scholarly journals Functional Outcome Oxford Shoulder Score After Modified Weaver Dunn Technique Reconstruction in Patients with Acromioclavicular Injuries

2019 ◽  
Vol 7 (11_suppl6) ◽  
pp. 2325967119S0047
Author(s):  
Hendra ◽  
Nino Nasution ◽  
Andriandi
Keyword(s):  
Clinical Outcome ◽  
Range Of Motion ◽  
Functional Outcome ◽  
External Rotation ◽  
Reconstruction Technique ◽  
Forward Flexion ◽  
Oxford Shoulder Score ◽  
Healthy Side ◽  
Gender Characteristics ◽  
Shoulder Score

Objectives: This study aimed to compare the clinical outcome of the Oxford Shoulder Score in patients with acromioclavicular injuries that were operated with Modified Weaver Dunn Technique Reconstruction compared with the healthy side. Methods: A total of 8 patients with acromioclavicular injuries from 2011 until 2019 that were included in the study that were treated with the Modified Weaver Dunn Technique. Age, gender, range of motion and OSS score that was followed for a minimum of 6 months after surgery (Oxford Shoulder Score [OSS]) were recorded. Results: Patients’ gender characteristics totaled three females (3) and five males (5). There weren’t significant differences with regard to the OSS at minimum six months prior to surgery (p<0,05) with OSS score of joints that were treated with Modified Weaver Dunn Technique (44 ± 1,309) compared to healthy side (46,88 ± 0,835), range of motion forward flexion (169,63±0,835) and healthy side (177,88±2,1), extension (50±2,673) and healthy side (58,25±2,188), abduction (169,38±3623) and healthy side (178,±2,070), internal rotation (58,63±2,326) and healthy side (63,36±4,173), and also external rotation (49,38±3,204) and healthy side (56,88±3,720). Conclusion: Modified Weaver Dunn Reconstruction Technique can give good functional outcome and has no differences with the healthy side.

scholarly journals Arthroscopic capsular release for idiopathic frozen shoulder with intra-articular injection and a controlled manipulation

2014 ◽  
Vol 96 (1) ◽  
pp. 55-60 ◽  
Author(s):  
CD Smith ◽  
P Hamer ◽  
TD Bunker
Keyword(s):  
Pain Relief ◽  
Range Of Motion ◽  
Frozen Shoulder ◽  
Stage Ii ◽  
Capsular Release ◽  
Oxford Shoulder Score ◽  
Arthroscopic Capsular Release ◽  
Good Pain Relief ◽  
The Mean ◽  
Shoulder Score

INTRODUCTION The aim of this prospective study was to assess the immediate and long-term effectiveness of arthroscopic capsular release in a large cohort of patients with a precise and isolated diagnosis of stage II idiopathic frozen shoulder. METHODS All patients underwent a preoperative evaluation. Patients with secondary frozen shoulder and those with concurrent pathology at arthroscopy were excluded. This left 136 patients with a stage II arthroscopically confirmed idiopathic frozen shoulder. At each postoperative attendance, a record was made of pain, function and range of motion. At 12 months, the Oxford shoulder score was calculated, and pain and range of motion were assessed. RESULTS Fifty per cent achieved good pain relief within a week and eighty per cent within six weeks of arthroscopic capsular release. The mean preoperative visual analogue scale pain score was 6.6 and the mean postoperative score was 1.0. The mean time to achieving good pain relief was 16 days following surgery. No patient could sleep through the night prior to surgery while 90% reported having a complete night’s sleep at a mean of 12 days after surgery. The mean postoperative Oxford shoulder score was 38/48 and the mean improvement was 19.2. CONCLUSIONS This large series demonstrates that arthroscopic capsular release is a safe procedure, with rapid improvement in pain and a marked improvement in range of motion.

scholarly journals Continuous Cervical Epidural Analgesia for Rehabilitation after Shoulder Surgery: A Retrospective Evaluation

2009 ◽  
Vol 1;12 (1;1) ◽  
pp. 189-194
Author(s):  
Samer N. Narouze
Keyword(s):  
Epidural Analgesia ◽  
Range Of Motion ◽  
Epidural Catheter ◽  
Shoulder Joint ◽  
External Rotation ◽  
Frozen Shoulder ◽  
Shoulder Surgery ◽  
Forward Flexion ◽  
Pain Scores ◽  
The Mean

Background: Patients with frozen shoulder who fail conservative therapy need surgical treatment and aggressive post-operative rehabilitation. Objective: To evaluate the effect of continuous cervical epidural analgesia on pain scores and range of motion of the shoulder joint in patients undergoing surgery for treatment of refractory frozen shoulder. Methods: Twenty-one patients with refractory frozen shoulder who had failed conservative treatment and undergone surgical procedure (manipulation under anesthesia or capsular release) were identified and the data were collected retrospectively. These patients had cervical tunneled epidural catheter (TEC) placement for continuous infusion of a mixture of lowdose narcotic and local anesthetics at the time of surgery and were discharged home with the catheter in place. They were then involved in an active physical therapy program to increase the range of motion of the affected shoulder joint. The patients (N = 21) were followed for a median of 4.7 weeks. They were assessed for range of motion, function, visual analog pain scores (VAS), and opiate use before the surgery and after tunneled epidural catheter removal. Results: Statistically significant changes from the time of placement to the time of removal of the tunneled epidural catheter (TEC) were observed for VAS pain score and range of motion of the shoulder in forward flexion, external rotation, and internal rotation. The mean rate of change among the patients for pain score, forward flexion, external rotation, and internal rotation was also computed. The mean change per week in each of these 4 measurements significantly differed from zero. 33 percent of the patients returned to work within one week. Conclusion: Our data show that the continuous infusion of epidural opioids and local anesthetics through a tunneled cervical epidural catheter during the rehabilitation phase after shoulder surgery for adhesive capsulitis may be a safe and effective tool for post-operative pain control and to facilitate rehabilitation. Key words: Cervical epidural, epidural analgesia, shoulder surgery

scholarly journals Modified Weaver-Dunn Procedure Versus The Use of Semitendinosus Autogenous Tendon Graft for Acromioclavicular Joint Reconstruction

2016 ◽  
Vol 10 (1) ◽  
pp. 166-178 ◽  
Author(s):  
Galal Hegazy ◽  
Hesham Safwat ◽  
Mahmoud Seddik ◽  
Ehab A. Al-shal ◽  
Ibrahim El-Sebaey ◽  
...  
Keyword(s):  
Acromioclavicular Joint ◽  
Tendon Graft ◽  
Semitendinosus Tendon ◽  
Reconstruction Technique ◽  
Coracoclavicular Ligaments ◽  
Joint Reconstruction ◽  
Oxford Shoulder Score ◽  
Joint Dislocations ◽  
Rockwood Type Iii ◽  
Shoulder Score

Background: The optimal operative method for acromioclavicular joint reconstruction remains controversial. The modified Weaver-Dunn method is one of the most popular methods. Anatomic reconstruction of coracoclavicular ligaments with autogenous tendon grafts, widely used in treating chronic acromioclavicular joint instability, reportedly diminishes pain, eliminates sequelae, and improves function as well as strength. Objective: To compare clinical and radiologic outcomes between a modified Weaver-Dunn procedure and an anatomic coracoclavicular ligaments reconstruction technique using autogenous semitendinosus tendon graft. Methods: Twenty patients (mean age, 39 years) with painful, chronic Rockwood type III acromioclavicular joint dislocations were subjected to surgical reconstruction. In ten patients, a modified Weaver-Dunn procedure was performed, in the other ten patients; autogenous semitendinosus tendon graft was used. The mean time between injury and the index procedure was 18 month (range from 9 – 28). Clinical evaluation was performed using the Oxford Shoulder Score and Nottingham Clavicle Score after a mean follow-up time of 27.8 months. Preoperative and postoperative radiographs were compared. Results: In the Weaver-Dunn group the Oxford Shoulder Score improved from 25±4 to 40±2 points. While the Nottingham Clavicle Score increased from 48±7 to 84±11. In semitendinosus tendon graft group, the Oxford Shoulder Score improved from 25±3 points to 50±2 points and the Nottingham Clavicle Score from 48±8 points to 95±8, respectively. Conclusion: Acromioclavicular joint reconstruction using the semitendinosus tendon graft achieved better Oxford Shoulder Score and Nottingham Clavicle Score compared to the modified Weaver-Dunn procedure.

scholarly journals Shoulder and Elbow Range of Motion Can Be Maintained in Major League Baseball Pitchers Over the Course of the Season, Regardless of Pitching Workload

2019 ◽  
Vol 7 (2) ◽  
pp. 232596711882506 ◽  
Author(s):  
Michael H. McGraw ◽  
Michael Vrla ◽  
Dean Wang ◽  
Christopher L. Camp ◽  
John M. Zajac ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Case Control Study ◽  
Major League Baseball ◽  
External Rotation ◽  
Pearson Correlation ◽  
Level Of Evidence ◽  
Forward Flexion ◽  
Major League ◽  
Baseball Pitchers ◽  
Control Study

Background: Studies examining the evolution of shoulder and elbow range of motion (ROM) in baseball pitchers over a single season have yielded inconsistent results. Purpose: To evaluate shoulder and elbow ROM in Major League Baseball (MLB) pitchers over a single season and to assess for correlations between these changes and measures of a pitcher’s workload. Study Design: Case-control study; Level of evidence, 3. Methods: Bilateral shoulder ROM (internal rotation [IR], external rotation [ER], and total range of motion [TROM]) was assessed in 92 MLB pitchers pre- and postseason. Shoulder forward flexion (FF) was measured in 64 pitchers, horizontal adduction (HA) was measured in 87 pitchers, and elbow ROM was measured in 86 pitchers. Data collected included demographics (age, height, weight, and body mass index) and measures of workload for pitchers (pitches thrown, innings pitched, and mean fastball velocity). Pitchers were not specifically excluded if they had an injury during the season but had recovered and were actively pitching at the time of postseason measurements. The change in motion from pre- to postseason was measured and the associations with player demographics and workload were calculated by use of the Pearson correlation coefficient. Results: On average, pitchers demonstrated an increase in dominant shoulder ER from 118.8° to 125.4° ( P < .001) and TROM from 173.1° to 181.7° ( P < .001). HA was increased by an average of 15.7° ( P < .001). The average shoulder IR ( P = .189), FF ( P = .432), and elbow ROM (flexion, P = .549; extension, P = .185) remained similar over the span of the season. Average glenohumeral IR deficit did not increase. Pitcher demographics and measures of throwing workload (total pitches thrown, innings pitched, mean fastball velocity) were not significantly correlated with changes in shoulder or elbow ROM. Conclusion: Significant increases in dominant shoulder ER, TROM, and HA were identified in MLB pitchers over the course of a single baseball season. These ROM changes were not correlated with measures of pitching workload.

Radiographic parameters associated with excellent versus poor range of motion outcomes following reverse shoulder arthroplasty

2020 ◽  
pp. 175857322093623
Author(s):  
Georges Haidamous ◽  
Alexandre Lädermann ◽  
Robert U Hartzler ◽  
Bradford O Parsons ◽  
Evan S Lederman ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Arthroplasty ◽  
External Rotation ◽  
Reverse Shoulder Arthroplasty ◽  
Level Of Evidence ◽  
Component Size ◽  
Excellent Outcome ◽  
Forward Flexion ◽  
Humeral Component ◽  
Radiographic Measurements

Background The purpose was to evaluate the relationship of component size and position to postoperative range of motion following reverse shoulder arthroplasty. The hypothesis was that increased lateralization, larger glenospheres, and a decreased acromiohumeral distance would be associated with excellent postoperative range of motion. Methods A retrospective multicenter study was performed at a minimum of one year postoperatively on 160 patients who underwent primary reverse shoulder arthroplasty with a 135° humeral component. Outcomes were stratified based on postoperative forward flexion and external rotation into excellent ( n = 42), defined as forward flexion >140° and external rotation > 30°, or poor ( n = 36), defined as forward flexion <100° and external rotation < 15°. Radiographic measurements and component features were compared between the two groups. Results A larger glenosphere size was associated with an excellent outcome ( p = 0.009). A 2-mm posterior offset humeral cup ( p = 0.012) and an increased inferior glenosphere overhang (3.1 mm vs 1.4 mm; p = 0.002) were also associated with excellent outcomes. Humeral lateralization and distalization were not associated with an excellent outcome. Conclusion: Larger glenosphere size and inferior positioning as well as posterior humeral offset are associated with improved postoperative range of motion following reverse shoulder arthroplasty. Level of Evidence Level 3, retrospective comparative study.

Plate fixation of midshaft clavicle fractures for delayed union and non-union is a cost-effective intervention but functional deficits persist at long-term follow-up

2021 ◽  
pp. 175857322199036
Author(s):  
Ben Fox ◽  
Nicholas David Clement ◽  
Deborah J MacDonald ◽  
Michael Robinson ◽  
Jamie A Nicholson
Keyword(s):  
Functional Outcome ◽  
Cost Effective ◽  
Operative Management ◽  
Matched Cohort ◽  
Non Union ◽  
Oxford Shoulder Score ◽  
Non Operative Management ◽  
Shoulder Score

Background The primary aim of this study was to compare the long-term functional outcome of midshaft clavicle fracture fixation for delayed (≥3 month) and non-union (≥6 month) compared to a matched cohort of patients that achieved union with non-operative management. The secondary aim was to assess cost-effectiveness of fixation. Methods A consecutive series of patients over 10-years were retrospectively reviewed using the QuickDASH, Oxford Shoulder Score and EuroQol five-dimension summary index (EQ-5D). These patients were compared to a matched cohort that achieved union after non-operative management using propensity score matching. Results Sixty patients (follow-up 79%, n = 60/76) at 4.1 years post-operative (1.1–10.0 years) had a QuickDASH of 16.5 (95% CI 11.6–21.5), Oxford Shoulder Score 41.5 (39.0–44.1) and EQ-5D 0.7621 (0.6822–0.8421). One in five patients were dissatisfied with their final outcome ( n = 13/60). Functional outcome was inferior following fixation when compared to patients that united with non-operative management (QuickDASH 16.5 vs. 5.5, p < 0.001 and EQ-5D 0.7621 vs. 0.9073, p = 0.001). However, significant improvements were found when compared to pre-operative scores (QuickDASH p < 0.001 and EQ-5D p < 0.001). The cost per QALY for fixation was £5624.62 for the study cohort. Conclusions Clavicle fixation for delayed and non-union is a cost-effective intervention but outcomes are worse compared to patients that unite with non-operative management.

scholarly journals Long-term results of arthroscopic and mini-open repair of small- to medium-size full-thickness rotator cuff tears

2018 ◽  
Vol 11 (1_suppl) ◽  
pp. 68-76 ◽  
Author(s):  
DFP van Deurzen ◽  
VAB Scholtes ◽  
WJ Willems ◽  
HH Geerdink ◽  
HJ van der Woude ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Functional Outcome ◽  
Structural Integrity ◽  
Rotator Cuff Tears ◽  
Medium Size ◽  
Oxford Shoulder Score ◽  
Shoulder Score

Background This retrospective cohort study evaluated functional outcome and structural integrity after arthroscopic- or mini-open repair of small- to medium-size rotator cuff tears assessed at long-term follow-up. Methods All patients operated between 2001 and 2004 were invited to participate. Functional outcome was measured by Constant–Murley Score, Disability of Arm, Shoulder and Hand and Oxford Shoulder Score. Quality of life was assessed with EuroQol Health 5 Dimension. Patient satisfaction was assessed in terms of pain and overall result. Structural integrity of the rotator cuff repair was determined using ultrasound. Results Of the eligible 62 patients, 44 patients were available for follow-up. After a mean of 11.3 years, 76% of the patients had good to excellent functional outcome on the Constant–Murley Score (median 82, range 29–95). The majority of patients reported good results on both Disability of Arm, Shoulder and Hand and Oxford Shoulder Score (median Disability of Arm, Shoulder and Hand 5.0, range 1.0–54; median Oxford Shoulder Score 19, range 13–39). The quality of life was also good (mean EuroQol Health 5 Dimension utility score 0.88, standard deviation 0.12). Eighty per cent was satisfied with the overall result. Ultrasound examination revealed structural integrity in 76% of all cases. Conclusion This study shows that functional outcome is good and structural integrity is high for the majority of patients 11.3 years after repair of small- to medium-size rotator cuff lesions.

scholarly journals Clinical validation of kinematic assessments of post-stroke upper limb movements with a multi-joint arm exoskeleton

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Florian Grimm ◽  
Jelena Kraugmann ◽  
Georgios Naros ◽  
Alireza Gharabaghi
Keyword(s):  
Clinical Outcome ◽  
Range Of Motion ◽  
Upper Limb ◽  
External Rotation ◽  
Clinical Status ◽  
Objective Evaluation ◽  
Joint Space ◽  
Multiple Regression Model ◽  
Stroke Patients ◽  
Flexion Extension

Abstract Background The clinical evaluation of the upper limb of severely impaired stroke patient is challenging. Sensor-based assessments may allow for an objective evaluation of this patient population. This study investigated the validity of a device-assisted approach in comparison to the clinical outcome that it is supposed to reflect. Methods In nineteen severely impaired chronic stroke patients, we applied a gravity-compensating, multi-joint arm exoskeleton (Armeo Spring) and compared this sensor-based assessment with the clinical outcome measure Upper Extremity Fugl-Meyer Assessment (UE-FMA) scale. Specifically, we assessed separately and subsequently the range of motion in joint space for four single joints (i.e., wrist, elbow and shoulder flexion/extension (FE), and shoulder internal/external rotation (IER)), and the closing and opening of the hand with a pressure sensor placed in the handle. Results Within the kinematic parameters, a strong correlation was observed between wrist and elbow FE (r > 0.7, p < 0.003; Bonferroni corrected). The UE-FMA was significantly predicted by a multiple regression model (F (5, 13) = 12.22, p < 0.0005, adj. R2 = 0.83). Both shoulder IER and grip pressure added significantly (p < 0.05) to the prediction with the standardized coefficients β of 0.55 and 0.38, respectively. Conclusions By applying an exoskeleton-based self-contained evaluation of single-joint movements, a clinically valid assessment of the upper limb range of motion in severely impaired stroke patients is feasible. Shoulder IER contributed most relevantly to the prediction of the clinical status. These findings need to be confirmed in a large, independent patient cohort.

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