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https://read.qxmd.com/read/30782436/factors-associated-with-the-cost-of-care-for-the-most-common-atraumatic-painful-upper-extremity-conditions
#1
Tom J Crijns, David Ring, Victoria Valencia
PURPOSE: To help strategize efforts to optimize value (relative improvement in health for resources invested), we analyzed the factors associated with the cost of care and use of resources for painful, nontraumatic conditions of the upper extremity. METHODS: The following were the most common upper extremity diagnoses in the Truven Health MarketScan database: shoulder pain and rotator cuff tendinopathy, shoulder stiffness, shoulder arthritis, lateral epicondylitis, hand arthritis, trigger finger, wrist pain, and hand pain...
February 16, 2019: Journal of Hand Surgery
https://read.qxmd.com/read/30777107/clinical-outcomes-and-complications-of-cementless-reverse-total-shoulder-arthroplasty-during-the-early-learning-curve-period
#2
Sungwook Choi, Jong-Hwan Bae, Yong Suk Kwon, Hyunseong Kang
BACKGROUND: Reverse total shoulder arthroplasty (RTSA) is a treatment option for patients with severe osteoarthritis, rotator cuff arthropathy, or massive rotator cuff tear with pseudoparalysis. We are to deduce not only the early functional outcomes and complications of cementless RTSA during the learning curve period but also complication-based, and operation time-based learning curve of RTSA. METHODS: Between March 2010 and February 2014, we retrospectively evaluated 38 shoulders (6 male, 32 female)...
February 18, 2019: Journal of Orthopaedic Surgery and Research
https://read.qxmd.com/read/30775132/open-reduction-and-internal-fixation-with-a-locking-plate-via-deltopectoral-approach-for-the-treatment-of-three-and-four-part-and-proximal-humeral-fractures
#3
Jonathan Heath Thompson, Basem Attum, Andres Rodriguez-Buitrago, Kurt Yusi, Cesar Cereijo, William T Obremskey
Open reduction and internal fixation (ORIF) via the deltopectoral approach is the gold standard for operatively treated proximal humeral fractures when joint preservation is desired. Indications include an unacceptable deformity, need for stability and early mobilization, and osteoporotic bone. (1) A 12 to 14-cm incision is made in the deltopectoral groove. The fracture is reduced. (2) Pins and tension sutures are placed for provisional fixation. (3) The locking plate is placed with unicortical screws in the metaphysis of the proximal part of the humerus and bicortical screws in the shaft...
December 26, 2018: JBJS Essential Surgical Techniques
https://read.qxmd.com/read/30773441/can-a-functional-difference-be-detected-in-reverse-arthroplasty-with-135%C3%A2-versus-155%C3%A2-prosthesis-for-the-treatment-of-rotator-cuff-arthropathy-a-prospective-randomized-study
#4
Reuben Gobezie, Yousef Shishani, Evan Lederman, Patrick J Denard
BACKGROUND: The purpose of this randomized controlled trial was to compare humeral inclinations of 135° and 155° in patients undergoing primary reverse shoulder arthroplasty (RSA). Our hypothesis was that forward flexion would be higher in the 155° group but be associated with a higher rate of scapular notching. METHODS: A randomized controlled trial was conducted on 100 primary RSAs performed with a humeral inclination of either 135° or 155°. The prostheses were otherwise identical and a neutral glenosphere was used in all cases...
February 14, 2019: Journal of Shoulder and Elbow Surgery
https://read.qxmd.com/read/30770957/an-intact-subscapularis-tendon-and-compensatory-teres-minor-hypertrophy-yield-lower-failure-rates-for-non-operative-treatment-of-irreparable-massive-rotator-cuff-tears
#5
Tae-Hwan Yoon, Sung-Jae Kim, Chong-Hyuk Choi, Soon-Phil Yoon, Yong-Min Chun
PURPOSE: To investigate whether subscapularis integrity and compensatory teres, minor hypertrophy is associated with maintaining relatively good function and tolerable pain levels during non-operative treatment. METHODS: This study included 108 patients with irreparable, massive rotator cuff tears involving at least two tendons and stage III or IV muscle hypotrophy and fatty infiltration on oblique sagittal magnetic resonance imaging, in which even a partial repair does not seem feasible...
February 15, 2019: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://read.qxmd.com/read/30770421/ultrasound-guided-percutaneous-peripheral-nerve-stimulation-neuromodulation-of-the-suprascapular-nerve-and-brachial-plexus-for-postoperative-analgesia-following-ambulatory-rotator-cuff-repair-a-proof-of-concept-study
#6
Brian M Ilfeld, John J Finneran, Rodney A Gabriel, Engy T Said, Patrick L Nguyen, Wendy B Abramson, Bahareh Khatibi, Jacklynn F Sztain, Matthew W Swisher, Pia Jaeger, Dana C Covey, Matthew J Meunier, Eric R Hentzen, Catherine M Robertson
BACKGROUND AND OBJECTIVES: Percutaneous peripheral nerve stimulation (PNS) is an analgesic modality involving the insertion of a lead through an introducing needle followed by the delivery of electric current. This modality has been reported to treat chronic pain as well as postoperative pain following knee and foot surgery. However, it remains unknown if this analgesic technique may be used in ambulatory patients following upper extremity surgery. The purpose of this proof-of-concept study was to investigate various lead implantation locations and evaluate the feasibility of using percutaneous brachial plexus PNS to treat surgical pain following ambulatory rotator cuff repair in the immediate postoperative period...
February 15, 2019: Regional Anesthesia and Pain Medicine
https://read.qxmd.com/read/30770212/do-we-need-to-stabilize-and-treat-the-os-acromiale-when-performing-reverse-shoulder-arthroplasty
#7
Ali Erşen, Serkan Bayram, Ata Can Atalar, Mehmet Demirhan
INTRODUCTION: The purpose of this study is to investigate the incidence of os acromiale in patients who had reverse shoulder arthroplasty (RSA) for rotator cuff tear arthropathy and the effect of presence of os acromiale on the functional results. HYPOTHESIS: We hypothesize than in the presence of os acromiale, the contraction strength of the deltoid would decrease due to the dynamic downward depression of the bony fragment leading to less favorable clinical results...
February 12, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://read.qxmd.com/read/30766643/ultrasound-guided-biodegradable-subacromial-spacer-implantation-in-a-patient-with-massive-irreparable-rotator-cuff-tears
#8
Tomasz Poboży, Maciej Kielar, Jakub Miąskiewicz
The aim of this manuscript is to present a modification of the current arthroscopic implantation technique of a biodegradable subacromial spacer. This modified ultrasound-guided technique was intended to maximally reduce the invasiveness of the procedure. The ultrasound technique was used to measure the subacromial space for an optimal fit and to verify subacromial spacer placement in the sagittal and frontal planes. This finding is of particular importance for patients with contraindications to general or regional anesthesia...
January 2019: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://read.qxmd.com/read/30766638/assessment-of-ultrasonography-as-a-diagnostic-tool-in-shoulder-pain-and-alterations-in-glenohumeral-range-of-motion-in-tennis-players
#9
Krzysztof Guzowski, Artur Stolarczyk, Zbigniew Czyrny, Anna Dębek, Bernard Kranc
Introduction: Shoulder pain and alterations in the range of motion are common disorders in tennis players. However, the relation between shoulder structures and these conditions is unknown. Aim: To evaluate whether, using ultrasonography, one can identify tennis players with shoulder pain and those having specific changes of the range of rotation of the glenohumeral joint. Material and methods: A total of 66 subjects were assessed through examination of the range of rotation of the glenohumeral joint and ultrasonography...
January 2019: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://read.qxmd.com/read/30765311/an-arthroscopic-technique-for-full-thickness-rotator-cuff-repair-by-transposition-of-the-long-head-of-biceps
#10
Jian Lin, Weihui Qi, Zhongtang Liu, Kai Chen, Xiaobin Li, Yingzhao Yan, Xinxian Xu, Xinghe Xue, Yang Yang, Xiaoyun Pan
Arthroscopic rotator cuff (RC) repair is now considered as an effective treatment for patients with symptomatic rotator cuff tears. We reported a new method for repairing a full-thickness RC tear by using the double-row technique with transposition of the long head of biceps (LHB). The novelty of this technique is using the long head of the biceps as an augmentation. The indication of this technique consists of two aspects including LHB lesions and RC tears. Three patients were enrolled. An ideal reconstruction of the anatomic footprint of the tendon and stabilization of glenohumeral joint was achieved after the double-row technique with the transposition of the long head of biceps...
February 11, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://read.qxmd.com/read/30762320/which-nostril-should-be-used-for-nasotracheal-intubation-with-airtraq-nt%C3%A2-the-right-or-left-a-randomized-clinical-trial
#11
Zehra İpek Arslan, Zehra Türkyılmaz
Background/aim: Nasotracheal Airtraq is specifically designed to improve the glottis view and ease the nasotracheal intubation process in normal and difficult cases. Materials and methods: After Ethics committee approval, we decided to enroll 40 patients with an ASA physical status of I or II, between 18 and 70 years of age undergoing elective maxillofascial, oral, and double chin surgery to determine which nostril is more suitable for nasotracheal intubation with nasotracheal Airtraq...
February 11, 2019: Turkish Journal of Medical Sciences
https://read.qxmd.com/read/30758977/the-timing-of-corticosteroid-injections-after-arthroscopic-shoulder-procedures-affects-postoperative-infection-risk
#12
Michelle E Kew, Jourdan M Cancienne, James E Christensen, Brian C Werner
BACKGROUND: Corticosteroid injections are sometimes used in the postoperative period after shoulder arthroscopy; however, a well-defined safety profile has not been established. PURPOSE: To examine the association between the timing of postoperative corticosteroid injections and rates of infection after shoulder arthroscopy. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Private payer and Medicare national insurance databases were queried for patients who underwent arthroscopic rotator cuff repair, debridement, or subacromial decompression...
February 13, 2019: American Journal of Sports Medicine
https://read.qxmd.com/read/30755039/n-acetylcysteine-reduces-glutamate-induced-cytotoxicity-to-fibroblasts-of-rat-supraspinatus-tendons
#13
Ra Jeong Kim, Young-Sool Hah, Ji-Yong Gwark, Hyung Bin Park
PURPOSE: Neuronal theory regarding rotator cuff degeneration has developed from the findings that glutamate, an amino acid and an excitatory neurotransmitter, is present in increased concentrations in tendon tissues with tendinopathy and that glutamate induces cell death in fibroblasts of origin in rat supraspinatus tendon. The purpose of the current study was to determine whether N-acetylcysteine (NAC) has cytoprotective effects against glutamate-induced fibroblast death. MATERIALS AND METHODS: Primary cultured fibroblasts were obtained from rat supraspinatus tendons...
February 12, 2019: Connective Tissue Research
https://read.qxmd.com/read/30747435/augmentation-of-chronic-rotator-cuff-healing-using-adipose-derived-stem-cell-seeded-human-tendon-derived-hydrogel
#14
Yukitoshi Kaizawa, Austin Franklin, Jacinta Leyden, Anthony W Behn, U Serdar Tulu, Daniel Leon, Zhen Wang, Geoffrey D Abrams, James Chang, Paige M Fox
Rotator cuff (RTC) repair outcomes are unsatisfactory due to the poor healing capacity of the tendon bone interface (TBI). In our preceding study, tendon hydrogel (tHG), which is a type I collagen rich gel derived from human tendons, improved biomechanical properties of the TBI in a rat chronic RTC injury model. Here we investigated whether adipose-derived stem cell (ASC)-seeded tHG injection at the repair site would further improve RTC healing. Rats underwent bilateral supraspinatus tendon detachment. Eight weeks later injured supraspinatus tendons were repaired with one of four treatments...
February 12, 2019: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://read.qxmd.com/read/30746301/treatment-of-rotator-cuff-tendinopathy-as-a-contractile-dysfunction-a-clinical-commentary
#15
Guido Spargoli
Background and purpose: Rotator cuff (RC) tendinopathy is a common disorder affecting many individuals, both in athletic and sedentary settings. Etiology of RC pathology or the most effective conservative treatment are not totally understood. The Mechanical Diagnosis and Treatment (MDT®) method is a widely known rehabilitative technique that allows therapists to diagnose and treat spinal, and peripheral mechanical disorders. Therefore, the purpose of this clinical commentary is to briefly describe RC tendinopathy, and its management using the MDT® method...
February 2019: International Journal of Sports Physical Therapy
https://read.qxmd.com/read/30746294/neuromuscular-adaptions-following-a-daily-strengthening-exercise-in-individuals-with-rotator-cuff-related-shoulder-pain-a-pilot-case-control-study
#16
Amee L Seitz, Lisa A Podlecki, Emily R Melton, Tim L Uhl
Background: The goal of therapeutic exercise is to facilitate a neuromuscular response by increasing or decreasing muscular activity in order to reduce pain and improve function. It is not clear what dosage of exercise will create a neuromuscular response. Purpose: The purpose of this study was to assess the effects following a three-week home program of a daily single exercise, the prone horizontal abduction exercise (PHA), on neuromuscular impairments of motor control as measured by scapular muscle EMG amplitudes, strength, and secondarily outcomes of self-reported pain and function between individuals with and without subacromial pain syndrome...
February 2019: International Journal of Sports Physical Therapy
https://read.qxmd.com/read/30744304/diagnostic-accuracy-of-ultrasound-for-rotator-cuff-tears
#17
Kelechi R Okoroha, Mohsin S Fidai, Joseph S Tramer, Kayla D Davis, Patricia A Kolowich
Ultrasonography (US) is an inexpensive, convenient, and effective tool that can be used to evaluate the shoulder. It does not expose the patient to harmful radiation and can be used to evaluate the musculoskeletal system dynamically. Additionally, US is not subject to metal artifacts when evaluating patients with previously placed hardware. Over the years, US has been found to be reliable and accurate for diagnosing rotator cuff tears (RCTs), despite its operator-dependence. The usage of US for diagnosing RCTs in orthopedic practice varies depending on practitioners' familiarity with the exam and the availability of experienced technicians...
November 17, 2018: Ultrasonography
https://read.qxmd.com/read/30740373/a-rare-cause-of-compression-of-the-suprascapular-nerve-the-paraglenoid-cyst
#18
Sabri Mahjoub, Ahmed Amine Lahmar, Mourad Zarâa, Belhadj Massoud Ahmed, Mohamed Abdelkafi, Mondher Mbarek
Introduction: The ductal syndromes of the shoulder combine all the compressive processes of the suprascapular nerve at the level of its passage in the spinoglenoid notch and this for several causes. The most common is a lesion of the labrum resulting in the formation of a cyst. These cysts are rare and often underestimated. Provoking a compression of the suprascapular nerve, they are likely to cause an atrophy of the external rotator muscles of the cuff. Case Report: We present a rare case of a paraglenoid cyst resulting in a ductal syndrome by suprascapular nerve compression...
September 2018: Journal of Orthopaedic Case Reports
https://read.qxmd.com/read/30740365/unusual-case-of-a-volleyball-athlete-presenting-with-posterior-shoulder-pain-and-infraspinatus-muscle-wasting
#19
Tan Shi Ming, Lim Dao Min, Tan HweeChye Andrew
Introduction: Entrapment of the suprascapular nerve is an uncommon but important differential in patients who present with posterior shoulder pain. Frequently misdiagnosed as rotator cuff or cervical disc disease, this increasingly recognized entity can result from traction-related or compression-related etiology. Two sites of compression include the suprascapular and spinoglenoid notches with the latter less commonly encountered. Case Report: In our study, we describe a case of arthroscopic decompression of suprascapular nerve entrapment at the spinoglenoid notch due to hypertrophied spinoglenoid ligament using an improvised arthroscopic technique...
September 2018: Journal of Orthopaedic Case Reports
https://read.qxmd.com/read/30739762/influence-of-sutures-configuration-on-the-strength-of-tendon-patch-joints-for-rotator-cuff-tears-treatment
#20
Tommaso Ingrassia, Benedetto Lombardo, Vincenzo Nigrelli, Vito Ricotta, Lorenzo Nalbone, Antonio D'Arienzo, Michele D'Arienzo, Giuseppe Porcellini
PURPOSE: Massive rotator cuff tears are common in the aging population. The incidence of failed rotator cuff repairs is still quite high, especially in the treatment of full-thickness tears or revision repairs. In this context, natural and synthetic meshes can be used as augmentation scaffolds or as devices to close the gap between a retracted tendon and the bone. The purpose of this work is to evaluate the ultimate tensile strength of different tendon-patch joints in order to consider their use in the treatment of massive cuff tears...
February 2, 2019: Injury
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