scholarly journals Modern concepts of surgical treatment of anterior shoulder instability in military personnel

2020 ◽  
pp. 76-86
Author(s):  
A. A. Vetoshkin
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Shoulder Instability ◽  
Treatment Approach ◽  
Individual Characteristics ◽  
Anterior Shoulder Instability ◽  
Individual Treatment ◽  
Russian Science ◽  
Russian Science Citation Index ◽  
Wide Range

Relevance. Shoulder instability covers a wide range of pathology, there is a fairly high level of its prevalence with a tendency to increase in military personnel.Intention. To assess a comprehensive diagnostic and preoperative planning algorithm taking into account the individual characteristics of the patient in order to optimize the choice of effective treatment approach.Methodology. The object of the study was scientific articles indexed in the abstract-bibliographic database of the Russian Science Citation Index (RSCI) and the international database Scopus in 2005-2019.Results and Discussion. The main approaches to assessing intra-articular injuries are analyzed, which are fundamental for choosing the optimal individual treatment approach, including the interpretation of risk factors for unsuccessful clinical outcomes and recurrence. The data on the clinical effectiveness of the main methods of surgical treatment of pathology and the prospects for their development are summarized. The most common types of complications, risk factors for their occurrence are highlighted. The concept of surgical treatment of anterior shoulder instability notes the technological and scientific improvement of diagnostic and planning methods in order to obtain the most complete objective clinical picture and verification of risk factors for selecting optimal and personalized surgical modalities.Conclusion. The development of promising treatment technologies, including additive ones, will allow reaching a qualitatively new level of medical care, increasing efficiency and reducing the risk of complications.

scholarly journals MEAN 6 YEAR CLINICAL OUTCOMES, SURVIVORSHIP, AND RETURN TO SPORTS AFTER ARTHROSCOPIC CAPSULAR REPAIR WITH SUTURE ANCHORS FOR ADOLESCENT MULTIDIRECTIONAL SHOULDER INSTABILITY

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0002
Author(s):  
Brendon C. Mitchell ◽  
Matthew Y. Siow ◽  
Alyssa Carrol ◽  
Andrew T. Pennock ◽  
Eric W. Edmonds
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Shoulder Instability ◽  
Surgical Intervention ◽  
Operation Time ◽  
Demographic Variables ◽  
Return To Sports ◽  
Suture Anchors ◽  
Surgical Failure

Background: Multidirectional shoulder instability (MDI) refractory to rehabilitation can be treated with arthroscopic capsulolabral reconstruction with suture anchors. No studies have reported on outcomes or examined the risk factors that may contribute to poor outcomes in adolescent athletes. Hypothesis/Purpose: To identify risk factors for surgical failure by comparing anatomic, clinical, and demographic variables in adolescents who underwent surgical intervention for MDI. Methods: All patients undergoing arthroscopic shoulder surgery at one institution between January 2009 and April 2017 were reviewed. Patients >20 years old at presentation were excluded. Multidirectional instability was defined by positive drive-through sign on arthroscopy plus positive sulcus sign and/or multidirectional laxity on anterior and posterior drawer testing while under anesthesia. Two-year minimum follow-up was required, but those whose treatment failed earlier were included for reporting purposes. Demographics and intraoperative findings were recorded, as were Single Assessment Numeric Evaluation (SANE) scoring, Pediatric and Adolescent Shoulder Survey (PASS), and the short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) results. Results: Eighty adolescents (88 shoulders) were identified for having undergone surgical treatment of MDI. Of these 80 patients, 42 (50 shoulders; 31 female, 19 male) were available at a minimum of 2-year follow-up. Mean follow-up was 6.3 years (range, 2.8-10.2 years). Thirteen (26.0%) shoulders experienced surgical failure defined by recurrence of subluxation and instability, all of which underwent re-operation. Time to re-operation occurred at a mean of 1.9 years (range, 0.8-3.2). Our cohort had an overall survivorship of 96% at 1 year after surgery and 76% at 3 years. None of the anatomic, clinical, or demographic variables tested, or the presence of generalized ligamentous laxity, were correlated with subjective outcomes or re-operation. Number of anchors used was not different between those that failed and those that did not fail. Patients reported a mean SANE score of 83.3, PASS score of 85.0, and QuickDASH score of 6.8. Return to prior level of sport (RTS) occurred in 56% of patients. Conclusion: Multidirectional shoulder instability is a complex disorder that can be challenging to treat. Adolescent MDI that is refractory to non-surgical management appears to have long-term outcomes after surgical intervention that are comparable to adolescent patients with unidirectional instability. In patients who do experience failure of capsulorraphy, we show that failure will most likely occur within 3 years of the index surgical treatment. [Table: see text][Figure: see text]

scholarly journals Treatment of anterior shoulder instability: a bibliometric analysis

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Mingtao Zhang ◽  
Zhitao Yang ◽  
Borong Zhang ◽  
Tao Liu ◽  
Xiangdong Yun
Keyword(s):  
United States ◽  
Risk Factors ◽  
Shoulder Instability ◽  
Sports Medicine ◽  
The United States ◽  
Bankart Repair ◽  
Anterior Shoulder Instability ◽  
Arthroscopic Bankart Repair ◽  
Number Of Citations ◽  
Research Frontiers

Abstract Purpose The treatment of anterior shoulder instability is a focus in the field of sports medicine. While much research has been conducted, few bibliometric studies have been performed in this field. This study analyzed the main characteristics and identified emerging research trends and hotspots related to the treatment of anterior shoulder instability over the past four decades. Methods We searched for (anterior shoulder instability OR anterior shoulder dislocation) AND (treatment OR reconstruction) in ARTICLE (Mesh) in the Web of Science database from 1980 to 2020. We analyzed the keywords, author, institution, country, number of citations, average number of citations, publication year, and partnership of the identified articles. Information about annual publications was analyzed using Microsoft Excel 2019; the remaining data were analyzed using VOSviewer version 1.6.11 (Leiden University, Leiden, Netherlands) and CiteSpace version 5.7.R2 (Drexel University, Philadelphia, PA, USA). Results A total of 1964 articles were published between 1980 and 2020. The American Journal of Sports Medicine, the United States, the United States Department of Defense, and Arcieio were journals, countries, institutions, and authors with the highest numbers of publications. The topic hotspots were instability, shoulder, and dislocation, while the research frontiers were arthroscopic, Bankart repair, Latarjet procedure, risk factors, recurrence, and complications. Conclusion The treatment of anterior shoulder instability has shown an increasing number of publications each year and achieved great progress. The United States made the most outstanding contributions to this important field. Arthroscopic, Bankart repair, and Latarjet procedures were research hotspots and risk factors, recurrence, and complications were likely to research frontiers.

scholarly journals Capabilities of photoplethysmography as a method for screening of cardiovascular system pathology

Cardio-IT ◽  
2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Margarita A. Simonyan ◽  
Olga M. Posnenkova ◽  
Anton R. Kiselev
Keyword(s):  
Cardiac Activity ◽  
Vascular Wall ◽  
Smart Devices ◽  
Russian Science ◽  
Cardiovascular Pathology ◽  
Individual Health ◽  
Physiological Processes ◽  
Russian Science Citation Index ◽  
Wide Range ◽  
Diagnostic Capabilities

Currently, vegetative dysfunction considered to be one of principal mechanisms in the pathogenesis of cardiovascular pathology, which causes a cascade of events leading to changes in the properties and a structure of vascular wall. This review article contains literature from various databases (Russian science citation index, PubMed, Google Shcolar, Scopus). It presents the methods for assessing vegetative imbalance. In particular, the method of photoplethysmography (PPGV) is considered for recording periodic fluctuations at various frequencies in the distal vascular bed which characterize physiological processes (cardiac activity, respiratory influences, neurogenic, myogenic and endothelial activity). In addition, other diagnostic capabilities of PPGV such as heart rate (HR) assessment, determining the properties of vascular wall and the level of blood saturation are elucidated. This paper demonstrates a wide range of PPGV applications. The simplicity of PPGV reproduction and its cost-effectiveness make it feasible both in routine clinical practice for the purposes of screening for cardiovascular pathology, and for individual health monitoring incorporated in smart devices.

scholarly journals Microsurgical Treatment of Epidermoids. Case Report and Literature Review

2019 ◽  
Vol 4 (2) ◽  
pp. 114-121
Author(s):  
V. A. Byvaltsev ◽  
A. A. Kalinin ◽  
E. G. Belykh ◽  
S. L. Antipina ◽  
D. I. Badaguev
Keyword(s):  
Surgical Treatment ◽  
Literature Review ◽  
Aseptic Meningitis ◽  
Epidermoid Cyst ◽  
Surgical Intervention ◽  
Perioperative Complications ◽  
Medical Knowledge ◽  
Clinical Results ◽  
Russian Science ◽  
Russian Science Citation Index

The aim of the research: study the features of surgical treatment of epidermoids.Materials and methods. We present a literature review and the clinical case of surgical treatment of a patient with epidermoid. We have searched medical databases: Medline, Russian Science Citation Index, EMedicine, United Medical Knowledge Base. We considered the features of the clinic, diagnosis, and surgical intervention. The article presents a clinical example of successful surgical treatment of a patient with an epidermoid cyst of the posterior cranial fossa. The result of the literature review was the writing of a clinical lecture; the current state of the issue of etiopathogenesis, diagnosis and management of patients with epidermoids was studied.Results. The authors found that total microsurgical removal is the method of choice, and the operative technique should be aimed at preventing postoperative aseptic meningitis. Although it was not possible to establish the cause of the development of aseptic meningitis, the authors assume that the mechanism of its formation lies in the self-breaking of the capsule of the epidermoid cyst, probability of which was confirmed by a number of studies. Further study of this pathology is a promising direction in neurosurgery.Conclusion. Difficulties in the diagnosis and choice of surgical tactics point at the need for detailed preoperative planning of surgical intervention, performing a precise total removal of a lesion with compliance with preventive measures for aseptic meningitis to improve clinical results and reduce the incidence of perioperative complications.

scholarly journals Analysis of the demand for research results in the fieldof energy and related industries

2020 ◽  
pp. 85-96
Author(s):  
V. V. Arutyunov
Keyword(s):  
Electrical Engineering ◽  
Power Engineering ◽  
Publication Activity ◽  
Annual Number ◽  
Russian Science ◽  
Radio Engineering ◽  
Research Results ◽  
Russian Science Citation Index ◽  
Wide Range ◽  
Number Of Publications

The paper analyzes the importance of power engineering for solving a wide range of practical problems. The purpose of this study is to evaluate the results of the research of scientists and specialists in 2013–2019 in power engineering, electrical engineering, electronics and radio engineering on the basis of RSCI databases (Russian Science Citation Index). The analysis was carried out taking into account a number of scientometric indicators: the publication activity of researchers – the annual number of their publications, as well as the citation of these publications and the demand for the results of their work. Features of dynamics of formation of indicators of publication activity are revealed: its high values are typical for electronics and radio engineering and minimum values (more than three times smaller) – for electrical engineering. For all three industries analyzed the number of publications increased in 2013–2018. It is noted that the citation indicators for the three industries have been continuously decreasing since 2014. At the same time, in the field of electronics and radio engineering in 2013–2017, citation rates are three or more times higher than similar indicators for energy and electrical engineering. The results of research in the field of electronics and radio engineering are the most popular, while the results of research in the energy sector are the least popular. At the same time, the annual demand for research results in electronics and radio engineering exceeds similar indicators for energy by about 1.4 times. The low demand indicators for all areas of research in 2019 are obviously due to the same reason as for small citation indicators this year: the slow “response” of the scientific community to this year's publications.

scholarly journals Incidence of and Risk Factors for Glenohumeral Osteoarthritis After Anterior Shoulder Instability: A US Population–Based Study With Average 15-Year Follow-up

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096251
Author(s):  
Bradley M. Kruckeberg ◽  
Devin P. Leland ◽  
Christopher D. Bernard ◽  
Aaron J. Krych ◽  
Diane L. Dahm ◽  
...  
Keyword(s):  
Risk Factors ◽  
Shoulder Instability ◽  
The United States ◽  
Anterior Shoulder Instability ◽  
Geographic Population ◽  
Increased Risk ◽  
Modifiable Factors ◽  
History Of ◽  
Former Smokers

Background: The rate of osteoarthritis (OA) in patients with a history of previous anterior shoulder instability (ASI) varies within the literature, with the majority of studies investigating rates after surgical stabilization. ASI appears to lead to increased rates of OA, although risk factors for developing OA in cohorts treated nonoperatively and operatively are not well-defined. Purpose: To determine the incidence of clinically symptomatic OA and identify potential risk factors for the development of OA in patients younger than 40 years with a known history of ASI. Study Design: Case-control study; Level of evidence, 3. Methods: An established, geographically based database was used to identify patients in the United States who were younger than 40 years and were diagnosed with ASI between 1994 and 2014. Patient information, including demographic, imaging, and surgical details, was collected. Comparative analysis was performed between groups with and without OA at final follow-up as well as between patients who underwent surgical and nonsurgical management. Results: The study population consisted of 154 patients with a mean follow-up of 15.2 years (range, 5.1-29.8 years). The mean age at initial instability event was 20.9 years (95% CI, 19.9-22.0 years). Overall, 22.7% of patients developed clinically symptomatic glenohumeral OA. Multivariate analysis revealed that current or former smokers (odds ratio [OR], 4.3; 95% CI, 1.1-16.5; P = .030), hyperlaxity (OR, 10.1; 95% CI, 1.4-72.4; P = .020), laborer occupation (OR, 6.1; 95% CI, 1.02-36.1; P = .043), body mass index (BMI) (OR, 1.2; 95% CI, 1.03-1.3; P = .012), and age at initial instability (OR, 1.1; 95% CI, 1.02-1.2; P = .013) as potential independent risk factors when accounting for other demographic and clinical variables. Conclusion: In a US geographic population of patients younger than 40 years with ASI, approximately one-fourth of patients developed symptomatic OA at a mean follow-up of 15 years from their first instability event. When accounting for differences in patient demographic and clinical data, we noted a potentially increased risk for the development of OA in patients who are current or former smokers, have hyperlaxity, are laborers, have higher BMI, and have increased age at initial instability event. Smoking status, occupation, and BMI are modifiable factors that could potentially decrease risk for the development of symptomatic OA in these patients.

scholarly journals EVALUATION OF THE RESULTS FROM ARTHROSCOPIC SURGICAL TREATMENT FOR TRAUMATIC ANTERIOR SHOULDER INSTABILITY USING SUTURING OF THE LESION AT THE OPENED MARGIN OF THE GLENOID CAVITY

2012 ◽  
Vol 47 (3) ◽  
pp. 318-324
Author(s):  
Alberto Naoki Miyazaki ◽  
Marcelo Fregoneze ◽  
Pedro Doneux Santos ◽  
Luciana Andrade da Silva ◽  
Guilherme do Val Sella ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Shoulder Instability ◽  
Anterior Shoulder Instability ◽  
Glenoid Cavity

scholarly journals Risk factors of recurrence after an arthroscopic stabilisation procedure performed for traumatic anterior shoulder instability in pediatric population

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0006 ◽  
Author(s):  
Mustafa Özer ◽  
Tacettin Ayanoğlu ◽  
Muhammet Baybars Ataoğlu ◽  
Mehmet Çetinkaya ◽  
Ulunay Kanatlı
Keyword(s):  
Risk Factors ◽  
Recurrence Rate ◽  
Shoulder Instability ◽  
Pediatric Population ◽  
Anterior Shoulder Instability ◽  
Sports History ◽  
Contact Sports ◽  
Pediatric Age Group ◽  
Arthroscopic Stabilisation ◽  
History Of

Arthroscopic stabilisation of traumatic anterior shoulder instability is being performed also in pediatric age group, and reports associated with risks of recurrent instability have been presented. The aim of the current study was determining the risk factors of recurrence after the arthroscopic anatomic repair preformed in pediatric age group. 46 patients who underwent arthroscopic Bankart repair for traumatic anterior shoulder instability with the mean age of 17 ±0.8 (15-18) were included in this study. After an average follow-up time of 40.4± 22.7(24-155) months age, gender, dominant side, number of dislocations before surgery, participation in contact sports, Rowe and Oxford shoulder scores, labral lesion type, number of anchor used, and capsular laxity were assessed, and their correlation with recurrence were investigated. Recurrence was encountered in 9 (19,5%) patients, on average, 16.1 ±13.43 months after surgery. The only risk factor of recurrence was found to be the history of five or more times of dislocation before surgery (p=0,006). Although statistically insignificant, when evaluated separately, it was found that patients with contact sports history had double times of recurrence rate if they had ALPSA or SLAP lesion and triple times of recurrence rate if they had capsular laxity. The recurrence rate was found to be 38,4% when accompained by capsular laxity, 50% when accompained by both capsular laxity and ALPSA lesion, and 100% when accompanied by all capsular laxity, ALPSA lesion and contact sports history. Arthroscopic stabilisation of traumatic anterior shoulder instability in pediatric population is an appropriate technique, especially in those with less than five times of dislocation because of the low recurrence rate (3.4%). Surgical procedures that are non-anotomic, such as coracoid transfer or anterior glenoid bone block, should be considered in patients with high risk of recurrence rate after an arthroscopic anatomic repair because of the risk factors like history of five or more times of dislocation, being accompanied by an ALPSA, SLAP lesion, or a capsular laxity and participation in contact sports.

scholarly journals Drug adjustment of modified risk factors as one of the leading strategies for managing patients with cardiovascular diseases

2020 ◽  
pp. 22-38
Author(s):  
S. K. Zyryanov ◽  
E. A. Baybulatova
Keyword(s):  
Risk Factors ◽  
Cardiovascular Diseases ◽  
Beta Blockers ◽  
Individual Characteristics ◽  
Lipid Lowering ◽  
Individual Treatment ◽  
Combination Drug ◽  
Chronic Heart Disease ◽  
Continuous Chain ◽  
Cardiovascular Continuum

Cardiovascular diseases (CVDs) are the number 1 cause of death globally. Risk factors for CVDs may trigger the development of pathological conditions to a certain degree. The cardiovascular continuum is a continuous chain of interconnected changes in the cardiovascular system from exposure to risk factors via the gradual onset and progression of CVD to the development of terminal heart damage and death. The continuous chain of interconnected changes in the structure and function of several body organs and systems at once within the continuum suggests the presence of common pathophysiological processes, mechanisms of development and progression of organ damages. The drug’s ability to affect all stages of the cardiovascular continuum defines the choice of modern pharmacotherapy for cardiological patients. Using drugs with multi-target (multi-purpose) action is one of the possibilities for optimizing pharmacotherapy. The provided results of clinical studies show that drugs meeting this requirement include ACE inhibitors (ramipril), beta-blockers (metoprolol), lipid-lowering drugs (combination drug rosuvastatin/ezetimib), allopurinol. The choice of drugs for pharmacotherapy of patients with cardiovascular diseases should be based on the presence and severity of all risk factors and associated conditions and taking into account the individual characteristics of the drugs. Patients with chronic heart disease usually need lifelong therapy, and search for the best individual treatment for each patient is crucial. Using drugs with multi-target (multi-purpose) action is one of the possibilities for optimizing treatment.

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