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Item Metadata only Scapular dyskinesis after treatment of proximal humerus fracture, a 3-dimensional motion analysis and clinical outcomes(2023-10-01) Suphakitchanusan W.; Kerdsomnuek P.; Jamkrajang P.; Fossum B.W.; Sudjai N.; Paugchawee J.; Limroongreungrat W.; Vanadurongwan B.; Keyurapan E.; Ganokroj P.; Mahidol Universitypain and malposition, and dyskinesis of scapular movement) Scapula Rating Scale, the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), the visual analog scale (VAS) for pain, and the EuroQol-5 Dimension 5-LevelItem Metadata only Unicortical button fixation provides higher strength compared with transosseous repair for subscapularis tendon in total shoulder arthroplasty(2024-01-01) Ganokroj P.; Garcia A.R.; Hollenbeck J.F.M.; Whalen R.J.; Brown J.R.; Drumm A.; McBride T.J.; Suppauksorn S.; Jildeh T.R.; Provencher M.T.; Ganokroj P.; Mahidol UniversityBackground: Subscapularis tendon (SSc) dysfunction after total shoulder arthroplasty (TSA) results in poor functional outcomes. There have been numerous SSc repair constructs tested biomechanically and clinically; however, none has been demonstrated as superior. Newer techniques and implants have emerged but have not been fully tested. Hypothesis: We hypothesized that the unicortical button (UB) fixation would provide significantly improved restoration of the anatomic footprint and biomechanical properties compared with transosseous (TO) repair of the SSc. Methods: A digital footprint of SSc humeral insertion was obtained in 6 pairs of fresh-frozen cadaveric shoulders using a 3-dimensional digitizer. A complete SSc tear was created, and each pair of shoulders was randomized to either SSc repair with UB or TO repair. Each specimen underwent a cyclic loading protocol, followed by pull to failure. The failure load, elongation at failure, gapping failure, number of cycles until failure, the load at key gapping points (1 mm, 3 mm, 5 mm, and 10 mm), and the failure mode were recorded using high-resolution video recording. Three-dimensional surfaces of the insertion footprint and repair site were obtained, and surface areas were calculated using a custom MATLAB script and laser scanner. Paired t tests were conducted to compare differences between the 2 repair groups. Results: Failure load was significantly higher in the UB group (382.4 N ± 56.5 N) than in the TO group (253.6 N ± 103.4 N, P = .005). TO repair provided higher gapping at failure (28.8 mm ± 8.2 mm) than UB repair (10.4 mm ± 6.8 mm, P = .0017). UB repair had significantly higher load at the 1-mm, 5-mm, and 10-mm gapping than TO repair, with P = .042, P = .033, and P = .0076, respectively. There were no significant differences in elongation failure, the difference in footprint area from native to repair states, or the percentage of the restored footprint area between the groups (P = .26, P = .18, and P = .21, respectively). Conclusions: The UB fixation showed a significantly lower gap at failure, higher failure load and number of cycles until failure, and higher gap loads than the traditional TO repair for SSc. Although more clinical research is necessary, the UB fixation that uses cortical bone presents promising results.Item Metadata only Anatomic safe zones for arthroscopic snapping scapula surgery: quantitative anatomy of the superomedial scapula and associated neurovascular structures and the effects of arm positioning on safety(2022-10-01) Dey Hazra R.O.; Elrick B.P.; Ganokroj P.; Nolte P.C.; Fossum B.W.; Brown J.R.; Hanson J.A.; Douglass B.W.; Dey Hazra M.E.; Provencher M.T.; Millett P.J.; Mahidol UniversityBackground: Neurovascular anatomy has not been previously quantified for the arthroscopic snapping scapula approach with the patient in the most frequent patient position (“chicken-wing” position). The purposes of this study were (1) to determine anatomic relationships of the superomedial scapula and neurovascular structures at risk during arthroscopic surgical treatment of snapping scapula syndrome (SSS), (2) to compare these measurements between the arm in the neutral position and the arm in the chicken-wing position, and (3) to establish safe zones for arthroscopic treatment of SSS. Methods: Eight fresh-frozen cadaveric hemi-torsos (mean age, 55.8 years; range, 52-66 years) were dissected to ascertain relevant anatomic structure locations including the (1) spinal accessory nerve, (2) dorsal scapular nerve, and (3) suprascapular nerve. A coordinate measuring device was used to collect data on the relationships of anatomic landmarks and at-risk structures during the surgical approach. Results: The dorsal scapular nerve was a mean of 24.4 mm medial to the superomedial scapula in the neutral position and 33.1 mm medial in the chicken-wing position (P < .001); the dorsal scapular nerve was 21.7 mm medial to the medial border of the scapular spine in the neutral position and 35.5 mm medial in the chicken-wing position (P < .001). The mean distance from the superomedial angle to the spinal accessory nerve intersection at the superior scapular border was 16.5 mm in the neutral position and 15.0 mm in the chicken-wing position (P = .031). The average distance from the superomedial angle to the closest point of the spinal accessory nerve was 11.6 mm and 10.4 mm in the neutral position and chicken-wing position, respectively (P = .039). Conclusion: Neurologic structures around the scapula vary significantly between the neutral arm position and the chicken-wing position commonly used in the arthroscopic treatment of SSS. The chicken-wing position improves safe distances for the dorsal scapular nerve during medial-portal placement and should be considered as a primary position for arthroscopic management of SSS.Item Metadata only Minimum 5-Year Clinical Outcomes of Arthroscopically Repaired Massive Rotator Cuff Tears: Effect of Age on Clinical Outcomes(2023-01-01) Dey Hazra R.O.; Dey Hazra M.E.; Hanson J.A.; Rutledge J.C.; Doan K.C.; Ganokroj P.; Horan M.P.; Dornan G.J.; Millett P.J.; Mahidol UniversityShoulder and Elbow Surgeons (ASES) score; Single Assessment Numeric Evaluation (SANE) score; the shortened version of the Disabilities of the Arm, Shoulder and Hand score (QuickDASH); the 12-Item Short Form Health Survey (SF-12) Physical Component SummaryItem Metadata only Predictors of Clinical Outcomes and Quality of Life After Sternoclavicular Joint Reconstruction With Hamstring Tendon Autograft(2024-01-01) Rupp M.C.; Geissbuhler A.R.; Rutledge J.C.; Horan M.P.; Ganokroj P.; Chang P.; Provencher M.T.; Millett P.J.; Rupp M.C.; Mahidol Universityminimum of 2 years postoperatively, clinical outcomes were collected, including the following patient-reported outcomes (PROs): the 12-Item Short Form Survey (SF-12) score; American Shoulder and Elbow Surgeons (ASES) score; Quick Disabilities of the Arm