RSA as a reconstructive procedure improved function at the time of short-term follow-up in our young patients with glenohumeral arthritis and rotator cuff deficiency. Objective outcomes in our patient cohort were similar to those in previously reported studies. However, overall satisfaction was much lower in this patient population (81%) compared with that in the older patient population as reported in the literature (90% to 96%).

This study provides the first prospective data on global cerebral perfusion during shoulder arthroscopy in the beach-chair position with use of controlled hypotension. Our study suggests that patients may be able to safely tolerate a reduction in blood pressure greater than current recommendations. In the future, intraoperative cerebral monitoring may play a role in preventing neurological injury in patients undergoing shoulder arthroscopy in the beach-chair position.

Background Complex, disease-specific factors help to determine post-traumatic quality of life, but current practice utilizes outcome measures generated from the general population. Trauma survivorship has grown rapidly while defining the factors that influence post-traumatic quality of life has lagged. This study sought to develop a valid and reliable trauma-specific quality of life measure to help guide future post-traumatic research and clinical care. Methods Qualitative data were collected from adult trauma patients and their caregivers (Phase 1). Subsequent analysis of these data resulted in the development of a 59-item quality of life (QoL) questionnaire. The 59-item trauma-specific QoL questionnaire (T-QoL) was then administered to adult trauma patients (n=394) and a factor analysis was conducted. The validity of the final TQoL measurement tool was assessed (n=111) using the Medical Outcomes Study 36-Item Short Form Health Survey version 2 and the PTSD Checklist-Civilian Version (Phase 2). Results A 5-component structure using 43 items appeared to best represent the data. The 5 components included: Emotional Well-Being, Functional Engagement, Recovery/Resilience, Peri-Traumatic Experience, Physical Well-Being. Four of the five components were found to have strong Cronbach's alpha scores (>0.7), demonstrating consistent inter-item reliability. All subscales of the T-QoL correlated negatively with the PCL-C (p<.01), demonstrating that as the T-QoL increases, the likelihood of PTSD decreases. The physical well-being subscale of the T-QoL correlated significantly with the SF-36v2 PCS as did the emotional well-being subscale with the SF-36v2 MCS (p<.05). Conclusions This study utilized the experiences of trauma victims and their informal caregivers to develop a five-component, 43-item questionnaire with domains that are unique to trauma populations. Its accuracy and validity was confirmed using the PCL-C and the SF-36v2. We believe that the TQoL represents a novel and sensitive tool that can be used by trauma professionals to positively impact research efforts and clinical care. Level of Evidence Level II – Prognostic and Epidemiological