Relationship between subscapularis tears and injuries to the biceps pulley

The purpose of this study was to analyse the relationship between long head of the biceps brachii (LHBT) lesions and subscapularis tears. The hypothesis was that a bicipital pulley might remain intact, even in the case of a subscapularis tear

Transtendon, Double-Row, Transosseous-Equivalent Arthroscopic Repair of Partial-Thickness, Articular-Surface Rotator Cuff Tears

Arthroscopic transtendinous techniques for the arthroscopic repair of partial-thickness, articular-surface rotator cuff tears offer the advantage of minimizing the disruption of the patient's remaining rotator cuff tendon fibers. In addition, double-row fixation of full-thickness rotator cuff tears has shown biomechanical advantages. We present a novel method combining these 2 techniques for transtendon, double-row, transosseous-equivalent arthroscopic repair of partial-thickness, articular-surface rotator cuff tears. Direct visualization of the reduction of the retracted articular tendon layer to its insertion on the greater tuberosity is the key to the procedure. Linking the medial-row anchors and using a double-row construct provide a stable repair that allows early shoulder motion to minimize the risk of postoperative stiffness

Long Head of the Biceps Tendon Allis Clamp Evaluation Technique

Disorders of the long head of the biceps brachii are a common finding in conjunction with other causes of shoulder pathology. Nonoperative means as first-line treatment are often successful; however, surgery can be indicated for refractory tendinopathy. There is debate as to the best surgical treatment of the long head of the biceps tendon (LHBT) with different types of arthroscopic and open techniques. The decision on what treatment option to perform is often made at the time of surgery after arthroscopic evaluation of the LHBT. Certain examples of tendon disease are easily visible intra-articularly; however, a large portion of the tendon is not intra-articular and not readily viewed during routine arthroscopy. This study describes a simple arthroscopic technique for evaluation of an increased portion of the LHBT using an Allis clamp. The clamp is inserted through the anterior portal, placed around the LHBT, and rotated such that the tendon is wrapped around itself, bringing the distal tendon into the joint for arthroscopic viewing. This procedure is a routine part of our assessment of the LHBT during arthroscopy

Arthroscopic Tissue Culture for the Evaluation of Periprosthetic Shoulder Infection

Background: Periprosthetic shoulder infections can be difficult to diagnose. The purpose of this study was to investigat

Current concepts in locking plate fixation of proximal humerus fractures

Despite numerous available treatment strategies, the management of complex proximal humeral fractures remains demanding. Impaired bone quality and considerable comorbidities pose special challenges in the growing aging population. Complications after operative treatment are frequent, in particular loss of reduction with varus malalignment and subsequent screw cutout. Locking plate fixation has become a standard in stabilizing these fractures, but surgical revision rates of up to 25% stagnate at high levels. Therefore, it seems of utmost importance to select the right treatment for the right patient. This article provides an overview of available classification systems, indications for operative treatment, important pathoanatomic principles, and latest surgical strategies in locking plate fixation. The importance of correct reduction of the medial cortices, the use of calcar screws, augmentation with bone cement, double-plate fixation, and auxiliary intramedullary bone graft stabilization are discussed in detail