The purpose of the review was to synthesize the current literature regarding the effect of miRNA on biological processes known to be involved in tendon and tenocyte development and homeostasis. Using multiple databases, a systematic review was performed with a customized search term crafted to identify any study examining micro-RNA in relation to tendon and/or tenocytes. Results were classified based on the following categories: Gene expression, tenocyte development and differentiation, tendon tissue repair, and tenocyte senescence. A total of 3,112 potentially relevant studies were reviewed, and after exclusion criteria was applied, 15 investigations were included in the final analysis. There were 14 specific miRNA included in this review, with 11 studies reporting on tendon-related gene expression, five reporting on tendon development and/or tenocyte differentiation, six reporting on tendon tissue repair, and five reporting on tenocyte senescence. The miR-29 family was the most commonly reported micro-RNA in the investigation. We also report on a number of micro-RNA which are associated with both positive and negative effects on tendon homeostasis. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

Background: Dual mobility (DM) has been used in primary total hip arthroplasty recently for their low dislocation rates, low revision rates, and improved patient functional outcomes. We compared 2 DM systems, anatomic dual mobility (ADM; Stryker, Mahwah, NJ) and modular dual mobility (MDM; Stryker, Mahwah, NJ), to determine differences in dislocation rates, revision rates, and patient outcome scores. Methods: The study was a single-center matched retrospective review of prospectively collected data of patients who underwent primary total hip arthroplasty surgery with an ADM or MDM system by a single surgeon from 2012 to 2017. Demographics, operative details, postoperative patient-reported outcomes, and clinical outcomes were recorded. A Kaplan-Meier survivorship curve to compare survival time between groups was collected as well. Results: Five hundred seventy-four patients were included in the study with 287 patients matched in each group with mean 2.86 years of follow-up. The dislocation rate in each cohort was 0%, the acetabularspecific revision rate was 0%, and in each cohort, overall revision rate in each cohort was 1.7%. In general, patient-reported outcomes were similar for each group (Harris Hip Score Pain (P ¼ .919), Harris Hip Score Function (P ¼ .736), Western Ontario and McMaster Universities Osteoarthritis Index (P ¼ .139), Pain Visual Analog Scale (P ¼ .146), Veterans RAND 12-Item Health Survey (P ¼ .99), University of California, Los Angeles (P ¼ .417), and Harris Hip Score Total (P ¼ .136). There was a slight clinically insignificant increase in hip flexion between the cohorts favoring the ADM group (98.6 ± 9.8 vs 94.0 ± 9.7, P < .001). Conclusions: Both DM systems had similar patient-reported outcomes that were quite favorable. At 2.86 years of follow-up, neither the ADM nor MDM systems demonstrated dislocation, and both had low acetabular-specific and overall revision rates in this matched cohort study.

Background: With dislocation as a leading cause for revision after total hip arthroplasty (THA), modular dualmobility (MDM) constructs are more commonly used at present in an attempt to decrease postoperative instability. With modularity, there is potential for additional complications, including malseating of the liner. The goal of this study was to perform a radiographic analysis on the incidence of MDM liner malseating. Methods: We retrospectively identified 305 patients (305 THAs) who underwent primary THA with an MDM liner from a single manufacturer inserted by a single surgeon. One hundred fifty-six (51%) patients were male. The mean age was 68 years, and the mean body mass index was 31 kg/m 2. Only patients with both anteroposterior and cross-table lateral radiographs at a minimum of 6 weeks postoperatively were included. Dislocations and reoperations were determined at 1 year after the procedure. All MDM liners were routinely tested intraoperatively with a "4-quadrant test" to assess for proper seating. Results: Four (4/305, 1.3%) MDM liners were noted to be radiographically malseated at early follow-up with three (3/147, 2.0%) occurring in a thinner two dimentional (2D) ongrowth shell and only one (1/ 158, 0.6%) observed in a thicker three dimentional (3D) additively manufactured shell. They were inferiorly prominent by a median of 1.2 mm, best seen on the cross-table lateral radiograph. In patients with at least 1-year follow-up, no MDM liners dissociated and no patients sustained a dislocation. Five (1.6%) patients required reoperation unrelated to the acetabular or MDM construct. Conclusions: Surgeons should be aware that malseating of dual-mobility liners may occur. However, with utilization of a consistent surgical technique to test for seating of the liner, the radiographic incidence of MDM liner malseating was low at 1%. Although there were no short-term clinical implications of liner malseating, long-term follow-up is needed.

Background As the value of patient-reported outcomes becomes increasingly recognized, minimum clinically important difference (MCID) thresholds have seen greater use in shoulder arthroplasty. However, MCIDs are unique to certain populations, and variation in the modes of calculation in this field may be of concern. With the growing utilization of MCIDs within the field and value-based care models, a detailed appraisal of the appropriateness of MCID use in the literature is necessary and has not been systematically reviewed. Questions/purposes We performed a systematic review of MCID quantification in existing studies on shoulder arthroplasty to answer the following questions: (1) What is the range of values reported for the MCID in commonly used shoulder arthroplasty patient-reported outcome measures (PROMs)? (2) What percentage of studies use previously existing MCIDs versus calculating a new MCID? (3) What techniques for calculating the MCID were used in studies where a new MCID was calculated? Methods The Embase, PubMed, and Ovid/MEDLINE databases were queried from December 2008 through December 2020 for total shoulder arthroplasty and reverse total shoulder arthroplasty articles reporting an MCID value for various PROMs. Two reviewers (DAK, MAM) independently screened articles for eligibility, specifically identifying articles that reported MCID values for PROMs after shoulder arthroplasty, and extracted data for analysis. Each study was classified into two categories: those referencing a previously defined MCID and those using a newly calculated MCID. Methods for determining the MCID for each study and the variability of reported MCIDs for each PROM were recorded. The number of patients, age, gender, BMI, length of follow-up, surgical indications, and surgical type were extracted for each article. Forty-three articles (16,408 patients) with a mean (range) follow-up of 20 months (0.75 to 68) met the inclusion criteria. The median (range) BMI of patients was 29.3 kg/m 2 (28.0 to 32.2 kg/m 2 ), and the median (range) age was 68 years (53 to 84). There were 17 unique PROMs with MCID values. Of the 112 MCIDs reported, the most common PROMs with MCIDs were the American One of the authors (AJ) certifies receipt of personal payments or benefits, during the study period, in an amount of less than USD 10,000 from DJO Global; in an amount of less than USD 10,000 from Ignite Orthopedics; in an amount of less than USD 10,000 from DePuy Synthes. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. Ethical approval for this study was not sought.

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