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Rotater cuff repair

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https://www.readbyqxmd.com/read/27916191/the-rotator-cuff-and-the-superior-capsule-why-we-need-both
#1
Christopher R Adams, Angelica M DeMartino, George Rego, Patrick J Denard, Stephen S Burkhart
Tears of the rotator cuff are frequent. An estimated 250,000 to 500,000 repairs are performed annually in the United States. Rotator cuff repairs have been successful despite fatty infiltration and atrophy of the rotator cuff muscles. Although the emphasis in rotator cuff repair has historically focused on re-establishing the tendon attachment, there is growing interest in and understanding of the role of the superior capsule. The superior capsule is attached to the undersurface of the supraspinatus and infraspinatus muscle-tendon units, and it resists superior translation of the humeral head...
December 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27916184/editorial-commentary-muscle-atrophy-after-arthroscopic-rotator-cuff-repair-reversible
#2
EDITORIAL
Randy Mascarenhas, Nikhil N Verma
Muscle atrophy has been established as a predictor of failure after rotator cuff repair. Traditionally, preoperative magnetic resonance imaging has been used as a baseline for subsequent comparison. Use of a preoperative baseline may overestimate the degree of atrophy present. In addition, postoperative progression of atrophy correlates with the integrity of the tendon.
December 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27914845/does-magnetic-resonance-imaging-appearance-of-supraspinatus-muscle-atrophy-change-after-repairing-rotator-cuff-tears
#3
Sang-Hoon Lhee, Anant Kumar Singh, Do Young Lee
BACKGROUND: This study was conducted to determine whether supraspinatus muscle atrophy appearance changes after arthroscopic rotator cuff repair and to quantify the change in appearance on magnetic resonance imaging (MRI), if any, based on age and tendon retraction. METHODS: We retrospectively reviewed patients who underwent arthroscopic rotator cuff repair and considered only 209 patients who had both preoperative and immediate postoperative MRI. Patients were grouped by age <60 years and >60 years...
November 30, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27914841/progression-of-degenerative-changes-of-the-biceps-tendon-after-successful-rotator-cuff-repair
#4
Norimasa Takahashi, Hiroyuki Sugaya, Momoko Matsumoto, Hikaru Miyauchi, Keisuke Matsuki, Morihito Tokai, Nobuaki Kawai, Kazutomo Onishi, Yusuke Ueda, Shota Hoshika
BACKGROUND: This study investigated the morphologic changes in the biceps tendon using ultrasonography before and after successful arthroscopic posterosuperior rotator cuff repair. METHODS: Forty-four patients (44 shoulders) underwent arthroscopic posterosuperior rotator cuff repair with 1-year postoperative magnetic resonance imaging (MRI) follow-up. The patients comprised 22 men and 22 women with an average age of 61 years. The cross-sectional area (CSA) of the biceps tendon in the bicipital groove was measured, and the vascularity in the bicipital groove was graded as 0 to 3, based on the signal density of the anterior circumflex artery, using power Doppler ultrasonography...
November 30, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27909678/bridge-tenodesis-a-secure-fixation-technique-for-biceps-long-head-tendinopathy-during-arthroscopic-rotator-cuff-repair-using-a-suture-bridge-technique
#5
Jin-Young Park, Jae-Hyung Lee, Kyung-Soo Oh, Seok-Won Chung, Jin-Young Bang, Young-Min Noh
Tendinopathy of the long head of the biceps is often found as an intra-articular pathology in the glenohumeral joint. Because long head of the biceps lesions are common, surgical intervention to properly manage the long head of the biceps has become an important issue. Both tenodesis and tenotomy have been shown to provide benefits in biceps long head tendinopathy. But because of concerns about muscle power reduction, cramping, and "Popeye's deformity," which may result from biceps tenotomy, biceps tenodesis is a good option for treating biceps lesions...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909670/treating-rotator-cuff-tears-through-a-coracoacromial-mini-open-approach
#6
Wolfram Thomas, Tom Sascha Thomas, Luca Tafuro, Sebastian Walter
The purpose of this study is to present a "smart," open, minimally invasive surgical technique for rotator cuff repair of the shoulder. On the basis of an anatomic study by Tichy, we use a coracoacromial mobile window: We split-not detach-the deltoid muscle by respecting its fibers' orientation and resect the coracoacromial ligament before repairing the torn rotator cuff tendons with anchors. The described approach is fast, is technically uncomplicated, and can be carried out with a standard set of instruments...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909668/triple-row-modification-of-the-suture-bridge-technique-for-arthroscopic-rotator-cuff-repair
#7
Roger V Ostrander, Jarrod Smith, Michael Saper
Recent advances to improve outcomes in rotator cuff repair include using arthroscopic double-row suture-bridge techniques in an effort to reconstruct the rotator cuff footprint and improve fixation. However, when using this technique for larger tears, it can be difficult to get the lateral portion of the rotator cuff into an anatomic position. This report describes a triple-row modification of the suture-bridge technique that results in significantly more footprint contact area and contact pressure compared with the double-row and standard suture-bridge techniques...
October 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27909128/the-development-of-a-quantitative-scoring-system-to-predict-whether-a-large-to-massive-rotator-cuff-tear-can-be-arthroscopically-repaired
#8
S-J Kim, J-S Park, K-H Lee, B-G Lee
AIMS: The aim of the study was to develop a quantitative scoring system to predict whether a large-to-massive rotator cuff tear was arthroscopically reparable prior to surgery. PATIENTS AND METHODS: We conducted a retrospective review of the pre-operative MR imaging and surgical records of 87 patients (87 shoulders) who underwent arthroscopic repair of a large-to-massive rotator cuff tear. Patients were divided into two groups, based on the surgical outcome of the repair...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27909127/costs-quality-of-life-and-cost-effectiveness-of-arthroscopic-and-open-repair-for-rotator-cuff-tears-an-economic-evaluation-alongside-the-ukuff-trial
#9
J Murphy, A Gray, C Cooper, D Cooper, C Ramsay, A Carr
AIMS: A trial-based comparison of the use of resources, costs and quality of life outcomes of arthroscopic and open surgical management for rotator cuff tears in the United Kingdom NHS was performed using data from the United Kingdom Rotator Cuff Study (UKUFF) randomised controlled trial. PATIENTS AND METHODS: Using data from 273 patients, healthcare-related use of resources, costs and quality-adjusted life years (QALYs) were estimated at 12 months and 24 months after surgery on an intention-to-treat basis with adjustment for covariates...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27904725/rotator-cuff-repair-in-patients-over-75-years-of-age-clinical-outcome-and-repair-integrity
#10
Jung Gwan Park, Nam Su Cho, Jong Hoon Song, Jong Hun Baek, Ho Yeon Jeong, Yong Girl Rhee
BACKGROUND: Some studies have shown significant functional improvement after rotator cuff (RC) repair in elderly patients. However, few studies have reported the healing potential of RC tears in elderly patients. METHODS: Twenty-five patients aged ≥ 75 years who underwent RC repair were enrolled. The mean age at the time of surgery was 78.3 years (range, 75 to 88 years) while the mean follow-up was 36.3 months (range, 18 to 114 months). We evaluated clinical and structural outcomes after RC repair in the retear and healed groups...
December 2016: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/27904211/post-operative-pain-management-in-shoulder-surgery-suprascapular-and-axillary-nerve-block-by-arthroscope-assisted-catheter-placement
#11
H Çağdaş Basat, D Hakan Uçar, Mehmet Armangil, Berk Güçlü, Mehmet Demirtaş
BACKGROUND: Postoperative pain management is the part of shoulder surgery to improve patient satisfaction, start rehabilitation process rapidly and decrease for hospital stay. Various treatment modalities have been used for pain management, but they have some limitations, side effects and risks. Throughout intraoperative and postoperative period, nerve blocks have been used more popularly than others because of efficacy. For the regional nerve block, local anesthetic should be infiltrated close to the nerve for maximum effect...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27900705/sleep-quality-and-disturbances-in-patients-with-different-sized-rotator-cuff-tear
#12
S Gumina, V Candela, D Passaretti, T Venditto, L Mariani, G Giannicola
INTRODUCTION: The literature is unanimous in saying that shoulder pain, due to rotator cuff tear (RCT), may be mostly at night; to our knowledge, this statement is not supported by scientific evidence. Our aim was to investigate sleep quality and disturbances in patient with RCT and in a control group. MATERIALS AND METHODS: A case-control design study was used. We enrolled 324 consecutive patients (Group A) (156M-168F, mean age ± SD: 64.94 ± 6.97; range 47-74) who underwent arthroscopic rotator cuff repair...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27900700/platelet-rich-plasma-supplementation-in-arthroscopic-repair-of-full-thickness-rotator-cuff-tears-a-randomized-clinical-trial
#13
R D'Ambrosi, F Palumbo, A Paronzini, V Ragone, R M Facchini
BACKGROUND: Results on the effectiveness of PRP supplementation in arthroscopic rotator cuff repair are conflicting, making it difficult to draw definitive conclusions. METHODS: This was a prospective, randomized, and double-blind study with two groups of 20 patients each (PRP group and control group). Degenerative supraspinatus full-thickness tears grade C2-C3 were subjected to arthroscopic repair; PRP supplementation was given to patients in the PRP group. The outcomes were assessed by DASH, Constant scales, and ultrasound before and 6 months after surgery...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27900336/optimal-lateral-row-anchor-positioning-in-posterior-superior-transosseous-equivalent-rotator-cuff-repair-a-micro-computed-tomography-study
#14
Matthias A Zumstein, Sumit Raniga, Agatha Labrinidis, Kevin Eng, Gregory I Bain, Beat K Moor
BACKGROUND: The optimal placement of suture anchors in transosseous-equivalent (TOE) double-row rotator cuff repair remains controversial. PURPOSE: A 3-dimensional (3D) high-resolution micro-computed tomography (micro-CT) histomorphometric analysis of cadaveric proximal humeral greater tuberosities (GTs) was performed to guide optimal positioning of lateral row anchors in posterior-superior (infraspinatus and supraspinatus) TOE rotator cuff repair. STUDY DESIGN: Descriptive laboratory study...
November 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27900313/semitendinosus-and-gracilis-free-muscle-tendon-graft-for-repair-of-massive-rotator-cuff-tears-surgical-technique
#15
Antonio Gigante, Carlo Bottegoni, Giuseppe Milano, Michele Riccio, Luca Dei Giudici
Massive rotator cuff tears are difficult to treat surgically due to retraction, degeneration and fraying of the ends of torn tendons, severe fatty infiltration and atrophy of the respective muscles. Procedures developed to close the gap between the rotator cuff and the greater tuberosity of the humerus, such as soft tissue release may be inadequate for large tears. Human or porcine dermal allografts still have uncertain benefits, and tendon transfers seem to be associated with poor outcomes, donor site morbidity and altered mechanics...
July 2016: Joints
https://www.readbyqxmd.com/read/27887870/involvement-of-indian-hedgehog-signaling-in-mesenchymal-stem-cell-augmented-rotator-cuff-tendon-repair-in-an-athymic-rat-model
#16
Jian-Chun Zong, Michael J Mosca, Ryan M Degen, Amir Lebaschi, Camila Carballo, Andrew Carbone, Guang-Ting Cong, Liang Ying, Xiang-Hua Deng, Scott A Rodeo
BACKGROUND: Bone marrow aspirate has been used in recent years to augment tendon-to-bone healing, including in rotator cuff repair. However, the healing mechanism in cell-based therapy has not been elucidated in detail. METHODS: Sixteen athymic nude rats were randomly allocated to 2 groups: experimental (human mesenchymal stem cells in fibrin glue carrier) and control (fibrin glue only). Animals were sacrificed at 2 and 4 weeks. Immunohistochemical staining was performed to evaluate Indian hedgehog (Ihh) signaling and SOX9 signaling in the healing enthesis...
November 22, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27881294/comparison-of-outcomes-with-arthroscopic-repair-of-acute-on-chronic-within-6-months-and-chronic-rotator-cuff-tears
#17
Jeung Yeol Jeong, Seung Yeop Song, Jae Chul Yoo, Keun Min Park, Sang Min Lee
BACKGROUND: The purpose of this study was to define preoperative and intraoperative findings of acute-on-chronic rotator cuff tears (RCTs). This study also compared the functional and clinical outcomes with acute-on-chronic RCTs and chronic RCTs. METHODS: This study was conducted between December 2007 and December 2013. An acute-on-chronic full-thickness RCT was diagnosed with preoperative and intraoperative findings on arthroscopy. The study group consisted of 36 patients with preoperative and intraoperative findings (surgery performed within 6 months of trauma) indicative of an acute-on-chronic RCT...
November 21, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27876086/suprascapular-neuropathy-in-the-setting-of-rotator-cuff-tears-study-protocol-for-a-double-blinded-randomized-controlled-trial
#18
Nikolaos Platon Sachinis, Achilleas Boutsiadis, Sotirios Papagiannopoulos, Konstantinos Ditsios, Anastasios Christodoulou, Pericles Papadopoulos
BACKGROUND: It has been indicated that rotator cuff tears, especially large or massive ones, can cause suprascapular neuropathy. When such a diagnosis has been established, it is still unknown whether an arthroscopic release of the superior transverse scapular ligament during cuff repair can change the course of this neuropathy. METHODS/DESIGN: This is a single-center, double-blinded randomized controlled trial for which 42 patients with large or massive repairable rotator cuff tears and suprascapular neuropathy will be recruited and followed up at 6 and 12 months...
November 22, 2016: Trials
https://www.readbyqxmd.com/read/27874914/surgical-cost-disclosure-may-reduce-operating-room-expenditures
#19
Luke S Austin, Fotios P Tjoumakaris, Alvin C Ong, Nicholas J Lombardi, Charles D Wowkanech, Michael J Mehnert
Health care expenditures are rising in the United States. Recent policy changes are attempting to reduce spending through the development of value-based payment systems that rely heavily on cost transparency. This study was conducted to investigate whether cost disclosure influences surgeons to reduce operating room expenditures. Beginning in 2012, surgeon scorecards were distributed at a regional health care system. The scorecard reported the actual direct supply cost per case for a specific procedure and compared each surgeon's data with those of other surgeons in the same subspecialty...
November 22, 2016: Orthopedics
https://www.readbyqxmd.com/read/27855678/augmentation-and-repair-of-tendons-using-demineralised-cortical-bone
#20
Sherif Elnikety, Catherine J Pendegrass, Roberta Ferro de Godoy, Charles Holden, Gordon W Blunn
BACKGROUND: In severe injuries with loss of tendon substance a tendon graft or a synthetic substitute is usually used to restore functional length. This is usually associated with donor site morbidity, host tissue reactions and lack of remodelling of the synthetic substitutes, which may result in suboptimal outcome. A biocompatible graft with mechanical and structural properties that replicate those of normal tendon and ligament has so far not been identified. The use of demineralised bone for tendon reattachment onto bone has been shown to be effective in promoting the regeneration of a normal enthesis...
November 17, 2016: BMC Musculoskeletal Disorders
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