Daniel D Buss

North Jersey Orthopaedic Specialists, Teaneck, New Jersey, United States

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Publications (20)48.62 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: In this article, we present our technique for arthroscopic posterior-inferior capsular release and report the results of applying this technique in a population of athletes with symptomatic glenohumeral internal rotation deficit (GIRD) that was unresponsive to nonoperative treatment and was preventing them from returning to sport. Fifteen overhead athletes met the inclusion criteria. Two were lost to follow-up. Of the 13 remaining, 6 underwent isolated posterior-inferior capsular releases, and 7 had concomitant procedures. Before and after surgery, patients completed an activity questionnaire, which included the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form. Passive internal rotation in the scapular plane was measured with a bubble goniometer. Mean age was 21 years (range, 16-33 years). Mean follow-up was 31.1 months (range, 24-59 months). Mean ASES score improved significantly (P < .01) from before surgery (71.5) to after surgery (86.9). Mean GIRD improved from 43.1° to 9.7° (P < .05). Three athletes (23%) did not return to their preoperative level of play; the other 10 (77%) returned to their same level of play or a higher level.
    American journal of orthopedics (Belle Mead, N.J.) 05/2015; 44(5):223-7.
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    ABSTRACT: Background: A variety of complications associated with the use of poly-L-lactic acid (PLLA) implants, including anchor failure, osteolysis, glenohumeral synovitis, and chondrolysis, have been reported in patients in whom these implants were utilized for labral applications. We report on a large series of patients with complications observed following utilization of PLLA implants to treat either labral or rotator cuff pathology. Methods: Patients who had undergone arthroscopic debridement to address pain and loss of shoulder motion following index labral or rotator cuff repair with PLLA implants were identified retrospectively with use of our research database. A total of forty-four patients in whom macroscopic anchor debris had been observed and/or biopsy samples had been obtained during the debridement were included in the study. Synovial biopsy samples taken at the time of the arthroscopic debridement were available for thirty-eight of the forty-four patients and were analyzed by a board-certified pathologist. Magnetic resonance imaging (MRI) scans acquired after the index procedure and data from the arthroscopic debridement were available for all patients. Results: Macroscopic intra-articular anchor debris was observed in >50% of the cases. Giant cell reaction was observed in 84%; the presence of polarizing crystalline material, in 100%; papillary synovitis, in 79%; and arthroscopically documented Outerbridge grade-III or IV chondral damage, in 70%. A significant correlation (rho = 0.36, p = 0.018) was observed between the time elapsed since the index procedure and the degree of chondral damage. A recurrent rotator cuff tear that was larger than the tear documented at the index procedure was observed in all patients whose index procedure included a rotator cuff repair. Conclusions: Clinically important gross, histologic, and MRI-visualized pathology was observed in a large cohort of patients in whom PLLA implants had been utilized to repair lesions of the labrum or rotator cuff.
    The Journal of Bone and Joint Surgery 02/2013; 95A(6). DOI:10.2106/JBJS.L.00314 · 5.28 Impact Factor
  • Daniel D Buss · Michael Q Freehill · Guido Marra
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    ABSTRACT: The cause of shoulder impingement syndrome usually is considered to be compression of the rotator cuff and subacromial bursa against the anterolateral aspect of the acromion. The typical symptom is anterolateral shoulder pain that worsens at night and with overhead activity. However, the pain may be caused by factors other than a hooked acromion. Atypical impingement syndrome most commonly results from an os acromiale, a subcoracoid disorder, acromioclavicular joint undersurface hypertrophy, a deconditioned rotator cuff, or scapular dyskinesis. The correct diagnosis is made through the patient history and physical examination, with appropriate diagnostic imaging. Nonsurgical treatment is successful for most types of impingement syndrome; if it is not successful, all structural causes of mechanical impingement must be corrected.
    Instructional course lectures 02/2009; 58:447-57.
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    ABSTRACT: The purpose of this anatomic study is to define the morphologic changes of the coracoid and surrounding soft tissue after arthroscopic coracoid decompression. We obtained 5 fresh-frozen forequarter cadaveric specimens, 3 female and 2 male, with a mean age of 86.2 years. Arthroscopic coracoid decompression was performed, and intraarticular pathology was documented. Preoperative and postoperative measures of coracoid overlap, coracoid index, and coracohumeral distance were made on limited-cut axial computed tomography scans. Dissection was performed to assess anatomic relationships after coracoid decompression. Arthroscopic findings revealed subscapularis pathology and glenohumeral arthritis in all specimens, long head of biceps pathology in 3, and supraspinatus pathology in 2. Gross dissection confirmed the pathologic findings. Arthroscopic coracoid decompression effectively improves coracoid overlap, coracoid index, and coracohumeral distance. The adjacent major neurovascular structures are at a safe distance from the decompression site.
    Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 03/2007; 16(2):245-50. DOI:10.1016/j.jse.2006.05.005 · 2.29 Impact Factor
  • Medicine &amp Science in Sports &amp Exercise 05/2005; 37(Supplement):S143. DOI:10.1249/00005768-200505001-00779 · 3.98 Impact Factor
  • Medicine &amp Science in Sports &amp Exercise 05/2005; 37(Supplement). DOI:10.1097/00005768-200505001-00779 · 3.98 Impact Factor
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    ABSTRACT: Acute or recurrent anterior shoulder instability is a frequent injury for in-season athletes. Treatment options for this injury include shoulder immobilization, rehabilitation, and shoulder stabilization surgery. To determine if in-season athletes can be returned to their sports quickly and effectively after nonoperative treatment for an anterior instability episode. Over a 2-year period, 30 athletes matched the inclusion criteria for this study. Nineteen athletes had experienced anterior dislocations, and 11 had experienced subluxations. All were treated with physical therapy and fitted, if appropriate, with a brace. These athletes were followed for the number of recurrent instability episodes, additional injuries, subjective ability to compete, and ability to complete their season or seasons of choice. Twenty-six of 30 athletes were able to return to their sports for the complete season at an average time missed of 10.2 days (range, 0-30 years). Ten athletes suffered sport-related recurrent instability episodes (range, 0-8 years). An average of 1.4 recurrent instability episodes per season per athlete occurred. There were no further injuries attributable to the shoulder instability. Sixteen athletes underwent surgical stabilization for their shoulders during the subsequent off-season. Most of the athletes were able to return to their sport and complete their seasons after an episode of anterior shoulder instability, although 37% experienced at least 1 additional episode of instability during the season.
    The American Journal of Sports Medicine 10/2004; 32(6):1430-3. DOI:10.1177/0363546503262069 · 4.36 Impact Factor
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    ABSTRACT: Progress has been made in the design of bioabsorbable implants, with reduced complication rates and slower degradation times. To report on complications related to use of poly-L-lactic acid implants after arthroscopic shoulder stabilization procedures. Retrospective cohort study. Between 1997 and 1999, 52 patients underwent arthroscopic stabilization at one institution with an average of 2.2 poly-L-lactic acid tacks. Ten patients (19%), with an average age of 30 years, developed delayed onset of symptoms at an average of 8 months after surgery, including pain in all 10 and progressive stiffness in 6. The patients underwent magnetic resonance imaging and arthroscopic evaluation and debridement. Nine patients had gross implant debris. Evidence of glenohumeral synovitis was seen arthroscopically in all 10 patients. Three patients had significant full-thickness chondral damage on the humeral head. All preexisting labral lesions were healed. One year after arthroscopic debridement, loose body removal, and synovectomy, seven patients reported no or minimal pain and full return of motion. Two patients continued to have persistent pain and stiffness, and one patient reported discomfort with overhand throwing; all three had chondral lesions. Patients with symptoms of delayed pain and progressive stiffness after arthroscopic stabilization with poly-L-lactic acid implants should be evaluated for synovitis and chondral injury. Arthroscopic treatment provides a significant decrease in symptoms and increased range of motion.
    The American Journal of Sports Medicine 09/2003; 31(5):643-7. DOI:10.1177/03635465030310050201 · 4.36 Impact Factor
  • Daniel D Buss · J David Watts
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    ABSTRACT: Acromioclavicular injuries in the overhead or throwing athlete are frequently encountered by team physicians. Treatment regimens vary greatly, depending on dominant versus nondominant arm, injury in-season or out-of-season, and the athlete's goals for future seasons. This article focuses on each of these unique issues with regards to acromioclavicular separations and fractures, acromioclavicular arthritis, and acromioclavicular osteolysis.
    Clinics in Sports Medicine 05/2003; 22(2):327-41, vii. DOI:10.1016/S0278-5919(02)00113-8 · 1.22 Impact Factor
  • Cedric J Ortiguera · Daniel D Buss
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    ABSTRACT: Os acromiale is an uncommon cause of shoulder pain with symptoms often resulting from an unstable meso-acromion. The associated pain may be due to impingement from the unfused fragment, a concomitant rotator cuff tear, or gross motion at the os acromiale site. Currently, initial treatment includes physical therapy, nonsteroidal anti-inflammatory agents, and subacromial corticosteroid injections. Surgical intervention is reserved for patients who do not respond to nonoperative treatment. Treatment options include open fragment excision, open reduction and internal fixation, and arthroscopic decompression. Open fragment excision can lead to persistent deltoid dysfunction and should be reserved for small fragments or after failed internal fixation. Open reduction and internal fixation allows for both preservation of large fragments and anterior deltoid function. Internal fixation is technically difficult, has led to frequent nonunion rates and often requires hardware removal as a result of postoperative irritation. Arthroscopic subacromial decompression with complete or nearly complete resection of the unstable meso-acromion can be performed without the aforementioned complications. The surgical technique requires no special instrumentation and may be performed reproducibly by those familiar with arthroscopic techniques of the shoulder. Advantages include more rapid rehabilitation, better range of motion, and shorter surgical times. Satisfactory short-term results have shown this to be an effective treatment option for the unstable meso-acromion.
    Journal of Shoulder and Elbow Surgery 09/2002; 11(5):521-8. DOI:10.1067/mse.2002.122227 · 2.29 Impact Factor
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    ABSTRACT: Unstable symptomatic os acromiale is an unusual cause of impingement syndrome and rotator cuff pathology. Failure of nonoperative measures may require surgical intervention. Arthroscopic excision of the unstable bone fragment and treatment of any associated minor rotator cuff pathology have produced acceptable results.
    Techniques in Shoulder and Elbow Surgery 08/2001; 2(3):219-224. DOI:10.1097/00132589-200109000-00009
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    ABSTRACT: With the advent of magnetic resonance imaging, supraglenoid cyst identification has become more common. A high incidence of type II SLAP lesions has been described in association with these cysts, which are frequently located in the region of the suprascapular notch. Clinical evaluation frequently reveals posterolateral shoulder pain and infraspinatus weakness and atrophy. We have successfully treated patients with symptomatic cysts using diagnostic arthroscopy followed by arthroscopic cyst decompression. All patients in our study were identified with a superior labral pathology and subsequently went on to have arthroscopic superior labral stabilization. Open decompression is reserved for patients when an adequate arthroscopic decompression cannot be confirmed, or a large cyst is associated with significant neurologic involvement of the infraspinatus or supraspinatus muscle, or both.
    Techniques in Shoulder and Elbow Surgery 05/2001; 2(2):100-105. DOI:10.1097/00132589-200106000-00005
  • John E. Samani · Scott B. Marston · Daniel D. Buss
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    ABSTRACT: To document the outcomes of arthroscopic stabilization of Snyder type II SLAP (superior labrum, anterior and posterior) lesions, using a bioabsorbable tack. A case series. Twenty-five SLAP lesions were repaired arthroscopically using a bioabsorbable tack. There were 22 recreational, 2 high school, and 1 professional athlete in this group. Shoulder function was surveyed at a mean follow-up of 35 months (range, 24 to 51 months) using the UCLA and ASES shoulder scoring algorithms. Shoulder function improved in 24 of the 25 cases. Follow-up UCLA scores averaged 32 points with 9 patients scoring as excellent, 13 good, 2 fair, and 1 poor, for an overall success rate of 88%. ASES shoulder scores similarly improved from a preoperative average of 45 points to a postoperative average of 92. All but 2 of the athletes had returned to their preinjury level of sports participation. Detachment of the superior labrum from the glenoid is recognized as a problematic injury in throwing athletes and others who engage in repetitive overhead activities. We conclude from our experience that using an absorbable tack to repair type II SLAP lesions is an effective treatment, even in athletes with high demands and expectations for shoulder function.
    Arthroscopy The Journal of Arthroscopic and Related Surgery 02/2001; 17(1):19-24. DOI:10.1053/jars.2001.19652 · 3.21 Impact Factor
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    ABSTRACT: The purpose of this study was to examine cases of patients with impingement syndrome secondary to an unfused, unstable, os acromiale. Retrospective case series. Twelve consecutive patients (13 shoulders) presented with impingement symptoms in the presence of an os acromiale. The os acromiale, at the meso-acromion level, was seen on standard radiographs. The patients were all treated conservatively with rotator cuff strengthening, stretching, anti-inflammatory medications, and steroid injections. All patients underwent an impingement test with lidocaine, resulting in complete relief of their pain. After failure of the conservative management, the 12 patients (13 shoulders) underwent an extended arthroscopic subacromial decompression. The goal of the modified arthroscopic acromioplasty was resection of adequate bone to remove the mobile anterior acromial tip. In general, this consisted of more bony resection than the typical arthroscopic acromioplasty. Postoperatively, the patients began a rehabilitation program emphasizing early range of motion followed by isolated free-weight rotator cuff strengthening exercises. Five shoulders had a partial-thickness tear of the rotator cuff. Four involved less than 50% of the thickness of the rotator cuff. These 4 partial-thickness tears underwent arthroscopic rotator cuff debridement. One partial-thickness tear was greater than 50% and repair was performed with a mini-open deltoid-splitting technique. Results were evaluated using UCLA shoulder scoring. Preoperatively, the score averaged 17. The 3-month postoperative score was 27, and at 6 and 12 months, averaged 28. The final follow-up score averaged 31. There were 11 satisfactory results with UCLA scores >/=28. Two unsatisfactory results showed UCLA scores in the fair category. Full strength of the anterior deltoid and rotator cuff muscles was achieved in all patients by 6 months postoperatively as evaluated by manual muscle testing. Twelve of the 13 shoulders were rated by the patients as having a satisfactory result. All of the patients rated their cosmetic results as acceptable. There was no evidence of postoperative deltoid detachment. No patient developed pain at the pseudarthrosis point. Given the previously reported poor results with attempts at fusion of an unstable os acromiale and open complete excision of meso-acromial fragments, the authors conclude that an extended arthroscopic subacromial decompression results in a reasonable outcome for patients with impingement syndromes secondary to an unstable os acromiale.
    Arthroscopy The Journal of Arthroscopic and Related Surgery 10/2000; 16(6):595-9. DOI:10.1053/jars.2000.9239 · 3.21 Impact Factor
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    ABSTRACT: This prospective study was designed to measure the costs and benefits of using a laser rather than electrocautery for soft tissue resection during arthroscopic shoulder decompression. Forty-nine shoulders with refractory Neer stage II impingement (persistent fibrosis and tendinitis) were divided into 2 groups. The composition of the 2 groups was similar with regard to sex, worker's compensation status, dominant arm involvement, duration of symptoms, and length of conservative treatment. In one group, electrocautery was used to ablate the bursa and periosteum, release the coracoacromial ligament, and maintain hemostasis. In the other group, a laser was used in place of electrocautery. Patients had been evaluated preoperatively with 2 functional scoring systems. The patients were reexamined at 1 week and at 1, 2, 3, 6, and 12 months after surgery. There were no differences between the groups with regard to functional outcome or satisfaction. There was also no difference in terms of estimated blood loss or operative time. However, there was a statistically significant difference in total hospital charges between groups, with the laser group having a 23% higher hospital bill. On the basis of these results, it is concluded that there was no medical benefit to laser-assisted arthroscopic subacromial decompression but there was an increased monetary cost.
    Journal of Shoulder and Elbow Surgery 05/1999; 8(3):275-8. DOI:10.1016/S1058-2746(99)90142-8 · 2.29 Impact Factor
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    R W Wright · H M Fritts · G S Tierney · D D Buss
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    ABSTRACT: OBJECTIVE: The purpose of this study was to determine the appropriate minimum waiting time between an impingement test with subacromial injection and subsequent MR imaging to avoid misinterpretation if the injected fluid is still present. CONCLUSION: MR imaging should be delayed a minimum of 24 hr after a subacromial injection. Fluid in the subacromial space 24 hr after subacromial injection is unrelated to an impingement test.
    American Journal of Roentgenology 10/1998; 171(3):769-73. DOI:10.2214/ajr.171.3.9725314 · 2.73 Impact Factor
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    ABSTRACT: Twenty-two cases of suprascapular nerve entrapment caused by supraglenoid cyst compression were reviewed. Pain and weakness were the presenting symptoms in 14 shoulders and pain alone in 8. Twenty of the cysts were diagnosed by magnetic resonance imaging, and two were confirmed at surgical exploration. Electromyography of 20 shoulders was positive for neurologic involvement for both the infraspinatus and supraspinatus in 4 cases, for the infraspinatus only in 12, and negative in 4. Sixteen shoulders were treated by open excision, arthroscopy, or both. Superior labral lesions were diagnosed in 11 of 12 patients who underwent arthroscopy. At follow-up 10 of the patients who underwent surgery had complete resolution of symptoms, 5 had occasional pain or weakness, and 1 recurrence required a second surgery. Of six patients treated without surgery, two improved and four had no change. Supraglenoid ganglion cysts are common and can easily be diagnosed by magnetic resonance imaging. For patients with symptoms arthroscopy with repair of the superior labral lesion and either arthroscopic debridement or direct open decompression and excision of the cyst is recommended.
    Journal of Shoulder and Elbow Surgery 09/1997; 6(5):455-62. DOI:10.1016/S1058-2746(97)70053-3 · 2.29 Impact Factor
  • D P Tewes · H M Fritts · R D Fields · D C Quick · D D Buss
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    ABSTRACT: Magnetic resonance imaging has been said to be highly reliable for diagnosis of acute posterior cruciate ligament insufficiency. In the present study, 13 patients whose posterior cruciate ligament insufficiency had been documented by magnetic resonance imaging within 10 weeks of the acute injury were recalled for a followup examination and magnetic resonance imaging. The followup interval ranged from 5 months to 4 years. In only 23% of the cases did the posterior cruciate ligament still appear discontinuous on followup magnetic resonance imaging. In the remaining 77%, the posterior cruciate ligament was continuous from tibia to femur, although it appeared abnormally arcuate or hyperbuckled. Conventional interpretation of these magnetic resonance images would suggest that the posterior cruciate ligament had healed. Nevertheless, by clinical examination results, these same patients all were judged to have posterior cruciate ligament insufficiency. Thus, it was concluded that although magnetic resonance imaging may be reliable for evaluation of acute posterior cruciate ligament injury, magnetic resonance imaging findings should not be used to infer functional status in chronic cases.
    Clinical Orthopaedics and Related Research 03/1997; 335(335):224-32. · 2.77 Impact Factor
  • CA Guanche · D C Quick · K M Sodergren · D D Buss
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    ABSTRACT: We compared open and arthroscopic stabilizations of true Bankart lesions in patients with traumatic, unidirectional anterior glenohumeral dislocations. The 27 patients were men (age range, 18 to 56 years) who were involved in recreational sports. One group (15 patients) had elected an arthroscopic Bankart repair; the other group (12 patients) had chosen open stabilization with a standard deltopectoral approach. Patients were followed up 17 to 42 months after surgery by examination, radiographs, and interviews. In the open repair group, 1 of the 12 patients experienced a subluxation in the follow-up period, but no patients had dislocations or reoperations. In the arthroscopic group, 5 of 15 patients had experienced subluxation or dislocation; of these 5 patients, 2 underwent reoperation. The arthroscopic group had significantly worse results in satisfaction, stability, apprehension, and loss of forward flexion in the operated limb. In summary, the arthroscopic procedure did not significantly improve function; instead, it produced an increased failure rate compared with the open procedure. Therefore, we believe that open stabilization remains the procedure of choice for patients with true Bankart lesions.
    The American Journal of Sports Medicine 03/1996; 24(2):144-8. DOI:10.1177/036354659602400204 · 4.36 Impact Factor