scholarly journals Degeneratív és onkológiai indikációk alapján beültetett reverz vállprotézisek funkcionális kimenetelének összehasonlítása

2018 ◽  
Vol 159 (45) ◽  
pp. 1838-1843
Author(s):  
Attila Szatmári ◽  
Balázs Benedek ◽  
Tamás Perlaky ◽  
Krisztián Szalay ◽  
Imre Sallai ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Patient Group ◽  
Proximal Humerus ◽  
Scoring Systems ◽  
Shoulder Function ◽  
Shoulder Prosthesis ◽  
Functional Score ◽  
Reverse Prosthesis ◽  
Prosthesis Implantation ◽  
Rotator Cuff Arthropathy

Abstract: Introduction: Several methods (bone graft, endoprosthesis) are used to reconstruct proximal humerus resections due to primary and metastatic tumours. One of the new procedures is the replacement of the joint surfaces and the removed proximal humerus end with reverse shoulder prosthesis, optionally supplemented with bone implantation (composite procedure) in the hope of achieving better shoulder function. Aim: The aim of this study was to compare the shoulder function of the patient group operated by the above procedure with reverse prosthesis to a patient group operated by indication of degenerative shoulder disease (rotator cuff arthropathy). Method: The study involved 23 patients (13 men, 10 women) who were operated between 2012 and 2016 in our institution. Among them, 15 had rotator cuff arthropathy indication of reverse prosthesis, while in 8 cases, resection of the humerus and prosthesis implantation were performed due to tumour lesions. The average age of our patients was 62.5 years (17–82) and the average follow-up was 23.5 months (5–57). We performed physical examination, X-ray pictures on their operated arm, and data were recorded and analysed based on functional score systems. Results: The level of postoperative pain was almost the same in the two groups, but only the rotator cuff arthropathy group needed pain medications. In line with our expectations, we received slightly lower values by each of the three scoring systems in case of tumorous patients. The tumorous patients were satisfied with the results achieved. Conclusions: Following proximal humerus resections, reversed prosthesis implantation with occasional bone allografts is a reliable method of reconstruction, which approaches available functions and reliability as compared to non-tumour-indicating patients. Orv Hetil. 2018; 159(45): 1838–1843.

scholarly journals Transosseous Suture Fixation of True 4-part Valgus Impacted Fractures of the Proximal Humerus: Clinical and Radiological Outcome in 49 Patients

2018 ◽  
Vol 12 (1) ◽  
pp. 41-52
Author(s):  
Andreas Panagopoulos ◽  
Irini Tatani ◽  
Seferlis Yannis ◽  
Bavelou Aikaterini ◽  
Antonis Kouzelis ◽  
...  
Keyword(s):  
Avascular Necrosis ◽  
Humeral Head ◽  
Proximal Humerus ◽  
Constant Score ◽  
Reverse Shoulder Arthroplasty ◽  
Proximal Part ◽  
Shoulder Function ◽  
Functional Score ◽  
Invasive Technique

Background: The valgus-impacted (VI) 4-part fractures are a subset of fractures of the proximal humerus with a unique anatomic configuration characterized by a relatively lower incidence of avascular necrosis after operative intervention. Objectives: The present study reports the midterm clinical and radiological results of a large series of consecutive patients with 4-part VI fractures treated with a minimal invasive technique of internal fixation. Methods: Over a ten-year period (2004-2014), we treated 56 patients with a true 4-part valgus impacted fracture of the proximal part of the humerus. Four patients were lost to follow-up and three died, leaving 49 patients (33 female, 16 males, average age 60,1 years) available for the study. Fracture fixation was achieved through the lateral transdeltoid approach with transosseous suturing of the tuberosities to each other, to the metaphysis and to the articular part of the humeral head avoiding gross disimpaction of the humeral head from the valgus position. Functional outcome assessment was performed using the parameters of the Constant-Murley score within a mean follow up period of 43,8 months (range, 24 to 115 months). Results: All fractures were united within the first 3 months except one that showed late displacement and finally nonunion. The median Constant score was 81,7 points and the functional score in comparison with the unaffected shoulder was 86.2%. There were three patients with total Avascular Necrosis (AVN) of the head revised to hemiarthroplasty. The nonunion case was revised to reverse shoulder arthroplasty 12 months after surgery. In five cases, absorption of the greater tuberosity was noted in the last radiographic control without any serious consequences to the shoulder function. Conclusion: Advantages of this minimally invasive technique can be summarized as shorter operative time, no use of hardware, minimal soft tissue damage, low incidence of avascular necrosis, stable osteosynthesis with “tension band effect” and adequate rotator cuff repair allowing for early joint motion.

scholarly journals Reverse shoulder arthroplasty-early results

2021 ◽  
Vol 38 (3) ◽  
pp. 216-220
Author(s):  
Ferhat SAY ◽  
Numan KUYUBAŞI ◽  
Ahmet PİŞKİN ◽  
Murat BÜLBÜL
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Proximal Humerus ◽  
External Rotation ◽  
Constant Score ◽  
Reverse Shoulder Arthroplasty ◽  
Fracture Group ◽  
Scapular Notching ◽  
Early Results ◽  
Rotator Cuff Arthropathy

Although reverse shoulder arthroplasty is used in massive rotator cuff tears, it is also used in proximal humerus fractures and shoulder arthroplasty revision. In this study, we aimed to examine the early radiological and clinical results of patients undergoing reverse shoulder arthroplasty with different diagnoses. Between 2010 and 2013, reverse shoulder arthroplasty was applied to 10 patients (4 men, 6 women) with the diagnosis of arthropathy due to rotator cuff tear (n: 7), multi-fragmentary proximal humerus fracture (n: 2) and hemiarthroplasty revision (n: 1). The median age of the patients was 74 (64-85) years and the median follow-up was 15.5 (3-35) months. Patients were assessed in terms of joint range of motion, Constant score and Visual Pain Scale (VAS) and radiological examinations before and after surgery. Preoperative active shoulder flexion, abduction, internal and external rotation degrees of the patients were 65, 30, 40 and 50 degrees, and 105, 95, 30, 57.5 degrees respectively in their final controls. Constant score was 20.5 (14-63) preoperatively, and 54.5 (38-64) in the final controls (p˂0.05). While the preoperative VAS was 7 (3-9), it was found to be 1.5 (1-3) in the final controls (p˂0.05). As a complication, scapular notching was observed in one patient. Internal external rotation values were better in the rotator cuff arthropathy group than the fracture group. Reverse shoulder arthroplasty, especially in the treatment of patients with rotator cuff arthropathy, has good early results and a low complication rate. We recommend paying attention to the glenoid component location to avoid scapular notching.

scholarly journals Effect of Microcurrent Stimulation on Pain, Shoulder Function, and Grip Strength in Early Post-Operative Phase after Rotator Cuff Repair

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 491
Author(s):  
Donghyun Yi ◽  
Hwanyong Lim ◽  
Jongeun Yim
Keyword(s):  
Rotator Cuff ◽  
Grip Strength ◽  
Rotator Cuff Repair ◽  
Controlled Trial ◽  
Shoulder Function ◽  
Control Group ◽  
Simple Shoulder Test ◽  
General Physical ◽  
Cuff Repair ◽  
Experimental Group

Background and Objectives: The purpose of this study was to investigate the effects of microcurrent stimulation on pain, shoulder function, and grip strength in patients with rotator cuff repair. Materials and Methods: This randomized single-blind controlled trial was conducted on inpatients of the rehabilitation department, and included 28 patients who underwent rotator cuff repair. Participants were randomly assigned to the experimental group (n = 14), treated with microcurrent stimulation, and the control group (n = 14), treated with false microcurrent stimulation. The microcurrent stimulation administered to the experimental group underwent general physical therapy and microcurrent stimulation three times a week for 4 weeks. Results: Changes in pain, range of motion in shoulder, simple shoulder test, and grip strength were assessed before and after the intervention. Both groups showed a significant decrease in pain and shoulder function (t = 27.412, 22.079, 19.079, and 18.561; p < 0.001), and grip strength showed a significant increase (t = −8.251 and −9.946; p < 0.001). The experimental group that underwent microcurrent stimulation exhibited a significant effect on pain, shoulder function, and grip strength compared with the control group that underwent false microcurrent stimulation (t = −2.17, −2.22, and 2.213; p = 0.039, 0.035, and 0.036). Conclusions: This study confirmed that microcurrent stimulation is effective for the treatment of rotator cuff repair patients.

scholarly journals Delayed Rehabilitation Protocol after Rotator Cuff Repair

Osteology ◽  
2020 ◽  
Vol 1 (1) ◽  
pp. 29-38
Author(s):  
Alessandra Berton ◽  
Sergio De Salvatore ◽  
Vincenzo Candela ◽  
Gabriele Cortina ◽  
Daniela Lo Presti ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Muscle Strength ◽  
Internal Rotation ◽  
Outcome Measures ◽  
Rotator Cuff Repair ◽  
External Rotation ◽  
Shoulder Function ◽  
Rehabilitation Protocol ◽  
Patient Reported ◽  
Cuff Repair

Rotator cuff tears are a frequent cause of shoulder pain that often require arthroscopic repair. After surgery an intense and well-studied rehabilitation protocol is needed to obtain the complete recovery of shoulder function. Fifty patients, who sustained arthroscopic rotator cuff repair for symptomatic, atraumatic and full-thickness supraspinatus tendon tear, were involved. According to our rehabilitation protocol, during the first four postoperative weeks, the arm was supported with an abduction sling pillow, and pendulum exercises, table slide and active elbow extension and flexion were conceded. Outcome measures (Oxford shoulder score (OSS), simple shoulder test (SST), patient-reported satisfaction), shoulder function (range of motion (ROM) and muscle strength), and MRI examination were evaluated. The mean OSS score and SST score increased from 16 to 30.2 and from 5.3 to 11.4, respectively. Patient-reported satisfaction was 96%. At 12 months, patients improved ROM and muscle strength. Postoperative passive anterior elevation was 176; external rotation averaged 47; internal rotation was 90. Postoperative muscle strength during anterior elevation was 8.3 ± 2.2 kg, internal rotation 6.8 ± 3 kg, external rotation 5.5 ± 2.3 kg. Five out of seven patients with recurrent tears evaluated their results as satisfactory. They reported improvements in terms of OSS and SST mean scores despite recurrent tears; therefore, they did not undergo revision surgery. The delayed postoperative physical therapy protocol was associated with improvements in the outcome measures and shoulder function compared to the preoperatory state and rotator cuff healing demonstrated by MRI.

Arthroscopic Subscapularis Tendon Repair Using the Mason-Allen Technique

2021 ◽  
Author(s):  
Junqi Huang ◽  
Jiajia Cheng ◽  
Shitian Tang ◽  
Bo Shi ◽  
Gang Liu ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Tendon Repair ◽  
Shoulder Function ◽  
Arthroscopic Rotator Cuff Repair ◽  
Subscapularis Tendon ◽  
Function Recovery ◽  
The Mean ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Abstract Background Arthroscopic rotator cuff repair has recently been popularized for treating tears. In a biomechanical trial, the Mason-Allen stitch improved the fixation quality of poorly vascularized tendons. The use of this technique involving the subscapularis tendon remains rare. The aim of this study was to evaluate the clinical outcomes of Mason-Allen technique repaired subscapularis tendons. Methods A retrospective research of collected data from 98 patients with subscapularis tears who had undergone arthroscopic repair between May 2015 and December 2018. There were 75 males and 23 females. The mean age was 56.4 ± 9.6 years and the mean follow-up was 12.5 ± 4.0 months. The visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, and Constant-Murley score were used to analyze shoulder function. An MRI was performed to assess the integrity of the repair. Results Patients had significantly less pain and a better active range of motion compared with preoperative levels. VAS improved significantly from a preoperative mean of 3.42 to a postoperative mean of 1.91. ASES increased significantly from the preoperative mean of 43.6 to the postoperative mean of 74.5. Seven cases suffered from retears, which were confirmed by an MRI examination. Conclusion Arthroscopic rotator cuff repair with the Mason-Allen method resulted in a decreased level of pain and satisfied function recovery.

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