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Tearing

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https://www.readbyqxmd.com/read/29353150/biodegradable-spacer-reduces-the-subacromial-pressure-a-biomechanical-cadaver-study
#1
Yan Chevalier, Matthias F Pietschmann, Christoph Thorwächter, Ofir Chechik, Eliyahu Adar, Assaf Dekel, Peter E Müller
BACKGROUND: Failure after rotator cuff repair remains a major clinical problem and could be related to excessive pressures from the acromion. Previous studies with irreparable tears showed good clinical results of tendon healing with arthroscopic insertion of a protective biodegradable spacer balloon between the repaired tendon and the acromion. One hypothesis is that compression pressures on the repaired tendon will be reduced by the spacer. This cadaver study aimed to investigate the effects of this subacromial spacer on compression pressures over a repaired supraspinatus tendon in passive motion...
December 18, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/29352758/-arthroscopic-rotator-cuff-surgery-new-and-established-methods
#2
REVIEW
S Pauly, M Scheibel
This present article summarizes established and current developments and aspects of rotator cuff surgery. Achieved milestones as well as current approaches are presented and assessed with respect to their clinical and radiographic impact. Despite biomechanical and technical improvements in modern rotator cuff repair techniques, re-defect and re-tearing rates could not be fully eliminated. Meanwhile, the importance of biological processes around successful tendon-bone reintegration has been increasingly recognized...
January 19, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29352567/asymptomatic-ascending-aorta-aneurysm-with-severe-aortic-regurgitation-caused-by-multiple-intimal-medial-tears-unassociated-with-aortic-dissection
#3
Carlos E Velasco, Helen Hashemi, Christina P Roullard, Juan Machannaford, William C Roberts
A 62-year-old man was found to have an asymptomatic ascending aortic aneurysm (6.6 cm) associated with severe aortic regurgitation. Operative resection of the wall of the aneurysm disclosed its cause to be multiple healed intimal-medial tears without dissection involving a previously normal aorta. The concept of an intimal-medial tear unassociated with aortic dissection is a poorly recognized entity and these tears appear to be asymptomatic and after the aortic tearing lead to aneurysmal formation.
December 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29352439/single-incision-laparoscopic-transgastric-underrunning-and-closure-of-cameron-ulcers-in-acute-gastrointestinal-bleeding
#4
Chun Han Nigel Tan, Guowei Kim, Jimmy So, Asim Shabbir
INTRODUCTION: Endoscopic therapy remains the cornerstone of hemostasis for gastrointestinal bleeding. In situations where hemostasis cannot be achieved via endoscopic or radiological methods, surgery is necessary. Traditional open surgery for bleeding gastric ulcers can be very morbid and unsuitable especially in hemodynamically unstable patients in extremis. We describe a minimally invasive, transgastric approach for underrunning and closure of Cameron ulcers. METHODS: Our patient is a 75-year-old Chinese lady, who presented to the emergency department with fresh melena...
January 19, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29351746/concomitant-glenohumeral-injuries-in-neer-type-ii-distal-clavicle-fractures
#5
Tobias Helfen, Georg Siebenbürger, Florian Haasters, Wolfgang Böcker, Ben Ockert
BACKGROUND: To identify the prevalence of concomitant glenohumeral injuries in surgically treated Neer type II distal clavicle fractures and relate its clinical importance. METHODS: Between 11/2011 and 11/2015 41 patients, suffering from a displaced and unstable distal clavicle fracture were included. 20 patients (group 1) received surgical treatment by means of plate osteosynthesis in combination with an arthroscopically assisted coraco-clavicular ligament augmentation...
January 19, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29350634/mri-of-popliteo-meniscal-fasciculi-of-the-knee-a-pictorial-review
#6
Marcello Zappia, Alfonso Reginelli, Vito Chianca, Michela Carfora, Francesco Di Pietto, Germano Iannella, Pier Paolo Mariani, Mariano Di Salvatore, Silvia Bartollino, Nicola Maggialetti, Salvatore Cappabianca, Luca Brunese
The popliteomeniscal fascicules (PMFs) provide the attachment of the lateral meniscus to the popliteus musculotendinous region, forming the floor and the roof the popliteal hiatus. In the second half of 1900's, some anatomic studies claim the important function of the PMF as stabilizers of the lateral meniscus; these anatomical structures work in conjunction with the popliteus musculotendinous unit to prevent excessive lateral meniscal movement and possible meniscus subluxation. A correct diagnosis of the PMFs pathology is crucial to establish the suitable surgical treatment for each patient...
January 19, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29350447/effect-of-sedation-with-butorphanol-on-variables-pertaining-to-the-ophthalmic-examination-in-dogs
#7
Jean-Yves Douet, Alain Regnier, Agnès Dongay, Sophie Jugant, Géraldine Jourdan, Didier Concordet
OBJECTIVE: To evaluate whether sedation with intramuscular butorphanol can interfere with different variables of the ocular examination in dogs. ANIMALS: Twenty-two beagles without ophthalmic abnormalities. PROCEDURES: Each dog was examined 20 min prior to and again just before administration of butorphanol to establish baseline data. The globe and nictitating membrane position was evaluated, and the following were recorded: menace response, dazzle reflex, corneal blink reflex, phenol red thread tear test (PRT), Schirmer tear test-1 (STT-1), pupil size (PS) measurement, and rebound tonometry...
January 19, 2018: Veterinary Ophthalmology
https://www.readbyqxmd.com/read/29350325/evaluation-and-management-of-rotator-cuff-tears-a-primary-care-perspective
#8
REVIEW
Ross Mathiasen, Christopher Hogrefe
PURPOSE OF REVIEW: To provide a primary care perspective regarding the evaluation and management of shoulder pain and rotator cuff tears. RECENT FINDINGS: In the primary care setting, rotator cuff pathology is commonly encountered. Information regarding the risks of oral medications for the management of the associated pain keeps mounting. Partial-thickness rotator cuff tears remain difficult to diagnose with a single imaging modality. Musculoskeletal education in medical schools and non-orthopaedic residency and fellowship training programs continues to be an area for additional improvement...
January 19, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29349997/-surgical-outcome-of-percutaneous-endoscopic-technique-for-highly-migrated-disc-herniation-via-three-different-approaches
#9
Yi Jiang, Ru-Jun Zuo, Lei Wu, Cheng Huang, Yan Shi, Hua-Wei Song, Yi-Wei Wang, Bin Li
OBJECTIVE: To analyze the clinical effects of percutaneous endoscopic technique via three different approaches for highly migrated lumbar disc herniation. METHODS: The clinical data of 68 patients underwent percutaneous endoscopic technique from June 2011 to June 2014 were retrospectively analyzed. There were 43 males and 25 females, aged from 11 to 77 years old with an average of (42.29±15.92) years. The patients were divided into three groups according to different operative approaches, of them, 45 cases were by transforaminal approach (group A), 15 cases by translaminar approach (group B), and 8 cases by transpedicular approach (group C)...
February 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29349991/-effects-of-creating-a-tunnel-through-intercondylar-fossa-under-arthroscopy-for-the-treatment-of-complex-tears-at-the-medial-meniscus-posterior-horn
#10
Ling-Dai Dong, Chang-Jian Bing, Jian-Lin Li, Yue Cai
OBJECTIVE: To discuss the advantages of the arthroscopic treatment for complex tears of the medial meniscus posterior horn by creating a tunnel passageway through the intercondylar fossa. METHODS: All 127 patients including 24 males and 103 females with complex tears at the medial meniscus posterior horn were reviewed. The age of all patients ranged from 45 to 78 years old, with an average of 67 years old. All 127 patients were treated with partial meniscectomy, in which 112 patients were treated with partial meniscectomy smoothly with three incisions (anterior medial incision, anterior lateral incision, high anterior lateral incision), and 15 patients were treated with four incisions (anterior medial incision, anterior lateral incision, high anterior lateral incision, posterior medial incision)...
April 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29349028/knotless-suture-bridge-technique-in-high-grade-bursal-sided-rotator-cuff-tears-is-this-the-way-forward
#11
Bancha Chernchujit, Mohd Azrin Shahul Hamid, Sittan Aimprasittichai
We present our technique in managing high-grade bursal-sided rotator cuff tears. In this technique, the remaining intact cuff tissue is not sacrificed. The suture bridge technique is used to uniformly tension the torn tissue to the rotator cuff footprint. No knots are tied on the rotator cuff to minimize the tension on the cuff. The sutures are then anchored on the lateral cortex of the humerus. This technique allows repair with minimum tension while preserving the original length of the rotator cuff.
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349027/arthroscopic-repair-of-massive-subscapularis-and-supraspinatus-tear-by-double-row-knotless-technique
#12
Bancha Chernchujit, Pankaj N Sharma
Subscapularis is the most powerful muscle in the rotator cuff. A steep learning curve and constrained space anteriorly make the repair difficult. In massive tears of the rotator cuff, repair of the subscapularis initially makes the massive supraspinatus tear repairable. We present our technique to repair subscapularis and supraspinatus tear by double-row anchors in a knotless and tension-free manner. This technique can be done in partial or full-thickness tears of the upper subscapularis.
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349025/anterior-capsule-reconstruction-for-irreparable-subscapularis-tears
#13
Jason P Rogers, Adam Kwapisz, John M Tokish
A subscapularis complete tear presents its own challenges in management. The glenohumeral biomechanics and force couple are reliant on a competent and functioning subscapularis muscle. An irreparable subscapularis makes those same challenges even more difficult to address. Traditionally, this problem has been addressed with tendon transfers, including pectoralis major or latissimus dorsi. These techniques can alter the ideal biomechanics of the shoulder and have high rates or failure. Iliotibial autograft or tibialis anterior have also been wrought with high failure rates...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349021/arthroscopic-repair-of-medial-transtendinous-rotator-cuff-tears
#14
Brian J Kelly, Larry D Field
Rotator cuff tears are extremely common in the adult population, and medial transtendinous rotator cuff tears, although rare, have recently been reported in the literature. These tears are almost always traumatic, which is a common indication for surgical management. It is necessary to consider these tears as a distinct subset when planning for rotator cuff repair because traditional repair techniques would overtension the tendon, increasing the risk for failure of the repair. The objective of this Technical Note is to describe an arthroscopic repair technique for these tears that avoids overtensioning the rotator cuff while still using repair techniques that are familiar to the arthroscopic shoulder surgeon...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349020/an-arthroscopic-humeral-medializing-repair-of-the-supraspinatus
#15
Amir Ghazanfari, Daniel J H Henderson, Geoffroy Nourissat
Posterosuperior repair of the rotator cuff is one of the most frequently performed surgical procedures in the shoulder. Its aim is to fix the tendon back to the bone to restore anatomy, improve shoulder function, and prevent progression of cuff tear arthropathy and attendant muscle degeneration. Despite technical advances in this procedure, in some cases, the tendon cannot be fixed back to the footprint without excessive tension on the repair. In young patients or in patients with low-grade muscle atrophy and fatty degeneration (Goutallier grade 1 or 2), it is mandatory to attempt fixation of the tendon to restore functional anatomy and prevent further muscle degeneration...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349011/middle-glenohumeral-ligament-abrasion-causing-upper-subscapularis-tear
#16
Paul C Brady, Heather Grubbs, Alexandre Lädermann, Christopher R Adams
The middle glenohumeral ligament (MGHL) typically contributes partially to the anterior stability of the shoulder. In a very limited number of cases, the MGHL can cause abrasion on the upper edge of the subscapularis causing persistent pain symptoms for patients. The condition is exacerbated by internal rotation of the arm. In this Technical Note, we describe this entity and call it the SAM lesion (Subscapularis Abrasion from the MGHL). We present a technique of addressing this lesion.
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349010/arthroscopic-repair-of-hip-labrum-with-suture-anchors
#17
Kartik Shenoy, Amos Z Dai, Siddharth A Mahure, Daniel J Kaplan, Brian Capogna, Thomas Youm
The acetabular labrum and the transverse acetabular ligament form a continuous ring of tissue on the periphery of the acetabulum that provides a seal for the hip joint and increases the surface area to spread load distribution during weight-bearing. When a labral tear is suspected, the treatment algorithm always begins with conservative management, including physical therapy and nonsteroidal anti-inflammatory drugs. When conservative management fails, patients become candidates for arthroscopic labral repair...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349009/arthroscopic-repair-of-type-ii-slap-tears-using-suture-anchor-technique
#18
Mathew Hamula, Siddharth A Mahure, Daniel J Kaplan, Brent Mollon, Joseph D Zuckerman, Young W Kwon, Andrew S Rokito
Arthroscopic SLAP tear repair has become an increasingly used treatment for patients presenting with symptomatic SLAP tears after failed nonoperative management. Debridement, SLAP repair, and open or arthroscopic biceps tenodesis or tenotomy have been used for the treatment of SLAP tears. Various techniques for repair have been described, and furthermore, there is a high incidence of concomitant pathology of the shoulder. Repair remains an excellent option in isolated SLAP tears amenable to repair, with excellent outcomes in well-indicated patients...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29346717/anterior-cruciate-ligament-tear-induces-a-sustained-loss-of-muscle-fiber-force-production
#19
Jonathan P Gumucio, Kristoffer B Sugg, Elizabeth R Sibilsky Enselman, Alexis C Konja, Logan R Eckhardt, Asheesh Bedi, Christopher L Mendias
INTRODUCTION: Patients with anterior cruciate ligament (ACL) tears have persistent quadriceps strength deficits that are thought to be due to altered neurophysiological function. Our goal was to determine the changes in muscle fiber contractility independent of the ability of motor neurons to activate fibers. METHODS: We obtained quadriceps biopsies of patients undergoing ACL reconstruction, and additional biopsies one, two, and six months after surgery. Muscles fiber contractility was assessed in vitro, along with whole muscle strength testing...
January 18, 2018: Muscle & Nerve
https://www.readbyqxmd.com/read/29345402/association-of-long-term-glycaemic-control-on-tear-break-up-times-and-dry-eye-symptoms-in-chinese-patients-with-type-2-diabetes
#20
Andre Ma, Martin Sy Mak, Kendrick Co Shih, Claudia Ky Tsui, Rachel Ky Cheung, Sherman Haynam Lee, Hubert Leung, Joyce Ns Leung, Jason Th Leung, Marco Zhenji Van-Boswell, Michael Tl Wong, Alex Lap-Ki Ng, Chi-Ho Lee, Vishal Jhanji, Louis Tong
Importance Diabetes mellitus is known to be associated with dry eye syndrome (DES), but the effects of long term glycaemic control on tear film metrics and dry eye symptoms are not known in the Chinese population. BACKGROUND: To evaluate tear film stability and dry eye symptoms and their associations with systemic risk factors in Chinese patients with type 2 diabetes (T2DM) Design Cross-sectional study set at the Lo Fong Siu Po Eye Centre (Grantham Hospital), Hong Kong.
January 18, 2018: Clinical & Experimental Ophthalmology
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