Manguito Rotador

Fatty degeneration is an important clinical factor in patients with rotator cuff tears. Goutallier grade, occupation ratio, and tangent sign help identify fatty degeneration; however, little is known about how closely these measurement techniques correlate with actual muscle strength deficits. The authors evaluated each method's ability to determine the correlation between fatty degeneration and muscle strength deficits. The authors included 203 patients who underwent full-thickness rotator cuff repair (mean age, 61...

Many radiologists are familiar with the preoperative imaging assessment of patients with labral tears, rotator cuff abnormalities, and end-stage arthritis, as well as the subsequent primary reconstructions and repairs commonly encountered in routine clinical management. However, the second-line surgical procedures and augmentation procedures performed for refractory or recurrent shoulder instability and the extra-articular surgical procedures of the shoulder girdle may challenge even the most experienced musculoskeletal radiologist...

BACKGROUND: The optimal technique for arthroscopic rotator cuff repair is controversial, and both single and double-row techniques are commonly used. In the current era of increasing costs, health-care delivery models are focusing on the value of care. In this study, we compared the cost-effectiveness of single-row and double-row reconstructions in patients undergoing arthroscopic rotator cuff repair. METHODS: A cost-utility analysis was performed from the perspective of a publicly funded health-care system...

OBJECTIVE: The aim of this study was to compare the microarchitecture of the greater tuberosity with or without rotator cuff tear and to obtain optimum location for anchor screw insertion for rotator cuff repair. METHODS: Twenty-five humeral heads were harvested from 13 male cadavers of mean age 58.4 years, including 6 humeri with rotator cuff tear and 19 intact humeri. Six regions of interest (proximal, intermediate, and distal zones of the superficial and deep regions) were divided into the anterior (G1), middle (G2), and posterior (G3) areas of the greater tuberosity...

BACKGROUND: Massive rotator cuff tears (MRCTs) represent a major clinical concern, especially when degeneration and chronicity are involved, which highly compromise healing capacity. PURPOSE: To study the effect of the secretome of mesenchymal stem cells (MSCs) on tendon cells (TCs) followed by the combination of these activated TCs with an electrospun keratin-based scaffold to develop a tissue engineering strategy to improve tendon-bone interface (TBi) healing in a chronic MRCT rat model...

BACKGROUND: This study prospectively examined the relationship of direct and indirect measures of shoulder activity with the risks of tear progression and pain development in subjects with an asymptomatic degenerative rotator cuff tear. METHODS: A cohort of asymptomatic degenerative rotator cuff tears was prospectively monitored annually, documenting tear size progression with ultrasound imaging and potential shoulder pain development. Shoulder activity level, self-reported occupational and physical demand level, and hand dominance were compared with risks of tear enlargement and future pain development...

BACKGROUND: There have been numerous reports of clinical outcomes associated with tendon healing after repair that suggest a nonhealed tendon has a negative effect on postoperative clinical outcomes. However, to our knowledge, there has been no report on the relationship between tear size progression of nonhealed tendons and clinical outcomes. QUESTIONS/PURPOSES: (1) Do patients with healed arthroscopic rotator cuff repairs have better outcomes, less pain, and more strength than patients whose repair did not heal? (2) In patients with nonhealed rotator cuff tendons, does tear size progression (increase or decrease) affect outcomes, pain, and strength? (3) Is there continued improvement beyond 6 months in outcomes, pain, and strength; and how do the improvements differ based on whether the tear size has increased or decreased? METHODS: Between May 2008 and December 2012, 647 patients underwent arthroscopic rotator cuff repair for full-thickness tears at our institution...

BACKGROUND: The treatment effect of acromioplasty for chronic subacromial pain syndrome (SAPS) on long-term shoulder function and rotator cuff deterioration has still to be determined. This study aimed to determine the long-term clinical and radiologic treatment effect of arthroscopic acromioplasty in patients with chronic SAPS. METHODS: In this double-blind, randomized clinical trial, 56 patients with chronic SAPS (median age, 47 years; age range, 31-60 years) were randomly allocated to arthroscopic bursectomy alone or to bursectomy combined with acromioplasty and were followed up for a median of 12 years...

This study evaluated dorsal root ganglia from C3-C7, analyzed gait, and compared the expression of calcitonin gene-related peptide (CGRP) which was a marker of inflammatory pain in a rat rotator cuff tear model in which the supraspinatus and infraspinatus tendons were detached; comparisons were made to a sham group in which only the tendons were exposed. Fluorogold was injected into the glenohumeral joint 21 days after surgery in both groups, and saline, steroids, or hyaluronic acid was injected into the glenohumeral joint in the rotator cuff tear group 26 days after surgery...

BACKGROUND: Degenerative changes and inflammation in the rotator cuff (RC) are the most important causes of shoulder pain. The aim of the present study was to determine the effectiveness of platelet-rich plasma (PRP) in patients with chronic RC tendinopathy. MATERIALS AND METHODS: This study was an open-label study performed at Kashani Hospital between April 2012 and June 2014. Patients with a <1 cm partial tearing of the bursal side of RC with no or little response to conservative management were included...

Bone marrow aspirate concentrates (BMACs) and platelet-rich plasma (PRP) are good sources to control the differentiation of tendon-derived stem cells (TDSCs), but there has been no study about the effect of the BMAC-PRP complex on TDSCs and tendinopathy. The aim of this study was to investigate the effect of BMAC-PRP on the TDSCs and to find the therapeutic effect of BMAC-PRP on the rotator cuff tendon tear. The chondrogenic and osteogenic potential of TDSCs decreased, but the adipogenic potential of TDSCs revealed no significant difference when they were cocultured with BMAC-PRP...

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...

BACKGROUND: Reports of glenohumeral chondrolysis following arthroscopy have raised concern about the deleterious effects that thermal devices may have on articular cartilage. The purpose of this study was to investigate the effects of flow and duration of treatment with a thermal device on temperatures within cadaveric glenohumeral joint specimens. It was hypothesized that the use of a thermal device during surgery increases the temperature of fluid within the joint to >45 degrees C, which has been shown to cause chondrocyte death...

BACKGROUND: Fatty degeneration of the cuff muscles is usually evaluated at the Y-view in oblique sagittal images. It was recently proposed that muscle shift after repair may influence the fatty degeneration values, and the evaluation of the muscles at a more medial site was recommended. However, the differences in muscle quality in accord with measurement sites have been unclear. Here we evaluated differences in fatty degeneration of the rotator cuff muscles measured quantitatively at different sites, using T2 mapping...

The aim of this study was to document the incidence of postoperative shoulder stiffness (SS) after arthroscopic rotator cuff repair and evaluate the role of risk factors for its development. Seventy-five consecutive patients that underwent arthroscopic rotator cuff repair were included. The incidence of postoperative SS was prospectively investigated and the presence of 20 potential risk factors was documented retrospectively. The incidence of post-operative SS was 10.4%. All patients were women, and sex was significantly associated to pathology development (p=0...

We wanted to observe and compare the appearance of neurovascular tissue from tendon ex vivo, in patients with and without painful rotator cuff tendinopathy. Supraspinatus tendons were biopsied from 5 participants with painful tendinopathy and normal tendon from a young male. Slides were stained with haematoxylin and eosin and toluidine blue for histological assessment. Immunohistochemical markers for general nerves (protein gene-product 9.5 and synaptophysin), sensory nerves (calcitonin gene-related peptide; substance-P) and vascularisation (vascular endothelial growth factor) were used...

The incidence of arthroscopic rotator cuff repair (RCR) continues to rise. Given the changing healthcare climate, it is becoming increasingly important to critically evaluate current practice and attempt to make modifications that decrease costs without compromising patient outcomes. We conducted a study of the costs associated with arthroscopic anchorless (transosseous [TO]) RCR and those associated with the more commonly performed anchor-based TO-equivalent (TOE) method to determine whether there are any cost savings with the TO-RCR method...

BACKGROUND: Platelet-rich plasma (PRP) has the potential to improve tendon-bone healing. The evidence is still controversial as to whether PRP application after repair of medium-sized to large cuff tears leads to superior structural and clinical outcome, especially after single-row repair. METHODS: In a randomized study, 102 patients (PRP group, 52 patients; control group, 50 patients) with medium-sized and large degenerative posterosuperior tears were included for arthroscopic repair with a minimum follow-up of 2 years...

PURPOSE: To analyze and compare the gene and protein expression characteristics in torn rotator cuff tendon tissues between diabetic and nondiabetic patients. METHODS: This was a pilot study. Twelve samples of rotator cuff tendon tissue from diabetic patients (mean age, 62.3 ± 9.9 years) and 12 age- and sex-matched nondiabetic tendon tissues (62.3 ± 9.9 years) were acquired from the torn tendon end of medium rotator cuff tears during arthroscopic surgery, after applying the same inclusion and exclusion criteria...

BACKGROUND: Recent studies have confirmed the existence of neuropathic pain (NeP) components in patients with musculoskeletal disorders. However, the presence of NeP in patients with rotator cuff tears has not been investigated thus far. Therefore, we studied the prevalence of NeP and the prognostic factors for NeP in patients with rotator cuff tears. METHODS: Data were collected from 110 patients with rotator cuff tears, diagnosed by physical examination and magnetic resonance imaging, who attended an outpatient clinic between August 2013 and August 2014...