scholarly journals Mid to long-term-results of postoperative immobilization in internal- versus external rotation after arthroscopic anterior shoulder stabilization

2021 ◽  
Author(s):  
Marvin Minkus ◽  
Julia Wolke ◽  
Doruk Akgün ◽  
Markus Scheibel
Keyword(s):  
External Rotation ◽  
Long Term Results ◽  
Shoulder Stabilization

scholarly journals Postoperative stiff shoulder after open rotator cuff repair: a 3- to 20-year follow-up study

2014 ◽  
Vol 103 (4) ◽  
pp. 263-270 ◽  
Author(s):  
H. Vastamäki ◽  
M. Vastamäki
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Rotator Cuff Repair ◽  
External Rotation ◽  
Long Term Results ◽  
Shoulder Stiffness ◽  
Stiff Shoulder ◽  
Cuff Repair ◽  
Postoperative Shoulder

Background and Aims: Stiffness after a rotator cuff tear is common. So is stiffness after an arthroscopic rotator cuff repair. In the literature, however, postoperative restriction of passive range of motion after open rotator cuff repair in shoulders with free passive range of motion at surgery has seldom been recognized. We hypothesize that this postoperative stiffness is more frequent than recognized and slows the primary postoperative healing after a rotator cuff reconstruction. We wondered how common is postoperative restriction of both active and passive range of motion after open rotator cuff repair in shoulders with free passive preoperative range of motion, how it recovers, and whether this condition influences short- and long-term results of surgery. We also explored factors predicting postoperative shoulder stiffness. Material and Methods: We retrospectively identified 103 postoperative stiff shoulders among 416 consecutive open rotator cuff repairs, evaluating incidence and duration of stiffness, short-term clinical results and long-term range of motion, pain relief, shoulder strength, and functional results 3–20 (mean 8.7) years after surgery in 56 patients. Results: The incidence of postoperative shoulder stiffness was 20%. It delayed primary postoperative healing by 3–6 months and resolved during a mean 6.3 months postoperatively. External rotation resolved first, corresponding to that of the controls at 3 months; flexion and abduction took less than 1 year after surgery. The mean summarized range of motion (flexion + abduction + external rotation) increased as high as 93% of the controls’ range of motion by 6 months and 100% by 1 year. Flexion, abduction, and internal rotation improved to the level of the contralateral shoulders as did pain, strength, and function. Age at surgery and condition of the biceps tendon were related to postoperative stiffness. Conclusions: Postoperative stiff shoulder after open rotator cuff repair is a common complication resolving in 6–12 months with good long-term results.

Syndesmosis fixation in supination-external rotation ankle fractures. Long-Term results of a prospective randomised study

2021 ◽  
Author(s):  
Ristomatti Lehtola ◽  
Hannu-Ville Leskelä ◽  
Tapio E. Flinkkilä ◽  
Harri J. Pakarinen ◽  
Jaakko L. Niinimäki ◽  
...  
Keyword(s):  
External Rotation ◽  
Ankle Fractures ◽  
Long Term Results ◽  
Randomised Study ◽  
Supination External Rotation ◽  
Prospective Randomised Study

Long-term results for Kinemax and Kinematic knee bearings on a six-station knee wear simulator

2000 ◽  
Vol 214 (5) ◽  
pp. 437-447 ◽  
Author(s):  
H E Ash ◽  
I C Burgess ◽  
A Unsworth
Keyword(s):  
External Rotation ◽  
Wear Test ◽  
Long Term Results ◽  
Wear Rates ◽  
Flexion Extension ◽  
Average Wear ◽  
Posterior Translation ◽  
Wear Simulator

A long-term wear test was performed on Kinemax and Kinematic (Howmedica Inc.) knee bearings on the Durham six-station knee wear simulator. The bearings were subjected to flexion/extension of 65–0°, anterior-posterior translation of between 4.5 and 8.5 mm and a maximum axial load of 3 kN. Passive abduction/adduction and internal/external rotation were also permitted, however, two of the stations had a linkage system which produced ± 5° active internal/external rotation. The bearings were tested at 37 °C in a 30 per cent bovine serum solution and the test was run to 5.6 × 106 cycles. The bearings from stations 2 and 3, and stations 4 and 5 were swapped during the test to investigate the effects of interstation variability. The average wear rate and standard error was 3.00 ± 0.98 mg/106 cycles (range 1.33-4.72 mg/106 cycles) for the Kinemax bearings and 3.78 ± 1.04 mg/106 cycles (range 1.87-4.89 mg/106 cycles) for the Kinematic bearings. There were no significant differences in wear rates between the different bearing designs, the addition of active internal/external rotation or a change of stations. However, the wear tracks were different for the two types of bearings and with active internal/external rotation. The wear rates and factors were generally lower than previously published in vitro wear results; however, this may have been due to a difference in the axial loads and lubricants used. The appearance of the wear tracks with active internal/external rotation was comparable with those seen on explanted knee bearings.

Partial Ipsilateral C7 Transfer to the Upper Trunk for C5-C6 Avulsion of the Brachial Plexus

Neurosurgery ◽  
2011 ◽  
Vol 70 (5) ◽  
pp. 1176-1182 ◽  
Author(s):  
Hua-Wei Yin ◽  
Su Jiang ◽  
Wen-Dong Xu ◽  
Lei Xu ◽  
Jian-Guang Xu ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
External Rotation ◽  
Elbow Flexion ◽  
Suprascapular Nerve ◽  
Long Term Results ◽  
Shoulder Abduction ◽  
Novel Approach ◽  
Group A ◽  
Group B

Abstract BACKGROUND: Ipsilateral whole C7 root transfer has been reported in treating C5-C6 avulsion. To minimize donor deficits, partial ipsilateral C7 (PIC7) transfer was developed. OBJECTIVE: To investigate the long-term results of PIC7 transfer to the upper trunk in treating C5-C6 avulsion of the brachial plexus. METHODS: We prospectively studied 8 young adults with C5-C6 avulsion. Five patients (group A) who also had spinal accessory nerve (SAN) injury underwent PIC7 transfer to the upper trunk. The other 3 patients (group B) without SAN injury underwent a combination of PIC7 to the upper trunk and the SAN to the suprascapular nerve (SSN). Postsurgical evaluations including donor deficits, functional recovery, and co-contraction of the muscles were performed 1 week later and then at intervals of 3 months. RESULTS: After a mean period of 39.2 months, all subjects were found to have gained elbow flexion of 110 to 150° with muscle strength of M4-5. The patients in group B achieved external rotation of 60 to 70° at M3-4, and 2 achieved shoulder abductions approaching 180° at M4. The patients in group A showed no active external rotation and shoulder abduction of 25 to 50° at M2-3. The temporary deficits caused by PIC7 transfer disappeared in all subjects within the first 3 months. Co-contraction of the latissimus dorsi against the deltoid was recorded in group A but not in group B. CONCLUSION: PIC7 transfer, when combined with SAN transfer to SSN as a novel approach, is a safe, easy, and efficacious surgical procedure for patients with simple C5-C6 avulsion.

Paper # 137: Long-Term Results After Arthroscopic Shoulder Stabilization Using Suture Anchors: An 8-10 Year Follow Up Study

2011 ◽  
Vol 27 (10) ◽  
pp. e158-e159
Author(s):  
W. Jaap Willems ◽  
Just Alexander van der Linde ◽  
Derk Anton van Kampen ◽  
Caroline B. Terwee ◽  
Lea M. Dijksman
Keyword(s):  
Long Term Results ◽  
Suture Anchors ◽  
Shoulder Stabilization ◽  
Follow Up Study ◽  
Arthroscopic Shoulder Stabilization

Clinical and Radiological Long-term Results After Implant-Free, Autologous, Iliac Crest Bone Graft Procedure for the Treatment of Anterior Shoulder Instability

2018 ◽  
Vol 46 (12) ◽  
pp. 2975-2980 ◽  
Author(s):  
Philipp Moroder ◽  
Fabian Plachel ◽  
Johannes Becker ◽  
Eva Schulz ◽  
Shejla Abdic ◽  
...  
Keyword(s):  
Bone Graft ◽  
Shoulder Instability ◽  
External Rotation ◽  
Contralateral Side ◽  
Long Term Results ◽  
Anterior Shoulder Instability ◽  
Iliac Crest Bone Graft ◽  
Active Range Of Motion

Background: The implant-free, autologous, iliac crest bone graft procedure (J-bone graft) for the treatment of anterior shoulder instability shows low rates of recurrent dislocations and moderate progression of instability arthropathy in the midterm follow-up. Purpose: To analyze the clinical and radiological long-term results of the J-bone graft procedure. Study Design: Case series; Level of evidence, 4. Methods: A total of 46 patients (47 shoulders) with anterior shoulder instability and a relevant bony glenoid defect who received a J-bone graft between 1993 and 2000 and who were previously subjected to a midterm follow-up (mean, 8 years) were included. In total, 34 patients and 35 shoulders (74%) were clinically and radiologically assessed after a mean follow-up of 18 years (range, 15-23 years). Patients were assessed in terms of pain, bilateral active range of motion, and strength; in addition, the Western Ontario Shoulder Instability Index (WOSI), the Rowe Score, and the Subjective Shoulder Value (SSV) were obtained. Both an apprehension test and a relocation test were performed. Radiological imaging included bilateral radiographs (true anteroposterior and axillary view) to determine the grade of instability arthropathy. Results: At final follow-up, a mean WOSI score of 295 (range, 0-1765), Rowe Score of 94 (range, 55-100), SSV of 90% (range, 20%-100%), and pain level of 0.5 (range, 0-4) were noted. Slight differences were detected in active range of motion between the affected and the contralateral side: flexion 178° vs 179° ( P = .325), abduction 177° vs 179° ( P = .225), external rotation 63° vs 67° ( P = .048), high external rotation 77° vs 82° ( P = .007), internal rotation 8.8 vs 9.4 points ( P = .017), and high internal rotation 70° vs 74° ( P = .026). No significant strength deficit of the affected side was noticed. In 1 patient, a traumatic redislocation with fracture of the bone graft was observed 6 weeks after index surgery. No further recurrences were found during the follow-up period. Negative apprehension and relocation tests were confirmed in 77% of the shoulders, while 23% were positive. At final follow-up, 9 shoulders showed no signs of instability arthropathy (26%), mild arthropathy was revealed in 22 shoulders (63%), moderate arthropathy was noted in 3 shoulders (9%), and signs of severe arthropathy were found in 1 shoulder (3%) (collective instability arthropathy score, 0.9). The collective instability arthropathy score on the contralateral side was 0.4 ± 0.8 with no instability arthropathy in 24 shoulders (69%), mild arthropathy in 8 shoulders (23%), moderate signs of arthropathy in 2 shoulders (6%), and severe arthropathy in 1 shoulder (3%) at the time of follow-up examination (collective instability arthropathy score, 0.4). The overall difference between affected shoulders and contralateral shoulders was significant ( P = .005). Conclusion: The J-bone graft procedure for the treatment of recurrent anterior shoulder instability shows excellent results regarding stability and function after a mean follow-up period of 18 years. However, the development of instability arthropathy of the affected shoulder is not prevented by this procedure.

scholarly journals Mid-Long Term Results in the Arthroscopic Selective Capsular Release and Manipulation Treatment of Frozen Shoulder

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0018
Author(s):  
Haluk Celik ◽  
Mustafa Faik Seckin ◽  
Adnan Kara ◽  
Savas Camur ◽  
Eray Kilinc ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
External Rotation ◽  
Frozen Shoulder ◽  
Functional Results ◽  
Long Term Results ◽  
Capsular Release ◽  
Preoperative Status ◽  
Rate Of Success ◽  
Shoulder Score

Objectives: Our aim was to present mid-long term functional outcomes of patients who underwent arthroscopic selective capsular release and manipulation for frozen shoulder refractory to conservative treatment. Methods: Between 2006 and 2012, 32 patients presented to our clinic with the diagnosis of frozen shoulder. 24 shoulders of 22 patients treated with arthroscopic selective capsular release and manipulation were included in the study. Functional results were analyzed with Constant shoulder score. The mean follow-up was 4.3 years (range 1-7 years). Results: We detected an average increase in passive range of motion in flexion 72°, abduction 90°, abduction-internal rotation 33°, and abduction-external rotation 38°, adduction-external rotation at 37° compared to the preoperative status. Constant shoulder score increased by an average of 44 points after surgery. Eighteen (82%) patients were satisfied with the operation. Three of four patients whose symptoms persisted had resistant diabetes mellitus. Conclusion: Frozen shoulder is one of the most well-known causes of shoulder pain and disability. Although surgery has a good rate of success it does not help in all cases. Unsatisfactory results may be experienced in patients who have diabetes mellitus as a confounding factor.

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