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Background: A bony Bankart lesion directly affects the stability of the shoulder by reducing the glenoid joint-contact area. The aim of this study was to report on the epidemiological data relating to bony Bankart lesions in Sweden using the Swedish fracture register. The purpose is to evaluate age and sex distribution in the population with bony Bankart lesions, its impact on treatment strategy and further to analyse patient-reported outcomes. Methods: This was an epidemiological descriptive study. The inclusion criteria were all patients with a unilateral bony Bankart lesion registered between April 2012 and April 2019. The patients' specific data (age, sex, type and time of injury, treatment option and patient-reported outcomes) were extracted from the Swedish fracture register database. Results: A total of 790 unilateral bony Bankart fractures were identified. The majority of the patients were male (58.7%). The median age for all patients at the time of injury was 57 years. Females had a higher median age of 66 years, compared with males, 51 years. Most of the bony Bankart lesions, 662 (91.8%), were registered as a low-energy trauma. More than two-thirds of all treatment registered cases, 509/734 patients (69.3%), were treated non-surgically, 225 (30.7%) were treated surgically, while, in 17 patients (7.5% of all surgically treated patients), the treatment was changed from non-surgical to surgical due to recurrent instability. Surgical treatment was chosen for 149 (35%) of the males and for 76 (25%) of the females. Patient quality of life decreased slightly in both surgically and non-surgically treated groups 1 year after bony Bankart injury. Conclusion: This national register-based study provides detailed information on the epidemiology, choice of treatment and patient-reported outcomes in a large cohort of bony Bankart lesions. Most bony Bankart lesions affected males between 40 and 75 years after low-energy falls and non-surgical treatment dominated. [ABSTRACT FROM AUTHOR]

The ideal glenoid implant for anatomic total shoulder arthroplasty (aTSA) is one that provides sound fixation and allows ease of conversion to a reverse shoulder arthroplasty should the clinical need arise. This study is the first to report a consecutive series of patients treated with a novel convertible all polyethylene glenoid with hybrid fixation. The aim of the study was to evaluate the clinical, functional, and radiological outcomes of aTSA, for treatment of primary glenohumeral joint osteoarthritis using the SMR TT Hybrid Glenoid. This is a prospective study including consecutive patients from two centers in New Zealand and Sweden. Between August 29, 2017 and April 22, 2020, 103 patients received an aTSA for osteoarthritis with the SMR TT Hybrid Glenoid implant (LimaCorporate, San Daniele del Friuli, Italy). Ninety-seven patients had a minimum follow-up of 24 months and were therefore included in this study. There were 45 female and 52 male patients. The average age at the time of surgery was 68.2 years (range 49-81 years). Preoperative and postoperative clinical evaluations were performed using the American Shoulder and Elbow Surgeons score and the Oxford Shoulder Score. Preoperative and postoperative range of motion measures were conducted using a goniometer. Standardized Grashey and axillary lateral radiographs were utilized to assess for evidence of glenoid and humeral component failure and loosening. The mean follow-up duration was 2.3 years (range 2.0-4.6 years). The mean preoperative and postoperative American Shoulder and Elbow Surgeons scores were 29.0 ± 12.4 and 90.3 ± 14.5, respectively (P <.001). The mean preoperative and postoperative Oxford Shoulder Scores were 21.0 ± 6.7 and 45.3 ± 4.4, respectively (P <.001). We found significant improvements in the range of motion, with mean forward flexion increasing from 87° to 155° and abduction 73° to 149°, respectively. Radiologically, there was no evidence of glenoid or humeral component failure or loosening. Six patients had evidence of reduced bone density around the humeral component. Two patients had repair of traumatic rupture of subscapularis tendon in the early postoperative period. None of the patients had revision of the glenoid or humeral components. Patients treated with an aTSA with the SMR TT Hybrid Glenoid, a novel glenoid implant that has the potential to simplify the process of revision, achieved promising clinical and radiologic results at a minimum of two years. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate whether adolescent elite female and male handball players with shoulder muscle weakness, deficits in shoulder rotation range of motion (ROM) or in joint position sense (JPS), or scapular dyskinesis in the preseason had a higher rate of new shoulder injuries compared to players without these characteristics. DESIGN: Prospective cohort study. METHODS: We studied 344 uninjured players (452 player-seasons, 50% female). We measured their shoulder strength in isometric external rotation (1ER), isometric internal rotation (HR), isometric abduction, and eccentric external rotation, as well as their shoulder ROM, JPS, and scapular dyskinesis, during the preseason. Players were monitored weekly regarding match and training hours and shoulder injuries during 1 or 2 seasons. We used multivariable Cox proportional hazard models to calculate hazard rate ratios related to the first Injury and 95% confidence intervals (CIs). RESULTS: During 2 seasons, the participants reported 48 new shoulder injuries. In female players, the hazard rate ratio was 2.37 (95% Cl: 1.03,5.44) for 1ER weakness and 2.44 (95% Cl: 1.06, 5.51) for HR weakness. The hazard rate ratio was 0,85 (95% Cl: 0.39,1.83) for an lER/IIR ratio of less than 0.75 and 1.53 (95% Cl: 0.36,6.52) for scapular dyskinesis. In male players, the hazard rate ratio was 1,02 (95% Cl: 0.44,2.36) for 1ER weakness, 0.74 (95% Cl: 0.31,1.75) for HR weakness, 2.0 (95% Cl: 0.68, 5.92) for an IER/IIR ratio of less than 0.75, and 3.43 (95% Cl: 1,49,7.92) for scapular dyskinesis. There were no associations between new shoulder injuries and deficits in ROM or JPS. CONCLUSION: In adolescent elite handball, male players with preseason scapular dyskinesis and female players with preseason HR or 1ER shoulder weakness had an increased shoulder injury rate. [ABSTRACT FROM AUTHOR]

Few studies have investigated the incidence of injuries in kayakers. The aim was to study the prevalence of shoulder pain in competitive flatwater kayakers and to evaluate any differences in range of motion or scapula stability of the shoulder joint among kayakers with or without the history of shoulder pain. Thirty-one kayakers were participated in the study, and a questionnaire including background data was used. Shoulder range of motion was measured with a goniometer, and the participants were observed for scapula dyskinesis in flexion and abduction. Of the participating kayakers, 54.8% (n = 17) had experienced shoulder pain. Kayakers who had experienced shoulder pain showed a significantly lower degree of internal rotational range of motion versus kayakers with no reported shoulder pain, with a mean degree of internal rotation in the right shoulder 49.3 vs 60.0 (P = 0.017) and the left shoulder 51.9 vs 66.0 (P = 0.000). Kayakers who had experienced shoulder pain were also observed with a scapular dyskinesis (n = 15 of 17 kayakers) to a significantly higher degree (P = 0.001) than kayakers with no reported shoulder pain. Findings suggest that screening for scapular dyskinesis and testing for rotational range of motion in the shoulder joint is essential in order to treat and maybe prevent shoulder pain in kayakers. [ABSTRACT FROM PUBLISHER]

The purpose of this study was to evaluate possible effects of synchronized metronome training (SMT) on movement dynamics during golf-swing performance, as captured by kinematic analysis. A one-group, between-test design was applied on 13 male golfers (27.5 ± 4.6 years old, 12.7 ± 4.9 handicap) who completed 12 sessions of SMT over a four-week period. Pre- and post-assessments of golf swings with three different clubs (4-iron, 7-iron, and pitching wedge) were performed using a three-dimensional motion capture system. Club velocity at three different swing phases (backswing, downswing, and follow-through) was measured and cross-correlation analysis of time-series signals were made on joint couplings (wrist–elbow–shoulder) of both arms, and between joints and the club, during the full golf swing. There were significantly higher cross-correlations between joint-couplings and concomitant changes of the associated phase-shift differences, as well as reduced phase-shift variability at post-test. No significant effect of SMT was found for the club velocities. We suggest that domain-general influences of SMT on the underlying brain-based motor control strategies lead to a more coordinated movement pattern of the golf-swing performance, which may explain previous observations of significantly improved golf-shot accuracy and decreased variability after SMT. [ABSTRACT FROM PUBLISHER]

Background: The aim of the present study was to translate the Western Ontario Osteoarthritis Shoulder (WOOS) index into Swedish and to test its validity, reliability, and responsiveness in patients with subacromial pain., Methods: The validity of the WOOS translation was tested in 54 patients who completed the WOOS and the Shoulder Rating Questionnaire, Swedish version (SRQs). Of these patients, 46 were retested to assess reliability. Responsiveness was evaluated in 29 subjects who completed the WOOS and SRQs before surgery and again at 3 months after surgery, when they also rated perceived change in shoulder function. The relationship between the questionnaires and patient-perceived improvement was assessed., Results: A high correlation was found between the Swedish version of WOOS and the SRQs. The correlations were similar in a group of working patients (r = -0.832) and in all patients (r = -0.843; P < .001). A high degree of agreement between WOOS at test and retest was also observed. A Bland-Altman plot showed a small mean difference and no trend across the range of WOOS values. A strong significant agreement was also shown by a κ value of 0.649 (P < .001) and an intraclass correlation coefficient of 0.95 (95% confidence interval, 0.92-0.97, P < .001) as well as by a low difference between the test and retest means. Responsiveness, calculated by standardized response mean, was excellent (1.02)., Conclusion: The results of the present study provide evidence that the Swedish version of WOOS is valid, reliable, and responsive in patients with subacromial pain and performs similarly to the original Canadian version., (Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.)

The study was performed to investigate the relationship between perceived muscle tension and electromyographic hyperactivity and to what extent electromyographic (EMG) hyperactivity relates to personality traits in fibromyalgics. Thirty-six females with fibromyalgia performed isokinetic maximal forward flexions of the shoulder combined with surface EMG recordings of the trapezius and infraspinatus muscles. Signal amplitude ratio and peak torque were calculated in the initial and endurance test phases. Pain intensity, perceived general and local shoulder muscle tension, and personality traits using the Karolinska Scales of Personality were assessed pre-test. Neither perceived muscle tension nor muscular tension personality trait correlated with EMG muscle hyperactivity. Perceived general muscle tension correlated with aspects of anxiety proneness (including muscle tension) of the Karolinska Scales of Personality. Pain intensity interacted with many of the variables. We propose that when patients with fibromyalgia report muscle tension that they may be expressing something other than physiological muscle tension.

Two new national orthopedic quality registers were started in Sweden in 1999, the Swedish Shoulder Arthroplasty Register and the Swedish Elbow Arthroplasty Register. Both are owned by the Swedish Shoulder and Elbow Section of the Swedish Orthopedic Association. The purpose of the registers is to improve surgical techniques and selection of implants and identify individual risk factors. Two of the main problems in starting a new national quality register involve inducing all centers in the country to participate and deciding on the data to register.

Studies on 574 subjects demonstrated the prevalence of shoulder pain and its relationship to occupational work load and psychosocial factors. The prevalence of shoulder pain was 14% (13% men, 15% women). Women had more often myalgias with a tenderness on palpation of the shoulder muscles and rhizopathia-brachialgia type of pain, whereas men had mainly intraarticular pain. Three percent had been on sick leave because of shoulder pain in the year preceding the examination and 5% had a reduced range of shoulder joint motion. The subjects with shoulder pain were less satisfied with their jobs and had been less successful in a childhood intelligence test. No difference could be demonstrated between subjects with or without shoulder pain in estimated overall work load, but women with signs of supraspinatus tendinitis more often had jobs with physical demands.