Fukuda and Mikasa survey the history of modern shoulder surgery from Codman's first rotator cuff repair in 1909 through the arthroscopic era. The paper identifies landmark publications, classification systems, and organizational milestones, and benchmarks Japan's contributions to the global shoulder literature. This is a narrative review, not a primary study.
Several concepts in this paper directly govern clinical decisions you make every week.
When a 19-year-old comes in after a first-time anterior dislocation, Rowe's data tells you the recurrence risk is 94%. That number changes the conversation from "let's see how rehab goes" to a frank discussion about early surgical stabilization versus structured nonoperative management with realistic expectations.
When you are planning a massive rotator cuff repair, Goutallier's 5-stage classification is your preoperative prognostic tool. Advanced fatty infiltration on MRI or CT predicts poor functional recovery regardless of technical repair quality. Grading muscle quality before surgery is a decision gate, not a formality.
For proximal humeral fractures, the critical distinction the AO classification adds to Neer's system is the valgus-impacted four-part pattern. These fractures may preserve the medial capsule and with it partial humeral head vascularity, making them more amenable to fixation than a true four-part fracture. Recognizing this on imaging changes the operative plan.
Fukuda and Mikasa survey the history of modern shoulder surgery from Codman's first rotator cuff repair in 1909 through the arthroscopic era. The paper identifies landmark publications, classification systems, and organizational milestones, and benchmarks Japan's contributions to the global shoulder literature. This is a narrative review, not a primary study.
Several concepts in this paper directly govern clinical decisions you make every week.
When a 19-year-old comes in after a first-time anterior dislocation, Rowe's data tells you the recurrence risk is 94%. That number changes the conversation from "let's see how rehab goes" to a frank discussion about early surgical stabilization versus structured nonoperative management with realistic expectations.
When you are planning a massive rotator cuff repair, Goutallier's 5-stage classification is your preoperative prognostic tool. Advanced fatty infiltration on MRI or CT predicts poor functional recovery regardless of technical repair quality. Grading muscle quality before surgery is a decision gate, not a formality.
For proximal humeral fractures, the critical distinction the AO classification adds to Neer's system is the valgus-impacted four-part pattern. These fractures may preserve the medial capsule and with it partial humeral head vascularity, making them more amenable to fixation than a true four-part fracture. Recognizing this on imaging changes the operative plan.