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  • Supraclavicular intraplexal reconstruction may restore elbow flexion in infants

    Elbow flexion can be restored in infants with neonatal brachial plexus palsy who have neurotmesis of C5 and avulsion of C6 with supraclavicular intraplexal reconstruction with use of C5 as the proximal outlet, according to study results.
    Of the 421 patients with neonatal brachial plexus palsy who underwent nerve surgery from 1990 to 2008, 34 infants who had a neurotmetic lesion of C5 and avulsion or intraforaminalneurotmesis of C6, irrespective of C7, were included in the study.

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  • Intraoperative gentamicin may reduce infection after shoulder arthroplasty

    Intraoperative injection of gentamicin may be a cost-effective way to reduce deep infection stemming from shoulder arthroplasty, according to recently published data.

    Researchers retrospectively evaluated 507 shoulder arthroplasties performed by a single surgeon between 2005 and 2011. Although all patients received systemic prophylactic antibiotics, those who underwent surgery after June 2007 also received 160 mg of gentamicin in the glenohumeral joint to prevent surgery-related deep infection. Patients who received gentamicin (group B) and those who did not receive gentamicin (group A) were compared and evaluated for preexisting medical conditions, type of surgery and presence of infection. Minimum follow-up was 1 year.

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  • Higher readmission rates experienced after reverse total shoulder arthroplasty

    Compared with patients who underwent hemiarthroplasty or total shoulder arthroplasty, patients who underwent reverse total shoulder arthroplasty had higher readmission rates, according to study results.
    Using the State Inpatient Database from seven different states, researchers identified 26,218 patients who underwent hemiarthroplasty, total shoulder arthroplasty (TSA) or reverse total shoulder arthroplasty (RTSA) from 2005 to 2010. The researchers determined the 90-day readmission rate, causes of readmission and risk factors for readmission. Additionally, factors and risk for readmission were measured using multivariate modeling and a Cox proportional hazards model.

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  • Elbow surgery risk may be increased by early entry to Major League Baseball

    The common elbow surgery made famous by Major League Baseball (MLB) pitcher, Tommy John, definitely does its job to return pitchers to the mound, but risks for having the surgery may be able to be recognized earlier in a player’s career, say researchers presenting their work at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Annual Meeting. The study was the largest cohort of MLB pitchers, to date, that have undergone UCL reconstruction.

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  • 3-D printed wrist splints for arthritis sufferers

    A computer software concept has been developed that will enable clinicians with no experience in Computer Aided Design (CAD) to design and make custom-made 3D printed wrist splints for rheumatoid arthritis sufferers. The 3D printed splints are not only more comfortable and attractive but potentially cheaper than the current ones that are ‘ugly, bulky, and can make a patients arm sweat’.

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  • In ‘tennis elbow’ tendon stimulation is the key to repair

    New data presented at the European League Against Rheumatism Annual Congress (EULAR 2014) show that ultrasound-guided injections of growth factors-containing platelet-rich plasma (PRP) are no more effective in treating recently developed epicondylitis than injections of saline.

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  • Exercise intensity often overestimated

    Do you work out for health benefits and feel you are exercising more than enough? You might be among the many Canadians who overrate how hard they work out or underestimate what moderate intensity exercise means, according to a recent study out of York University’s Faculty of Health.

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  • Anatomic features not tied to pain in rotator cuff tears

    Anatomic features associated with the severity of atraumatic rotator cuff tears are not associated with pain level, according to a study published in the May 21 issue of The Journal of Bone & Joint Surgery.

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  • Extended capsular release unnecessary for shoulder stiffness in arthroscopic surgery

    Although arthroscopic capsular release is a known treatment for shoulder stiffness, posterior extended capsular release might not be necessary in arthroscopic surgery, according to study results.
    Researchers enrolled 75 patients who underwent arthroscopic capsular release for shoulder stiffness. The patients were randomly assigned to one of two groups: those in whom capsular release, including release of the rotator interval and anterior and inferior capsule, was performed (n = 37), and those in whom capsular release was extended to the posterior capsule (n = 38).
    The researchers used American Shoulder and Elbow Surgeons scores, Simple Shoulder Test, VAS pain scores and range of motion (ROM) for evaluation before surgery, at 3, 6 and 12 months postoperatively, and at the last follow-up. Mean follow-up was 18.4 months.
    ROM increased significantly among both groups at the last follow-up compared with preoperative scores (P < .05). However, there were no statistical differences between the two groups in American Shoulder and Elbow Surgeons scores, Simple Shoulder Test and VAS pain scores at the last follow-up (P > .05), according to the researchers.

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  • Shoulder activity not associated with severity of atraumatic rotator cuff tear

    Among patients with atraumatic rotator cuff tears, shoulder activity was not associated with severity of the tear, but was affected by patients’ age, sex and occupation, according to study results.
    Researchers prospectively enrolled patients with an atraumatic rotator cuff tear on MRI in the Multicenter Orthopaedic Outcomes Network shoulder study of nonoperative treatment. Patients were asked to complete a previously validated shoulder activity scale; 434 patients completed the scale and were included in the analysis. Mean patient age was 62.7 years.
    The researchers performed a regression analysis to assess the association of shoulder activity level to rotator cuff tear characteristics, including tendon involvement and traction, as well as patient factors such as age, sex, smoking and occupation.
    Shoulder activity was not associated with severity of the rotator cuff tear, according to the researchers. However, shoulder activity was negatively associated with age and female sex. According to the regression model, 69-year-old patients with rotator cuff tears were 1.5 points less active on the 20-point scale vs. identical 56-year-old patients; female patients were 1.6 points less active vs. similar male patients. Occupation was also a significant predictor of shoulder activity level, with unemployed patients predicted to be 4.8 points less active compared with employed patients.

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  • NFL players return to the game after stabilizing shoulder surgery

    Shoulder instability is a common injury in football players but the rate of return to play has not been regularly determined following surgery. A new study, discussed at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Annual Meeting, details that return rates for NFL players is approximately 90 percent no matter what the stabilization procedure (open vs. arthroscopic).

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  • Risk factors identified for little league shoulder

    As cases of Little League Shoulder (LLS) occur more frequently, the need for additional information about the causes and outcomes of the condition has become clear. Researchers presenting at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Annual Meeting shared new data identifying associated risk factors, common treatment options and return to play.

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  • Shock therapy improves pain and function in patients with chronic calcific shoulder tendinitis

    Shock therapy improves pain and function in patients with chronic calcific shoulder tendinitis, according to an article published in Annals of Internal Medicine. Rotator cuff tendonitis is one of the most common causes of shoulder pain and may present with or without calcifications. There is little evidence to suggest that conventional therapies, such as rest, ice, nonsteroidal anti-inflammatory drugs, physical therapy, and subacromial corticosteroid injections can effectively ease pain or restore function. Calcific tendinitis, in particular, may be more difficult to manage and may require surgery. Extracorporeal shockwave therapy (ESWT), which uses sound waves of high or low energy that impart rapid fluctuations of pressure to tissues, has been suggested as an alternative treatment to expensive and risky surgical interventions.

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  • Physical therapy instructional video may be as good as an in-person visit for shoulder rehabilitation exercises

    A rehab video may get the same results as an in-person visit for shoulder rehabilitation exercises, a new study suggests. "These results are significant for two reasons," said the lead researcher. "First, having an additional tool to augment what the patient learns at an initial physical therapy visit may help with exercise accuracy and hopefully therefore improve outcomes. Additionally as access to physical therapy becomes more limited due either to cost or insurance, identifying new tools to better help out patients will be essential."

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  • Baseball pitchers, volleyball spikers have something in common: Similar shoulder, elbow injuries

    Baseball and volleyball players share the similar arm injuries due to overuse of their shoulders and elbows. In both circumstances, the shoulder muscles generate and transmit an incredible amount of energy and serve as the transition point where built up energy is transferred from the rest of the body down the arm. After too many pitches or serves, these shoulder muscles get overworked and tend to cause the shoulder to tighten up.

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  • Short term improvements only for shoulder revision repair surgery

    Long-term outcomes of revision arthroscopic rotator cuff repair surgery is not as successful as in a first-time surgery, according to researchers from the Orthopaedic Research Institute in Sydney, Australia, who presented their work at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Specialty Day.

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  • Rotator Cuff Repair and Immobilization

    Shoulder rotator cuff repair aims to suture torn rotator cuff tendons and provide them with the optimal environment to heal and minimize chance of retear. Overall retear rates have decreased over the years, but are still a major concern. Better suture techniques have been thoroughly investigated but there is less attention paid to the rehabilitation protocol. Currently the gold standard for rehabilitation after surgery is to wear an abduction brace and begin physical therapy for passive range of motion within the first few weeks. As surgical techniques have evolved from open surgery to arthroscopic surgery, there are questions as to whether this rehabilitation protocol is ideal. Animal studies have shown that longer periods of immobilization are beneficial to healing after rotator cuff repair.

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  • In pitching injuries, the elbow is connected to the hip bone

    New University of Florida research suggests that a pitcher’s elbow injury could be linked to movement in the hips. Dr. Kevin W. Farmer, an assistant professor in the UF department of orthopaedics and rehabilitation, presented research at the March meeting of the American Academy of Orthopaedic Surgeons that shows a limited range of motion in a pitcher’s hips could be a risk factor in injury to his elbow.

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  • Volar plating not suited for all distal radius fractures

    Distal radius fracture fixation techniques can differ and be more or less effective based on the patient’s age, bone quality and fracture stability. In a Cover Story in Orthopaedics Today Europe, investigators from throughout Europe discuss their results with distal radius fracture treatments, how to avoid complications and factors that impact a patient’s return to preinjury levels of activity.

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  • Year-round play contributes to 10-fold increase of ulnar collateral ligament reconstruction among youth

    Baseball season is back and so are the injuries. But, elbow injuries, once seen as a problem for professional athletes, are becoming more prevalent among high school and middle school athletes due to increased play and competition at the youth level. Repetitive stress to a pitcher’s ulnar collateral ligament (UCL) – an important stabilizing ligament of the elbow joint – can lead to pain and eventually to the inability to pitch and throw.

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  • American Society for Surgery of the Hand
  • American Academy of Orthopaedic Surgeons
  • Healthtap
  • The American Board of Orthopaedic Surgery