共查询到20条相似文献，搜索用时 31 毫秒
1.
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2.
Muhammet Baybars Ataoglu Mehmet Cetinkaya Mustafa Ozer Tacettin Ayanoglu Ulunay Kanatli 《Journal of orthopaedic science》2018,23(2):304-309
Background
The purpose of this study was to assess the frequency of superior labrum anterior posterior (SLAP) lesions, long head of biceps tendon (LHBT) pathologies, and superior rotator cuff tears accompanying subscapularis tears. We hypothesised that LHBT lesions, superior rotator cuff tears, and especially SLAP lesions were very frequent with subscapularis tears.Methods
The digital files of patients who underwent shoulder arthroscopy were reviewed retrospectively. One hundred and eleven patients with subscapularis tears evident on surgery videos were examined. Superior labrum, LHBT, and superior rotator cuff lesions were investigated by the authors of this study. The statistical analyses were made with SPSS statistics software, and significance was set at P < 0.05 value.Results
There were 111 patients with both subscapularis tears and surgery videos. The mean age was 58.09 ± 10.21, and 63.1% of the patients were female. 98.2% of the 111 patients had a SLAP lesion. 7.2% of those were SLAP I and 91% were SLAP II lesions while 1.8% were healthy. The 75.7% of the patients had a LHBT pathology, and 83.8% had superior cuff tear.Conclusions
Subscapularis tears were almost always accompanied by SLAP lesions. On the other hand, biceps tendon pathologies and superior rotator cuff tears were also very frequent with subscapularis tears.Level of evidence
Prognostic study, Level IV (retrospective cohort study). 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.
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5.
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.
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8.
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9.
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10.
Jae Chul Yoo Tae Kang Lim Dong Hyok Kim Kyoung-Hwan Koh 《Journal of orthopaedic science》2018,23(1):64-69
Purpose
Symptomatic full-thickness rotator cuff (RC) tears are often recommended for surgical repairs. However, some patients decide not to have surgery. The aim of this study was to see if there was any difference in preoperative variables between the two groups.Methods
137 consecutive patients recommended for surgery due to symptomatic full-thickness RC tear were evaluated. At mean 58.1 months after surgery-recommendation, the patients were asked whether they had surgery and their clinical outcome was assessed. Variables at the time of surgery-recommendation including demographics, range-of-motion (ROM), tear size, and fatty infiltration on MRI, and clinical score were compared between the two groups.Results
The 59 men and 78 women had a mean age of 64.4 years. Overall, 104 (75.9%) patients were treated with RC repair and 33 (24.1%) were not. The main three reasons for not having surgery were improvement of symptoms or minimal pain (55%), economic burden (12%), and concern for postoperative long rehabilitation (9%). Demography and ROM measured at the time of surgery-recommendation did not differ. All clinical scores at one year and final follow-up survey showed no difference between the two groups. The Constant and UCLA scores at the time of surgery-recommendation were significantly higher and tear size was smaller in the ‘No-surgery’ group. Fatty infiltration of supraspinatus (2.0 versus 1.2, p < 0.001) and global fatty degeneration index (1.4 versus 0.8, p = 0.011) were statistically lower in ‘No-surgery’ group as well.Conclusion
Patients with relatively preserved function and small size tear tend to select non-surgical treatment and lead to relatively good outcome. 相似文献11.
Yuki Shiota Nobuyuki Yamamoto Jun Kawakami Hideaki Nagamoto Takayuki Muraki Kazuo Kaneko Eiji Itoi 《Journal of orthopaedic science》2017,22(6):1031-1041
Backgrounds
There have been many reports describing that the capsular fibrosis of the shoulder joint is the main cause of frozen shoulder, whereas others reported the significance of subacromial impingement as an etiological factor. The purpose of this study was to investigate the contact pressure between the coracoacromial arch and the rotator cuff tendons to clarify the contact phenomenon in shoulders with joint contracture.Methods
Fourteen fresh-frozen cadaveric shoulders were used. Specimens were divided into two groups: normal group (8 shoulders, definition: more than 61° of flexion and abduction and more than 21° of external rotation) and joint contracture group (6 shoulders, definition: less than 60° of flexion and abduction and less than 20° of external rotation). Contact pressure and area beneath the coracoacromial arch were measured by a flexible force sensor during flexion, abduction, internal and external rotation in adduction and abduction, extension and horizontal extension motions.Results
The peak contact pressure under the acromion was observed at 90° in flexion and abduction in the normal group, whereas that in the contracture group was observed at 30° in flexion (P = 0.037) and at 30° in abduction (P = 0.041). Contact pressure in the contracture group was significantly higher than that in the normal group at 20° and 30° of abduction (P = 0.043, P = 0.041, respectively). There were no significant differences of contact pressure during other motions. Although no significant differences of contact pressure beneath the coracoacromial ligament were observed, contact area significantly increased in extension and horizontal extension motion.Conclusion
The contact between the acromion and the rotator cuff was observed in lower angles of flexion and abduction in shoulders with contracture than in those without. When treating patients with shoulder contracture, we need to perform rehabilitation taking such an abnormal movement into consideration. 相似文献12.
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13.
Xiao Yu Difeng Zhang Xianjun Chen Ji Yang Lin Shi Qingjiang Pang 《Journal of orthopaedic science》2018,23(2):356-364
Background
Non-traumatic osteonecrosis of the femoral head (ONFH) is a refractory osteonecrosis disease caused by an abnormal blood supply to bone tissue. However, therapeutic hip preservation strategies are diverse, and the therapeutic outcomes are not ideal.Objective
A network meta-analysis was performed to assess the effect of hip preservation treatments on non-traumatic ONFH.Methods
We searched public electronic databases through May 15, 2017 using the following keywords: “femoral head necrosis osteonecrosis”; “femoral head osteonecrosis”; “osteonecrosis of femoral head”; “avascular necrosis of femoral head”; “necrosis of femoral”; and “random*”. The primary outcome in the present analysis was the treatment failure rate. Secondary outcomes included the Harris hip and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores.Results
We included 21 articles assessing a total of 1415 hips in our analysis. In the network meta-analysis, the treatments were ranked by the surface under the cumulative ranking curve (SUCRA). Core decompression (CD) plus cytotherapy was most likely to reduce the treatment failure rate (SUCRA score = 18.9%), followed by alendronate treatment (SUCRA score = 17.8%), cocktail treatments (SUCRA score = 15.6%), extracorporeal shock wave therapy (ESWT) plus alendronate (SUCRA score = 15.4%), and avascular biomaterials plus cytotherapy (SUCRA score = 13.8%) in a frequentist framework; similar results were obtained in a Bayesian framework. For the secondary outcomes, ESWT was most likely to improve the Harris hip score (SUCRA score = 33.7%), followed by ESWT plus alendronate (SUCRA score = 33.1%) and cocktail (SUCRA score = 19.6%) treatments in a frequentist framework. A traditional analysis showed that the effect of CD plus cytotherapy was significantly better than the effect of CD alone in improving the WOMAC score (SMD, ?6.01; 95% CI, ?7.81 to ?4.22; p < 0.001).Conclusion
CD plus cytotherapy is a relatively superior treatment for reducing treatment failure rates in early and intermediate ONFH patients, and ESWT is the most effective treatment for improving Harris hip scores. 相似文献14.
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15.
Akira Tsujii Hiroshi Amano Yoshinari Tanaka Keisuke Kita Ryohei Uchida Yoshiki Shiozaki Shuji Horibe 《Journal of orthopaedic science》2018,23(1):122-126
Background
Radial/oblique tears of the midbody of the lateral meniscus significantly impair the ability of the meniscus to withstand the tibiofemoral load, requiring meniscal repair. However, healing status after meniscal repair has not been fully elucidated. This study aimed to evaluate arthroscopic findings after inside-out suture repair for isolated radial/oblique tears of the midbody of the lateral meniscus.Methods
From 2011 to 2015, 18 consecutive patients with isolated radial/oblique tears of the midbody of the lateral meniscus underwent arthroscopic inside-out repair with the tie-grip suture technique. All knees were stable with no previous surgery. All patients were evaluated by second-look arthroscopy at six months postoperatively. Activities including jogging were not allowed until meniscal status was evaluated arthroscopically. To analyze factors associated with healing rates, age, time from injury to initial surgery, and tear zone were compared.Results
Second-look arthroscopy revealed complete healing in four (22%) patients, partial healing in seven (39%), and failure to heal in seven (39%). Significant differences were observed for tear zone (p < 0.0001), but not for age and timing of repair.Conclusions
Arthroscopic evaluation revealed that inside-out repair with the tie-grip suture technique for isolated radial/oblique tears of the midbody of the lateral meniscus achieved complete or partial healing only in 61% of patients. Satisfactory results were observed particularly in patients with tears extending to the vascular zone, whereas those with tears in the avascular zone failed to achieve healing. Therefore, the operative indication of inside-out repair for radial/oblique tears of the midbody of the lateral meniscus might be limited to tears extending into the vascular zone. Given that 39% of cases were arthroscopically considered a failure even if patients complained of no symptoms in daily life, decisions should be made carefully to allow patients to return to sports activities. 相似文献16.
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17.
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18.
Mohammad Suhrab Rahmani Shinji Takahashi Masatoshi Hoshino Kazushi Takayama Ryuichi Sasaoka Tadao Tsujio Hiroyuki Yasuda Fumiaki Kanematsu Hiroshi Kono Hiromitsu Toyoda Hiroaki Nakamura 《Journal of orthopaedic science》2018,23(4):627-634
Background
With the increasing aging population in developed countries, there has been an associated increased prevalence of osteoporotic vertebral fracture (OVF). Many previous reports have attempted to predict the risk of delayed union associated with OVF. However, the role of endplate failure and the degeneration of adjacent intervertebral discs, and their association with delayed union has received little attention. The aim of this study was to evaluate the endplate fracture and disc degeneration rank as risk factors for delayed union.Materials and methods
Two hundred and eighteen consecutive patients with fresh OVF were enrolled in the study. MRI and X–ray were performed at the time of enrollment and at the 6 months follow-up. The MR images were used to assess the degeneration grade of adjacent intervertebral discs (using the modified Pfirrmann grading system), and endplate failure. Supine and weight-bearing radiographs were used to define angular motion and compression ratio of the anterior vertebral body wall.Results
A total of 139 patients (112 female, 27 male) completed the 6 month follow-up (a 65.1% follow-up rate). The study revealed 27 cases of delayed union (19.4%). A healthier adjacent caudal disc with low grade degeneration was found to be associated with an increased risk of delayed union (P = 0.008). Bi-endplate injury and significant compression of the anterior vertebral body wall were significantly associated with delayed union (P = 0.019, and P = 0.001 respectively). Rapid progression of the adjacent cranial disc degeneration was observed at the end of the 6 month follow-up period (P = 0.001).Conclusion
Modified Pfirrmann grading system revealed that a healthier adjacent intervertebral disc at the caudal level and bi-endplate fracture were significantly associated with an increased risk of delayed union. These findings may influence the management strategy for patients with OVF. 相似文献19.
Purpose:
Partial-thickness articular-sided rotator cuff tears have a multifactorial etiology and are associated with degeneration of the tendon. They are often described as an injury of the young athlete, although they are also found in the older population. The aim of this study was to investigate the frequency and associations of partial-thickness articular-sided tears in patients over the age of 35 years.Design:
RetrospectiveMaterials and Methods:
A retrospective study of all arthroscopic procedures for rotator cuff pathology in patients over the age of 35 years over a 2-year period by a single surgeon was performed. The included patients were divided into two groups based on the arthroscopic findings: those with a partial-thickness articular-sided rotator cuff tear and those with pure tendinopathy. The groups were then compared to identify the associated pathology with the rotator cuff lesions. 2×2 contingency table analysis and unpaired Student''s t-test were used for statistical analysis.Results:
One hundred patients were included in the study of whom 62 had a partial articular-sided tear. Those with a partial articular-sided tear were older (P=0.0001), were more commonly associated with a documented injury (P=0.03), and more commonly had biceps degeneration (P=0.001) and synovitis (P=0.02) within the joint.Conclusion:
Partial-thickness articular-sided tears are a common occurrence in patients requiring arthroscopic surgery for rotator cuff pathology over the age of 35 years. This probably reflects an injury in an already degenerate cuff. This would support the theory of intrinsic degeneration of the tendon in this age group and probably represent a different etiology to those seen in the young athletes.Level of Evidence:
Level 3 相似文献20.
Daisuke Chiba Eiichi Tsuda Harehiko Tsukada Kohei Iio Yasuyuki Ishibashi 《Journal of orthopaedic science》2017,22(5):892-897