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Rotator cuff augmentation

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https://www.readbyqxmd.com/read/29664803/posterior-shoulder-dislocation-associated-with-the-head-splitting-and-humeral-neck-fracture-impact-of-understanding-radiologic-signs-and-experience-with-an-extended-deltopectoral-approach
#1
Kemal Gokkus, Ergin Sagtas, Hasan Kara, Ahmet T Aydin
In this paper, our main objective was to emphasize the competency of extended deltopectoral exposure, enforced with the supraspinatus and subscapularis detachment, to gain access to the entire head. The second important point in this paper was to underline the importance of the knowledge that is necessary for interpreting classic radiologic signs of posterior fracture-dislocation of the shoulder. A 47-year-old woman fell down directly onto her shoulder while she was skiing. She was diagnosed with posterior shoulder dislocation, associated with fracture of the head (head splitting) and humeral neck fracture, with the aid of plain radiographs and computed tomographic results...
April 11, 2018: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/29622263/editorial-commentary-is-the-biceps-tendon-a-valid-option-for-augmentation-in-rotator-cuff-repair-future-perspectives-on-superior-capsule-reconstruction
#2
EDITORIAL
Giuseppe Milano
Biceps autograft can be a viable option for biological augmentation of massive rotator cuff repair, albeit results of this procedure might depend on the surgical technique. In the present qualitative systematic review, 8 case series were analyzed, in which biceps autograft was used as a scaffold or tissue bridge. Indeed, leaving the proximal portion intact and fixing it onto the greater tuberosity can simulate a superior capsule reconstruction, with potentially high biologic and mechanical advantages.
April 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29606528/outcomes-of-rotator-cuff-augmentation-surgery-with-autologous-fascia-lata
#3
A P Rosales-Varo, M A García-Espona, O Roda-Murillo
OBJECTIVE: To evaluate whether augmentation grafts using autologous fascia lata improve functional results for rotator cuff repairs and reduce the retear rate compared to those without augmentation. MATERIAL AND METHODS: This is a prospective evaluation comprising 20 patients with a complete symptomatic rotator cuff tear. The operations were carried out from a superior approach performing a total cuff repair, for 10 patients we used a suture augmented with an autologous graft taken from their own fascia lata while unaugmented sutures were used for the other 10 patients...
March 29, 2018: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29587146/pullout-strength-of-standard-vs-cement-augmented-rotator-cuff-repair-anchors-in-cadaveric-bone
#4
Keith T Aziz, Brendan Y Shi, Louis C Okafor, Jeremy Smalley, Stephen M Belkoff, Uma Srikumaran
BACKGROUND: We evaluate a novel method of rotator cuff repair that uses arthroscopic equipment to inject bone cement into placed suture anchors. A cadaver model was used to assess the pullout strength of this technique versus anchors without augmentation. METHODS: Six fresh-frozen matched pairs of upper extremities were screened to exclude those with prior operative procedures, fractures, or neoplasms. One side from each pair was randomized to undergo standard anchor fixation with the contralateral side to undergo anchor fixation augmented with bone cement...
March 20, 2018: Clinical Biomechanics
https://www.readbyqxmd.com/read/29552476/latissimus-dorsi-tendon-transfer-with-acromial-osteotomy-for-massive-irreparable-rotator-cuff-tear
#5
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
https://www.readbyqxmd.com/read/29533674/arthroscopic-rotator-cuff-repair-with-graft-augmentation-of-3-dimensional-biological-collagen-for-moderate-to-large-tears-a-randomized-controlled-study
#6
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
https://www.readbyqxmd.com/read/29516107/-reversed-total-shoulder-arthroplasty-in-rotator-cuff-defect-arthropathy
#7
REVIEW
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
https://www.readbyqxmd.com/read/29494715/use-of-a-novel-magnesium-based-resorbable-bone-cement-for-augmenting-anchor-and-tendon-fixation
#8
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
https://www.readbyqxmd.com/read/29459078/biomechanical-histologic-and-molecular-evaluation-of-tendon-healing-in-a-new-murine-model-of-rotator-cuff-repair
#9
Amir H Lebaschi, Xiang-Hua Deng, Christopher L Camp, Jianchun Zong, Guang-Ting Cong, Camila B Carballo, Zoe Album, Scott A Rodeo
PURPOSE: To develop a clinically relevant, robust murine model of rotator cuff tendon repair to examine cellular and molecular mechanisms of healing. METHODS: Sixty C57BL/6 male mice underwent rotator cuff transection and repair using microsurgical techniques. A modified Kessler suturing technique was used prior to tendon detachment. Sutures were passed through 2 intersecting bone tunnels that were made at the tendon attachment site. Mice were sacrificed at 2 and 4 weeks with subsequent biomechanical, histologic, micro-CT, and gene expression evaluations...
February 16, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29430398/revision-of-failed-rotator-cuff-reconstruction-with-a-large-humeral-head-cyst
#10
Bashar Reda, Catherine Coady, Ivan Wong
A revision rotator cuff repair is a technically challenging surgical procedure. This can be further complicated by the presence of poor quality of the cuff tissue, as well as a large greater tuberosity cyst, typically located at the rotator cuff footprint. This Technical Note discusses the surgical approach to deal with a revision rotator cuff tear with a large humeral head cyst. This described arthroscopic technique is performed in a single-stage procedure using a human dermal allograft (GraftJacket) for augmentation...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29411322/the-role-of-biologic-therapy-in-rotator-cuff-tears-and-repairs
#11
REVIEW
Michael D Charles, David R Christian, Brian J Cole
PURPOSE OF REVIEW: The purpose of this review was to establish the foundation of the major biologic adjuvants to rotator cuff repairs and review recent scientific findings. RECENT FINDINGS: Platelet-rich plasma (PRP) overall has no significant impact on functional outcomes and repair integrity, but may be more advantageous in small to medium tears. Further studies should focus on leukocyte-rich versus poor preparations and the use of PRP in patients that are high risk for repair failure...
February 7, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29398989/the-primary-stability-of-a-bioabsorbable-poly-l-lactic-acid-suture-anchor-for-rotator-cuff-repair-is-not-improved-with-polymethylmethacrylate-or-bioabsorbable-bone-cement-augmentation
#12
Mehmet F Güleçyüz, Michael Kraus-Petersen, Christian Schröder, Andreas Ficklscherer, Markus U Wagenhäuser, Christian Braun, Peter E Müller, Matthias F Pietschmann
Background: The incidence of osteoporosis and rotator cuff tears increases with age. Cement augmentation of bones is an established method in orthopedic and trauma surgery. Questions/Purposes: This study analyses if polymethylmethacrylate or bioabsorbable cement can improve the primary stability of a bioabsorbable suture anchor in vitro in comparison to a non-augmented suture anchor in osteoporotic human humeri. Methods: The trabecular bone mineral density was measured to ensure osteopenic human specimens...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/29398399/augmentation-with-a-reinforced-acellular-fascia-lata-strip-graft-limits-cyclic-gapping-of-supraspinatus-repairs-in-a-human-cadaveric-model
#13
Ryan A Milks, Joel D Kolmodin, Eric T Ricchetti, Joseph P Iannotti, Kathleen A Derwin
BACKGROUND: A reinforced biologic strip graft was designed to mechanically augment the repair of rotator cuff tears that are fully reparable by arthroscopic techniques yet have a likelihood of failure. This study assessed the extent to which augmentation of human supraspinatus repairs with a reinforced fascia strip can reduce gap formation during in vitro cyclic loading. METHODS: The supraspinatus tendon was sharply released from the proximal humerus and repaired back to its insertion with anchors in 9 matched pairs of human cadaveric shoulders...
February 2, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29393349/enhancement-of-tendon%C3%A2-bone-healing-following-rotator-cuff-repair-using-hydroxyapatite-with-tgf%C3%AE-1
#14
Xiebo You, Yueqin Shen, Weihan Yu, Yaohua He
The formation of fibrocartilage at the healing site following a rotator cuff tear repair is a major problem in the field of tendon‑bone healing. The present study aimed to enhance the healing of the tendon‑bone interface following rotator‑cuff tear repair by the interposition of hydroxyapatite (HA) encapsulated with transforming growth factor β1 (TGFβ1). Using an acute rotator cuff repair model, rats were divided into three groups: i) Repair only (control); ii) HA group; and iii) HA‑TGFβ1 group...
January 26, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29373293/biceps-autograft-augmentation-for-rotator-cuff-repair-a-systematic-review
#15
REVIEW
Egbert J D Veen, Martin Stevens, Ronald L Diercks
PURPOSE: To improve surgical outcomes in patients with massive cuff defects, different techniques and augmentations are proposed. The biceps tendon is easily available as an autograft. Our aim was to conduct a qualitative systematic review of various methods and surgical techniques that use a biceps autograft (BAG) for rotator cuff repair. Functional outcomes are also reported. We hypothesized that by using a BAG to treat massive rotator cuff tears, a more anatomic and biomechanical reconstruction could be achieved compared with other techniques...
January 17, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29362995/the-repaired-rotator-cuff-mri-and-ultrasound-evaluation
#16
REVIEW
Susan C Lee, Danielle Williams, Yoshimi Endo
PURPOSE OF REVIEW: The purposes of this review were to provide an overview of the current practice of evaluating the postoperative rotator cuff on imaging and to review the salient imaging findings of the normal and abnormal postoperative rotator cuff, as well as of postoperative complications. RECENT FINDINGS: The repaired rotator cuff frequently appears abnormal on magnetic resonance imaging (MRI) and ultrasound (US). Recent studies have shown that while the tendons typically normalize, they can demonstrate clinically insignificant abnormal imaging appearances for longer than 6 months...
March 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29354447/arthroscopic-superior-capsule-reconstruction-technique-in-the-setting-of-a-massive-irreparable-rotator-cuff-tear
#17
George Sanchez, William H Rossy, Kyle P Lavery, Kevin J McHale, Marcio B Ferrari, Anthony Sanchez, Matthew T Provencher
Massive, irreparable rotator cuff tears are challenging to treat and associated with pain and severe limitation in shoulder elevation due to the proximal migration of the humeral head and, consequently, subacromial impingement. Furthermore, retraction of the tendons in combination with fat infiltration and muscular weakness results in unpredictable treatment outcomes. While conservative treatment may be warranted for low-demand patients, surgical treatment is often indicated for a successful return to activities of daily living as well as an improved quality of life...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29352758/-arthroscopic-rotator-cuff-surgery-new-and-established-methods
#18
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...
February 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29351746/concomitant-glenohumeral-injuries-in-neer-type-ii-distal-clavicle-fractures
#19
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/29328887/macroscopic-rotator-cuff-tendinopathy-and-histopathology-do-not-predict-repair-outcomes-of-rotator-cuff-tears
#20
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...
March 2018: American Journal of Sports Medicine
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