JSES International国际肩肘外科杂志
JSES International(英文缩写 JSES INT),ISSN 2666-6383,eISSN 2666-6383,中文译名:国际肩肘外科杂志 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-10-01 至 2026-09-30，按本站收录文献的发表日期统计。
期刊介绍
JSES International 最新收录文献
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1. Anatomic feasibility of using Shark Screw tendon for humeral ligament re-construction in medial and posterolateral elbow instability.
PMID:日期:2026-08-28Medial and posterolateral rotational instability of the elbow, often resulting from collateral ligament insufficiency, can lead to pain and functional impairment. Surgical re-construction is indicated when conservative treatment fails, yet complications such as graft failure and donor-site morbidity persist. This study investigates the anatomic and biomechanical feasibility of the Shark Screw tendon as a representative human allogeneic bone screw for humeral ligament fixation in cases of elbow instability. Eight fresh-frozen cadaveric specimens were used to evaluate the feasibility of the use of a Shark Screw tendon for humeral fixation on both medial and lateral sides. Cyclic loading and failure testing were performed to assess time-zero fixation characteristics and failure load. A total of sixteen testing scenarios were conducted on the specimens. Implantation was technically feasible without anatomic limitations related to implant size or positioning. Six graft failures occurred (38%), all attributable to poor tissue quality. Tendon slippage was observed in 9 of 16 cases (56%) under progressively increasing axial load, while the Shark Screw tendon remained seated. The mean failure load was 101 N (±50) for medial insertions, 118 N (±77) for lateral insertions, and 110 N (±64) overall. After 100 cycles, tendon displacement averaged 1.1 mm (±0.4) during extension-flexion on the medial side, 1.0 mm (±1.0) on the lateral side, and 1.0 mm (±0.7) overall. During supination-pronation, displacement was 0.8 mm (±0.7) medially, 1.0 mm (±0.8) laterally, and 0.9 mm (±0.7) overall. No anchor pullout was observed, although one anchor tip fractured during insertion. The Shark Screw tendon appears to be a feasible biologically integrative alternative for humeral fixation in medial and posterolateral elbow ligament re-construction, demonstrating preliminary time-zero fixation characteristics in a cadaveric model. Further biomechanical and clinical studies are needed to confirm long-term outcomes.
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2. Antero-inferior glenohumeral instability is associated with an abnormal position of the coracoid process.
PMID:日期:2026-08-22The role of morphologic variation in the etiology of antero-inferior glenohumeral instability (GHAI) remains debated. Clinically, the coracoid process (CP) varies in size and position, and simple coracoid lowering ("Trillat procedure") can prevent recurrent anterior dislocation. Additionally in some cases, fracture of the coracoid is necessary for an anterior dislocation to occur. Therefore, the CP position relative to the glenoid center was compared in stable and unstable shoulders, hypothesizing that the CP tip is more superior, more medial, and more anterior in patients with recurrent GHAI than in those with stable shoulders or posterior glenohumeral instability (GHPI). Computed tomographic scans of shoulders of 60 patients with GHAI, age- and sex-matched to 30 shoulders of patients with GHPI and 13 unmatched individuals with healthy shoulders (control group) were semi-automatically segmented into three-dimensional models. All shoulders were scaled to uniform size, and left-sided cases were mirrored to the right side. A statistical shape model was created for each cohort, and anatomic landmarks were generated automatically. Models were aligned to the glenoid plane and center, and three-dimensional distances and angles were measured in both the original (absolute) models and the uniformly scaled models. With both measurement techniques, the CP in GHAI was more superior to that in CTRL (mean difference [MD] = 6.5 mm, = .001 absolute; MD = 6 mm, = .003 for scaled) and GHPI (MD = 2.4 mm, = .015 absolute; MD = 2.2 mm, = .021 scaled). The anterior coracoid coverage in GHAI was significantly lower than that in GHPI (MD = 3°, = .009) and in CTRL (MD = 9°, = .003). The lateral coracoid coverage in GHAI was lower than that in CTRL (MD = 13°, = .008). The posterior acromial coverage of GHPI was decreased compared with that in both GHAI (MD = 5°, = .006) and CTRL (MD = 5°, = .018). All differences reported here remained statistically significant after Benjamini-Hochberg correction. The position of the CP is more superior in patients with GHAI compared to GHPI and CTRL cohorts. Further research is needed to determine the biomechanical and clinical context in which a more superior CP position is associated with GHAI. Future studies should also determine whether, and under exactly which conditions, these morphologic findings should influence the surgical treatment decisions regarding recurrent anterior glenohumeral shoulder instability.
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3. Relationship between implant positioning and post-operative scapulohumeral rhythm following reverse total shoulder arthroplasty.
PMID:日期:2026-08-17Scapulohumeral rhythm (SHR) after reverse total shoulder arthroplasty (rTSA) is typically reduced, with shoulder elevation relying predominantly on scapulothoracic motion. Previous studies have shown that higher post-operative SHR is associated with improved shoulder elevation and superior patient-reported outcome measures. Therefore, despite the non-anatomic design of rTSA, achieving a favorable SHR is desirable. Although implant positioning is believed to influence post-operative shoulder kinematics, the specific implant-related factors contributing to improved SHR remain unclear. This study aimed to investigate the relationship between post-operative SHR and changes in humeral lateralization or distalization, as well as medialization or distalization of the center of rotation. Forty-six shoulders from 45 patients who underwent rTSA at a single institution and achieved more than 90° of humeral abduction were included. The cohort comprised 27 men and 18 women with a mean age of 75 years. Three implant configurations were used as follows: medialized glenoid-medialized humerus, medialized glenoid-lateralized humerus, and medialized glenoid-mildly lateralized humerus. At a mean of 14 months post-operatively, computed tomography and fluoroscopy were performed during active scapular plane abduction. Three-dimensional implant and scapular motions were analyzed using model-image registration. SHR was calculated from 20° to 90° of humeral abduction. Implant positioning parameters were measured from post-operative radiographs, and changes from pre-operative values were calculated. Correlations between SHR and each parameter were assessed using Pearson correlation coefficient. The mean SHR was 1.39 ± 0.64. A significant positive correlation was identified between post-operative SHR and the change in humeral distalization (r = 0.321, = .030). No significant correlations were observed between SHR and other implant positioning parameters. The increase in humeral distalization from the pre-operative to the post-operative state following rTSA showed a significant but weak positive correlation with post-operative SHR, whereas no other implant positioning parameters were significantly correlated with post-operative SHR.
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4. Navigation-recorded plan execution in augmented total shoulder arthroplasty using the Advita GPS system and implant platform.
PMID:日期:2026-08-15Computer-assisted navigation (CAN) is increasingly utilized in total shoulder arthroplasty (TSA), yet data validating its intra-operative agreement with pre-operative plans in glenoid deformities remain limited. This study evaluated the navigation-recorded execution of the pre-operative plan for glenoid entry point, version, and inclination in TSA treated with augmented glenoid components. In this retrospective database study, we analyzed pre-operative computed tomography and intra-operative navigation reports from 19,054 navigated TSAs performed by 871 surgeons using the Advita GPS system and implant platform. Cohorts were subdivided by glenoid retroversion (GRV) ≥15° or <15° and glenoid inclination ≥10° or <10°. Plan deviations were calculated from the navigation-recorded entry point and central drill trajectory, used as surrogates for the final implant position, and compared by deformity severity and augment sub-type. After excluding 189 cases (0.85%) with discontinued CAN, the cohort comprised 2,266 anatomic TSA (aTSA) and 16,788 reverse TSA (rTSA). In rTSA, GRV ≥15° showed marginally greater version deviation than GRV <15° although both groups remained approximately 0.3° from plan ( = .006). Entry-point deviations were statistically higher with GRV ≥15° and glenoid inclination ≥10° but remained approximately 1 mm across groups ( < .001 and = .009, respectively). Posterior augments demonstrated higher version deviation than superior augments although both remained below 1° ( < .001). In aTSA, no sub-group differences were identified. CAN showed close intra-operative agreement between the pre-operative plan and the navigation-recorded surrogate for the final implant position across augmented aTSA and rTSA irrespective of glenoid deformity severity. Statistically significant differences remained below thresholds of clinical relevance.
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5. Machine learning-based prediction of retear after arthroscopic rotator cuff repair: a multicenter cohort study.
PMID:日期:2026-08-14Rotator cuff retears following arthroscopic rotator cuff repair (ARCR) remain a critical clinical challenge, influenced by patient, tear, and rehabilitation factors. Conventional assessment methods struggle to capture this multifactorial complexity, limiting accurate retear prediction and personalized management. The purpose of this study was to develop a machine learning-based predictive model to stratify the risk of structural retear at 6 months post-operatively. This study analyzed 1,428 patients with complete datasets from an initial cohort of 3,090 patients who underwent ARCR between January 2011 and May 2024 across four centers. A total of 79 clinical variables were collected, including patient demographics, tear size, range of motion, muscle strength, and pain and functional scores at baseline and at 2-4 months post-operatively. Retear was defined as Sugaya classification type IV or V on standardized 6-month post-operative magnetic resonance imaging. Five machine learning models (Logistic Regression, k-Nearest Neighbors, Support Vector Machine, Convolutional Neural Network, and Multi-Layer Perceptron; [MLP]) were evaluated for retear prediction. Model performance was evaluated using accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve. The MLP model showed the most favorable numerical performance among the evaluated models, with a retear-class F1-score of 0.76 and precision of 0.92 under a random 80:20 split, and the largest area under the receiver operating characteristic curve among the models tested. However, under temporal validation the retear-class F1-score fell to 0.30, indicating limited generalizability over time. The MLP model demonstrated potential for stratifying the risk of magnetic resonance imaging-defined 6-month structural retear after ARCR and may serve as an adjunctive tool for early post-operative risk stratification. Because it relies on post-operative predictors and has been evaluated only within a single hospital network, external validation is required before clinical use.
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6. Rise in radial head arthroplasty utilization in young patients: an analysis of the Nationwide Ambulatory Surgery Sample.
PMID:日期:2026-08-14Utilization of radial head arthroplasty (RHA) has increased in recent years, but national age-specific trends in ambulatory RHA use in the United States have not been described. The purpose of this study was to evaluate national trends in ambulatory RHA by age. The Nationwide Ambulatory Surgery Sample (2016-2022) was used to identify adults (≥20 years) undergoing ambulatory RHA for isolated acute radial head or neck fractures. Patients were stratified by age (20-39, 40-59, and ≥60 years). Descriptive statistics and sample-weighted regression models were used to assess temporal trends and factors associated with younger age at surgery. Age- and sex-adjusted national incidence rates were calculated using negative binomial regression. A weighted total of 13,453 patients were identified, of which 20.3% were young (20-39 years), 35.9% middle-aged (40-59 years), and 43.9% elderly (≥60 years). Annual ambulatory RHA volume increased from 1,657 cases in 2016 to 2,289 cases in 2022 (+38.1%). The greatest relative increase occurred in young patients (+58.2%), compared with elderly (+47.0%) and middle-aged (+19.5%) patients. Age- and sex-adjusted incidence increased significantly in young patients (0.45 to 0.54 per 100,000; incidence rate ratio: 1.21; 95% confidence interval (CI): 1.05-1.39; = .009) but stayed stable in elderly patients. Young patients undergoing RHA were more likely to be male (female odds ratio (OR): 0.32; 95% CI: 0.28-0.35; < .001), have lower household income (highest vs. lowest quartile OR: 0.54; 95% CI: 0.45-0.64; < .001), and be treated at urban teaching hospitals (OR: 1.49; 95% CI: 1.29-1.72; < .001) and in the Western region (OR: 1.28; 95% CI: 1.09-1.49; = .003). Overall ambulatory RHA utilization in the United States increased from 2016 to 2022, most significantly in young adults. These findings demonstrate increasing ambulatory utilization of RHA among young adults and highlight the need for longitudinal studies evaluating implant durability, revision risk, and functional outcomes in this population. Whether this trend reflects changes in treatment patterns, referral practices, outpatient migration, or other factors also warrants further investigation.
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7. Corrective osteotomies of malunited proximal humerus fractures with 3D patient-specific guides: a feasibility study.
PMID:日期:2026-08-14Corrective osteotomies for malunions after proximal humerus fractures are reserved for selected cases. These procedures are technically demanding, and surgical planning based on two-dimensional imaging, with free-hand operative correction, may lead to surgical inaccuracy. Three-dimensional (3D) pre-operative planning combined with patient-specific surgical guides and surgical simulation can overcome this issue. This study introduces 3D patient-specific guides for corrective osteotomies in proximal humeral malunions and determines the accuracy of achieved correction in human cadaveric shoulders with 2 innovative surgical techniques. Seven reversed corrective osteotomies were planned and performed on 4 Thiel-embalmed human specimens using 7 different respective 3D patient-specific cutting and reduction guides. Computed tomography scans were used to create 3D segmentations of all specimens. Subsequently, virtual surgical plans of osteotomies were created, and 3D-printed patient-specific cutting and reposition guides were designed and produced. Three humeri underwent an "extracapsular" corrective osteotomy, and 4 humeri underwent correction using a novel "humeral head-tuberosity separation" technique. Accuracy was assessed for valgus angulation and rotation by comparing pre-operative planning with post-operative results quantified with computed tomography scans. The overall median difference between pre-operative planning and post-operative results was 5.2° (min-max: 2.9°-8.5°) for rotation and 3.4° (min-max: 2.4°-5.8°) for valgus angulation. For the "extracapsular" method, the median difference was 5.2° (min-max: 2.9°-7.0°) for rotation and 3.9° (min-max: 3.2°-5.8°) for valgus angulation. The median differences in rotation and valgus angulation for the "humeral head-tuberosity separation" corrections were 6.3° (min-max: 3.6°-8.5°) and 3.1° (min-max: 2.4°-3.6°), respectively. The application of 3D surgical planning and patient-specific guides is feasible for corrective osteotomies of malunited proximal humerus and resulted in reconstructions with less than 10° deviation from pre-operative planning, demonstrating acceptable technical accuracy and supporting the potential of this approach for future clinical application. The extracapsular osteotomy technique may serve as a solution for malunions with an intact anatomic relationship between the humeral head and greater tuberosity, whereas the novel osteotomy may be a solution for severe malunions with disrupted anatomy between the humeral head, greater tuberosity, and surgical neck. Future studies need to evaluate the use of the proposed techniques in patients with actual proximal humeral malunions.
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8. Long-term shoulder-related secondary health-care contact among people with subacromial pain: a secondary analysis of a randomized controlled trial of home-based vs. supervised exercise regimens.
PMID:日期:2026-08-12Subacromial pain is associated with substantial individual burden and health-care costs. Exercise rehabilitation can be delivered either at home or under physiotherapist supervision. This study investigated whether home-based exercise rehabilitation was associated with increased long-term secondary health-care utilization compared with supervised exercise rehabilitation. A total of 208 participants were randomized to home-based, group-based, or individually supervised exercise rehabilitation. For this secondary analysis, the 2 supervised groups were pooled and compared with the home-based group. The outcomes were shoulder-related secondary health-care contacts and shoulder surgery during the 5-year follow-up. Associations were analyzed using logistic regression and reported as adjusted odds ratios (ORs) with 95% confidence intervals (CIs). During the 5-year follow-up, 22/71 participants (31%) in the home-based group and 45/137 (33%) in the supervised group had a shoulder-related secondary health-care contact (adjusted OR 0.91; 95% CI 0.52-1.61). Shoulder surgery was recorded in 14/71 participants (20%) in the home-based group and 24/137 (18%) in the supervised group (adjusted OR 1.16; 95% CI 0.42-3.22). In this 5-year register-based follow-up of a randomized controlled trial, we found no evidence of increased shoulder-related secondary health-care contacts or surgery following home-based compared with supervised exercise rehabilitation for subacromial pain. However, the estimates were imprecise and should be interpreted with caution. These findings support home-based exercise as a potentially scalable rehabilitation strategy, although larger studies are needed to confirm long-term health-care utilization outcomes.
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9. Undersurface rotator cuff repair for partial-thickness tears using the Opus knotless system: a prospective cohort of 1000 consecutive cases with a 1.4% retear rate.
9. 使用Opus无结系统进行肩袖下滑囊侧修复治疗部分厚度撕裂：1000例连续病例的前瞻性队列研究及1.4%再撕裂率PMID:日期:2026-08-07Partial-thickness rotator cuff tears are a common cause of shoulder pain and disability. There are few large prospective cohort studies evaluating outcomes following arthroscopic repair, and reported structural failure rates vary widely across techniques. The purpose of this study was to (1) evaluate the structural and clinical outcomes of an arthroscopic undersurface knotless inverted mattress repair for partial-thickness rotator cuff tears, (2) assess the effect of surgical experience on outcomes, and (3) place these outcomes in the context of published series of alternative techniques. A prospectively collected cohort of 1000 consecutive patients with articular- or bursal-sided partial-thickness supraspinatus tears >50% thickness underwent arthroscopic repair using the Opus knotless system (Smith & Nephew) with an undersurface knotless inverted mattress technique. Structural integrity was assessed using ultrasound at a minimum of 6 months. Pain, range of motion, and strength were assessed pre-operatively and at 6 weeks, 12 weeks, and 6 months. The cohort comprised 570 males and 430 females with a mean (±standard deviation) age of 56 ± 11 years (range, 18-87). Tear area was 1.5 ± 1.0 cm, and median anchor number was 1 (range, 1-5). Repairs were intact in 986 patients at 6 months, with a retear rate of 1.4% (95% confidence interval: 0.8-2.3%). Seven patients (0.7%) underwent revision rotator cuff repair, and no patients required reoperation for infection or post-operative stiffness. Significant improvements were observed across pain, range of motion, strength, and functional outcomes ( < .01). A learning curve was identified, with retear rates peaking at 5% between cases 100-200 and declining to ≤1% after approximately 200 cases. Arthroscopic undersurface knotless inverted mattress repair of partial-thickness rotator cuff tears achieved a retear rate of 1.4%, with no reoperations for infection or post-operative stiffness and consistent improvements across all clinical outcome measures. Retear rates declined after approximately 200 cases, a pattern consistent with a learning-curve effect, although this descriptive moving-average analysis is exploratory and was not subjected to formal change-point modeling. The favorable structural outcomes and short operative time observed with this technique may relate, in part, to minimal disruption of the remaining tendon and subacromial bursa and the direct intra-articular visualization afforded by this undersurface approach.
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10. The natural history of traumatic posterior glenohumeral dislocations in a high-risk population.
PMID:日期:2026-08-05The purpose of this study was to define the clinical trajectory and treatment outcomes after traumatic posterior shoulder dislocation in patients treated both operatively and non-operatively. We queried for all patients ≤50 years old who had a posterior shoulder dislocation or subluxation event, confirmed on imaging between January 2017 and December 2024. Patients were excluded for <6 months of follow-up from the date of the dislocation or subluxation event. Functional failure was defined as persistent subjective instability/pain with a positive Kim/Jerk exam, permanent activity restrictions, or failure to return to work. Additionally, recurrent dislocation, revision surgery, or transition from therapy to surgery was considered structural failure at any time point. Thirty-three shoulders met inclusion criteria. Mechanisms of injury included falls (n = 15, 45%), seizures (n = 7, 21%), combat/military training (n = 7, 21%), sports (n = 2, 6%), and motorcycle accident (n = 2, 6%). The average age at the time of injury was 28.5 years. There were 31/33 (94%) active duty service members and 2/33 (6%) immediate family of service members. Non-operative treatment was undergone in 18/33 patients (55%), and 11/18 patients (61%) failed treatment most commonly due to recurrent dislocations (n = 8, 73%). Operative treatment was undergone in 15/33 patients (45%), and the most common procedure was an arthroscopic posterior labral repair (n = 11, 73%). The average posterior glenoid bone loss in the non-operative group was 11.9% and 12.2% in the operative group. The average gamma angle for the reverse Hill-Sachs lesions in the non-operative group was 97.5° and 83.13° in the operative group. The overall failure rate of operatively managed shoulders was 8/15 shoulders (53%), due to revision surgery in 4/8 patients (50%), redislocation events in 2/8 patients (25%), and subjective instability in 2/8 patients (25%). Seven of 15 (47%) of the operative cohort were placed on permanent profile restrictions or failed to return to duty due to the injured shoulder. Traumatic posterior dislocations in young, active individuals demonstrated high failure rates with both operative (53%) and non-operative (61%) management, though direct comparison between treatment groups is limited by treatment selection bias. Nearly all patients with failure after operative intervention failed to return fully to their occupation.