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Background: Reverse shoulder arthroplasty (RSA) is an established operative treatment for failed rotator cuff repair (RCR) that may not be amenable to revision repair. The purpose of this meta-analysis is to evaluate the clinical outcomes for patients undergoing RSA following prior failed RCR compared with patients without prior RCR undergoing primary RSA. Methods: A systematic search of articles in Pubmed, EMBASE and The Cochrane Library databases was carried out according to PRISMA guidelines. Comparative studies assessing outcomes of RSA after failed RCR versus primary RSA were included. Results: Seven studies with 2149 total patients were included; 760 patients had a prior RCR and 1389 patients did not have a prior RCR. Prior failed RCR resulted in significantly lower postoperative ASES scores (mean difference [MD], −8.31 95% confidence interval [CI] −10.96, −5.66), less forward flexion (MD, −6.71 95%CI −11.75, −1.67), and higher VAS pain scores (MD; 0.85, 95% CI 0.47, 1.22) when compared to primary RSA. There were no significant differences in external rotation, complications rate, or rate of revision. Conclusion: This study found that failed RCR prior to RSA was associated with lower functional outcomes scores, higher pain scores, and worse range of motion compared to primary RSA without prior RCR. [ABSTRACT FROM AUTHOR]

It has been reported that use of the Latarjet procedure for anterior shoulder instability increased 250% from 2008 to 2019. With this increase in use, it is imperative to minimize complications. At present, most literature focuses on male patients, with scant evidence regarding female patients. Outcomes are similar when female with male patients are compared, but female patients have greater postoperative visits to the emergency department than male patients, which requires specific attention during the postoperative period. In addition, the literature reporting complications in female versus male patients after Latarjet is conflicting; some studies show similar rates of complications, whereas other studies show greater rates of adverse events in female patients. Previous consensus statements recommended (1) careful dissection; (2) identification of the musculocutaneous and axillary nerves; (3) prevention of overlateralization of the graft; (4) the use of tranexamic acid to reduce blood loss; (5) accurate screw placement; and (6) careful preparation of the glenoid neck and coracoid to reduce rates of nonunion or delayed union. [ABSTRACT FROM AUTHOR]

Superior labral tears are common shoulder injuries among athletes, and for athletes undergoing surgical intervention, one of the main priorities is to return to preinjury levels of activity in a timely manner. However, the literature surrounding return to play after superior labral repair presents inconsistent results, with limited studies evaluating the timing of return to play.To systematically review the rate and timing of return to play in athletes after arthroscopic superior labral repair.Systematic review; Level of evidence, 4.A systematic literature search was conducted based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, using the PubMed, EMBASE, and Cochrane Library databases. Eligible for inclusion were clinical studies reporting on return to play after arthroscopic superior labral repair. Subgroup analysis was conducted for overhead and collision athletes as well as for return to duty among military personnel. Meta-analysis was performed using Review Manager to compare superior labral repair to biceps tenodesis in the subset of studies comparing these treatments directly. A P value <.05 was considered to be statistically significant.This review identified 42 studies including 1759 unique cases meeting the inclusion criteria. The majority of patients were male (76.7%), with a mean age of 31.5 years (range, 15-75 years) and a mean follow-up of 50.4 months. The overall rate of return to sport was 77.5%, with 68.2% returning to the same level at a mean of 8.2 months. In overhead athletes, the overall rate of return to play was 69.9% and the rate of return to preinjury level was 55.5%. In collision and contact athletes, the overall rate of return to play was 77.2% and the rate of return to preinjury level was 70.2%. Among military personnel, the overall rate of return to duty was 83.4%, and 81.7% returned to preinjury level at a mean of 4.4 months. In the studies comparing return to play after superior labral repair and biceps tenodesis, a nonsignificant difference was found (risk ratio, 0.92; 95% CI, 0.85-1.00; I2 = 13%; P = .05).Overall, nearly a quarter of athletes were unable to return to play after arthroscopic superior labral repair. However, a high rate of return to duty was found among the military population treated with arthroscopic superior labral repair. [ABSTRACT FROM AUTHOR]

Purpose: To compare arthroscopic Bankart repair versus the open Latarjet procedure at a minimum of 10-year follow-up evaluating recurrence and arthropathy development rates., Methods: A systematic review was performed in concordance with PRISMA guidelines. Studies were included if they reported on the arthroscopic Bankart repair or open Latarjet procedure with a minimum of 10-year follow-up. Recurrent instability, revisions, and instability arthropathy were evaluated., Results: Overall, 40 studies met our criteria and were included with 2019 shoulders undergoing ABR, and 1069 undergoing the open Latarjet procedure. The rate of recurrent instability was 0.0%-22.6% (redislocations: 0.0%-9.6%) in those undergoing an open Latarjet procedure and 13.3%-82.2% (redislocations: 9.6%-25.7%) among those undergoing arthroscopic Bankart repair. The rate of total revisions was 0.0%-17.9% in those undergoing an open Latarjet procedure and 4.8%-42.9% among those undergoing arthroscopic Bankart repair. The rate of overall arthritis was 10.3%-71.4% in those undergoing an open Latarjet procedure and 16.7%-89.3% among those undergoing arthroscopic Bankart repair., Conclusion: There was a lower recurrent instability rate and revision rate in the open Latarjet group compared to the arthroscopic Bankart group at long-term follow-up. The rates of moderate-severe arthritis were comparable between the two procedures., Level of Evidence: Level IV: Systematic review of Level I-IV studies., (Copyright © 2025. Published by Elsevier Inc.)

Background: Surgeons often use abduction pillows after reverse total shoulder arthroplasty (rTSA), but evidence for their benefits is limited. This study compares outcomes for patients using a sling with or without an abduction pillow post-operatively., Methods: A retrospective review was conducted on patients undergoing primary rTSA. Patients were grouped based on post-operative use of an abduction pillow or not. Data was collected at 6 weeks, 3 months, 6 months, 1 year, and final follow-up. Primary outcomes included rates of post-operative dislocation, range of motion, and patient-reported outcomes., Results: Patients using an abduction pillow showed reduced forward flexion at 3 months (120° vs. 139°, p = 0.002) and 6 months (135° vs. 147°, p = 0.049). At 6 weeks, abduction was lower in the pillow group (90° vs. 124°, p = 0.01). There were no significant differences in other range-of-motion metrics or patient-reported outcomes. Using no pillow did not increase dislocation risk (OR: 1.67, p = 0.60), infection, readmission, revision, or repeat surgery rates., Conclusions: Post-operative sling use without an abduction pillow after rTSA appears safe, with no increase in complications and similar patient satisfaction and outcomes., Level of Evidence: Therapeutic Level III., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)