Transmural supraspinatus tendon tear caused by suture anchor tip 19-month postacromioclavicular joint stabilisation

2021 ◽  
Vol 14 (7) ◽  
pp. e242511
Author(s):  
Manuel Waltenspül ◽  
Karl Wieser ◽  
Samy Bouaicha
Keyword(s):  
Case Report ◽  
Rotator Cuff ◽  
Suture Anchor ◽  
Supraspinatus Tendon ◽  
Anatomical Location ◽  
Ac Joint ◽  
Tendon Tear ◽  
Paediatric Patients ◽  
Lateral Clavicle ◽  
Rotator Cuff Injuries

Rotator cuff injuries present rarely in paediatric patients due to the tendon strength at this age. There are reports of ruptures caused by either irritation of the lateral clavicle or acromioclavicular (AC) joint in fractures or after usage of hook plates. In this case report, we present a patient with an acute complete supraspinatus rupture caused by a suture anchor tip from a previously performed AC joint stabilisation. After the diagnosis of a new complete supraspinatus, the causative prominent suture anchor was removed, and the tendon subsequently repaired. This case highlights the close anatomic relation of the AC joint and the rotator cuff, which is imperative to adequately address in injuries to this anatomical location.

scholarly journals Repair of Lafosse I subscapularis injury adds no additional value in anterosuperior rotator cuff injury

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Binghao Zhao ◽  
Qingsong Zhang ◽  
Bo Liu
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Shoulder Joint ◽  
Statistical Difference ◽  
Supraspinatus Tendon ◽  
Joint Function ◽  
Tendon Tear ◽  
Rotator Cuff Injury ◽  
Additional Value ◽  
Repair Group

Abstract Background The study aimed to explore the additional value of repair of Lafosse I subscapularis injury compared with debridement in anterosuperior rotator cuff injury. Methods The prospective study was conducted on a total of 41 patients with supraspinatus tendon tear combined with Lafosse I subscapularis injury. Eighteen patients were divided into the repair group and 23 patients were divided into the non-repair group. The two groups were compared for intraoperative parameters, pain score, range of motion of the shoulder joint, shoulder joint function and quality of life (QoL) at pre-operation, 3 and 6 months postoperatively and the final follow-up visit. Results The width of supraspinatus tendon tear did not exceed 3 cm and did not retract beyond the glenoid in among patients. There was no statistical difference of preoperative data between two groups, including age, course of disease, positive Jobe test, positive Bear-hug test, positive Lift-off test, Patte stage, longitudinal tear and pain severity (P > 0.05). Compared to preoperative levels, the severity of pain, ASES scores and EQ-5D-3L scores were significantly lower at 3 and 6 months postoperatively and the final position (P < 0.05). However, there was no statistical difference in pain severity, ASES scores and EQ-5D-3L scores between repair group and non-repair group (P > 0.05). Similarly, compared to preoperative levels, the range of motion of shoulder joint was significantly improved after operation, including internal rotation, external rotation, forward flexion and elevation (P < 0.05). However, there was no statistical difference in range of motion of shoulder joint between repair group and non-repair group (P > 0.05). Conclusion Operative treatment can effectively lessen severity of pain in the patients, improve shoulder joint function, increase the range of motion of the shoulder joint and enhance the QoL in treating anterosuperior rotator cuff injury. However, repair of subscapularis brings no benefit compared to debridement in treating supraspinatus tendon tear combined with Lafosse I subscapularis injury.

Ultrasonography and MR Arthrogram in detection of shoulder joint disorders

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Souad Elsayed Mohammed Mansour ◽  
Mohammed Sobhi Hassan ◽  
Mohammed Gamal Eldin Abdel Motelib
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Shoulder Dislocation ◽  
Mr Arthrography ◽  
Golden Rule ◽  
Supraspinatus Tendon ◽  
Tendon Tear ◽  
Diagnosis Classification

Abstract Purpose To know the role of Ultrasonography and MR Arthrogram in detection of shoulder joint disorders Methods and material Thirty patients with suspected shoulder joint disorders underwent US,MRI ,MR arthrography shoulder. Results All cases with ALAPSA, Bankert, reverse bankert, hillsachs, perthes and SLAP are diagnosed accurately by MR arthrography with sensitivity of (100%) in GLAD ,Supraspinatus tendenopathy ,Supraspinatus tendon tear and IGHL injury sensitivity was decreased to 75%,in cases of paraglenid cysts arthrography did not diagnose any of them as there are no communication between the cyst and the joint Conclusion MR arthrography shoulder has a golden rule in diagnosis ,classification of cases of shoulder dislocation ,SLAP injuries and rotator cuff impingement

A Novel Acromion Radiological Classification and Its Clinical Application Study: Comparing Rockwood Tilt View with Arthroscopic Findings in 101 Shoulders

2020 ◽  
Vol 10 (5) ◽  
pp. 1184-1189
Author(s):  
Yingchun Zhu ◽  
Xuewen Jia ◽  
Zhanping Jin ◽  
Yunfeng Mi ◽  
Zheyang Wang ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Classification System ◽  
Supraspinatus Tendon ◽  
New Classification ◽  
Tendon Tear ◽  
Cuff Tear ◽  
Observer Reliability ◽  
Traditional Classification

Background: It is estimated that more than 25% of general population more than 60 years old experience rotator cuff tear, acromial impingement syndrome is one of the most common causes. Morphology of acromion is an important extrinsic factor in the development of rotator cuff tear. The traditional classification of the acromion by Bigliani et al. based on supraspinatus outlet view has been widely used, but due to the high requirements for patients to obtain true supraspinatus outlet view and the poor inter-observer reliability, it brings lots of limitations to the clinical use of this classification. In our clinical work, we have noticed that the formation of acromial anterolateral spur on Rockwood tilt view has some relationship to a rotator cuff tear. Objectives: To develop a new classification of acromion based on the subacromial impingement theory and the Rockwood tilt view. And explore the application value of the new classification in the diagnosis and treatment of rotator cuff tear. Methods: From January 2017 to December 2017, 101 cases of shoulder arthroscopic surgeries for impingement syndrome or rotator cuff tear were retrospectively analyzed. We developed a new classification of the acromion based on the Rockwood tilt view as type I flat acromion, type II bump acromion and type III impingement acromion. The status of the supraspinatus tendon was also recorded as no tear, partial-thickness tear, and full-thickness tear. We tested the inter-observer and intra-observer reliability of the new classification system (Kappa value) and analyzed the correlation between the acromion morphology and the rupture of the supraspinatus tendon. Results: In all 101 cases, the most common type was the impingement acromion with 46 patients (45.5%), followed by bump acromion in 37 patients (36.6%), and the flat acromion in 18 patients (17.8%). The inter-observer reliability of the new classification system was significantly better than that of the traditional classification (0.826 vs. 0.281). The incidence of supraspinatus tendon tear in the patients with impingement acromion was significantly higher than that of the other two types of acromion (ϰ2 = 50.316,P < 0.05). Conclusion: The Rockwood tilt view can well demonstrate the exact architecture of the anterolateral acromion spur. The new classification based on Rockwood tilt view has high reliability and good reproducibility. The type III impingement acromion correlates highly with the supraspinatus tendon tear. Level of evidence: Level II.

scholarly journals Prevalence and Grading of Rotator Cuff and Labral Injuries in Shoulder Pain and Instability using MRI: ACross-sectional Study

2021 ◽  
Author(s):  
Ashok Srikar Chowdhary ◽  
Naresh Babu Lakshmipathi Nikhil ◽  
Nidhi Hemendra Chandrakar ◽  
Nidhi Raj Buddaraju
Keyword(s):  
Rotator Cuff ◽  
Shoulder Pain ◽  
Biceps Tendon ◽  
Supraspinatus Tendon ◽  
Sectional Study ◽  
Rotator Cuff Injuries ◽  
Rotator Cuff Injury ◽  
Biceps Pulley ◽  
Study Population ◽  
Long Head

Introduction: Shoulder joint is a highly mobile joint but is prone for rotator cuff injuries and dislocations. It is necessary to accurately diagnose rotator cuff and labral injuries so that appropriate plan of action for treatment can be taken. Magnetic Resonance Imaging (MRI) can be used to diagnose and describe the extent of rotator cuff tendon and labral injuries and any secondary rotator cuff muscle abnormalities. Aim: To study the demographic profile of patients presenting with shoulder pain and instability, identify the various rotator cuff injuries causing shoulder pain, identify the rotator cuff interval lesions causing microinstability, identify the various labral and bony pathologies in instability, describe the MRI features of the rotator cuff, rotator cuff interval, labral and bony injuries. Materials and Methods: This study was a cross-sectional study of patients with symptoms of either shoulder pain or instability who underwent MRI evaluation of the shoulder in the Department of Radiodiagnosis, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India, from July 2018 to December 2020. The study population consisted of 54 patients with either shoulder pain or instability who underwent MRI of shoulder. All the MRI scans of the shoulder in this study were performed using 1.5 Tesla Siemens Magnetom Avanto (Tim 76x18) MR machine using a flex coil. Results: The study population consisted of 54 patients comprising of 38 males and 16 females. The age of the patients ranged from 20-77 years. Majority of the patients were older than 50 years constituting about 33.33% of the total study population. Rotator cuff injury was the commonest cause of pain. Tendinosis was the commonest type of rotator cuff injury followed by partial-thickness and full-thickness tendon tears. The commonest grade of tendinosis was mild or grade 1. Supraspinatus tendon was the most commonly affected tendon followed by subscapularis and infraspinatus tendons. Teres minor tendon was normal in all the cases. Anterior instability was the commonest type of instability with equal prevalence of soft tissue Bankart, bony Bankart and Perthes lesions. Biceps pulley lesions resulted in long head of biceps tendon instability, microinstability and internal impingement. Conclusion: Rotator cuff injuries are the commonest cause of shoulder pain and are seen more frequently after the fifth decade. Shoulder instability is most commonly seen in young male adults. Tendinosis is the commonest type of rotator cuff injury. Supraspinatus tendon is the most commonly injured tendon. Anterior instability is the commonest type of shoulder instability. Biceps pulley lesions result in long head of biceps tendon instability, microinstability and internal impingement. MRI can diagnose interstitial or intrasubstance tendon tears which are not visualised on arthroscopy. MRI description of tendon and labral tears, tendon retraction and muscle atrophy can guide the orthopaedician during arthroscopy and in treatmentplanning.

scholarly journals Recovery of Range of Motion and Decrease in Pain after Progression of Supraspinatus Tendon Tear: A Case Report

2019 ◽  
Vol 13 (1) ◽  
pp. 84-88
Author(s):  
Yoshihiro Hagiwara ◽  
Junichiro Hamada ◽  
Akira Ando ◽  
Kenji Kanazawa ◽  
Yutaka Yabe ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
The Elderly ◽  
Supraspinatus Tendon ◽  
Operative Management ◽  
Rotator Cuff Tears ◽  
Tendon Tear ◽  
Duration Of Symptoms ◽  
First Case ◽  
The Right

Rotator cuff disease is one of the most prevalent shoulder disabilities especially in the elderly population. Tear progression is significantly greater in the symptomatic patients than in the asymptomatic ones. From these aspects, shoulder surgeons interpret surgical indications and counsel patients regarding the risk of non-operative treatments. However, there were a few reports that pain and duration of symptoms were not strongly associated with severity of rotator cuff tears, and non-operative management with physical therapy was effective. There have remained controversies for the treatment of rotator cuff tears.A 59-year-old man with a sedentary work life experienced right shoulder pain with abduction at night. However, the pain kept worsening after two months, and he finally visited our clinic three months after the onset of pain. Magnetic resonance imaging in the coronal and axial planes showed effusion around the subacromial and subcoracoid bursae and joint-side tear of the supraspinatus tendon. A range of motion in the right shoulder was severely restricted at the initial visit of our clinic. After sufficient rehabilitation, the symptoms were not changed and an arthroscopic rotator cuff repair was scheduled. However, during waiting for surgery, he felt something popped in the right shoulder while wearing a jacket. Immediately after this, pain during motion and at night decreased, and he experienced no difficulty with activities of daily living and the surgery was cancelled. This is the first case with a recovery of range of motion and a decrease in pain after progression of a supraspinatus tendon tear.

scholarly journals Combination of graphene oxide and platelet-rich plasma improves tendon-bone healing in a rabbit model of supraspinatus tendon reconstruction

2021 ◽  
Author(s):  
Dingsu Bao ◽  
Jiacheng Sun ◽  
Min Gong ◽  
Jie Shi ◽  
Bo Qin ◽  
...  
Keyword(s):  
Graphene Oxide ◽  
Rotator Cuff ◽  
Platelet Rich Plasma ◽  
Rabbit Model ◽  
Supraspinatus Tendon ◽  
In Vitro Assays ◽  
Tendon Reconstruction ◽  
Rotator Cuff Injuries ◽  
Tgf Β1

Abstract The treatment of rotator cuff tear is one of the major challenges for orthopedic surgeons. The key to treatment is the reconstruction of the tendon-bone interface (TBI). Autologous platelet-rich plasma (PRP) is used as a therapeutic agent to accelerate the healing of tendons, as it contains a variety of growth factors (GFs) and is easy to prepare. Graphene oxide (GO) is known to improve the physical properties of biomaterials and promote tissue repair. In this study, PRP gels containing various concentrations of GO were prepared to promote TBI healing and supraspinatus tendon reconstruction in a rabbit model. The incorporation of GO improved the ultrastructure and mechanical properties of the PRP gels. The gels containing 0.5 mg/mL GO (0.5GO/PRP) continuously released TGF-β1 and PDGF-AB, and the released TGF-β1 and PDGF-AB were still at high concentrations, ∼1063.451 pg/ml and ∼814.217 pg/ml, respectively, on the 14th day. In vitro assays showed that the 0.5GO/PRP gels had good biocompatibility and promoted BMSCs proliferation and osteogenic and chondrogenic differentiation. After 12 weeks of implantation, the MRI, μCT, and histological results indicated that the newly regenerated tendons in the 0.5GO/PRP group had a similar structure to natural tendons. Moreover, the biomechanical results showed that the newly formed tendons in the 0.5GO/PRP group had better biomechanical properties compared to those in the other groups, and had more stable TBI tissue. Therefore, the combination of PRP and GO has the potential to be a powerful advancement in the treatment of rotator cuff injuries.

scholarly journals Sonographic and MRI Presentation of Geyser Sign in Rotator Cuff Tears

2021 ◽  
Vol 0 ◽  
pp. 1-3
Author(s):  
Amandeep Singh ◽  
Aaina Devgan ◽  
Jasmin Khatana ◽  
Gauravdeep Singh
Keyword(s):  
Rotator Cuff ◽  
Ganglion Cyst ◽  
Incidental Finding ◽  
Supraspinatus Tendon ◽  
Rotator Cuff Tears ◽  
Left Shoulder ◽  
Full Thickness ◽  
Ac Joint ◽  
Benign Process

Limited cases of rotator cuff tears with acromioclavicular (AC) degeneration in association with cystic swelling or ganglion cyst have been described till date. The “geyser radiographic sign” was originally described by Craig in 1984. Its significance was to document a tear in the articular capsule of the AC joint in the setting of a chronic full-thickness tear of the rotator cuff, which gave the appearance of a geyser arising from the subacromial bursa as radiographic contrast tracked through the AC joint to project superiorly from the shoulder. An 82-year-old male presented with pain on rest in the left shoulder and with difficulty in overhead abduction from last few months. MRI showed near complete full-thickness tear of supraspinatus tendon with retraction of the tendon and reduced bulk of the supraspinatus muscle with associated superior subluxation of humerus with AC arthropathic changes causing ganglion cyst and incidental finding of superior labrum anterior and posterior tear. AC cysts are further divided into Type 1 and Type 2. Repeated aspirations of these masses are not advised, as they often recur and repeated attempts at aspiration may lead to formation of a draining fistula. MRI geyser sign is highly suggestive of a benign process, which suggests underlying rotator cuff pathology.

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