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Rotator cuff repair

Jong Pil Yoon, Chang-Hwa Lee, Jae Wook Jung, Hyun-Joo Lee, Yong-Soo Lee, Ja-Yeon Kim, Ga Young Park, Jin Hyun Choi, Seok Won Chung
BACKGROUND: The failure rate for healing after rotator cuff repair is relatively high. PURPOSE: To establish a system for sustained release of transforming growth factor β1 (TGF-β1) using an alginate scaffold and evaluate the effects of the sustained release of TGF-β1 on rotator cuff healing in a rabbit model. STUDY DESIGN: Controlled laboratory study. METHODS: Before the in vivo animal study, a standard MTS assay was performed to evaluate cell proliferation and metabolic activity on the alginate scaffold...
March 1, 2018: American Journal of Sports Medicine
Mak Wai Keong, Denny Lie Tijauw Tjoen
INTRODUCTION: Rotator cuff (RC) tears are common and a frequent cause of dysfunction in the shoulder, especially with progression of age. Biceps pathology occurs concomitantly and its relationship with RC tears has been well described. However, the study of biceps intervention affecting outcomes of RC repair is limited. We aim to study the effect of biceps tenotomy in RC repair after matching for cuff tear size. METHODS: We collected data of 24 consecutive patients undergoing RC repair and biceps tenotomy and matched them with patients undergoing RC repair only ( n = 24)...
January 2018: Journal of Orthopaedic Surgery
You-Zhi Cai, Chi Zhang, Ri-Long Jin, Tong Shen, Peng-Cheng Gu, Xiang-Jin Lin, Jian-De Chen
BACKGROUND: Due to the highly organized tissue and avascular nature of the rotator cuff, rotator cuff tears have limited ability to heal after the tendon is reinserted directly on the greater tubercle of the humerus. Consequently, retears are among the most common complications after rotator cuff repair. Augmentation of rotator cuff repairs with patches has been an active area of research in recent years to reduce retear rate. HYPOTHESIS: Graft augmentation with 3D collagen could prevent retears of the repaired tendon and improve tendon-bone healing in moderate to large rotator cuff tears...
March 1, 2018: American Journal of Sports Medicine
Christian Jung, Lena Tepohl, Reina Tholen, Knut Beitzel, Stefan Buchmann, Thomas Gottfried, Casper Grim, Bettina Mauch, Gert Krischak, Hans Ortmann, Christian Schoch, Frieder Mauch
Background: Tears and lesions of the rotator cuff are a frequent cause of shoulder pain and disability. Surgical repair of the rotator cuff is a valuable procedure to improve shoulder function and decrease pain. However, there is no consensus concerning the rehabilitation protocol following surgery. Objectives: To review and evaluate current rehabilitation contents and protocols after rotator cuff repair by reviewing the existing scientific literature and providing an overview of the clinical practice of selected German Society of Shoulder and Elbow Surgery e...
2018: Obere Extremität
Ahmet Emrah Acan, Onur Hapa, Levent Horoz, Aylin Kara, Hasan Havıtçıoğlu
OBJECTIVES: This study aims to evaluate the effects of anchor positions on the suture holding strength of a double-row knotless fixation in rotator cuff repair. MATERIALS AND METHODS: Four different double-row fixation techniques were assessed. In group 1, a 15-mm-wide mattress suture was fixed using a knotless lateral row anchor, horizontal to the shaft. In group 2, the medial sutures were fixed with a 5-mm more lateral anchor that was placed at 45° to the long axis of the humeral shaft...
April 2018: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Harrison S Mahon, James E Christensen, Stephen F Brockmeier
Rotator cuff repair is an increasingly common orthopedic procedure. As with any surgical procedure, the complications can be potentially devastating when they do happen to occur. This review attempts to summarize the most frequently encountered complications, including retear, failure to heal, stiffness, missed concomitant pathology, and infection. Also included are several cases that outline the diagnosis and management of these complications.
April 2018: Clinics in Sports Medicine
Arel Gereli, Baris Kocaoglu, Tekin Kerem Ulku, Sena Silay, Evren Kilinc, Serap Uslu, Ufuk Nalbantoglu
PURPOSE: Little information is available regarding the healing capacity of in situ and completion repair for the treatment of partial thickness rotator cuff tears. The purpose of the study was to analyze the healing characteristics of both techniques. METHODS: Twenty-four adult Sprague-Dawley rats were operated. Partial thickness bursal side tears were created bilaterally at the supraspinatus tendons. Additional 6 rats were used as the sham group. The right shoulders were repaired in situ, and the left shoulders were repaired using the tear completion technique on the 10th day after detachment surgery...
March 7, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Andreas Panagopoulos, Irini Tatani, Seferlis Yannis, Bavelou Aikaterini, Antonis Kouzelis, Minos Tyllianakis, Panayotis Dimakopoulos
Background: The valgus-impacted (VI) 4-part fractures are a subset of fractures of the proximal humerus with a unique anatomic configuration characterized by a relatively lower incidence of avascular necrosis after operative intervention. Objectives: The present study reports the midterm clinical and radiological results of a large series of consecutive patients with 4-part VI fractures treated with a minimal invasive technique of internal fixation. Methods: Over a ten-year period (2004-2014), we treated 56 patients with a true 4-part valgus impacted fracture of the proximal part of the humerus...
2018: Open Orthopaedics Journal
Takuya Tokunaga, Hitoshi Arimura, Hiroshi Mizuta, Yuji Hiraki, Chisa Shukunami
Tendons and ligaments are dense fibrous connective tissues mainly composed of type I collagen, aligned in highly ordered arrays along the axis of the tendon and ligament. The enthesis is defined as the attachment site of a tendon, ligament, joint capsule, or fascia to bone. During morphogenesis, the cell population co-expressing Scleraxis(Scx)and the SRY-box containing gene 9(Sox9)contributes to the formation of fibrocartilaginous entheses. Scx regulates tendon and ligament maturation, while Sox9 is a key regulatory factor for cartilage formation...
2018: Clinical Calcium
Yang-Soo Kim, Hyo-Jin Lee, Jong-Ho Kim, Dong-Young Noh
BACKGROUND: Patients with partial-thickness rotator cuff tears (PTRCTs) can be treated nonoperatively and/or undergo operative treatment, but the ideal time for surgical intervention is unclear. PURPOSE: The purpose is to compare the results of immediate arthroscopic rotator cuff repair with repair after 6 months of nonoperative care of PTRCTs involving more than 50% of the tendon thickness. STUDY DESIGN: Randomized controlled trial; Level of evidence, 2...
March 1, 2018: American Journal of Sports Medicine
Nicola Maffulli
The process of healing in musculoskeletal tissues is complex, and the addition of devices, including platelet-rich plasma and mesenchymal stem cells, to biologically enhance it may favor its optimization. This work shows in a compelling fashion that it is possible to produce the right admixture of physical and biological factors to make it happen in rotator cuff repair.
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Timothy J Hunt
Arthroscopic rotator cuff repair in the obese patient offers functional outcomes and rates of complications comparable to those seen in nonobese patients. Future prospective studies with better methodology, as well as including larger numbers of severely obese patients with a body mass index of 40 or greater, will help to further elucidate if obesity truly affects outcomes in rotator cuff repair. In the meantime, be sure to consider admission of your obese rotator cuff repair patients.
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
S G Walter, T Stadler, T S Thomas, W Thomas
BACKGROUND: To introduce a (semi-)quantitative surgical score for the classification of rotator cuff tears. MATERIAL AND METHODS: A total of 146 consecutive patients underwent rotator cuff repair and were assessed using the previously defined Advanced Rotator Cuff Tear Score (ARoCuS) criteria: muscle tendon, size, tissue quality, pattern as well as mobilization of the tear. The data set was split into a training (125 patients) and a testing set (21 patients). The training data set fitted a nonlinear predictive model of the tear score based on the ARoCuS criteria, while the testing data served as control...
March 2, 2018: Musculoskeletal Surgery
Michael Livesey, John G Horneff, Daniel Sholder, Mark Lazarus, Gerald Williams, Surena Namdari
A well-functioning rotator cuff is necessary for successful anatomic total shoulder arthroplasty (TSA). This study evaluated patients who underwent concomitant TSA and rotator cuff repair (RCR) for functional outcomes, revision rates, and predictors of poor results. Retrospective chart review was conducted to identify patients who underwent TSA and RCR. Demographic data, rotator cuff tear and RCR characteristics, range of motion, and radiographs were recorded. Minimum 2-year functional outcomes were obtained...
March 1, 2018: Orthopedics
Brandon L Roller, Keiichi Kuroki, Chantelle C Bozynski, Ferris M Pfeiffer, James L Cook
The aim of this study was to assess the efficacy and safety of a novel magnesium-based resorbable bone cement (OsteoCrete, Bone Solutions Incorporated) for anchor and tendon fixation. Cadaveric humeral testing involved straight pull-to-failure of rotator cuff suture anchors; OsteoCrete was injected through one anchor, and a second anchor served as the uninjected control. Testing was conducted 15 minutes post-injection. A canine preclinical model was used to evaluate the safety of the following parameters: Rotator cuff repair: A double-row technique was used to repair transected infraspinatus tendons; OsteoCrete was injected through both anchors in one limb, and the contralateral limb served as the uninjected control...
February 2018: American Journal of Orthopedics
Kyung Cheon Kim, Woo-Yong Lee, Hyun Dae Shin, Sun-Cheol Han
PURPOSE: This study compared the functional outcome and repair integrity of arthroscopic rotator cuff repair according to articular-side repair state in full-thickness tears. METHODS: We prospectively enrolled 80 consecutive patients with full-thickness rotator cuff tears of 1.5-3.5 cm at the anterior to posterior dimension. These patients were divided into two groups according to intraoperative articular-side repair state during operation: complete and incomplete repair groups...
January 2018: Journal of Orthopaedic Surgery
Gregory T Mahony, Brian C Werner, Brenda Chang, Brian M Grawe, Samuel A Taylor, Edward V Craig, Russell F Warren, David M Dines, Lawrence V Gulotta
BACKGROUND: Although anatomic total shoulder arthroplasty (TSA) successfully improves pain and function, not all patients improve clinically. This study was conducted to determine patient-related factors for failure to achieve improvement after primary TSA for osteoarthritis at 2 years postoperatively. METHODS: This prospective study reviewed an institutional shoulder registry for consecutive patients who underwent primary TSA for osteoarthritis from 2007 to 2013 with baseline and 2-year postoperative American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form scores...
February 23, 2018: Journal of Shoulder and Elbow Surgery
Shuxiang Li, Han Sun, Xiaomin Luo, Kun Wang, Guofeng Wu, Jian Zhou, Peng Wang, Xiaoliang Sun
BACKGROUND: The argument on the recommended rehabilitation protocol following arthroscopic rotator cuff repair remains to be resolved. So this meta-analysis was presented to evaluate the differences of clinical effects between the 2 distinct rehabilitation protocols after arthroscopic rotator cuff repair. METHODS: The PubMed, Cochrane Library, Web of Science, and EMBASE were systematically searched. Only randomized controlled trials (RCTs) published up to July 25, 2017, comparing early passive motion (EPM) versus delayed passive motion (DPM) rehabilitation protocols following arthroscopic rotator cuff repair were identified...
January 2018: Medicine (Baltimore)
Joshua M Matthews, Susan S Wessel, Ryan C Pate, Alexander Cm Chong
No abstract text is available yet for this article.
May 2017: Kansas Journal of Medicine
Sung-Min Rhee, Nam Yun Chung, Hyeon Jang Jeong, Joo Han Oh
BACKGROUND: Subacromial pain pumps are used for analgesia after arthroscopic rotator cuff surgery. However, there is controversy about myotoxic or tendinotoxic effects of local anesthetics. HYPOTHESIS: Ropivacaine administered via a subacromial pain pump would have no adverse effect on rotator cuff tendon healing, fatty degeneration, strength, or functional outcomes after arthroscopic repair. STUDY DESIGN: Cohort study; Level of evidence, 3...
February 1, 2018: American Journal of Sports Medicine
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