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New Trends in Shoulder Arthroscopy and Arthroplasty Techniques

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

Deadline for manuscript submissions: closed (30 September 2024) | Viewed by 6824

Special Issue Editor


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Guest Editor
1. Schulterzentrum, Wien, Vienna, Austria
2. Healthpi Medical Center, Vienna, Austria
3. AURROM - Austria Research Group for Regenerative and Orthopedic Medicine, Vienna, Austria
Interests: double-layer rotator cuff repair; labral reconstruction; tendon-to-bone healing; biologic augmentation; stem-cell therapy; non-operative treatment; frozen shoulder; shoulder pacemaker; shoulder instability

Special Issue Information

Dear Colleagues,

Some challenges in arthroplasty present at the turn of the millennium are no longer an issue. Techniques, knowledge of anatomy and materials have evolved so quickly that arthroscopy is now the gold standard for the treatment of most shoulder pathologies; even partial resurfacing can be done. For joint replacements, the reconstruction of anatomical biomechanics and rapid recovery are possible. In rotator cuff repair with exact reconstruction of the anatomy, the healing biology is now the bottleneck, which is challenging to improve. In shoulder instability, the trend for early coracoid transfer is now changing, as stable anatomic reconstruction of the labrum shows results as favorable as those obtained in open repair, with faster rehabilitation.

It would be an honor to publish your up-to-date research regarding accelerated rehabilitation, improved tendon-to-bone healing, new techniques in instability and rotator cuff repair as well as improvements in shoulder arthroplasty. The goal should now be to maintain the patient’s own joint as long as possible—reconstruction before replacement!

Dr. Philipp R. Heuberer
Guest Editor

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Keywords

  • shoulder arthroscopy
  • rotator cuff tear
  • delamination
  • double layer repair
  • shoulder instability
  • shoulder osteoarthritis
  • total shoulder replacement
  • accelerated rehabilitation
  • stem-cell therapy
  • biologic augmentation

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Published Papers (4 papers)

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Research

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10 pages, 4854 KiB  
Article
Biological Patch in the Repair of Rotator Cuff Tears: Functional and Clinical Evaluation of Twenty-Three Cases with a Mean Follow-Up of Six Years
by Nicolò Nuvoli, Elisa Troiano, Azzurra Masini, Giovanni Battista Colasanti, Nicola Mondanelli and Stefano Giannotti
J. Clin. Med. 2024, 13(18), 5596; https://doi.org/10.3390/jcm13185596 - 20 Sep 2024
Cited by 1 | Viewed by 1400
Abstract
Background: Rotator cuff (RC) repair leads to less than optimal results when dealing with massive lesions, so the use of scaffolds as biological support has been proposed to improve RC repair site biology. The present study aims to evaluate the clinical and radiographical [...] Read more.
Background: Rotator cuff (RC) repair leads to less than optimal results when dealing with massive lesions, so the use of scaffolds as biological support has been proposed to improve RC repair site biology. The present study aims to evaluate the clinical and radiographical outcomes of a series of patients suffering from massive or irreparable RC tears treated with patch (porcine or human scaffolds) repair (augmentation or bridging). Methods: Twenty-three patients with a minimum follow-up of 24 months were subjectively, clinically, and radiographically assessed before and after surgery. Three different patient-related outcome measurements (PROMs) (American Shoulder and Elbow Surgeons score, Constant score, visual analog scale) were used for the subjective and clinical evaluation, while plain radiographs and magnetic resonance imaging where employed for radiographical follow-up. Results: Regardless of the technique (augmentation or bridging) or type of scaffold (porcine or human) employed, at follow-up, all patients experienced a statistically significant improvement in all PROMs and clinically. Conclusions: Patch repair represents a valid salvage procedure in massive or irreparable RC tears, improving the quality of life and eventually delaying the need for prosthetic replacement. Full article
(This article belongs to the Special Issue New Trends in Shoulder Arthroscopy and Arthroplasty Techniques)
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11 pages, 1267 KiB  
Article
Computer-Assisted Navigation in Reverse Shoulder Arthroplasty: Surgical Experience and Clinical Outcomes
by Luca Andriollo, Silvia Pietramala, Alberto Polizzi, Giuseppe Niccoli, Guido Zattoni and Vincenzo Morea
J. Clin. Med. 2024, 13(9), 2512; https://doi.org/10.3390/jcm13092512 - 25 Apr 2024
Cited by 2 | Viewed by 1911
Abstract
Background: The primary cause of medium- to long-term complications in reverse shoulder arthroplasty (RSA) is the failure of the glenoid component. The purpose of this study was to evaluate both the achievement of planning through computer-assisted navigation and the clinical outcomes at a [...] Read more.
Background: The primary cause of medium- to long-term complications in reverse shoulder arthroplasty (RSA) is the failure of the glenoid component. The purpose of this study was to evaluate both the achievement of planning through computer-assisted navigation and the clinical outcomes at a minimum follow-up (FU) of 12 months. Methods: From December 2019 to December 2022, 57 Equinoxe RSAs with computer-assisted navigation were performed. The average age was 72.8 ± 6.6 years. Using the Orthoblue software, the version and inclination of the glenoid were evaluated from a preoperative CT scan, and planning was performed. Intraoperative navigation data were evaluated, and the clinical outcomes were assessed at a minimum follow-up of 12 months. Results: The average follow-up was 30.7 ± 13.5 months. The planning was reproduced in all implants. No errors in the computer-assisted navigation system were detected. No intraoperative or postoperative complications were recorded. At the final FU, the average active anterior elevation was 143° ± 36°, external rotation was 34° ± 5°, QuickDASH score was 19 ± 16 points, and constant score was 77 ± 18. Conclusions: Computer-assisted navigation is a reliable system for positioning prosthetic implants on challenging glenoids. A longer follow-up period is necessary to confirm the reduction in postoperative complications and the increase in survival compared to traditional RSA. Full article
(This article belongs to the Special Issue New Trends in Shoulder Arthroscopy and Arthroplasty Techniques)
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11 pages, 235 KiB  
Article
The Value of Computed Tomography-Based Planning in Shoulder Arthroplasty Compared to Intra-/Interobserver Reliability of X-ray Planning
by Martin Bischofreiter, Edanur Sacan, Michael Gattringer, Michael S. Gruber, Franziska L. Breulmann, Harald Kindermann, Philipp Heuberer, Georg Mattiassich and Reinhold Ortmaier
J. Clin. Med. 2024, 13(7), 2022; https://doi.org/10.3390/jcm13072022 - 30 Mar 2024
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Abstract
Background: Reversed total shoulder arthroplasty (RTSA) is an established surgery for many pathologies of the shoulder and the demand continues to rise with an aging population. Preoperative planning is mandatory to support the surgeon’s understanding of the patient’s individual anatomy and, therefore, [...] Read more.
Background: Reversed total shoulder arthroplasty (RTSA) is an established surgery for many pathologies of the shoulder and the demand continues to rise with an aging population. Preoperative planning is mandatory to support the surgeon’s understanding of the patient’s individual anatomy and, therefore, is crucial for the patient’s outcome. Methods: In this observational study, we identified 30 patients who underwent RTSA with two- and three-dimensional preoperative planning. Each patient underwent new two-dimensional planning from a medical student and an orthopedic resident as well as through a mid-volume and high-volume shoulder surgeon, which was repeated after a minimum of 4 weeks. The intra- and interobserver reliability was then analyzed and compared to the 3D planning and the implanted prosthesis. The evaluated parameters were the size of the pegged glenoid baseplate, glenosphere, and humeral short stem. Results: The inter-rater reliability showed higher deviations in all four raters compared to the 3D planning of the base plate, glenosphere, and shaft. The intra-rater reliability showed a better correlation in more experienced raters, especially in the planning of the shaft. Conclusions: Our study shows that 3D planning is more accurate than traditional planning on plain X-rays, despite experienced shoulder surgeons showing better results in 2D planning than inexperienced ones. Full article
(This article belongs to the Special Issue New Trends in Shoulder Arthroscopy and Arthroplasty Techniques)

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16 pages, 2771 KiB  
Systematic Review
Comparison of En Masse Repair versus Separate Double-Layer Repair for Delaminated Rotator Cuff Tears: A Systematic Review and Meta-Analysis
by Kyun-Ho Shin, Il-Tae Jang and Seung-Beom Han
J. Clin. Med. 2024, 13(5), 1393; https://doi.org/10.3390/jcm13051393 - 28 Feb 2024
Cited by 1 | Viewed by 1125
Abstract
Background: Delamination of cuff tendons has a negative impact on outcomes following arthroscopic rotator cuff repair (RCR). The purpose of this study is to compare en masse repair (EMR) and separate double-layer repair (SDLR) for delaminated rotator cuff tears. Methods: A systematic literature [...] Read more.
Background: Delamination of cuff tendons has a negative impact on outcomes following arthroscopic rotator cuff repair (RCR). The purpose of this study is to compare en masse repair (EMR) and separate double-layer repair (SDLR) for delaminated rotator cuff tears. Methods: A systematic literature search was conducted on major databases (MEDLINE/PubMed, EMBASE, Cochrane Library, and Scopus) until 1 June 2023. Comparative studies with a minimum 24-month follow-up of patients undergoing arthroscopic RCR for delaminated tears were included. The outcomes assessed retear rates and functional outcomes. Results: Five eligible studies involving 325 cases were analyzed. The meta-analysis showed no significant difference in retear rates between SDLR and EMR for delaminated tears (OR = 0.73, 95% CI: 0.35–1.49). However, the meta-analysis demonstrated a significant intergroup difference in favor of the SDLR for the total Constant score (SMD = 0.68, 95% CI: 0.35 to 1.02), SST score (SMD = 0.37, 95% CI: 0.02 to 0.71), and postoperative range of abduction (SMD = 0.34, 95% CI: 0.03 to 0.64). Conclusion: The evidence suggests that the SDLR in arthroscopic RCR for delaminated rotator cuff tears leads to improved short-term functional outcomes and range of motion compared to EMR. However, there is no significant difference in retear risk between the two approaches. Full article
(This article belongs to the Special Issue New Trends in Shoulder Arthroscopy and Arthroplasty Techniques)
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