{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T08:56:58Z","timestamp":1773565018466,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,2,18]],"date-time":"2023-02-18T00:00:00Z","timestamp":1676678400000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2023,2,18]],"date-time":"2023-02-18T00:00:00Z","timestamp":1676678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2023,2,18]],"date-time":"2023-02-18T00:00:00Z","timestamp":1676678400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2023,2,18]],"date-time":"2023-02-18T00:00:00Z","timestamp":1676678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,2,18]],"date-time":"2023-02-18T00:00:00Z","timestamp":1676678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T00:00:00Z","timestamp":1674172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009885","name":"American Academy of Orthopaedic Surgeons","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009885","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008542","name":"Arthroscopy Association of North America","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008542","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000090","name":"Congressionally Directed Medical Research Programs","doi-asserted-by":"publisher","award":["W81XWH-14-DMRCP-CRI-IRA-MTI"],"award-info":[{"award-number":["W81XWH-14-DMRCP-CRI-IRA-MTI"]}],"id":[{"id":"10.13039\/100000090","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","award":["HU0001-15-2-0028"],"award-info":[{"award-number":["HU0001-15-2-0028"]}],"id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008542","name":"Arthroscopy Association of North America","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["arthroscopysportsmedicineandrehabilitation.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy, Sports Medicine, and Rehabil."],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To report the frequencies of surgical stabilization procedures performed by military shoulder surgeons and to use decision tree analysis to describe how bipolar bone loss affects surgeons\u2019 decision to perform arthroscopic versus open stabilization procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Military Orthopaedics Tracking Injuries and Outcomes Network (MOTION) database was queried for anterior shoulder stabilization procedures from 2016 to 2021. A nonparametric decision tree analysis was used to generate a framework for classifying surgeon decision making based on specified injury characteristics (labral tear location, glenoid bone loss [GBL], Hill\u2010Sachs lesion [HSL] size, and on\u2010track vs off\u2010track HSL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 525 procedures were included in the final analysis, with a mean patient age of 25.9 \u00b1 7.2 years and a mean GBL percentage of 3.6% \u00b1 6.8%. HSLs were described based on size as absent (n\u00a0= 354), mild (n\u00a0= 129), moderate (n\u00a0= 40), and severe (n\u00a0= 2) and as on\u2010track versus off\u2010track in 223 cases, with 17% (n\u00a0= 38) characterized as off\u2010track. Arthroscopic labral repair (n\u00a0= 428, 82%) was the most common procedure, whereas open repair (n\u00a0= 10, 1.9%) and glenoid augmentation (n\u00a0= 44, 8.4%) were performed infrequently. Decision tree analysis identified a GBL threshold of 17% or greater that resulted in an 89% probability of glenoid augmentation. Shoulders with GBL less than 17% combined with a mild or absent HSL had a 95% probability of an isolated arthroscopic labral repair, whereas a moderate or severe HSL resulted in a 79% probability of arthroscopic repair with remplissage. The presence of an off\u2010track HSL did not contribute to the decision\u2010making process as defined by the algorithm and data available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among military shoulder surgeons, GBL of 17% or greater is predictive of a glenoid augmentation procedure whereas HSL size is predictive of remplissage for GBL less than 17%. However, the on\u2010track\/off\u2010track paradigm does not appear to affect military surgeons\u2019 decision making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.asmr.2023.01.007","type":"journal-article","created":{"date-parts":[[2023,2,18]],"date-time":"2023-02-18T01:51:11Z","timestamp":1676685071000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Glenoid Track Paradigm Does Not Reliably Affect Military Surgeons\u2019 Approach to Managing Shoulder Instability"],"prefix":"10.1002","volume":"5","author":[{"given":"Daniel J.","family":"Cognetti","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery San Antonio Military Medical Center San Antonio Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew S.","family":"Tenan","sequence":"additional","affiliation":[{"name":"Rockefeller Neuroscience Institute West Virginia University Morgantown West Virginia U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan F.","family":"Dickens","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Duke University Medical Center Durham North Carolina U.S.A."},{"name":"Department of Orthopaedics Institute of Clinical Sciences Sahlgrenska Academy Gothenburg University Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeanne C.","family":"Patzkowski","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery San Antonio Military Medical Center San Antonio Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark P.","family":"Cote","sequence":"additional","affiliation":[{"name":"University of Connecticut Health Center Farmington Connecticut U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikael","family":"Sansone","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Institute of Clinical Sciences Sahlgrenska Academy Gothenburg University Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J.","family":"Sheean","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery San Antonio Military Medical Center San Antonio Texas U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,2,18]]},"reference":[{"key":"e_1_2_3_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506288239"},{"key":"e_1_2_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/2047-783X-14-1-18"},{"key":"e_1_2_3_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.L.01656"},{"key":"e_1_2_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546505283267"},{"key":"e_1_2_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.08.033"},{"key":"e_1_2_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507300262"},{"key":"e_1_2_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515578250"},{"issue":"2","key":"e_1_2_3_9_2","article-title":"Predictive value and clinical validation of the \u201con\u2010track\u201d vs. \u201coff\u2010track\u201d concept in bipolar bone loss in anterior glenohumeral instability","volume":"3","author":"Tokish J.M.","year":"2015","journal-title":"Orthop J Sports Med"},{"key":"e_1_2_3_10_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200608000-00010"},{"key":"e_1_2_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520949840"},{"key":"e_1_2_3_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-012-2140-1"},{"key":"e_1_2_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2015.03.008"},{"key":"e_1_2_3_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967117712476"},{"key":"e_1_2_3_15_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.15.01478"},{"key":"e_1_2_3_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511406869"},{"key":"e_1_2_3_17_2","first-page":"E91","article-title":"Shoulder instability management: A survey of the American Shoulder and Elbow Surgeons","volume":"45","author":"Garcia G.H.","year":"2016","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"e_1_2_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2019.02.035"},{"key":"e_1_2_3_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usaa304"},{"key":"e_1_2_3_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-017-9436-1"},{"key":"e_1_2_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2006.12.012"},{"key":"e_1_2_3_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000153074.19245.be"},{"key":"e_1_2_3_23_2","first-page":"126","article-title":"Decision trees for decision making","volume":"42","author":"Magee J.F.","year":"1964","journal-title":"Harv Bus Rev"},{"key":"e_1_2_3_24_2","doi-asserted-by":"publisher","DOI":"10.1201\/9781315139470"},{"key":"e_1_2_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2020.10.039"},{"key":"e_1_2_3_26_2","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2000.17715"},{"key":"e_1_2_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2021.04.059"},{"key":"e_1_2_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2021.06.021"},{"key":"e_1_2_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2013.10.004"},{"key":"e_1_2_3_30_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.15.01099"}],"container-title":["Arthroscopy, Sports Medicine, and Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2666061X2300007X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2666061X2300007X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.asmr.2023.01.007","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.asmr.2023.01.007","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.asmr.2023.01.007","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.asmr.2023.01.007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T08:37:43Z","timestamp":1773563863000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.asmr.2023.01.007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,18]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,4]]}},"alternative-id":["10.1016\/j.asmr.2023.01.007"],"URL":"https:\/\/doi.org\/10.1016\/j.asmr.2023.01.007","archive":["Portico"],"relation":{},"ISSN":["2666-061X","2666-061X"],"issn-type":[{"value":"2666-061X","type":"print"},{"value":"2666-061X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,18]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The Glenoid Track Paradigm Does Not Reliably Affect Military Surgeons\u2019 Approach to Managing Shoulder Instability","name":"articletitle","label":"Article Title"},{"value":"Arthroscopy, Sports Medicine, and Rehabilitation","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.asmr.2023.01.007","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Published by Elsevier Inc. on behalf of the Arthroscopy Association of North America.","name":"copyright","label":"Copyright"}]}}