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Shoulder & Elbow

Mikel Aramberri-Gutiérrez, Amaia Martínez-Menduiña, Simon Boyle, Maria Valencia
Background: Rotator cuff tears are one of the most common causes of shoulder pain. All-suture anchors are increasingly being used in the arthroscopic repair of rotator cuff tears. The purpose of this experimental study is to evaluate the biomechanical properties of all-suture anchors at different insertion sites in the proximal humerus relevant to rotator cuff repairs and the remplissage procedure. Methods: Sixteen cadaveric shoulders were used for the study. Four all-suture anchors were inserted in each proximal humerus at common anchor insertion sites on the rotator cuff footprint and a simulated Hill-Sachs defect...
May 2019: Shoulder & Elbow
Dfp van Deurzen, Vab Scholtes, W J Willems, H H Geerdink, H J van der Woude, Vpm van der Hulst, Mpj van den Bekerom
Background: This retrospective cohort study evaluated functional outcome and structural integrity after arthroscopic- or mini-open repair of small- to medium-size rotator cuff tears assessed at long-term follow-up. Methods: All patients operated between 2001 and 2004 were invited to participate. Functional outcome was measured by Constant-Murley Score, Disability of Arm, Shoulder and Hand and Oxford Shoulder Score. Quality of life was assessed with EuroQol Health 5 Dimension...
May 2019: Shoulder & Elbow
Claudia C Sidler-Maier, Jennifer A Mutch, Martin Sidler, Dimitra Leivadiotou, Jubin B Payandeh, Diane Nam
Background: The surgical treatment of irreparable massive rotator cuff tears is challenging. The purpose of the present study was to report the initial outcomes after a modified latissimus dorsi transfer (LDT) augmented by acellular dermal allograft (ADA). Methods: This retrospective study includes 24 patients managed with LDT using ADA augmentation as a bursal-sided onlay between March 2009 and December 2015. Results: All patients were men with a mean age of 57 years (range 48 years to 70 years)...
May 2019: Shoulder & Elbow
Adam C Watson, Richard P Jamieson, Andrew C Mattin, Richard S Page
Background: We aimed to assess the validity of magnetic resonance imaging (MRI) in assessing the subcorocoid space and determine the validity of novel sagittal plane subcorocoid space measurements. Methods: We assessed 33 arthroscopically proven subscapularis tears with MRIs compared to 33 (instability) controls with normal subscapularis tendons. Three examiners analyzed MRIs for seven static indices of corocoid morphology, in axial and sagittal planes. We explored reviewer variation using intraclass correlation coefficients (ICC) and differences between the two groups was explored using t -tests...
May 2019: Shoulder & Elbow
Kuen Chin, Alex Chowdhury, Dimitra Leivadiotou, Helen Marmery, Philip Michael Ahrens
Background: A number of radiographic signs have been previously demonstrated to be associated with degenerative rotator cuff tears. An ability to predict the presence of a tear by radiography would permit the early commencement of appropriate treatment and the avoidance of unnecessary invasive investigations. The aim of the present study was to determine the accuracy of using radiographic signs to predict the presence of a cuff tear on arthroscopy. Methods: Fifty consecutive patients who had undergone shoulder arthroscopy and had pre-operative plain radiographs were included...
May 2019: Shoulder & Elbow
Ann Livingstone, Rafik Asaid, Afshin Kamali Moaveni
Background: The objective of the present study was to perform a systematic review and meta-analysis of randomized controlled trials looking at the effect of distal clavicle resection in patients undergoing rotator cuff repair (RCR). Methods: A systematic literature search was undertaken to identify randomized controlled trials looking at RCR +/- distal clavicle resection. Primary clinical outcome measures included in the meta-analysis were American Shoulder Elbow Society (ASES) score, pain on visual analogue scale and range of motion in forward elevation...
May 2019: Shoulder & Elbow
Andrew P Matson, Christopher Kim, Swara Bajpai, Cynthia L Green, Thomas W Hash, Grant E Garrigues
Background: The modified Goutallier classification system describes the fatty infiltration of rotator cuff musculature (RCM) seen on magnetic resonance imaging (MRI) to assist with surgical decision-making for patients with rotator cuff tears (RCT). We describe the relationship between body mass index (BMI) and fatty infiltration in patients without RCT. Methods: Twenty-five patients from each of four different BMI ranges (< 25 kg/m2 ; 25 kg/m2 to 30 kg/m2 ; 30 kg/m2 to 35 kg/m2 ; > 35 kg/m2 ) were randomly selected from 1088 consecutive shoulder MRI scans (T1 parasagittal series)...
May 2019: Shoulder & Elbow
Ethan Caruana, Carlos Wigderowitz, Fraser Harrold
Background: The objective of the present study was to determine the size and position of the rotator cuff moment arms constructed from the cuff footprints, incident on the line of force acting through the humeral head. Methods: Five humeri were dissected, leaving the footprints of the rotator cuff intact. Each of the rotator cuff footprints and the cartilage/calcar interface were digitized and the articular surface was scanned using a high precision surface laser scanner...
May 2019: Shoulder & Elbow
Simon M Thompson, Joe A I Prinold, Adam M Hill, Peter Reilly, Roger J H Emery, Anthony M J Bull
Background: Detachment of the central tendon of the supraspinatus from its insertion is considered to be crucial to functional deficit. The aim of the present study was to assess the function of the supraspinatus in terms of abduction moments by introducing different tear configurations to assess the functional effect of the central tendon insertion. Methods: Ten fresh frozen shoulders from five cadavers were prepared for testing. A testing protocol was established to measure the abduction moment of the supraspinatus under physiological loading tailored to the anthropometrics of each specimen...
May 2019: Shoulder & Elbow
Kelms Amoo-Achampong, Michael K Krill, Derrick Acheampong, Benedict U Nwachukwu, Frank McCormick
Introduction: Rotator cuff tear surgical repair techniques have significantly progressed. However, tendon retear following primary repair persistently occurs at high rates. Rehabilitation protocols, surgical fixation techniques, biologic therapy with scaffolds, platelet-rich plasma, and even stem cell applications are under study to promote adequate tendon healing. Methods: A nonsystematic query of the PubMed database was conducted in July 2016 utilizing the search terms "rotator cuff repair," "tear," "rehabilitation," "scaffold," "platelet-rich plasma," and "stem cell" to identify, analyze, and summarize relevant studies...
May 2019: Shoulder & Elbow
David Stanley
No abstract text is available yet for this article.
May 2019: Shoulder & Elbow
Kimberly I M van den Ende, Renée Keijsers, Michel P J van den Bekerom, Denise Eygendaal
Background: Diagnosing capitellar osteochondritis dissecans (OCD) can be difficult, causing delay in treating young athletes. The main aim of this retrospective diagnostic study was to determine which radiological technique is preferred to identify and classify elbow OCD. Methods: We identified young patients who underwent elbow arthroscopy because of symptomatic OCD. We included all patients who had pre-operative radiographs, a computed tomography (CT) scan and magnetic resonance imaging (MRI) available...
April 2019: Shoulder & Elbow
Alessandro Castagna, Raffaele Garofalo
Anatomic total shoulder arthroplasty (TSR) has been shown to generate good to excellent results for patients with osteoarthritis and a functioning rotator cuff. Many studies have reported that the glenoid component loosening and failure remain the most common long-term complication of total shoulder arthroplasty. The approach to glenoid component is critical because a surgeon should consider patient-specific anatomy, preserving bone stock and joint line restoration, for a good and durable shoulder function...
April 2019: Shoulder & Elbow
Hassan M T Fawi, Stefan Dojcinov, Kathleen Lyons, Timothy J W Matthews
We report the case of a middle-age lady who presented following minor trauma, with dominant-sided anterior elbow pain and swelling of 6 months in duration. She was assessed clinically, and underwent investigations, which confirmed features consistent with giant cell tumour (GCT) of distal biceps tendon sheath. She underwent uneventful en-bloc excisional surgery. She did not have radiotherapy. She is now 5 years postoperatively asymptomatic, with full function, and with no signs of recurrence.
April 2019: Shoulder & Elbow
Anne Couture, Jonah Hébert-Davies, Julien Chapleau, G Yves Laflamme, Emilie Sandman, Dominique M Rouleau
Background: Partial radial head fractures (PRHF) can involve the proximal radioulnar joint (PRUJ) or be restricted to the 'safe zone' (SZ) during forearm rotation. The objective of the present study was to develop an assessment method for PRUJ involvement in radial head fractures using axial computed tomography (CT) scans. Methods: The area of the radial head in contact with the PRUJ zone was identified, and defined on 18 cadaveric elbows CT scans; the quantitative relationship between PRUJ zone and radial tuberosity was established...
April 2019: Shoulder & Elbow
Jeremy S Somerson, Matthew R Boylan, Kevin T Hug, Qais Naziri, Carl B Paulino, Jerry I Huang
Background: For patients undergoing total elbow arthroplasty (TEA), the present study aimed to investigate: (i) what risk factors are associated with periprosthetic elbow infection; (ii) what is the incidence of infection after TEA; and (iii) what is the acuity with which these infections present? Methods: The Statewide Planning and Research Cooperative System database was used to identify all patients who underwent TEA between 2003 and 2012 in New York State. Admissions for prosthetic joint infection (PJI) were identified using ICD-9 (International Classification of Diseases, Ninth Revision, Clinical Modification) diagnosis code 996...
April 2019: Shoulder & Elbow
Aritri Mandal, Madhavan C Papanna, Richard Bryant
We report a case of 30-year-old lady presenting with a suprascapular nerve (SSN) injury in the postpartum period. Two days following normal delivery, the patient experienced progressive weakness in her left shoulder, of spontaneous onset. Initially thought to be a rotator cuff tear, further imaging indicated a lesion in the SSN. Isolated SSN palsy is a rare occurrence. Previously reported cases of brachial plexus nerve injuries are due to trauma, traction, iatrogenic and the positioning of the patient during surgery...
April 2019: Shoulder & Elbow
Max Rogerio Freitas Ramos, Yonder Archanjo Ching San Junior, Luiz Henrique Pereira Alves, Flavio Carvalho Cruz, Henrique Mansur
Background: To evaluate the reliability of the Bare Spot (BS) as an anatomical landmark for the intra-operative definition of bone loss in anterior shoulder instability. Methods: The distances from the BS to the anterior (BS-A), posterior (BS-P) and inferior margins of the glenoid cavity were determined both under arthroscopic visualization and by an open approach in 20 shoulders. Results: The BS did not coincide with the centre of the glenoid cavity of the studied shoulders because the BS-P distance was greater than the BS-A distance ( p  < 0...
April 2019: Shoulder & Elbow
Simon B M MacLean, Joideep Phadnis, Chi M Ling, Gregory I Bain
Background: Chlorhexidine as a skin surface antiseptic has been shown to be ineffective with respect to reducing Proprionibacterium acnes colonization within the dermis. The purpose of the present study was to determine whether the application of aqueous chlorhexidine solution to the dermal layer decreased P. acnes colonization during open shoulder surgery. Methods: The present study enrolled 50 patients who were undergoing open shoulder surgery. Patients received standard antimicrobial preparation...
April 2019: Shoulder & Elbow
Saqib Javed, Puneet Monga, Linda Hallam, Emma Torrance, Lennard Funk
Rupture of the pectoralis major remains an infrequent injury, although, recently, it has been reported more commonly as a result of the expansion and increasing popularity of competitive sports, as well as developments in sports medicine. A number of surgical repair techniques have been described for direct repair in the acute setting. However, on occasion, the pectoralis major muscle is so retracted that a tension-free direct repair is not possible. We describe a technique for allograft reconstruction of the pectoralis major, with our preliminary outcomes, where it is found or anticipated that a direct repair is not possible...
April 2019: Shoulder & Elbow
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