Browsing by Author "Hoyer, Reed W."

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    Accuracy of MRI in Assessment of High-Grade Partial Distal Biceps Tears
    (Sage, 2025) Schmidt, Gregory J.; Fischer, James P.; Hoyer, Reed W.; Greenberg, Jeffrey A.; Crosby, Nicholas E.; Graduate Medical Education, School of Medicine
    Background: Magnetic resonance imaging (MRI) is commonly used to diagnose and assess the extent of partial distal biceps injuries. The aim of this study was to report on the accuracy of MRI and the effect of injury history and study timing on its performance. Methods: A retrospective review of all patients who underwent surgical treatment of partial thickness distal biceps tears at a single center by multiple surgeons was performed. Inclusion criteria consisted of the performance of a preoperative MRI and documentation of the intraoperatively visualized extent of the tear, and 68 patients met the criteria for inclusion. A chart review was completed to evaluate the symptom duration, injury history, and tear extent. Results: All patients had distal biceps tears of greater than 50% intraoperatively. However, MRI did not indicate any tearing in 20 (29%) patients, and its sensitivity for high-grade tear was 44%. Magnetic resonance imaging was significantly less likely to be read as high-grade tears in patients with insidious onset of their symptoms in comparison with patients who reported a traumatic onset (27% vs 55%, P = .024). However, the time from symptom onset to MRI did not significantly correlate with diagnosis of a high-grade tear on MRI (r = -0.15, P = .21). Conclusions: These results indicate that MRI can underreport partial distal biceps tear extent, and this more commonly occurs in patients with insidious onset of pain.
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    Efficacy of a Single Image-Guided Corticosteroid Injection for Glenohumeral Arthritis
    (Elsevier, 2020) Metzger, Cameron M.; Farooq, Hassan; Merrell, Gregory A.; Kaplan, F. Thomas D.; Greenberg, Jeffrey A.; Crosby, Nicholas E.; Peck, Kathryn M.; Hoyer, Reed W.; Orthopaedic Surgery, School of Medicine
    Background There is limited data available on the efficacy of cortisone injection for glenohumeral osteoarthritis (GHOA). The amount and longevity of pain relief provided by a single cortisone injection is unclear. Additionally, it remains uncertain how the severity of radiographic GHOA and patient reported function and pain levels impact the efficacy of injection. Therefore, we sought to describe relief provided by a single, image guided glenohumeral injection for patients with GHOA. Additionally, we hypothesized that patients with more severe radiographic GHOA and poorer baseline shoulder function would require earlier secondary intervention. Methods Patients with symptomatic GHOA who elected to receive a corticosteroid injection for pain relief were prospectively enrolled. A phone interview was conducted to record baseline OSS and VAS scores prior to the injection, as well as at months 1, 2, 3, 4, 6, 9, and 12. Endpoints were designated when patients required a second injection, progressed to surgery, or reached month 12. Patients were grouped by their respective baseline OSS (mild, moderate/severe) and Samilson-Prieto radiographic classification (mild, moderate, severe) for analysis. Results Thirty shoulders (29 patients) were analyzed. 52% of patients were male. The average age of 66.1 years. No significant difference was seen in overall survival (defined as no additional intervention) between groups based on either OSS or Samilson-Prieto grades. Additionally, OSS and VAS scores at each follow-up were compared to baseline. For the entire cohort, a clinically significant difference was seen between baseline and months 1-4 for OSS and between baseline and months 1-4, 6,9, and 12 for VAS. Discussion This study aimed to determine the efficacy of corticosteroid injections for GHOA. There were no differences in the need for secondary interventions in this population based on severity of either the OSS or the Samilson-Prieto radiographic classification. However, patients with more severe shoulder dysfunction based on OSS did experience a statistically significant greater symptomatic relief compared with patients with milder dysfunction. Additionally, following a single injection, patients in this cohort experienced statistically and clinically relevant improvements in shoulder function and pain up to 4 months post-injection.
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    Primary Repair of Chronic Distal Biceps Tendon Tears
    (Sage, 2024) Schmidt, Gregory J.; Dmochowski, Jakub M.; Gudeman, Andrew S.; Cage, Emily S.; Greenberg, Jeffrey A.; Hoyer, Reed W.; Graduate Medical Education, School of Medicine
    Background: This study reports the clinical results following primary repair of distal biceps tendon ruptures more 6 weeks after injury. Methods: A retrospective review of distal biceps tendon repairs performed by 8 different hand surgeons from January 1, 2015 to October 15, 2020 was performed. Patients with complete tears surgically treated ≥6 weeks after injury without tendon graft were included. Thirty patients qualified and underwent chart review for complication and range of motion (ROM) data. They were contacted for final patient-reported outcome measures (PROMs) using Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) and Patient Reported Elbow Evaluation (PREE) scores. Final PROMs were obtained from 21 patients with an average follow-up of 31.3 months (range: 4-71 months). Results: Average time from injury to repair was 71 days (range: 42-204). The average QuickDASH score was 6.6 (±6.2) and PREE score was 7.8 (±8.0). The amount of elbow flexion necessary to complete the repair was documented in 21 patients and averaged 64º (±10º). Postoperatively, patients achieved an average extension/flexion of 1º (±1º) to 138º (±2º) and pronation/supination of 76º (±4º) to 77º (±3º). Complications were reported in 14 patients (47%) and included 2 re-ruptures, 1 adhesive scar formation, 1 superficial infection, 1 intraoperative lateral antebrachial cutaneous nerve laceration, 12 neuropraxias, and 1 case of heterotopic ossification (HO). Conclusions: Primary repair of chronic distal biceps tendon tears greater than 6 weeks from injury demonstrated excellent PROMs and elbow ROM. However, the complication rate may be higher than early repair.