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massive rotator cuff

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https://www.readbyqxmd.com/read/27909664/arthroscopic-assisted-lower-trapezius-tendon-transfer-for-massive-irreparable-posterior-superior-rotator-cuff-tears-surgical-technique
#1
Bassem T Elhassan, Eduard Alentorn-Geli, Andrew T Assenmacher, Eric R Wagner
Tendon transfer options to reconstruct a massive irreparable posterior-superior rotator cuff tear include latissimus dorsi, teres major, or lower trapezius transfer. We previously described the lower trapezius transfer using a 2-incision approach, which includes a medial incision to harvest the lower trapezius and lateral transacromial incision to expose the rotator cuff and then perform the transfer through a deep tunnel connecting these 2 sites. In this report, we describe an arthroscopic-assisted technique of lower trapezius transfer augmented with an Achilles tendon allograft to reconstruct an irreparable posterior-superior rotator cuff tear...
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
#2
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/27904725/rotator-cuff-repair-in-patients-over-75-years-of-age-clinical-outcome-and-repair-integrity
#3
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/27900707/fluoroscopy-guided-biodegradable-spacer-implantation-using-local-anesthesia-safety-and-efficacy-study-in-patients-with-massive-rotator-cuff-tears
#4
E Gervasi, E Maman, A Dekel, E Cautero
BACKGROUND: The management of massive rotator cuff tears (MRCTs) is challenging and associated with a high failure rates. Studies have shown that advanced age, lower American Society of Anesthesiologists physical status score and concomitant comorbidities are associated with higher risks of death and postoperative complications. This study was designed to assess the safety and efficacy of fluoroscopy-guided biodegradable spacer implantation under local anesthesia, in patients with MRCT and comorbidities completely or partially contraindicating surgeries under general anesthesia...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27900705/sleep-quality-and-disturbances-in-patients-with-different-sized-rotator-cuff-tear
#5
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/27900313/semitendinosus-and-gracilis-free-muscle-tendon-graft-for-repair-of-massive-rotator-cuff-tears-surgical-technique
#6
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/27876086/suprascapular-neuropathy-in-the-setting-of-rotator-cuff-tears-study-protocol-for-a-double-blinded-randomized-controlled-trial
#7
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/27803226/suprascapular-neuropathy-in-massive-rotator-cuff-tears-with-severe-fatty-degeneration-in-the-infraspinatus-muscle
#8
B Y Kong, S H Kim, D H Kim, H Y Joung, Y H Jang, J H Oh
AIMS: Our aim was to describe the atypical pattern of increased fatty degeneration in the infraspinatus muscle compared with the supraspinatus in patients with a massive rotator cuff tear. We also wished to describe the nerve conduction and electromyography findings in these patients. PATIENTS AND METHODS: A cohort of patients undergoing surgery for a massive rotator cuff tear was identified and their clinical records obtained. Their MRI images were reviewed to ascertain the degree of retraction of the torn infraspinatus and supraspinatus muscles, and the degree of fatty degeneration in both muscles was recorded...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27799834/a-comparison-of-functional-outcomes-in-patients-undergoing-revision-arthroscopic-repair-of-massive-rotator-cuff-tears-with-and-without-arthroscopic-suprascapular-nerve-release
#9
Felix H Savoie, Mark Zunkiewicz, Larry D Field, William H Replogle, Michael J O'Brien
PURPOSE: This study was designed to compare functional outcomes in patients undergoing revision repair of massive rotator cuff tears (retracted medial to the glenoid) with Goutallier Grade 4 atrophy and concomitant release of the suprascapular nerve to a similar group of patients with Grade 3 atrophy undergoing revision rotator cuff repair (RTCR) without nerve release. We hypothesized that patients undergoing nerve release would have more favorable functional outcomes as measured by the Modified University of California at Los Angeles shoulder rating scale (UCLA)...
2016: Open Access Journal of Sports Medicine
https://www.readbyqxmd.com/read/27768610/biologic-and-synthetic-grafts-in-the-reconstruction-of-large-to-massive-rotator-cuff-tears
#10
Robert J Gillespie, Derrick M Knapik, Ozan Akkus
Rotator cuff injuries are common in both young and elderly patients. Despite improvements in instrumentation and surgical techniques, the failure rates following tendon reconstruction remain unacceptably high. To improve outcomes, graft patches have been developed to provide mechanical strength and to furnish a scaffold for biologic growth across the delicate tendon-bone junction. Although no patch effectively re-creates the structured, highly organized system of prenatal tendon development, augmenting rotator cuff repair may help restore native tendon-to-bone attachment while reproducing the mechanical and biologic properties of native tendon...
December 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27757408/functional-outcomes-after-double-row-versus-single-row-rotator-cuff-repair-a-prospective-randomized-trial
#11
Stephen J Nicholas, Steven J Lee, Michael J Mullaney, Timothy F Tyler, Takumi Fukunaga, Christopher D Johnson, Malachy P McHugh
BACKGROUND: The functional benefits of double-row (DR) versus single-row (SR) rotator cuff repair are not clearly established. PURPOSE: To examine the effect of DR versus SR rotator cuff repair on functional outcomes and strength recovery in patients with full-thickness tears. STUDY DESIGN: Randomized controlled trial; Level of evidence, 2. METHODS: Forty-nine patients were randomized to DR or SR repairs; 36 patients (13 women, 23 men; mean age, 62 ± 7 years; 20 SR, 16 DR) were assessed at a mean 2...
October 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27720414/rotator-cuff-surgery-in-patients-older-than-75-years-with-large-and-massive-tears
#12
Hong Jun Jung, Gyeong-Bo Sim, Kun Hyung Bae, Aashay L Kekatpure, Jae-Myeung Chun, In-Ho Jeon
BACKGROUND: The purpose of this study was to evaluate whether rotator cuff repair improves subjective and functional outcomes in patients aged ≥75 years. METHODS: From May 2005 to March 2013, 121 elderly patients who underwent rotator cuff repair for large and massive rotator cuff tears were evaluated retrospectively. Patients with an American Society of Anesthesiologists physical status classification system grade ≥4 were excluded. The patients were evaluated using visual analog scales, subjective satisfaction surveys, American Shoulder and Elbow Surgeons scores, and Constant scores...
October 5, 2016: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/27709027/-owl-technique-for-all-arthroscopic-augmentation-of-a-massive-or-large-rotator-cuff-tear-with-extracellular-matrix-graft
#13
A Ali Narvani, Paolo Consigliere, Ioannis Polyzois, Tanaya Sarkhel, Rohit Gupta, Ofer Levy
Despite the vast improvement in techniques and technology for arthroscopic rotator cuff surgery, repairs of massive and large tears remain challenging because they are associated with significantly high failure rates. In recent years, patch augmentation has gained popularity as a technique to decrease these high failure rates. Arthroscopic patch augmentation of rotator cuff repair, however, is technically difficult. The purpose of this report is to describe a simple and reproducible technique for all-arthroscopic extracellular matrix graft augmentation...
August 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/27708735/summary-of-meta-analyses-dealing-with-single-row-versus-double-row-repair-techniques-for-rotator-cuff-tears
#14
U J Spiegl, S A Euler, P J Millett, P Hepp
BACKGROUND: Several meta-analyses of randomized clinical trials have been performed to analyze whether double-row (DR) rotator cuff repair (RCR) provides superior clinical outcomes and structural healing compared to single-row (SR) repair. The purpose of this study was to sum up the results of meta-analysis comparing SR and DR repair with respect on clinical outcomes and re-tear rates. METHODS: A literature search was undertaken to identify all meta-analyses dealing with randomized controlled trials comparing clinical und structural outcomes after SR versus DR RCR...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27708733/patch-augmented-rotator-cuff-repair-and-superior-capsule-reconstruction
#15
M Petri, J A Greenspoon, S G Moulton, P J Millett
BACKGROUND: Massive rotator cuff tears in active patients with minimal glenohumeral arthritis remain a particular challenge for the treating surgeon. METHODS: A selective literature search was performed and personal surgical experiences are reported. RESULTS: For patients with irreparable rotator cuff tears, a reverse shoulder arthroplasty or a tendon transfer are often performed. However, both procedures have rather high complication rates and debatable long-term results, particularly in younger patients...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27708730/irreparable-rotator-cuff-tears-restoring-joint-kinematics-by-tendon-transfers
#16
Joshua A Greenspoon, Peter J Millett, Samuel G Moulton, Maximilian Petri
BACKGROUND: Tendon transfers can be a surgical treatment option in managing younger, active patients with massive irreparable rotator cuff tears. The purpose of this article is to provide an overview of the use of tendon transfers to treat massive irreparable rotator cuff tears and to summarize clinical outcomes. METHODS: A selective literature search was performed and personal surgical experiences are reported. RESULTS: Latissimus dorsi transfers have been used for many years in the management of posterosuperior rotator cuff tears with good reported clinical outcomes...
2016: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/27703412/all-arthroscopic-modified-rotator-interval-slide-for-massive-anterosuperior-cuff-tears-using-the-subdeltoid-space-surgical-technique-and-early-results
#17
Keith T Corpus, Samuel A Taylor, Stephen J O'Brien, Lawrence V Gulotta
BACKGROUND: Traditional intra-articular arthroscopic repair techniques for massive anterosuperior rotator cuff tears are technically demanding and necessitate sacrifice of the rotator interval to enable visualization. An interval slide allows mobilization through release of the medial aspect of the rotator interval, while leaving the lateral, bridging fibers intact. QUESTIONS/PURPOSES: The purpose of this study was to report a novel, arthroscopic, open-equivalent technique using the subdeltoid space to address these tears along with early clinical results...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/27699827/rotator-cuff-tear-state-modulates-self-renewal-and-differentiation-capacity-of-human-skeletal-muscle-progenitor-cells
#18
Kelsey A Thomas, Michael C Gibbons, John G Lane, Anshuman Singh, Samuel R Ward, Adam J Engler
Full thickness rotator cuff tendon (RCT) tears have long-term effects on RC muscle atrophy and fatty infiltration, with lasting damage even after surgical tendon repair. Skeletal muscle progenitor cells (SMPs) are critical for muscle repair in response to injury, but the inability of RC muscles to recover from chronic RCT tear indicates possible deficits in repair mechanisms. Here we investigated if muscle injury state was a crucial factor during human SMP expansion and differentiation ex vivo. SMPs were isolated from muscles in patients with no, partial-thickness (PT), or full-thickness (FT) RCT tears...
October 4, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/27684078/treatment-of-massive-irreparable-rotator-cuff-tears-a-cost-effectiveness-analysis
#19
Jason R Kang, Aaron T Sin, Emilie V Cheung
Massive irreparable rotator cuff tears cause significant shoulder pain and dysfunction. Physical therapy (PT), arthroscopic debridement with biceps tenotomy (AD-BT), and hemiarthroplasty (HA) are treatments shown to reduce pain and improve quality of life. Reverse total shoulder arthroplasty (RTSA) is a newer surgical treatment option that may offer improved function. A cost-effectiveness analysis of these interventions has never been performed, and no head-to-head comparative effectiveness trials currently exist...
September 29, 2016: Orthopedics
https://www.readbyqxmd.com/read/27633461/biomechanical-study-comparing-3-fixation-methods-for-rotator-cuff-massive-tear-transosseous-no-2-suture-transosseous-braided-tape-and-double-row
#20
Stéphanie Hinse, Jérémie Ménard, Dominique M Rouleau, Fanny Canet, Marc Beauchamp
BACKGROUND: Important rotator cuff repair failure rates have prompted this study of the techniques and materials used in order to optimize clinical results. QUESTIONS/PURPOSES: Is the reconstruction of the rotator cuff biomechanically stronger when using: 1) transosseous with 2 mm braided tape suture (TOT), 2) transosseous with multi-strand No. 2 sutures (TOS), or 3) double row suture bridge with suture anchors loaded with No. 2 braided sutures (DRSB)? METHODS: Twenty-four cadaveric pig shoulders were randomized in the three repair constructs...
November 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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