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  1. Article ; Online: Editorial Commentary: Superior Capsular Reconstruction: Indications and Proper Technique Results in Good Outcomes but Reports of Complications.

    Khan, Moin

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association

    2021  Volume 37, Issue 9, Page(s) 2973–2974

    Abstract: Superior capsular reconstruction is a minimally invasive option to treat massive irreparable rotator cuff tears. In the appropriately selected patient, available data suggest that while the procedure generally results in improved function, there is a not ...

    Abstract Superior capsular reconstruction is a minimally invasive option to treat massive irreparable rotator cuff tears. In the appropriately selected patient, available data suggest that while the procedure generally results in improved function, there is a not insignificant risk of complications. Moreover, the rate of complications is likely underestimated given that outcomes are typically published by those with significant technical expertise. The literature supports improved outcomes in patients without significant degenerative change (less than Hamada 3) along with an intact or repairable subscapularis. Graft failure is the most common complication, and appropriate graft selection (ideally at least 4 mm thick) and careful preparation are essential. Additionally, surgeons could consider 3 anchors on the glenoid to provide secure fixation and a double-row transosseous equivalent construct on the humerus. To prevent suture pullout or excessive tension on the graft, it is important to maintain a sufficient border of graft and measure the graft in 30° of forward elevation and 30° of abduction. Additional fixation with posterior side-to-side repair of the graft to the infraspinatus has been reported to improve biomechanical properties of the construct. Existing research is skewed toward low-level evidence at high risk of bias and the reported results of high-volume surgeons. High-quality pragmatic trials are required to truly understand the optimal indications and real-world outcomes of the superior capsular reconstruction.
    MeSH term(s) Humans ; Range of Motion, Articular ; Rotator Cuff ; Rotator Cuff Injuries/surgery ; Shoulder Joint ; Treatment Outcome
    Language English
    Publishing date 2021-09-02
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 632528-2
    ISSN 1526-3231 ; 0749-8063
    ISSN (online) 1526-3231
    ISSN 0749-8063
    DOI 10.1016/j.arthro.2021.05.047
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  2. Article ; Online: Editorial Commentary: Suture Button Fixation for the Latarjet Procedure Is Superior to Screw Fixation.

    Chakrabarti, Moyukh O / Khan, Moin

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association

    2024  Volume 40, Issue 5, Page(s) 1655–1657

    Abstract: An increasing body of evidence suggests that suture button fixation is comparable with screw fixation in Latarjet and potentially associated with reduced graft resorption. Suture button fixation may facilitate performing the Latarjet procedure, ... ...

    Abstract An increasing body of evidence suggests that suture button fixation is comparable with screw fixation in Latarjet and potentially associated with reduced graft resorption. Suture button fixation may facilitate performing the Latarjet procedure, particularly when done in an arthroscopic manner. The use of suture button fixation technique theoretically facilitates improved positioning of the graft on the glenoid, as it frees the surgeon from the potential of the soft-tissue envelope to impact positioning of the graft, which can occur with screw-based guides. The bone graft can be shuttled into an optimal position and then tensioned with relative ease in comparison with screw-based techniques. Suture button fixation results in lower complication rates compared with screw fixation; almost one third of the screw fixation complications are hardware-related, and screw fixation results in a high rate of hardware removal. Moreover, the arthroscopic Latarjet suture button literature is published by experienced surgeons. Arthroscopic Latarjet has a significant learning curve, reducing the translatability of studies that report superior findings with any one technique. The generalizability of results reminds us that evidence-based medicine should be practiced through the lens of not only patient preferences, but also through an honest appraisal of a surgeon's own ability.
    MeSH term(s) Humans ; Bone Screws ; Suture Techniques ; Arthroscopy/methods ; Bone Transplantation/methods ; Shoulder Joint/surgery ; Sutures
    Language English
    Publishing date 2024-01-11
    Publishing country United States
    Document type Editorial
    ZDB-ID 632528-2
    ISSN 1526-3231 ; 0749-8063
    ISSN (online) 1526-3231
    ISSN 0749-8063
    DOI 10.1016/j.arthro.2023.11.035
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  3. Article ; Online: Editorial Commentary: Repair of Horizontal Meniscal Tears-A Need for High-Quality Research!

    Khan, Moin

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association

    2020  Volume 36, Issue 8, Page(s) 2332–2333

    Abstract: A paucity of evidence exists by which to inform clinical decision-making in the management of repair of horizonal cleavage tears of the meniscus. Available data suggest reasonable outcomes and low failure rates; however, high-quality research is required ...

    Abstract A paucity of evidence exists by which to inform clinical decision-making in the management of repair of horizonal cleavage tears of the meniscus. Available data suggest reasonable outcomes and low failure rates; however, high-quality research is required to refine our understanding of optimal indications, techniques, and long-term outcomes with respect to function and joint preservation.
    MeSH term(s) Cartilage Diseases ; Humans ; Knee Injuries ; Menisci, Tibial ; Rupture ; Tibial Meniscus Injuries
    Language English
    Publishing date 2020-08-04
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 632528-2
    ISSN 1526-3231 ; 0749-8063
    ISSN (online) 1526-3231
    ISSN 0749-8063
    DOI 10.1016/j.arthro.2020.05.032
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  4. Article ; Online: Cochrane in CORR®: Kinesio Taping for Rotator Cuff Disease.

    Comeau-Gauthier, Marianne / Khan, Moin

    Clinical orthopaedics and related research

    2022  Volume 480, Issue 4, Page(s) 661–668

    MeSH term(s) Athletic Tape ; Humans ; Range of Motion, Articular ; Rotator Cuff
    Language English
    Publishing date 2022-01-14
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 80301-7
    ISSN 1528-1132 ; 0009-921X
    ISSN (online) 1528-1132
    ISSN 0009-921X
    DOI 10.1097/CORR.0000000000002128
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  5. Article ; Online: Regarding "Arthroscopic Bankart Repair With and Without Curettage of the Glenoid Edge: A Prospective, Randomized, Controlled Study".

    Gazendam, Aaron / Khan, Moin

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association

    2021  Volume 37, Issue 4, Page(s) 1064–1065

    MeSH term(s) Arthroplasty ; Arthroscopy ; Curettage ; Humans ; Prospective Studies ; Scapula/surgery
    Language English
    Publishing date 2021-04-03
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 632528-2
    ISSN 1526-3231 ; 0749-8063
    ISSN (online) 1526-3231
    ISSN 0749-8063
    DOI 10.1016/j.arthro.2021.01.030
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  6. Article ; Online: Proximal Row Carpectomy With Soft Tissue Interposition: A Systematic Review of Clinical Outcomes.

    Aravinthan, Neveadan / Siddiqui, Salwa / Khan, Moin / Moro, Jaydeep / Pino, Paula A / Prada, Carlos

    Hand (New York, N.Y.)

    2024  , Page(s) 15589447231221245

    Abstract: Proximal row carpectomy (PRC) with soft tissue interposition arthroplasty (STIA) presents an alternative approach to addressing wrist arthritis patterns involving the capitate and/or lunate fossa, in lieu of wrist arthrodesis. This systematic review ... ...

    Abstract Proximal row carpectomy (PRC) with soft tissue interposition arthroplasty (STIA) presents an alternative approach to addressing wrist arthritis patterns involving the capitate and/or lunate fossa, in lieu of wrist arthrodesis. This systematic review aimed to evaluate clinical outcomes and techniques associated with PRC-STIA in patients with advanced wrist arthritis. We conducted a systematic review using databases including PubMed, Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials. Inclusion criteria involved articles reporting outcomes of patients who underwent PRC-STIA with at least 1 relevant outcome. The analysis encompassed 8 studies involving 106 patients (108 wrists) meeting the inclusion criteria. A majority of patients were men (69%, n = 88), with a mean age of 54.4 ± 12.7 years and an average follow-up of 4.8 ± 6.3 years. Dorsal capsule was the most commonly interposed tissue (63%, 5 out of 8 studies). Patients receiving STIA achieved comparable patient-reported outcome measures scores to those undergoing PRC alone. Postoperative pain, measured by the Visual Analog Scale, averaged 3.7 ± 0.6. The Disabilities of the Arm, Shoulder, and Hand score averaged 27.8 ± 8, while the Patient-Rated Wrist Evaluation score averaged 41.5 ± 25.9. Five complications were reported in three studies. The addition of STIA into PRC for patients with capitate and/or lunate fossa cartilage degeneration yielded outcomes akin to traditional PRC, improving wrist function, pain, and grip strength in a safe and straightforward manner. Future research should prioritize high-quality comparative studies, extended follow-up periods, and standardized core outcome measures for a more comprehensive understanding of its role in wrist arthritis treatment.
    Language English
    Publishing date 2024-01-30
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2277325-3
    ISSN 1558-9455 ; 1558-9447
    ISSN (online) 1558-9455
    ISSN 1558-9447
    DOI 10.1177/15589447231221245
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    Zs.A 6820: Show issues Location:
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  7. Article ; Online: Glenoid bone loss in shoulder arthroplasty: a narrative review.

    Al-Omairi, Sultan / Albadran, Adeeba / Dagher, Danielle / Leroux, Timothy / Khan, Moin

    Annals of joint

    2024  Volume 9, Page(s) 8

    Abstract: Background and objective: Crucial to the success of any total or reverse shoulder arthroplasty (RSA) is the stability of the glenoid component fixation. Instability can lead to early implant failure and unsatisfactory results. Patients often present ... ...

    Abstract Background and objective: Crucial to the success of any total or reverse shoulder arthroplasty (RSA) is the stability of the glenoid component fixation. Instability can lead to early implant failure and unsatisfactory results. Patients often present with varying forms of glenoid bone loss (GBL) in both the primary and revision settings, which can be a challenge for the treating surgeon. Severe cases of GBL can increase the risk of potential complications and diminish implant longevity. The use of the reverse total shoulder replacement has been particularly helpful when addressing significant glenoid bony defects. Various approaches have been proposed to deal with GBL, all of which require an individualized assessment of the specifics of the defect in order to provide maximal fixation and thereby optimize the longevity of the shoulder arthroplasty. This article aims to review the recent literature on GBL in shoulder arthroplasty to provide guidance when considering treatment based on the best available evidence.
    Methods: PubMed, MEDLINE, EMBASE, AccessMedicine, ClinicalKey, DynaMed, and Micromedex were queried for publications utilizing the following keywords: "glenoid bone loss" AND "glenoid bone deficiency" AND "shoulder arthroplasty" AND "classification". The search was restricted to research published between 2004 and 2023. There were no restrictions on study type or language.
    Key content and findings: GBL should be critically evaluated prior to undertaking total shoulder arthroplasty (TSA). The treating surgeon should be aware of various methods of addressing bone defects.
    Conclusions: The use of TSA is increasing to address various shoulder pathologies. Addressing glenoid bone defects is of critical importance to maximize the longevity and outcome of TSA.
    Language English
    Publishing date 2024-01-05
    Publishing country China
    Document type Journal Article ; Review
    ISSN 2415-6809
    ISSN (online) 2415-6809
    DOI 10.21037/aoj-23-24
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  8. Article ; Online: Arthroscopic stabilization surgery for first-time anterior shoulder dislocations: a systematic review and meta-analysis.

    Abdel Khalik, Hassaan / Lameire, Darius L / Leroux, Timothy / Bhandari, Mohit / Khan, Moin

    Journal of shoulder and elbow surgery

    2024  

    Abstract: Background: The optimal management of first-time anterior shoulder dislocations (FTASDs) remains controversial. Therefore, the purpose of this study was to assess the efficacy of arthroscopic stabilization surgery for FTASDs through a systematic review ... ...

    Abstract Background: The optimal management of first-time anterior shoulder dislocations (FTASDs) remains controversial. Therefore, the purpose of this study was to assess the efficacy of arthroscopic stabilization surgery for FTASDs through a systematic review and meta-analysis of existing literature.
    Methods: MEDLINE, Embase, and Web of Science were searched from inception to December 18, 2022, for single-arm or comparative studies assessing FTASDs managed with arthroscopic stabilization surgery following first-time dislocation. Eligible comparative studies included studies assessing outcomes following immobilization for an FTASD, or arthroscopic stabilization following recurrent dislocations. Eligible levels of evidence were I to IV. Primary outcomes included rates of shoulder redislocations, cumulative shoulder instability, and subsequent shoulder stabilization surgery.
    Results: Thirty-four studies with 2222 shoulder dislocations were included. Of these, 5 studies (n = 408 shoulders) were randomized trials comparing immobilization to arthroscopic Bankart repair (ABR) after a first dislocation. Another 16 studies were nonrandomized comparative studies assessing arthroscopic Bankart repair following first-time dislocation (ABR-F) to either immobilization (studies = 8, n = 399 shoulders) or arthroscopic Bankart repair following recurrent dislocations (ABR-R) (studies = 8, n = 943 shoulder). Mean follow-up was 59.4 ± 39.2 months across all studies. Cumulative loss to follow-up was 4.7% (range, 0%-32.7%). A composite rate of pooled redislocation, cumulative instability, and reoperations across ABR-F studies was 6.8%, 11.2%, and 6.1%, respectively. Meta-analysis found statistically significant reductions in rates of redislocation (odds ratio [OR] 0.09, 95% confidence interval [CI] 0.04-0.3, P < .001), cumulative instability (OR 0.05, 95% CI 0.03-0.08, P < .001), and subsequent surgery (OR 0.08, 95% CI 0.04-0.15, P < .001) when comparing ABR-F to immobilization. Rates of cumulative instability (OR 0.32, 95% CI 0.22-0.47, P < .001) and subsequent surgery rates (OR 0.27, 95% CI 0.09-0.76, P = .01) were significantly reduced with ABR-F relative to ABR-R, with point estimate of effect favoring ABR-F for shoulder redislocation rates (OR 0.59, 95% CI 0.19-1.83, P = .36). Return to sport rates to preoperative levels or higher were 3.87 times higher following ABR-F compared to immobilization (95% CI 1.57-9.52, P < .001), with limited ABR-R studies reporting this outcome. The median fragility index of the 5 included randomized controlled trials (RCTs) was 2, meaning reversing only 2 outcome events rendered the trials' findings no longer statistically significant.
    Conclusion: Arthroscopic stabilization surgery for FTASDs leads to lower rates of redislocations, cumulative instability, and subsequent stabilization surgery relative to immobilization or arthroscopic stabilization surgery following recurrence. Although a limited number of RCTs have been published on the subject matter to date, the strength of their conclusions is limited by a small sample size and statistically fragile results.
    Language English
    Publishing date 2024-03-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1170782-3
    ISSN 1532-6500 ; 1058-2746
    ISSN (online) 1532-6500
    ISSN 1058-2746
    DOI 10.1016/j.jse.2024.01.037
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    Zs.A 3973: Show issues Location:
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  9. Article ; Online: Return to Sport After Arthroscopic Bankart Repair With Remplissage: A Systematic Review.

    Gouveia, Kyle / Harbour, Eric / Athwal, George S / Khan, Moin

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association

    2023  Volume 39, Issue 4, Page(s) 1046–1059.e3

    Abstract: Purpose: To determine the return-to-sport rate following arthroscopic Bankart repair with remplissage (ABR), including overall rate of return to sport, rate of return to preinjury level of sport, and the rate of return for specific subgroups such as ... ...

    Abstract Purpose: To determine the return-to-sport rate following arthroscopic Bankart repair with remplissage (ABR), including overall rate of return to sport, rate of return to preinjury level of sport, and the rate of return for specific subgroups such as contact or throwing athletes.
    Methods: EMBASE, PubMed, and MEDLINE were searched from database inception until February 2022. Studies were screened by 2 reviewers independently and in duplicate for data regarding rates of return to sport following ABR. Data on return to sport and functional outcomes were recorded. Data are presented in a descriptive fashion.
    Results: Overall, 20 studies were included with a total of 736 patients (738 shoulders) who underwent ABR. These patients had a mean age of 28 years (range 14-72 years) and were 83% male. Mean follow-up time after surgery was 45 months (range 12-127 months). The rate of return to any level of sport ranged from 60% to 100%, whereas the rate of return to the preinjury level ranged from 63% to 100%. When we excluded those who underwent ABR as a revision procedure, the rate of return to any level of sport was 68% to 100%. Lastly, the return to sport rates for contact or collision athletes ranged from 80% to 100%, whereas for overhead or throwing athletes it was 46% to 79%. The rate of recurrence of instability postoperatively ranged from 0% to 20% in included studies.
    Conclusions: For athletes with anterior shoulder instability, ABR led to a high rate of return to sport along with a low rate of recurrence of instability. Although most athletes are able to return to the same level of sport, certain groups such as throwing athletes may face greater difficulty.
    Level of evidence: Level IV, systematic review of Level III and IV studies.
    MeSH term(s) Humans ; Male ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Female ; Shoulder Dislocation/surgery ; Return to Sport ; Shoulder Joint/surgery ; Joint Instability/surgery ; Sports ; Arthroscopy/methods ; Recurrence
    Language English
    Publishing date 2023-01-13
    Publishing country United States
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 632528-2
    ISSN 1526-3231 ; 0749-8063
    ISSN (online) 1526-3231
    ISSN 0749-8063
    DOI 10.1016/j.arthro.2022.12.032
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  10. Article ; Online: Editorial Commentary: Does the Scope Have a Role in Painful Shoulder Arthroplasty?

    Khan, Moin / Ayeni, Olufemi R

    Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association

    2020  Volume 36, Issue 6, Page(s) 1515–1516

    Abstract: Arthroscopy is a powerful tool in the management of the painful total shoulder arthroplasty and should be considered when evaluating cases in which a clear cause of pain is not present. Patients may present with a painful shoulder arthroplasty due to a ... ...

    Abstract Arthroscopy is a powerful tool in the management of the painful total shoulder arthroplasty and should be considered when evaluating cases in which a clear cause of pain is not present. Patients may present with a painful shoulder arthroplasty due to a number of causes-occult infection, instability, component loosening, malposition, or rotator cuff pathology. In certain cases, advanced imaging may not be diagnostic, given the presence of metal artifact. It is our routine clinical practice to evaluate arthroscopically such cases in which the diagnosis is not readily evident. The most common indication for shoulder arthroscopy is pain with no clear cause or loss of motion (39%), followed by biopsy to rule out occult infection (25%), and finally rotator cuff assessment (19%).
    MeSH term(s) Arthroplasty ; Arthroplasty, Replacement, Shoulder ; Arthroscopy ; Humans ; Rotator Cuff/surgery ; Rotator Cuff Injuries ; Shoulder Joint/surgery
    Language English
    Publishing date 2020-05-04
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 632528-2
    ISSN 1526-3231 ; 0749-8063
    ISSN (online) 1526-3231
    ISSN 0749-8063
    DOI 10.1016/j.arthro.2020.02.031
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