scholarly journals Rotator Cuff

2021 ◽  
pp. 11-21
Author(s):  
Eva Llopis ◽  
Alexeys Perez ◽  
Luis Cerezal
Keyword(s):  
Decision Making ◽  
Differential Diagnosis ◽  
Rotator Cuff ◽  
Shoulder Pain ◽  
Surgical Techniques ◽  
Rotator Cuff Tears ◽  
Musculoskeletal Complaints ◽  
Clinical Correlation ◽  
Imaging Studies ◽  
Entire Spectrum

AbstractShoulder pain accounts for 16% of the musculoskeletal complaints and represents an important cause of absenteeism of work. Abnormalities of the rotator cuff, including tears, are frequently seen on imaging studies. Unfortunately, asymptomatic tears are frequent, up to 60% in patients older than 60 years old; therefore clinical correlation is essential.New anatomical concepts and new surgical techniques have evolved within the entire spectrum of lesions. It is essential to be aware of the information that is important for the decision-making as this information should stand out in our reports.In this course we will therefore review the different rotator cuff tears and its differential diagnosis.

scholarly journals Arthroscopic-Assisted Latissimus Dorsi Tendon Transfer for Massive Rotator Cuff Tears: A Systematic Review

2018 ◽  
Vol 6 (6) ◽  
pp. 232596711877773 ◽  
Author(s):  
Muzammil Memon ◽  
Jeffrey Kay ◽  
Emily Quick ◽  
Nicole Simunovic ◽  
Andrew Duong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Shoulder Pain ◽  
Latissimus Dorsi ◽  
Tendon Transfer ◽  
Clinical Findings ◽  
Rotator Cuff Tears ◽  
Level Of Evidence ◽  
Massive Rotator Cuff Tears

Background: Arthroscopic-assisted latissimus dorsi tendon transfer (LDTT) has shown promising results with good outcomes in patients with massive rotator cuff tears (MRCTs), as reported by individual studies. However, to the best of the authors’ knowledge, no systematic review has been performed to assess the collective outcomes of these individual studies. Purpose/Hypothesis: The primary purpose of this study was to assess patient outcomes after arthroscopic-assisted LDTT for the management of MRCTs. The secondary objectives were to report on the management of MRCTs, including diagnostic investigations, surgical decision making, and arthroscopic techniques, as well as to evaluate the quality of evidence of the existing literature. It was hypothesized that nearly all patients were satisfied with arthroscopic-assisted LDTT and that they experienced improvements in pain symptoms, function, and strength after the procedure, with an overall complication rate of less than 10%. Study Design: Systematic review; Level of evidence, 4. Methods: The databases MEDLINE, Embase, and PubMed were searched from database inception (1946) until August 18, 2017, with titles, abstracts, and full-text articles screened independently by 2 reviewers. Inclusion criteria were English-language studies investigating arthroscopic-assisted LDTT for the management of MRCTs on patients of all ages. Conference papers, book chapters, review articles, and technical reports were excluded. The quality of the included studies was categorized by level of evidence and the Methodological Index for Non-Randomized Studies (MINORS) checklist. Results: In total, 8 studies (7 case series [median MINORS score, 7 of 16] and 1 prospective comparative study [median MINORS score, 14 of 24]) were identified; the studies included 258 patients (258 shoulders) with MRCTs treated with LDTT using arthroscopic-assisted techniques. The decision to pursue surgery was based on both clinical findings and investigations in 5 studies, investigations only in 2 studies, and clinical findings only in 1 study. Overall, 88% of patients were satisfied with the results of surgery and experienced significant improvement in their symptoms, including shoulder pain, strength, range of motion, and overall function, over a mean follow-up period of 34.3 months. Overall, there was a low rate of complications (7%) associated with the procedure. Conclusion: Arthroscopic-assisted LDTT for MRCTs provides patients with marked improvement in shoulder pain, strength, and function, and the procedure is associated with a low risk of complication. Further high-quality comparative studies are warranted to validate these findings in comparison with other operative techniques.

scholarly journals Rotator cuff unloading versus loading exercise program in the conservative treatment of patients with rotator cuff tear: protocol of a randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040820
Author(s):  
Larissa Pechincha Ribeiro ◽  
Ann Cools ◽  
Paula Rezende Camargo
Keyword(s):  
Rotator Cuff ◽  
Conservative Treatment ◽  
Shoulder Pain ◽  
Rotator Cuff Tear ◽  
Social Life ◽  
Rotator Cuff Tears ◽  
Fear Avoidance ◽  
Fear Avoidance Beliefs ◽  
Cuff Tear ◽  
Shoulder Range Of Motion

IntroductionAtraumatic and degenerative rotator cuff tears are common in individuals over 55 years of age. This condition can have a high impact on social life and is associated with chronic pain, weakness and dysfunction of the upper limb. There is evidence that conservative approaches should be the first treatment option. Conservative treatment usually addresses a variety of therapeutic behaviours without providing scientific arguments for the choice and progression of exercises.ObjectiveTo compare the effects of two different exercise programmes based on the load of the rotator cuff on a population with shoulder pain and rotator cuff tears.Methods and analysisThis is a controlled, randomised, blinded clinical trial. Seventy-eight individuals with shoulder pain and presence of atraumatic and degenerative rotator cuff tear will participate and will be randomly distributed between two groups. The primary outcome will be quality of life (The Western Ontario Rotator Cuff Index), and secondary outcomes will include pain, function (Disabilities of the Arm, Shoulder and Hand), fear avoidance beliefs (Fear Avoidance Beliefs Questionnaire-Brazil), kinesiophobia (Tampa Scale), Pain Catastrophizing Scale, muscle strength of abductors, external and internal rotators of the shoulder, range of motion of arm elevation and patient satisfaction. The treatment will be performed for 12 weeks (2 x/week) acording to the selected group (Rotator Cuff Unloading x Rotator Cuff Loading Exercise Programme).Ethics and disseminationThe study protocol was approved by the Institutional Review Board. The findings of the trial will be disseminated through peer-reviewed journals and scientific conferences.Trial registration numberNCT03962231.

scholarly journals A Single Knotless-anchor for Bursal-side Ellman III Partial Thinkness Rotar Cuff Tears: A Biomechanical Cadaveric Study

2021 ◽  
Author(s):  
Gang Liu ◽  
Baolu Zhang ◽  
Qian Zhao ◽  
Xiaoguang Guo ◽  
Yang Liu ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Surgical Techniques ◽  
Supraspinatus Tendon ◽  
Rotator Cuff Tears ◽  
Loading Test ◽  
Double Row ◽  
Knotless Anchor ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background: Bursal-side partial thickness rotator cuff tears (PTRCTs) are frequent lesions with the treatment of multiple surgical techniques. However, to the best of our knowledge, no single knotless-anchor with two Ethicon 2# repair technique has been reported.Methods: Bursal-side PTRCTs (Ellman type III, 75% thickness of tears) were created in the supraspinatus tendon on 16 fresh-frozen cadaveric shoulders. The specimens were randomized into two groups of 8 each: (1) Group A (Transtendon repairs), a single knotless-anchor repair with two Ethicon 2#, (2) Group B, the Conversion repair (Double-row, DR). Each specimen underwent cyclic loading test from 5 to 100 N by 50 cycles, then followed by an ultimate failure test. The displacement of greater tuberosity (mm) and ultimate (N) were recorded.Results: Compared with the load-to-failure test, there was no significant difference between Group A and B (Group A, 359.25±17.91N; Group B, 374.38±13.75 N, P＞0.05). There were also no significant differences in the rotator cuff displacement of 10 mm(Group A, 190.50±8.52N; Group B, 197.25±6.84, P＞0.05) and 15mm (Group A, 282.25±12.20 N; Group B, 291.13±14.74 N, P＞0.05). However, concerning the displacement of 3 mm and 5mm, we found a significant difference in these two groups (P<0.05).Conclusions: A single knotless-anchor with two Ethicon 2# for Bursal-side Ellman III PTRCTs is a simple, cheap, and effective technique that we could choose.

A Prospective Study of Patient Factors and Decision-making for Surgical Repair of Symptomatic Full-Thickness Rotator Cuff Tears

Orthopedics ◽  
2019 ◽  
Vol 43 (2) ◽  
pp. 85-90
Author(s):  
Danielle G. Weekes ◽  
Richard E. Campbell ◽  
Jordan R. Allegretto ◽  
Samantha G. Lopez ◽  
Matthew D. Pepe ◽  
...  
Keyword(s):  
Decision Making ◽  
Rotator Cuff ◽  
Prospective Study ◽  
Surgical Repair ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Patient Factors ◽  
A Prospective Study

Related Factors and Therapeutic Effect of Rotator Cuff Delamination

2020 ◽  
Author(s):  
Bingli Liu ◽  
Jian Hu ◽  
Baoqing Yu
Keyword(s):  
Rotator Cuff ◽  
Constant Score ◽  
Surgical Techniques ◽  
Suture Technique ◽  
Rotator Cuff Tears ◽  
Treatment Result ◽  
Good Effect ◽  
Level Of Evidence ◽  
Related Factors ◽  
Rotator Cuff Injuries

Abstract Objective: This study aims to explore the related factors and treatment result of RCT with delamination. Materials and methods: From February 2016 to July 2019, a total 155 patients with RCT were enrolled into the present study. Among these patients, 66 were male and 89 were female, and their an average age was 56.4±7.8 years old (41-75 years old). The medical history of each patient was recorded before the operation, and the joint function was evaluated using the Constant score table. During the operation, the RCT was examined using an arthroscope, the delamination was evaluated, and the RCT type was classified. A proper suture technique was executed for these different types of rotator cuff injuries, and routine functional exercises were performed after the operation. Poisson chi-square test was used to analyze the related factors of delamination, and t-test was used to analyze the result of the treatment. Results: Among the 115 patients, 47 patients had delamination, while 68 cases had no delamination. The larger the RCT size, the greater probability of delamination. Furthermore, the delamination probability of a RCT with subacromial impact would also increase. However, there was no statistical correlation between disease history or trauma and delamination. All patients achieved good therapeutic results. Conclusion: The incidence of rotator cuff delamination remains high, and the occurrence of delamination is correlated to the size of the tear, and the determination of whether this is accompanied by subacromial impact. However, there is no correlation between delamination and trauma or disease duration. For rotator cuff tears with delamination, reasonable surgical techniques can be used to treat the rotator cuff injury, in order to obtain a good effect.Level of evidence: Level III, Retrospective Cohort Design, Treatment Study

ROLE OF MRI IN DIAGNOSIS OF ROTATOR CUFF TEAR ASSUMING ARTHROSCOPY AS GOLD STANDARD

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr. Chaturbhuj Prasad Swarnkar ◽  
Dr. Shiv Raj Meena
Keyword(s):  
Rotator Cuff ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Shoulder Pain ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Gold Standard ◽  
Shoulder Joint ◽  
Rotator Cuff Tears ◽  
Arthroscopic Findings

Background- Rotator cuff tears are one of the most common causes of shoulder pain for which patients seek treatment. As in our daily work, the shoulder joint is the most frequently used, there is higher chance of having shoulder joint injury. The aim of the study is to compare the efficacy of MRI in diagnosing shoulder pathologies in comparison to arthroscopy, considering arthroscopy as the gold standard. Methods- 30 Patient with suspected rotator cuff injury patients, between 18-80 years of age was included in the study. MRI of the shoulder joint was done followed by shoulder arthroscopy. The data collected was analysed for the significant correlation between MRI of shoulder and arthroscopic findings by kappa statistics. Results- The accuracy of MRI in diagnosis of rotator cuff partial tears, was 90%, while sensitivity and specificity was 100.00%, 78.57% and positive predictive value was 84.21% and negative predictive value was 100.00% and accuracy of MRI in diagnosis of rotator cuff full tears, was 86.67%, while sensitivity and specificity was 63.64%, 100.00%) and positive predictive value was 100.00% and negative predictive value was 82.61% in our study. Conclusion- Our study demonstrates a high sensitivity and specificity for the MRI diagnosis of both partial and full thickness rotator cuff tears and good correlation with arthroscopic findings. Keywords: Rotator cuff, Shoulder pain, Arthroscopy, MRI.

scholarly journals How common is fatty infiltration of the teres minor in patients with shoulder pain? A review of 7,367 consecutive MRI scans

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
William R. Aibinder ◽  
Derrick A. Doolittle ◽  
Doris E. Wenger ◽  
Joaquin Sanchez-Sotelo
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Muscle Atrophy ◽  
External Rotation ◽  
Reverse Shoulder Arthroplasty ◽  
Fatty Infiltration ◽  
Deltoid Muscle ◽  
Rotator Cuff Tears ◽  
Shoulder Mri ◽  
Teres Minor

Abstract Purpose The teres minor is particularly important for activities that require external rotation in abduction in the settings of both rotator cuff tears and reverse shoulder arthroplasty. This study sought to assess the incidence of teres minor fatty infiltration in a large cohort of consecutive patients evaluated with shoulder MRI for shoulder pain and to identify all associated pathologies in an effort to determine the various potential etiologies of teres minor involvement. Methods A retrospective review of 7,376 non-contrast shoulder MRI studies performed between 2010 and 2015 were specifically evaluated for teres minor fatty infiltration. Studies were reviewed by two fellowship trained musculoskeletal radiologists. Muscle atrophy was graded on a 3-point scale according to Fuchs and Gerber. The remaining rotator cuff tendons and muscles, biceps tendon, labrum, and joint surfaces were assessed on MRI as well. Results In this series, 209 (2.8%) shoulders were noted to have fatty infiltration of the teres minor. The rate of isolated fatty infiltration of the teres minor was 0.4%. Concomitant deltoid muscle atrophy was common, and occurred in 68% of the shoulders with fatty infiltration of the teres minor. Tearing of the teres minor tendon was extremely rare. Conclusion Fatty infiltration of the teres minor can occur in isolation, be associated with deltoid muscle atrophy only, or occur in the setting of rotator cuff full tears. Thus, fatty infiltration of the teres minor may be related to a neurologic process or disuse. Further long term longitudinal studies are necessary to be elucidate the etiologies. Level of Evidence Level IV.

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