/j.xrrt.2026.100663","url":null,"abstract":"","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 1","pages":"Article 100663"},"PeriodicalIF":0.0,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976404","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":"Low short-term complication rates following acromioclavicular joint surgery: a large database study","authors":"Shahabeddin Yazdanpanah MS ,&nbsp;Grayson M. Talaski BSE ,&nbsp;Matthew S. Smith MD ,&nbsp;Braeden R. Gooch BS ,&nbsp;Benjamin P. Cassidy MD ,&nbsp;Andrew S. Cuthbert MD ,&nbsp;Jennifer L. Vanderbeck MD","doi":"10.1016/j.xrrt.2025.100660","DOIUrl":"10.1016/j.xrrt.2025.100660","url":null,"abstract":"<div><h3>Background</h3><div>Acromioclavicular (AC) joint injuries represent approximately 11% of all shoulder injuries and are managed surgically in severe cases via techniques such as hook-plating, button fixation, and graft-based reconstruction. While much of the existing literature on AC joint surgery points to relatively high rates of long-term complications and reoperations, short-term outcomes are not fully understood. Therefore, this study investigates short-term outcomes following AC joint surgery using a large database to provide comprehensive complication data and elucidate risk factors.</div></div><div><h3>Methods</h3><div>The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2010 to 2023. Patients undergoing surgical intervention for AC joint injuries were identified using Current Procedural Terminology 23550, 23552, and 21320, and their 30-day postoperative outcomes were retrieved. Patients with unknown or null values for demographic or complication metrics were excluded. Statistical analyses included multivariate odds-ratio (OR) logistic regression. Operative time threshold analysis was performed to identify the optimal time cut-point associated with increased complication risk.</div></div><div><h3>Results</h3><div>A total of 13,117 patients underwent AC joint surgery (average age 49.6 ± 15.2 years; average body mass index 30.1 ± 6.44 kg/m²; 70.5% male). The overall adverse event rate was 2.7%: surgical site infection (1.2%) and return to operating room (1%) were among the most common. An average operating time of 85 ± 56 minutes was determined, and threshold analysis revealed a significant increase (<em>P</em> &lt; .001) in complications for operations lasting longer than 148 minutes. Operative time (OR = 1.01), history of chronic obstructive pulmonary disease (OR = 2.47), steroids (OR = 3.16), dialysis (OR = 5.57), bleeding disorders (OR = 2.67), and type 1 diabetes (OR = 1.61) were all significant risk factors for complications.</div></div><div><h3>Conclusion</h3><div>AC joint surgery demonstrated relatively low short-term complication rates; however, comorbidities such as type 1 diabetes and chronic obstructive pulmonary disease are linked to a higher risk of experiencing adverse events. Preoperative counseling is recommended for at-risk patients, and future studies should explore surgery-specific operative time and patient management to provide further insights and enhance surgical decision-making.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100660"},"PeriodicalIF":0.0,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079010","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":"Outcomes following arthroscopic rotator cuff repair adversely affected by underlying diagnosis of glenohumeral osteoarthritis: a matched cohort analysis","authors":"Ismail Ajjawi BS,&nbsp;Anthony E. Seddio MD,&nbsp;Jeremy K. Ansah-Twum MD,&nbsp;Kenneth Donohue MD,&nbsp;Jonathan N. Grauer MD","doi":"10.1016/j.xrrt.2025.100659","DOIUrl":"10.1016/j.xrrt.2025.100659","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Arthroscopic rotator cuff repair (ARCR) has evolved to be the gold standard treatment for rotator cuff tears that are symptomatic despite conservative measures. Patients considered for this procedure may have underlying glenohumeral osteoarthritis (GHOA). The potential correlation of GHOA on short-term and long-term outcomes following ARCR remain unclear due to mixed literature that is limited by cohort size and/or generalizability.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Patients undergoing ARCR were identified from 2010 to Q1 2022 in the M165Ortho PearlDiver Mariner Patient Claims Database. Exclusion criteria included age &lt;18 years, prior ARCR, concurrent nonrotator cuff related arthroscopic shoulder procedures, any upper extremity fractures, neoplasms or infections diagnosed within 90 days before surgery, and &lt;90 days follow-up in the database. Ipsilateral GHOA diagnosis within 1 year prior to ARCR was determined. ARCR (+)GHOA patients were matched 1:4 with ARCR (−)GHOA patients based on age, sex, and Elixhauser Comorbidity Index. Occurrence of any, severe, and minor adverse events within 90 days, delayed functional outcomes between 3 months and 6 months (stiffness, pain, and instability), and 2-year retear were compared by multivariable logistic regression. Two-year retear rates and 5-year subsequent total shoulder arthroplasty (TSA) were assessed by Kaplan–Meier survival analysis and compared by log-rank test.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of 474,285 ARCR patients, concurrent GHOA was identified in 128,606 (27.1%). After matching, there were 84,209 ARCR (+)GHOA and 335,947 ARCR (−)GHOA patients. Compared to ARCR (−)GHOA patients, ARCR (+)GHOA patients had significantly higher odds of 90-day any adverse event (odds ratio [OR]: 1.75, &lt;em&gt;P&lt;/em&gt; &lt; .001), severe adverse event (OR: 1.52, &lt;em&gt;P&lt;/em&gt; &lt; .001), minor adverse event (OR: 1.86, &lt;em&gt;P&lt;/em&gt; &lt; .001), Surgical Site Infections (OR: 1.45, &lt;em&gt;P&lt;/em&gt; &lt; .001), wound complications (OR: 1.89, &lt;em&gt;P&lt;/em&gt; &lt; .001), plus increased 90-day readmissions (OR: 1.72, &lt;em&gt;P&lt;/em&gt; &lt; .001), and emergency visits (OR: 1.84, &lt;em&gt;P&lt;/em&gt; &lt; .001). Functionally, at 3-6 months postoperative, ARCR (+)GHOA patients had higher odds of stiffness (OR: 1.70, &lt;em&gt;P&lt;/em&gt; &lt; .001), pain (OR: 1.32, &lt;em&gt;P&lt;/em&gt; &lt; .001), and instability (OR: 2.89, &lt;em&gt;P&lt;/em&gt; &lt; .001). At 2 years, they had increased odds of retear (OR: 1.44, &lt;em&gt;P&lt;/em&gt; &lt; .001), and at 5 years, higher odds of TSA (OR: 1.55, &lt;em&gt;P&lt;/em&gt; &lt; .001). Among GHOA patients undergoing ARCR, older age (OR: 1.07), female sex (OR: 1.24), opioid use disorder (OR: 2.05), depression (OR: 1.58), anxiety (OR: 1.18), diabetes (OR: 1.36), and postoperative complications independently predicted progression to TSA (all &lt;em&gt;P&lt;/em&gt; &lt; .001).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;The presence of concurrent GHOA was associated with a significant increase in the odds of both short- and longer-term complications follow","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100659"},"PeriodicalIF":0.0,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078936","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":"Return to play and recovery metrics after arthroscopic Bankart repair with augmentations in rugby players","authors":"Yuki Miyasaka RPT, Med ,&nbsp;Shota Hoshika MD, PhD ,&nbsp;Keisuke Matsuki MD, PhD ,&nbsp;Takashi Takamura RPT, MD ,&nbsp;Hideki Kamijo MD, PhD ,&nbsp;Tomoyuki Matsuba MD, PhD ,&nbsp;Tomoshige Tamaki MS ,&nbsp;Norimasa Takahashi MD, PhD ,&nbsp;Hiroyuki Sugaya MD, PhD","doi":"10.1016/j.xrrt.2025.100649","DOIUrl":"10.1016/j.xrrt.2025.100649","url":null,"abstract":"<div><h3>Background</h3><div>There is limited data on the relationship between recovery metrics, including psychological factors, and shoulder function in rugby players after arthroscopic Bankart repair. The purpose of this study was to investigate return to play (RTP) in rugby players who underwent shoulder stabilization for anterior shoulder instability and to assess the relationship between postoperative ranges of motion (ROMs) and various recovery metrics, including performance, pain, and psychological conditions.</div></div><div><h3>Methods</h3><div>We retrospectively investigated subjects who underwent arthroscopic shoulder stabilization at our institute from January 2012 to April 2022. Inclusion criteria were as follows: (1) rugby players with traumatic anterior shoulder instability and (2) arthroscopic Bankart repair with rotator interval closure and Hill–Sachs remplissage. Exclusion criteria were as follows: (1) revision surgery and (2) incomplete questionnaire at the final follow-up. A questionnaire at the final follow-up was used to evaluate the recovery metrics as a visual analog scale (VAS), including athletic performance, pain, and fear of contact. Regression analyses were performed to assess the relationship between the VAS scores and ROMs.</div></div><div><h3>Results</h3><div>Ninety-one shoulders in 82 patients met the inclusion criteria, and 32 shoulders were excluded due to revision surgery, one shoulder; incomplete questionnaire, 31 shoulders. The remaining 59 shoulders in 50 patients were included in this study. The patients consisted of 48 males and 2 females, with a mean age at surgery of 19 years (range, 14-36). The mean follow-up was 31 months (range, 13-56). The mean time to start contact practice was 7 ± 5 months (range, 3-36), and the mean time to RTP was 8 ± 5 months (range, 4-36). Forty-nine patients (98%) returned to their preinjury sports level. The median of VAS values were as follows: 91 for athletic performance (range, 25-100), 100 for pain (range, 10-100), and 70 for fear of contact (range, 10-100). ROM data were available in 52 shoulders. Multiple regression analyses showed significant relationships between total VAS scores and ROMs at postoperative three months (anterior elevation, <em>P</em> = .015; external rotation at the side, <em>P</em> = .002).</div></div><div><h3>Conclusion</h3><div>Arthroscopic shoulder stabilization resulted in a 98% RTP rate in rugby players. The VAS score for fear of contact was relatively low, even in patients with complete return. The total VAS value was correlated with ROMs at three months postoperatively. A rehabilitation protocol that simultaneously addresses psychological and physical aspects may be required for better RTP.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100649"},"PeriodicalIF":0.0,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078556","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":"A biomechanical comparison of hook plate vs. superolateral locking plate with coracoclavicular suture fixation for distal third clavicle fractures with coracoclavicular ligament disruption","authors":"Alexander A. Hysong MD ,&nbsp;Jonathan Day MD ,&nbsp;Manaswini Chennoju MS ,&nbsp;Gabriel J. Yohe MS ,&nbsp;Pooyan Abbasi MSc ,&nbsp;Christopher L. Forthman MD ,&nbsp;Aviram M. Giladi MD, MS","doi":"10.1016/j.xrrt.2025.100645","DOIUrl":"10.1016/j.xrrt.2025.100645","url":null,"abstract":"<div><h3>Background</h3><div>Unstable distal third clavicle fractures involving coracoclavicular (CC) ligament disruption are prone to nonunion and often require surgical fixation. While hook plates (HPs) and superolateral locking plate (SLP) with CC suture augmentation are both commonly used, biomechanical comparisons are limited.</div></div><div><h3>Methods</h3><div>Eighteen fresh-frozen adult cadaveric shoulders (9 contralateral matched pairs) were randomized to receive either HPs or SLP with CC suture fixation constructs after simulated Neer type IIb distal clavicle fractures. Constructs were cyclically loaded at 70 N for 500 cycles, followed by load-to-failure testing. Displacement and failure modes were recorded and statistically analyzed using paired <em>t</em>-tests (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>At 50 N and 70 N, SLP with CC suture fixation demonstrated significantly less displacement than HPs (<em>P</em> &lt; .05) across all measured cycles. Comparisons were made using a paired <em>t</em>-test. Mean displacement at 70 N at cycle 500 was 5.5 mm (HPs) vs. 3.0 mm (SLP with CC suture fixation). SLP with CC suture fixation constructs also had significantly higher load to failure (364.8 N vs. 281.9 N, <em>P</em> &lt; .05). Failure modes differed. HPs typically failed by hook bending and screw pullout, while SLP with CC suture fixation failed primarily via suture rupture or anchor pullout.</div></div><div><h3>Conclusion</h3><div>SLP with CC suture fixation constructs provide superior biomechanical stability compared to HPs in Neer type IIb fractures, with less displacement and greater failure strength under load. These results support the clinical use of SLP with CC suture fixation as a robust alternative to traditional hook plating.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100645"},"PeriodicalIF":0.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078564","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":"Acute pectoralis major tendon tear repair with semitendinosus augmentation: case series","authors":"Giovanna Medina MD, PhD,&nbsp;Luiz Henrique Boraschi Vieira Ribas MD,&nbsp;Breno Schor MD, PhD,&nbsp;Juliana R. Mauad MD,&nbsp;Antonio Guilherme Padovani Garofo MD","doi":"10.1016/j.xrrt.2025.100653","DOIUrl":"10.1016/j.xrrt.2025.100653","url":null,"abstract":"","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100653"},"PeriodicalIF":0.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078594","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":"Severe glenohumeral ankylosis following revision reverse shoulder arthroplasty","authors":"Artem Klimov MD ,&nbsp;Florian Freislederer MD ,&nbsp;Alexander Pieringer MD ,&nbsp;Markus Scheibel MD","doi":"10.1016/j.xrrt.2025.100647","DOIUrl":"10.1016/j.xrrt.2025.100647","url":null,"abstract":"","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100647"},"PeriodicalIF":0.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078560","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":"A modern advanced analytic approach to cost and performance loss analysis of ulnar collateral ligament surgery to Major League Baseball teams","authors":"Michael A. Mastroianni MD,&nbsp;Ritt R. Givens MD,&nbsp;Dongyeon J. Kim MD,&nbsp;Matthew R. LeVasseur MD,&nbsp;Andrew J. Luzzi MD,&nbsp;Frank J. Alexander MS, ATC,&nbsp;Christopher S. Ahmad MD","doi":"10.1016/j.xrrt.2025.100651","DOIUrl":"10.1016/j.xrrt.2025.100651","url":null,"abstract":"<div><h3>Background</h3><div>Ulnar collateral ligament (UCL) surgery has become increasingly prevalent among Major League Baseball (MLB) pitchers. While its clinical implications have been extensively studied, the economic and performance impact on MLB teams remains incompletely understood.</div></div><div><h3>Methods</h3><div>Cost analysis on all MLB pitchers who underwent UCL reconstruction between 2014 and 2024 was conducted. Pitchers were identified, and data were collected using public databases affiliated with MLB and used in previous studies. Economic losses were calculated using 2 primary components: (1) salary cost of recovery (COR), which quantified salaries paid to injured players during recovery, and (2) performance cost, a metric we defined using common FanGraphs wins above replacement (fWAR) conversions to estimate lost player contributions.</div></div><div><h3>Results</h3><div>During the study period, a total of 276 UCL surgeries were performed from 2014 to 2024. Over the past 5 seasons (2020-2024), the number of UCL reconstructions in MLB pitchers has significantly increased to an average of 29.0 ± 4.7 surgeries per year compared to 21.8 ± 4.3 surgeries per year the 6 seasons prior (2014-2019; <em>P</em> = .05), with a peak of 35 surgeries in 2023. From 2014 to 2024, the COR salary losses adjusted for inflation totaled over $1.26 billion, with an increase in average COR over the past 5 seasons ($141 million ± 72 million) compared to the 6 seasons prior ($92 million ± 52 million; <em>P</em> = .14). The estimated COR per player for starters, relievers, and closers was $7.3 million, $2.3 million, and $11.5 million, respectively. The average cumulative fWAR lost per pitcher was 1.9, translating to an estimated annual market loss of $14.3 million per player. The total cumulative fWAR loss across all players was 452.8. Using the conversion of 1 fWAR is equal to approximately $7.5 million in salary, an estimated $3.4 billion worth of performance value was lost for the entire study period.</div></div><div><h3>Conclusion</h3><div>UCL injuries that require surgery impose an increasingly significant financial burden on MLB teams, leading to the loss of $1.26 billion dollars in salary paid out to injured players and likely over $3 billion worth of performance value lost to injury to teams over 10 years. Players also struggle to provide the same value in fWAR as they did prior to injury. This study shows that investing in UCL prevention and recovery efforts can potentially save teams, players, and local communities millions of dollars.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100651"},"PeriodicalIF":0.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079008","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":"Talus allograft for bipolar bone loss in locked anterior shoulder fracture dislocation","authors":"Cameron R. Guy MD,&nbsp;Jonathan Burke MS, ATC,&nbsp;Tyler Thorne MD,&nbsp;Christopher D. Joyce MD","doi":"10.1016/j.xrrt.2025.100652","DOIUrl":"10.1016/j.xrrt.2025.100652","url":null,"abstract":"","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100652"},"PeriodicalIF":0.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078592","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":"Anatomical characterization of sternoclavicular joint and correlation of arthroscopic portals and structures at risk: a cadaveric study on Colombian specimen","authors":"Fabio Alfonso Suarez Romero MD ,&nbsp;Deisy Consuelo Celeita Medina MD ,&nbsp;María Camila Ruiz Cardenas MD ,&nbsp;Andrea Juliana Hernández Caicedo MD ,&nbsp;Federico Suarez MD","doi":"10.1016/j.xrrt.2025.100650","DOIUrl":"10.1016/j.xrrt.2025.100650","url":null,"abstract":"<div><h3>Background</h3><div>The sternoclavicular joint (SCJ) is a synovial saddle joint and the only articulation between the axial skeleton and the upper limb. Although SCJ pathology is rare, it may include degenerative, autoimmune, infectious, tumoral, or traumatic conditions. Arthroscopic approaches to this region carry a risk of damaging vital mediastinal structures. This study aims to anatomically characterize the SCJ and surrounding neurovascular structures, emphasizing the posterior capsule as a critical safety barrier during arthroscopy.</div></div><div><h3>Methods</h3><div>Ten cadaveric specimens were bilaterally dissected. Arthroscopic portals were first marked and used to identify the posterior capsule. Open dissections were performed to measure the distances between the portals and nearby mediastinal structures using digital calipers. Data were recorded in Excel 2024 (Microsoft Corp., Redmond, WA, USA) and REDCap (Vanderbilt University, Nashville, TN, USA) and analyzed with SPSS version 28 (IBM Corp., Armonk, NY, USA).</div></div><div><h3>Results</h3><div>The posterior capsule consistently acted as a protective boundary between the joint and mediastinal structures. The average distances from the superomedial (SM) and inferolateral (IL) portals to the posterior capsule were 26.3 mm and 26.5 mm, respectively. From the posterior capsule, the average distances to key mediastinal structures were: common carotid artery: 42.5 mm (SM), 44.1 mm (IL), brachiocephalic trunk: 40.5 mm (SM), 43.5 mm (IL), innominate vein: 37.8 mm (SM), 39.7 mm (IL), and vagus nerve: 45.4 mm (SM), 46.5 mm (IL).</div></div><div><h3>Discussion and/or Conclusion</h3><div>The posterior capsule provides a reliable anatomical safety margin between the SCJ and vital mediastinal structures. During SCJ arthroscopy, referencing the anterior sternoclavicular ligament and maintaining a minimum 5.1 cm safety margin posteriorly can minimize the risk of catastrophic injury. These findings support safer surgical planning and highlight the importance of precise portal placement.</div></div>","PeriodicalId":74030,"journal":{"name":"JSES reviews, reports, and techniques","volume":"6 2","pages":"Article 100650"},"PeriodicalIF":0.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078937","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}