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1.
Mehmet Cetinkaya Muhammet Baybars Ataoglu Mustafa Ozer Tacettin Ayanoglu Ali Yusuf Oner Ulunay Kanatli 《Acta orthopaedica et traumatologica turcica》2018,52(2):109-114
Objectives
The aim of this study was to analyse the effect of subscapularis tear on superior humeral excursion (SHE) and acromiohumeral distance (AHD). The hypothesis was that subscapularis tears do not result in superior humeral excursion.Methods
Patients who underwent shoulder arthroscopy between August of 2011 and 2015 were reevaluated. Those with isolated Bankart lesion were used as control group and included in the Group 1, isolated full-thickness supraspinatus tear in the Group 2, isolated subscapularis tear in the Group 3, and combined subscapularis and supraspinatus tear in the Group 4. The mean SHE and AHD measurements on magnetic resonance imaging of these groups were compared to reveal any difference in superior humeral migration (SHM).Results
There were 30 patients in each group. The mean age of Group 1 (26.44 ± 8.34) was younger than the other 3 groups. The mean AHD and SHE were higher in Group 1 and 3 (Mean AHD: 12.89 ± 2.24 and 12.28 ± 1.9, respectively. Mean SHE: ?3.2 ± 0.99 and ?2.78 ± 0.64, respectively) than Group 2 and 4 (Mean AHD: 6.2 ± 1.78 and 6.16 ± 1.52, respectively. Mean SHE: 0.72 ± 0.65 and 1.24 ± 0.63, respectively). The AHD and SHE were strongly correlated with each other (Pearson correlation coefficient = 0.184). The inter-observer and intra-observer correlation of the measurements of SHE on MRI were excellent with intraclass correlation coefficient of 0.95 and 0.94, respectively.Conclusion
Subscapularis tears do not lead to SHM and subacromial impingement. However, superior rotator cuff tears can still lead to SHM and subacromial impingement even when subscapularis tendon is intact.Level of evidence
Level III, diagnostic study. 相似文献2.
Yasuhito Sasaki Nobuyasu Ochiai Eiko Hashimoto Yu Sasaki Takeshi Yamaguchi Takehiro Kijima Koji Akimoto Seiji Ohtori Kazuhisa Takahashi 《Journal of orthopaedic science》2018,23(2):414-419
Background
Rotator cuff tears are believed to coexist with cervical spine lesions. In cases of preexisting neuropathy, such as cervical spine lesions, fatty degeneration has likely already occurred due to the neuropathy. In these cases, rotator cuff tear is thought to occur easily because of preexisting extensive fatty degeneration and degeneration of the tendons due to neuropathy. This study aimed to evaluate the effects of paralysis due to neuropathy proximal to the suprascapular nerve on the supraspinatus and infraspinatus tendons using a rat model of brachial plexus paralysis.Methods
This study included fifteen, 8-week-old Sprague–Dawley rats. The left shoulder was included in the paralysis group and the contralateral shoulder constituted the sham group. Biomechanical testing (evaluated maximum tear force, maximum displacement and Young's modulus) (n = 10) and histological analyses (n = 5) (using the Bonar scale) were performed at 12 weeks postoperatively to confirm the degeneration of the tendon.Results
The mean maximum tear force was significantly lower in the paralysis group than in the sham group (P = 0.008), indicating that rotator cuff tears occurred with a lower force in the paralysis group. Additionally, the average Young's modulus was significantly greater in the paralysis group than in the sham group (P = 0.003), indicating that the rotator cuff muscle became hard and inflexible in the paralysis group. The Bonar scales of the histological analyses were significantly higher in the paralysis group (total score = 7.04 ± 0.61) than the sham group (total score = 0) (p < 0.0001).Conclusions
If neuropathy of proximal to the suprascapular nerve, such as cervical spine or brachial plexus lesion, exists, weakness and degeneration of the rotator cuff tendon and stiffness of the rotator cuff muscle develop. Neuropathy is likely a cause of rotator cuff tears. 相似文献3.
Toru Morihara Yoshikazu Kida Ryuhei Furukawa Tsuyoshi Sukenari Yukichi Kabuto Masao Kurokawa Hiroyoshi Fujiwara Toshikazu Kubo 《Journal of orthopaedic science》2018,23(3):495-503
Background
In cases of the large or massive rotator cuff tears, retear rates after rotator cuff repairs remain high. We introduced an arthroscopic-assisted modified Debeyre-Patte procedure which enables to decrease the tension of torn rotator cuff by sliding supraspinatus and infraspinatus laterally keeping fascia connection to the rhomboids.Purpose
The objective of this study was to examine the clinical outcomes and retear rates after an arthroscopic-assisted modified Debeyre-Patte procedure for irreparable large and massive rotator cuff tears.Methods
Thirty-three rotator cuff tear patients (34 shoulders) were selected. These patients underwent arthroscopic-assisted modified Debeyre-Patte procedures and were observed postoperatively for at least 24 months. Magnetic resonance imaging (MRI) was used to evaluate the preoperative location of the torn rotator cuff stump and fatty infiltration of the muscles composing the rotator cuff, as well as the repaired rotator cuffs. Shoulder functional evaluations through the use of the Constant and Murley scores and the University of California Los Angeles (UCLA) shoulder score were compared before and after surgery, and the preoperative global fatty degeneration index (GFDI) was compared between retear and healed shoulders.Results
MRI showed that 77% of shoulders were healed and 23% exhibited retear postoperatively. The mean preoperative GFDI was 1.99 among the 26 healed shoulders and 2.54 among the 8 retear shoulders (p < .05). When the Goutallier's classification was grade 3 or lower for all 3 cuff muscles for fatty infiltration, the retear rate was 14.3%. The mean Constant and Murley scores in healed and retear groups respectively improved from 34.7 ± 15.8, 30.0 ± 15.1 points (p = 0.47) preoperatively to 70.8 ± 8.3, 53.9 ± 14.0 points (p < .001), and UCLA scores in healed and retear groups from 13.8 ± 3.9, 12.4 ± 5.0 points (p = 0.46) preoperatively to 32.8 ± 2.7, 28.4 ± 3.6 points (p < .001).Conclusion
The clinical outcomes of healed shoulders after the arthroscopic-assisted modified Debeyre-Patte procedure were favorable. If the torn rotator cuff stump is retracted near the glenoid fossa, and the rotator cuff muscle scored Goutallier grade 3 or lower, this modified Debeyre-Patte procedure would be a viable option. 相似文献4.
R. Narasimhan K. Shamse C. Nash D. Dhingra S. Kennedy 《International orthopaedics》2016,40(5):975-979
Purpose
Subscapularis tears can be difficult to diagnose and their treatment requires advanced arthroscopic skills. The objective of this study was to find the prevalence of subscapularis tears on arthroscopic examination of shoulders with rotator cuff pathology and to determine the accuracy of pre-operative ultrasound in diagnosing these tears.Method
Ultrasound and intra-operative reports of 236 patients who underwent shoulder arthroscopy for rotator cuff pathology by the senior author at his institution were compared. Prevalence of subscapularis tear was noted and classified using Lafosse classification system. Ultrasound reports and intra-operative findings were compared to determine the accuracy, sensitivity and specificity of ultrasound in detecting subscapularis tears.Results
The prevalence of subscapularis tears in patients needing rotator cuff repair was found to be 31.4 %. A total of 6.4 % of patients needing a rotator cuff repair had an isolated subscapularis tear. The sensitivity of ultrasound was 39.5 % and specificity 93.1 % in detection of these tears. The overall accuracy of ultrasound was 75.8 %. Sensitivity of ultrasound was low (42.8 %) for smaller (type 1 and 2) tears and higher (79 %) for larger (types 3, 4, 5) tears. The overall positive predictive value of USS was 73.1 % and negative predictive value 76.4 %.Conclusion
The shoulder surgeon should be skilled in diagnosing and repairing subscapularis tendon tears arthroscopically and cannot completely rely on pre-operative ultrasound scans in ruling out smaller tears as its sensitivity in diagnosing smaller tears is quite low. Unsettling anterior shoulder pain with a normal ultrasound may need further arthroscopic evaluation to rule out missed subscapularis tears.5.
Yuki Iijima Keisuke Matsuki Shota Hoshika Yusuke Ueda Kazutomo Onishi Morihito Tokai Norimasa Takahashi Hiroyuki Sugaya Kazuhiko Dougo Atsuya Watanabe 《Journal of orthopaedic science》2017,22(2):281-284
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.Methods
We assessed 702 shoulders of 675 patients (335 males, 340 females; mean age, 62 years) who underwent MRI including T2 mapping. There were 345 shoulders without rotator cuff tears and 357 shoulders with tears: partial tear = 103 shoulders; small = 63; medium = 94; large = 71; massive = 26. T2 values of the supraspinatus and infraspinatus muscles were measured on the Y-view and on the image that was 15 mm medial to the Y-view.Results
The T2 values at the medial site increased with the tear extent, as did those on the Y-view. There were no significant differences in supraspinatus T2 values between those on the Y-view and at the medial site in all tear size groups except medium and large tears (p = 0.008 and p < 0.001, respectively). There were also no significant differences in infraspinatus T2 values between the two sites in all tear size groups except large tears (p = 0.002). However, the differences were relatively small (2.4–5.6 ms), which were within the standard deviations of the measurements.Conclusions
The T2 values of the supraspinatus and infraspinatus muscles on the Y-view and at 15 mm medial to it were almost identical, with the exception of small differences in the case of larger tears. 相似文献6.
Yu Sasaki Nobuyasu Ochiai Arata Nakajima Takahisa Sasho Tomonori Kenmoku Takeshi Yamaguchi Takehiro Kijima Eiko Hashimoto Yasuhito Sasaki Seiji Ohtori 《Journal of orthopaedic science》2018,23(5):834-841
Background
Rotator cuff tears are the most common shoulder injury, and little is known about the underlying etiology of fatty infiltration after rotator cuff tear. Previous studies speculated that rotator cuff tears lead to neural injury due to tethering of the suprascapular nerve at the notch. This study aimed to evaluate fatty infiltration after suprascapular nerve injury and rotator cuff tears.Methods
Ninety adult male Sprague–Dawley rats were used and were divided into four groups: sham, tendon transection only, suprascapular nerve ligation, and tendon transection plus suprascapular nerve ligation. The suprascapular nerve injury models were created by tying the suprascapular nerve. At 2, 4, and 8 weeks postoperatively, histological analysis and biomechanical testing were performed to evaluate fatty infiltration and elastic change in the supraspinatus muscles.Results
The amount of fatty infiltration in the supraspinatus muscle was significantly higher in both the suprascapular nerve ligation and tendon transection plus suprascapular nerve ligation groups than in the tendon transection only group at 2, 4, and 8 weeks. The ultimate failure load and tensile strength were significantly different among the tendon transection only, suprascapular nerve ligation, and tendon transection plus suprascapular nerve ligation groups at 8 weeks postoperatively. Furthermore, the mean Young's modulus of the muscle was significantly greater in the tendon transection plus suprascapular nerve ligation group than in both the tendon transection only and suprascapular nerve ligation groups at 8 weeks postoperatively.Conclusions
In this study, based on the results of histological and biomechanical examinations in our rat models, the etiology of fatty infiltration after massive rotator cuff tear might be different from the suprascapular nerve injury. 相似文献7.
Tetsutaro Fukuhara Teruhisa Mihata Bong Jae Jun Masashi Neo 《Journal of orthopaedic science》2017,22(5):852-857
Background
Inconsistent tension distribution may decrease the biomechanical properties of the rotator cuff tendon after double-row repair, resulting in repair failure. The purpose of this study was to compare the tension distribution along the repaired rotator cuff tendon among three double-row repair techniques.Methods
In each of 42 fresh-frozen porcine shoulders, a simulated infraspinatus tendon tear was repaired by using 1 of 3 double-row techniques: (1) conventional double-row repair (no bridging suture); (2) transosseous-equivalent repair (bridging suture alone); and (3) compression double-row repair (which combined conventional double-row and bridging sutures). Each specimen underwent cyclic testing at a simulated shoulder abduction angle of 0° or 40° on a material-testing machine. Gap formation and tendon strain were measured during the 1st and 30th cycles. To evaluate tension distribution after cuff repair, difference in gap and tendon strain between the superior and inferior fixations was compared among three double-row techniques.Results
At an abduction angle of 0°, gap formation after either transosseous-equivalent or compression double-row repair was significantly less than that after conventional double-row repair (p < 0.01). During the 30th cycle, both transosseous-equivalent repair (p = 0.02) and compression double-row repair (p = 0.01) at 0° abduction had significantly less difference in gap formation between the superior and inferior fixations than did conventional double-row repair. After the 30th cycle, the difference in longitudinal strain between the superior and inferior fixations at 0° abduction was significantly less with compression double-row repair (2.7% ± 2.4%) than with conventional double-row repair (8.6% ± 5.5%, p = 0.03).Conclusions
Bridging sutures facilitate consistent and secure fixation in double-row rotator cuff repairs, suggesting that bridging sutures may be beneficial for distributing tension equally among all sutures during double-row repair of rotator cuff tears. 相似文献8.
Mehmet Cetinkaya Ali Yusuf Öner Muhammet Baybars Ataoglu Mustafa Ozer Tacettin Ayanoglu Ulunay Kanatli 《Journal of orthopaedic science》2017,22(1):63-68
Background
We aimed to evaluate cysts in the lesser tuberosity of humeral head seen on magnetic resonance imaging (MRI) and their relationship with subcoracoid impingement and subscapularis tears evident on arthroscopic surgery videos. Our hypothesis was that the cysts would be more frequent with subscapularis tears and in the case of subcoracoid impingement.Methods
Patients who underwent shoulder arthroscopy between January 2010 and January 2016 were retrieved to evaluate subscapularis tears on surgery videos and lesser tuberosity cysts (LTC), coracohumeral distances (CHD) on both sagittal oblique and transverse sections of MRI retrospectively. There were 137 patients meeting the study criteria with subscapularis tear evident on surgery video and having preoperatively studied magnetic resonance images. All the tears were classified according to the Lafosse's system. The control group was constituted with 121 patients who underwent shoulder arthroscopy and were diagnosed with no subscapularis tear. Then, any statistically significant relationship between these parameters was investigated by the use of statistics software.Results
The mean age (57), gender distribution (female for 67.1%), and involved shoulder (right for 62.8%) rate of the groups were statistically similar. The existence rate of LTC was 55.5% and 19% for the study and control groups, respectively (P = .000). The study group was then evaluated in two groups regarding the existence of a cyst in the lesser tuberosity. There was no statistical difference between these two groups in terms of coracohumeral distances and tear type (P > .05). The study group was also divided into two depending on the transverse section CHD whether it was under 7 mm or not. There was still no statistical difference between these subgroups in terms of a cyst existence (P > .05). The supraspinatus tear rate and age distribution was also not differing in patients with and without LTC.Conclusions
The LTCs were significantly associated with subscapularis tears, and could be used as an indicator in the interpretation of MRI scans. However, there was no relationship between the subcoracoid impingement and LTCs. 相似文献9.
Yoshihiro Nakamura Shin Yokoya Yohei Harada Katsunori Shiraishi Nobuo Adachi Mitsuo Ochi 《Journal of orthopaedic science》2017,22(4):676-681
Background
The purpose of this study was to evaluate the relationship of fatty infiltration in rotator cuff muscles and shoulder strength in rotator cuff tears and these changes during nonsurgical treatment.Methods
Fifty-three shoulders from 47 patients (mean age: 69.9 years) diagnosed with rotator cuff tears by magnetic resonance imaging (MRI) were treated nonsurgically. The degrees of fatty infiltration in supraspinatus (SSP) and infraspinatus (ISP) muscles were graded by the modified Goutallier classification (grade 0–1, grade 2–3, or grade 4). The isometric strength of the abductors (Abd) and external rotators (ER) were examined with a hand dynamometer. We analyzed the correlation of the modified Goutallier classification in SSP and ISP muscles with the strength of Abd and ER at initial visit. In addition, MRI and strength tests were repeated after 24 ± 6 months, and changes in fatty infiltration and strength were examined.Results
Fatty infiltration of SSP and ISP muscles had a negative correlation with the strengths of Abd and ER at initial visit, respectively. Six of 45 shoulders (SSP grade: 0–3) and 7 of 43 shoulders (ISP grade: 0–3) had progression of fatty infiltration. Predictive factor of a progression of fatty infiltration during follow-up was decreased initial strength of Abd. There was no significant change in the strength of Abd, and the strength of ER showed significant improvement between the initial and post-treatment measurements. Even in the subgroup that had progression of fatty infiltration at follow-up, the strength of Abd and ER did not decrease significantly.Conclusions
Although fatty infiltration of the rotator cuff muscles exhibited a negative correlation with muscle strength, fatty infiltration and muscle weakness did not progress at the same rate. 相似文献10.
Takamitsu Okada Hidehiko Yuge Takeshi Kamitani Takahiro Senju Naohide Takeuchi Koji Sagiyama Naoya Kozono Yoshitaka Nakanishi Hiroshi Honda Yasuharu Nakashima 《Journal of orthopaedic science》2019,24(2):258-262
Background
It is unclear whether smaller rotator cuff tears cause cartilage degeneration. This study was designed to detect early humeral head cartilage degeneration in patients with small-to-medium cuff tears using magnetic-resonance-imaging T1 rho mapping.Methods
Five male and 5 female volunteers without shoulder symptoms (control group) and 5 male and 5 female patients with small-to-medium (<3 cm) rotator cuff tears underwent 3.0-T magnetic resonance imaging of a single shoulder. T1 rho values of the humeral head cartilage were measured and analyzed.Results
The total mean T1 rho value was 40.4 ± 3.4 ms for the control group and 45.0 ± 5.3 ms for the patient group. In the control group, the T1 rho values in the inferior articular cartilage were significantly higher than those in the superior and middle articular cartilage. In the patient group, there was no significant difference between all regions. A comparison between the patient and control groups showed that the mean T1 rho values in the superior-to-middle articular cartilage were significantly higher for the patient group than for the control group. However, in the inferior articular cartilage, there was no significant difference between both groups.Conclusions
This study showed the possibility of early cartilage degenerative changes in the superior-to-middle humeral head articular cartilage of patients with small-to-medium rotator cuff tears. 相似文献11.
Raffaele Garofalo Roberto Calbi Alessandro Castagna Eugenio Cesari Aydin Budeyri Sumant G. Krishnan 《Journal of orthopaedic science》2018,23(5):770-776
Background
Few studies have investigated clinical and structural outcomes after transosseous (TO) repair. The purpose of this study was to compare structural and clinical outcomes of rotator cuff tear, repaired arthroscopically, with a single row (SR) or transossoeus (TO) anchorless technique.Methods
96 patients who underwent an arthroscopic repair for superior or posterosuperior rotator cuff tear using TO (n:54) or a SR (n:42) were retrospectively enrolled in this study after evaluation of clinical and surgical notes. Functional evaluation was performed with the adjusted Constant score, and American Shoulder and Elbow Surgeons (ASES) score. Postoperative cuff integrity was determined through MRI study.Results
Patients were recalled after a minimum follow-up of two years. All the patients were available for the study. In the SR group the Constant rating system showed a significant improvement from a preoperative average rating of 44.8 to an average of 85.7. In the group of TO repair the Constant rating system showed a significant improvement from a preoperative average of 46.1 to an average of 87.6 postoperatively. According to ASES index scores, the average total score improved from 42.8 to 92.0 in the anchor group and from 40.4 to 94.6 in the TO group. There was no statistical difference between the two groups about clinical outcomes. Postoperative MRI revealed no differences in term of complete re-tears between the two techniques. In the SR group at MRI we observe significant more cases of rotator cuff with a Sugaya type III healing.Conclusions
Arthroscopic rotator cuff repair yielded successful clinical outcomes using SR and TO technique. However using the TO technique we saw less type 3 Sugaya readings on MRI suggesting a possible benefit with TO repair.Level of evidence II
Retrospective study. 相似文献12.
Takaki Imai Masafumi Gotoh Tsuyoshi Tokunaga Jyunichi Kawakami Yasuhiro Mitsui Keiji Fukuda Misa Ogino Takahiro Okawa Naoto Shiba 《Journal of orthopaedic science》2017,22(3):438-441
Background
The Japanese Orthopaedic Association shoulder score cutoff values were calculated in patients with rotator cuff repair using the University of California at Los Angeles shoulder score.Methods
Overall, 175 patients with rotator cuff repair were subjects in this study. The University of California at Los Angeles and Japanese Orthopaedic Association shoulder scores were evaluated before surgery and at 3, 6, 9, and 12 months after surgery. The cutoff value of the Japanese Orthopaedic Association shoulder score was determined using the 4-stage criteria of the University of California at Los Angeles shoulder score and a University of California at Los Angeles shoulder score of 28 points, which is the boundary between an excellent/good group and a fair/poor group.Results
Both the JOA shoulder and UCLA shoulder scores showed significant improvement at 6, 9, and 12 months from the preoperative scores (p < 0.0001). There was a strong correlation between the total values of the two scores (r = 0.85, p < 0.0001). The cutoff value of the Japanese Orthopaedic Association shoulder score based on the highest accuracy from receiver operating characteristic curve analysis was 83 points.Conclusion
A Japanese Orthopaedic Association shoulder score cutoff value of 83 was equivalent to a University of California at Los Angeles shoulder score cutoff value of 28 for distinguishing between excellent/good and fair/poor outcomes after rotator cuff repair. 相似文献13.
Sandra Boesmueller Antal Nógrádi Patrick Heimel Christian Albrecht Sylvia Nürnberger Heinz Redl Christian Fialka Rainer Mittermayr 《Journal of orthopaedic surgery and research》2017,12(1):181
Background
The postoperative course after arthroscopic superior labrum anterior to posterior (SLAP) repair using suture anchors is accompanied by a prolonged period of pain, which might be caused by constriction of nerve fibres. The purpose was to histologically investigate the distribution of neurofilament in the superior labrum and the long head of the biceps tendon (LHBT), i.e. the location of type II SLAP lesions.Methods
Ten LHBTs including the superior labrum were dissected from fresh human specimen and immunohistochemically stained against neurofilament (NF). All slides were scanned at high resolution and converted into tagged image file format, and regions of interest (ROIs) were defined as follows: ROI I—superior labrum anterior to the LHBT origin, ROI II—mid-portion of the superior labrum at the origin of the LHBT, ROI III—superior labrum posterior to the LHBT origin and ROI IV—the most proximal part of the LHBT before its attachment to the superior labrum. The entire images were automatically segmented according to the defined ROIs and measured using a programmed algorithm specifically created for this purpose. The NF-positive cells were counted, and their total size and the area of other tissue were measured separately for the different ROIs.Results
Distribution of NF-positive cells in absolute numbers revealed a clear but insignificantly higher amount in favour of ROI I, representing the superior labrum anterior to the LHBT origin. Setting ROI I at 100%, a significant difference could be seen compared to ROI III, representing the superior labrum posterior to the LHBT origin (ROI I vs. ROI III with a p value <?0.05).Conclusions
Summarizing, the density of neurofilament is inhomogeneously distributed throughout the superior labrum with the highest number of neurofilament in the anterior superior labrum. Thus, suture placement in type II SLAP repair could play an important role for the postoperative pain-related outcome.14.
Murad Pepe Onur Kocadal Zafer Gunes Emre Calisal Ertugrul Aksahin Cem Nuri Aktekin 《Acta orthopaedica et traumatologica turcica》2018,52(6):419-422
Objective
The aim of this study was to evaluate the effect of the rotator cuff tear repair on subacromial space volume.Methods
We retrospectively identified 21 eligible patients (5 males and 16 females; mean age: 56.4 (range; 46–71) years) who had shoulder arthroscopy for unilateral full-thickness small to medium rotator cuff tear and normal controlateral shoulder joint. The mean follow-up time was 16.1 (range; 12–25) months. Preoperative and postoperative 1 year bilateral shoulder MRIs and Constant scores were reviewed. Subacromial volume was calculated by using Osirix software. Pre-, postoperative and healthy side (contralateral control group) subacromial volumes were recorded. Paired sample and t-tests were used to compare the pre- and postoperative groups. Independent sample t-tests were used to compare the healthy and pre- and postoperative groups. The correlation between the changes in the subacromial volume and the shoulder Constant score were analyzed using Pearson correlation analyses.Results
The mean subacromial volume of the preoperative group was 2.95 cm3 (range; 1.53–4.23) and the postoperative group was 3.59 cm3 (range; 2.12–4.84). The volume increase was statistically significant (p < 0.05). The mean subacromial volume of the control group was 3.93 cm3 (range; 2.77–5.03), and the difference between the preoperative group and the control group was statistically significant. There was no significant difference found between the postoperative group and the control group (p = 0.156). There was no significant correlation found between the volume and the constant score changes (r = 0.170, p = 0.515).Conclusion
The subacromial space volume significantly decreases in full-thickness rotator cuff tears smaller than 3 cm and the surgical repair increases the subacromial volume significantly.Level of evidence
Level IV; Diagnostic Study. 相似文献15.
Erica Kholinne Hyun Joo Lee Sung Jung Kim So Hyun Park In-Ho Jeon 《Acta orthopaedica et traumatologica turcica》2018,52(1):22-26
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. Trabecular bone volume and cortical thickness were evaluated.Results
Total trabecular bone volume was greater in subjects <50 years old than in subjects >50 years old but did not differ significantly in subjects with and without rotator cuff tear. Cortical thickness in both intact and torn rotator cuff groups was significantly greater in the proximal and intermediate zones than in the distal zone. Cortical thickness was related to anatomic location rather than age or cuff tear.Conclusion
The optimal location for anchor screw insertion during rotator cuff repair is either the proximal or intermediate region of the greater tuberosity. Age has more influence in terms of trabecular bone volume loss than rotator cuff integrity. 相似文献16.
L. P. Stoppino P. Ciuffreda M. Rossi M. Lelario C. Bristogiannis R. Vinci E. A. Genovese L. Macarini 《Musculoskeletal surgery》2013,97(2):197-202
Background
To evaluate the diagnostic performance of magnetic resonance arthrography (MR-A) of the shoulder in the diagnosis of rotator cuff tears involving the humeral insertion of the supraspinatus and infraspinatus tendon (footprint), using arthroscopy as the reference standard.Materials and methods
The study population included 90 consecutive patients with history and clinical diagnosis of instability of the shoulder, rotator cuff tear or posterosuperior glenoid impingement. A total of 108 MR arthrograms were performed, since 18 patients had undergone a bilateral procedure. Arthroscopy, which was performed within 45 days after MR-A, was used as the reference standard. Sensitivity, specificity, accuracy, positive and negative predictive values were then calculated.Results
Magnetic resonance arthrography showed a sensitivity of 92 % and a specificity of 78 % for the overall detection of tears involving the rotator cuff footprint. The diagnostic accuracy was 90 %, and the positive and negative predictive values were 95 and 64 %, respectively. Ten lesions were non-classifiable on surgery, of which eight were non-classifiable on MR-A also.Conclusions
Magnetic resonance arthrography is extremely accurate for the detection and classification of rotator cuff footprint tears. Most of these lesions are articular-sided (partial articular-sided supraspinatus tendon avulsion lesions) with predominance in younger patients and concealed type of tear (concealed interstitial delamination lesions).17.
Tomohisa Hashiuchi Goro Sakurai Yoshinori Takakura Kazuya Inoue Tsukasa kumai Yasuhito Tanaka 《Journal of orthopaedic science》2014,19(3):424-428
Introduction
Superior labrum anterior and posterior (SLAP) lesions due to overuse by repeated pitching motion and trauma are often noted and usually. However, shoulder disorders with a chronic course are often accompanied by SLAP lesions. SLAP lesions are frequently observed during arthroscopic surgery of the shoulder joint for rotator cuff tear in middle-aged and elderly individuals, suggesting the involvement of factors other than pitching motion and traumatic events in the pathogenesis. We considered that blood flow in the labrum is altered. The purpose of this study was to clarify the superficial blood flow in the superior labrum during arthroscopic surgery of the rotator cuff tear and investigate whether it is altered with labrum injury.Materials and methods
We evaluated 33 subjects with a mean age of 55.1 years who underwent arthroscopic surgery for partial or complete rotator cuff tears. The blood flow measurement site for the superior labrum was set at the supraglenoid tubercle attachment site, and blood flow was measured twice using laser Doppler flowmeter. The mean was calculated and compared among the normal labrum and type 1 SLAP lesions.Results
The morphology of the labrum was normal in 16 subjects, and 17 subjects had type 1 SLAP lesions. The mean blood flow was 1.75 ml/min/100 g in subjects with a normal labrum; however, in subjects with type 1 SLAP lesions, blood flow was 1.32 ml/min/100 g, showing significant differences (P < 0.01).Conclusion
Superficial blood flow in the superior labrum of the shoulder with rotator cuff tear was measured using laser Doppler flowmetry. The blood flow in type 1 SLAP lesions was lower than that in the normal labrum. 相似文献18.
Daisuke Chiba Eiichi Tsuda Harehiko Tsukada Kohei Iio Yasuyuki Ishibashi 《Journal of orthopaedic science》2017,22(5):892-897
Objectives
There are not many chances to arthroscopically reassess how graft tunnel malpositions in primary anterior cruciate ligament reconstruction (ACLR) associate with intra-articular degeneration in revision ACLR. This study was aimed to evaluate whether radiographic tunnel position in primary ACLR affect cartilaginous changes and bucket-handle meniscus tears in revision ACLR.Methods
Thirty-five patients who underwent revision ACLR were recruited; their primary surgeries were single-bundle reconstructions. Tunnel positions were evaluated using the plain radiographs after primary surgery. The sagittal tunnel positions of the femur (FP) and tibia (TP) were determined on the lateral view. The articular cartilage was evaluated arthroscopically at primary and revision surgery using the International Cartilage Repair Society (ICRS) score. A progression of two grades was considered as cartilaginous changes. Meniscal tears were evaluated with an arthroscopic probe. Logistic regression analysis was conducted using the prevalence of cartilaginous changes or bucket-handle meniscus tears as the dependent variable; tunnel parameters were used as the independent variables.Results
Seven patients (20.0%) had cartilaginous changes and nine patients (25.7%) had bucket-handle tears in the medial meniscus. In logistic regression analysis, %FP [odds ratio (OR): 1.212; P = 0.007] and the cut-off of 60% in the FP (OR: 22.000; P = 0.008) were correlated with cartilaginous changes. %TP (OR: 1.126; P = 0.036) was correlated with the prevalence of bucket-handle meniscus tears.Conclusions
Anterior femoral tunnel malposition in the femur was associated with the cartilaginous changes, and posterior tibial tunnel malposition with the development of bucket-handle meniscus tears. 相似文献19.
M. Iglesias M. Ramírez-Berumen P. Butrón J. Alberú-Gómez F. Salazar-Hernández J. Macias-Gallardo R.P. Leal-Villalpando J. Zamudio-Bautista V. Acosta L. Jauregui A. Hernández-Campos V. Espinosa-Cruz J. Vázquez-Lamadrid J. González-Sánchez J. Cuellar-Rodriguez J.G. Sierra-Madero R. Gaytan-Cervantes S. Contreras-Barbosa M. Mayorquin-Ruiz 《Transplantation proceedings》2018,50(3):950-958