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Rotator cuff tear

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https://www.readbyqxmd.com/read/29352758/-arthroscopic-rotator-cuff-surgery-new-and-established-methods
#1
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/29351746/concomitant-glenohumeral-injuries-in-neer-type-ii-distal-clavicle-fractures
#2
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/29350325/evaluation-and-management-of-rotator-cuff-tears-a-primary-care-perspective
#3
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/29349028/knotless-suture-bridge-technique-in-high-grade-bursal-sided-rotator-cuff-tears-is-this-the-way-forward
#4
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
#5
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
#6
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
#7
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
#8
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/29338908/relationship-between-neuropathy-proximal-to-the-suprascapular-nerve-and-rotator-cuff-tear-in-a-rodent-model
#9
Yasuhito Sasaki, Nobuyasu Ochiai, Eiko Hashimoto, Yu Sasaki, Takeshi Yamaguchi, Takehiro Kijima, Koji Akimoto, Seiji Ohtori, Kazuhisa Takahashi
BACKGROUND: Rotator cuff tears are believed to coexist with cervical spine lesions. In cases of preexisting neuropathy, such as cervical spine lesions, fatty degeneration has likely already occurred due to the neuropathy. In these cases, rotator cuff tear is thought to occur easily because of preexisting extensive fatty degeneration and degeneration of the tendons due to neuropathy. This study aimed to evaluate the effects of paralysis due to neuropathy proximal to the suprascapular nerve on the supraspinatus and infraspinatus tendons using a rat model of brachial plexus paralysis...
January 12, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29337026/effect-of-recombinant-human-growth-hormone-on-rotator-cuff-healing-after-arthroscopic-repair-preliminary-result-of-a-multicenter-prospective-randomized-open-label-blinded-end-point-clinical-exploratory-trial
#10
Joo Han Oh, Seok Won Chung, Kyung-Soo Oh, Jae Chul Yoo, Wonhee Jee, Jung-Ah Choi, Yang-Soo Kim, Jin-Young Park
BACKGROUND: This study evaluated the effect of systemic injection of recombinant human growth hormone (rhGH) on outcomes after arthroscopic rotator cuff repair. METHODS: This multicenter, prospective, randomized, comparative trial, randomized patients who underwent arthroscopic repair of large-sized rotator cuff tears into 3 groups: rhGH 4 mg group (n = 26), rhGH 8 mg group (n = 24) , and control group (n = 26). Sustained release rhGH was injected subcutaneously once weekly for 3 months postoperatively...
January 11, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29332181/management-of-rotator-cuff-injuries-in-the-elite-athlete
#11
REVIEW
Leigh J Weiss, Dean Wang, Michael Hendel, Philip Buzzerio, Scott A Rodeo
PURPOSE OF REVIEW: Rotator cuff injuries are a common cause of pain and dysfunction for the elite athlete and can result in time loss from participation. This review highlights the current management of these injuries. RECENT FINDINGS: Conservative management of rotator cuff injuries continues to be the "gold standard" in the elite athlete. This includes a comprehensive rehabilitation program, anti-inflammatories, and corticosteroid injections. Newer treatment techniques such as intramuscular dry needling and the use of biologics such as platelet-rich plasma and stem cells demonstrate early promising results; however, these modalities require further investigation to determine their effectiveness...
January 13, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29330670/treatment-of-partial-thickness-rotator-cuff-tears-in-overhead-athletes
#12
REVIEW
Joseph N Liu, Grant H Garcia, Anirudh K Gowd, Brandon C Cabarcas, Michael D Charles, Anthony A Romeo, Nikhil N Verma
PURPOSE OF REVIEW: To review the etiology, classification, presentation, evaluation, treatment strategy, and outcomes in overhead athletes with partial thickness rotator cuff tears. RECENT FINDINGS: Despite advances in surgical repair techniques, return to play following surgical repair of partial rotator cuff tears remains modest at best. Overhead athletes may be particularly prone to rotator cuff pathology due to the supraphysiological strains within the tendon during the throwing motion, as well as mechanical stress with contact between the undersurface of the rotator cuff and the glenoid...
January 13, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29328887/macroscopic-rotator-cuff-tendinopathy-and-histopathology-do-not-predict-repair-outcomes-of-rotator-cuff-tears
#13
Paul M Sethi, Chirag D Sheth, Leo Pauzenberger, Mary Beth R McCarthy, Mark P Cote, Emma Soneson, Seth Miller, Augustus D Mazzocca
BACKGROUND: Numerous studies have identified factors that may affect the chances of rotator cuff healing after surgery. Intraoperative tendon quality may be used to predict healing and to determine type of repair and/or consideration of augmentation. There are no data that correlate how gross tendon morphology and degree of tendinopathy affect patient outcome or postoperative tendon healing. Purpose/Hypothesis: The purposes of this study were to (1) compare the gross appearance of the tendon edge during arthroscopic rotator cuff repair with its histological degree of tendinopathy and (2) determine if gross appearance correlated with postoperative repair integrity...
January 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29327176/how-to-use-a-graft-in-irreparable-rotator-cuff-tears-a-literature-review-update-of-interposition-and-superior-capsule-reconstruction-techniques
#14
REVIEW
Kevin C Wall, Alison P Toth, Grant E Garrigues
PURPOSE OF REVIEW: To introduce the challenges in addressing irreparable rotator cuff tears and examine the surgical options, specifically interposition grafting and superior capsule reconstruction. RECENT FINDINGS: Interposition grafting of rotator cuff tears shows promising results in reducing pain and improving function postoperatively and one study demonstrated that it performs significantly better than partial repair alone. Superior capsule reconstruction has become popular rapidly, but given the novelty of the procedure, there is currently a paucity of outcomes data to review...
January 11, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29325703/the-prevalence-and-morphometric-analysis-of-ossified-superior-transverse-scapular-ligaments-in-patients-with-rotator-cuff-tears
#15
Jung Youn Kim, Yong Girl Rhee
BACKGROUND: The prevalence of ossified superior transverse scapular ligaments (OSTSLs) in rotator cuff tears (RCTs) has not yet been determined. The purposes of this study were to evaluate the prevalence of OSTSLs in RCTs and to investigate the correlation between OSTSL morphology and supraspinatus muscle atrophy. METHODS: We analyzed a total of 213 patients with RCTs for whom 3-dimensional (3D) computed tomography (CT) and magnetic resonance imaging were performed prior to arthroscopic procedures...
January 8, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29325577/dynamic-kinematics-of-the-glenohumeral-joint-in-shoulders-with-rotator-cuff-tears
#16
Naoya Kozono, Takamitsu Okada, Naohide Takeuchi, Satoshi Hamai, Hidehiko Higaki, Takeshi Shimoto, Satoru Ikebe, Hirotaka Gondo, Yoshitaka Nakanishi, Takahiro Senju, Yasuharu Nakashima
BACKGROUND: No clear trend has emerged from the literature regarding three-dimensional (3D) translations of the humerus relative to the scapula in shoulders with rotator cuff tears (RCTs). The purpose of this study was to evaluate the kinematics of RCT shoulders using 3D-to-two-dimensional (2D) model-to-image registration techniques. METHODS: Dynamic glenohumeral kinematics during scapular plane abduction and axial rotation were analyzed in 11 RCT patients and 10 healthy control subjects...
January 11, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29319733/biomechanic-and-histologic-analysis-of-fibroblastic-effects-of-tendon-to-bone-healing-by-transforming-growth-factor-%C3%AE-1-tgf-%C3%AE-1-in-rotator-cuff-tears
#17
Chong Zhang, Yu-Jie Liu
PURPOSE: To evaluate the effect of transforming growth factor β1 (TGF-β1) on tendon-to-bone reconstruction of rotator cuff tears. METHODS: Seventy-two rat supraspinatus tendons were transected and reconstructed in situ. At 8 and 16 weeks, specimens of three groups; that is control, L-dose (low dose), and H-dose (high dose) were harvested and underwent a biomechanical test to evaluate the maximum load and stiffness values. Histology sections of the tendon-to-bone interface were identified by hematoxylin-eosin or Masson trichrome stain...
December 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/29319655/superior-capsular-reconstruction-with-a-partial-rotator-cuff-repair-a-case-report
#18
John M Tokish, Amit Momaya, Troy Roberson
CASE: Chronic massive irreparable rotator cuff tears remain challenging to treat. We present the case of a 70-year-old active and healthy woman who presented with 6 months of worsening shoulder pain and function; she had experienced considerable deterioration over the past 2 months. Nonoperative management of the massive rotator cuff tear was not successful. Superior capsule reconstruction (SCR) was performed with a partial rotator cuff repair. CONCLUSION: SCR is an exciting advancement for the chronic massive irreparable rotator cuff tear, one of the more challenging problems encountered by shoulder surgeons...
January 10, 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/29317260/growth-factor-delivery-strategies-for-rotator-cuff-repair-and-regeneration
#19
Anupama Prabhath, Varadraj N Vernekar, Enid Sanchez, Cato T Laurencin
The high incidence of degenerative tears and prevalence of retears (20-95%) after surgical repair makes rotator cuff injuries a significant health problem. This high retear rate is attributed to the failure of the repaired tissue to regenerate the native tendon-to-bone insertion (enthesis). Biological augmentation of surgical repair such as autografts, allografts, and xenografts are confounded by donor site morbidity, immunogenicity, and disease transmission, respectively. In contrast, these risks may be alleviated via growth factor therapy, which can actively influence the healing environment to promote functional repair...
January 6, 2018: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29314867/location-of-rotator-cuff-tear-initiation-a-magnetic-resonance-imaging-study-of-191-shoulders
#20
Jeung Yeol Jeong, Seul Ki Min, Keun Min Park, Yong Bok Park, Kwang Joon Han, Jae Chul Yoo
BACKGROUND: Degenerative rotator cuff tears (RCTs) are generally thought to originate at the anterior margin of the supraspinatus tendon. However, a recent ultrasonography study suggested that they might originate more posteriorly than originally thought, perhaps even from the isolated infraspinatus (ISP) tendon, and propagate toward the anterior supraspinatus. Hypothesis/Purpose: It was hypothesized that this finding could be reproduced with magnetic resonance imaging (MRI). The purpose was to determine the most common location of degenerative RCTs by using 3-dimensional multiplanar MRI reconstruction...
January 1, 2018: American Journal of Sports Medicine
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