Palm Beach Shoulder Service

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Howard D. Routman, DO

Research

Research and publications

Dr. Routman has published 70 peer-reviewed papers, most of them about one joint. This page is not the list — that is at the bottom. It is an account of what the work has been about, written for patients rather than for other surgeons.

How the implant is built, and why it changes what the shoulder can do

A reverse shoulder replacement is not one operation done with one implant the same way, all the time. Implant design impacts where the different parts of the replacement sit relative to one another and changes how hard the deltoid has to work, how far the arm will go, and whether the implant catches against the shoulder blade when the arm comes down. A large part of Dr. Routman’s published work is about those differences, including the classification system surgeons now use to describe them.

  • Reverse shoulder implants made by different companies differ in ways that change how the shoulder functions biomechanically, and surgeons had no agreed way to describe those differences. This paper set out the classification system used to do so.

    Routman HD, Flurin P-H, Wright TW, Zuckerman JD, Hamilton MA, Roche CP. Bull Hosp Jt Dis 2015;73 Suppl 1:S5–14. PubMed

  • Three reverse designs were compared in a computer model. How far the implant sits out from the arm bone changed the leverage the back of the deltoid had for turning the arm outward — an effect of humeral offset that had not been reported before.

    Hamilton MA, Diep P, Roche C, Flurin P-H, Wright TW, Zuckerman JD, Routman H. J Orthop Res 2015;33(4):605–13. DOI

  • Making the ball wider but thinner moves the center of rotation further in. In a computer model that gave the deltoid roughly 5 to 41 percent more efficiency than the other designs tested, which should mean less force needed for everyday tasks.

    Roche CP, Hamilton MA, Diep P, Wright TW, Flurin P-H, Zuckerman JD, Routman HD. Bull Hosp Jt Dis 2015;73 Suppl 1:S37–41. PubMed

  • Radiographs from 151 shoulders showed that placing the baseplate lower on the socket, with more of the ball overhanging it, went with less notching against the shoulder blade and fewer bone spurs — and that the pattern is not the same in men and women.

    Roche CP, Marczuk Y, Wright TW, Flurin P-H, Grey S, Jones R, Routman HD, Gilot G, Zuckerman JD. Bone Joint J 2013;95-B(4):530–5. DOI

  • Shifting the humeral tray backward and upward restored muscle tension closer to normal and increased the leverage available for turning the arm outward, with consequences for strength, stability and movement.

    Roche CP, Hamilton MA, Diep P, Flurin P-H, Routman HD. Bull Hosp Jt Dis 2013;71 Suppl 2:S18–24. PubMed

  • A computer model that predicts where a reverse implant will catch against the shoulder blade was checked against radiographs from 256 patients. It correctly predicted notching in most of the patients who developed it, so it can be used to guide where the implant is placed.

    Roche CP, Marczuk Y, Wright TW, Flurin P-H, Grey SG, Jones RB, Routman HD, Gilot GJ, Zuckerman JD. Bull Hosp Jt Dis 2013;71(4):278–83. PubMed

When the bone is worn away, and when a replacement has failed

Some shoulders arrive with the socket already worn away, or with a replacement in place that has failed. The problem then is not choosing an operation but working out what is left to build on. This work asks what to do when the bone is gone, how the parts hold up over the years, and which patients are at risk of the complications that matter.

  • In 567 shoulder replacements, using a wedge-shaped baseplate rather than grafting bone into the worn socket gave better movement and better patient scores, halved the operating time, and led to roughly eight times fewer returns to the operating room.

    Colasanti CA, Lin CC, Ross KA, Luthringer T, Elwell JA, Roche CP, Virk MS, Simovitch RW, Routman HD, Zuckerman JD. J Shoulder Elbow Surg 2023;32(5):958–71. DOI

  • When the back of the socket is worn away, reaming it flat to seat a standard baseplate shortens the rotator cuff further. A wedged baseplate restored more normal tension without reaming or grafting.

    Roche CP, Diep P, Hamilton MA, Wright TW, Flurin P-H, Zuckerman JD, Routman HD. Bull Hosp Jt Dis 2015;73 Suppl 1:S63–7. PubMed

  • Across 292 reverse replacements, the arm-side stem loosened in under one percent of shoulders — and in none of the 115 stems that had been fitted without cement.

    Gilot G, Alvarez-Pinzon AM, Wright TW, Flurin P-H, Krill M, Routman HD, Zuckerman JD. J Shoulder Elbow Surg 2015;24(10):1555–9. DOI

  • In 4,125 reverse replacements, 1.8 percent developed a fracture of the shoulder blade around the implant, and those patients ended up meaningfully worse off. Being female, having rheumatoid arthritis, and having arthritis from a worn-out cuff each carried higher risk — which is worth saying to a patient beforehand rather than afterward.

    Routman HD, Simovitch RW, Wright TW, Flurin P-H, Zuckerman JD, Roche CP. J Bone Joint Surg Am 2020;102(19):1724–33. DOI

Predicting how one particular patient will do

Most of what a surgeon can tell you about your likely result comes from averages. Working from thousands of shoulder replacements, this work built a model that estimates an individual patient’s result from what is known before the operation — and then tested it on patients who had nothing to do with building it.

  • Using data from nearly 2,000 shoulder replacements, this work built a model that estimates a patient’s two-year result from what is known beforehand. Tested on a separate group of patients operated on elsewhere, it landed within the difference a patient would actually notice in 85 percent of cases.

    Baessler AM, Brolin TJ, Azar FM, Sen S, Chang M, Falkner D, Zmistowski BM, Routman HD, Namdari S, Gulotta LV, Throckmorton TW. J Shoulder Elbow Surg 2021;30(12):2698–702. DOI

  • Two hundred and forty-three patients were given a personal forecast before their operation and then followed up. The predictions held, and for several measures — the Constant score, abduction, overall shoulder function — they were more accurate than in the original testing.

    Simmons C, DeGrasse J, Polakovic S, Aibinder W, Throckmorton T, Noerdlinger M, Papandrea R, Trenhaile S, Schoch B, Gobbato B, Routman H, Parsons M, Roche CP. Eur J Orthop Surg Traumatol 2024;34(3):1307–18. DOI

Pain afterward, and how much of it is decided before the operation ends

How much pain a patient has in the first two weeks, and how many narcotics that takes, is not settled by the operation alone. This work measured what patients actually needed rather than what was assumed, and tested whether changing what goes in during the operation changes what they need after it.

  • Patients were being sent home from a rotator cuff repair with eighty oxycodone tablets, and more than one in five was still filling prescriptions six months later. A hundred patients kept a daily pain diary: 77 percent used fewer than fifteen tablets and were satisfied with their pain control.

    Mandava NK, Sethi PM, Routman HD, Liddy N, Haidamous G, Denard PJ. J Shoulder Elbow Surg 2021;30(7):e399–408. DOI

  • Adding a long-acting local anesthetic and an intravenous steroid during shoulder replacement cut the hospital stay from two nights to one, halved the narcotics needed on the first day, and roughly halved the pain patients reported.

    Routman HD, Israel LR, Moor MA, Boltuch AD. J Shoulder Elbow Surg 2017;26(4):641–7. DOI

A shoulder broken into several pieces, in an older patient

When the top of the arm bone breaks into several pieces in an older person, it often cannot be rebuilt, and a reverse replacement is the better answer. The questions that follow are practical ones: does it matter how long you wait, does the pattern of the break predict the result, and what decides whether the arm turns outward afterward.

  • Replacing the ball alone gives unpredictable results in an older patient with a badly broken shoulder. A reverse replacement reliably restores the ability to lift the arm, even when the broken pieces do not heal — though whether they heal still decides how well the arm rotates.

    Routman HD. Bull Hosp Jt Dis 2013;71 Suppl 2:64–7. PubMed

  • In 55 patients over 65, the bony fragment carrying the rotator cuff healed in 83 percent. Whether it healed decided whether a patient could turn the arm outward — putting a hand behind the head, combing hair — even though it did not show up in the overall scores.

    Simovitch RW, Roche CP, Jones RB, Routman HD, Marczuk Y, Wright TW, Zuckerman JD. J Orthop Trauma 2019;33(2):e39–45. DOI

  • Sixty-one patients had a reverse replacement for a broken shoulder — some within two weeks of the injury, some after nearly a year. Movement, scores and complications came out the same, so the operation does not have to be rushed.

    Goguen J, Forbes J, Jackson GR, Movassaghi A, Lapica H, Routman H, Sabesan VJ. J Shoulder Elbow Surg 2025;34(11):2537–42. DOI

The tendon at the front of the shoulder

The tendon across the front of the shoulder is normally cut to reach the joint, and it is one of the things that can fail afterward. This work is about getting into the shoulder without cutting it, and about whether it needs repairing at the end.

  • Detaching only the bottom third of that tendon, and leaving the rest attached, gave enough room to do a shoulder replacement in 43 patients — whose strength on that side matched the other shoulder two years later.

    Routman HD, Savoie FH. Clin Sports Med 2018;37(4):559–68. DOI

  • Whether that tendon needs repairing at the end of a reverse replacement depends on the implant. With some designs the repair is what holds the shoulder stable; with others the stability comes from elsewhere, and repairing it only adds work for the muscles that are left.

    Routman HD. Bull Hosp Jt Dis 2013;71 Suppl 2:108–12. PubMed

  • A way of taking the shoulder x-ray that has to be taken, in a patient who cannot get out of a wheelchair or off a stretcher.

    Routman H. Orthopedics 2007;30(4):265–6. DOI

A note about the implant work

Dr. Routman has been a clinical evaluator for the Equinoxe shoulder replacement system since 2006, and a design surgeon on it since 2009, for the manufacturer now called Advita and previously Exactech. Several of the papers above concern that system. You should know that when you read them.

The complete list of 70 peer-reviewed publications

Newest first, as they appear on his curriculum vitae. Roughly forty are indexed in PubMed and link to the paper itself; the rest are in journals PubMed does not index, and have no link to give.

  1. Cartagena-Reyes, M. A., Lugo, E., Siddiqui, R. N., Gerges, P. E., Lima, D. J. L., Routman, H. D. (2026). A cost-utility analysis of pre-operative 12-week smoking cessation program in adults with indications of undergoing elective shoulder arthroplasty. Seminars in Arthroplasty: JSES, 36(2), 151572.
  2. Da Costa, A., Movassaghi, A., McKinley, M., Calpey, J., Goguen, J., Jackson, G. R., Lubert, J., Routman, H. D., Sabesan, V. J. (2026). Patient risk factors influencing functional recovery after reverse shoulder arthroplasty. Seminars in Arthroplasty: JSES, 36(2), 151549.
  3. Jean-David Werthel, Jules Descamps, Elyette Lugo, Routman, H. D. (2026). Inconsistencies in Terminology Used to Describe Reverse Shoulder Arthroplasty: A Systematic Review. Journal of Shoulder and Elbow Surgery. DOI
  4. Eric T. Ricchetti, Andrew P. Collins, Michael S. Khazzam, Thomas W. Wright, Vahid Entezari, Nathan D. Orvets, Anastasia J. Whitson, Jason E. Hsu, Kate L. Agan, Dawn B. Allen, Shivawn N. Angelo, Julie Y. Bishop, Matthew D. Budge, Michael C. Cusick, Gregory L. Cvetanovich, Megan K. Czachor, Matthew J. DiPaola, Thomas R. Duquin, T. Bradley Edwards, Catherine Fedorka, Kyle R. Flik, Grant E. Garrigues, Mohit N. Gilotra, Jason C. Ho, Corey F. Hryc, Christopher D. Joyce, Galen S. Kam, Adam Z. Khan, Scott E. Kilpatrick, H. Mike Kim, Joseph J. King, Xinning Li, Frederick A. Matsen, Gregory P. Nicholson, Robert J. Panganiban, Ryan C. Rauck, John D. Reith, Alaina S. Ritter, Adam A. Rizk, Brandon A. Romero, Routman, H. D., Vani J. Sabesan, Corey J. Schiffman, Cathy L. Shemo, Arden C. Shen, Aimee M. Struk, Robert Z. Tashjian, Joshua H. Taylor, Jennifer L. Vanderbeck, Jonathan O. Wright (2026). Evaluation of the International Consensus Meeting (ICM) Diagnostic Categories for Shoulder Periprosthetic Joint Infection: C. Acnes Predominates even in Definite Infections. Journal of Shoulder and Elbow Surgery.
  5. Daji, A., John, D. Q., Burzynski, C., DeShetler, D. F., Lima, D. J. L., Routman, H. D. (2026). Prognostic Value of the Neer and Mayo-FJD Classifications in Reverse Shoulder Arthroplasty for Proximal Humerus Fractures. JSES Reviews, Reports, and Techniques, 100767. DOI
  6. Mohamed, A. A., Redden, A., Calpey, J., Movassaghi, A., Jackson, G. R., Routman, H. D., Lima, D. J. L., Sabesan, V. J. (2025). Determining the minimal clinically important difference and substantial clinical benefit following revision reverse shoulder arthroplasty. Seminars in Arthroplasty: JSES, 35(4), 685-691.
  7. Mohamed, A. A., John, D. Q., Jackson, G. R., Movassaghi, A., Lima, D. J. L., Routman, H. D., Sabesan, V. J. (2025). Rate of improvement following reverse shoulder arthroplasty: a comparison of primary and revision reverse shoulder arthroplasty. Seminars in Arthroplasty: JSES, 35(4), 662-668.
  8. Goguen, J., Forbes, J., Jackson, G. R., Movassaghi, A., Lapica, H., Routman, H. D., Sabesan, V. J. (2025). Optimal timing of reverse total shoulder arthroplasty for proximal humerus fractures. Journal of Shoulder and Elbow Surgery, 34(11), 2537-2542. DOI
  9. Mohamed, A. A., Daji, S., Fomunung, C., Girshfeld, S. J., Macknofsky, B., Lavin, A., Yerke-Hansen, P., Jackson, G. R., Routman, H. D., Sabesan, V. (2025). Outcomes of augmented vs. standard baseplates in reverse shoulder arthroplasty. Journal of Shoulder and Elbow Surgery, 34(8), 1904-1913. DOI
  10. Mohamed, A. A., Kushner, J., Jackson, G. R., Movassaghi, A., Routman, H. D., Sabesan, V. J. (2025). Does Sleep Comfort Predict Recovery After Primary and Revision Reverse Shoulder Arthroplasty? Journal of Orthopaedic Experience & Innovation.
  11. Roche, C. P., Elwell, J., Jones, R., Routman, H. D., Simovitch, R., Flurin, P. H., Wright, T. W., Zuckerman, J. D. (2025). Analysis of patients with differing short-term rates of improvement and long-term rates of decline in range of motion and after anatomic and reverse total shoulder arthroplasty. JSES International, 9(4), 1327-1338. DOI
  12. Sabesan, V. J., Redden, A., Girshfeld, S., Pallissery, W., Macknofsky, B., Fomunung, C., Jackson, G. R., Routman, H. D. (2025). Prior Ipsilateral Steroid Injections Do Not Compromise Postoperative Outcomes or Increase Risk for Postoperative Complications or Revisions Surgery After Arthroscopic Rotator Cuff Repair. Journal of Orthopaedic Experience & Innovation, 6(1).
  13. Routman, H. D. (2025). “In My Experience.. Innovations in Reverse Shoulder Arthroplasty: The Roles of The Greater Tuberosity and Deltoid”. Journal of Orthopaedic Experience & Innovation, 6(1).
  14. Jackson, G. R., Knapik, D. M., Mowers, C. C., Lapica, H., Coutelle, N., Movassaghi, A., Routman, H. D., Sabesan, V. J. (2024). Reverse Shoulder Arthroplasty Provides Durable Outcomes Regardless of Diagnosis and Pathology. Journal of Orthopaedic Experience & Innovation, 5(2).
  15. Jackson, G. R., Brusalis, C. M., Mowers, C. C., Daji, A. V., John, D. Q., Movassaghi, A., Routman, H. D., Sabesan, V. J. (2024). Prior Shoulder Arthroscopy is Associated with Inferior Clinical Outcomes Following Primary Reverse Shoulder Arthroplasty for Rotator Cuff Tear Arthropathy. Journal of Orthopaedic Experience & Innovation, 5(2).
  16. Ogunfuwa, F. O., Desai, A., Fomunung, C., Jackson, G. R., Routman, H. D., Sabesan, V. J. (2024). Acromiohumeral Distance: Can Radiographic Factors Impact Outcomes after Reverse Shoulder Arthroplasty? Journal of Orthopaedic Experience & Innovation, 5(2).
  17. Girshfeld, S. J., Lama, G., Macknofsky, B., Fomunung, C., John, D., Jackson, G. R., Routman, H. D., Sabesan, V. J. (2024). Does prior ipsilateral steroid injection affect outcomes after shoulder arthroplasty? Seminars in Arthroplasty: JSES, 34(2), 398-405.
  18. Yerke Hansen, P., Fomunung, C., Lavin, A., Daji, A., Jackson, G. R., Sabesan, V. J. (2024). Outcomes Following Revision Reverse Shoulder Arthroplasty for Infection. Journal of Shoulder and Elbow Surgery, 33(11), 2433-2440.
  19. Larose, G., Aibinder, W. R., Greene, A. T., Roche, C. P., Grey, S., Faber, K. J., Routman, H. D., Antuña, S., Wright, T., Flurin, P. H., Zuckerman, J. D., Virk, M. S. (2024). Two-year minimum survivorship and radiographic analysis of a pressfit short humeral stem for total shoulder arthroplasty. JSES International, 8(1), 191-196. DOI
  20. Simmons, C. S., DeGrasse, J., Polakovic, S., Aibinder, W. R., Throckmorton, T. W., Noerdlinger, M. A., Papandrea, R. F., Trenhaile, S. W., Schoch, B. S., Gobbato, B., Routman, H. D., Parsons, M., Roche, C. (2023). Initial clinical experience with a predictive clinical decision support tool for anatomic and reverse total shoulder arthroplasty. European Journal of Orthopaedic Surgery & Traumatology, 34(3), 1307-1318. DOI
  21. Sabesan, V., Lama, G., Khoury, L., Fomunung, C. K., Lapica, H., Fernandez Peaguda, C. A., Routman, H. D. (2023). The impact of surgeon volume on subscapularis repair and postoperative management following reverse shoulder arthroplasty. Seminars in Arthroplasty: JSES, 33(4), 715-721.
  22. Allen, C., Kumar, V., Elwell, J., Overman, S., Schoch, B. S., Aibinder, W. R., Parsons, M., Watling, J. P., Ko, J. K., Gobbato, B., Throckmorton, T. W., Routman, H. D., Roche, C. (2023). Evaluating the fairness and accuracy of machine learning–based predictions of clinical outcomes after anatomic and reverse total shoulder arthroplasty. Journal of Shoulder and Elbow Surgery, 33(4), 888-899. DOI
  23. Roche, C. P., Fan, W., Simovitch, R., Wright, T., Flurin, P. H., Zuckerman, J. D., Routman, H. D. (2023). Impact of accumulating risk factors on the acromial and scapular fracture rate after reverse total shoulder arthroplasty with a medialized glenoid–lateralized humerus onlay prosthesis. Journal of Shoulder and Elbow Surgery, 32(7), 1465-1475. DOI
  24. Colasanti, C. A., Lin, C. C., Ross, K. A., Luthringer, T., Elwell, J. A., Roche, C. P., Virk, M. S., Simovitch, R. W., Routman, H. D., Zuckerman, J. D. (2023). Augmented baseplates yield optimum outcomes when compared with bone graft augmentation for managing glenoid deformity during reverse total shoulder arthroplasty: a retrospective comparative study. Journal of Shoulder and Elbow Surgery, 32(5), 958-971. DOI
  25. Labrum, J. T., Routman, H. D., Friedman, R. J., Roche, C. P., Byram, I. R. (2023). Stemless, short and standard humeral stems in total shoulder arthroplasty: is there a difference in intraoperative measures, pain, and outcomes in the short term? Seminars in Arthroplasty: JSES, 33(1), 200-206.
  26. Roche, C., Jones, R., Routman, H. D., Marczuk, Y., Flurin, P., Wright, T. W., Zuckerman, J. D. (2023). Longitudinal analysis of shoulder arthroplasty utilization, clinical outcomes, and value: a comparative assessment of changes in improvement over 15 years with a single platform shoulder prosthesis. Journal of Shoulder and Elbow Surgery, 32(8), 1562-1573. DOI
  27. Kumar, V., Allen, C., Overman, S., Teredesai, A., Simovitch, R., Flurin, P. H., Wright, T., Zuckerman, J., Routman, H. D., Roche, C. (2022). Development of a predictive model for a machine learning–derived shoulder arthroplasty clinical outcome score. Seminars in Arthroplasty: JSES, 32(2), 226-237.
  28. Harries, L. W., Roche, C. P., Routman, H. D., Friedman, R. J., Donaldson, O. W. (2022). Effect of subscapularis repair in patients with an intact rotator cuff undergoing reverse total shoulder arthroplasty. Seminars in Arthroplasty: JSES, 32(1), 100-106.
  29. Kumar, V., Schoch, B. S., Allen, C., Overman, S., Teredesai, A., Aibinder, W. R., Parsons, M., Watling, J. P., Ko, J. K., Gobbato, B., Throckmorton, T. W., Routman, H. D., Roche, C. (2021). Using machine learning to predict internal rotation after anatomic and reverse total shoulder arthroplasty. Journal of Shoulder and Elbow Surgery, 31(5), e234-e245. DOI
  30. Baessler, A. M., Brolin, T. J., Azar, F. M., Sen, Ś., Chang, M. S., Falkner, D., Zmistowski, B., Routman, H. D., Namdari, S., Gulotta, L. V., Throckmorton, T. W. (2021). Development and validation of a predictive model for outcomes in shoulder arthroplasty: a multicenter analysis of nearly 2000 patients. Journal of Shoulder and Elbow Surgery, 30(12), 2698-2702. DOI
  31. Kumar, V., Roche, C., Overman, S., Simovitch, R., Flurin, P. H., Wright, T., Zuckerman, J., Routman, H. D., Teredesai, A. (2021). Use of machine learning to assess the predictive value of 3 commonly used clinical measures to quantify outcomes after total shoulder arthroplasty. Seminars in Arthroplasty: JSES, 31(2), 263-271.
  32. Mandava, N. K., Sethi, P. M., Routman, H. D., Liddy, N., Haidamous, G., Denard, P. J. (2021). Opioid requirement after rotator cuff repair is low with a multimodal approach to pain. Journal of Shoulder and Elbow Surgery, 30(7), e399-e408. DOI
  33. Aibinder, W. R., Schoch, B. S., Parsons, M., Watling, J. P., Ko, J. K., Gobbato, B., Throckmorton, T. W., Routman, H. D., Fan, W., Simmons, C. S., Roche, C. (2021). Risk factors for complications and revision surgery after anatomic and reverse total shoulder arthroplasty. Journal of Shoulder and Elbow Surgery, 30(11), e689-e701. DOI
  34. Sabesan, V. J., Chatha, K., Lima, D. J. M., Yawman, J. P., Khoury, L., Routman, H. D. (2021). Equal care for all? Do surgical outcomes in shoulder arthroplasty depend on insurance type? JSES International, 5(5), 900-904. DOI
  35. Roche, C., Kumar, V., Overman, S., Simovitch, R. W., Flurin, P., Wright, T. W., Routman, H. D., Teredesai, A., Zuckerman, J. D. (2021). Validation of a machine learning–derived clinical metric to quantify outcomes after total shoulder arthroplasty. Journal of Shoulder and Elbow Surgery, 30(10), 2211-2224. DOI
  36. Kumar, V., Roche, C., Overman, S., Simovitch, R., Flurin, P. H., Wright, T., Zuckerman, J., Routman, H. D., Teredesai, A. (2020). What Is the Accuracy of Three Different Machine Learning Techniques to Predict Clinical Outcomes After Shoulder Arthroplasty? Clinical orthopaedics and related research, 478(10), 2351-2363. DOI
  37. Routman, H. D., Simovitch, R. W., Wright, T. W., Flurin, P. H., Zuckerman, J. D., Roche, C. P. (2020). Acromial and Scapular Fractures After Reverse Total Shoulder Arthroplasty with a Medialized Glenoid and Lateralized Humeral Implant: An Analysis of Outcomes and Risk Factors. The Journal of bone and joint surgery. American volume, 102(19), 1724-1733. DOI
  38. Parsons, M., Routman, H. D., Roche, C. P., Friedman, R. J. (2020). Preoperative external rotation deficit does not predict poor outcomes or lack of improvement after reverse total shoulder arthroplasty. Journal of orthopaedics, 21, 379-383. DOI
  39. Kumar, V., Roche, C., Overman, S., Simovitch, R., Flurin, P. H., Wright, T., Zuckerman, J., Routman, H. D., Teredesai, A. (2020). Using Machine Learning to Predict Clinical Outcomes After Shoulder Arthroplasty with a Minimal Feature Set. Journal of shoulder and elbow surgery, 30(5), e225-e236. DOI
  40. Carofino, B., Routman, H. D., Roche, C. (2020). The influence of preoperative external rotation weakness or stiffness on reverse total shoulder arthroplasty. JSES International, 4(2), 382-387. DOI
  41. Parsons, M., Routman, H. D., Roche, C. P., Friedman, R. J. (2019). Patient-reported outcomes of reverse total shoulder arthroplasty: a comparative risk factor analysis of improved versus unimproved cases. JSES open access, 3(3), 174-178. DOI
  42. Simovitch, R. W., Roche, C. P., Jones, R. B., Routman, H. D., Marczuk, Y., Wright, T. W., Zuckerman, J. D. (2019). Effect of Tuberosity Healing on Clinical Outcomes in Elderly Patients Treated With a Reverse Shoulder Arthroplasty for 3- and 4-Part Proximal Humerus Fractures. Journal of orthopaedic trauma, 33(2), e39-e45. DOI
  43. Hansen, M., Routman, H. D. (2019). The biomechanics of current reverse shoulder replacement options. Annals of Joint, 4, 17-17.
  44. Routman, H. D., Savoie, F. H. “. (2018). Subscapularis-Sparing Approaches to Total Shoulder Arthroplasty: Ready for Prime Time? Clinics in sports medicine, 37(4), 559-568. DOI
  45. Routman, H. D., Triplet, J. J., Kurowicki, J., Singh, N. (2018). Isolated Rhabdomyolysis of the Infraspinatus Muscle Following the CrossFit "Sissy Test": A Report of Two Cases. JBJS case connector, 8(1), e2-e2. DOI
  46. Routman, H. D., Israel, L. R., Moor, M. A., Boltuch, A. D. (2016). Local injection of liposomal bupivacaine combined with intravenous dexamethasone reduces postoperative pain and hospital stay after shoulder arthroplasty. Journal of shoulder and elbow surgery, 26(4), 641-647. DOI
  47. Routman, H. D., Israel, L. R., Moor, M. A., Boltuch, A. (2016). Liposomal marcaine combined with intravenous decadron results in decreased length of hospital stay and decreased narcotic use after elective shoulder arthroplasty. Journal of Shoulder and Elbow Surgery, 25(6), e180-e180.
  48. Ponzio, D. Y., VanBeek, C., Wong, J. C., Padegimas, E. M., Anakwenze, O. A., Getz, C. L., Abboud, J. A., (2016). Profile of Current Opinion on Arthroscopic Acromioplasty: A Video Survey Study. Arthroscopy, 32(7), 1253-1262.
  49. Roche, C. P., Hamilton, M. A., Diep, P., Wright, T. W., Flurin, P. H., Zuckerman, J. D., Routman, H. D. (2015). Optimizing Deltoid Efficiency with Reverse Shoulder Arthroplasty Using a Novel Inset Center of Rotation Glenosphere Design. Bulletin of the Hospital for Joint Disease, 73 Suppl 1, S37-41. PubMed
  50. Routman, H. D., Becks, L., Roche, C. P. (2015). Stemless and Short Stem Humeral Components in Shoulder Arthroplasty. Bulletin of the Hospital for Joint Disease, 73 Suppl 1, S145-7. PubMed
  51. Roche, C. P., Diep, P., Hamilton, M. A., Wright, T. W., Flurin, P. H., Zuckerman, J. D., Routman, H. D. (2015). Impact of Posterior Wear on Muscle Length with Reverse Shoulder Arthroplasty. Bulletin of the Hospital for Joint Disease, 73 Suppl 1, S63-7. PubMed
  52. Routman, H. D., Flurin, P. H., Wright, T. W., Zuckerman, J. D., Hamilton, M. A., Roche, C. P. (2015). Reverse Shoulder Arthroplasty Prosthesis Design Classification System. Bulletin of the Hospital for Joint Disease, 73 Suppl 1, S5-14. PubMed
  53. Janssen, S. J., Teunis, T., Guitton, T. G., Ring, D. (2015). Do Surgeons Treat Their Patients Like They Would Treat Themselves? Clinical orthopaedics and related research, 473(11), 3564-3572.
  54. Gilot, G., Alvarez-Pinzon, A. M., Wright, T. W., Flurin, P. H., Krill, M., Routman, H. D., Zuckerman, J. D. (2015). The incidence of radiographic aseptic loosening of the humeral component in reverse total shoulder arthroplasty. Journal of shoulder and elbow surgery, 24(10), 1555-1559. DOI
  55. Hamilton, M. A., Diep, P., Roche, C., Flurin, P. H., Wright, T. W., Zuckerman, J. D., Routman, H. D. (2015). Effect of reverse shoulder design philosophy on muscle moment arms. Journal of orthopaedic research, 33(4), 605-613. DOI
  56. Mellema, J. J., Doornberg, J. N., Guitton, T. G., Ring, D. (2014). Biomechanical studies: science (f)or common sense? Injury, 45(12), 2035-2039.
  57. Roche, C., Diep, P., Hamilton, M. A., Flurin, P., Zuckerman, J. D., Routman, H. D. (2013). Increasing Muscle Moment Arms Using an Offset Humeral Tray With Reverse Total Shoulder Arthroplasty. Journal of Bone and Joint Surgery-british Volume, 507-507.
  58. Roche, C., Diep, P., Hamilton, M. A., Flurin, P., Zuckerman, J. D., Routman, H. D. (2013). Improving Muscle Length Using an Offset Humeral Tray With Reverse Total Shoulder Arthroplasty. Journal of Bone and Joint Surgery-british Volume, 506-506.
  59. Hageman, M. G. J. S., Guitton, T. G., Ring, D. (2013). How surgeons make decisions when the evidence is inconclusive. The Journal of hand surgery, 38(6), 1202-1208.
  60. Roche, C. P., Marczuk, Y., Wright, T. W., Flurin, P. H., Grey, S., Jones, R., Routman, H. D., Gilot, G., Zuckerman, J. D. (2013). Scapular notching and osteophyte formation after reverse shoulder replacement: Radiological analysis of implant position in male and female patients. The bone & joint journal, 95-B(4), 530-535. DOI
  61. Roche, C. P., Marczuk, Y., Wright, T. W., Flurin, P. H., Grey, S. G., Jones, R. B., Routman, H. D., Gilot, G. J., Zuckerman, J. D. (2013). Scapular notching in reverse shoulder arthroplasty: validation of a computer impingement model. Bulletin of the Hospital for Joint Disease, 71(4), 278-83. PubMed
  62. Roche, C. P., Diep, P., Hamilton, M. A., Flurin, P. H., Routman, H. D. (2013). Comparison of bone removed with reverse total shoulder arthroplasty. Bulletin of the Hospital for Joint Disease, 71 Suppl 2, S36-40. PubMed
  63. Hamilton, M. A., Roche, C. P., Diep, P., Flurin, P. H., Routman, H. D. (2013). Effect of prosthesis design on muscle length and moment arms in reverse total shoulder arthroplasty. Bulletin of the Hospital for Joint Disease, 71 Suppl 2, S31-5. PubMed
  64. Roche, C. P., Hamilton, M. A., Diep, P., Flurin, P. H., Routman, H. D. (2013). Design rationale for a posterior/superior offset reverse shoulder prosthesis. Bulletin of the Hospital for Joint Disease, 71 Suppl 2, S18-24. PubMed
  65. Roche, C. P., Diep, P., Hamilton, M., Crosby, L. A., Flurin, P. H., Wright, T. W., Zuckerman, J. D., Routman, H. D. (2013). Impact of inferior glenoid tilt, humeral retroversion, bone grafting, and design parameters on muscle length and deltoid wrapping in reverse shoulder arthroplasty. Bulletin of the Hospital for Joint Disease, 71(4), 284-93. PubMed
  66. Routman, H. D. (2013). Indications, technique, and pitfalls of reverse total shoulder arthroplasty for proximal humerus fractures. PubMed, 71 Suppl 2, 64-7. PubMed
  67. Routman, H. D. (2013). The role of subscapularis repair in reverse total shoulder arthroplasty. Bulletin of the Hospital for Joint Disease, 71 Suppl 2, 108-12. PubMed
  68. McCluskey, G., Routman, H. D., Director, D. (2011). The deltopectoral approach for reverse shoulder arthroplasty. St Fr Orthop Inst Sci Bull, 3, 148–160.
  69. Routman, H. D. (2010). Tendon transfers about the shoulder. Current Orthopaedic Practice, 21(5), 453-461.
  70. Routman, H. D. (2007). The wheelchair axillary view of the shoulder. Orthopedics, 30(4), 265-266. DOI

The full curriculum vitae also lists published abstracts, textbook chapters, patents and invited lectures, which are not publications and are not counted here.