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To determine the clinical, biomechanical, and financial impact of the use of subacromial balloon spacers in the surgical management of massive, irreparable rotator cuff tears (RCTs).

All studies assessing the use of implantable subacromial balloon spacers for management of massive, irreparable RCTs were systematically searched. Risk of bias was assessed using Methodological Index for Non-Randomized Studies criteria. Data extraction and analysis was performed for pain and function scores, shoulder range of motion (ROM), glenohumeral contact pressure and vertical migration of humeral head, and cost. Subjective synthesis was performed with forest plots when outcomes were reported in 3 or more studies.

In total, 19 studies met inclusion criteria for analysis; 337 patients (mean age 68 years) had 343 subacromial balloon spacer implantations. Throughout a mean follow-up of 33 months, there was significant improvement in the Total Constant Score (preoperative 22.5-41.8; postoperative 51.4-72.3), Oxford Shoulderom this procedure appears to be minimal.

IV; Systematic review of level III-IV studies.
IV; Systematic review of level III-IV studies.
To perform a systematic review of biomechanical and clinical studies to determine whether the iliopsoas is a femoral head stabilizer.

A systematic review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Inclusion criteria were any human clinical (Levels I-IV evidence) or laboratory studies that investigated the role of the iliopsoas as a stabilizer of the hip. Exclusion criteria included studies that investigated patients undergoing spine surgery or those with a total hip arthroplasty or hip hemiarthroplasty. Study methodologic quality for clinical-outcomes studies were analyzed using the Modified Coleman Methodology Score. Because of the heterogeneity in the participants and interventions, no quantitative assimilative meta-analysis was performed.

Eight articles were analyzed (3 biomechanical [35 cadavers and 18 healthy subjects]; 5 clinical outcomes studies [537subjects, 207 arthroscopic iliopsoas tenotomies]). Two invivo biomechanical studies identified the iliopsoas as an anterior hip stabilizer. One cadaveric study identified the iliopsoas as a femoral head stabilizer at 0
-15
of hip flexion. Two clinical studies demonstrated the role of the iliopsoas as a dynamic hip stabilizer, particularly in patients with increased femoral version (greater than 15˚-25˚). Two studies reported cases of atraumatic anterior hip dislocations after arthroscopic iliopsoas tenotomies.

Evidence from biomechanical and clinical studies may suggest that the iliopsoas is a dynamic anterior femoral head stabilizer.

Level IV, systematic review of Level III and IV plus biomechanical studies.
Level IV, systematic review of Level III and IV plus biomechanical studies.
The purpose of this study was to review systematically the literature concerning postoperative management following arthroscopic Bankart repair for traumatic anterior shoulder instability in adolescent and young adult (≤25years) athletes.

The Pubmed, Medline, EMBASE, EBSCO (CINAHL), and Google Scholar databases were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify all studies reporting postoperative rehabilitation guidelines following arthroscopic Bankart repair in the adolescent and young adult population. The Methodological Index for Nonrandomized Studies instrument and Modified Coleman Methodology Score were used for quality assessment of the included studies. All aspects of rehabilitation were extracted and analyzed, including type/duration of immobilization, range of motion, strength, and return to sport (RTS) criteria.

Screening yielded 17 eligible studies with a total of 675 patients and an average age of 1etic population.

Level IV, systematic review of Level II-IV studies.
Level IV, systematic review of Level II-IV studies.
To report the annual incidence of anterior shoulder instability (ASI) diagnosis, injury severity, and surgical stabilization in a U.S. population.

An established U.S. geographic database was used to identify patients < 40 years old with diagnoses of ASI from 1994-2016. Medical records were reviewed to obtain patient demographics, histories, imaging results, and surgical details. Age- and sex-specific incidence rates were calculated and adjusted to the 2010 U.S. population. Poisson regression was performed to examine trends by timeline, sex and age.

The study population consisted of 652 patients with ASI and a mean age of 21.5 years (range, 3.6-39.5). Comparing 2015-2016 to 1994-1999, we found an increase in the number of dislocations (from 1.0-1.9;
= 0.016) and total instability events (from 2.3-3.4;
=0.041) per patient prior to presentation to a physician. Repotrectinib molecular weight There was a trend in increased diagnosis of bony Bankart and/or Hill-Sachs on MRI over time, with these lesions documented in 96% of patients undergoing MRI in 2015-2018 compared to 52.9% in 1994-1999 (
< .001). The use of arthroscopic procedures increased and peaked in 2005-2009 (90% of surgical cases performed). The proportion of open Latarjet procedures increased from 2010-2014 (14%) and 2015-2018 (31%).

The age- and sex- adjusted incidence of ASI diagnosis in a U.S. population from 1994-2016 is comparable to that demonstrated in Canadian and European populations. This study demonstrates an increasing number of instability events prior to surgical evaluation, which may correlate with patients' more commonly presenting with bone loss and requiring more aggressive surgical treatment or that ASI is being more frequently cared for and documented by present-day orthopedic surgeons.

Level III, cross-sectional study.
Level III, cross-sectional study.
The purpose of this study was to compare alignment measured on standard anteroposterior (AP) radiographs versus full-length weight-bearing radiographs.

Patients were prospectively enrolled from June 2019 to August 2019 from a single orthopedic surgeon's practice if they were ≥ 18 years of age, obtained both AP and full-length alignment radiographs and were capable of full weight-bearing with appropriate positioning. Patients were excluded if they were < 18 years of age, had previous knee arthroplasty, previous knee or hip osteotomy, were unable to bear full weight on both limbs, and if the patient's body habitus precluded appropriate visualization of necessary landmarks on the radiographs. Tibiofemoral angles were measured on AP radiographs using 2 techniques (AP angles 1 and 2). Linear regression and paired
tests were used to compare measurements. The minimal clinically important difference was defined as < 2°.

There were 120 patients (62 males, 58 females) with an average age of 45 ± 17 years who were enrolled.
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