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Targeted Diagnosis and Treatment of Shoulder and Elbow Disease: 2nd Edition

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

Deadline for manuscript submissions: 20 May 2026 | Viewed by 6178

Special Issue Editors

Dr. Teresa Paolucci

E-Mail Website
Guest Editor
Physical Medicine and Rehabilitation, Department of Oral Medi-cal 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
Special Issues, Collections and Topics in MDPI journals
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 Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is my pleasure to invite you to contribute to this Special Issue, entitled “Targeted Diagnosis and Treatment of Shoulder and Elbow Disease: 2nd Edition”. This is the second edition; we published nine papers in the first. For more details, please visit https://www.mdpi.com/journal/jcm/special_issues/L5BUF7U0OF.

Shoulder and elbow diseases include 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 include 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 to enable improved function and reduced pain in patients suffering from shoulder and elbow disease. Rehabilitation plays a crucial role in achieving this. An individual rehabilitation plan must follow international guidelines and requires a multidisciplinary and interdisciplinary team, including expert physiotherapists and physiatrists in shoulder and elbow pathologies and their rehabilitation, to enable its full operation.

The primary topics of this Special Issue include diagnosis, treatment, and rehabilitative relapses in shoulder and elbow disease. We look forward to your participation in this Special Issue, which will provide a platform for sharing knowledge with the scientific community, with the ultimate goal of positively influencing the treatment and care of 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 250 words) can be sent to the Editorial Office for assessment.

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
  • rehabilitative relapses

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Related Special Issue

Published Papers (4 papers)

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Research

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9 pages, 1019 KB  
Article
Scapular Morphometry Informs Suprascapular Nerve Injury Risk During Reverse Shoulder Arthroplasty: A Cadaveric Study
by Dave Osinachukwu Duru, Salma Chaudhury, Niel Kang and Cecilia Brassett
J. Clin. Med. 2026, 15(5), 1927; https://doi.org/10.3390/jcm15051927 - 3 Mar 2026
Viewed by 355
Abstract
Background: Reverse shoulder arthroplasty (RSA) relies on secure baseplate fixation to the glenoid. This carries a risk of suprascapular nerve (SSN) injury during peripheral screw insertion. Although fixed safe zones have been described, it remains unclear whether these scale with scapular morphometry [...] Read more.
Background: Reverse shoulder arthroplasty (RSA) relies on secure baseplate fixation to the glenoid. This carries a risk of suprascapular nerve (SSN) injury during peripheral screw insertion. Although fixed safe zones have been described, it remains unclear whether these scale with scapular morphometry or whether common screw positions confer differential SSN risk. Methods: Twenty cadaveric shoulders (ten pairs) were dissected. The superior safe zone (distance from the supraglenoid tubercle to SSN at the suprascapular notch) and posterior safe zone (distance from the glenoid rim to SSN at the spinoglenoid notch) were measured. Scapular dimensions (height, spine length, width) were measured. In ten shoulders, simulated RSA baseplate fixation was performed with superior screws placed at 11, 12, or 1 o’clock and posterior screws at 8, 9, or 10 o’clock. Screw lengths were based on glenoid depth. Cortical breach and SSN proximity were recorded. Linear regression assessed relationships between scapular dimensions and safe zones. Results: The superior safe zone (mean 2.9 ± 0.5 cm) significantly correlated with scapular dimensions (r = 0.78–0.86; p < 0.0001). All superior screws remained intraosseous across configurations. The posterior safe zone (1.9 ± 0.6 cm) showed no correlation. Posterior cortical breach occurred in 50% of specimens across all tested positions and was associated with smaller scapular spine length (p = 0.027). No significant difference in SSN proximity was observed between posterior screw positions. Conclusions: Scapular dimensions predict the superior, but not posterior, safe zone. Scapulae with shorter spine lengths demonstrated increased risk of posterior cortical breach, independent of screw position. These findings establish anatomical scalability of the superior safe zone and suggest that scapular morphometry may inform preoperative RSA planning; however, prospective validation is needed before routine clinical implementation. Full article
(This article belongs to the Special Issue Targeted Diagnosis and Treatment of Shoulder and Elbow Disease: 2nd Edition)
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34 pages, 5362 KB  
Article
Radial Extracorporeal Shock Wave Therapy Versus Multimodal Physical Therapy in Non-Traumatic (Degenerative) Rotator Cuff Tendinopathy with Partial Supraspinatus Tear: A Randomized Controlled Trial
by Zheng Wang, Lan Tang, Ni Wang, Lihua Huang, Christoph Schmitz, Jun Zhou, Yingjie Zhao, Kang Chen and Yanhong Ma
J. Clin. Med. 2026, 15(2), 471; https://doi.org/10.3390/jcm15020471 - 7 Jan 2026
Viewed by 1787
Abstract
Background/Objectives: Non-traumatic (degenerative) rotator cuff tendinopathy with partial supraspinatus tear (NT-RCTT) is a common source of shoulder pain and disability. Comparative evidence between radial extracorporeal shock wave therapy (rESWT) and multimodal physical therapy modalities (PTMs) remains scarce. Methods: In this single-center randomized controlled [...] Read more.
Background/Objectives: Non-traumatic (degenerative) rotator cuff tendinopathy with partial supraspinatus tear (NT-RCTT) is a common source of shoulder pain and disability. Comparative evidence between radial extracorporeal shock wave therapy (rESWT) and multimodal physical therapy modalities (PTMs) remains scarce. Methods: In this single-center randomized controlled trial, 60 adults with MRI-confirmed NT-RCTT were assigned (1:1) to rESWT (one session weekly for six weeks; 2000 impulses per session, 2 bar air pressure, positive energy flux density 0.08 mJ/mm2; 8 impulses per second) or a multimodal PTM program (interferential current, shortwave diathermy and magnetothermal therapy; five sessions weekly for six weeks). All participants performed standardized home exercises. The primary outcome was the American Shoulder and Elbow Surgeons (ASES) total score; secondary outcomes included pain (visual analog scale, VAS), satisfaction, range of motion (ROM), supraspinatus tendon (ST) thickness and acromiohumeral distance (AHD). Assessments were conducted at baseline, and at week 6 (W6) and week 12 (W12) post-baseline. Results: Both interventions significantly improved all outcomes, but rESWT produced greater and faster effects. Mean ASES total scores increased by 31 ± 5 points with rESWT versus 26 ± 6 with PTMs (p < 0.05). VAS pain decreased from 5.2 ± 0.7 to 1.0 ± 0.7 with rESWT and from 5.2 ± 0.8 to 1.7 ± 0.8 with PTMs (p < 0.01). rESWT achieved higher satisfaction and larger gains in abduction, flexion and external rotation. Ultrasound showed reduced ST thickness and increased AHD after rESWT but not after PTMs. No serious adverse events occurred. Conclusions: rESWT yielded superior pain relief, functional recovery and tendon remodeling compared with a multimodal PTM program, with markedly lower treatment time and excellent tolerability. Full article
(This article belongs to the Special Issue Targeted Diagnosis and Treatment of Shoulder and Elbow Disease: 2nd Edition)
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Review

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23 pages, 612 KB  
Review
The Role of Early and Delayed Surgery in Return to Sport After Anterior Shoulder Dislocation—A Scoping Review
by Martin Ingvardsen Vemmelund and Sten Rasmussen
J. Clin. Med. 2025, 14(19), 7045; https://doi.org/10.3390/jcm14197045 - 5 Oct 2025
Viewed by 2844
Abstract
Background: Anterior shoulder dislocations are common in athletes, particularly in contact sports. Surgical stabilization reduces recurrence, but the optimal timing—early versus delayed—remains uncertain, especially for in-season athletes. Methods: A systematic search of PubMed, Embase, and Cochrane (2013–2023) yielded 945 articles; 15 [...] Read more.
Background: Anterior shoulder dislocations are common in athletes, particularly in contact sports. Surgical stabilization reduces recurrence, but the optimal timing—early versus delayed—remains uncertain, especially for in-season athletes. Methods: A systematic search of PubMed, Embase, and Cochrane (2013–2023) yielded 945 articles; 15 met the inclusion criteria. Data were charted on procedure type, outcomes, follow-up, patient group, and timing of surgery. Search terms, e.g., ‘shoulder’, ‘athlete’, ‘anterior’ and ‘shoulder dislocation’, were used in a broad search protocol casting a wide net to maximize the likelihood of capturing all available data. Results: Surgery was superior to conservative care in lowering recurrence and enabling return-to-play, with arthroscopic and combined procedures most effective in high-contact sports. Conservative management carried higher instability risk. Evidence directly comparing early versus delayed surgery was scarce, and therefore inconclusive. Conclusions: Surgical stabilization remains the treatment with better outcomes compared to conservative treatment for young athletes. Still, athletes opt to delay surgery until postseason, with the impact of delaying surgery being unclear. Further research is needed to evaluate early versus delayed surgery regarding recurrence, joint damage, and return to sport. Full article
(This article belongs to the Special Issue Targeted Diagnosis and Treatment of Shoulder and Elbow Disease: 2nd Edition)
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Other

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12 pages, 2145 KB  
Systematic Review
Differentiating Outcomes and Complications Between Extraplexal Tendon Transfers and Arthrodesis for Shoulder Reanimation Following Traumatic Brachial Plexus Injury: A Systematic Review and Proportional Meta-Analysis
by Bradley J. Lauck, Jackson M. Cathey, Julian Mobley, Joshua K. Kim, Eoghan T. Hurley, Bryan S. Crook, Eliana B. Saltzman and Neill Y. Li
J. Clin. Med. 2025, 14(22), 7911; https://doi.org/10.3390/jcm14227911 - 7 Nov 2025
Viewed by 662
Abstract
Background: Glenohumeral arthrodesis (GHA) and extraplexal tendon transfers (TT) have been described as options for secondary shoulder stabilization and reanimation following adult traumatic brachial plexus injury (BPI) with delayed presentation or failure of primary nerve reinnervation. This study aimed to evaluate the outcomes [...] Read more.
Background: Glenohumeral arthrodesis (GHA) and extraplexal tendon transfers (TT) have been described as options for secondary shoulder stabilization and reanimation following adult traumatic brachial plexus injury (BPI) with delayed presentation or failure of primary nerve reinnervation. This study aimed to evaluate the outcomes and complication profiles of these two approaches to shoulder reanimation to better understand the indications, anticipated outcomes, and complication risks of each for traumatic brachial plexus injury. Methods: A systematic search of six databases (PubMed, EMBASE, SCOPUS, CINAHL, SPORTDiscus, Cochrane Library) was conducted in March 2025 following PRISMA guidelines. Studies reporting clinical outcomes in adults undergoing GHA or TT for traumatic BPI were included. Pooled mean range of motion and proportional complication and reoperation rates were calculated using random- and fixed-effects models, as appropriate. Results: A total of 22 studies involving 269 TT procedures and 194 GHA procedures were analyzed. Mean shoulder abduction was 81° (95% CI 54–108°) in the TT group and 51° (95% CI 37–65°) in the GHA group. Mean forward flexion was 88° (95% CI 51–124°) in the TT group and 56° (95% CI 44–68°) in the GHA group. The pooled complication rate was 4.8% (95% CI 2.6–8.6%) after TT and 26.4% (95% CI 18.5–36.1%) after GHA. The pooled reoperation rate was 3.2% (95% CI 1.5–6.6%) after TT and 17% (95% CI 10.8–25.7%) after GHA. Notably, TT cohorts generally had shorter follow-up durations, which may underrepresent late complications or reoperations. Conclusions: TT results in significantly lower complication and reoperation rates and demonstrates similar range-of-motion outcomes compared to GHA, suggesting that TT can be considered a first-line salvage option for motion preservation, while GHA remains an option for persistent instability, pain, or inability to achieve functional positioning of the hand in patients with traumatic BPIs. Additional comparative studies with higher levels of evidence are warranted to validate these findings. Full article
(This article belongs to the Special Issue Targeted Diagnosis and Treatment of Shoulder and Elbow Disease: 2nd Edition)
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