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Elizabeth E Hibberd, Kevin G Laudner, Kristen L Kucera, David J Berkoff, Bing Yu, Joseph B Myers
BACKGROUND: Subacromial space distance and forward head and shoulder posture are common characteristics resulting from swim training. These alterations can cause abnormal scapular kinematics and positioning, potentially increasing compression of structures in the subacromial space and increasing the risk for the development of swimmer's shoulder. PURPOSE: To evaluate the effect of the swim training season on subacromial space distance and forward head and forward shoulder posture as well as to determine the relationship between these variables...
October 18, 2016: American Journal of Sports Medicine
Birgit Castelein, Ann Cools, Thierry Parlevliet, Barbara Cagnie
BACKGROUND: Altered recruitment of rotator cuff and scapulothoracic muscles has been identified in patients with subacromial impingement syndrome. To date, however, the cause-consequence relationship between pain and altered muscle recruitment has not been fully unraveled. METHODS: The effect of experimental shoulder pain induced by injection of hypertonic saline in the supraspinatus on the activity of the supraspinatus, infraspinatus, subscapularis, trapezius, and serratus anterior activity was investigated during the performance of an elevation task by use of muscle functional magnetic resonance imaging in 25 healthy individuals...
October 14, 2016: Journal of Shoulder and Elbow Surgery
Darryn Marks, Tracy Comans, Michael Thomas, Shu Kay Ng, Shaun O'Leary, Philip G Conaghan, Paul A Scuffham, Leanne Bisset
BACKGROUND: Physiotherapists increasingly manage shoulder referrals in place of orthopaedic doctors. Better understanding the agreement between these professionals will help inform the safety, quality and potential costs of these care models. OBJECTIVE: To establish the level of agreement between a physiotherapist and an orthopaedic surgeon regarding diagnosis, management and corticosteroid injection, in a representative sample of orthopaedic shoulder referrals...
October 5, 2016: Manual Therapy
Erhan Şükür, Yusuf Öztürkmen, Yunus Emre Akman, Mustafa Güngör
OBJECTIVE: The aim of this study was to analyze the clinical and functional results of hook plate fixation in Neer type 2 distal clavicle fractures. METHODS: We retrospectively analyzed 16 patients (11 males, 5 females) who were diagnosed with Neer type 2 distal clavicle fractures and treated with hook plate fixation between 2013 and 2014. Mean age was 38 (range: 27-61), and mean follow-up time was 14.3 (range: 12-18) months. Complications seen on radiographs were implant failure and subacromial osteolysis...
October 11, 2016: Acta Orthopaedica et Traumatologica Turcica
William R Mook, Joshua A Greenspoon, Peter J Millett
BACKGROUND: Rotator cuff tears are a significant cause of shoulder morbidity. Surgical techniques for repair have evolved to optimize the biologic and mechanical variables critical to tendon healing. Double-row repairs have demonstrated superior biomechanical advantages to a single-row. METHODS: The preferred technique for rotator cuff repair of the senior author was reviewed and described in a step by step fashion. The final construct is a knotless double row transosseous equivalent construct...
2016: Open Orthopaedics Journal
William J Warrender, Usman Ali M Syed, Sommer Hammoud, William Emper, Michael G Ciccotti, Joseph A Abboud, Kevin B Freedman
BACKGROUND: Effective postoperative pain management after shoulder arthroscopy is a critical component to recovery, rehabilitation, and patient satisfaction. PURPOSE: This systematic review provides a comprehensive overview of level 1 and level 2 evidence regarding postoperative pain management for outpatient arthroscopic shoulder surgery. STUDY DESIGN: Systematic review. METHODS: We performed a systematic review of the various modalities reported in the literature for postoperative pain control after outpatient shoulder arthroscopy and analyzed their outcomes...
October 11, 2016: American Journal of Sports Medicine
Matthew H Lee, Scott E Sheehan, John F Orwin, Kenneth S Lee
Shoulder pain is one of the most common musculoskeletal conditions encountered in primary care and specialty orthopedic clinic settings. Although magnetic resonance (MR) imaging is typically the modality of choice for evaluating the soft-tissue structures of the shoulder, ultrasonography (US) is becoming an important complementary imaging tool in the evaluation of superficial soft-tissue structures such as the rotator cuff, subacromial-subdeltoid bursa, and biceps tendon. The advantages of US driving its recent increased use include low cost, accessibility, and capability for real-time high-resolution imaging that enables dynamic assessment and needle guidance...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
José L Arias-Buría, César Fernández-de-Las-Peñas, María Palacios-Ceña, Shane L Koppenhaver, Jaime Salom-Moreno
: This randomized clinical trial investigated the effectiveness of exercise vs. exercise plus trigger point dry needling (TrP-DN) in subacromial pain syndrome. A randomized parallel-group trial, with 1-year follow-up was conducted. Fifty subjects with subacromial pain syndrome were randomly allocated to receive exercise alone or exercise +TrP-DN. Participants in both groups were asked to perform an exercise program of the rotator cuff muscles twice daily for 5 weeks. Further, patients allocated to the exercise +TrP-DN group also received dry needling to active TrPs in the muscles reproducing shoulder symptoms during the 2(nd) and 4(th) sessions...
October 5, 2016: Journal of Pain: Official Journal of the American Pain Society
Matthew Yalizis, Kevin Kruse, Arnaud Godenèche
Proper visualization is of paramount importance during arthroscopic rotator cuff repair. We propose a technique that significantly improves the visualization of the rotator cuff when viewing from the anterolateral or lateral portals. This "panorama" view is obtained by a release of the deep layer of the deltoid fascia, which in turn increases the space between the humerus and the deltoid muscle. This release increases the volume of the subdeltoid bursa, secondarily increasing the field of view of the subacromial space with the camera viewing from the anterolateral or lateral portals...
August 2016: Arthroscopy Techniques
O Le Reun, J Lebhar, F Mateos, J L Voisin, H Thomazeau, M Ropars
INTRODUCTION: Many clinical anatomy studies have looked into how variations in the acromion, coracoacromial ligament (CAL) and subacromial space are associated with rotator cuff injuries. However, no study up to now had defined anatomically the fibro-osseous canal that confines the supraspinatus muscle in the subcoracoacromial space. Through an anatomical study of the scapula, we defined the bone-related parameters of this canal and its anatomical variations. MATERIALS AND METHODS: This study on dry bones involved 71 scapulas...
September 26, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Fumiaki Takase, Atsuyuki Inui, Yutaka Mifune, Ryosuke Sakata, Tomoyuki Muto, Yoshifumi Harada, Yasuhiro Ueda, Takeshi Kokubu, Masahiro Kurosaka
Atrophy with fatty degeneration is often seen in rotator cuff muscles with torn tendons. PRP has been reported to enhance tissue repair processes after tendon ruptures. However, the effect of PRP on atrophy and fatty degeneration of the muscle is not yet known. The aim of this study is to examine the effect of PRP on degeneration change of rotator cuff muscles in vitro and in vivo. A murine myogenic cell line and a rat rotator cuff tear model were used in this study and PRP was administrated into subacromial space which is widely used in clinical practice...
September 29, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
L I F Penning, R A De Bie, P Leffers, R E Weijers, G H I M Walenkamp
: Shoulder disorders are common in the general population : they occur in about 25 of every 1000 patients per year. A rather large majority are caused by cuff disorders. Differentiating between impingement and cuff rupture is essential to adequate treatment. Clinical tests have been developed, but their accuracy is limited. This study was performed to improve clinical accuracy by combining single tests and adding a subacromial injection. We postulated that the empty can and drop arm tests would result in higher sensitivity and specificity after subacromial injection...
August 2016: Acta Orthopaedica Belgica
Hamit Göksu, Figen Tuncay, Pınar Borman
OBJECTIVE: The aim of this study was to compare the therapeutic effects of kinesio taping (KT) and local subacromial injection in patients with subacromial impingement, syndrome (SIS) with regard to pain, range of motion (ROM) and disability. METHODS: Sixty-one patients (48 females and 13 males; mean age: 43.04 ± 6.31, years) with SIS were enrolled into the study. The patients were randomized into two treatment groups receiving either a single corticosteroid and local anesthetic (LA) injection, or kinesio taping performed three times by intervals of 3 day...
September 23, 2016: Acta Orthopaedica et Traumatologica Turcica
Karen A Keenan, Jonathan S Akins, Michelle Varnell, John Abt, Mita Lovalekar, Scott Lephart, Timothy C Sell
OBJECTIVE: To examine the effect of kinesiology tape (KT) on shoulder strength, proprioception, and scapular kinematics in healthy and Subacromial Impingement Syndrome (SAIS) subjects. DESIGN: Placebo-controlled quasi-experimental study. SETTING: Research laboratory. PARTICIPANTS: A total of 30 physically active subjects participated. Ten healthy subjects with no previous history of shoulder pathology received KT on the dominant shoulder...
June 19, 2016: Physical Therapy in Sport
Dominique M Rouleau, G Yves Laflamme, Jennifer Mutch
BACKGROUND: This is a retrospective prognostic study on soft tissue injury following isolated greater tuberosity (GT) fractures of the proximal humerus with respect to the relationship between rotator cuff tears and GT displacement. METHODS: Forty-three patients with isolated GT fractures were recruited and evaluated with a standardized interview and physical examination, quality of life and shoulder function questionnaires (Western Ontario Rotator Cuff Index, SF-12 Version 2, Constant, Quick-Disabilities of the Arm, Shoulder and Hand, Visual Analogue Scale), standard shoulder radiographs and an ultrasound...
October 2016: Shoulder & Elbow
Marcello Zappia, Alberto Aliprandi, Simona Pozza, Fabio Martino Doniselli, Salvatore Gitto, Luca Maria Sconfienza
OBJECTIVES: To define when an ultrasound examination of the shoulder can be considered complete and how many examinations currently performed in Italy are actually complete according to that definition. MATERIALS AND METHODS: Reports and images of previously performed ultrasound examinations of the shoulder of patients seen in 2014 for interventional procedures were reviewed for the following items, according to guidelines published by the European Society of Musculoskeletal Radiology: long biceps, subscapularis, supraspinatus, external rotators, acromioclavicular joint, subacromial bursa, subacromial space, coraco-acromial ligament, and the posterior recess...
September 16, 2016: Skeletal Radiology
Alva H Bdaiwi, Tanya Anne Mackenzie, Lee Heerington, Ian Horlsey, Ann Cools
CONTEXT: Compromise to the acromio-humeral distance has been reported in subjects with subacromial impingement syndrome when compared to healthy subjects. In clinical practice patients are taped with the intention of altering scapular position and influencing the acromio-humeral distance. However, research to determine the effects of taping on acromio-humeral distance is exiguous. OBJECTIVES: To evaluate the effect of ridged taping techniques to increase posterior scapular tilt and upward scapular rotation on the acromio-humeral distance...
August 24, 2016: Journal of Sport Rehabilitation
Darryn Marks, Leanne Bisset, Tracy Comans, Michael Thomas, Shu Kay Ng, Shaun O'Leary, Philip G Conaghan, Paul A Scuffham
BACKGROUND: Role substitution is a strategy employed to assist health services manage the growing demand for musculoskeletal care. Corticosteroid injection is a common treatment in this population but the efficacy of its prescription and delivery by physiotherapists has not been established against orthopaedic standards. This paper investigates whether corticosteroid injection given by a physiotherapist for shoulder pain is as clinically and cost effective as that from an orthopaedic surgeon...
2016: PloS One
Hyun-Jung Shin, Hyo-Seok Na, Ah-Young Oh, Jung-Won Hwang, Byung-Gun Kim, Hee-Pyoung Park, Young-Tae Jeon, Seong-Won Min, Jung-Hee Ryu
BACKGROUND: The shoulder area is mainly innervated with the C5 and C6 nerve roots, and interscalene brachial plexus block (ISB) is widely used for postoperative analgesia after shoulder surgery. However, it is associated with adverse effects, such as numbness and weakness in the blocked arm due to an unwanted block of the lower brachial plexus (C7-T1). We hypothesized that the C5 approach during ISB would provide postoperative analgesia while minimizing adverse events after arthroscopic shoulder surgery...
September 2016: Medicine (Baltimore)
Michele N Edison, Anthony Caram, Miguel Flores, Kurt Scherer
Most commonly associated with chronic inflammatory conditions, rice bodies represent an uncommon, nonspecific, often intra-articular inflammatory process. Presumably, rice bodies represent the sequelae of microvascular infarcts of the joint synovium. However, rice bodies have been seen in pleural fluid, in the setting of bursitis, and within the tendon sheath. The etiology and prognostic significance of rice bodies are not clear. MRI is the diagnostic imaging modality of choice for the evaluation of rice body formation...
2016: Curēus
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