Prompt surgical repair ensures satisfactory outcomes in patients with complete PM rupture; however, delayed allograft repair provides good results with only slight strength impairment. Fresh insights are provided on the role of US in evaluating PM anatomy and tendon attachment to bone.

Aim of this review is to underline some specific patterns of shoulder pain that are not related to musculoskeletal diseases but are manifestations of gastrointestinal, neurological, cardiological or rheumatological diseases. The most important pathologies (like gallstones, myocardial ischaemia and Parsonage-Turner syndrome...) that can manifest with shoulder pain will be presented by specialty doctors and elements for differential diagnosis will be discussed. Orthopaedic shoulder surgeons should always suspect other causes of pain, different from those related to bone, tendons and joint. If there is something unfair, patients should be referred to family doctor for further investigations in order to exclude major systemic diseases.

The aim of our study was to assess the predictive value of the Singh index (SI), which estimates bone architecture, and bone density (BMD) when dealing with the mechanical competence of bone and to analze possible differences in bone properties between gender in humans. The relationship between SI, BMD, and mechanical competence was analyzed in 106 bone cylinders from 37 human femoral heads obtained during hip-joint replacement surgery for low energy fracture or for osteoarthritis. Bones from osteoporotic patients are less dense and more brittle compared with bones from osteoarthritic patients, as expected. Among osteoporotic patients female bones were more brittle than those from males, although BMD was similar. In osteoarthritic patients there were no significant differences among sexes. Bone mechanical competence varies according to BMD and to SI categories. Thus, our study suggests that bone strength is predicted by both BMD and bone architecture.

Resurfacing arthroplasty is an effective device in young patients with advanced glenohumeral arthropathy; however, the high rate of postoperative glenoid erosion and the failure of biologic allograft lead us to consider glenoid replacement as the best option to improve clinical outcomes.

Complex (3-4 fragments) fractures of the proximal humerus often have a bad outcome, whatever treatment is performed. When revision surgery is required, reverse shoulder prosthesis can improve function and reduce pain in these patients. We analysed whether the choice of the first treatment (hemiarthroplasty vs. reduction and fixation) can influence the outcome of revision surgery. Our data demonstrate that results are not significantly dependent on the choice of the first implant, even though there is a tendency for patients with previous hemiarthroplasty to have a worse outcome.