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Special Issues
Targeted Diagnosis and Treatment of Shoulder and Elbow Disease
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Targeted Diagnosis and Treatment of Shoulder and Elbow Disease

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

Deadline for manuscript submissions: 30 October 2024 | Viewed by 4019

Special Issue Editors

Dr. Teresa Paolucci

E-Mail Website
Guest Editor
Physical Medicine and Rehabilitation, Department of Oral Medical Sciences and Biotechnology, University of G. d'Annunzio Chieti and Pescara Chieti, 66100 Chieti, Italy
Interests: rehabilitation; chronic pain; posture and balance; neurorehabilitation; rehabilitation in musculoskeletal diseases
Dr. Massimiliano Mangone

E-Mail Website
Guest Editor
Department of Anatomy, Histology, Forensic Medicine and Locomotor Sciences, School of Pharmacy and Medicine, Sapienza University of Rome, 00185 Rome, Italy
Interests: rehabilitation; bioengineering; biomechanics of movement and function

Special Issue Information

Dear Colleagues,

Shoulder and elbow disease includes a wide range of conditions that affect the joints, muscles, and tissues around the shoulder and elbow. Some common examples of shoulder and elbow diseases are rotator cuff tears, frozen shoulder, tennis elbow, golfer's elbow, and bursitis. Shoulder and elbow disease can cause pain and joint dysfunction that affect daily activities. The pain and disability associated with shoulder and elbow pain can have a large impact on individuals and their families, communities, and healthcare systems, affecting daily functioning and the ability to work. The diagnosis and treatment of these conditions require specialized medical attention, including personalized care that considers the patient's unique needs. Orthopedic specialists use advanced techniques to accurately diagnose the underlying issues and develop customized treatment plans that may include pain management and surgical procedures. The ultimate goal is improved function and reduced pain for patients suffering from shoulder and elbow disease. Hence, rehabilitation has a crucial role in achieving the goals described above. An individual rehabilitation plan has to follow international guidelines and requires a multidisciplinary and interdisciplinary team for its full operation, with expert physiotherapists and physiatrists in shoulder and elbow pathologies and their rehabilitation.

The primary goals of this Special Issue are to advance the targeted diagnosis and treatment of shoulder and elbow disease and trauma. We look forward to your enthusiastic participation in this Special Issue that will promote the scientific communication of our knowledge with the ultimate goal of positively influencing the treatment and care for our patients.

Dr. Teresa Paolucci
Dr. Massimiliano Mangone
Guest Editors

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

  • anterolateral deltoid split
  • joint pain
  • axillary nerve injury
  • rotator cuff injuries
  • shoulder arthroplasty
  • shoulder impingement syndrome
  • proximal humeral fracture
  • rehabilitation
  • exercise
  • physiotherapy

Published Papers (5 papers)

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Research

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14 pages, 1963 KiB  
Article
AI in Hand Surgery: Assessing Large Language Models in the Classification and Management of Hand Injuries
by Sophia M. Pressman, Sahar Borna, Cesar A. Gomez-Cabello, Syed Ali Haider and Antonio Jorge Forte
J. Clin. Med. 2024, 13(10), 2832; https://doi.org/10.3390/jcm13102832 (registering DOI) - 11 May 2024
Viewed by 92
Abstract
OpenAI’s ChatGPT (San Francisco, CA, USA) and Google’s Gemini (Mountain View, CA, USA) are two large language models that show promise in improving and expediting medical decision making in hand surgery. Evaluating the applications of these models within the field of hand surgery [...] Read more.
OpenAI’s ChatGPT (San Francisco, CA, USA) and Google’s Gemini (Mountain View, CA, USA) are two large language models that show promise in improving and expediting medical decision making in hand surgery. Evaluating the applications of these models within the field of hand surgery is warranted. This study aims to evaluate ChatGPT-4 and Gemini in classifying hand injuries and recommending treatment. Methods: Gemini and ChatGPT were given 68 fictionalized clinical vignettes of hand injuries twice. The models were asked to use a specific classification system and recommend surgical or nonsurgical treatment. Classifications were scored based on correctness. Results were analyzed using descriptive statistics, a paired two-tailed t-test, and sensitivity testing. Results: Gemini, correctly classifying 70.6% hand injuries, demonstrated superior classification ability over ChatGPT (mean score 1.46 vs. 0.87, p-value < 0.001). For management, ChatGPT demonstrated higher sensitivity in recommending surgical intervention compared to Gemini (98.0% vs. 88.8%), but lower specificity (68.4% vs. 94.7%). When compared to ChatGPT, Gemini demonstrated greater response replicability. Conclusions: Large language models like ChatGPT and Gemini show promise in assisting medical decision making, particularly in hand surgery, with Gemini generally outperforming ChatGPT. These findings emphasize the importance of considering the strengths and limitations of different models when integrating them into clinical practice. Full article
(This article belongs to the Special Issue Targeted Diagnosis and Treatment of Shoulder and Elbow Disease)
10 pages, 5196 KiB  
Article
Classification and Incidence of Heterotopic Ossifications in Relation to NSAID Prophylaxis after Elbow Trauma
by Diane Leyder, Stefan Döbele, Christian Konrads, Tina Histing, Cornelius S. Fischer, Marc-Daniel Ahrend and Patrick Ziegler
J. Clin. Med. 2024, 13(3), 667; https://doi.org/10.3390/jcm13030667 - 24 Jan 2024
Viewed by 618
Abstract
Heterotopic ossification (HO) after elbow trauma can be responsible for significant motion restrictions. The study’s primary aim was to develop a new X-ray-based classification for HO of the elbow. This retrospective study analyzed elbow injury radiographs from 138 patients aged 6–85 years (mean [...] Read more.
Heterotopic ossification (HO) after elbow trauma can be responsible for significant motion restrictions. The study’s primary aim was to develop a new X-ray-based classification for HO of the elbow. This retrospective study analyzed elbow injury radiographs from 138 patients aged 6–85 years (mean 45.9 ± 18) who underwent operative treatment. The new classification was applied at 6 weeks, 12 weeks, and 6 months postoperatively. The severity of HO was graded from 0 to 4 and localization was defined as r (radial), p (posterior), u (ulnar) or a (anterior) by two observers. The patients were categorized based on injury location and use of non-steroidal anti-inflammatory drugs (NSAIDs) for HO prophylaxis. The correlations between the generated data sets were analyzed using Chi-square tests (χ2) with a significance level of p < 0.05. The inter- and intraobserver reliability was assessed using Cohen’s Kappa. In 50.7% of the evaluated X-rays, the formation of HO could be detected after 12 weeks, and in 60% after 6 months. The analysis showed a significant correlation between the injury’s location and the HO’s location after 12 weeks (p = 0.003). The use of an NSAID prophylaxis did not show a significant correlation with the severity of HO. The classification showed nearly perfect inter- (κ = 0.951, p < 0.001) and intrareliability (κ = 0.946, p < 0.001) according to the criteria of Landis and Koch. Based on the presented classification, the dimension and localization of HO in the X-ray image can be described in more detail compared to previously established classifications and, thus, can increase the comparability of results across studies. Full article
(This article belongs to the Special Issue Targeted Diagnosis and Treatment of Shoulder and Elbow Disease)
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8 pages, 213 KiB  
Article
Minimum Clinically Important Difference (MCID) and Patient Acceptable Symptomatic State (PASS) Applied to the SF-36 in Patients Who Underwent Arthroscopic Rotator Cuff Repair
by Umile Giuseppe Longo, Sergio De Salvatore, Ilaria Piergentili, Alberto Lalli, Benedetta Bandini and Vincenzo Denaro
J. Clin. Med. 2024, 13(1), 178; https://doi.org/10.3390/jcm13010178 - 28 Dec 2023
Cited by 1 | Viewed by 935
Abstract
The 36-Item Short-Form Health Survey questionnaire (SF-36) is a reliable tool to assess the health-related quality of life of patients. If a mean difference between pre-operative evaluation and final follow-up is found to be statistically significant, then the change in score is not [...] Read more.
The 36-Item Short-Form Health Survey questionnaire (SF-36) is a reliable tool to assess the health-related quality of life of patients. If a mean difference between pre-operative evaluation and final follow-up is found to be statistically significant, then the change in score is not random. However, a statistically significant mean change may not correspond to a clinical amelioration for the patient or mean that the patient’s state of health is to be considered acceptable. For this reason, interest in the concepts of minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) has grown within recent years. The goal of the present work of research was to determine the MCID and PASS values for the SF-36 in patients who received rotator cuff repair (RCR). Forty-six patients (18 women and 28 men, mean age 58.5 ± 12.9) previously diagnosed with rotator cuff disease were enrolled. All of these patients underwent RCR. They were evaluated pre-operatively and six months after the surgical intervention as a final follow-up. The SF-36 questionnaire was assessed at each evaluation. The MCID cut-offs of the total, physical, and mental dimensions of the SF-36 for patients who underwent RCR were 23.1, 32.5, and 18.1, respectively. A 23.1 improvement in the SF-36 score at six months following RCR can be correlated with patients having reached a clinically significant improvement in health status. If 81.9 or more is attained in the SF-36 score after surgical repair, the symptom state can be judged as satisfactory by the majority of patients. Full article
(This article belongs to the Special Issue Targeted Diagnosis and Treatment of Shoulder and Elbow Disease)

Review

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17 pages, 505 KiB  
Review
Comparison of Early versus Traditional Rehabilitation Protocol after Rotator Cuff Repair: An Umbrella-Review
by Teresa Paolucci, Francesco Agostini, Marco Conti, Sara Cazzolla, Elena Mussomeli, Gabriele Santilli, Federica Poso, Andrea Bernetti, Marco Paoloni and Massimiliano Mangone
J. Clin. Med. 2023, 12(21), 6743; https://doi.org/10.3390/jcm12216743 - 25 Oct 2023
Viewed by 1261
Abstract
Rehabilitation after rotator cuff repair is crucial for functional recovery and for minimizing the risk of retear. There are two rehabilitation protocols (early and traditional) and the debate about which is the best is open. This umbrella review aimed to compare the effect [...] Read more.
Rehabilitation after rotator cuff repair is crucial for functional recovery and for minimizing the risk of retear. There are two rehabilitation protocols (early and traditional) and the debate about which is the best is open. This umbrella review aimed to compare the effect of these rehabilitation protocols in terms of reduction in pain, functional recovery, and retear risk. We selected systematic reviews and meta-analyses published between 2012 and 2022 dealing with the aim. Nineteen systematic reviews were included. No significant differences were found between early and traditional protocols in terms of pain reduction. Early rehabilitation provided better short-term results regarding Range of Motion improvement, but long-term functional outcomes were similar. Retear risk remains a significant concern for the early protocol. We found major differences between the analyzed protocols. This review suggests that both protocols are useful to recover global shoulder function, but the standard protocol has a greater safety profile for larger tears. On the other hand, the early protocol may be preferable for smaller lesions, allowing a faster recovery and having less impact on medical costs. Further research is needed to identify optimal rehabilitation strategies tailored to the individual patient’s needs and characteristics. Full article
(This article belongs to the Special Issue Targeted Diagnosis and Treatment of Shoulder and Elbow Disease)
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Other

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11 pages, 5127 KiB  
Case Report
Tackling Kinesiophobia in Chronic Shoulder Pain: A Case Report on the Combined Effect of Pain Education and Whole-Body Cryostimulation
by Angelo Alito, Mariachiara Elisabetta Cifalinò, Jacopo Maria Fontana, Federica Verme, Paolo Piterà and Paolo Capodaglio
J. Clin. Med. 2024, 13(7), 2094; https://doi.org/10.3390/jcm13072094 - 3 Apr 2024
Viewed by 626
Abstract
Background: Chronic shoulder pain may cause significant functional disability and reduced psychosocial well-being. Detailed Case Description: In this case, we propose the use of pain neuroscience education and whole-body cryostimulation (WBC) to treat a 64-year-old woman with severe functional limitations and chronic right [...] Read more.
Background: Chronic shoulder pain may cause significant functional disability and reduced psychosocial well-being. Detailed Case Description: In this case, we propose the use of pain neuroscience education and whole-body cryostimulation (WBC) to treat a 64-year-old woman with severe functional limitations and chronic right shoulder pain. The aim was to overcome kinesiophobia and improve her motor function, autonomy, and quality of life. Functional and clinical assessments were conducted at admission, discharge, and at a one-month follow-up via phone call. The patient’s global health, shoulder function, and quality of life showed improvement during hospitalisation and were maintained after one month. Discussion: Pain education is crucial in managing chronic shoulder pain, especially in addressing kinesiophobia and promoting positive patient outcomes. In this context, WBC was used as a supplementary treatment to traditional pain relief and exercise tolerance therapies. This can help individuals to participate more actively in their rehabilitation process, ultimately promoting functional recovery and an improved quality of life. Conclusion: The combination of cryostimulation, tailored physical exercises, pain education, manual therapy, and psychological support created a synergistic effect that addressed both the physical and psychological aspects of pain and kinesiophobia. Full article
(This article belongs to the Special Issue Targeted Diagnosis and Treatment of Shoulder and Elbow Disease)
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Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: coronoid fracture management:current concepts
Authors: Panagiotis Masouros
Affiliation: Evagelismos Hospital, Athens, Greece
Abstract: The coronoid process is a key-structure of the proximal ulna providing stability within the ulno-humeral articulation. Coronoid fractures are generally associated with specific injury patterns of the elbow, such as terrible triad injuries, trans-olecranon fracture-dislocations, posteromedial rotatory instability or Monteggia like lesions. In this context, failure to address correctly even subtle coronoid fractures may have a major impact on elbow stability and lead poor clinical outcomes. The objective of this study is to review current evidence, provide a better understanding and identification of these lesions and guide the appropriate management in a holistic way, as part of a more complex injury pattern

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