Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Apr 2020
Three-dimensional characterization of trabecular bone mineral density of the proximal ulna using quantitative computed tomography.
Although previous studies have measured general proximal forearm bone mineral density (BMD), no study has systematically mapped the 3-dimensional trabecular BMD of the proximal ulna. The aim of this study was to describe the 3-dimensional distribution of the trabecular bone density of the proximal ulna. We hypothesize a variable distribution of proximal ulna trabecular BMD depending on the region of interest (ROI). ⋯ Hardware in fixation constructs for proximal ulnar fractures should be directed toward ROIs with the highest BMD to maximize purchase. Hardware should approach the ulnohumeral joint without penetrating the joint to capture trabecular bone with the highest BMD. The most important fixation in such a construct will be that which captures trabecular bone with maximum BMD proximal to the trochlear notch (eg, the tip of the olecranon).
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J Shoulder Elbow Surg · Apr 2020
Diversity among academic orthopedic shoulder and elbow surgery faculty in the United States.
The purpose of this study was to perform a cross-sectional analysis of diversity among academic shoulder and elbow surgeons in the United States. ⋯ Racial and gender diversity among US shoulder and elbow surgeons who participate in fellowship and residency education is lacking. Hispanic, African American, and female surgeons are underrepresented. Efforts should be made to identify the reasons for these deficiencies and address them to further advance the field of orthopedic shoulder and elbow surgery.
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J Shoulder Elbow Surg · Apr 2020
Randomized Controlled TrialThe presence of Cutibacterium acnes on the skin of the shoulder after the use of benzoyl peroxide: a placebo-controlled, double-blinded, randomized trial.
We hypothesized that benzoyl peroxide (BPO) would reduce the presence of Cutibacterium acnes on the skin of the shoulder by 50% compared with placebo. Infections after shoulder surgery are most commonly caused by C acnes. Current prophylactic methods do not effectively reduce the bacterial load of this bacterium. However, it seems that BPO may reduce C acnes on the skin of the shoulder. Therefore, this study aimed to investigate the effect of BPO on the presence of C acnes on the shoulder skin. ⋯ Applying BPO 5 times on the shoulder skin effectively reduces C acnes. Consequently, BPO may reduce the risk of postoperative infections.
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J Shoulder Elbow Surg · Apr 2020
Multicenter StudySurgical outcomes in the Frequency, Etiology, Direction, and Severity (FEDS) classification system for shoulder instability.
The Frequency, Etiology, Direction, and Severity (FEDS) system was developed as a simple but reliable method for classifying shoulder instability based on 4 factors attainable by history and physical examination: frequency (solitary, occasional, or frequent); etiology (traumatic or atraumatic); direction (anterior, posterior, or inferior); and severity (subluxation or dislocation). This study investigated the epidemiology and 2-year surgical outcomes for the FEDS categories in the prospective Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Instability cohort. ⋯ Different FEDS categories showed varying degrees of improvement and failure rates, indicating that the system can be used to provide prognostic insight for presurgical education. Overall, outcomes decreased with a higher number of preoperative dislocations.
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J Shoulder Elbow Surg · Apr 2020
Industry payments to authors of Journal of Shoulder and Elbow Surgery shoulder arthroplasty manuscripts are accurately disclosed by most authors and are not significantly associated with better reported treatment outcomes.
Author transparency in disclosing potential conflicts of interest when reporting outcomes for shoulder arthroplasty implants is important. Using the Centers for Medicare & Medicaid Services Open Payments Program (OPP) database, we analyzed articles in the Journal of Shoulder and Elbow Surgery to evaluate (1) discrepancies between the stated conflicts of interest and associated payments recorded in the database, (2) the magnitude and types of payments received, and (3) possible relationships between industry financial support and positive study outcomes. ⋯ The majority of author disclosure statements accurately reflected the OPP data. Payments were not significantly associated with positive outcomes reported for the specific implant.