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Stefano Longo, Alberto Corradi, Giovanni Michielon, Francesco Sardanelli, Luca Maria Sconfienza
BACKGROUND: Subacromial space (SS) narrowing may result in unsafe contact of rotator cuff tendons and bursa with the acromion, possibly promoting rotator cuff pathologies and pain. We measured SS in asymptomatic subjects after three movements employed for shoulder muscles' training. PARTICIPANTS AND MAIN OUTCOME MEASURES: Twenty-five males (age 24±5years; stature 175±8 cm; body mass 74±12 kg) underwent SS ultrasound evaluation while executing with (WL) and without (NL) 4-kg load: 90° shoulder abduction (SA) without humerus rotation (90°neutral); 90° SA maximal humeral external rotation (90°er); maximum SA (above 90°) during upright row (UR)...
August 12, 2016: Physical Therapy in Sport
Jianqiang Lian, Lele Dong, Yanjun Zhao, Jinlei Sun, Wenlong Zhang, Chunzheng Gao
BACKGROUND: The Latarjet procedure addresses recurrent anterior shoulder instability in the context of a significant bony defect. However, the bony and soft tissue anatomy of the coracoid in coracoid transfer procedures has not yet been defined in Mongolian men. The aims of this study were to describe the soft tissue attachments of the coracoid regarding the bony anatomy, define the average amount of bone available for coracoid transfer, analyze the characteristics of the pectoralis minor and coracoid, and study the relationship between the bony dimensions of the coracoid and body length in Mongolian men...
October 24, 2016: Journal of Orthopaedic Surgery and Research
Achilleas Boutsiadis, Laurent Baverel, Hubert Lenoir, Philippe Delsol, Johannes Barth
Chronic acromioclavicular (AC) instability is a rare posttraumatic shoulder condition that can lead to undesirable symptoms like persistent pain, muscle fatigue, loss of strength, or even scapular dyskinesis. It is well known that in these cases the superior functional results depend on the restoration of the anatomy and stability of the AC joint in both vertical and horizontal planes. Considering the ligaments degeneration and atrophy in chronic AC joint dislocations, we present an arthroscopic-assisted reconstruction of both the coracoclavicular and AC ligaments using autograft augmentation...
October 21, 2016: Techniques in Hand & Upper Extremity Surgery
Tineke De Coninck, Steven S Ngai, Monica Tafur, Christine B Chung
The shoulder joint is the most unstable articulation in the entire human body. While this certainly introduces vulnerability to injury, it also confers the advantage of broad range of motion. There are many elements that work in combination to offset the inherent instability of the glenohumeral joint, but the glenoid labrum is perhaps related most often. Broadly, clinical unidirectional instability can be subdivided into anterior and posterior instability, which usually raise concern for anteroinferior and posteroinferior labral lesions, respectively...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Ritwik Kejriwal, Tarun Ahuja, Thin Hong
BACKGROUND: Plain radiographs still play a role in management of extraarticular scapular neck fractures. Glenopolar angle (GPA) is one of the radiograph measurements that is used to determine the necessity for surgery. Our aim was to establish reliability of GPA on plain radiograph in patients with extraarticular scapular neck fractures. METHODS: We performed a multicentre retrospective study including all patients with extraarticular scapular neck fractures with available imaging between 2006 and 2012...
October 4, 2016: Injury
O Le Reun, J Lebhar, F Mateos, J L Voisin, H Thomazeau, M Ropars
INTRODUCTION: Many clinical anatomy studies have looked into how variations in the acromion, coracoacromial ligament (CAL) and subacromial space are associated with rotator cuff injuries. However, no study up to now had defined anatomically the fibro-osseous canal that confines the supraspinatus muscle in the subcoracoacromial space. Through an anatomical study of the scapula, we defined the bone-related parameters of this canal and its anatomical variations. MATERIALS AND METHODS: This study on dry bones involved 71 scapulas...
September 26, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Aditya Sai Kadavkolan, Lars-Johannes Lehmann, Miriam Reichert, Katharina Lattka, Mohamed Moursy
OBJECTIVE: The aims were to study the acromion parameters in the population and to assess the extremity or sex variation in the acromion morphology. METHODS: The lateral acromion angle (LAA) and the acromion index (AI) were assessed in a computed tomographic scan database of 250 individuals in the age group of 20 to 49 years. For the analysis of LAA and AI, 286 and 234 shoulders were available, respectively. RESULTS: The LAA was 73.6 ± 6...
September 27, 2016: Journal of Computer Assisted Tomography
Joe De Beer, Michael Schaer, Kim Latendresse, Sumit Raniga, Beat K Moor, Matthias A Zumstein
Stabilizing the acromioclavicular joint in the vertical and horizontal planes is challenging, and most current techniques do not reliably achieve this goal. The BiPOD repair is an arthroscopically assisted procedure performed with image intensifier guidance that reconstructs the coracoclavicular ligaments as well as the acromioclavicular ligaments to achieve bidirectional stability. Repair is achieved with a combination of 2-mm FiberTape (Arthrex, Naples, Florida) and 20-mm Poly-Tape (Neoligaments, Leeds, England) to achieve rigid repair, prevent bone abrasion, and promote tissue ingrowth...
September 19, 2016: Orthopedics
Grant H Garcia, Ryan M Degen, Joseph N Liu, Cynthia A Kahlenberg, Joshua S Dines
BACKGROUND: Recent data suggest that inaccurate suture passage during remplissage may contribute to a loss of external rotation, with the potential to cause posterior shoulder pain because of the proximity to the musculotendinous junction. PURPOSE: To evaluate the accuracy of suture passage during remplissage and identify surface landmarks to improve accuracy. STUDY DESIGN: Descriptive laboratory study. METHODS: Arthroscopic remplissage was performed on 6 cadaveric shoulder specimens...
August 2016: Orthopaedic Journal of Sports Medicine
Rohit Singh, Akshay Malhotra, Gillian Cribb, Paul Cool, Stuart Hay
Impingement syndrome is usually caused by irritation of the rotator cuff within the sub acromial space and this includes the coraco-acromial arch (Acromion and Coraco-acromial ligament), the acromio-clavicular joint and occasionally the coracoid. Iatrogenic causes such as sutures, pins, plates or wires left from previous surgery can cause similar symptoms. We present a series of four cases mimicking "classical" impingement symptoms/signs in which the causal pathology was identified outside the sub-acromial space...
September 2016: Annals of Medicine and Surgery
Grant H Garcia, Joseph N Liu, Ryan M Degen, Christine C Johnson, Alexander Wong, David M Dines, Lawrence V Gulotta, Joshua S Dines
BACKGROUND: No evaluation has been done on the relationship of the critical shoulder angle (CSA) with retear after rotator cuff repair. Our purpose was to evaluate whether a higher CSA is associated with retear after rotator cuff repair. METHODS: This was a retrospective review of 76 patients who had undergone rotator cuff repair with postoperative ultrasound examination. Ultrasound findings were graded no retear (NT), partial-thickness (PT) retear, or full-thickness (FT) retear...
September 1, 2016: Journal of Shoulder and Elbow Surgery
Andreas Voss, Hardeep Singh, Felix Dyrna, Stefan Buchmann, Mark P Cote, Andreas B Imhoff, Augustus D Mazzocca, Knut Beitzel
BACKGROUND: Recent biomechanical and clinical studies have demonstrated the effectiveness of suture button and pulley-type fixations for surgical treatment of acromioclavicular instability. Concerns remain that such procedures can "overconstrain" (overreduce the lateral clavicle in relation to the acromion to a nonphysiological position) the joint. PURPOSE/HYPOTHESIS: The purpose of this study was to investigate the intra-articular pressure of native and reconstructed acromioclavicular (AC) joints in relation to the configuration of the joint...
September 1, 2016: American Journal of Sports Medicine
Andres F Cabezas, Kristi Krebes, Michael M Hussey, Brandon G Santoni, Hyuong Sik Kim, Mark A Frankle, Joo Han Oh
BACKGROUND: The aim of this study was to determine if there were significant differences in glenohumeral joint morphology between North American and East Asian populations that may influence sizing and selection of shoulder arthroplasty systems. METHODS: Computed tomography reconstructions of 92 North American and 58 East Asian patients were used to perform 3-dimensional measurements. The proximal humeral position was normalized in all patients by aligning it with the scapular plane utilizing anatomic landmarks...
September 2016: Clinics in Orthopedic Surgery
Ian P Mayne, Simon N Bell, Warwick Wright, Jennifer A Coghlan
Acromial and scapular spine fractures after reverse total shoulder arthroplasty occur predominantly as a result of bony insufficiency secondary to patient and intra-operative technical factors. The spectrum of the pathology can range from a stress reaction to an undisplaced or displaced fracture. Prompt diagnosis of these fractures requires a high suspicion in the postoperative patient with a clinical presentation of acute onset of pain along the acromion or scapular spine and/or deterioration of shoulder function...
April 2016: Shoulder & Elbow
Berdien Brandsema, Valentin Neuhaus, Gertraud Gradl, David C Ring
BACKGROUND: Discrete radiographic thresholds of scapular fracture deformity proposed as a guide for when to utilize operative treatment are a matter of debate. The purpose of the present study was to determine how many patients would have received operative treatment according to these criteria and how many actually received operative treatment. METHODS: Three hundred and thirty patients with an extra-articular fracture of the scapula at two level 1 trauma centers were retrospectively analyzed...
January 2016: Shoulder & Elbow
Christoph Engelhardt, Alain Farron, Fabio Becce, Nicolas Place, Dominique P Pioletti, Alexandre Terrier
BACKGROUND: Previous clinical studies have reported associations between glenoid inclination (GI), the acromion index (AI), and the critical shoulder angle (CSA) on the one hand and the occurrence of glenohumeral osteoarthritis and supraspinatus tendon tears on the other hand. The objective of this work was to analyze the correlations and relative importance of these different anatomic parameters. METHODS: Using a musculoskeletal shoulder model developed from magnetic resonance imaging scans of 1 healthy volunteer, we varied independently GI from 0° to 15° and AI from 0...
August 10, 2016: Journal of Shoulder and Elbow Surgery
Narjes Gorji, Reihaneh Moeini
BACKGROUND: Ankylosing spondylitis (AS) is a chronic inflammatory disease of the skeletal system without definitive treatment. Nowadays, the aim of therapeutic interventions is preventing disease progression, but eventually many patients have different degrees of decreased range of motion, especially in the spine accompanied by pain and fatigue. METHODS: A 44-year-old man with AS from 22 years ago was treated with NSAIDs and sulfasalazine. He visited for developed pain and stiffness in spine from 7 years ago...
May 2016: Iranian Journal of Medical Sciences
Alissa Zingman, Hiayan Li, Leigh Sundem, Becca DeHority, Michael Geary, Theron Fussel, Robert Mooney, Michael Zuscik, John Elfar
Untreated rotator cuff tears can progress to a distinct form of shoulder arthritis, and the mechanism of this progression is poorly understood. Biomechanical, molecular and genetic factors may be at play, and a reliable animal model is needed to enable further research. The purpose of this study was to create a reproducible model of posttraumatic shoulder arthritis in the mouse, and to develop a scoring system for this model to enable future research on interventions, the role of various gene products, and the development of therapies to alter the natural course of the disease...
August 8, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
M Krtička, D Ira
UNLABELLED: Displaced fractures of the acromion are rare injuries. A 45-year-old lady presented with an isolated acromion fracture (type III, Kuhn classification) resulting from a direct blow to the top of her right shoulder in a fall while skiing. After standard clinical and radiological examination of the shoulder, an open reduction and internal plate fixation using a postero-superior approach to the scapula was performed. Early rehabilitation of the arm and shoulder was initiated. At 50 days after surgery the patient achieved a full range of motion in her right shoulder and muscle strength equal to that of the contralateral extremity...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Mohsen Mardani-Kivi, Ali Karimi, Sohrab Keyhani, Keyvan Hashemi-Motlagh, Khashayar Saheb-Ekhtiari
OBJECTIVES: Acromioplasty has been one of the most common techniques amongst orthopedic surgeries in the past decade. However, its efficacy in arthroscopic surgeries of rotator cuff repair is still debatable. The purpose of this study is to compare the arthroscopic rotator cuff repair with or without acromioplasty in patients with complete rotator cuff tear. METHODS: In this prospective cohort study, patients with complete rotator cuff tear (acromion type II or III Bigliani) and a history of failure to the conservative treatment for at least 6 months were evaluated for eligibility...
September 2016: Physician and Sportsmedicine
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