scholarly journals Midterm Outcomes After Arthroscopic Coracoid Decompression Combined With Manipulation for the Treatment of Frozen Shoulder Associated With Subcoracoid Impingement

2021 ◽  
Author(s):  
Shengyang Jin ◽  
Xiaohong Wang ◽  
Yu He ◽  
Wei Huang ◽  
Ze Wang ◽  
...  
Keyword(s):  
Los Angeles ◽  
Rating Scale ◽  
External Rotation ◽  
Frozen Shoulder ◽  
Final Analysis ◽  
Pain Rating ◽  
Rating Score ◽  
Sleep Complaints ◽  
Forward Flexion

Abstract Background Patients with frozen shoulder (FS) suffer considerably, and some also present with subcoracoid impingement. However, effective treatments for frozen shoulder associated with subcoracoid impingement (FSASI) are limited. Primary purpose of this study was to introduce an arthroscopic coracoid decompression method combined with manipulation to treat FSASI and investigate its mid-term efficacy. Methods From April 2015 to May 2018, 177 patients with frozen shoulder who had no positive response to conservative therapy after a minimum of 6 months underwent arthroscopic coracoid decompression combined with manipulation. Shoulder condition was evaluated using the abbreviated Constant-Murley score (ACMS) and the modified University of California at Los Angeles Shoulder Rating Scale (MUCLA) preoperatively; at the 1st, 3rd, and 6th months postoperatively; and at the final follow-up (May 15, 2020). Results Eight patients were lost to follow-up, and 169 were included in the final analysis. The mean follow-up duration was 38.22 (range, 24–60) months. The ACMS improved from 16.39 ± 2.99 points (preoperative) to 72.08 ± 1.04 points at the last follow-up (p < 0.001). The MUCLA improved from 10.84 ± 0.71 points (preoperative) to 32.94 ± 0.74 points at the last follow-up (p < 0.001). Improvements in ACMS and MUCLA scores were significant in the first 3 months, then leveled off, and remained stable between the 6th month and the final follow-up. Recovery of forward flexion and abduction progressed synchronously, and almost full scores were achieved (9.96 ± 0.08 and 9.92 ± 0.11 points, respectively). Some patients lost ranges of motion: eight patients partially lost forward flexion and abduction, four partially lost external rotation, and fourteen partially lost internal rotation. The ACMS pain rating score improved from 1.12 ± 0.68 (preoperative) to 13.06 ± 0.71 points, and the MUCLA pain rating score improved from 1.67 ± 0.27 (preoperative) to 8.94 ± 0.43 points (last follow-up). Most improvements occurred in the first month after surgery. Timely pain improvement can effectively help patients improve sleep; complaints of sleep disturbance decreased significantly postoperatively. No complications or recurrence occurred. Conclusion Arthroscopic coracoid decompression combined with manipulation was an alternative method for treating FSASI, and satisfactory results were maintained through midterm follow-up.

scholarly journals Functional improvement of bilateral frozen shoulder by unilateral intra-articular corticosteroid injection: a retrospective study

2021 ◽  
Vol 49 (10) ◽  
pp. 030006052110505
Author(s):  
Minchul Kim ◽  
Ki-Yong Kim ◽  
Yool-Gang Huh ◽  
Sang Hyeok Ma ◽  
Kil-Yong Jeong ◽  
...  
Keyword(s):  
Rating Scale ◽  
External Rotation ◽  
Corticosteroid Injection ◽  
Frozen Shoulder ◽  
Numeric Rating Scale ◽  
Functional Improvement ◽  
Symptom Duration ◽  
The Mean ◽  
Numeric Rating

Objective Bilateral frozen shoulder (FS) is often treated with intra-articular corticosteroid injection (IACI). No studies have been performed to establish whether IACI must be administered in both shoulders or in only one shoulder to improve function. This study was therefore performed to determine whether unilateral IACI improves shoulder pain and passive range of motion (pROM) in bilateral FS. Methods The medical records of 165 patients with bilateral primary FS who underwent ultrasonography-guided IACI (2 mL of 10-mg/mL triamcinolone acetonide mixed with 5 mL of 1% lidocaine) in one shoulder were retrospectively reviewed. The outcome measures, namely the numeric rating scale (NRS) scores and pROM values (abduction, external rotation, flexion, hyperextension, and internal rotation), were evaluated pre- and post-injection. Results The patients’ mean age was 54.0 ± 8.0 years. The mean symptom duration was 6.5 ± 2.8 months. The mean follow-up period after injection was 6.7 ± 0.8 weeks. The NRS scores and pROM values significantly improved in both the injected and non-injected shoulders. Conclusions This study showed that unilateral IACI in patients with bilateral FS improves the clinical outcome of the non-injected shoulder. We suggest that physicians observe the non-injected shoulder after unilateral injection rather than performing bilateral injections.

scholarly journals Treatment of Acute Acromioclavicular Joint Injuries Using AO Hook Locking Plate

2014 ◽  
Vol 17 (3) ◽  
pp. 114-119 ◽  
Author(s):  
Kyung Cheon Kim ◽  
Yoo Sun Jeon
Keyword(s):  
Los Angeles ◽  
Acromioclavicular Joint ◽  
Locking Plate ◽  
Rating Scale ◽  
Treatment Method ◽  
Unaffected Side ◽  
Joint Injuries ◽  
Coracoclavicular Distance ◽  
The Mean

BACKGROUND: To evaluate clinical and radiological outcome using AO hook locking plate in acute acromioclavicular joint injuries.METHODS: This study was based on patients with Rockwood type 3 or 5 acromioclavicular joint injuries who received surgery with AO hook locking plate from June 2008 until June 2009. Among the 22 patients, 19 of them were male and 3 were female, the mean age was 44.4 +/- 15.57 years (20-72 years) and follow-up period was 15.5 +/- 3.90 months (12-23 months). Preoperatively, postoperatively, and at the final follow-up after the plate removal, both coracoclavicular distances were measured from the anteroposterior radiograph. Also, the Shoulder Rating Scale of the University of California at Los Angeles scores (UCLA scores), the American Shoulder and Elbow Surgeons scores (ASES scores), Constant scores, and the Korean Shoulder Society scores (KSS scores) were measured at the final follow-up to evaluate the function of the shoulder joint.RESULTS: At the time of injury, the mean coracoclavicular distance of the injured side was 17.69 +/- 4.23 mm (9.57-27.82 mm) and the unaffected side was 7.55 +/- 2.20 mm (3.24-13.05 mm). The mean coracoclavicular distance measured postoperatively and at the final follow-up was 6.87 +/- 2.34 mm (4.07-14.13 mm) and 8.47 +/- 2.96 mm (4.37-17.48 mm), respectively. The mean UCLA, ASES, Constant, and KSS scores measured in the final follow-up were 33.5 +/- 1.30 (31-35), 90.8 +/- 8.36 (72-100), 78.6 +/- 8.80 (62-100), and 94.4 +/- 5.08 (84-100) each.CONCLUSIONS: From this short-term research, the surgical treatment using AO hook locking plates in acute acromioclavicular joint injuries is clinically and radiographically satisfying and considered as a useful treatment method.

scholarly journals Arthroscopic Bankart repair with remplissage for non-engaging Hill-Sachs lesion in professional collision athletes

2017 ◽  
Vol 11 (1) ◽  
pp. 17-25 ◽  
Author(s):  
Peter Domos ◽  
Francesco Ascione ◽  
Andrew L. Wallace
Keyword(s):  
External Rotation ◽  
Frozen Shoulder ◽  
Return To Play ◽  
Bankart Repair ◽  
Recurrence Rates ◽  
Five Dimensions ◽  
Arthroscopic Bankart Repair ◽  
Scale Scores ◽  
The Mean

Background The present study aimed to determine whether arthroscopic remplissage with Bankart repair is an effective treatment for improving outcomes for collision athletes with Bankart and non-engaging Hill-Sachs lesions. Methods Twenty collision athletes underwent arthroscopic Bankart repair with posterior capsulotenodesis (B&R group) and were evaluated retrospectively, using pre- and postoperative WOSI (Western Ontario Shoulder Instability), EQ-5D (EuroQOL five dimensions), EQ-VAS (EuroQol-visual analogue scale) scores and Subjective Shoulder Value (SSV). The recurrence and re-operation rates were compared to a matched group with isolated arthroscopic Bankart repair (B group). Results The mean age was 25 years with an mean follow-up of 26 months. All mean scores improved with SSV of 90%. There was a mean deficit in external rotation at the side of 10°. One patient was treated with hydrodilatation for frozen shoulder. One patient had residual posterior discomfort but no apprehension in the B&R group compared to 5% persistent apprehension in the B group. In comparison, the recurrence and re-operation rates were 5% and 30% ( p = 0.015), 5% and 35% ( p = 0.005) in the B&R and B groups, respectively. Conclusions This combined technique demonstrated good outcomes, with lower recurrence rates in high-risk collision athletes. The slight restriction in external rotation does not significantly affect any clinical outcomes and return to play.

scholarly journals Arthroscopic remplissage: a valuable adjunct to arthroscopic Bankart’s repair in shoulder instability

2021 ◽  
Vol 7 (2) ◽  
pp. 391
Author(s):  
Gunjan Upadhyay ◽  
Gaurav Gupta
Keyword(s):  
Shoulder Instability ◽  
External Rotation ◽  
Arthroscopic Surgery ◽  
Difficult Problem ◽  
Capsular Shift ◽  
Forward Flexion ◽  
Valuable Adjunct ◽  
Arthroscopic Shoulder Surgery ◽  
The Hill

<p class="abstract">Current study present results of arthroscopic shoulder stabilisation surgery. 46 consecutive patients with recurrent anterior shoulder dislocations and less than 25% Glenoid bone loss were treated with arthroscopic surgery in 2017-2020. Arthroscopic repair of Bankart’s lesion with capsular shift was performed in each. In 8 patients, where the Hill sach’s lesion was “off track” or “engaging”, arthroscopic remplissage was performed along with arthroscopic Bankart’s repair. There was no recurrence of shoulder instability after a mean follow up of 1 year. This included the non-engaging Hill sach’s group (treated with Bankart’s repair) as well as the engaging or off track Hill sach’s group (treated with Bankart’s repair and remplissage). All patients went on to obtain full forward flexion, full abduction and internal rotation. The Bankart’s and remplissage group had a mean of 8 degrees restriction of external rotation. SST scores and oxford scores had improved considerably on follow up in both groups Arthroscopic shoulder surgery provides a safe and reliable option in the management of recurrent shoulder dislocations. Arthroscopic remplissage is a useful adjunct to Bankart’s repair when treating the difficult problem of a large engaging Hill Sachs lesion.</p><p class="abstract"> </p>

scholarly journals Body Mass Index Is Related to the Recovery After Intra-articular Injection of Triamcinolone Acetonide for the Treatment of Frozen Shoulder: Case Series Study

2021 ◽  
Author(s):  
Yang-Soo Kim ◽  
Bo-Seoung Kim ◽  
Hyo-Jin Lee
Keyword(s):  
Body Mass Index ◽  
Triamcinolone Acetonide ◽  
Body Mass ◽  
External Rotation ◽  
Frozen Shoulder ◽  
Smoking History ◽  
Outcome Variable ◽  
Symptom Duration ◽  
Forward Flexion ◽  
Case Series Study

Abstract Background: Patients with frozen shoulder tend to respond differently to the intra-articular injection of triamcinolone acetonide. The purpose of the present study was to evaluate the clinical effect of glenohumeral injection with triamcinolone acetonide for frozen shoulder and determine the factors related to extent of range of motion (ROM) recovery.Methods: A cohort of patients who underwent intra-articular glenohumeral injection of triamcinolone acetonide under diagnosis of primary frozen shoulder was reviewed. The primary outcome variable of interest was the range of changes in each aspect of ROM at six weeks after injection. The relationship between improvement and unresponsiveness to intra-articular injection for the treatment of frozen shoulder with various factors were evaluated. The analyzed factors were as follows: age, sex, body mass index (BMI), initial ROM before injection, symptom duration, hand dominance, smoking history, and the existence of underlying disease including diabetes mellitus, hypertension, coronary disase, thyroid disease and hypercholesterolemia.Results: A total of 305 patients were reviewed. There were significant improvements in all aspects of ROM at six weeks after injection. The forward flexion (ρ=-0.346, p<0.001) and external rotation (ρ=-0.204, p=0.040) showed a negative correlation with BMI. Multivariate analysis revealed that BMI is the sole factor related to recovery of forward flexion (p=0.032) and external rotation (p=0.007) at six weeks post-injection. Conclusion: Intra-articular injection of triamcinolone acetonide is an effective method for improving ROM in patients with frozen shoulder. Increased BMI showed adverse effects on ROM recovery.

scholarly journals Arthroscopic Latarjet for Recurrent Shoulder Instability

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 582 ◽  
Author(s):  
Castricini ◽  
Longo ◽  
Petrillo ◽  
Candela ◽  
De Benedetto ◽  
...  
Keyword(s):  
Los Angeles ◽  
Clinical Outcomes ◽  
Shoulder Instability ◽  
External Rotation ◽  
University Of California ◽  
Simple Shoulder Test ◽  
Recurrent Shoulder Instability ◽  
Arthroscopic Latarjet ◽  
Contralateral Shoulder

Background and Objectives: The all-arthroscopic Latarjet (aL) procedure was introduced to manage recurrent shoulder instability. Our study aimed to report the outcomes of aL procedures with the Rowe, University of California-Los Angeles (UCLA), simple shoulder test (SST) scores, and range of motion (ROM) in external rotation at a minimum follow-up of 2 years. Material and Methods: A total of 44 patients presenting recurrent shoulder instability were managed with aL procedure. Clinical outcomes were assessed at a mean follow-up of 29.6 ± 6.9 months. The postoperative active ROM was measured and compared with the contralateral shoulder. The Rowe, UCLA, and SST scores were administered preoperatively and postoperatively. Results: No patients experienced infections or neuro-vascular injuries. Seven (15%) patients required revision surgery. After surgery, the external rotation was statistically lower compared to the contralateral shoulder, but it improved; clinical outcomes also improved in a statistically significant fashion. Conclusions: The aL produced good results in the management of recurrent shoulder instability, but the complication rate was still high even in the hands of expert arthroscopist.

A prospective double-blind randomized trial on ultrasound-guided versus blind intra-articular corticosteroid injections for primary frozen shoulder

2021 ◽  
Vol 103-B (2) ◽  
pp. 353-359
Author(s):  
Chul-Hyun Cho ◽  
Byung-Woo Min ◽  
Ki-Cheor Bae ◽  
Kyung-Jae Lee ◽  
Du Hwan Kim
Keyword(s):  
Glenohumeral Joint ◽  
External Rotation ◽  
Frozen Shoulder ◽  
Range Of Movement ◽  
Double Blind ◽  
Pain Scores ◽  
The Us ◽  
Time Of Presentation ◽  
Corticosteroid Injections

Aims Ultrasound (US)-guided injections are widely used in patients with conditions of the shoulder in order to improve their accuracy. However, the clinical efficacy of US-guided injections compared with blind injections remains controversial. The aim of this study was to compare the accuracy and efficacy of US-guided compared with blind corticosteroid injections into the glenohumeral joint in patients with primary frozen shoulder (FS). Methods Intra-articular corticosteroid injections were administered to 90 patients primary FS, who were randomly assigned to either an US-guided (n = 45) or a blind technique (n = 45), by a shoulder specialist. Immediately after injection, fluoroscopic images were obtained to assess the accuracy of the injection. The outcome was assessed using a visual analogue scale (VAS) for pain, the American Shoulder and Elbow Surgeons (ASES) score, the subjective shoulder value (SSV) and range of movement (ROM) for all patients at the time of presentation and at three, six, and 12 weeks after injection. Results The accuracy of injection in the US and blind groups was 100% (45/45) and 71.1% (32/45), respectively; this difference was significant (p < 0.001). Both groups had significant improvements in VAS pain score, ASES score, SSV, forward flexion, abduction, external rotation, and internal rotation throughout follow-up until 12 weeks after injection (all p < 0.001). There were no significant differences between the VAS pain scores, the ASES score, the SSV and all ROMs between the two groups at the time points assessed (all p > 0.05). No injection-related adverse effects were noted in either group. Conclusion We found no significant differences in pain and functional outcomes between the two groups, although an US-guided injection was associated with greater accuracy. Considering that it is both costly and time-consuming, an US-guided intra-articular injection of corticosteroid seems not always to be necessary in the treatment of FS as it gives similar outcomes as a blind injection. Cite this article: Bone Joint J 2021;103-B(2):353–359.

EFFICACY OF COMBINATION OF VITAMIN B1, B6 AND B12 IN MANAGEMENT OF DIABETIC PERIPHERAL NEUROPATHY

2021 ◽  
pp. 54-55
Author(s):  
Abhishek Raj ◽  
Awadhesh Kumar Jha ◽  
Debarshi Jana
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Vitamin B6 ◽  
Rating Scale ◽  
Vitamin B1 ◽  
Pain Rating ◽  
Medical College ◽  
Numeric Pain Rating Scale ◽  
Pain Rating Scale

Aim: To determine the efcacy of combination of vitamin B1, B6 and B12 in the management of diabetic peripheral neuropathy. Methods: Patients of diabetes mellitus with diabetic peripheral neuropathy were selected from Department of Medicine, Govt. Medical College and Hospital, Bettiah, W. Champaran, Bihar and study done at Pharmacology Department of GMC, Bettiah, W. Champaran, Bihar. The duration of study was six months from March 2019 to August 2019. Patients were prescribed Tab Neurobion (vitamin B1 100mg, vitamin B6 100mg, Vitamin B12 200mcg) twice a day for a period of 4 weeks (28 days). Follow up visit was scheduled on 28th day of the initial visit. Efcacy was judged by documenting improvement in pain of at least 2 points from the baseline as assessed by numeric pain rating scale. Mean age of the patients was observed Results: 46.7±8.6 years. Out of 310 cases, 177 patients (57.0%) were male and remaining 133 patients (43.0%) were female. Duration of diabetes as follows: 83 patients (26.8%) had duration of 0-10 year, 139 patients (44.8%) had 11-20 year, 77 patients (24.8%) had 21-30 year and 11 patients (3.6%) had >30 years of duration. Combination of vitamin B1, B6 and B12 in the management of diabetic peripheral neuropathy was found to be efcacious in 271 patients (87.4%). Treatment with combination of vitamin B1, B6 and B12 Conclusion: appeared to improve pain relief among patients with diabetic peripheral neuropathy.

E-REHABILITATION SOLUTION FOR ROTATOR CUFF SYNDROME IN COVID-19 PANDEMIC ERA

2021 ◽  
pp. 2150002
Author(s):  
Amit Lakhani ◽  
Ena Sharma ◽  
Sarita Khadayat
Keyword(s):  
Rotator Cuff ◽  
External Rotation ◽  
Mobile Apps ◽  
Health Sector ◽  
The Elderly ◽  
Cross Infection ◽  
Main Mode ◽  
Forward Flexion ◽  
Rehabilitation Centers

Objectives: COVID-19 pandemic has severely affected the health sector in the whole world. Routine OPDs including rehabilitation centers are partially functional to minimize the risk of cross-infection. In elderly patients, rotator cuff syndrome is a common cause of shoulder pain and daily physiotherapy is the main mode of management. To minimize the risk of cross-infection (COVID-19), we introduced E-rehabilitation services via various mobile apps to our patients. In developing countries like India, E-rehabilitation is still a new concept. Methods: This study evaluated 70 patients who had been enrolled for E-rehabilitation with a minimum of 4 weeks follow-up. Every patient was asked to use the rehabilitation App as per their requirement. Results were assessed with Disabilities of the Arm, Shoulder and Hand (DASH), visual analogue scale (VAS) and active ranges of movement (forward flexion and external rotation). Results: The average age of enrolled patients at the time of surgery was 55.0 years (range, 40–65 years). In 2 and 4 weeks, the range of forward flexion and external rotation has improved significantly. DASH and VAS Score has also been decreased significantly at an average of 2 and 4 weeks with [Formula: see text]. Conclusion: In this paper, we summarized the management of rotator cuff syndrome by using various mobile apps and also the various challenges faced in the elderly population with the newer concept of E-rehabilitation in this pandemic.

scholarly journals Hybrid Glenoid Designs in Anatomic Total Shoulder Arthroplasty: A Systematic Review

2021 ◽  
pp. 155633162110408
Author(s):  
Ahmed Haleem ◽  
Phelopater Sedrak ◽  
Chetan Gohal ◽  
George S. Athwal ◽  
Moin Khan ◽  
...  
Keyword(s):  
Los Angeles ◽  
Shoulder Arthroplasty ◽  
Bone Ingrowth ◽  
External Rotation ◽  
Total Shoulder Arthroplasty ◽  
Glenoid Component ◽  
Patient Reported

Background: Hybrid glenoid components in total shoulder arthroplasty (TSA) utilize both polyethylene and metal components to provide short-term stability and long-term biologic fixation through bone ingrowth. Questions/Purpose: We sought to systematically review the literature for studies that assessed outcomes of TSA performed using hybrid glenoid components. Methods: PubMed, Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Embase were searched systematically for articles measuring clinical and patient-reported outcomes and rates of complication and revision following TSA using a hybrid glenoid component. Results: Seven studies with 593 shoulders were included in this review. The mean age of patients was 65 ± 1 years, and 46% of the population was male. Mean follow-up was 50 months (4.2 years). The overall complication rate was 7% and rate of revision was 2.5%; glenoid radiolucency was present in 33% of shoulders at mean follow-up of 50 months. Mean improvements in forward elevation, external rotation, internal rotation score, and abduction were 49°, 28°, 2 points, and 42°, respectively. Mean improvements in Constant, American Shoulder and Elbow Surgeons (ASES), and University of California, Los Angeles (UCLA) scores were 36 points, 52 points, and 17 points, respectively. Conclusion: Our review found that TSA using hybrid glenoid components results in low rates of complication and revision at early follow-up. Long-term studies are warranted to understand more fully the role of hybrid glenoid components in TSA.

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