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Tendon tears

Claudio Chillemi, Matteo Mantovani, Antonio Gigante
Superior capsular reconstruction (SCR) demonstrated its efficacy as a treatment option available in patients affected with irreparable posterosuperior rotator cuff tears without any signs of arthritis. Originally, the fascia lata autograft was fixed medially to the glenoid (with two or more anchors) and laterally to the greater tuberosity (with a compression double-row technique using four anchors or three transosseous tunnels). Additionally, side-to-side sutures were used to anteriorly and posteriorly connect the graft to the native residual rotator cuff tissue...
March 21, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Xiao Ning Liu, Cheol-Jung Yang, Ji Eui Kim, Zhen Wu Du, Ming Ren, Wei Zhang, Hong Yu Zhao, Kyung Ok Kim, Kyu-Cheol Noh
Background: To evaluate the influence of bone marrow aspirate concentrate (BMAC) on tendon-to-bone healing in a rabbit rotator cuff model and to characterize the composition of growth factors in BMAC. Methods: In this in vivo study, 40 rabbits were allocated into five groups: control (C), repair + saline (RS), repair + platelet-rich plasma (PRP; RP), repair + BMAC (RB) and repair + PRP + BMAC (RPB). A tear model was created by supraspinatus tendon transection at the footprint...
March 2018: Clinics in Orthopedic Surgery
Walid Ben-Nafa, Wendy Munro
INTRODUCTION: Lateral epicondylitis is a common musculoskeletal disorder of the upper limb. Corticosteroid injection has been widely used as a major mode of treatment. However, better understanding of the pathophysiology of the disease led to a major change in treating the disease, with new options including platelet-rich plasma (PRP) are currently used. Objectives/research aim: To systematically evaluate the effect of corticosteroid versus PRP injections for the treatment of LE. HYPOTHESIS: PRP injections provide longer-term therapeutic effect and less rate of complications compared to corticosteroid injection...
2018: SICOT-J
Tsuyoshi Sasaki, Hitoshi Shitara, Atsushi Yamamoto, Noritaka Hamano, Tsuyoshi Ichinose, Daisuke Shimoyama, Tsutomu Kobayashi, Toshihisa Osawa, Yoshito Tsushima, Kenji Takagishi, Hirotaka Chikuda
BACKGROUND: Supraspinatus muscle atrophy is typically assessed by the occupation ratio of the cross-sectional area of the muscle belly to the supraspinatus fossa at the medial border of the coracoid process in a slice along the oblique-sagittal plane on MRI. Previous studies have shown that the occupation ratio of the supraspinatus changed soon after rotator cuff repair compared with before surgery. However, no studies have examined the perioperative change in the muscle volume assessed with 3-dimensional measurement...
March 1, 2018: American Journal of Sports Medicine
Jae-Young Park, Tae-Joon Cho, Myung Chul Lee, Hyuk-Soo Han
A case of anterior cruciate ligament (ACL) reconstruction with meniscal repair in an osteogenesis imperfecta patient is reported. A 24-year-old female with osteogenesis imperfecta type 1a suffered from a valgus extension injury resulting in tear of ACL and medial meniscus. She underwent an arthroscopic-assisted ACL reconstruction and medial meniscus repair. Meniscal tear at the menisco-capsular junction of the posterior horn of medial meniscus was repaired with three absorbable sutures via inside-out technique...
March 20, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Lorenzo Merlini, Matthew Yalizis, Yannick Carrillon, Hugo Bothorel, Mo Saffarini, Arnaud Godenèche
BACKGROUND: A rare form of rotator cuff tear (RCT) is observed secondary to glenohumeral dislocation, followed by immediate repositioning, as well as formation of scar tissue between tendons and tuberosities. Radiographic diagnosis of such "degloving" tears is problematic because they are obscured by scar tissue. We aimed to describe characteristics of degloving tears and report outcomes following their arthroscopic repair. METHODS: Among 67 patients who underwent arthroscopic repair of RCTs secondary to shoulder dislocation, we identified 8 patients (12%) (7 anterior dislocations and 1 posterior dislocation), aged 54...
March 16, 2018: Journal of Shoulder and Elbow Surgery
Joseph T Gamboa, Edward C Shin, Neil P Pathare, Patrick J McGahan, James L Chen
Anterior cruciate ligament (ACL) tears are an unfortunate and devastating injury in the athletic patient. Surgical reconstruction of the ACL with a taut graft construct is necessary to restore knee stability and help expedite the patient's return to an active lifestyle. Arthroscopy-assisted ACL reconstruction can be a technically involved procedure, where strong fixation limits graft motion to allow sufficient healing within the tibial and femoral tunnels at the bone-tendon interfaces. Loss of tension in a graft can cause symptomatic anterior or rotatory instability and potential retear of the ACL graft...
February 2018: Arthroscopy Techniques
Nicholas R Pagani, Antonio Cusano, Xinning Li
Latissimus dorsi tendon transfer is an effective option for young and active patients with massive irreparable posterosuperior rotator cuff tears and intact subscapularis tendon. This approach has been shown to relieve pain and improve shoulder function in both the short and long term. We describe a surgical technique using an acromial osteotomy to better expose the greater tuberosity for the tendon transfer without disrupting the deltoid muscle. The latissimus dorsi tendon is reinforced with a human dermal collagen matrix (GraftJacket; Wright Medical Group) for additional augmentation of the muscle to gain more excursion for the tendon transfer to the greater tuberosity...
February 2018: Arthroscopy Techniques
Yang-Soo Kim, Hyo-Jin Lee, In Park, Gwang Young Sung, Dong-Jin Kim, Jong-Ho Kim
Large to massive rotator cuff tears are challenging to repair, although there are several options for dealing with them. Among them, superior capsular reconstruction was recently introduced as an effective procedure for retaining the static stability of the shoulder joint and preventing the progression to cuff tear arthropathy. The purpose of this technique-based article is to describe a surgical option, called arthroscopic in situ superior capsular reconstruction, for large to massive rotator cuff tears using the long head of the biceps tendon...
February 2018: Arthroscopy Techniques
Malte Holschen, Kai-Axel Witt, Jörn Steinbeck
Anterosuperior rotator cuff tears involve the subscapularis tendon, supraspinatus tendon, and rotator interval. The long head of the biceps is usually affected and unstable in these complex lesions. Arthroscopic repair of anterosuperior rotator cuff tears often consists of 2 different procedures. Whereas the subscapularis tendon is reconstructed under intra-articular visualization, the supraspinatus tendon is reconstructed under extra-articular visualization. The rotator interval is often sacrificed to improve visualization and instrumentation...
February 2018: Arthroscopy Techniques
Thomas Magee
OBJECTIVE: Post-operative shoulder patients are often difficult to image due to scar tissue, metallic artifact, and residual irregularity of anatomic structures. The purpose of this study was to assess MR versus MR arthrography versus CT arthrography in the post-operative shoulder. Also, we assessed whether injecting CT contrast in addition to MR contrast during arthrography improved patient care. METHODS AND MATERIALS: One hundred consecutive post-operative conventional shoulder MR and MR arthrography exams performed on the same patients were reviewed retrospectively by two musculoskeletal radiologists...
March 17, 2018: Skeletal Radiology
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
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
Hyun-Kyung Do, Joong-Hoon Lee, Jae-Young Lim
OBJECTIVE: Polydeoxyribonucleotide as adenosine receptor (A2A ) agonist has been used in plastic surgery and dermatology related to its regenerative property. The aim of this pilot study is to evaluate the safety and efficacy of polydeoxynucleotide injection in patients with rotator cuff tears by a variety of outcomes including pain, disability, physical performance test, and ultrasonography (US). METHODS: Seventeen patients (9 men, 8 women, age: 57.9 ± 9.1) with partial-thickness tear of supraspinatus tendon were evaluated in a prospective, open-label, and pre-and-post study...
March 14, 2018: Physician and Sportsmedicine
Hoseok Lee, Joong Mo Ahn, Yusuhn Kang, Joo Han Oh, Eugene Lee, Joon Woo Lee, Heung Sik Kang
Objective: To compare the T1-weighted spectral presaturation with inversion-recovery sequences (T1 SPIR) with T2-weighted turbo spin-echo sequences (T2 TSE) on 3T magnetic resonance arthrography (MRA) in the evaluation of the subscapularis (SSC) tendon tear with arthroscopic findings as the reference standard. Materials and Methods: This retrospective study included 120 consecutive patients who had undergone MRA within 3 months between April and December 2015. Two musculoskeletal radiologists blinded to the arthroscopic results evaluated T1 SPIR and T2 TSE images in separate sessions for the integrity of the SSC tendon, examining normal/articular-surface partial-thickness tear (PTTa)/full-thickness tear (FTT)...
March 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
Emilio Wagner, Pablo Wagner, Cristian Ortiz, Ruben Radkievich, Felipe Palma, Rodrigo Guzmán-Venegas
BACKGROUND: No clear guideline or solid evidence exists for peroneal tendon tears to determine when to repair, resect, or perform a tenodesis on the damaged tendon. The objective of this study was to analyze the mechanical behavior of cadaveric peroneal tendons artificially damaged and tested in a cyclic and failure mode. The hypothesis was that no failure would be observed in the cyclic phase. METHODS: Eight cadaveric long leg specimens were tested on a specially designed frame...
March 1, 2018: Foot & Ankle International
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
T Patzer
BACKGROUND: In a progredient rotator cuff tear with tendon retraction, fatty infiltration and atrophy of rotator cuff muscles the humerus cannot be centered and stabilized sufficiently in the glenohumeral joint. This leads to rotator cuff defect arthropathy as an eccentric osteoarthritis with acetabularization and wear of the acromion, as well as of the glenoid. INDICATION: A painful pseudoparalysis of the shoulder indicates the implantation of a reversed total shoulder arthroplasty (rTSA) to reduce pain and restore active motion...
March 7, 2018: Der Orthopäde
Eric Goodrich, Richard P Goodrich
A partial triceps tendon tear is an uncommon injury. Even rarer is a bilateral partial triceps tendon tear in which there has been one documented case. This case report illustrates a 37-yr-old African-American male who sustained non-simultaneous bilateral partial triceps tendon avulsions. He sustained a traumatic right partial triceps tendon avulsion after a fall onto an outstretched right arm that required operative repair after failure of conservative treatment. Five months later, he sustained a similar injury after falling on an outstretched left arm that was repaired 9 d later...
March 1, 2018: Military Medicine
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
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