Intra-articular treatment with corticosteroids increases apoptosis in human rotator cuff tears

2018 ◽  
Vol 60 (3) ◽  
pp. 283-290 ◽  
Author(s):  
Juan Pablo Ramírez ◽  
Francesca Bonati-Richardson ◽  
María Pía García ◽  
Christian Hidalgo ◽  
Caroll Stoore ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Human Rotator Cuff

A Biomechanical Model for Augmented Human Rotator Cuff Repairs

2010 ◽  
Author(s):  
Amit Aurora ◽  
Jorge E. Gatica ◽  
Antonie J. van den Bogert ◽  
Jesse A. McCarron ◽  
Kathleen A. Derwin
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Biomechanical Model ◽  
Load Sharing ◽  
Analytical Models ◽  
Rotator Cuff Tears ◽  
Synthetic Scaffolds ◽  
Cuff Repair ◽  
Human Rotator Cuff ◽  
Made In

Rotator cuff tears affect 40% or more of those over age 60 and are a common cause of pain and disability. Surgical repairs have high failure rates that range from 20 to 90%. Hence, natural and synthetic scaffolds are being developed to mechanically augment tendon repairs and to biologically enhance the intrinsic healing potential of the patient. When used as an augmentation device, scaffolds are believed to provide some degree of load sharing in a manner that decreases the likelihood of tendon re-tear. While significant advances are being made in the development of scaffolds, no studies have investigated the degree of load sharing provided by a scaffold used for rotator cuff repair augmentation. Furthermore, the manner in which loads on an augmented rotator cuff repair are distributed amongst the various components of the repair is not known, nor is the relative biomechanical importance of the various components of the repair. To answer these questions, the objectives of this study are to (1) develop quasi-static analytical models of simplified rotator cuff repairs, (2) validate the models by comparing the predicted model force to experimental measurements of force for human rotator cuff repairs, and (3) use the models to predict the degree of load sharing provided by a scaffold used for rotator cuff repair augmentation.

Accuracy of Rotator Cuff Tears and Tendinosis Diagnoses on Shoulder Ultrasound Performed by a Short-experienced Operator

2018 ◽  
Vol 1 ◽  
pp. 9
Author(s):  
Harshad Arvind Vanjare ◽  
Jyoti Panwar
Keyword(s):  
Rotator Cuff ◽  
Negative Predictive Value ◽  
Rotator Cuff Tear ◽  
Predictive Value ◽  
Rotator Cuff Tears ◽  
Mri Findings ◽  
Cuff Tear ◽  
Experienced Operator ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Objective The objective of the study was to assess the accuracy of ultrasound examination for the diagnosis of rotator cuff tear and tendinosis performed by a short experienced operator, compared to magnetic resonance imaging (MRI) results. Method A total of 70 subjects suspected to have rotator cuff tear or tendinosis and planned for shoulder MRI were included in the study. Shoulder ultrasound was performed either before or after the MRI scan on the same day. Ultrasound operator had a short experience in performing an ultrasound of the shoulder. Ultrasound findings were correlated to MRI findings. Results Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the diagnosis of tendinosis were 58%, 84%, 63%, 80%, and 75%, respectively, and it was 68%, 91%, 73%, 88%, and 85%, respectively, for the diagnosis of rotator cuff tear. Conclusions Sensitivity for diagnosing rotator cuff tear or tendinosis was moderate but had a higher negative predictive value. Thus, the ultrasound operator with a short experience in performing shoulder ultrasound had moderate sensitivity in diagnosing tendinosis or tears; however, could exclude them with confidence.

scholarly journals Use of Gracile and semi-tendinosus tendons (GRAST) for the reconstruction of irreparable rotator cuff tears

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marie Protais ◽  
Maxime Laurent-Perrot ◽  
Mickaël Artuso ◽  
M. Christian Moody ◽  
Alain Sautet ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Donor Site ◽  
Anatomical Study ◽  
Donor Site Morbidity ◽  
Rotator Cuff Tears ◽  
Subacromial Space ◽  
Greater Tuberosity ◽  
Working Zone ◽  
Superior Capsular Reconstruction

Abstract Background Irreparable rotator cuff tears are common and difficult to treat. Techniques for “filling the loss of substance” require fixation to the rotator cuff stump (tendon augmentation) or to the glenoid (superior capsular reconstruction), which are complicated by the narrow working zone of the subacromial space. The main objective of this study was to determine whether a braided graft of gracilis (GR) and semitendinosus (ST) could fill a loss of tendon substance from an irreparable rupture of the supra- and infraspinatus, by fixing the graft to the greater tuberosity and the spine of the scapula. Methods This was a cadaveric study with the use of ten specimens. The GRA and ST tendons were harvested, braided and reinforced with suture. An experimental tear of the supraspinatus (SS) and upper infraspinatus (IS) retracted at the glenoid was made. The GRAST transplant was positioned over the tear. The transplant was attached to the greater tuberosity by two anchors and then attached to the medial third of the scapular spine by trans-osseous stitching. The percentage of filling obtained was then measured and passive mobility of the shoulder was assessed. We proceeded to the same technique under arthroscopy for a 73 years old patient whom we treated for a painful shoulder with irreparable cuff tear. We inserted a GRAST graft using arthroscopy. Results The Braided-GRAST allowed a 100% filling of the loss of tendon substance. Mobility was complete in all cases. Conclusion This technique simplifies the medial fixation and restores the musculo-tendinous chain where current grafting techniques only fill a tendinous defect. The transplant could have a subacromial “spacer” effect and lower the humeral head. The donor site morbidity and the fate of the transplant in-vivo are two limits to be discussed. This anatomical study paves the way for clinical experimentation.

scholarly journals Tendon transfers for irreparable rotator cuff tears

2021 ◽  
Author(s):  
John R. Adam ◽  
Shashi K.T. Nanjayan ◽  
Melissa Johnson ◽  
Amar Rangan
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Tendon Transfers
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