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Prior studies have demonstrated that conservatively treated rotator cuff tears and rotator cuff tendinopathy may continue to progress. It is unclear whether that rate of progression differs between sides in patients with bilateral disease. This study evaluated the likelihood of progression of rotator cuff disease as confirmed via magnetic resonance imaging (MRI) in individuals with symptomatic bilateral pathology, treated conservatively for a minimum of 1 year.

Although nonoperative treatment is effective for degenerative rotator cuff tears (RCTs), it remains unclear whether the delay created by a trial of nonoperative treatment negatively influences the outcome of a subsequent surgical repair. In March 2020, the COVID-19 pandemic resulted in an involuntary delay in the surgical treatment of rotator cuff disease, creating a natural experiment. The purpose of this study was to evaluate the outcomes and healing of patients who underwent delayed surgical treatment of chronic degenerative RCTs as compared with the nondelayed surgical treatment of RCTs.

The purpose of this study was to determine the association between glenohumeral osteoarthritis (GHOA) and three-dimensional acromial and glenoid morphology.

Common genetic variants with small effect sizes have been associated with rotator cuff tearing although very few rare, highly penetrant variants have been identified. The purpose of this pilot study was to identify dominant coding variants that segregated with affected individuals in pedigrees at high risk for rotator cuff tears (RCTs). We hypothesize that rare variants contribute to symptomatic RCTs and that they can be identified in related cases with a full-thickness tear requiring surgical management.

Determining the presence of bacteria in the shoulder prior to shoulder arthroplasty can be challenging especially in the case of revision arthroplasty. An open biopsy provides an opportunity to obtain tissue samples with minimal patient morbidity. The purpose of this study was to characterize the diagnostic utility of an open shoulder biopsy.

The purpose of this study was to determine factors associated with early symptomatic acromial and scapular spine fractures in patients who underwent reverse total shoulder arthroplasty (RTSA).

Globally, reverse shoulder arthroplasty (RSA) has moved away from the Grammont design to modern prosthesis designs. The purpose of this 2-part study was to systematically review each of the most common complications of RSA, limiting each search to publications in 2010 or later. In this part (part I), we examined (1) scapular notching (SN), (2) periprosthetic infection (PJI), (3) mechanical failure (glenoid or humeral component), and (4) neurologic injury (NI).

Various surgical strategies have been used for the treatment of sternoclavicular joint instability with variable results. The purpose of this study was to report the clinical results of patients who underwent single-loop allograft reconstruction for sternoclavicular joint instability.

Persistent anterior shoulder pain is an under-reported complication after reverse total shoulder arthroplasty (RTSA). The purpose of this study was to determine the effectiveness of open conjoint tendon release in patients with anterior shoulder pain due to conjoint tendinitis after RTSA.

Revision reverse total shoulder arthroplasty (RTSA) reliably improves shoulder pain and function in patients with failed shoulder arthroplasty, although it can lead to significant postoperative complications. The purpose of this study was to determine the effect of postoperative complications on shoulder pain and function after revision RTSA.

The purpose of this study was to determine the clinical outcomes of arthroscopic labral repair for anteroinferior glenohumeral instability with the use of double-loaded suture anchors.

The purpose of this study was to determine the short-term outcomes for patients who underwent revision surgery for shoulder instability, including both revision arthroscopic repair and Latarjet.

Although surgical shoulder stabilization is a substantial cost nationally within the United States, little information exists to analyze this cost. The purpose of this study was to identify factors associated with variation in direct costs with the arthroscopic treatment of glenohumeral instability.

Shoulder arthroplasty has advanced considerably in recent decades, but the most recently published long-term outcomes continue to have unacceptably high failure rates, especially in young patients. However, there are several future frontiers that offer the promise of improved implant longevity and function including advances in surgical approach, such as subscapularis-sparing approaches and computer-assisted surgical planning; advances in humeral component fixation, such as stemless, short-stem, and convertible implants; advances in bearing surfaces, such as pyrocarbon, ceramic, and metal-on-metal; and advances in glenoid component geometry and fixation, such as augmented components, in-growth pegs, and inlay glenoid components.

One innovation to reduce glenoid loosening in total shoulder arthroplasty (TSA) is a large, central ingrowth peg. However, when bone ingrowth fails to occur, there is often increased bone loss surrounding the central peg which may increase complexity of subsequent revisions. Our goal was to compare outcomes between central ingrowth pegs and non-ingrowth pegged glenoid components during revision to reverse total shoulder arthroplasty (RTSA).

Significant advancements have been made in the understanding of the natural history of symptomatic and asymptomatic rotator cuff (RC) tearing as well as the indications for their treatment. RC tears have a significant predilection toward tear enlargement. Risk factors for tear enlargement include the initiation of pain, higher degrees of muscle degeneration, older age, longer duration of follow-up, and increased tear severity (full-thickness vs. partial-thickness). It is still unclear if larger tear size (width) predisposes toward a higher risk for tear enlargement. Increased tear retraction appears to be associated with further retraction with a critical threshold of about 1 cm. The treatment of tears can be triaged based upon age, tear size, muscle quality, arthritic changes, and tear chronicity. Initial nonoperative treatment is reasonable for patients with tendonitis, partial-thickness RC tears, small full-thickness tears (<1 cm), chronic irreparable tears in any age group, and chronic tears of any size in older patients (>65 y). Early surgical repair is indicated for acute tears in any patient and larger (>1 cm) full-thickness chronic tears in younger (<65 y) patients. Further research is required to identify possible biologic and genetic markers for tear progression as well as healing to improve treatment indications.

Areas of current controversy concerning shoulder arthroplasty include management of glenoid bone loss, the role of patient-specific instrumentation, differing design features of reverse shoulder arthroplasty, and options for humeral fixation in primary and revision procedures. At the 2015 meeting of the American Academy of Orthopaedic Surgeons, shoulder arthroplasty specialists presented a symposium on these controversial topics. In each area, surgeons presented their case for a given position on these issues. This article is a summary of those proceedings.

Historically, imaging osseous detail in three dimensions required a computed tomography (CT) scan with ionizing radiation that poorly visualizes the soft tissues. The purpose of this study was to determine the accuracy and reliability of ultrashort echo time (UTE) magnetic resonance imaging (MRI) in measuring humeral cortical thickness and cancellous density as compared with CT.

The most common causes of adolescent elbow disorders are either secondary to overuse, most often associated with athletics, or trauma. In this review, we describe the most recent developments in treatment of several of these disorders.

Globally, reverse shoulder arthroplasty (RSA) has moved away from the Grammont design to modern prosthesis designs. The purpose of this study was to provide a focused, updated systematic review for each of the most common complications of RSA by limiting each search to publications after 2010. In this part II, the following were examined: (1) instability, (2) humerus/glenoid fracture, (3) acromial/scapular spine fractures (AF/SSF), and (4) problems/miscellaneous.

The purpose of this study was to determine whether greater tuberosity morphology (1) could be measured reliably on magnetic resonance imaging (MRI), (2) differed between patients with rotator cuff tears (RCT) compared to those without tears or glenohumeral osteoarthritis, or (3) differed between patients with rotator cuff repairs (RCR) that healed and those that did not.

Diabetes mellitus (DM) may be associated with the etiology of rotator cuff disease; however, its effect on healing after surgical rotator cuff repair (RCR) is not well characterized. The purposes of this study are to analyze the association between DM and surgical RCR, the association between DM and revision RCR after RCR, and the association between DM and the cost of RCR.

The etiologies of glenohumeral osteoarthritis (GHOA) and eccentric glenoid wear within GHOA are unknown, but muscular imbalance may play a role. The purpose of the present study was to determine the relationship between deltoid muscle area, GHOA, and eccentric glenoid wear. We hypothesized that patients with GHOA would have overall deltoid atrophy as compared with controls and that increasing posterior deltoid areas would associate with glenoid retroversion in the Walch B-type (eccentric) GHOA group.