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Rotator cuff 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
Yong-Beom Lee, Cheol-Jung Yang, Cheng Zhen Li, Zhong Zhuan, Seung-Cheol Kwon, Kyu-Cheol Noh
Background: This study aimed to investigate whether fatty infiltration (FI) measured on a single sagittal magnetic resonance imaging (MRI) slice can represent FI of the whole supraspinatus muscle. Methods: This study retrospectively reviewed the MRIs of 106 patients (age 50-79 years) divided into three rotator cuff tear-size groups: medium, large, and massive. Fat mass and muscle mass on all T1-weighted sagittal MRI scans (FA and MA) were measured. Of the total MRI scans, the Y-view was defined as the most lateral image of the junction of the scapular spine with the scapular body on the oblique sagittal T1-weighted image...
March 2018: Clinics in Orthopedic Surgery
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
A Galland, S Airaudi, J Mancini, R Gravier, D Camus
BACKGROUND: Reports of early glenoid wear after humeral resurfacing hemiarthroplasty have prompted the use, in combination with this procedure, of newly developed glenoid implants. This combination can increase global humeral offset. The objectives of this study were to assess changes in overall lateral offset and their potential short-term clinical consequences after combined humeral resurfacing and glenoid replacement. HYPOTHESIS: Combined humeral resurfacing and glenoid replacement induces a large increase in overall lateral offset, resulting in short-term clinical consequences...
March 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
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
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
Freek Hollman, Nienke Wolterbeek, Petra E Flikweert, Kiem G Auw Yang
Fatty infiltration is an important prognostic factor for cuff healing after rotator cuff repair. Treatment options for stage 2-3 Goutallier rotator cuff tears vary widely and there is lack of decent comparative studies. Purposes: The objective of this study was 1) to give an overview of the treatment options of stage 2-3 Goutallier rotator cuff tears and their clinical outcome and 2) to give a recommendation of the optimal treatment within this specific subgroup. Methods: We searched the databases of Medline, Embase, Cochrane library, NHS Centre for Reviews and Dissemination, PEDro from inception to December 12th, 2016...
June 2018: Journal of Orthopaedics
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
Molly K Lewis, Omar Ramos-Williams, Hasan M Syed, Theodore K Gregorius
CASE: A 9-year-old boy sustained intrasubstance tears of the rotator cuff and periscapular muscles due to a fall, resulting in scapular winging and severely decreased shoulder range of motion. Treatment consisted of a modified thoracolumbosacral orthosis (TLSO) with a shoulder immobilizer attachment (to reduce the scapula to the thoracic wall and hold the arm in 10° of abduction). The brace was worn for 8 weeks. The patient recovered full, pain-free shoulder function and range of motion, and returned to high-level athletics...
March 14, 2018: JBJS Case Connector
Ting-Yue Lin, Xiao-Jun Weng, Jing Wang, Xin-Tong Chen, Meng Que
No abstract text is available yet for this article.
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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
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
Sangeeta Rathi, Nicholas F Taylor, Brendan Soo, Rodney A Green
OBJECTIVES: To determine whether patients with symptomatic rotator cuff pathology had more glenohumeral joint translation and different patterns of rotator cuff muscle activity compared to controls. DESIGN: Repeated measurements of glenohumeral translation and muscle activity in two positions and six testing conditions in two groups. METHODS: Twenty participants with a symptomatic and diagnosed rotator cuff tear and 20 age, and gender matched controls were included...
March 2, 2018: Journal of Science and Medicine in Sport
F Guerra-Soriano, M I Encalada-Díaz, M Ruiz-Suárez, F S Valero-González
INTRODUCTION: Glenohumeral arthritis secondary to massive rotator cuff tear presents with a superior displacement and femoralization of the humeral head with coracoacromial arch acetabularization. The purpose of this study was to establish prevalence of rotator cuff tear artropathy (CTA) at our institution. MATERIAL AND METHODS: Four hundred electronic records were reviewed from which we identified 136 patients with rotator cuff tears. A second group was composed with patients with massive cuff tears that were analized and staged by the Seebauer cuff tear arthropathy classification...
September 2017: Acta Ortopédica Mexicana
Michael S Khazzam, Edward P Mulligan, Meredith Brunette-Christiansen, Zachary Shirley
BACKGROUND: Little is known about the influence of rotator cuff pathology on sleep. The purpose of this study was to determine which patient-reported factors correlate with sleep disturbance in patients with rotator cuff disease. METHODS: A nonrandomized, cross-sectional cohort study was performed to evaluate the effects of rotator cuff disease on sleep quality. Data collected at time zero (before any treatment) included the Single Assessment Numeric Evaluation rating, the American Shoulder and Elbow Surgeons score, the Pittsburgh Sleep Quality Index, patient demographics, and medical comorbidities...
March 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
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