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Shoulder, LAM,rotator cuff

Andrew Dj McKeown, Rebekah F Beattie, George Ac Murrell, Patrick H Lam
BACKGROUND: Massive irreparable rotator cuff tears are a difficult problem. Modalities such as irrigation and debridement, partial repair, tendon transfer and grafts have been utilized with high failure rates and mixed results. Synthetic interpositional patch repairs are a novel and increasingly used approach. The present study aimed to examine the biomechanical properties of common synthetic materials for interpositional repairs in contrast to native tendon. METHODS: Six ovine tendons, six polytetrafluoroethylene (PTFE) felt sections and six expanded PTFE (ePTFE) patch sections were pulled-to-failure to analyze their biomechanical and material properties...
January 2016: Shoulder & Elbow
Andrew K Tse, Patrick H Lam, Judie R Walton, Lisa Hackett, George Ac Murrell
BACKGROUND: Rotator cuff repair aims to reattach the torn tendon to the greater tuberosity footprint with suture anchors. The present study aimed to assess the diagnostic accuracy of ultrasound in predicting rotator cuff tear repairability and to assess which sonographic and pre-operative features are strongest in predicting repairability. METHODS: The study was a retrospective analysis of measurements made prospectively in a cohort of 373 patients who had ultrasounds of their shoulder and underwent rotator cuff repair...
January 2016: Shoulder & Elbow
Hayden A Robinson, Patrick H Lam, Judie R Walton, George A C Murrell
BACKGROUND: Rotator cuff tears are often surgically repaired, generally with good results. However, repairs not infrequently retear, and how important repair integrity is with respect to early functional outcomes after rotator cuff repair is unclear. Thus, the purpose of this study was to determine the effect of a retear on overhead activities in a large cohort of patients after rotator cuff repair. METHODS: This was a retrospective cohort study of prospectively collected data from 1600 consecutive rotator cuff repairs...
August 9, 2016: Journal of Shoulder and Elbow Surgery
Lisa Hackett, Neal L Millar, Patrick Lam, George A C Murrell
BACKGROUND: Calcific tendinitis can be a substantial cause of pain and dysfunction in the shoulder, and the pathophysiology is unclear. Recent studies have shown a link among nerve ingrowth, neovascularization, and pain in tendinopathy. The aim of this study was to determine whether there is evidence of neoinnervation and/or neovascularization in calcific tendinitis lesions of the shoulder. METHODS: At arthroscopy, ultrasound was used to identify calcium within the tendon...
February 3, 2016: Journal of Bone and Joint Surgery. American Volume
Jordan P McGrath, Patrick H Lam, Martin T S Tan, George A C Murrell
BACKGROUND: There is debate as to whether to operate or to defer surgery on patients with concomitant rotator cuff tear and shoulder stiffness. The purpose of this study was therefore to compare the outcomes in those patients who had both their rotator cuff tear and shoulder stiffness treated with the outcomes of patients who had a rotator cuff repair but no stiffness. METHODS: Twenty-five patients formed the stiffness group (receiving a concomitant rotator cuff repair and manipulation under anesthesia ± arthroscopic capsular release for preoperative ipsilateral stiffness), and a chronologically matched group of 170 rotator cuff repair-only patients formed the nonstiffness group...
May 2016: Journal of Shoulder and Elbow Surgery
Kyu Rim Hwang, George A C Murrell, Neal L Millar, Fiona Bonar, Patrick Lam, Judie R Walton
BACKGROUND: The pathophysiologic mechanisms behind proliferation of fibroblasts and deposition of dense collagen matrix in idiopathic frozen shoulder remain unclear. Accumulation of advanced glycation end products (AGEs) with cross-linking and stabilization of collagen has been hypothesized to contribute to this pathophysiologic process. This study investigated whether the immunoreactivity of AGEs is higher in patients with idiopathic frozen shoulder than in the control groups. METHODS: Shoulder capsule samples were collected from 8 patients with idiopathic frozen shoulder, 6 with unstable shoulders (control 1), and 8 with rotator cuff tears (control 2)...
June 2016: Journal of Shoulder and Elbow Surgery
Patrick H Lam, Kaitlyn Hansen, Geffrey Keighley, Lisa Hackett, George A C Murrell
BACKGROUND: Rotator cuff repair is a common method to treat rotator cuff tears; however, retear rates remain high. High-frequency, low-magnitude vibration has been demonstrated to promote new bone formation in both animal models and in humans. HYPOTHESIS: This type of mechanical stimulation applied postoperatively will enhance tendon-to-bone healing and reduce postoperative retear rates. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1...
November 2015: American Journal of Sports Medicine
Martin Tan, Patrick H Lam, Brian T N Le, George A C Murrell
BACKGROUND: Patients with rotator cuff tears often recall a specific initiating event (traumatic), whereas many cannot (nontraumatic). It is unclear how important a history of trauma is to the outcomes of rotator cuff repair. METHODS: This question was addressed in a study cohort of 1300 consecutive patients who completed a preoperative questionnaire regarding their shoulder injury and had a systematic evaluation of shoulder range of motion and strength, a primary arthroscopic rotator cuff repair performed by a single surgeon, an ultrasound scan, and the same subjective and objective measurements made of their shoulder 6 months after surgery...
January 2016: Journal of Shoulder and Elbow Surgery
Aminudin Shamsudin, Patrick H Lam, Karin Peters, Imants Rubenis, Lisa Hackett, George A C Murrell
BACKGROUND: Symptomatic rotator cuff tears are often treated surgically. However, there is a paucity of information regarding the outcomes of revision arthroscopic rotator cuff repairs. PURPOSE: To evaluate the outcome of revision arthroscopic rotator cuff surgery when compared with primary arthroscopic rotator cuff surgery in a large cohort of patients. STUDY DESIGN: Cohort study; Level of evidence, 3. METHOD: A consecutive series of 50 revision arthroscopic rotator cuff repairs performed by a single surgeon, with minimum 2-year follow-up, were retrospectively reviewed using prospectively collected data...
March 2015: American Journal of Sports Medicine
Lijkele Beimers, Patrick H Lam, George A C Murrell
BACKGROUND: This study investigated the biomechanical effects of expanded polytetrafluoroethylene (ePTFE) suture augmentation patches in rotator cuff repair constructs. METHODS: The infraspinatus tendon in 24 cadaveric ovine shoulders was repaired using an inverted horizontal mattress suture with 2 knotless bone anchors (ArthroCare, Austin, TX, USA) in a lateral-row configuration. Four different repair groups (6 per group) were created: (1) standard repair using inverted horizontal mattress sutures, (2) repair with ePTFE suture augmentations on the bursal side of the tendon, (3) repair with ePTFE suture augmentations on the articular side, and, (4) repair with ePTFE suture augmentations on both sides of the tendon...
October 2014: Journal of Shoulder and Elbow Surgery
Brian T N Le, Xiao L Wu, Patrick H Lam, George A C Murrell
BACKGROUND: The rate of retears after rotator cuff repair varies from 11% to 94%. A retear is associated with poorer subjective and objective clinical outcomes than intact repair. PURPOSE: This study was designed to determine which preoperative and/or intraoperative factors held the greatest association with retears after arthroscopic rotator cuff repair. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: This study retrospectively evaluated 1000 consecutive patients who had undergone a primary rotator cuff repair by a single surgeon using an arthroscopic inverted-mattress knotless technique and who had undergone an ultrasound evaluation 6 months after surgery to assess repair integrity...
May 2014: American Journal of Sports Medicine
Brett M Andres, Patrick H Lam, George A C Murrell
INTRODUCTION: Shoulder motion after rotator cuff repair may result in changes in tension and contact pressure at the repair site. Our goal was to determine how tension and motion affect a repair and what type of repair best tolerates these variables. METHODS: Rotator cuff tears were created ex vivo in 30 ovine shoulders divided into 5 groups: single-row repair, double-row repair, tension-band repair, suture bridge repair, and double-row tension-band repair. A pressure probe was passed through a hole created in the footprint to dynamically measure footprint pressure...
October 2010: Journal of Shoulder and Elbow Surgery
Karin S Peters, Patrick H Lam, George A C Murrell
PURPOSE: The purpose of this study was to determine whether transtendon repair by use of a novel small-diameter knotless anchor showed enhanced mechanical properties compared with tear completion and repair. METHODS: Articular-sided partial-thickness tears were created ex vivo in the infraspinatus of 24 ovine shoulders. The specimens were randomized into 4 groups of 6 each: (1) no repair, (2) transtendon repair, (3) completion of tear with tension-band single-row repair, and (4) completion of tear with double-row repair...
July 2010: Arthroscopy: the Journal of Arthroscopic & related Surgery
Deepak N Bhatia, Joe F de Beer, Karin S van Rooyen, Francis Lam, Donald F du Toit
BACKGROUND: Tendinopathies of the rotator cuff muscles, biceps tendon and pectoralis major muscle are common causes of shoulder pain in athletes. Overuse insertional tendinopathy of pectoralis minor is a previously undescribed cause of shoulder pain in weightlifters/sportsmen. OBJECTIVES: To describe the clinical features, diagnostic tests and results of an overuse insertional tendinopathy of the pectoralis minor muscle. To also present a new technique of ultrasonographic evaluation and injection of the pectoralis minor muscle/tendon based on use of standard anatomical landmarks (subscapularis, coracoid process and axillary artery) as stepwise reference points for ultrasonographic orientation...
August 2007: British Journal of Sports Medicine
F Lam, D Mok
The purpose of the study was to evaluate the functional outcome and identify possible preoperative prognostic factors in patients aged 65 years or over undergoing open repair for a massive (>5 cm) full-thickness rotator cuff tear. Patients were assessed after a mean of 48 months by an independent observer by use of the Constant score and the Oxford Shoulder Questionnaire. The outcome was excellent or good in 44% and poor in 23%. The patient satisfaction rate was 84%. Pain relief was obtained in 93%. We found three preoperative variables to be significantly associated with a poor outcome: female sex, duration of symptoms greater than 34 months before surgery, and American Society of Anesthesiologists grade...
September 2004: Journal of Shoulder and Elbow Surgery
Gabriel Y F Ng, Patrick C W Lam
STUDY DESIGN: Normative descriptive study. OBJECTIVES: Exploring the isokinetic work ratios of eccentric antagonist/concentric agonist shoulder rotators in the late cocking and deceleration phases of a forehand overhead smash in badminton players. Comparing the work ratios between dominant and nondominant shoulders. BACKGROUND: The strength of shoulder muscles for badminton players has been studied but there is little information on the work output of these muscles for a specific range of movement...
August 2002: Journal of Orthopaedic and Sports Physical Therapy
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