scholarly journals Dynamic scapulohumeral rhythm: Comparison between healthy shoulders and those with large or massive rotator cuff tear

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902098177
Author(s):  
Naoya Kozono ◽  
Naohide Takeuchi ◽  
Takamitsu Okada ◽  
Satoshi Hamai ◽  
Hidehiko Higaki ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
External Rotation ◽  
Three Dimensional ◽  
Control Group ◽  
Scapular Kinematics ◽  
Cuff Tear ◽  
And Control ◽  
Matching Techniques ◽  
Scapular Plane

Introduction: Assessment of scapular kinematics and the dynamics of the scapulohumeral rhythm (SHR) would be important for understanding pathologies of the shoulder and to inform treatment. Our aim in this study was to evaluate the SHR and scapular kinematics in patients with a rotator cuff tear (RCT), compared to a control group with healthy shoulders using image-matching techniques. Materials and Methods: The shoulder kinematics of large or massive RCT patients were evaluated and compared to a control group with healthy shoulders. Radiographic surveillance was performed throughout the full range of external rotation and scapular plane abduction. Computed tomography imaging of the shoulder complex was performed, with three-dimensional image reconstruction and matching to the radiographs to measure three-dimensional positions and orientations. SHR and angular values of the scapula were measured. Results: Scapular external rotation in the late phase of external rotation movement was greater in the RCT group than in the control group ( p < 0.05), but with no difference in the SHR. During scapular plane abduction, there were significant differences in SHR, scapular posterior tilt and scapular upward rotation between the RCT and control group ( p < 0.05). Conclusions: Regarding clinical relevance, this study clarified the differences of SHR and angular values of the scapula between the RCT and control group. These results underline the importance of assessment the SHR and scapular kinematics in individuals with a RCT. RCT is associated with specific compensation in the kinematics of the scapula and SHR during external rotation and scapular plane abduction, which could inform treatment.

scholarly journals Recombinant Human Bone Morphogenetic Proteins-4 Enhanced the Tendon-to-bone Attachment Healing in a Murine Model of Rotator Cuff Tear: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Huabin Chen ◽  
Zhanwen Wang ◽  
Li Zhou ◽  
Bing Wu ◽  
Hongbin Lu ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Bone Morphogenetic Proteins ◽  
Murine Model ◽  
Controlled Trial ◽  
Supraspinatus Tendon ◽  
Control Group ◽  
Cuff Tear ◽  
Tendon Insertion ◽  
And Control

Abstract Background: Injuries on tendon-to-bone attachment (TBA) are common clinical dilemmas. Bone Morphogenetic Proteins-4 (BMP-4) has been found the potency in chondrogenesis. But there is rare studies focusing the influence of BMP-4 on the TBA healing. Thus, the objective of this study was to explore the effect of BMP-4 on the healing of TBA in murine model of rotator cuff tear.Methods: 120 mature C57BL/6 mice (12 weeks old) were randomly divided into BMP-4 group, noggin (an inhibitor of all BMP activities) group and control group after being established an injury model of supraspinatus tendon insertion. At week 2 and 4 after surgery, the supraspinatus tendon- humerus complex (SSTHC) were harvested for microradiographic, histologic, immunofluorescent and biomechanical evaluations.Results: Radiographic data showed that BMP-4 was able to improve the quality of subchondral bone, manifested as higher BV/TV, Tb.N, TB.Th, and lower Tb.Sp. Histologically, the BMP-4 group at week-2 and -4 showed better BTA healing interface, characterized by better organizational integration and remodeling, thicker fibrocartilage layer and more fibrocartilage cells. Immunoflorescence evaluation demonstrated the number of SOX 9 positive cells in the BMP-4 group was significantly more than that in the control or noggin group at postoperative weeks 2 and 4 (p<0.05 for all). Mechanical testing results demonstrated the failure load and stiffness in the BMP-4 group were significantly higher (p<0.05 for both), while in the noggin group were lower (p<0.05 for both), compared to the control group at postoperative weeks 4.Conclusion: BMP-4 might enhance the TBA healing by promoting the regeneration of fibrocartilaginous enthesis and mineralization, while noggin inhibited this process.Clinical Relevance: BMP-4 may be a potential therapy to augment TBA healing, and finally lead to more rapid rehabilitation and reduce risk of recurrent repair.

scholarly journals Three-dimensional Scapular Kinematics During Arm Elevation in Massive Rotator Cuff Tear Patients

2017 ◽  
Vol 2 (0) ◽  
pp. n/a
Author(s):  
Yuichiro Miura ◽  
Yoshihiro Kai ◽  
Toru Morihara ◽  
Hideaki Fukushima ◽  
Ryuhei Furukawa ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Three Dimensional ◽  
Massive Rotator Cuff Tear ◽  
Scapular Kinematics ◽  
Cuff Tear ◽  
Arm Elevation

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.   

Chronic massive rotator cuff tear in rats: in vivo evaluation of muscle force and three-dimensional histologic analysis

2014 ◽  
Vol 23 (12) ◽  
pp. 1822-1830 ◽  
Author(s):  
Konstantinos Ditsios ◽  
Achilleas Boutsiadis ◽  
Dorothea Kapoukranidou ◽  
Athanasios Chatzisotiriou ◽  
Ioannis Kalpidis ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Muscle Force ◽  
Three Dimensional ◽  
Massive Rotator Cuff Tear ◽  
In Vivo Evaluation ◽  
Histologic Analysis ◽  
Cuff Tear

scholarly journals Pseudoparalysis and pseudoparesis of the shoulder

2021 ◽  
Author(s):  
Roland Stefan Camenzind ◽  
Laurent Lafosse ◽  
Thibault Lafosse
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Tears ◽  
Subscapularis Tendon ◽  
Cuff Tear ◽  
Active Range Of Motion ◽  
Definition Of ◽  
Shoulder Elevation ◽  
Scapular Plane

Abstract Background Clinical presentation of massive rotator cuff tears range from pain to loss of active range of motion. Pseudoparalysis and pseudoparesis are defined inconsistently in the literature, but both include limited active with maintained passive range of motion. Objective This article aims to provide a consistent definition of pseudoparalysis and pseudoparesis of the shoulder and show structural and biomechanical differences between these two types of rotator cuff tear with their implications for treatment. Methods A literature review including key and basic papers discussing clinical symptoms, biomechanical differences, and their impact on therapeutic options for pseudoparalysis and pseudoparesis was performed. Results Biomechanically, structural differences between pseudoparalysis (active scapular plane abduction <45°) and pseudoparesis (active scapular plane abduction 45–90°) exist. For massive posterosuperior rotator cuff tears, the integrity of the inferior subscapularis tendon is the most predictive factor for active humeral elevation. Patients with pseudoparalysis have a higher grade of subscapularis tendon involvement (>50%) and fatty infiltration of the subscapularis muscle. Treatment options depend on the acuteness and repairability of the tear. Rotator cuff repair can reliably reverse the active loss of active range of motion in acute and reparable rotator cuff tears. In chronic and irreparable cases reverse total shoulder arthroplasty is the most reliable treatment option in elderly patients. Conclusion The most concise definition of pseudoparalysis is a massive rotator cuff tear that leads to limited active (<45° shoulder elevation) with free passive range of motion in the absence of neurologic deficits as the reason for loss of active elevation. The integrity of the subscapularis tendon is the most important difference between a pseudoparalytic and pseudoparetic (active shoulder elevation 45–90°) shoulder. Decision-making for surgical options depends more on reparability of the tendon tear and patient age than on differentiation between pseudoparalysis and pseudoparesis.

Three-dimensional analysis of the scapular motion in rotator cuff tear

1995 ◽  
Vol 4 ◽  
pp. S70
Author(s):  
K. Kamada ◽  
M. Kurokawa ◽  
K. Miura ◽  
Y. Aria ◽  
T. Yamashita ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Dimensional Analysis ◽  
Rotator Cuff Tear ◽  
Three Dimensional ◽  
Cuff Tear ◽  
Scapular Motion

TNF-α plays a role in sleep disturbance in patients with rotator cuff tear

2021 ◽  
Author(s):  
Chul-Hyun Cho ◽  
Du Hwan Kim ◽  
Eun Hee Baek ◽  
Du-Han Kim
Keyword(s):  
Rotator Cuff ◽  
Sleep Disturbance ◽  
Serum Levels ◽  
Control Group ◽  
Control Groups ◽  
Cuff Tear ◽  
Clinical Scores ◽  
Tnf Α ◽  
And Control ◽  
Concentration Levels

Abstract Background The purpose of this study was to determine serum levels of sleep-related cytokines in patients with rotator cuff tear (RCT) and to investigate the correlations between serum levels of sleep-related cytokines and clinical scores. Methods Peripheral blood samples were collected from 63 study participants were divided into three groups: RCT patients with sleep disturbance (sleep disturbance group; SD group) (n = 21), RCT patients without sleep disturbance (normal sleep group; NS group) (n = 21), and patients with shoulder instability (control group) (n = 21). Serum concentration levels of sleep-related cytokines including interleukin-1α (IL-1α), IL-1β, IL-2, IL-6, IL-8, IL-10, and tumor necrosis factor-α (TNF-α) were measured via enzyme-linked immunosorbent assay. The associations between serum levels of sleep-related cytokines and clinical scores including the Visual Analogue Scale (VAS) pain score, the University of California at Los Angeles (UCLA) score, and the Pittsburgh Sleep Quality Index (PSQI) were analyzed. Results Serum concentration levels of TNF-α were significantly higher in the SD group compared with those of the NS and control groups (P = < 0.001 and 0.05). Serum levels of IL-8 and IL-10 were significantly higher in the SD group compared with those of control group (P = 0.01 and = 0.05), but did not differ significantly from that of the NS group (P > 0.05). Serum level of IL-6 was significantly lower in the SD group compared with those of the NS and control groups (P = < 0.001 and 0.01). There were no associations between serum levels of sleep-related cytokines and all clinical scores including VAS pain, UCLA, and PSQI scores (all P > 0.05). Conclusion The current findings suggest that TNF-α may play a significant role in the pathophysiology of sleep disturbance in patients with RCT and be a possible therapeutic target to improve sleep disturbance in patients with RCT.

Shoulder Strength Requirements for Upper Limb Functional Tasks: Do Age and Rotator Cuff Tear Status Matter?

2017 ◽  
Vol 33 (6) ◽  
pp. 446-452 ◽  
Author(s):  
Anthony C. Santago ◽  
Meghan E. Vidt ◽  
Xiaotong Li ◽  
Christopher J. Tuohy ◽  
Gary G. Poehling ◽  
...  
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Upper Limb ◽  
External Rotation ◽  
Strength Loss ◽  
Cuff Tear ◽  
Supraspinatus Tear ◽  
Shoulder Strength

Understanding upper limb strength requirements for daily tasks is imperative for early detection of strength loss that may progress to disability due to age or rotator cuff tear. We quantified shoulder strength requirements for 5 upper limb tasks performed by 3 groups: uninjured young adults and older adults, and older adults with a degenerative supraspinatus tear prior to repair. Musculoskeletal models were developed for each group representing age, sex, and tear-related strength losses. Percentage of available strength used was quantified for the subset of tasks requiring the largest amount of shoulder strength. Significant differences in strength requirements existed across tasks: upward reach 105° required the largest average strength; axilla wash required the largest peak strength. However, there were limited differences across participant groups. Older adults with and without a tear used a larger percentage of their shoulder elevation (p < .001,p < .001) and external rotation (p < .001,p = .017) strength than the young adults, respectively. Presence of a tear significantly increased percentage of internal rotation strength compared to young (p < .001) and uninjured older adults (p = .008). Marked differences in strength demand across tasks indicate the need for evaluating a diversity of functional tasks to effectively detect early strength loss, which may lead to disability.

scholarly journals Reverse Shoulder Prosthesis With a Lateralized Glenosphere: Early Results of a Prospective Multicenter Study Stratified by Diagnosis

2019 ◽  
Vol 3 ◽  
pp. 247154921984404 ◽  
Author(s):  
Samer S Hasan ◽  
Jonathan C Levy ◽  
Zachary R Leitze ◽  
Avinash G Kumar ◽  
Gary D Harter ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Multicenter Study ◽  
Shoulder Arthroplasty ◽  
External Rotation ◽  
Reverse Shoulder Arthroplasty ◽  
Design Team ◽  
Scapular Notching ◽  
Cuff Tear ◽  
Glenohumeral Arthritis

Background We report here on the results, stratified by diagnosis, of a multicenter prospective study by surgeons unaffiliated with the design team of reverse shoulder arthroplasty (RSA) performed using a lateralized glenosphere. We hypothesized that outcomes would be comparable to those reported previously.Methods: A total of 245 patients underwent RSA for cuff tear arthropathy or glenohumeral arthritis with rotator cuff tear, rotator cuff tear with instability or escape and without glenohumeral arthritis, or failed shoulder arthroplasty. Clinical, radiographic, and self-assessed outcome measures were obtained preoperatively and at standardized time points postoperatively. At 2 years, 173 patients were available as 23 patients were deceased, 12 had undergone revision, and 37 were unavailable.Results: Range of motion and outcomes improved, irrespective of diagnosis. Active forward flexion, abduction, and external rotation improved (73°–127°, 65°–109°, and 24°–37°, respectively, P < .0001 for all). Simple Shoulder Test (3.2–8.5) and American Shoulder and Elbow Surgeons scores (45–86) also improved. Scapular notching occurred in 13.3%; scapular spine/acromial fractures in 6.5%. Patients undergoing revision shoulder arthroplasty improved more modestly.Conclusion: In this multicenter study, surgeons unaffiliated with the design team obtained clinical improvements comparable to those reported previously and that exceeded minimal clinically important differences for RSA. Improvements in external rotation and low scapular notching rates potentially relate to the lateralized design.

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