While shoulder hemiarthroplasty is still used to treat young patients with shoulder pathology, the use of this procedure has substantially declined in recent years due to its significant complication profile. Glenoid wear with arthrosis is one of the major postoperative complications following shoulder hemiarthroplasty, and efforts to prevent this complication led many scientists to explore alternative weight-bearing surfaces on arthroplasty implants to decrease joint wear and improve patient outcomes. Pyrolytic carbon, or pyrocarbon, is a material that has better biocompatibility, survivorship, strength, and wear resistance compared to the materials used in traditional shoulder hemiarthroplasty. Pyrocarbon implants have been used in orthopedics for over 50 years; recently, their utility in shoulder hemiarthroplasty has garnered much interest. The purpose behind the use of pyrocarbon in shoulder hemiarthroplasty is to decrease the risk of progressive glenoid wear, especially in young active patients in whom joint preservation is important. Promising survivorship and outcomes have been demonstrated by recent studies, including limited glenoid wear following pyrocarbon hemiarthroplasty. Nevertheless, these clinical studies have been limited to relatively small case series with limited long-term follow-up. Accordingly, additional research and comparative studies need to be conducted in order to properly assess the therapeutic efficacy and value of pyrocarbon hemiarthroplasty.

Background: This study analyzed questions entered online by rotator cuff patients and determined types and quality of websites providing information at the top of queries. Methods: Three strings related to rotator cuff repair were explored in Google Search. The result pages were manually collected under the “People also ask” function for frequent questions and associated webpages. Questions were categorized using Rothwell’s classification with further topical subcategorization. Webpages were evaluated by Journal of American Medical Association (JAMA) benchmark criteria for source quality. Results: One hundred twenty “People also ask” questions were collected with their associated webpages. Based on the Rothwell classification of questions, queries were thematically organized into fact (41.7%), value (31.7%), and policy (26.7%) categories. The most common webpage categories were academic (28.3%) and medical practice (27.5%). The most common question subcategories were timeline of recovery (21.7%), indications/management (21.7%), and pain (18.3%). The average JAMA score for all 120 webpages was 1.50. Journal articles had the highest average JAMA score (3.77), while commercial websites had the lowest JAMA score (0.91). The most common suggested question for rotator cuff repair/surgery was, “Is rotator cuff surgery worth having?,” while the most common suggested question for rotator cuff repair pain was, “What happens if a rotator cuff is not repaired?” Conclusions The most common questions asked on Google pertaining to rotator cuff repair evaluate management options and relate to the timeline of recovery and pain management. Most information is provided by medical practice, academic, and medical information websites, which have highly variable reliability. By understanding the questions that rotator cuff repair patients are asking online, surgeons can tailor preoperative education to common patient concerns and improve postoperative outcomes.Level of evidence: IV.

Background: YouTube has become a popular source of healthcare information in orthopedic surgery. Although quality-based studies of YouTube content have been performed for information concerning many orthopedic pathologies, the quality and accuracy of information on the rotator cuff have yet to be evaluated. The purpose of the current study was to evaluate the reliability and educational content of YouTube videos concerning the rotator cuff. Methods: YouTube was queried for the term “rotator cuff.” The first 50 videos from this search were evaluated. Video reliability was assessed using the Journal of the American Medical Association (JAMA) benchmark criteria (range, 0–5). Educational content was assessed using the global quality score (GQS; range, 0–4) and the rotator cuff-specific score (RCSS; range, 0–22). Results: The mean number of views was 317,500.7±538,585.3. The mean JAMA, GQS, and RCSS scores were 2.7±2.0, 3.7±1.0, and 5.6±3.6, respectively. Non-surgical intervention content was independently associated with a lower GQS (β=–2.19, p=0.019). Disease-specific video content (β=4.01, p=0.045) was the only independent predictor of RCSS. Conclusions The overall quality and educational content of YouTube videos concerned with the rotator cuff were low. Physicians should caution patients in using such videos as resources for decision-making and should counsel them appropriately.