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Background: The relationship between abnormalities of the ulnar collateral ligament (UCL) on magnetic resonance imaging (MRI) and elbow symptoms in baseball players remains unclear. Purpose/Hypothesis: This study aimed to compare findings of the UCL on microscopic MRI between asymptomatic and symptomatic elbows in baseball players. We hypothesized that the MRI grade of UCL injuries would exhibit no correlation with medial elbow symptoms in baseball players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The study participants were skeletally mature baseball players who underwent high-resolution microscopic MRI of the medial elbow including for medical checkups. Elbows with previous surgical treatment or traumatic UCL injuries were excluded. The patients were divided into symptomatic and asymptomatic groups. The UCL appearance on microscopic MRI was categorized into 4 grades and compared between the groups. Abnormal findings in the medial elbow including bony fragments at the medial epicondyle, osteophytes or bony fragments in the sublime tubercle, and bone marrow edema (BME) in the sublime tubercle were also evaluated. Results: A total of 426 baseball players (426 elbows) with a mean age of 20 years (range, 14-41 years) were included. The asymptomatic and symptomatic groups included 158 and 268 elbows, respectively. In the asymptomatic group, based on MRI grading of the UCL, 46 (29%) elbows were rated as grade I, 64 (41%) as grade II, 40 (25%) as grade III, and 8 (5%) as grade IV. In the symptomatic group, 75 (28%) elbows were rated as grade I, 118 (44%) as grade II, 61 (23%) as grade III, and 14 (5%) as grade IV. There was no significant difference in the MRI grades between the groups (P =.9). BME in the sublime tubercle was more frequently seen in the symptomatic group than in the asymptomatic group (P <.001). Conclusion: There was no difference in MRI grades of the UCL between symptomatic and asymptomatic elbows in baseball players; approximately 30% of elbows demonstrated high-grade UCL injuries in both groups. BME in the sublime tubercle was more frequently seen in symptomatic elbows than in asymptomatic elbows. BME in the sublime tubercle was a better indicator of symptoms than was MRI grading of the UCL. [ABSTRACT FROM AUTHOR]

[BACKGROUND]: Biomechanical differences between reverse shoulder arthroplasty (RSA) designs, specifically those with larger neck-shaft angles like the Grammont-type prosthesis and those with smaller neck-shaft angles such as lateralized humerus RSAs, have been analyzed in ex vivo studies. However, there is limited data on the differences in in vivo shoulder kinematics between these designs. The purpose of this study was to analyze in vivo kinematics of lateralized humerus RSA during active scaption and external rotation at the side, and to compare them to previously reported data for Grammont-type RSA. [METHODS]: Twenty shoulders that underwent RSA using a lateralized onlay prosthesis were included in this study. They consisted of 10 males and 5 females with a mean age of 76 years (range, 69-83). Patients underwent fluoroscopy during active scaption and external rotation at the side at or after postoperative 1 year; additionally, computed tomography was performed to create three-dimensional scapular implant models. Using these fluoroscopic images and three-dimensional models, three-dimensional shoulder kinematics were computed using model-image registration techniques. Scaption kinematics and scapular-neck distance were compared with data from previous studies on Grammont-type RSA, which were analyzed using the same techniques as in this study. [RESULTS]: There were no significant differences in scaption kinematics between lateralized humerus and Grammont-type RSA. However, the scapular neck-insert distance during active external rotation at the side was significantly greater in lateralized humerus RSA (3.2-5 mm) than in Grammont-type RSA (approximately 1 mm, P < .001) despite the glenohumeral abduction angles being significantly smaller (P = .03). [CONCLUSION]: Lateralized humerus RSA showed similar scaption kinematics to Grammont-type RSA; however, the scapular neck-insert distance during active external rotation at the side was significantly greater in lateralized humerus RSA than in Grammont-type RSA. The greater neck-insert distance may contribute to a lower incidence of scapular notching., (Copyright © 2025. Published by Elsevier Inc.)

Background: There remain arguments regarding whether fatty degeneration of the rotator cuff muscles improves following rotator cuff repair. The purpose of this study was to prospectively investigate changes in fatty degeneration of the rotator cuff muscles, quantitatively measured on magnetic resonance imaging (MRI) with use of transverse relaxation time (T2) mapping techniques, and to assess the relationship between these changes and clinical outcomes., Methods: Patients were included if they were scheduled for arthroscopic rotator cuff repair using the suture-bridge technique between June 2014 and December 2015, underwent preoperative MRI including the T2 mapping sequence, and consented to participate in the study. Exclusion criteria consisted of trauma within 2 months before preoperative MRI, isolated subscapularis tears, patch augmentation, neuromuscular disease, and a follow-up duration of <2 years. MRI scans were acquired preoperatively and at 2 years postoperatively, and T2 values of the supraspinatus and infraspinatus muscles were measured, with smaller T2 values indicating less fat content. Shoulders were evaluated on the basis of active range of motion (ROM), Constant and University of California Los Angeles Shoulder Rating Scale scores, shoulder external rotation strength with the arm at the side, and rotator cuff integrity on postoperative MRI., Results: A total of 103 patients (103 shoulders) with a mean age of 65 ± 9 years (range, 42 to 83 years) were included, of whom 52 were male and 51 were female. There were 13 partial, 18 small, 35 medium, 33 large, and 4 massive tears. Concomitant subscapularis tears were observed in 35 shoulders. Overall, ROM, clinical scores, and external rotation strength significantly improved postoperatively. Retears were found in 27 shoulders (26%). External rotation strength significantly improved postoperatively only in shoulders without a retear. Among shoulders without a retear, the postoperative T2 values of the supraspinatus and infraspinatus were significantly smaller than the preoperative values (p < 0.001 for both); however, no improvement was seen in shoulders with a retear., Conclusions: Shoulders with successful repair demonstrated significantly smaller T2 values postoperatively as well as significantly improved external rotation strength. Fatty degeneration of the cuff muscles can be reversed, at least in part, and muscle strength improves in shoulders with successful repair., Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence., Competing Interests: Disclosure: No external funding was received for this work. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSOA/A586)., (Copyright © 2024 The Authors. Published by The Journal of Bone and Joint Surgery, Incorporated. All rights reserved.)