Surgical treatment of shoulder rotator cuff injuries

Introduction. The rotator cuff is the most important functional structure of the shoulder. The aim of this study was to determine which factors contribute to a rotator cuff injury and to evaluate the results of the surgical treatment at the Department of Orthopedic Surgery and Traumatology in Novi Sad since December 2009 until May 2012. Material and Methods. The study sample consisted of 20 patients who had been operated for a shoulder rotator cuff injury. Their mean age was 56.8 ? 9.1. Results. According to the Constant Shoulder Score, 75% of the patients had excellent and good results. A statistically significant difference (p?0.05) was found between Constant Shoulder Score of the operated should and the opposite shoulder as well as between the range of external and internal rotation and abduction. After the surgical treatment, 95% of the patients have no limitations in the activities of daily living and they are satisfied with the results of treatment. Conclusion. Surgical treatment of a shoulder rotator cuff injury is reliable, time-tested and provides good clinical results especially in patients who were operated within the first three weeks after the injury.

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The use of partial prosthesis in shoulder surgery

Medicinski pregled ◽

10.2298/mpns16s1047n ◽

2016 ◽

Vol 69 (suppl. 1) ◽

pp. 47-51

Author(s):

Srdjan Ninkovic ◽

Sladjana Radosavljevic ◽

Vladimir Harhaji ◽

Ivica Lalic ◽

Natasa Janjic ◽

...

Keyword(s):

Orthopedic Surgery ◽

Daily Living ◽

Articular Surface ◽

Functional Results ◽

Risk Groups ◽

Daily Activities ◽

Shoulder Prosthesis ◽

Clinical Center ◽

Novi Sad ◽

Shoulder Score

Introduction. Indications for the use of partial shoulder prosthesis are dislocated four-part fractures and multi-part and four-part fractures-dislocations, impressive fractures of the humeral head (including involvement of more than 40% of the articular surface) and ?head splitting? fractures of humerus. The aim of this study was to present the results of the application of partial shoulder prosthesis at the Department of Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina in Novi Sad and identify risk groups among the participants. Material and Methods. The study, which was retrospective, included 22 patients who had undergone the partial shoulder arthroplasty in the period from 2005 to 2015 at the Department of Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina. The functional results were evaluated on the basis of the Constant Shoulder Score. Results. The study sample consisted of 15 women and 7 men, whose mean age was 64.9 ? 9.1 years. The average time from the injury to surgery was 13.3 days. According to the Constant scoring scale, the result was excellent in 6 (27%) patients, good in 3 (14%), fair in 7 (32%), and poor in 6 (27%) participants. 75% of participants said they were satisfied with the results of the operation. Conclusion. Partial shoulder prosthesis gives good functional results and allows resumption of activities of daily living. Better results were obtained within the subjective segments (pain, daily activities, vitality), which points out a greater subjective patient?s satisfaction in relation to the measured functio?nal outcome.

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The surgical treatment of the recurrent dislocation on the shoulder joint with minimum invasion anterior approach

Medicinski pregled ◽

10.2298/mpns0802049n ◽

2008 ◽

Vol 61 (1-2) ◽

pp. 49-54 ◽

Cited By ~ 1

Author(s):

Srdjan Ninkovic ◽

Milan Stankovic ◽

Dragan Savic ◽

Radmila Matijevic ◽

Miroslav Milankov

Keyword(s):

Shoulder Joint ◽

Open Surgery ◽

Recurrent Dislocation ◽

Clinical Results ◽

Mean Value ◽

Basketball Player ◽

Physical Treatment ◽

Significant Difference ◽

The Right ◽

Novi Sad

Shoulder joint is one of the spherical joints and one of the most movable but also the most unstable joint of locomotive apparatus. The aims of this work are to review and analyze the results of medical treatment of frontal recurrent dislocations on the shoulder with open surgery technique on the Clinic for Orthopaedic Surgery and Traumatology in Novi Sad in the period from 2002 to 2005. Twenty one patients with anterior recurrent dislocations of the shoulder were operated on, 19 men and 2 women. The average age of those patients was 24.8 (15-40 year-olds). Ten patients had an injury of the left and 11 patients the injury of the right shoulder. There were eight handball players, four fighting skills players; two of them played volleyball and one was a basketball player. Six of them were not sportsmen. The preoperational and post operational mean value of the modified Rowe scale showed a statistically significant difference (P<0.001). Observing the patients after the operation in the period of 2 years, according to Neer scale, 3 patients (14.28%) had great results (grade over 90), 16 patients (76.19%) had a good result, (75-89), and only two patients (9.52%) had results less than 75. The measuring of the volume of movements after physical treatment in 12 patients (57.14%) has shown the decrease of the outside rotation. Open surgery treatment of the front unstable shoulder joint is reliable and time tested and it gives good clinical results in young sportsmen with undirected unstable, bigger number of dislocations and associated osseous defects. .

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Clinical Results of Surgical Treatment for Rotator Cuff Tear in Tsushima.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.48.145 ◽

1999 ◽

Vol 48 (1) ◽

pp. 145-147

Author(s):

Masahiko Nishiguchi ◽

Satoshi Nakamura ◽

Katsumi Yano ◽

Masayuki Egashira ◽

Junji Oda ◽

...

Keyword(s):

Surgical Treatment ◽

Rotator Cuff ◽

Rotator Cuff Tear ◽

Clinical Results ◽

Cuff Tear

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Prevalence and Grading of Rotator Cuff and Labral Injuries in Shoulder Pain and Instability using MRI: ACross-sectional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48773.14845 ◽

2021 ◽

Author(s):

Ashok Srikar Chowdhary ◽

Naresh Babu Lakshmipathi Nikhil ◽

Nidhi Hemendra Chandrakar ◽

Nidhi Raj Buddaraju

Keyword(s):

Rotator Cuff ◽

Shoulder Pain ◽

Biceps Tendon ◽

Supraspinatus Tendon ◽

Sectional Study ◽

Rotator Cuff Injuries ◽

Rotator Cuff Injury ◽

Biceps Pulley ◽

Study Population ◽

Long Head

Introduction: Shoulder joint is a highly mobile joint but is prone for rotator cuff injuries and dislocations. It is necessary to accurately diagnose rotator cuff and labral injuries so that appropriate plan of action for treatment can be taken. Magnetic Resonance Imaging (MRI) can be used to diagnose and describe the extent of rotator cuff tendon and labral injuries and any secondary rotator cuff muscle abnormalities. Aim: To study the demographic profile of patients presenting with shoulder pain and instability, identify the various rotator cuff injuries causing shoulder pain, identify the rotator cuff interval lesions causing microinstability, identify the various labral and bony pathologies in instability, describe the MRI features of the rotator cuff, rotator cuff interval, labral and bony injuries. Materials and Methods: This study was a cross-sectional study of patients with symptoms of either shoulder pain or instability who underwent MRI evaluation of the shoulder in the Department of Radiodiagnosis, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India, from July 2018 to December 2020. The study population consisted of 54 patients with either shoulder pain or instability who underwent MRI of shoulder. All the MRI scans of the shoulder in this study were performed using 1.5 Tesla Siemens Magnetom Avanto (Tim 76x18) MR machine using a flex coil. Results: The study population consisted of 54 patients comprising of 38 males and 16 females. The age of the patients ranged from 20-77 years. Majority of the patients were older than 50 years constituting about 33.33% of the total study population. Rotator cuff injury was the commonest cause of pain. Tendinosis was the commonest type of rotator cuff injury followed by partial-thickness and full-thickness tendon tears. The commonest grade of tendinosis was mild or grade 1. Supraspinatus tendon was the most commonly affected tendon followed by subscapularis and infraspinatus tendons. Teres minor tendon was normal in all the cases. Anterior instability was the commonest type of instability with equal prevalence of soft tissue Bankart, bony Bankart and Perthes lesions. Biceps pulley lesions resulted in long head of biceps tendon instability, microinstability and internal impingement. Conclusion: Rotator cuff injuries are the commonest cause of shoulder pain and are seen more frequently after the fifth decade. Shoulder instability is most commonly seen in young male adults. Tendinosis is the commonest type of rotator cuff injury. Supraspinatus tendon is the most commonly injured tendon. Anterior instability is the commonest type of shoulder instability. Biceps pulley lesions result in long head of biceps tendon instability, microinstability and internal impingement. MRI can diagnose interstitial or intrasubstance tendon tears which are not visualised on arthroscopy. MRI description of tendon and labral tears, tendon retraction and muscle atrophy can guide the orthopaedician during arthroscopy and in treatmentplanning.

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Prospective Clinical Research of the Efficacy of Platelet-rich Plasma in the Outpatient-based Treatment of Rotator Cuff Tendinopathy

Clinics in Shoulder and Elbow ◽

10.5397/cise.2019.22.2.61 ◽

2019 ◽

Vol 22 (2) ◽

pp. 61-69

Author(s):

Ho-Won Lee ◽

Kyung-Ho Choi ◽

Jung-Youn Kim ◽

Ik Yang ◽

Kyu-Cheol Noh

Keyword(s):

Rotator Cuff ◽

Conservative Treatment ◽

Rating Scale ◽

Platelet Rich Plasma ◽

Constant Score ◽

Statistical Significance ◽

Clinical Results ◽

Control Group ◽

Significant Difference ◽

Rotator Cuff Tendinopathy

Background: The purpose of this study is to compare the clinical outcomes of the control group and platelet-rich plasma (PRP) group among the patients who failed to respond to conservative treatment as outpatient-based therapy for rotator cuff tendinopathy, and to compare the clinical results of leukocyte-poor (LP) PRP and leukocyte-rich (LR) PRP.Methods: Inclusion criteria are (1) over 18-year-old, (2) patients with rotator cuff tendinopathy, no rotator cuff tear by radiologic diagnosis (ultrasonography or magnetic resonance imaging) within the last 3 months, and (3) not effective to conservative treatment for more than 1 month. Of the final 60 subjects, 33 patients in the exercise treatment group and 27 patients in the PRP injection group (LP-PRP, 13; LR-PRP, 14) were included. Clinical evaluation was carried out by assessing the outcomes of treatment using the Numeric Rating Scale pain score, the American Shoulder and Elbow Society (ASES) score, and the Constant score at baseline and at 3 and 6 months after the procedure.Results: There was a statistically significant difference in ΔASES3months (ASES3months-ASESfirst) score between the control and PRP groups (p=0.006). However, there was no statistical significance between LP-PRP and LR-PRP groups (p>0.05).Conclusions: This study showed that PRP injection was more effective than exercise therapy for the first 3 months. However, there was no difference between the LP-PRP group and the LR-PRP group. Regardless of the type of PRP, clinical application of PRP injection in patients with rotator cuff tendinopathy seems to be effective in early treatment.

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Comparison of Valveplasty and Replacement for Surgical Treatment of Infective Tricuspid Valve Endocarditis

10.21203/rs.3.rs-842173/v1 ◽

2021 ◽

Author(s):

Xie Linfeng ◽

Chen Xiaodong ◽

He Jian ◽

Lin Sixian ◽

Chen Xingfeng ◽

...

Keyword(s):

Surgical Treatment ◽

Infective Endocarditis ◽

Tricuspid Valve ◽

Drug Users ◽

Clinical Effect ◽

Clinical Results ◽

Reoperation Rate ◽

Red Blood Cell Transfusion ◽

Significant Difference ◽

Tricuspid Valve Endocarditis

Abstract Background In recent years, due to the increase in intravenous drug injection and intracardiac and vascular interventional treatments among drug users, infective endocarditis involving the right heart of the tricuspid valve has gradually increased.At present, there is no systematic report on surgical treatment of tricuspid infective endocarditis. This paper summarizes the experience of surgical treatment of 56 patients with tricuspid infective endocarditis in our hospital and analyzes its clinical effect. Methods From January 2006 to August 2019, 56 cases of tricuspid infective endocarditis treated by tricuspid valve surgery in our hospital were analyzed retrospectively.including 23 cases of tricuspid valvuloplasty (TVP) and 33 cases of tricuspid valve replacement (TVR). All patients were complicated with tricuspid valve vegetations or moderate and severe tricuspid regurgitation and had surgical indications.The perioperative data were collected and followed up for 6 months to 14 years to summarize and analyze the clinical effect of surgical treatment of tricuspid infective endocarditis. Results Compared with TVR group, the CPB time (79.68 ± 19.02min VS 107.39 ± 25.64min, P < 0.01), ACC time (50.29 ± 16.14min VS 65.52 ± 20.62min, P < 0.01), postoperative mechanical ventilation time (18.65 ± 8.18h VS 44.85 ± 57.68h, P < 0.01) and ICU stay time (38.13 ± 21.80h VS 102.64 ± 142.11h, P = 0.015) in TVP group were shorter. The perioperative red blood cell transfusion (4.87 ± 3.81U VS 7.55 ± 5.42U, P < 0.01) and the incidence of postoperative complications (8.7% VS 33.3%, P < 0.01) were lower.Perioperative death occurred in 1 case in the TVR group, and there was no perioperative death in the TVP group, There was no significant difference between the two groups(3.03% VS 0, P = 0.855). A total of 52 cases were followed up for an average of (5.50 ± 3.79) years.The postoperative 3-year, 5-year and 7-year survival rate were 100%,100%,91.7% in TVP group and 95.2%, 93.8% and 87.5%.The 5-year and 10-year reoperation rate were 0%, 0% in TVP group and 6.7%, 20% in TVR group. Conclusion Surgical treatment of severe tricuspid valve endocarditis has achieved good mid-term clinical results, and the rate of avoiding reoperation is better in TVP group than in TVR group.

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Evaluation of the results from arthroscopic surgical treatment of rotator cuff injuries in patients aged 65 years and over

Revista Brasileira de Ortopedia (English Edition) ◽

10.1016/j.rboe.2015.06.001 ◽

2015 ◽

Vol 50 (3) ◽

pp. 305-311 ◽

Cited By ~ 1

Author(s):

Alberto Naoki Miyazaki ◽

Luciana Andrade da Silva ◽

Pedro Doenux Santos ◽

Sergio Luiz Checchia ◽

Carina Cohen ◽

...

Keyword(s):

Surgical Treatment ◽

Rotator Cuff ◽

Rotator Cuff Injuries

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The Arthroscopic Intra-Articular Stabilization of the Shoulder for Irreparable Rotator Cuff Tear: A New Technique Proposal

Frontiers in Surgery ◽

10.3389/fsurg.2021.624100 ◽

2021 ◽

Vol 8 ◽

Author(s):

Pierfrancesco Luciani ◽

Luca Farinelli ◽

Luca De Berardinis ◽

Antonio Gigante

Keyword(s):

Rotator Cuff ◽

Humeral Head ◽

Biceps Tendon ◽

Reverse Shoulder Arthroplasty ◽

Supraspinatus Tendon ◽

Biomechanical Study ◽

Rotator Cuff Tears ◽

Rotator Cuff Injuries ◽

Superior Capsular Reconstruction ◽

Significant Difference

Background: Superior capsular reconstruction (SCR) has shown good results in the management of irreparable rotator cuff tears due to the depressive effect on the humeral head, but it is a technically demanding and expensive procedure.Purpose: We hypothesized that an intra-articular neoligament that prevents the superior translation of the humeral head could give similar results in terms of the superior translation of humerus (STH) and range of motion (ROM).Study Design: To compare our proposed technique and the SCR, we conducted a biomechanical study on 10 porcine shoulders in a custom shoulder testing system.Methods: STH and total rotational ROM were quantified in the following four scenarios: (1) when the rotator cuff was intact, (2) after cutting the supraspinatus tendon, (3) after the reconstruction of the superior capsule by long head of the biceps tendon (LHB), and (4) after an arthroscopic intra-articular stabilization by an intra-articular graft. Our proposed technique provides the creation of a humeral and glenoid tunnel, the passage of a graft through these tunnels under arthroscopic guidance, and the graft fixation in the two tunnels. We analyzed the STH and total ROM in each scenario.Results: With respect to the STH, we reported that the present proposed technique is characterized by a significant reduction of superior translation at 0 and 45° compared to scenario 2. In addition, the comparison between our proposed technique and SCR showed a significant difference of the STH at 0° of abduction. Total rotational ROMs of the two tenchinques were similar to scenario 2. Therefore, the use of an intra-articular ligament that prevents the STH can restore shoulder stability in irreparable rotator cuff injuries at both 0 and 45° of glenohumeral abduction without apparently limiting the total rotational ROM.Conclusion: Our proposed technique could be an important treatment option in irreparable rotator cuff tears, especially in patients under 65 years in whom reverse shoulder arthroplasty (RSA) has shown poor results and many complications.

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Early clinical results of surgical treatment of patients with femoroacetabular impingement

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1406325m ◽

2014 ◽

Vol 142 (5-6) ◽

pp. 325-329 ◽

Cited By ~ 5

Author(s):

Desimir Mladenovic ◽

Zoran Andjelkovic ◽

Zoran Vukasinovic ◽

Milorad Mitkovic ◽

Sasa Milenkovic ◽

...

Keyword(s):

Surgical Treatment ◽

Femoroacetabular Impingement ◽

Hip Osteoarthritis ◽

Womac Score ◽

Clinical Results ◽

Results Of Treatment ◽

Surgical Dislocation ◽

Early Results ◽

Before And After ◽

One Year

Introduction. Surgical treatment is the treatment of choice in patients with symptoms and radiological signs of femoroacetabular impingement. Objective. Our experience and early results of surgical treatment of patients with signs of femoroacetabular impingement and early hip osteoarthritis are reported. Methods. The results of treatment of 21 patients aged 23-54 years with different types of femoroacetabular impingement are presented. Safe open surgical dislocation of the hip was performed in all patients. Before and after surgery, the WOMAC score was performed, clinical and radiographic data of the operated hips were evaluated and t-tests were used for statistical analyzes of data. Results. The WOMAC score improved from 70.5 points ( range 56.3 to 89.8 points) to 90.3 points (range 70.3 to 100 points) at one year of follow-up (p<0.0001), anterior impingement test was negative in all operated cases, average hip internal rotation improved significantly, no complications were found, except trochanteric nonunion at the site of osteotomy, which was reaffixed. Conclusion. Postoperative results have shown that the surgical approach to treating patients with femoroacetabular impingement is the method of choice. Three operated patients, with advanced osteoarthritis of the hip, had to be converted to total hip replacement.

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Do Articular-Sided Partial-Thickness Rotator Cuff Tears After a First-Time Traumatic Anterior Shoulder Dislocation in Young Athletes Influence the Outcome of Surgical Stabilization?

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118781311 ◽

2018 ◽

Vol 6 (6) ◽

pp. 232596711878131

Author(s):

Madis Rahu ◽

Jüri-Toomas Kartus ◽

Elle Põldoja ◽

Kirsti Pedak ◽

Ivo Kolts ◽

...

Keyword(s):

Surgical Treatment ◽

Rotator Cuff ◽

Shoulder Dislocation ◽

Clinical Results ◽

Rotator Cuff Tears ◽

Anterior Shoulder Dislocation ◽

Young Athletes ◽

Bony Bankart ◽

Traumatic Anterior Shoulder Dislocation ◽

First Time

Background: Because of the high risk for redislocations after a first-time traumatic anterior shoulder dislocation with conservative treatment, recent publications have recommended early arthroscopic intervention, especially for young athletes. Concomitant rotator cuff tendon damage may occur when the shoulder dislocates; however, its presence and influence on clinical results have not been well described in this patient category. Hypothesis: In opposition to current opinion, a substantial number of articular-sided partial-thickness rotator cuff tears (APTRCTs) would be found at surgery after a first-time traumatic anterior shoulder dislocation in young athletes. However, the impact of these injuries on 2-year postoperative results would be negligible. Study Design: Cohort study; Level of evidence, 3. Methods: Sixteen male patients (mean age, 21 years [range, 16-25 years]) with a first-time traumatic anterior shoulder dislocation without bony Bankart lesions were included in this study. The indications for surgical treatment were age less than 25 years and being active in collision or contact sports at a competitive level. Arthroscopic surgery was performed at a mean 7.8 days (range, 2-14 days) after injury. Rowe and American Shoulder and Elbow Surgeons (ASES) scores as well as range of motion were evaluated at a minimum 2 years after an arthroscopic Bankart procedure, and a comparison of the clinical results between patients with and without APTRCTs was conducted. Results: An anterior-inferior capsulolabral injury was found in all patients. There were no bony Bankart lesions. An APTRCT was found in 9 of the 16 patients. At 2 years after surgical treatment, there were no significant differences between the patients with and without APTRCTs in terms of the Rowe score (90.0 and 87.1, respectively; P = .69) and ASES score (94.6 and 90.4, respectively; P = .67). Conclusion: APTRCTs were found in the superior part of the shoulder joint after a first-time traumatic anterior shoulder dislocation in a majority of young male athletes treated with surgical stabilization. There were no significant differences found between patients with and without APTRCTs in terms of the Rowe and ASES scores at 2 years after surgical treatment.

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