scholarly journals Characteristics and Clinical Outcomes in Overhead Sports Athletes after Rotator Cuff Repair

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Tomoyuki Muto ◽  
Hiroaki Inui ◽  
Hiroki Ninomiya ◽  
Hiroshi Tanaka ◽  
Katsuya Nobuhara
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Tears ◽  
Aged Patients ◽  
Overhead Athletes ◽  
Cuff Tear ◽  
Rotator Cuff Injuries ◽  
Overhead Sports ◽  
Infraspinatus Tendon

Rotator cuff tears in young overhead sports athletes are rare. The pathomechanism causing rotator cuff tears in young overhead athletes is different from that in aged patients. The purpose of this study was to investigate rotator cuff tear characteristics in young overhead sports athletes to reveal the pathomechanism causing these injuries. This study included 25 overhead sports athletes less than 30 years old with atraumatic rotator cuff tears necessitating repair. Rotator cuff tear characteristics were evaluated intraoperatively, including rotator cuff tear shape and injured rotator cuff tendon. Clinical outcome measures were assessed before surgery and at the final follow-up. In this study, 22 patients reported minimal to no shoulder pain and returned to sports without significant complaints at last follow-up. The isolated infraspinatus tendon was most often injured; the incidence rate of the tear at this site was 32% (8 cases). In the deceleration phase of overhead motion, the eccentric contraction force of the ISP (infraspinatus) tendon peaks and the increased load leads to injury at the ISP tendon. The pathomechanism of rotator cuff injuries in young overhead athletes might be not only internal or subacromial impingement, but also these mechanisms.

Comparison of Clinical and Structural Outcomes by Subscapularis Tendon Status in Massive Rotator Cuff Tear

2017 ◽  
Vol 45 (11) ◽  
pp. 2555-2562 ◽  
Author(s):  
Sung Hyun Lee ◽  
Dae Jin Nam ◽  
Se Jin Kim ◽  
Jeong Woo Kim
Keyword(s):  
Magnetic Resonance Imaging ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Tears ◽  
Subscapularis Tendon ◽  
Resonance Imaging ◽  
Massive Rotator Cuff Tear ◽  
Cuff Tear ◽  
Massive Rotator Cuff Tears

Background: The subscapularis tendon is essential in maintaining normal glenohumeral biomechanics. However, few studies have addressed the outcomes of tears extending to the subscapularis tendon in massive rotator cuff tears. Purpose: To assess the clinical and structural outcomes of arthroscopic repair of massive rotator cuff tears involving the subscapularis. Study Design: Cohort study; Level of evidence, 3. Methods: Between January 2010 and January 2014, 122 consecutive patients with massive rotator cuff tear underwent arthroscopic rotator cuff repair. Overall, 122 patients were enrolled (mean age, 66 years; mean follow-up period, 39.5 months). Patients were categorized into 3 groups based on subscapularis tendon status: intact subscapularis tendon (I group; n = 45), tear involving less than the superior one-third (P group; n = 35), and tear involving more than one-third of the subscapularis tendon (C group; n = 42). All rotator cuff tears were repaired; however, subscapularis tendon tears involving less than the superior one-third in P group were only debrided. Pain visual analog scale, Constant, and American Shoulder and Elbow Surgeons scores and passive range of motion were measured preoperatively and at the final follow-up. Rotator cuff integrity, global fatty degeneration index, and occupation ratio were determined via magnetic resonance imaging preoperatively and 6 months postoperatively. Results: We identified 37 retears (31.1%) based on postoperative magnetic resonance imaging evaluation. Retear rate in patients in the C group (47.6%) was higher than that in the I group (22.9%) or P group (20.0%) ( P = .011). Retear subclassification based on the involved tendons showed that subsequent subscapularis tendon retears were noted in only the C group. The improvement in clinical scores after repair was statistically significant in all groups but not different among the groups. Between-group comparison showed significant differences in preoperative external rotation ( P = .021). However, no statistically significant difference was found in any shoulder range of motion measurements after surgery. Conclusion: Arthroscopic repair of massive tears results in substantial improvements in shoulder function, despite the presence of combined subscapularis tears. However, this study showed a high failure rate of massive posterosuperior rotator cuff tear repair extending more than one-third of the subscapularis tendon. When combined subscapularis tendon tear was less than the superior one-third of the subscapularis tendon, arthroscopic debridement was a reasonable treatment method where comparable clinical and anatomic outcomes could be expected.

scholarly journals Arthroscopic Partial Repair of Massive Contracted Rotator Cuff Tears

2014 ◽  
Vol 17 (1) ◽  
pp. 44-47 ◽  
Author(s):  
Sung Jae Kim ◽  
Young Hwan Kim ◽  
Yong Min Chun
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Functional Outcomes ◽  
Muscle Quality ◽  
Rotator Cuff Tears ◽  
Massive Rotator Cuff Tear ◽  
Cuff Tear ◽  
Partial Repair ◽  
Tendon Coverage

Typically, massive rotator cuff tears have stiff and retracted tendon with poor muscle quality, in such cases orthopaedic surgeons are confronted with big challenging to restore the cuff to its native footprint. Furthermore, even with some restoration of the footprint, it is related with a high re-tear rate due to less tension free repair and less tendon coverage. In this tough circumstance, the partial repair has yielded satisfactory outcomes at relatively short follow-up by re-creating the transverse force couple of the rotator cuff. Through this partial repair, the massive rotator cuff tear can be converted to the "functional rotator cuff tear" and provide improvement in pain and functional outcomes in patient's shoulder.

scholarly journals Does a Partial Rotator Cuff Tear Affect Pitching Ability? Results From an MRI Study

2019 ◽  
Vol 7 (11) ◽  
pp. 232596711987969
Author(s):  
Jin-Young Park ◽  
Junhyun Kim ◽  
Jae-Hyung Lee ◽  
Kyung-Soo Oh ◽  
Seok Won Chung ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Performance Indicators ◽  
Athletic Performance ◽  
Rotator Cuff Tears ◽  
Abnormal Finding ◽  
Cuff Tear ◽  
Partial Thickness ◽  
Baseball Pitchers

Background: Numerous studies have examined changes in the athletic performance of baseball pitchers after rotator cuff surgery. However, only a few studies have evaluated changes in athletic performance caused by partial rotator cuff tears that are not treated surgically. Purpose: To examine the course of partial-thickness rotator cuff tears and its possible effect on the athletic performance of professional pitchers. Study Design: Case series; Level of evidence, 4. Method: Of 191 professional pitchers who attended our clinic between January 2009 and October 2018, 52 individuals had partial-thickness tears with at least 2 years of follow-up magnetic resonance imaging (MRI) scans and were included in this study. All initial MRI examinations were performed when a season was finished or during the off-season for regular medical check-up purposes. Hence, any abnormal finding on MRI, which suggests damage to the rotator cuff tendon, was assumed to have occurred during the previous season. The mean follow-up MRI period was 40.8 months (range, 24.4-100.9 months). We defined the year before an athlete’s first MRI at our clinic as the year of damage, and we evaluated athletic performance during the season before the damage (pre-damage year 1), the season of the damage (damage year), and 1 and 2 seasons after the damage (post-damage years 1 and 2). We evaluated the changes in 5 statistical performance indicators: earned run average (ERA), fielding independent pitching (FIP), walks plus hits divided by innings pitched (WHIP), winning percentage (WPCT), and innings pitched (IP). Results: The partial-thickness tears progressed in 39 of 52 (75%) patients. Of these 39 patients, 34 (87%) were grade 1 in severity and 5 (12.8%) were grade 2 or higher. The ERA of the pitchers did not increase significantly immediately after damage or at post-damage years 1 and 2. WPCT increased significantly compared with pre-damage year 1 ( P < .001), and IP decreased significantly during the follow-up period ( P < .001). Although no significant decrease in pitching ability was noted based on these 3 indices, significant increases were observed for FIP and WHIP. Conclusion: A partial-thickness rotator cuff tear does not have significant influence on the athletic performance of professional baseball pitchers in the short term based on conventional performance indicators. Our findings suggest that WHIP and IP decline significantly at 2 years after damage is noticed.

scholarly journals Two-year results of double row repair for medium sized rotator cuff tear in elderly patients

2019 ◽  
Vol 6 (2) ◽  
pp. 423
Author(s):  
Afsar T. Ozkut
Keyword(s):  
Rotator Cuff ◽  
Internal Rotation ◽  
Rotator Cuff Tear ◽  
External Rotation ◽  
Constant Score ◽  
Rotator Cuff Tears ◽  
Double Row ◽  
Cuff Tear ◽  
Forward Flexion

Background: Rotator cuff tears are treated surgically when conservative treatment methods fail. Since osteoporosis is common and the cuff is degenerative in nature, it may be a challenge to treat the tears surgically in the elderly. The objective of this study was to evaluate the results rotator cuff repair with double row two anchors (one medial and one lateral) for middle sized tears in patients over 65years old.Methods: 18 patients who are over 65years old treated arthroscopically for medium sized rotator cuff tear were included in the study. Inclusion criteria were patients with MR findings and physical findings consistent with medium sized (1-3cm) rotator cuff tears, patients with follow up period of at least 2years. All of the patients were repaired using (two anchors, one medially and one laterally placed) double row technique arthroscopically.  The patients were evaluated with constant Murley score and ASES scores. All these measurements (both ROM and functional tests) were performed preoperatively and at postoperative third sixth months, first year and after second year.Results: Mean age of the patients was 69.3 (±2.6). The mean follows up period was 34months (±4.1) Preoperative mean forward flexion and external rotation were 127.3±25.3º and 48.9±14.6º respectively. The preoperative mean internal rotation was 9.1±6.9º. Preoperative mean ASES score was 59.1º (±9.6) and mean constant score was 53.7º (±11.2). At the last follow up mean forward flexion was 158.3º (±17.9), external rotation was 63.2º (±11.4) and internal rotation was 9.3º (±7.3).  Mean ASES score and constant score of the patients were 84.3 (±9.1) and 77.3 (±10.8) in the last follow up.Conclusions: It is possible to obtain good results in medium sized rotator cuff tears in patients over 65years old particularly if fatty degeneration over grade II has not prevailed.

Mini-Open Rotator Cuff Tear Repair: An Institutional Experience with a Midterm Follow-up

2018 ◽  
Vol 20 (5) ◽  
pp. 383-387 ◽  
Author(s):  
Adil Bashir ◽  
Suleiman Seth ◽  
Iftikhar H. Wani ◽  
Munir Farooq ◽  
Naseem ul Gani ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Tears ◽  
Fixation Method ◽  
Full Thickness ◽  
Open Procedure ◽  
Cuff Tear ◽  
Rotator Cuff Tear Repair ◽  
Mini Open

Background. Rotator cuff tears have long been recognised as a cause of pain and disability. Over the past decades the treatment of rotator cuff tears has evolved from an open procedure to a mini-open procedure to an all-arthroscopic one. The indications and benefits of each of the procedures are still debated. The purpose of this study was to observe the results of “Mini-open repair rotator cuff tear”. Material and methods. This was a prospective study conducted in the postgraduate department of Ortho­paedics Government Medical College, Srinagar, from March 2013 to January 2018 with cases followed up for a minimum of 3 years. This study included 50 patients of either sex with non-massive full thickness tears of rotator cuff. Results. The mean UCLA score improved from 10.96 preoperatively to 30.68 at final follow-up. Overall, 88% of the patients achieved excellent or good results and 92% were satisfied. No significant difference was noted in functional outcomes between traumatic and degenerative tears. Size of tear seems to be a determining factor in the functional outcome. Stiffness as a complication occurred in two patients. Conclusion. 1. Mini-open rotator cuff tear repair eliminated sym­pto­matic full thickness rotator cuff tears with significant improvement in functional scores. 2. There were no major complications of the surgical procedure adop­ted or the fixation method used. 3. Mini-open rotator cuff repair remains a useful technique despite advan­ces in arthroscopy.

scholarly journals Evaluate the Results at Minimum 2-Years of Treating Rotator Cuff Tear by Arthroscopic Surgery

2019 ◽  
Vol 7 (24) ◽  
pp. 4199-4203
Author(s):  
Dung Tran Trung ◽  
Duc Nguyen Anh ◽  
Tuan Tran Duc ◽  
Van Nguyen Trung ◽  
Thien Chu Dinh
Keyword(s):  
Quality Of Life ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Arthroscopic Surgery ◽  
University Hospital ◽  
Rotator Cuff Tears ◽  
Average Score ◽  
Cuff Tear

BACKGROUND: Rotator cuff tear (RCT) is a common injury of the shoulder, especially middle-aged people. Nonoperative treatment, cortisone injections are only effective at an early stage. Open surgery causes postoperative atrophy of the deltoid muscle, so results are limited. Arthroscopic rotator cuff repair surgery has been performed in Vietnam for about ten years, with many advantages such as the ability to accurately assess the lesions and less invasive procedure. In order to have a clearer view, we performed a mid-term assessment of the effectiveness of this surgery. AIM: Evaluate results over 2 years of patients with rotator cuff tears treated with arthroscopic surgery and their quality of life. METHOD: A group of 30 patients were diagnosed with RCT and surgery by arthroscopy to treat at Hanoi Medical University Hospital and Saint Paul Hospital between Jun 2015 and April 2017. The results of the surgeries were assessed by the degree of pain, muscle power, motion of the shoulder joint according to UCLA shoulder score. Evaluate the quality of life through the Rotator Cuff-Quality of Life (RC-QoL) index. RESULTS: The average age was 60.7 years. Female / male ratio was 1.3. Thirty-six months ± 6.41 was the average follow-up time (min 27 – max 50 months). The shoulder function is recorded according to UCLA has an average score of 30.9, therein good and excellent result were 90 %. The mean RC-QoL index was 91.5%. CONCLUSION: Treatment of RCT by arthroscopic surgery that has been evaluated for a minimum of 2 years follow-up showed good results and high quality of patient’s life.

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 DOES HYPERCHOLESTOLEMIA PREDISPOSE TO ROTATOR CUFF PATHOLOGIES?

2017 ◽  
Vol 10 (4) ◽  
pp. 373 ◽  
Author(s):  
Surendra Umesh Kamath ◽  
Sunil Murthy
Keyword(s):  
Rotator Cuff ◽  
Total Cholesterol ◽  
Rotator Cuff Tear ◽  
Indian Population ◽  
Statistical Significance ◽  
Elevated Serum ◽  
Density Lipoprotein ◽  
Rotator Cuff Tears ◽  
Control Group ◽  
Cuff Tear

Background:  Rotator cuff tear are one of most common orthopedic musculoskeletal problem gaining importance due to large health scale expenditure. Causes of rotator cuff tears are multifactorial and unclear.  Previous studies have suggested relation between elevated serum lipid profile and rotator cuff tear in western population. We therefore undertook study in our Indian population to correlate association of hypercholesterolemia with rotator cuff tear.Objective: To find association of rotator cuff pathology with hypercholesterolemia in Indian patients.Materials and methods: After obtaining clearance from institutional ethics committee. We prospectively collected fasting lipid samples of population who came to our hospitals with complaints of shoulder pain during our study period. 50 patients had rupture of rotator cuff which was confirmed by ultrasound of involved shoulder. 50 were seen for non-cuff related complaints.  We followed strict inclusion and exclusion criteria.Results: Total cholesterol, Triglycerides and low density lipoprotein concentration of patients with rotator cuff tendon tear were on higher side than control group. High density lipoprotein trend showed being lower than control group.  21 of 50 (42%) had high cholesterol (total cholesterol greater than 240mg/dl) than compared to 18 of 50 (36%) in control group. however P value=0.539 and showed no statistical significance between groups.Conclusion: In Indian population there was no correlation between hypercholesterolemia and rotator cuff tear which is statistically significant.Key words Rotator cuff tear, Hypercholesterolemia, Indian population.   

scholarly journals Treatment of Partial Rotator Cuff Tear with Ultrasound-guided Platelet-rich Plasma

2017 ◽  
Vol 7 ◽  
pp. 32 ◽  
Author(s):  
Vetrivel Chezian Sengodan ◽  
Sajith Kurian ◽  
Raghupathy Ramasamy
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Platelet Rich Plasma ◽  
Rotator Cuff Tears ◽  
Lateral Side ◽  
Ultrasound Guided ◽  
Cuff Tear ◽  
Plasma Injection ◽  
Partial Rotator Cuff Tear ◽  
Shoulder Score

Background: The treatment of symptomatic partial rotator cuff tear has presented substantial challenge to orthopaedic surgeons as it can vary from conservative to surgical repair. Researches have established the influence of platelet rich plasma in healing damaged tissue. Currently very few data are available regarding the evidence of clinical and radiological outcome of partial rotator cuff tear treated with ultrasound guided platelet rich plasma injection in English literature. Materials and Methods: 20 patients with symptomatic partial rotator cuff tears were treated with ultrasound guided platelet rich plasma injection. Before and after the injection of platelet rich plasma scoring was done with visual analogue score, Constant shoulder score, and UCLA shoulder score at 8 weeks and third month. A review ultrasound was performed 8 weeks after platelet rich plasma injection to assess the rotator cuff status. Results: Our study showed statistically significant improvements in 17 patients in VAS pain score, constant shoulder score and UCLA shoulder score. No significant changes in ROM were noted when matched to the contra-lateral side (P < 0.001) at the 3 month follow-up. The study also showed good healing on radiological evaluation with ultrasonogram 8 weeks after platelet rich plasma injection. Conclusion: Ultrasound guided platelet rich plasma injection for partial rotator cuff tears is an effective procedure that leads to significant decrease in pain, improvement in shoulder functions, much cost-effective and less problematic compared to a surgical treatment.

scholarly journals Calcific tendinitis of the shoulder in the Korean population: demographics and its relation with coexisting rotator cuff tear

2021 ◽  
Vol 24 (1) ◽  
pp. 21-26
Author(s):  
Yon-Sik Yoo ◽  
Jin-Young Park ◽  
Myung-sun Kim ◽  
Nam-Su Cho ◽  
Yong-Beom Lee ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Mean Value ◽  
Calcific Tendinitis ◽  
Older Age ◽  
Korean Population ◽  
Rotator Cuff Tears ◽  
Treatment Modalities ◽  
Duration Of Symptoms ◽  
Cuff Tear

Background: To evaluate the demographics, clinical and radiographic features of calcific tendinitis of the shoulder in the Korean population, specifically focusing on the incidence of coexisting rotator cuff tear.Methods: Between October 2014 and January 2015, we performed a prospective multicenter study with 506 patients from 11 training hospitals in Korea. We collected data of demographics and radiographic analysis based on simple radiographs, clinical assessments based on visual analog scale (VAS) and the American Shoulder Elbow Surgeons (ASES) score, and treatment modalities that are used currently. We also evaluated coexisting rotator cuff tear by ultrasonography (US) or magnetic resonance imaging (MRI) images. Results: There were 402 female patients (79%) with mean age of 55 years (range, 31–87 years). Mean duration of symptoms was 15.5 months. Mean size of calcific materials was 11.4 mm (range, 0.9-35). Mean value of VAS and ASES scores were 6.5 (range, 1–10) and 47 (range, 8–95), respectively. Of 383 patients (76%), 59 (15%) had rotator cuff tear including 15 full-thickness tears on US or MRI. Patients with rotator cuff tears were significantly associated with older age, recurrent symptoms, menstrual disorders in females, and having undergone calcification removal surgery and rotator cuff repair (all P<0.05).Conclusions: This study reported demographic, radiographic, and clinical features of calcific tendinitis of the shoulder in Korean population, which were not different from those of Western population. Coexisting rotator cuff tear was found with 15% incidence in this large series, suggesting that further radiographic study to evaluate rotator cuff tear might be needed in some calcific tendinitis patients of older age and presenting with recurrent symptoms.

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