scholarly journals Subscapularis Insufficiency: What’s All the Fuss About?

2018 ◽  
Vol 2 ◽  
pp. 247154921879237 ◽  
Author(s):  
Elisabeth Böhm ◽  
Markus Scheibel ◽  
Alexandre Lädermann
Keyword(s):  
Shoulder Arthroplasty ◽  
Diagnostic Algorithm ◽  
Clinical Results ◽  
Postoperative Rehabilitation ◽  
Postoperative Function ◽  
Rehabilitation Protocols ◽  
Rehabilitation Concepts ◽  
Early Failures ◽  
Technical Modifications ◽  
Repair Techniques

There has been increase attention to the surgical treatment of the subscapularis (SSC) tendon with risk of postoperative dysfunction and early failures following shoulder arthroplasty. Studies investigating the clinical results after shoulder arthroplasty indicate that SSC tendon detachment or incision techniques and rehabilitation concepts may impair SSC recovery and consequently the postoperative function. In response to these results, technical modifications have been proposed and evaluated anatomically, biomechanically, and clinically. The aim of this article is to give an overview of current SSC take-down approaches, subsequent repair techniques, and postoperative rehabilitation protocols as well as to present the diagnostic algorithm and clinical impacts of the increasingly acknowledged condition of SSC insufficiency following shoulder arthroplasty procedures.

The search for the ideal tendon repair in zone 2: strand number, anchor points and suture thickness

2013 ◽  
Vol 39 (1) ◽  
pp. 20-29 ◽  
Author(s):  
R. Savage
Keyword(s):  
Animal Model ◽  
Laboratory Tests ◽  
Tendon Repair ◽  
Clinical Results ◽  
Review Article ◽  
Cyclic Motion ◽  
Mechanical Factors ◽  
Anchor Points ◽  
Repair Techniques ◽  
The Ideal

This review article examines the mechanical factors involved in tendon repair by sutures. The repair strength, repair stiffness and gap resistance can be increased by increasing the number of core strands and anchor points, by increased anchor point efficiency and the use of peripheral sutures, and by using thicker sutures. In the future, laboratory tests could be standardized to a specific animal model and to a defined cyclic motion programme. Clinical studies support the use of multi-strand core and peripheral sutures, but two-strand core sutures are not adequate to ensure consistently good clinical results. Training surgeons in complex tendon repair techniques is essential.

Higher preoperative sensitivity to pain and pain at rest are associated with worse functional outcome after stemless total shoulder arthroplasty

2018 ◽  
Vol 100-B (4) ◽  
pp. 480-484 ◽  
Author(s):  
B. Kadum ◽  
C. Inngul ◽  
R. Ihrman ◽  
G. O. Sjödén ◽  
A. S. Sayed-Noor
Keyword(s):  
Shoulder Arthroplasty ◽  
Pearson Correlation ◽  
Total Shoulder Arthroplasty ◽  
Linear Regression Analysis ◽  
Short Version ◽  
Preoperative Pain ◽  
Postoperative Function ◽  
Pain At Rest ◽  
And Function ◽  
Sensitivity To Pain

Aims The aims of this study were to investigate any possible relationship between a preoperative sensitivity to pain and the degree of pain at rest and on exertion with postoperative function in patients who underwent stemless total shoulder arthroplasty (TSA). Patients and Methods In this prospective study, we included 63 patients who underwent stemless TSA and were available for evaluation one year postoperatively. There were 31 women and 32 men; their mean age was 71 years (53 to 89). The pain threshold, which was measured using a Pain Matcher (PM) unit, the degree of pain (visual analogue scale at rest and on exertion, and function using the short version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH), were recorded preoperatively, as well as three and 12 months postoperatively. Results We found an inverse relationship between both the preoperative PM threshold and pain (VAS) at rest and the 12-month postoperative QuickDASH score (Pearson correlation coefficient (r) ≥ 0.4, p < 0.05). A linear regression analysis showed that the preoperative PM threshold on the affected side and preoperative pain (VAS) at rest were the only factors associated with the QuickDASH score at 12 months. Conclusion These findings indicate the importance of central sensitization in the restoration of function after TSA. Further studies are required to investigate whether extra analgesia and rehabilitation could influence the outcome in at risk patients. Cite this article: Bone Joint J 2018;100-B:480–4.

Postoperative Rehabilitation Concepts

2022 ◽  
pp. 455-465
Author(s):  
Luke O’brien ◽  
Brett Mueller ◽  
Henry Scholz ◽  
Matthew Giordanelli
Keyword(s):  
Postoperative Rehabilitation ◽  
Rehabilitation Concepts

Postoperative Rehabilitation and Outcomes of Primary Anatomic Shoulder Arthroplasty

2016 ◽  
Vol 17 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Brian E. Etier ◽  
Hakan C. Pehlivan ◽  
Stephen F. Brockmeier
Keyword(s):  
Shoulder Arthroplasty ◽  
Postoperative Rehabilitation

scholarly journals The Arthroscopic Ulnohumeral Arthroplasty: From Mini-Open to Arthroscopic Surgery

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Ilse Degreef ◽  
Luc De Smet
Keyword(s):  
Elbow Joint ◽  
Arthroscopic Surgery ◽  
Clinical Results ◽  
Open Approach ◽  
Postoperative Rehabilitation ◽  
Elbow Arthroscopy ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Active Patients ◽  
Mini Open

In cubarthritis—osteoarthritis of the elbow—surgical procedures may be considered to debride the elbow joint to reduce pain, to increase mobility, and to postpone joint replacement surgery. The ulnohumeral arthroplasty as described by Outerbridge and Kashiwagi was originally introduced to debride both anterior and posterior elbow compartments through a direct posterior mini-open approach. To achieve this, a distal humeral fenestration throughout the humeral fossa is performed. Although with an elbow arthroscopy, a technique that was obviously developed later on, all compartments can be easily visualized. The arthroscopic fenestration of the humerus preserves its advantages, with good clinical results focused on pain relief and gaining mobility. On top, future elbow joint locking based on degenerative loose bodies can be prevented. Therefore, this surgery is often done in young, more active patients and even in sportsmen. These patients, however, need to be prompted to restrict loading on the elbow in the immediate postoperative period, because the elbow is biomechanically weakened and may be prone to a fracture. However, both outcome and postoperative rehabilitation are promising and the arthroscopic Outerbridge procedure is a reliable procedure with an easy rehabilitation. Therefore, the threshold is relatively low in early cubarthritis and recurrent locking of the elbow. In this paper, we present a literature review and the author's experience and own research on the Outerbridge procedure.

Lesser tuberosity osteotomy and subscapularis tenotomy repair techniques during total shoulder arthroplasty: A meta-analysis of cadaveric studies

2016 ◽  
Vol 40 ◽  
pp. 33-36 ◽  
Author(s):  
John B. Schrock ◽  
Matthew J. Kraeutler ◽  
Darby A. Houck ◽  
Gina G. Provenzano ◽  
Eric C. McCarty ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Meta Analysis ◽  
Total Shoulder Arthroplasty ◽  
Lesser Tuberosity ◽  
Subscapularis Tenotomy ◽  
Repair Techniques
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