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Advances in Shoulder Surgery
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Advances in Shoulder Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 5262

Special Issue Editor

Dr. Daniel P. Berthold

E-Mail Website
Guest Editor
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, Ziemssenstraße 5, 80336 Munich, Germany
Interests: shoulder surgery; sports medicine; biomechanics; rotator cuff; shoulder instability; reverse total shoulder arthroplasty

Special Issue Information

Dear Colleagues,

The shoulder joint is one of the most complex and versatile joints in the human body. Shoulder surgery has advanced significantly in recent years, resulting in better outcomes for patients with shoulder problems. Advances in technology, surgical techniques, and implant designs have enabled surgeons to perform minimally invasive procedures, leading to less postoperative pain and faster recovery times.

Arthroscopic shoulder surgery as a minimally invasive technique has revolutionized shoulder surgery, and has been used for a variety of procedures, including rotator cuff repair, labral repair, and treatment of shoulder instability. In addition, advances in imaging techniques have allowed for more accurate diagnoses and treatment of shoulder injuries.

Implant design has also improved significantly, with newer materials and designs providing better outcomes for patients. For example, reverse shoulder arthroplasty has become a popular procedure for patients with rotator cuff arthropathy or irreparable rotator cuff tears. This procedure involves reversing the anatomy of the shoulder joint and placing the ball of the joint on the glenoidal side and the socket on humerus. This technique has improved outcomes for patients with previously difficult-to-treat conditions.

This Special Issue will focus on the recent advances in shoulder surgery and their impact on patient outcomes. It will cover topics, such as arthroscopic shoulder surgery, biological augmentation, reverse shoulder arthroplasty, imaging techniques, including virtual and augmenting reality, and implant design. The articles in this issue will provide valuable insights for clinicians and researchers in the field of shoulder surgery, helping to improve patient care and outcomes.

Dr. Daniel P. Berthold
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • arthroscopic shoulder surgery
  • rotator cuff repair
  • biological augmentation
  • superior capsular reconstruction
  • biomechanics
  • tendon transfer
  • virtual reality
  • shoulder instability
  • labral repair
  • arthroplasty
  • reverse shoulder arthroplasty

Published Papers (5 papers)

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14 pages, 10593 KiB  
Article
Reinforcement Techniques in Arthroscopic Repair of Large-to-Massive Rotator Cuff Tears: A Comparative Study of Superior Capsule Reconstruction and Patch Graft Augmentation
by Jae-Sung Yee, Jin-Kwan Choi, Ki-Tae Kim, Ho-Won Lee and Yong-Beom Lee
J. Clin. Med. 2024, 13(8), 2276; https://doi.org/10.3390/jcm13082276 - 14 Apr 2024
Viewed by 630
Abstract
Background: Large-to-massive rotator cuff tears (LMRCTs) present challenges in achieving successful repair due to factors such as muscle atrophy and tendon retraction. Arthroscopic rotator cuff repair (ARCR) with reinforcement techniques like superior capsule reconstruction (SCR) or patch graft augmentation (PGA) has emerged [...] Read more.
Background: Large-to-massive rotator cuff tears (LMRCTs) present challenges in achieving successful repair due to factors such as muscle atrophy and tendon retraction. Arthroscopic rotator cuff repair (ARCR) with reinforcement techniques like superior capsule reconstruction (SCR) or patch graft augmentation (PGA) has emerged as a less invasive option to improve shoulder joint stability and prevent retear. This study aimed to compare the clinical and radiological outcomes of SCR and PGA as reinforcement techniques for the arthroscopic repair of LMRCTs. Methods: A single-center retrospective study was conducted on patients undergoing LMRCT repair between January 2019 and December 2021. Patients were divided into two groups: those receiving SCR (Group 1) and those receiving PGA (Group 2). Various clinical parameters including range of motion, functional scores, and radiological assessments were evaluated preoperatively and six months postoperatively. Results: Both SCR and PGA techniques demonstrated significant improvements in the range of motion and clinical scores postoperatively. However, Group 2 showed higher postoperative SST and UCLA scores compared to Group 1. Radiologically, there was a slightly higher retear rate in Group 2, although this was not statistically significant. Group 2 also had a shorter mean duration of surgery compared to Group 1. Conclusions: In the arthroscopic repair of LMRCTs, both SCR and PGA techniques exhibit favorable clinical and radiological outcomes. Despite the simplicity of PGA compared to SCR, it offers comparable results with a shorter surgical duration, making it a feasible reinforcement option for surgeons. Full article
(This article belongs to the Special Issue Advances in Shoulder Surgery)
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10 pages, 2926 KiB  
Article
Deltoid Muscle Tension Alterations Post Reverse Shoulder Arthroplasty: An Investigation Using Shear Wave Elastography
by Annabel Fenwick, Thomas Reichel, Lars Eden, Jonas Schmalzl, Rainer Meffert, Piet Plumhoff and Fabian Gilbert
J. Clin. Med. 2023, 12(19), 6184; https://doi.org/10.3390/jcm12196184 - 25 Sep 2023
Viewed by 919
Abstract
Introduction: This study aimed to evaluate the utility of shear wave elastography (SWE) in assessing changes in deltoid muscle properties following reverse shoulder arthroplasty (RSA). Methods: Our cohort consisted of 18 patients who underwent RSA due to various conditions, including osteoarthritis, cuff arthropathy, [...] Read more.
Introduction: This study aimed to evaluate the utility of shear wave elastography (SWE) in assessing changes in deltoid muscle properties following reverse shoulder arthroplasty (RSA). Methods: Our cohort consisted of 18 patients who underwent RSA due to various conditions, including osteoarthritis, cuff arthropathy, and irreducible proximal humeral fractures. Pre- and postoperative muscle elasticity and stiffness were measured using SWE and were compared with functional outcomes and radiological parameters. Results: Our results showed significant changes in deltoid muscle elasticity after RSA, particularly in the anterior and middle portions. However, these alterations were not correlated with postoperative functional outcomes or specific radiological parameters. The study also underscored the potential of SWE for future applications, including the preoperative assessment of deltoid function, postoperative monitoring, and intraoperative use for optimal component positioning during RSA. Conclusion: Further research, involving larger, more homogeneous patient cohorts is needed to confirm these findings and to explore the potential influence of these changes on the biomechanical design of implants and prosthesis positioning in RSA. Full article
(This article belongs to the Special Issue Advances in Shoulder Surgery)
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12 pages, 1931 KiB  
Article
Combined Biologic Augmentation Strategies with Collagen Patch Graft, Microfractures, and Platelet Concentrate Injections Improve Functional and Structural Outcomes of Arthroscopic Revision Rotator Cuff Repair
by Alessandro Colosio, Andrea Bergomi, Andrea Pratobevera, Marco Paderno, Maristella Francesca Saccomanno and Giuseppe Milano
J. Clin. Med. 2023, 12(17), 5694; https://doi.org/10.3390/jcm12175694 - 1 Sep 2023
Viewed by 1187
Abstract
Background: Arthroscopic revision rotator cuff repair (ARRCR) is challenging. Biologic strategies seem to be promising. The aim was to evaluate the effectiveness of the combination of microfractures of the greater tuberosity, augmentation with collagen patch graft, and platelet concentrate injections in ARRCR. Methods: [...] Read more.
Background: Arthroscopic revision rotator cuff repair (ARRCR) is challenging. Biologic strategies seem to be promising. The aim was to evaluate the effectiveness of the combination of microfractures of the greater tuberosity, augmentation with collagen patch graft, and platelet concentrate injections in ARRCR. Methods: A retrospective comparative study was conducted on patients that underwent ARRCR with a minimum follow-up of two years. Patients in the augmentation group underwent ARRCR combined with microfractures, collagen patch graft, and postoperative subacromial injections of platelet concentrate. A standard rotator cuff repair was performed in the control group. Primary outcome: Constant-Murley score (CMS). Secondary outcomes: disease-specific, health-related quality of life using the Disabilities of the Arm, Shoulder, and Hand (DASH) score; assessment of tendon integrity with magnetic resonance at least six months after surgery. Significance was set at p < 0.05. Results: Forty patients were included. Mean follow-up was 36.2 ± 8.7 months. The mean CMS was greater in the augmentation group (p = 0.022). No differences could be found for DASH score. Healing failure rate was higher in the control group (p = 0.002). Conclusion: Biologic augmentation of ARRCR using a combination of microfractures, collagen patch graft, and subacromial injections of platelet concentrate is an effective strategy in improving tendon healing rate. Level of evidence: retrospective cohort study, level III. Full article
(This article belongs to the Special Issue Advances in Shoulder Surgery)
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13 pages, 1067 KiB  
Article
Contact Mechanics of Elliptical and Spherical Head Implants during Axial Rotation in Anatomic Total Shoulder Arthroplasty: A Biomechanical Comparison
by Lukas N. Muench, Maria Slater, Simon Archambault, Daniel P. Berthold, Marco-Christopher Rupp, Elifho Obopilwe, Mark P. Cote and Augustus D. Mazzocca
J. Clin. Med. 2023, 12(15), 4918; https://doi.org/10.3390/jcm12154918 - 26 Jul 2023
Viewed by 865
Abstract
Background: Elliptical humeral head implants have been proposed to result in more anatomic kinematics following total shoulder arthroplasty (aTSA). The purpose of this study was to compare glenohumeral contact mechanics during axial rotation using spherical and elliptical humeral head implants in the setting [...] Read more.
Background: Elliptical humeral head implants have been proposed to result in more anatomic kinematics following total shoulder arthroplasty (aTSA). The purpose of this study was to compare glenohumeral contact mechanics during axial rotation using spherical and elliptical humeral head implants in the setting of aTSA. Methods: Seven fresh-frozen cadaveric shoulders were utilized for biomechanical testing in neutral (NR), internal (IR), and external (ER) rotation at various levels of abduction (0°, 15°, 30°, 45°, 60°) with lines of pull along each of the rotator cuff muscles. Each specimen underwent the following three conditions: (1) native, and TSA using (2) an elliptical and (3) spherical humeral head implant. Glenohumeral contact mechanics, including contact pressure (CP; kPa), peak contact pressure (PCP; kPa), and contact area (CA; mm2), were measured in neutral rotation as well as external and internal rotation using a pressure mapping sensor. Results: Elliptical head implants showed a significantly lower PCP in ER compared to spherical implants at 0° (Δ−712.0 kPa; p = 0.034), 15° (Δ−894.9 kPa; p = 0.004), 30° (Δ−897.7 kPa; p = 0.004), and 45° (Δ−796.9 kPa; p = 0.010) of abduction, while no significant difference was observed in ER at 60° of abduction or at all angles in NR and IR. Both implant designs had similar CA in NR, ER, and IR at all tested angles of abduction (p > 0.05, respectively). Conclusions: In the setting of aTSA, elliptical heads showed significantly lower PCP during ER at 0° to 45° of abduction, when compared to spherical head implants. However, in NR and IR, PCP was similar between implant designs. Both designs showed similar CA during NR, ER, and IR at all abduction angles. Level of Evidence: basic science; controlled laboratory study. Full article
(This article belongs to the Special Issue Advances in Shoulder Surgery)
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15 pages, 1344 KiB  
Systematic Review
Acromioclavicular Joint Lesions in Adolescents—A Systematic Review and Treatment Guidelines
by Naman Wahal, Alper Sukru Kendirci, Carlos Abondano, Mark Tauber and Frank Martetschläger
J. Clin. Med. 2023, 12(17), 5650; https://doi.org/10.3390/jcm12175650 - 30 Aug 2023
Viewed by 1216
Abstract
True acromioclavicular joint (ACJ) injuries are rare in children and adolescents due to the strength of ligaments in this age group. However, a standardized management guideline for these injuries is currently lacking in the literature. This systematic review aims to provide an organized [...] Read more.
True acromioclavicular joint (ACJ) injuries are rare in children and adolescents due to the strength of ligaments in this age group. However, a standardized management guideline for these injuries is currently lacking in the literature. This systematic review aims to provide an organized overview of associated injuries and propose a management algorithm for pediatric ACJ injuries. Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic review was conducted. Two independent observers searched PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus databases for ACJ injuries in children and adolescents. The extracted data were analyzed (due to the limited number of publications and inhomogeneity of data, no formal statistical analysis was conducted), and cases were categorized based on injury frequency and pattern, leading to the formulation of a treatment algorithm. The risk of bias was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. A total of 77 articles were identified, and 16 articles (4 case series and 12 case reports) met the inclusion criteria. This study included 37 cases in 36 patients (32 males, 4 females) with a mean age of 13 years (9–17 years). Six injury categories were described. Surgical management was performed in 27 ACJ injuries (25 open, 2 arthroscopic). Various surgical implants were used including K wires, polydioxanone sutures (PDS), screws, hook plates, suture anchors, and suture button devices. Most cases achieved good to excellent outcomes, except for one case of voluntary atraumatic dislocation of the ACJ. This systematic review provides the first comprehensive analysis of ACJ injury management in adolescents with open physis. It categorizes injury patterns and presents a treatment algorithm to enhance the understanding of these injuries. The review’s findings contribute valuable insights for clinicians dealing with pediatric ACJ injuries. Full article
(This article belongs to the Special Issue Advances in Shoulder Surgery)
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