Shoulder Injuries

Springbok is building AI technology to provide a more accurate and objective scoring system for evaluating rotator cuff muscles and better predict surgical outcomes CHARLOTTESVILLE, Va., March 5, 2024 /PRNewswire/ - Springbok Analytics (), a life sciences muscle analytics company, announced today that it has received a $1.7 million Phase II Small Business Innovation Research (SBIR) grant from the National Institutes of Health (NIH) to develop a commercially viable machine learning algorithm to automatically detect shoulder muscle pathology. Alongside its research partners from the University of Virginia, the San Antonio Orthopedic Group (TSAOG), and the University of Wisconsin, Springbok is building AI technology to provide a more accurate and objective scoring system for evaluating RC muscles and better predict surgical outcomes. "Springbok has the potential to significantly enhance how we understand, manage, and treat RC tears and improve surgical outcomes. I'm excited about its technology and the role it can play in helping surgeons make better clinical decisions," said Andrew J. Sheean, MD, Director of the Research for Accelerated Therapeutics and Orthopaedic Rehabilitation (REACTOR) Lab, San Antonio. RC repairs are the second most common orthopedic soft tissue surgery in the US with over 400,000 performed annually, but they remain a challenging clinical problem with a high surgical failure rate. The Goutallier classification system, used to assess muscle atrophy and fatty replacement in RC tears, is the current standard for surgical evaluation, but is highly limited due to its qualitative nature and inability to predict surgical outcomes. Researchers have shown that quantitative 3D measures of atrophy and fatty replacement are better predictors of surgical outcomes, but these methods have not been clinically accessible because of the long processing time and reliance on specialized research MRI methods. Springbok's technology overcomes these two challenges through the use of AI and innovative analysis methods, described in recent studies in Radiology: Artificial Intelligence and Scientific Reports. "We are excited to commence Phase II after successfully developing and validating our deep-learning-based algorithm for automated quantification of rotator cuff muscle and fatty infiltration from clinical scans," said Lara Riem, PhD and Springbok's Director of AI and Data Science. "In creating an extensive digital database of both healthy and pathological rotator cuff clinical scans in Phase I, we developed a novel method to account for variability in scan coverage, which led to the establishment of key muscle metrics that can be derived precisely and automatically, at scale, from MR images." Leveraging its proprietary muscle analytics, Springbok's AI technology produces an enhanced RC analysis from standard MRIs that are acquired within the clinical workflow. Its 3D volumetric measurement provides a more comprehensive and sensitive assessment of RC pathology, and the output is a simple, objective, and actionable report available to both providers and patients for an improved surgical decision-making process. "To obtain a proper treatment plan and avoid poor surgical outcomes and possible retears, it is critical to better understand a patient's rotator cuff musculature in 3D and objectively measure both muscle atrophy and fat infiltration," said Silvia Blemker, PhD and Springbok's Co-Founder and Chief Science Officer. "Phase I demonstrated implementation viability of our new analysis, proving it was both valuable and practical within the clinical setting. Our goal with this next phase is to continue product development in the pursuit of an automatic rotator cuff segmentation and analysis technology that can benefit millions of patients and improve upon the subjective scoring standard used today." Completing Phase II will enable Springbok to apply for FDA 510(k) market clearance, with the aim to significantly improve the accuracy of shoulder pathology assessments, the diagnosis and treatment of shoulder injuries, and the outcomes of costly orthopedic procedures, potentially even eliminating unnecessary surgeries. "Our ultimate goal at Springbok Analytics is to become the standard for how we understand human musculature and improve clinical diagnosis, injury management and human performance through innovative, AI-based technologies," concluded Blemker. About Springbok Analytics: Springbok is a life sciences muscle analytics company that drives better health and performance outcomes. Its technology analyzes MRI data and creates personalized 3D visualizations of muscle health, enhancing the assessment, treatment monitoring, research and diagnostic value of advanced imaging. Springbok's rapid imaging sequence and AI-based analysis reveals a complete view of musculoskeletal health, precisely quantified individual muscle volume and quality, fat infiltration, left-right asymmetries, as well as scar tissue, edema, and tendon morphology. To learn more about how Springbok is creating a better view of health, please visit . SOURCE Springbok Analytics

Goldilocks is designed to tackle the delicate equilibrium between joint stability and mobility, and is said to have advanced capabilities for pre- and post-operative adjustments Exactech partners with Statera Medical to develop smart reverse shoulder implant called Goldilocks. (Credit: marionbrun from Pixabay) Exactech has unveiled an exclusive partnership with medical device developer Statera Medical to design a smart reverse shoulder implant called Goldilocks. Based in Florida, US, Exactech is a developer and manufacturer of implants, instrumentation, and intelligent technologies for joint replacement surgeries. Statera Medical, which is a startup based in Canda, is engaged in developing smart and personalised orthopaedic implants. The project kick-off meeting between Exactech and Statera Medical took place last month, marking the beginning of a collaborative effort over the coming years to co-design and develop the smart reverse shoulder implant. Designed to address the critical balance between joint stability and mobility, Goldilocks is said to have advanced pre- and post-operative adjustment capabilities. These ensure personalised optimisation for various shoulder pathologies while minimising the risks of complications. One of the features of Goldilocks is its ability to facilitate micro-adjustments to the implant. This allows for optimal functionality through minimally invasive means and will reduce the likelihood of invasive revision surgeries in the event of complications. Goldilocks utilises a patented communication protocol to stay connected, offering full passivity without the need for batteries, thereby ensuring patient safety and guaranteeing an infinite lifespan. Communication is activated only when necessary, during surgery and patient follow-up to enhance safety and reliability. Furthermore, the implant comes equipped with an intuitive interface, which streamlines the surgical process and provides real-time insights into in vivo behaviour. This feedback enables surgeons to optimise the mobility and stability of the implant, thus improving overall surgical outcomes. Statera Medical CEO Samuel Bourdon said: “Through the use of smart implants, which provide more objective data, we aim to help surgeons select the correct implant size and offset for a particular patient and provide the best balance of joint mobility and stability for all major joints. “Our breakthrough device-designated technology provides real-time data and adjustment capability to help surgeons uniquely treat their patients.” By using this technology, surgeons gain a more accurate and straightforward method for assessing soft tissue tension during surgery, which ultimately boost precision and efficacy in joint replacement procedures. Exactech extremities senior vice president Chris Roche said: “Currently, the process surgeons use to select reverse shoulder implant size and offset for a given patient is subjective. “If the reconstructed joint is too loose, the patient may be at risk for instability, whereas if the joint is too tight, the patient may be at risk for scapular stress fractures and perhaps implant loosening as well. “In partnership with Statera, we will create a new process to help surgeons objectively quantify a patient’s soft tissue tension and then adjust the ideal implant offset and size for that particular patient.”

ROSEMONT, Ill., Feb. 2, 2024 /PRNewswire/ -- The 2024 Kappa Delta Ann Doner Vaughn Award was presented to the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Group for shifting the way physicians treat patients with atraumatic, symptomatic rotator cuff tears. Their research determined that physical therapy (PT), is an effective treatment for over 70% of these patients to improve pain and patient-reported outcome measures (PROMs) followed for over 10 years. This award recognizes research in musculoskeletal disease or injury with great potential to advance patient care. Continue Reading The 2024 Kappa Delta Ann Doner Vaughn Award was presented to the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Group for shifting the way physicians treat patients with atraumatic, symptomatic rotator cuff tears. To read more about the award, please click here. According to the American Academy of Orthopaedic Surgeons (AAOS), each year, almost 2 million people in the United States visit their doctors because of rotator cuff tears. This type of injury creates a significant economic burden to the U.S. health care system, as the prevalence of rotator cuff tears accelerates with age, and more than two-thirds of patients who have surgery are of working age. "When I finished my training in 1994, we were taught that surgery was the preferred way to treat a rotator cuff tear," said John E. Kuhn, MD, MS, FAAOS, chief of shoulder surgery and director of Vanderbilt Sports Medicine and director of the MOON Shoulder Group. "As the approach to treating rotator cuff tears remained unclear, we wanted a more thorough understanding of the disease to help define the indications for rotator cuff repair surgery and determine which patients would benefit from nonoperative treatment." Over the course of 10 years, the MOON Shoulder Group used their multicenter outcomes network to prospectively collect data on patients with rotator cuff disease to answer clinically important questions and better understand the natural history and treatment of rotator cuff disease. To predict failure rates of nonoperative treatment of rotator cuff tears, the group developed a standard, evidence-based PT protocol that included a "gold standard" PT protocol, with elements derived from a systematic review. The cohort study enrolled patients aged 18 to 100 years with shoulder symptoms and MRI-documented, symptomatic, atraumatic, full-thickness rotator cuff tears (where the tendon is completely detached from the bone). Patients were given two instructive rehabilitation books—one for physical therapists and another for home-based PT written at the eighth-grade level—with an accompanying DVD. The specific exercises included daily range of motion (postural exercises, active-assisted motion, active training of scapular muscles and active range of motion); daily flexibility (anterior and posterior shoulder stretching); and strengthening three times per week (rotator cuff and scapula exercises). Therapists were instructed to provide manual mobilization exercises as needed based on evidence that supports their use in impingement and to progress the patient to a home therapy program when ready. Based on the systematic review, heat and cold were recommended as modalities, but ultrasound was not.i Patient outcome scores were tracked at entry into the study and during each follow-up visit at six weeks, 12 weeks, one year, and two, five, seven and 10 years. At the six-week mark, patients were given three options: no additional follow up if they considered themselves "cured"; continue PT for six more weeks if they were "improved"; and, if they were "no better", they could elect to have surgery. At any point during the study, patients could opt to have surgery. Results from the research include: At 10 years, PT was shown to be highly effective in over 70% of patients with atraumatic, symptomatic, full-thickness rotator cuff tears in reducing pain and improving PROMs. Most patients who decided to have surgery within six months were driven primarily by their expectations of the effectiveness of physical therapy. In other words, if they thought PT would work, it worked. If they didn't believe it would work, it didn't. When comparing those who had surgery before six months and those who had surgery between six months and 10 years, worker's compensation status and activity level were more important in predicting the need for surgery after 6 months. Structural factors (tear size, retraction), visual analog pain score and weakness were not predictors of having surgery and are likely not helpful in determining surgical indications. There was no correlation between rotator cuff tear anatomy and pain, the duration of symptoms, and patient activity level. "Our team was shocked when so many patients in the cohort improved with physical therapy, because it's not at all what we expected," said Kuhn. "We're also optimistic about the finding that low expectations for therapy drives patients to having surgery because we can modify this variable by educating patients that physical therapy can work." The MOON Shoulder Group and other surgeons are engaged in the Arthroscopic Rotator Cuff Trial, a multicenter, randomized trial funded by the Patient Centered Outcomes Research Institute, where patients with symptomatic, atraumatic full-thickness rotator cuff tears are randomized to either treatment with PT or surgical repair of their rotator cuff tear to help determine which treatment option might be best suited for a particular patient. In addition to Dr. Kuhn, the MOON Shoulder Group includes the following researchers: Warren R. Dunn, MD, MPH, FAAOS, Rosemary Sanders, BA, Keith M. Baumgarten, MD, FAAOS, Julie Y. Bishop, MD, FAAOS, Robert H. Brophy, MD, FAAOS, James L. Carey, MD, MPH, FAAOS, Brian G. Holloway, MD, Grant L. Jones, MD, FAAOS, C. Benjamin Ma, MD, FAAOS, Robert G. Marx, MD, MS, FAAOS, Eric C. McCarty, MD, FAAOS, Sourav K. Poddar, MD, Matthew V. Smith, MD, FAAOS, Edwin E. Spencer, MD, FAAOS, Armando F. Vidal MD, FAAOS, Brian R. Wolf, MD, MS, FAAOS, and Rick W. Wright, MD, FAAOS. About the Kappa Delta Awards In 1947, at its golden anniversary, the Kappa Delta Sorority established the Kappa Delta Research Fellowship in Orthopaedics, the first award ever created to honor achievements in the field of orthopaedic research. The first annual award, a single stipend of $1,000, was made available to the AAOS in 1949 and presented at the AAOS meeting in 1950. The Kappa Delta Awards have been presented by the AAOS to persons who have performed research in orthopaedic surgery that is of high significance and impact. The sorority has since added two more awards and increased the award amounts to $20,000 each. Two awards are named for the sorority national past presidents who were instrumental in the creation of the awards: Elizabeth Winston Lanier and Ann Doner Vaughn. The third is known as the Young Investigator Award. For more information about the manuscript submission process, please visit aaos.org/kappadelta. Learn more about the Kappa Delta Foundation, here. About the AAOS With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world's largest medical association of musculoskeletal specialists. The AAOS is the trusted leader in advancing musculoskeletal health. It provides the highest quality, most comprehensive education to help orthopaedic surgeons and allied health professionals at every career level to best treat patients in their daily practices. The AAOS is the source for information on bone and joint conditions, treatments and related musculoskeletal health care issues; and it leads the health care discussion on advancing quality. Follow the AAOS on Facebook, X, LinkedIn and Instagram. Disclosure Funding and Conflicts of Interest For a list of disclosures, funding and conflicts of interest, email [email protected]. i Kuhn JE. Exercise in the treatment of rotator cuff impingement: a systematic review and a synthesized evidence-based rehabilitation protocol. J Shoulder Elbow Surg. 2009 Jan-Feb;18(1):138-60. SOURCE American Academy of Orthopaedic Surgeons