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rotator cuff

Mona Alilet, Julien Behr, Jean-Philippe Nueffer, Benoit Barbier-Brion, Sébastien Aubry
: The subscapularis (SSC) muscle is the most powerful of the rotator cuff muscles, and plays an important role in shoulder motion and stabilization. SSC tendon tear is quite uncommon, compared to the supraspinatus (SSP) tendon, and, most of the time, part of a large rupture of the rotator cuff. Various complementary imaging techniques can be used to obtain an accurate diagnosis of SSC tendon lesions, as well as their extension and muscular impact. Pre-operative diagnosis by imaging is a key issue, since a lesion of the SSC tendon impacts on treatment, surgical approach, and post-operative functional prognosis of rotator cuff injuries...
October 17, 2016: Insights Into Imaging
Birgit Castelein, Ann Cools, Thierry Parlevliet, Barbara Cagnie
BACKGROUND: Altered recruitment of rotator cuff and scapulothoracic muscles has been identified in patients with subacromial impingement syndrome. To date, however, the cause-consequence relationship between pain and altered muscle recruitment has not been fully unraveled. METHODS: The effect of experimental shoulder pain induced by injection of hypertonic saline in the supraspinatus on the activity of the supraspinatus, infraspinatus, subscapularis, trapezius, and serratus anterior activity was investigated during the performance of an elevation task by use of muscle functional magnetic resonance imaging in 25 healthy individuals...
October 14, 2016: Journal of Shoulder and Elbow Surgery
Jennica J Tucker, Joshua A Gordon, Robert C Zanes, Andrey Zuskov, John D Vinciguerra, Roy D Bloebaum, Louis J Soslowsky
BACKGROUND: Current techniques in rotator cuff repair often lack structural integrity. P(2) porous titanium-coated constructs (DJO Surgical, Austin, TX, USA) promote osseointegration and soft tissue ingrowth. This study examined the ability of this material to improve the structural integrity of supraspinatus tendon repair in a rat model. We hypothesized that P(2) implants placed at the tendon-to-bone interface would improve mechanical and histologic measures of supraspinatus healing...
October 14, 2016: Journal of Shoulder and Elbow Surgery
Sahishnu Patel, Anthony P Gualtieri, Helen H Lu, William N Levine
Rotator cuff tear is a very common shoulder injury that often necessitates surgical intervention for repair. Despite advances in surgical techniques for rotator cuff repair, there is a high incidence of failure after surgery because of poor healing capacity attributed to many factors. The complexity of tendon-to-bone integration inherently presents a challenge for repair because of a large biomechanical mismatch between the tendon and bone and insufficient regeneration of native tissue, leading to the formation of fibrovascular scar tissue...
October 17, 2016: Annals of the New York Academy of Sciences
William R Aibinder, Bradley Schoch, Cathy Schleck, John W Sperling, Robert H Cofield
BACKGROUND: Glenoid component loosening is a common indication for revision shoulder arthroplasty. The objective of this study is to assess the longer-term outcomes of patients undergoing revision specifically for aseptic loosening. MATERIALS AND METHODS: Between 1985 and 2005, 34 revision shoulder arthroplasties were performed for aseptic glenoid loosening. Three patients were lost to follow-up. Treatment included component reimplantation in 20 shoulders (group I) or component removal with bone grafting in 11 shoulders (group II)...
October 10, 2016: Journal of Shoulder and Elbow Surgery
Tressa D Amirthanayagam, Andrew A Amis, Peter Reilly, Roger J H Emery
BACKGROUND: The deltopectoral approach for total shoulder arthroplasty can result in subscapularis dysfunction. In addition, glenoid wear is more prevalent posteriorly, a region difficult to access with this approach. We propose a posterior approach for access in total shoulder arthroplasty that uses the internervous interval between the infraspinatus and teres minor. This study compares this internervous posterior approach with other rotator cuff-sparing techniques, namely, the subscapularis-splitting and rotator interval approaches...
October 10, 2016: Journal of Shoulder and Elbow Surgery
Jourdan M Cancienne, Stephen F Brockmeier, Scott A Rodeo, Chris Young, Brian C Werner
PURPOSE: To evaluate the association of postoperative fluoroquinolone use following arthroscopic primary rotator cuff repair with failure requiring revision rotator cuff repair. METHODS: An insurance database was queried for patients undergoing rotator cuff repair from 2007 to 2015. These patients were divided into three groups: (1) patients prescribed fluoroquinolones within 6 months postoperatively (divided into 0-2, 2-4, and 4-6 months), (2) a matched negative control cohort of patients not prescribed fluoroquinolones, and (3) a matched positive control cohort of patients prescribed fluoroquinolones between 6 and 18 months following rotator cuff repair...
October 13, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Christopher S Lee, Shane M Davis, Brittany Doremus, Shalen Kouk, William B Stetson
BACKGROUND: At present, there is no widely accepted classification system for partial-thickness rotator cuff tears, and as a result, optimal treatment remains controversial. PURPOSE: To examine the interobserver reliability and accuracy of classifying partial rotator cuff tears using the Snyder classification system. We hypothesized that the Snyder classification would be reproducible with high reliability and accuracy. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2...
September 2016: Orthopaedic Journal of Sports Medicine
Timothy G Baumer, Derek Chan, Veronica Mende, Jack Dischler, Roger Zauel, Marnix van Holsbeeck, Daniel S Siegal, George Divine, Vasilios Moutzouros, Michael J Bey
BACKGROUND: Physical therapy (PT) is often prescribed for patients with rotator cuff tears. The extent to which PT influences strength, range of motion (ROM), and patient-reported outcomes has been studied extensively, but the effect of PT on in vivo joint kinematics is not well understood. PURPOSE: To assess the influence of symptomatic rotator cuff pathology and the effects of PT on shoulder motion, strength, and patient-reported outcomes. STUDY DESIGN: Controlled laboratory study...
September 2016: Orthopaedic Journal of Sports Medicine
William R Mook, Joshua A Greenspoon, Peter J Millett
BACKGROUND: Rotator cuff tears are a significant cause of shoulder morbidity. Surgical techniques for repair have evolved to optimize the biologic and mechanical variables critical to tendon healing. Double-row repairs have demonstrated superior biomechanical advantages to a single-row. METHODS: The preferred technique for rotator cuff repair of the senior author was reviewed and described in a step by step fashion. The final construct is a knotless double row transosseous equivalent construct...
2016: Open Orthopaedics Journal
Breda H Eubank, Nicholas G Mohtadi, Mark R Lafave, J Preston Wiley, J C Herbert Emery
BACKGROUND: The Rotator Cuff Quality of Life Index (RC-QOL) was developed to evaluate quality of life in patients with rotator cuff disorders (RCD). The purpose of this study was to provide additional reliability, validity, and responsiveness testing in accordance with the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) guidelines. METHODS: Preliminary patient interviews included 15 patients. Seventy patients (mean age, 58; standard deviation, 9 years) with RCD were evaluated...
October 7, 2016: Journal of Shoulder and Elbow Surgery
Bauke W Kooistra, W Jaap Willems, Eelke Lemmens, Bas P Hartel, Michel P J van den Bekerom, Derek F P van Deurzen
BACKGROUND: Compared with total shoulder arthroplasty (TSA), total shoulder surface replacement (TSSR) may offer the advantage of preservation of bone stock and shorter surgical time, possibly at the expense of glenoid component positioning and increasing lateral glenohumeral offset. We hypothesized that in patients treated for osteoarthritis with a sufficient rotator cuff, TSA and TSSR patients have comparable functional outcome, glenoid component version, and lateral glenohumeral offset...
October 7, 2016: Journal of Shoulder and Elbow Surgery
Jennifer L Pierce, Nicholas C Nacey, Stephen Jones, Davis Rierson, Brian Etier, Stephen Brockmeier, Mark W Anderson
Imaging interpretation of the postoperative shoulder is a challenging and difficult task for both the radiologist and the orthopedic surgeon. The increasing number of shoulder rotator cuff, labrum, and biceps tendon repairs performed in the United States also makes this task a frequent occurrence. Whether treatment is surgical or conservative, imaging plays a crucial role in patient care. Many imaging findings can be used to predict prognosis and functional outcomes, ultimately affecting treatment. In addition, evolving surgical techniques alter the normal anatomy and imaging appearance of the shoulder such that accepted findings proved to be pathologic in the preoperative setting cannot be as readily described as pathologic after surgery...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Matthew H Lee, Scott E Sheehan, John F Orwin, Kenneth S Lee
Shoulder pain is one of the most common musculoskeletal conditions encountered in primary care and specialty orthopedic clinic settings. Although magnetic resonance (MR) imaging is typically the modality of choice for evaluating the soft-tissue structures of the shoulder, ultrasonography (US) is becoming an important complementary imaging tool in the evaluation of superficial soft-tissue structures such as the rotator cuff, subacromial-subdeltoid bursa, and biceps tendon. The advantages of US driving its recent increased use include low cost, accessibility, and capability for real-time high-resolution imaging that enables dynamic assessment and needle guidance...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Amir Lebaschi, Xiang-Hua Deng, Jianchun Zong, Guang-Ting Cong, Camila B Carballo, Zoe M Album, Christopher Camp, Scott A Rodeo
Rotator cuff (RC) injuries represent a significant source of pain, functional impairment, and morbidity. The large disease burden of RC pathologies necessitates rapid development of research methodologies to treat these conditions. Given their ability to model anatomic, biomechanical, cellular, and molecular aspects of the human RC, animal models have played an indispensable role in reducing injury burden and advancing this field of research for many years. The development of animal models in the musculoskeletal (MSK) research arena is uniquely different from that in other fields in that the similarity of macrostructures and functions is as critical to replicate as cellular and molecular functions...
October 10, 2016: Annals of the New York Academy of Sciences
José L Arias-Buría, César Fernández-de-Las-Peñas, María Palacios-Ceña, Shane L Koppenhaver, Jaime Salom-Moreno
: This randomized clinical trial investigated the effectiveness of exercise vs. exercise plus trigger point dry needling (TrP-DN) in subacromial pain syndrome. A randomized parallel-group trial, with 1-year follow-up was conducted. Fifty subjects with subacromial pain syndrome were randomly allocated to receive exercise alone or exercise +TrP-DN. Participants in both groups were asked to perform an exercise program of the rotator cuff muscles twice daily for 5 weeks. Further, patients allocated to the exercise +TrP-DN group also received dry needling to active TrPs in the muscles reproducing shoulder symptoms during the 2(nd) and 4(th) sessions...
October 5, 2016: Journal of Pain: Official Journal of the American Pain Society
Hong Jun Jung, Gyeong-Bo Sim, Kun Hyung Bae, Aashay L Kekatpure, Jae-Myeung Chun, In-Ho Jeon
BACKGROUND: The purpose of this study was to evaluate whether rotator cuff repair improves subjective and functional outcomes in patients aged ≥75 years. METHODS: From May 2005 to March 2013, 121 elderly patients who underwent rotator cuff repair for large and massive rotator cuff tears were evaluated retrospectively. Patients with an American Society of Anesthesiologists physical status classification system grade ≥4 were excluded. The patients were evaluated using visual analog scales, subjective satisfaction surveys, American Shoulder and Elbow Surgeons scores, and Constant scores...
October 5, 2016: Journal of Shoulder and Elbow Surgery
Nicholas A Early, John J Elias, Steven B Lippitt, Danielle E Filipkowski, Robert A Pedowitz, William J Ciccone
BACKGROUND: This in vitro study evaluated the biomechanical benefit of adding spanning sutures to single-row rotator cuff repair. METHODS: Mechanical testing was performed to evaluate 9 pairs of cadaveric shoulders with complete rotator cuff repairs, with a single-row technique used on one side and the suture spanning technique on the other. The spanning technique included sutures from 2 lateral anchors securing tendon near the musculotendinous junction, spanning the same anchor placement from single-row repair...
October 5, 2016: Journal of Shoulder and Elbow Surgery
Ro Woon Lee, Soo-Jung Choi, Man Ho Lee, Jae Hong Ahn, Dong Rock Shin, Chae Hoon Kang, Ki Won Lee
OBJECTIVE: To evaluate the diagnostic performance (DP) of 3T (3 Tesla field strength) conventional shoulder magnetic resonance imaging (MRI) in detecting the long head of the biceps tendon (LHBT) tears in association with rotator cuff tendon tears. MATERIALS AND METHODS: This study included 80 consecutive patients who underwent arthroscopic surgery for rotator cuff tendon tears. Two radiologists independently evaluated the preoperative 3T shoulder MRI for the presence of LHBT tears...
October 7, 2016: Skeletal Radiology
Els Fieremans, Gregory Lemberskiy, Jelle Veraart, Eric E Sigmund, Soterios Gyftopoulos, Dmitry S Novikov
The time dependence of the diffusion coefficient is a hallmark of tissue complexity at the micrometer level. Here we demonstrate how biophysical modeling, combined with a specifically tailored diffusion MRI acquisition performing diffusion tensor imaging (DTI) for varying diffusion times, can be used to determine fiber size and membrane permeability of muscle fibers in vivo. We describe the random permeable barrier model (RPBM) and its assumptions, as well as the details of stimulated echo DTI acquisition, signal processing steps, and potential pitfalls...
October 7, 2016: NMR in Biomedicine
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