A study on the position sense of the shoulder joint in the cases of the rotator cuff tears

1995 ◽  
Vol 4 ◽  
pp. S82 ◽  
Author(s):  
Yutaka Morisawa
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Position Sense ◽  
Rotator Cuff Tears

scholarly journals Biceps Detachment Preserves Joint Function in a Chronic Massive Rotator Cuff Tear Rat Model

2018 ◽  
Vol 46 (14) ◽  
pp. 3486-3494 ◽  
Author(s):  
Mengcun Chen ◽  
Snehal S. Shetye ◽  
Julianne Huegel ◽  
Corinne N. Riggin ◽  
Daniel J. Gittings ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Subscapularis Tendon ◽  
Joint Function ◽  
Massive Rotator Cuff Tears ◽  
Sham Surgery ◽  
Biceps Tenotomy

Background: Lesions of the long head of the biceps tendon are often associated with massive rotator cuff tears (MRCTs), and biceps tenotomy is frequently performed for pain relief and functional reservation. However, the efficacy and safety of biceps tenotomy regarding the effects on the surrounding tissues in chronic MRCT are unclear. Hypothesis: Biceps tenotomy would result in improved mechanical and histological properties of the intact subscapularis tendon and improved in vivo shoulder function while not compromising glenoid cartilage properties. Study Design: Controlled laboratory study. Methods: Right supraspinatus and infraspinatus tendons were detached in 25 male Sprague-Dawley rats, followed by 4 weeks of cage activity to create a chronic MRCT condition. Animals were randomly divided into 2 groups and received either biceps tenotomy (n = 11) or sham surgery (n = 14) and were sacrificed 4 weeks thereafter. Forelimb gait and ground-reaction forces were recorded 1 day before the tendon detachment (baseline), 1 day before the surgical intervention (biceps tenotomy or sham), and 3, 7, 10, 14, 21, and 28 days after the intervention to assess in vivo shoulder joint function. The subscapularis tendon and glenoid cartilage were randomly allocated for mechanical testing or histologic assessment after the sacrifice. Results: Compared with sham surgery, biceps tenotomy partially restored the in vivo shoulder joint function, with several gait and ground-reaction force parameters returning closer to preinjury baseline values at 4 weeks. With biceps tenotomy, mechanical properties of the subscapularis tendons were improved, while mechanical properties and histological Mankin scores of the glenoid cartilage were not diminished when compared with the sham group. Conclusion: Biceps tenotomy in the presence of chronic MRCT partially preserves overall shoulder function and potentially restores subscapularis tendon health without causing detrimental effects to joint cartilage. This laboratory study adds to the growing literature regarding the protective effects of biceps tenotomy on the shoulder joint in a chronic MRCT model. Clinical Relevance: This study provides important basic science evidence supporting the use of biceps tenotomy in patients with massive rotator cuff tears.

scholarly journals The experience with the use of a subacromial balloon in the treatment of patients with large, massive, irreparable rotator cuff tears

2020 ◽  
Vol 11 (4) ◽  
pp. 14-22
Author(s):  
Мaksim F. Lazko ◽  
Alexey P. Prizov ◽  
Fedor L. Lazko ◽  
Evgeny A. Beliak ◽  
Ivan G. Maglaperidze ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Pain Syndrome ◽  
Rotator Cuff Tears ◽  
Average Score ◽  
Subacromial Space ◽  
Rotator Cuff Injuries ◽  
Goutallier Classification ◽  
Upper Extremity Function ◽  
A Prospective Study

Background. Large, massive irreparable rotator cuff tears lead to a significant decrease in the function of the shoulder joint together with the development of a pronounced pain syndrome. Such injuries are difficult to treat, and the number of relapses, when trying to restore them, is quite high. The installation of a subacromial balloon is the method of choice for this group of patients and allows restoring the function of the shoulder joint fairly successfully. Aim: to evaluate the results of the treatment of patients with massive irreparable rotator cuff tears injuries in a prospective study from 2016 to 2018. Methods. The results of the arthroscopic treatment of large, irreparable rotator cuff injuries in 25 patients (with the average age of 67 5 years) with the installation of a subacromial balloon are presented. In all the clinical cases, there was a pronounced (grades 34, according to the Goutallier classification) fatty dystrophy of the rotator cuff muscles (supraspinatus or in combination with subaspinatus). All the patients underwent the subacromial space release with a thorough bursectomy and subsequent installation of a subacromial balloon. Results. The average score on the UCLA scale was 14 3 points (1117) before the operation and 312 points (2933) 12 months after the operation, the results were considered good and excellent. Conclusion. The results obtained allow us to evaluate the described technique as low-traumatic, simple and fast in its accomplishment, aimed at the reduction of the pain syndrome and restoration of the upper extremity function.

scholarly journals Features of Partial Rotator Cuff Tears Diagnostics

2019 ◽  
Vol 25 (2) ◽  
pp. 143-149 ◽  
Author(s):  
A. N. Logvinov ◽  
D. O. Ilyin ◽  
P. M. Kadantsev ◽  
O. V. Makarieva ◽  
M. E. Burtsev ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Articular Surface ◽  
Supraspinatus Tendon ◽  
Rotator Cuff Tears ◽  
Joint Surface ◽  
Subacromial Space ◽  
Diagnostic Significance ◽  
Combined Application ◽  
Shoulder Range Of Motion

Partial rotator cuff tears are the most common pathology of the shoulder joint. Diagnostic of such conditions is a challenging problem for trauma surgeon.Purpose of the study is to analyze the diagnostic significance of manual tests and the standard MRI of the shoulder joint.Materials and Methods. The study is a retrospective analysis of disease history data of 25 patients (15 males, 10 females) treated at the authors’ hospital during the period from 2014 to 2017. Examination was performed according to a standard protocol: assessment of shoulder range of motion, palpation, manual examination, including “full/empty can” test, a painful arc symptom and the Hawkins – Kennedy test. All patients underwent MRI of the shoulder joint. The mean age of patients was 50.8 years. Shoulder joint arthroscopic inspection was considered the gold standard for diagnostics.Results. After data analysis, the following results were obtained: sensitivity of the “full can” test was 68%, the accuracy was 68%; “empty can” test sensitivity and accuracy were 76%, respectively. MRI sensitivity for diagnostics of supraspinatus tendon ruptures was 84% with the accuracy of 84%. The combination of the Hawkins – Kennedy test with the symptom of painful arch demonstrated accuracy and sensitivity of 64%. The study evaluated the effectiveness of MRI for diagnostic of the rupture type: sensitivity for injury from the joint surface — 80%, from the subacromial space — 70%; specificity for ruptures from the articular surface — 90% and from the subacromial space — 93%. The accuracy was 84% for both types of ruptures.Conclusions. Combined application of manual tests and MRI of the shoulder joint allows to diagnose partial rotator cuff tears in the majority of cases.

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.

Primary and Secondary Consequences of Rotator Cuff Injury on Joint Stabilizing Tissues in the Shoulder

2017 ◽  
Vol 139 (11) ◽  
Author(s):  
Hafizur Rahman ◽  
Eric Currier ◽  
Marshall Johnson ◽  
Rick Goding ◽  
Amy Wagoner Johnson ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Treatment Algorithm ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Shoulder Injuries ◽  
Joint Stability ◽  
Shoulder Injury ◽  
Physician Visits ◽  
Variable Success Rate

Rotator cuff tears (RCTs) are one of the primary causes of shoulder pain and dysfunction in the upper extremity accounting over 4.5 million physician visits per year with 250,000 rotator cuff repairs being performed annually in the U.S. While the tear is often considered an injury to a specific tendon/tendons and consequently treated as such, there are secondary effects of RCTs that may have significant consequences for shoulder function. Specifically, RCTs have been shown to affect the joint cartilage, bone, the ligaments, as well as the remaining intact tendons of the shoulder joint. Injuries associated with the upper extremities account for the largest percent of workplace injuries. Unfortunately, the variable success rate related to RCTs motivates the need for a better understanding of the biomechanical consequences associated with the shoulder injuries. Understanding the timing of the injury and the secondary anatomic consequences that are likely to have occurred are also of great importance in treatment planning because the approach to the treatment algorithm is influenced by the functional and anatomic state of the rotator cuff and the shoulder complex in general. In this review, we summarized the contribution of RCTs to joint stability in terms of both primary (injured tendon) and secondary (remaining tissues) consequences including anatomic changes in the tissues surrounding the affected tendon/tendons. The mechanical basis of normal shoulder joint function depends on the balance between active muscle forces and passive stabilization from the joint surfaces, capsular ligaments, and labrum. Evaluating the role of all tissues working together as a system for maintaining joint stability during function is important to understand the effects of RCT, specifically in the working population, and may provide insight into root causes of shoulder injury.

scholarly journals A Comparative Evaluation of Rotator Cuff Injuries of the Shoulder Joint using High Resolution Ultrasound and Magnetic Resonance Imaging

2012 ◽  
Vol 10 (1) ◽  
pp. 9-14 ◽  
Author(s):  
MS Shrestha ◽  
A Alam
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Rotator Cuff ◽  
Diagnostic Accuracy ◽  
Shoulder Joint ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Resonance Imaging ◽  
Rotator Cuff Injuries

Introduction: Pathology of the rotator cuff is the cause of most common problems at the shoulder joint and accurate diagnosis is essential for appropriate management. High-resolution real-time ultrasonography and MRI are successful imaging modalities for both rotator cuff and non–rotator cuff disorders and have important implications in the management of rotator cuff pathologies. This study was conducted to Compare the results obtained after the evaluation of rotator cuff injuries of shoulder joint by high resolution Ultrasonography and Magnetic Resonance Imaging. Methods: 50 patients with suspected rotator cuff injuries of the shoulder joint were included in this study over a period of 2years. Patients had presented with various complaints like prolonged pain in the shoulder joint with stiffness, restriction and difficulty in movement of the shoulder joint, traumatic injuries and recurrent dislocations of the shoulder joints. Results: Mean age was 41.6years ( range 15-80 ).Maximum patients were between 41-50 years (24%). 29 were males and 21 were females. In our study diagnostic accuracy of ultrasound in rotator cuff tears was 57. 14% for full thickness tears and 58.33 for partial thickness tears. The diagnostic accuracy of ultrasound in detection of complete tear of the supraspinatus muscle was 57.14% while that of MRI was 100%. Conclusion: High resolution Ultrasound being a dynamic study can be used as the first-line investigation for rotator cuff tear. Full-thickness rotator cuff tears can be identified using ultrasound and MRI with comparable accuracy. DOI: http://dx.doi.org/10.3126/mjsbh.v10i1.6443 Medical Journal of Shree Birendra Hospital Jan-June 2011 10(1) 9-14

scholarly journals Advanced Glycation End-products Are Associated With Limited Range of Motion of the Shoulder Joint Following Rotator Cuff Tears

2022 ◽  
Author(s):  
Issei Shinohara ◽  
Yutaka Mifune ◽  
Atsuyuki Inui ◽  
Hanako Nishimoto ◽  
Kohei Yamaura ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Rotator Cuff ◽  
Advanced Glycation End Products ◽  
Shoulder Joint ◽  
Limited Range ◽  
Rotator Cuff Tears ◽  
Advanced Glycation ◽  
Limited Range Of Motion ◽  
Glycation End Products ◽  
End Products

Abstract Background: Most degenerative rotator cuff tears (RCTs) are associated with a limited range of motion (ROM) of the shoulder joint. Additionally, patients with diabetes mellitus (DM) show a higher frequency of limited ROM. Recently, advanced glycation end products (AGEs) of proteins have been observed to cause tissue fibrosis, primarily through abnormal collagen cross-linking and oxidative stress. In this study, we investigated the effect of AGEs on ROM limitation in the shoulder capsule and its relationship with DM.Methods: 16 patients (8 each in the DM and non-DM groups) who underwent arthroscopic surgery for RCT with limited shoulder ROM were included in this study. AGE-related pathologies in both groups were compared, and the relationship between AGE accumulation and shoulder joint ROM was evaluated. Shoulder capsule tissue was harvested and subjected to histological and in vitro evaluation. Results: The DM group displayed high levels of AGEs and reactive oxygen species (ROS), and reduced cell viability. There was a significant positive correlation between ROS expression, apoptosis, and preoperative hemoglobin A1c. ROS expression, apoptosis, and ROM of the shoulder joint showed a negative correlation. The NADPH oxidase (NOX) expression and collagen III/I ratio were significantly higher in the DM group than in the non-DM group.Conclusions: The DM group showed significant AGE deposition in the shoulder capsule. Additionally, there was a significant association between AGEs and ROM limitation. The oxidative stress induced by AGE deposition, which leads to fibrosis and local inflammation, might contribute to the limited ROM of the shoulder joint.

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