scholarly journals Calcifying tendinitis of the shoulder: arthroscopic needling versus complete calcium removal and rotator cuff repair. A prospective comparative study

Joints ◽  
2015 ◽  
Vol 03 (04) ◽  
pp. 166-172 ◽  
Author(s):  
Alessandro Castagna ◽  
Silvana De Giorgi ◽  
Raffaele Garofalo ◽  
Marco Conti ◽  
Silvio Tafuri ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Comparative Study ◽  
Clinical Outcomes ◽  
Tendon Repair ◽  
Complete Removal ◽  
Calcium Deposit ◽  
Calcifying Tendinitis ◽  
Clinical Scores ◽  
Prospective Comparative Study

Purpose: the aim of the present study was to verify the differences in the clinical outcomes of two arthroscopic techniques used to treat calcifying tendinitis of the shoulder: needling versus complete removal of the calcium deposit and tendon repair. Methods: from September 2010 to September 2012, 40 patients with calcifying tendinitis of the rotator cuff were arthroscopically treated by the same surgeon using one of the two following techniques: needling (Group 1) and complete removal of the calcium deposit and tendon repair with suture anchors (Group 2). Both groups followed the same rehabilitation program. The two groups were compared at 6 and 12 months of follow-up for the presence of residual calcifications and for the following clinical outcomes: Constant score, American Shoulder and Elbow Surgeons Evaluation Form (ASES) shoulder score, University of California Los Angeles (UCLA) shoulder rating scale, Simple Shoulder Test (SST) and Visual Analogue Scale (VAS). Results: all the clinical scores (Constant, ASES, UCLA, SST and VAS scores) improved significantly between baseline and postoperative follow-up, both at 6 and at 12 months. no differences at final follow-up were found between the two groups. Conclusions: both the techniques were effective in solving the symptoms of calcifying tendinitis of the shoulder. Clinical scores improved in both groups. Residual calcifications were found in only a few cases and were always less than 10 mm. Level of evidence:Level II, prospective comparative study.

Quantitative Magnetic Resonance Imaging UTE-T2* Mapping of Tendon Healing After Arthroscopic Rotator Cuff Repair: A Longitudinal Study

2020 ◽  
Vol 48 (11) ◽  
pp. 2677-2685
Author(s):  
Yuxue Xie ◽  
Shaohua Liu ◽  
Jianxun Qu ◽  
Puye Wu ◽  
Hongyue Tao ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
T2 Mapping ◽  
Healing Process ◽  
Tendon Healing ◽  
Healthy Controls ◽  
Clinical Scores ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Background: Quantitative ultrashort echo time–T2* (UTE-T2*) mapping shows promise for the detection of potential tendon biochemical conditions, while validation against established clinical studies in the shoulder is needed. Purpose: To evaluate and characterize the healing process of the repaired rotator cuff based on longitudinal changes in UTE-T2* values, clinical outcomes, and repair status in patients after arthroscopic rotator cuff repair (ARCR). Study Design: Cohort study; Level of evidence, 2. Methods: Patients with ARCR (n = 25) underwent quantitative MRI and clinical examinations at serial follow-up time points: 3, 6, 12, and 24 months postoperatively. Age-matched healthy controls (n = 15) were evaluated at 3 and 12 months after enrollment. Clinical scores included the Constant, American Shoulder and Elbow Surgeons, and Fudan University Shoulder score, and visual analog scale for pain. The MRI examination included UTE-T2*mapping. UTE-T2* maps were generated for T2* values at the healing site. Sugaya classification was adopted to evaluate the repair status. Longitudinal analyses of clinical outcomes, UTE-T2* changes, and Sugaya classification were conducted. Results: The overall retear rate was 8% (2/25, all Sugaya type IV). All patients (including the ones with retear) achieved satisfactory outcomes at 12 months that lasted to 24 months on the basis of clinical scores. The mean UTE-T2* values at the healing site showed an increase from 3 to 6 months ( P = .03) and then decreased to a level similar to that observed in age-matched healthy tendons at 12 months ( P = .1). No significant differences were found between UTE-T2* values at 12 and 24 months ( P = .6). UTE-T2* values at the healing site significantly varied with the repair status according to Sugaya classification ( P < .05). Moreover, significant correlations were noted between clinical scores and UTE-T2* values at 6 months ( r = −0.6 to −0.3; all P < .05) and 12 months ( r = −0.6 to −0.2; all P < .05). Conclusion: This study indicated a healing-related relationship between clinical outcomes and quantitative UTE-T2* values, which highlights the potential of using UTE-T2* mapping to track the tendon-healing process noninvasively. Moreover, the repaired tendon was comparable to age-matched healthy controls at 12-month follow-up based on UTE-T2* values.

scholarly journals The Effect of Critical Shoulder Angle on Clinical Scores and Retear Risk After Rotator Cuff Tendon Repair at Short-term Follow Up

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Tahsin Gürpınar ◽  
Barış Polat ◽  
Engin Çarkçı ◽  
Murat Eren ◽  
Ayşe Esin Polat ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Tendon Repair ◽  
Short Term ◽  
Rotator Cuff Tendon ◽  
Critical Shoulder Angle ◽  
Clinical Scores ◽  
Shoulder Angle

Efficacy of Adjuvant Application of Platelet-Rich Plasma After Needle Aspiration of Calcific Deposits for the Treatment of Rotator Cuff Calcific Tendinitis: A Double-Blinded, Randomized Controlled Trial With 2-Year Follow-up

2021 ◽  
Vol 49 (4) ◽  
pp. 873-882
Author(s):  
Bart W. Oudelaar ◽  
Rianne Huis In ‘t Veld ◽  
Edwin M. Ooms ◽  
Relinde Schepers-Bok ◽  
Rob G.H.H. Nelissen ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Rotator Cuff ◽  
Mixed Model ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Needle Aspiration ◽  
Randomized Controlled ◽  
Clinical Scores ◽  
Calcific Deposits

Background: Needle aspiration of calcific deposits (NACD) is a frequently used treatment for rotator cuff calcific tendinitis (RCCT). However, a substantial number of patients experience recurrent or persisting shoulder symptoms after NACD. Purpose: To compare the effects of adjuvant application of platelet-rich plasma (PRP) after NACD (NACP+PRP) with those of conventional NACD with corticosteroids (NACD+corticosteroids) on pain, shoulder function, and quality of life (QoL). Study Design: Randomized controlled trial; Level of evidence, 1. Methods: In a single-center, double-blinded, randomized controlled trial, 80 adults with symptomatic RCCT were randomly allocated to receive NACD+corticosteroids or NACD+PRP. Pain, shoulder function, and QoL were assessed at baseline; 6 weeks; and 3, 6, 12, and 24 months after treatment using a numeric rating scale for pain (NRS); the Constant-Murley score (CMS); the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH); the Oxford Shoulder Score (OSS); and the EuroQol 5-dimension scale (EQ-5D). Additionally, resorption of calcific deposits and the integrity of rotator cuff tendons were assessed by using standard radiographs and ultrasound examination, respectively. The results were analyzed using noninferiority analysis for NRS scores and a mixed model for repeated measures. Results: Eighty patients were included (48 female; mean age, 49 ± 6 years; 41 patients in the NACD+PRP group). Both groups showed improvement of clinical scores at the 2-year follow-up ( P < .001 for all clinical scores). NACD+PRP was found to be noninferior to NACD+corticosteroids with regard to the mean decrease of NRS scores (4.34 vs 3.56; P = .003). Mixed-model analysis showed a significant difference in favor of NACD+PRP (CMS, P < .001; DASH, P = .002; OSS, P = .010; EQ-5D, P < .001). However, clinically relevant differences in favor of NACD+PRP were only seen at the 6-month follow-up for NRS and CMS scores, whereas at the 6-week follow-up a clinically relevant difference in favor of NACD+corticosteroids was found for all clinical scores except for the NRS. Full resorption of calcific deposits was present in 84% of the NACD+PRP group compared with 66% in the NACD+corticosteroids group ( P = .081). In the NACD+PRP group, 10 (24%) patients required a second NACD procedure compared with 19 (49%) patients in the NACD+corticosteroids group ( P = .036). Six complications, of which 5 were frozen shoulders, occurred in the NACD+PRP group compared with 1 complication in the NACD+corticosteroids group ( P = .11). Conclusion: NACD+PRP resulted in worse clinical scores at the 6-week follow-up but better clinical scores at the 6-month follow-up compared with NACD+corticosteroids. At the 1- and 2-year follow-ups, the results were comparable between groups. Furthermore, PRP seemed to reduce the need for additional treatments but was associated with more complications. In conclusion, NACD+corticosteroids had a favorable early effect on pain and function combined with low comorbidity. Thus, it remains the treatment of choice for patients with RCCT. Registration: NCT02173743 (ClinicalTrials.gov identifier).

scholarly journals Comparative study between endoscopic cartilage myringoplasty and endoscopic temporalis fascia myringoplasty

2018 ◽  
Vol 5 (1) ◽  
pp. 24 ◽  
Author(s):  
P. Chozhan ◽  
M. Sankara Subramanian ◽  
D. Kannathal ◽  
R. Malarvizhi
Keyword(s):  
Comparative Study ◽  
Prospective Study ◽  
Temporalis Fascia ◽  
Ear Surgery ◽  
Medical College ◽  
The World ◽  
Prospective Comparative Study ◽  
Patient Series ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Myringoplasty is a common ear surgery performed all over the world. This study is focused on prospective comparative study using two different graft materials.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study done in the Department of ENT Stanley Medical College, Chennai during the period from March 2013 to September 2013. Sample size was 60 patients. Follow up was done till 6 months.  </p><p class="abstract"><strong>Results:</strong> Graft acceptance was achieved in 28 patients (93%) who underwent palisade cartilage myringoplasty, whereas it was achieved in 24 patients (80%) in the temporalis fascia myringoplasty group.</p><p class="abstract"><strong>Conclusions:</strong> The outcomes in our patient series indicate that cartilage myringoplasty achieves good results. Cartilage, a very effective material for the reconstruction of the TM and grafts can provide an excellent anatomical result, perfect stability and good functional outcome.</p>

scholarly journals Reduction of the Risk of Relapse of Symptoms When Using Esophagoprotector in Patients Requiring Temporary Cancellation of Antisecretory Therapy

2021 ◽  
Vol 17 (16) ◽  
pp. 26-30
Author(s):  
Yu.A. Kucheryavy ◽  
◽  
P.R. Movtaeva ◽  
D.N. Andreev ◽  
R.I. Shaburov ◽  
...  
Keyword(s):  
Comparative Study ◽  
Underlying Disease ◽  
On Demand ◽  
Long Time ◽  
Prospective Comparative Study ◽  
Group 2 ◽  
Significant Regression ◽  
Risk Of Relapse ◽  
Group 1

Objective: to evaluate the effectiveness of an esophagoprotector in reducing the risk of recurrent symptoms of gastroesophageal reflux disease (GERD) in patients who requiring temporary cancellation of therapy with proton pump inhibitors (PPIs). Material and methods. For the prospective comparative study there were selectively chose patients who had been taking PPIs for a long time (at least one month) for the underlying disease and who required temporary discontinuation of antisecretory therapy due to objective medical reasons. The study included patients with endoscopically and/or pH-metrically verified GERD, as well as histologically verified Barrett's esophagus. In the process of randomization of patients, two equal groups were formed, depending on the therapy received at the time of PPI withdrawal: group 1 received antacids on demand, group 2 received antacids on demand, as well as the esophagoprotector Alfasoxx at a dose of 10 ml four times a day (after each meal and at night). The follow-up period was two weeks. The patients recorded episodes of heartburn in their personal diaries. Results. The study included 60 patients (28 men and 32 women). The average age of the examined patients was 43.1 ± 5.3 years. By the end of the two-week follow-up period, the frequency of recurrent symptoms in group 1 was 36.7%, while in group 2 it was 13.3%. The use of the esophagoprotector Alfasoxx contributed to the significant regression of the risk of heartburn recurrence (odds ratio 0.2657; 95% confidence interval (CI) 0.07328-0.9637; p = 0.0438) in comparison with the group of patients who received only antacids in the on-demand mode. When analyzing the population of patients who had relapsed symptoms, it was demonstrated that the average number of heartburn episodes in group 1 was 6.18 (95% CI 4,1930-8,1706), and in group 2 – 4.50 (95% CI 0,7121-8,2879). Conclusion. This prospective comparative study demonstrated that the use of the esophagoprotector Alfasoxx helps to reduce the risk of relapse of GERD symptoms in patients requiring temporary cancellation of PPI therapy.

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