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superior capsular reconstruction

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https://www.readbyqxmd.com/read/29319655/superior-capsular-reconstruction-with-a-partial-rotator-cuff-repair-a-case-report
#1
John M Tokish, Amit Momaya, Troy Roberson
CASE: Chronic massive irreparable rotator cuff tears remain challenging to treat. We present the case of a 70-year-old active and healthy woman who presented with 6 months of worsening shoulder pain and function; she had experienced considerable deterioration over the past 2 months. Nonoperative management of the massive rotator cuff tear was not successful. Superior capsule reconstruction (SCR) was performed with a partial rotator cuff repair. CONCLUSION: SCR is an exciting advancement for the chronic massive irreparable rotator cuff tear, one of the more challenging problems encountered by shoulder surgeons...
January 10, 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/29281797/biomechanical-comparison-of-3-glenoid-side-fixation-techniques-for-superior-capsular-reconstruction
#2
Jonas Pogorzelski, Kyle J Muckenhirn, Justin J Mitchell, J Christoph Katthagen, Jason M Schon, Kimi D Dahl, Alan M Hirahara, Joshua S Dines, Christopher R Adams, Thomas Dooney, Patrick J Denard, Travis Lee Turnbull, Peter J Millett
BACKGROUND: Superior capsular reconstruction (SCR) was recently introduced as a treatment for irreparable superior rotator cuff tears in younger patients. Purpose/Hypothesis: The purpose was to assess the biomechanical strength of 3 methods for fixation of the graft to the glenoid for SCR. It was hypothesized that a 4-anchor technique would provide greater load to failure than 3-anchor techniques. STUDY DESIGN: Controlled laboratory study. METHODS: Thirty-six cadaveric specimens were randomized into 3 groups of previously established glenoid-side graft fixation techniques: (1) three 3...
December 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29277713/clinical-hip-fracture-is-accompanied-by-compression-induced-failure-in-the-superior-cortex-of-the-femoral-neck
#3
Tengteng Tang, Peter A Cripton, Pierre Guy, Heather A McKay, Rizhi Wang
Hip fractures pose a major health problem throughout the world due to their devastating impact. Current theories for why these injuries are so prevalent in the elderly point to an increased propensity to fall and decreases in bone mass with ageing. However, the fracture mechanisms, particularly the stress and strain conditions leading to bone failure at the hip remain unclear. Here, we directly examined the cortical bone from clinical intra-capsular hip fractures at a microscopic level, and found strong evidence of compression induced failure in the superior cortex...
December 22, 2017: Bone
https://www.readbyqxmd.com/read/29230426/lateral-patellofemoral-ligament-an-anatomic-study
#4
Kalpit N Shah, Steven F DeFroda, James Kristopher Ware, Sarath C Koruprolu, Brett D Owens
Background: Medial instability of the patellofemoral joint is a rare but known phenomenon that may result from an incompetent lateral patellofemoral ligament (LPFL). Surgical reconstruction of the LPFL has been described. However, anatomic details of the ligament have not been the subject of scrutiny. Purpose: To describe the anatomic origin and insertion of the LPFL. Study Design: Descriptive laboratory study. Methods: Ten fresh-frozen, unpaired human cadaveric knees (mean age, 57 years) were dissected to identify the LPFL...
December 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29198353/editorial-commentary-when-the-shoulder-joint-has-lost-stoichiometry-does-arthroscopic-assisted-latissimus-dorsi-transfer-stack-up
#5
EDITORIAL
Robert D Graham
Non-arthroplasty treatment options for pseudoparalysis of the shoulder are preferable in the younger patient population. Although there are differing philosophies among shoulder surgeons, many prefer to avoid reversed total shoulder arthroplasty for patients under age 60 years. Arthroscopically assisted latissimus dorsi transfer may be a good alternative for these patients, but how the results compare with arthroscopic superior capsular reconstruction is the question.
December 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29039871/superior-capsular-reconstruction
#6
Robert U Hartzler, Stephen S Burkhart
Superior capsular reconstruction (SCR) of the shoulder has recently gained popularity as an option for joint-preserving shoulder surgery for patients with an irreparable rotator cuff tear. In the absence of glenohumeral arthritis, rotator cuff tear irreparability should only be diagnosed for most patients after a careful diagnostic arthroscopy. Superior capsular reconstruction adds biological, passive, superior constraint to the glenohumeral joint, thereby optimizing the rotator cuff force couples and improving joint kinematics...
October 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28831349/a-limited-submuscular-direct-to-implant-technique-utilizing-allomax
#7
Michal Brichacek, Kimberly Dalke, Edward Buchel, Thomas E J Hayakawa
This study evaluates a novel limited submuscular direct-to-implant technique utilizing AlloMax where only the upper few centimeters of the implant is covered by the pectoralis, whereas the majority of the implant including the middle and lower poles are covered by acellular dermal matrix. METHODS: The pectoralis muscle is released off its inferior and inferior-medial origins and allowed to retract superiorly. Two sheets of AlloMax (6 × 16 cm) are sutured together and secured to the inframammary fold, serratus fascia, and the superiorly retracted pectoralis...
July 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28748362/case-study-failure-of-superior-capsular-reconstruction-using-dermal-allograft
#8
J Zerr, J D McDermott, N M Beckmann, R K Fullick, A Chhabra
Superior capsular reconstruction (SCR) is a novel technique for treating irreparable rotator cuff tears in younger patients in whom a reverse total shoulder arthroplasty is not the optimal treatment choice. This case study describes a middle-aged male with a recurrent, massive, irreparable rotator cuff tear treated with SCR that subsequently failed at the glenoid attachment. The patient underwent successful arthroscopic revision of the SCR. The case illustrates the MRI and arthroscopic correlations of the failed dermal allograft reconstruction, which to our knowledge has not been previously shown in the radiology literature...
November 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28632288/all-arthroscopic-superior-shoulder-capsule-reconstruction-with-partial-rotator-cuff-repair
#9
E Grant Sutter, Jonathan A Godin, Grant E Garrigues
Massive irreparable rotator cuff tears are difficult to treat. Although several treatment options exist, none provides superior long-term results. There is no consensus on optimal surgical technique. Superior capsular reconstruction is an operative treatment option aimed at restoring native biomechanics of the glenohumeral joint by providing a restraint to superior subluxation. Partial rotator cuff repair for massive tears has also been shown to improve shoulder kinematics and can be performed in conjunction with superior capsule reconstruction...
July 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28560141/the-pull-over-technique-for-arthroscopic-superior-capsular-reconstruction
#10
A Ali Narvani, Paolo Consigliere, Ioannis Polyzois, Tanaya Sarkhel, Rohit Gupta, Ofer Levy
The management of irreparable rotator cuff tears is a difficult problem to deal with. The options include nonoperative route with anterior deltoid exercises, debridement with or without long head of biceps tenotomy, partial rotator cuff repair, tuberoplasty, muscle transfer, patch augmentation, biodegradable spacers, and reverse shoulder arthroplasty. None of these options are without their limitations. In recent years, arthroscopic superior capsular reconstruction has gained popularity as an alternative technique to address irreparable rotator cuff tears...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28434037/open-capsular-and-ligament-reconstruction-with-semitendinosus-hamstring-autograft-successfully-controls-superior-and-posterior-translation-for-type-v-acromioclavicular-joint-dislocation
#11
Raffaele Garofalo, Enrico Ceccarelli, Alessandro Castagna, Vittorio Calvisi, Brody Flanagin, Marco Conti, Sumant G Krishnan
PURPOSE: Appropriate surgical management for type V complete acromioclavicular (AC) joint dislocation remains controversial. The purpose of this paper is to retrospectively report the clinical and radiographic outcomes of an open surgical technique consisting for AC joint ligamentous and capsular reconstruction using autologous hamstring tendon grafts and semi-permanent sutures. METHODS: Between January 2005 and December 2011, 32 consecutive patients with symptomatic type V complete AC joint dislocation underwent surgical treatment using the same technique...
July 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28273056/technique-to-promote-symmetry-in-2-staged-bilateral-breast-reconstruction-in-the-setting-of-unilateral-postmastectomy-radiation
#12
COMPARATIVE STUDY
Daniel S Roh, Matthew D Treiser, Emily H Lafleur, Yoon S Chun
BACKGROUND: Bilateral breast reconstruction in the setting of unilateral postmastectomy radiation therapy (PMRT) remains one of the most difficult reconstructive challenges due to significant radiation-induced asymmetry from capsular contracture and superior migration of the irradiated reconstructed breast. We describe a novel and straightforward intraoperative technique for creating compensatory asymmetry to maximize postradiation symmetry in immediate bilateral tissue expander (TE) and acellular dermal matrix (ADM) reconstruction requiring unilateral PMRT...
April 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28263160/-reconstructive-breast-surgery-using-implant-and-mesh
#13
Lene Nyhøj Heidemann, Gudjon Leifur Gunnarsson, Camilla Bille, Jens Ahm Sørensen, Jørn Bo Thomsen
The demand for reconstructive surgery after therapeutic and prophylactic mastectomy is increasing. The hammock technique for breast reconstruction was introduced in 2001 and provides support for the implant using either biologically derived or synthetic mesh. The material is formed as a hammock in the lower pole of the reconstructed breast, and due to its supportive capabilities it has been found to shorten the time needed for reconstruction, decrease the risk of capsular contracture and leave a superior aesthetic result...
March 6, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28149739/arthroscopic-superior-capsular-reconstruction-for-massive-irreparable-rotator-cuff-repair
#14
Stephen S Burkhart, Patrick J Denard, Christopher R Adams, Paul C Brady, Robert U Hartzler
We have been performing arthroscopic superior capsular reconstruction (SCR) with acellular dermal allograft for almost 2 years. Our techniques are based on Mihata's original concept for SCR, in which he used fascia lata autograft. In this report, we describe our standard arthroscopic technique as well as 2 variations of a "zip-line" technique, which we have found particularly useful for large dermal allografts (grafts that are ≥40 mm in any dimension).
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27552457/the-arthroscopic-superior-capsular-reconstruction
#15
Christopher R Adams, Patrick J Denard, Paul C Brady, Robert U Hartzler, Stephen S Burkhart
In a subset of patients with rotator cuff tears, the glenohumeral joint has minimal degenerative changes and the rotator cuff tendon is either irreparable or very poor quality and unlikely to heal. Reverse shoulder arthroplasty (RSA) is often considered for these patients despite the lack of glenohumeral arthritis. However, due to the permanent destruction of the glenohumeral articular surfaces, complication rates, and concerns about implant longevity with RSA, we believe the superior capsular reconstruction (SCR) is a viable alternative...
July 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27385946/direct-repair-of-the-superior-band-of-bigelow-s-ligament-after-hip-arthroplasty-a-surgical-technique
#16
Joseph Liu, Alexander S McLawhorn, Alexander B Christ, Peteris Dzenis, John H Healey
BACKGROUND: The posterolateral approach is one of the most common approaches used during hip arthroplasty. A posterior soft tissue repair is necessary to limit the risk of postoperative dislocation. For a trapezoidal capsulotomy, the proximal limb divides the superior band of the iliofemoral ligament (Bigelow's ligament). A transosseous repair frequently leaves a defect in this region, which may elevate the risk for dislocation. The purpose of this article is to describe a simple, rational technique for reinforcing the posterior capsular repair...
July 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/27284506/arthroscopic-superior-capsule-reconstruction-for-irreparable-rotator-cuff-tears
#17
Maximilian Petri, Joshua A Greenspoon, Peter J Millett
Massive irreparable rotator cuff tears in young patients are a particular challenge for the orthopaedic surgeon. Surgical treatment options include debridement, partial rotator cuff repair, patch-augmented rotator cuff repair, bridging rotator cuff reconstruction with graft interposition, tendon transfer, and reverse total shoulder arthroplasty. Recently, reconstruction of the superior glenohumeral capsule using a fascia lata autograft has been suggested to reduce superior glenohumeral translation and restore superior stability...
December 2015: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27214881/massive-rotator-cuff-tears-trends-in-surgical-management
#18
REVIEW
Robert Thorsness, Anthony Romeo
Compared with smaller tears, massive rotator cuff tears present significant clinical management dilemmas for the treating surgeon because they are often fraught with structural failure and poor outcomes. To optimize healing, current surgical methods look to optimize footprint coverage and enhance the biological environment for healing. Double-row techniques have demonstrated clear biomechanical advantages in controlled cadaveric studies, but have yet to demonstrate clear clinical efficacy over more simple repair techniques...
May 1, 2016: Orthopedics
https://www.readbyqxmd.com/read/27054752/shoulder-function-after-breast-reconstruction-with-the-latissimus-dorsi-flap-a-prospective-cohort-study-combining-dash-score-and-objective-evaluation
#19
C Garusi, A Manconi, G Lanni, G Lomeo, P Loschi, M C Simoncini, L Santoro, M Rietjens, J Y Petit
OBJECTIVES: The latissimus dorsi (LD) flap is well-known in breast reconstruction especially in previously-irradiated patients, in order to have a low capsular contraction rate whenever an implant is associated. The aim of this study is to closely evaluate the effect of LD flap harvesting on shoulder function as well as specific movements related to the LD, both objectively and subjectively. MATERIALS AND METHODS: We retrospectively collected data on 86 patients who underwent pedicled LD muscle flap for breast reconstruction at the European Institute of Oncology between September 1995 until March 2011...
June 2016: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/26945948/editorial-commentary-superior-capsular-reconstruction-for-irreparable-supraspinatus-tear-reveals-improved-biomechanics-with-a-thicker-graft-placed-in-15%C3%A2-to-45%C3%A2-of-shoulder-abduction
#20
EDITORIAL
Michael J Rossi
Biomechanical study of superior capsular reconstruction for irreparable supraspinatus tears has lower subacromial contact pressures with a thicker graft placed in 15° to 45° of shoulder abduction. Whether this translates to the clinical situation of massive rotator cuff insufficiency remains to be determined.
March 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
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