scholarly journals Results of treatment of arthrosis of the acromial-clavicular joint in patients with partial rupture of the supraspinatus muscle tendon

2021 ◽  
Author(s):  
Serhii S. Strafun ◽  
Serhii V. Bohdan ◽  
Samir M. Abbasov ◽  
Serhii O. Bezruchenko ◽  
Olexander S. Strafun
Keyword(s):  
Shoulder Joint ◽  
Supraspinatus Tendon ◽  
Abdominal Muscle ◽  
Clinical Group ◽  
Partial Rupture ◽  
Joint Function ◽  
Results Of Treatment ◽  
Post Surgery ◽  
Shoulder Muscle ◽  
Joint Material

Introduction: Very often, partial tear tendons of the superficial shoulder muscle are combined with arthrosis of the clavicular-acromial joint. This is due to violations of the shoulder-patch rhythm, which in turn leads to a chronic overload of the clavicular-acromial joint and the progression of arthrosis in this joint. Aim: The purpose of the study is to improve the results of treatment of patients with injuries of the supraspinatus tendon against the background of deforming arthrosis of the clavicular-acromial joint. Material and methods: For the study a clinical group was assembled, which consisted of 84 patients with injuries of the tendon of the supraspinatus and deforming arthrosis of the clavicular-acromial joint 3–4 parts. All patients, depending on the treatment, were divided into two groups. Results and discussion: The consequences and influence of the arthrosis of the clavicular-acromial joint were determined. Movements of the joint were examined. The shoulder joint function was under control in the post-surgery period, which provided particular results and conclusions according to the comparative analysis of the two groups. Conclusions: Based on the provided results, it can be concluded that deforming arthrosis of the clavicular acromial joint can cause contracture in the shoulder joint in patients after the suture of the tendon of the abdominal muscle.

scholarly journals Repair of Lafosse I subscapularis injury adds no additional value in anterosuperior rotator cuff injury

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Binghao Zhao ◽  
Qingsong Zhang ◽  
Bo Liu
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Shoulder Joint ◽  
Statistical Difference ◽  
Supraspinatus Tendon ◽  
Joint Function ◽  
Tendon Tear ◽  
Rotator Cuff Injury ◽  
Additional Value ◽  
Repair Group

Abstract Background The study aimed to explore the additional value of repair of Lafosse I subscapularis injury compared with debridement in anterosuperior rotator cuff injury. Methods The prospective study was conducted on a total of 41 patients with supraspinatus tendon tear combined with Lafosse I subscapularis injury. Eighteen patients were divided into the repair group and 23 patients were divided into the non-repair group. The two groups were compared for intraoperative parameters, pain score, range of motion of the shoulder joint, shoulder joint function and quality of life (QoL) at pre-operation, 3 and 6 months postoperatively and the final follow-up visit. Results The width of supraspinatus tendon tear did not exceed 3 cm and did not retract beyond the glenoid in among patients. There was no statistical difference of preoperative data between two groups, including age, course of disease, positive Jobe test, positive Bear-hug test, positive Lift-off test, Patte stage, longitudinal tear and pain severity (P > 0.05). Compared to preoperative levels, the severity of pain, ASES scores and EQ-5D-3L scores were significantly lower at 3 and 6 months postoperatively and the final position (P < 0.05). However, there was no statistical difference in pain severity, ASES scores and EQ-5D-3L scores between repair group and non-repair group (P > 0.05). Similarly, compared to preoperative levels, the range of motion of shoulder joint was significantly improved after operation, including internal rotation, external rotation, forward flexion and elevation (P < 0.05). However, there was no statistical difference in range of motion of shoulder joint between repair group and non-repair group (P > 0.05). Conclusion Operative treatment can effectively lessen severity of pain in the patients, improve shoulder joint function, increase the range of motion of the shoulder joint and enhance the QoL in treating anterosuperior rotator cuff injury. However, repair of subscapularis brings no benefit compared to debridement in treating supraspinatus tendon tear combined with Lafosse I subscapularis injury.

scholarly journals PREOPERATIVE EXAMINATION OF PATIENTS WITH ANTERIOR-INFERIOR AND INFERIOR HABITUAL SHOULDER DISLOCATION

2017 ◽  
Vol 2 (3) ◽  
pp. 50-54
Author(s):  
YuV V Larteev ◽  
VV V Kobzarev
Keyword(s):  
Shoulder Joint ◽  
Shoulder Dislocation ◽  
Functional Restoration ◽  
Clinical Group ◽  
Chronic Instability ◽  
Diagnostic Measures ◽  
Head Displacement ◽  
Results Of Treatment ◽  
Choice Of Treatment ◽  
Diagnostic Complex

Aim - to determine a rational method for the treatment of patients with anterior-inferior and inferior habitual shoulder dislocation based on the results of examination of patients. Material and methods. The study involved analysis of the treatment results of 98 patients with anterior-inferior and inferior chronic instability of the shoulder joint. Patients were divided into two clinical groups. The first group consisted of 52 patients, and the choice of treatment was based only on the diagnosis and did not take into account the peculiarities of pathology in each particular patient, which led to unsatisfactory results. To improve the results of treatment of patients with anterior-inferior and inferior chronic instability of the shoulder joint, a set of diagnostic measures was proposed, which made it possible to choose the proper method and volume of intervention taking into account the direction of the dislocation and the plane ofjoint displacement. The second clinical group consisted of 46 patients who underwent examination and treatment according to the proposed complex. A detailed description of the proposed diagnostic complex is presented, including a number of clinical and instrumental methods for examining patients, and a self-administered questionnaire for the patients. Based on the results of the survey, taking into account the direction of the dislocation, the patients underwent surgical intervention, which made it possible to achieve stability of the joint and restore the function of the limb. Conclusion. The choice of optimal diagnostic complex with regard to the direction of dislocation and the plane of shoulder head displacement in habitual shoulder dislocation helps to choose pathogenically justified surgical method and contributes to the full functional restoration of the limb.

scholarly journals Biceps Detachment Preserves Joint Function in a Chronic Massive Rotator Cuff Tear Rat Model

2018 ◽  
Vol 46 (14) ◽  
pp. 3486-3494 ◽  
Author(s):  
Mengcun Chen ◽  
Snehal S. Shetye ◽  
Julianne Huegel ◽  
Corinne N. Riggin ◽  
Daniel J. Gittings ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Subscapularis Tendon ◽  
Joint Function ◽  
Massive Rotator Cuff Tears ◽  
Sham Surgery ◽  
Biceps Tenotomy

Background: Lesions of the long head of the biceps tendon are often associated with massive rotator cuff tears (MRCTs), and biceps tenotomy is frequently performed for pain relief and functional reservation. However, the efficacy and safety of biceps tenotomy regarding the effects on the surrounding tissues in chronic MRCT are unclear. Hypothesis: Biceps tenotomy would result in improved mechanical and histological properties of the intact subscapularis tendon and improved in vivo shoulder function while not compromising glenoid cartilage properties. Study Design: Controlled laboratory study. Methods: Right supraspinatus and infraspinatus tendons were detached in 25 male Sprague-Dawley rats, followed by 4 weeks of cage activity to create a chronic MRCT condition. Animals were randomly divided into 2 groups and received either biceps tenotomy (n = 11) or sham surgery (n = 14) and were sacrificed 4 weeks thereafter. Forelimb gait and ground-reaction forces were recorded 1 day before the tendon detachment (baseline), 1 day before the surgical intervention (biceps tenotomy or sham), and 3, 7, 10, 14, 21, and 28 days after the intervention to assess in vivo shoulder joint function. The subscapularis tendon and glenoid cartilage were randomly allocated for mechanical testing or histologic assessment after the sacrifice. Results: Compared with sham surgery, biceps tenotomy partially restored the in vivo shoulder joint function, with several gait and ground-reaction force parameters returning closer to preinjury baseline values at 4 weeks. With biceps tenotomy, mechanical properties of the subscapularis tendons were improved, while mechanical properties and histological Mankin scores of the glenoid cartilage were not diminished when compared with the sham group. Conclusion: Biceps tenotomy in the presence of chronic MRCT partially preserves overall shoulder function and potentially restores subscapularis tendon health without causing detrimental effects to joint cartilage. This laboratory study adds to the growing literature regarding the protective effects of biceps tenotomy on the shoulder joint in a chronic MRCT model. Clinical Relevance: This study provides important basic science evidence supporting the use of biceps tenotomy in patients with massive rotator cuff tears.

Freeze-dried chitosan-platelet-rich plasma implants improve supraspinatus tendon attachment in a transosseous rotator cuff repair model in the rabbit

2018 ◽  
Vol 33 (6) ◽  
pp. 792-807 ◽  
Author(s):  
Gabrielle Deprés-Tremblay ◽  
Anik Chevrier ◽  
Martyn Snow ◽  
Scott Rodeo ◽  
Michael D Buschmann
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Platelet Rich Plasma ◽  
Rabbit Model ◽  
Supraspinatus Tendon ◽  
Rotator Cuff Tears ◽  
Polymorphonuclear Cells ◽  
Post Surgery ◽  
Freeze Dried ◽  
Cuff Repair

Rotator cuff tears result in shoulder pain, stiffness, weakness and loss of motion. After surgical repair, high failure rates have been reported based on objective imaging and it is recognized that current surgical treatments need improvement. The aim of the study was to assess whether implants composed of freeze-dried chitosan (CS) solubilized in autologous platelet-rich plasma (PRP) can improve rotator cuff repair in a rabbit model. Complete tears were created bilaterally in the supraspinatus tendon of New Zealand White rabbits ( n = 4 in a pilot feasibility study followed by n = 13 in a larger efficacy study), which were repaired using transosseous suturing. On the treated side, CS-PRP implants were injected into the transosseous tunnels and the tendon itself, and healing was assessed histologically at time points ranging from one day to two months post-surgery. CS-PRP implants were resident within transosseous tunnels and adhered to tendon surfaces at one day post-surgery and induced recruitment of polymorphonuclear cells from 1 to 14 days. CS-PRP implants improved attachment of the supraspinatus tendon to the humeral head through increased bone remodelling at the greater tuberosity and also inhibited heterotopic ossification of the supraspinatus tendon at two months. In addition, the implants did not induce any detectable deleterious effects. This preliminary study provides the first evidence that CS-PRP implants could be effective in improving rotator cuff tendon attachment in a small animal model.

scholarly journals Motor learning and transfer: from feedback to feedforward control

2019 ◽  
Author(s):  
Rodrigo S. Maeda ◽  
Paul L. Gribble ◽  
J. Andrew Pruszynski
Keyword(s):  
Motor Learning ◽  
Muscle Activity ◽  
Shoulder Joint ◽  
Stretch Reflex ◽  
Feedforward Control ◽  
Motor Task ◽  
Joint Torques ◽  
Motor Commands ◽  
Shoulder Muscle ◽  
Long Latency

AbstractPrevious work has demonstrated that when learning a new motor task, the nervous system modifies feedforward (ie. voluntary) motor commands and that such learning transfers to fast feedback (ie. reflex) responses evoked by mechanical perturbations. Here we show the inverse, that learning new feedback responses transfers to feedforward motor commands. Sixty human participants (34 females) used a robotic exoskeleton and either 1) received short duration mechanical perturbations (20 ms) that created pure elbow rotation or 2) generated self-initiated pure elbow rotations. They did so with the shoulder joint free to rotate (normal arm dynamics) or locked (altered arm dynamics) by the robotic manipulandum. With the shoulder unlocked, the perturbation evoked clear shoulder muscle activity in the long-latency stretch reflex epoch (50-100ms post-perturbation), as required for countering the imposed joint torques, but little muscle activity thereafter in the so-called voluntary response. After locking the shoulder joint, which alters the required joint torques to counter pure elbow rotation, we found a reliable reduction in the long-latency stretch reflex over many trials. This reduction transferred to feedforward control as we observed 1) a reduction in shoulder muscle activity during self-initiated pure elbow rotation trials and 2) kinematic errors (ie. aftereffects) in the direction predicted when failing to compensate for normal arm dynamics, even though participants never practiced self-initiated movements with the shoulder locked. Taken together, our work shows that transfer between feedforward and feedback control is bidirectional, furthering the notion that these processes share common neural circuits that underlie motor learning and transfer.

scholarly journals The Structure of the Causes of Primary Prosthetics of the Shoulder Joint

2021 ◽  
pp. 42-48
Author(s):  
S.S. Strafun ◽  
I.S. Zanko
Keyword(s):  
Shoulder Joint ◽  
General Structure ◽  
High Energy ◽  
Acute Injury ◽  
Clinical Group ◽  
Aseptic Necrosis ◽  
Traumatic Injuries ◽  
Female Patients ◽  
Number Of Patients ◽  
Post Traumatic

Relevance. Shoulder prosthetics is the method of choice in the treatment of patients with traumatic injuries that significantly impair joint function and are accompanied by prolonged pain. Objective: to investigate the main causes of injuries of the shoulder joint that led to its prosthetics. Materials and Methods. The clinical group consisted of 162 patients who underwent shoulder prosthetics in the Department of Microsurgery and Reconstructive Surgery of the Upper Limb of the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine”. There were 44.4% male and 55.5% female patients. The average age of male patients was 62±11.4 years; the average age of female patients was 66±10.1 years. The average period of seeking specialized medical care after an acute injury was 24±10.9 days and 50.6±81.1 months in patients with post-traumatic consequences. In most cases, patients underwent unipolar prosthetics of the shoulder joint (126 patients, 78.7%); 27 patients (15.6%) underwent reversible prosthetics and 9 (5.6%) – total prosthetics, respectively. Results. In most cases, shoulder prosthetics were performed in patients with acute (up to 3 weeks from the date of injury) and old fractures and fractures of the proximal epimetaphysis of the humerus – 35 (21.6%) and 48 (29.6%) patients, respectively. The number of patients with posttraumatic aseptic necrosis of the humeral head was 49 (30.2%) (p<0.005), which indicates a high frequency of complications after osteosynthesis etc. The number of patients with massive traumatic injuries of the tendons of the rotator cuff who needed shoulder prosthetics was 18 (11.1%) and with false joints – 12 (7.4%). Unipolar prosthesis systems predominated in the general structure of the prosthesis type (126 patients, 78.7%), since reversible and total prosthesis in Ukraine were registered not so long ago. Conclusions. The analysis of our observations showed that the causes of shoulder prosthetics are severe injuries that occur with high-energy injuries (101 patients, 62.3%) and post-traumatic aseptic necrosis (49 patients, 30.2%). Acute and old fractures and fractures of the proximal metaepiphysis of the humerus are one of the most common injuries according to the analysis (35 patients, 21.6% and 48 patients, 29.6%), and their number and complexity continues to increase with age. Understanding the etiological factors that led to shoulder endoprosthetics makes it possible to predict long-term functional results and work to reduce the number of such patients.

Ultrasonography and MR Arthrogram in detection of shoulder joint disorders

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Souad Elsayed Mohammed Mansour ◽  
Mohammed Sobhi Hassan ◽  
Mohammed Gamal Eldin Abdel Motelib
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Shoulder Dislocation ◽  
Mr Arthrography ◽  
Golden Rule ◽  
Supraspinatus Tendon ◽  
Tendon Tear ◽  
Diagnosis Classification

Abstract Purpose To know the role of Ultrasonography and MR Arthrogram in detection of shoulder joint disorders Methods and material Thirty patients with suspected shoulder joint disorders underwent US,MRI ,MR arthrography shoulder. Results All cases with ALAPSA, Bankert, reverse bankert, hillsachs, perthes and SLAP are diagnosed accurately by MR arthrography with sensitivity of (100%) in GLAD ,Supraspinatus tendenopathy ,Supraspinatus tendon tear and IGHL injury sensitivity was decreased to 75%,in cases of paraglenid cysts arthrography did not diagnose any of them as there are no communication between the cyst and the joint Conclusion MR arthrography shoulder has a golden rule in diagnosis ,classification of cases of shoulder dislocation ,SLAP injuries and rotator cuff impingement

The Influence of Hand Dominance in Wrist Fracture Post-Operative Functional Evaluation

2020 ◽  
pp. 229255032093369
Author(s):  
Ronit Wollstein ◽  
Dafna Michael ◽  
Hani Harel ◽  
Lois Carlson
Keyword(s):  
Wrist Fracture ◽  
Functional Evaluation ◽  
Dominant Hand ◽  
Hand Dominance ◽  
Radius Fractures ◽  
Results Of Treatment ◽  
Post Surgery ◽  
Time Period ◽  
Dominant Side ◽  
Little Finger

Sensorimotor testing is used to measure outcomes in surgery, to document results of treatment and rehabilitation, and to compare results between surgeons, therapists, and institutions. When performing sensorimotor testing, failure to address dominant side differences may cause a bias in evaluation of outcomes. This study evaluated the effect of hand dominance on outcomes testing performed on patients following surgery for distal radius fractures (DRF). We hypothesized that the injured dominant hand will perform differently than the injured non-dominant hand. This is a retrospective study of patients following DRF treated surgically and evaluated in therapy. The patients were evaluated at fixed intervals: initially, at 6 weeks, and at 3 months post-surgery. Testing included grip strength, monofilaments, static and moving 2-point discrimination, Moberg testing, and stereognosis. Sixty patients included 46 (76.6%) females. Age averaged 62.1 (standard deviation: 16.9) years, and 54 were right-handed (90%). There were differences between dominant and non-dominant hand injury in 2 of 9 tests of sensibility for each time period, including little finger monofilament and Moberg testing initially, and moving 2-point discrimination in the little finger, monofilament testing of the thumb at 3 months. Both groups improved between initial and 3-month evaluation without differences in amount of improvement. Despite some significant differences in the applied tests between dominant and non-dominant injured hands, our results do not support correction for hand-dominance when using the described examinations in evaluating outcomes following DRF surgery.

scholarly journals Generalizing movement patterns following shoulder fixation

2020 ◽  
Vol 123 (3) ◽  
pp. 1193-1205 ◽  
Author(s):  
Rodrigo S. Maeda ◽  
Julia M. Zdybal ◽  
Paul L. Gribble ◽  
J. Andrew Pruszynski
Keyword(s):  
Muscle Activity ◽  
Shoulder Joint ◽  
Internal Model ◽  
Movement Patterns ◽  
Partial Reduction ◽  
Forearm Rotation ◽  
General Internal ◽  
Shoulder Muscle ◽  
Intersegmental Dynamics ◽  
Partial Learning

Generalizing newly learned movement patterns beyond the training context is challenging for most motor learning situations. Here we tested whether learning of a new physical property of the arm during self-initiated reaching generalizes to new arm configurations. Human participants performed a single-joint elbow reaching task and/or countered mechanical perturbations that created pure elbow motion with the shoulder joint free to rotate or locked by the manipulandum. With the shoulder free, we found activation of shoulder extensor muscles for pure elbow extension trials, appropriate for countering torques that arise at the shoulder due to forearm rotation. After locking the shoulder joint, we found a partial reduction in shoulder muscle activity, appropriate because locking the shoulder joint cancels the torques that arise at the shoulder due to forearm rotation. In our first three experiments, we tested whether and to what extent this partial reduction in shoulder muscle activity generalizes when reaching in different situations: 1) different initial shoulder orientation, 2) different initial elbow orientation, and 3) different reach distance/speed. We found generalization for the different shoulder orientation and reach distance/speed as measured by a reliable reduction in shoulder activity in these situations but no generalization for the different elbow orientation. In our fourth experiment, we found that generalization is also transferred to feedback control by applying mechanical perturbations and observing reflex responses in a distinct shoulder orientation. These results indicate that partial learning of new intersegmental dynamics is not sufficient for modifying a general internal model of arm dynamics. NEW & NOTEWORTHY Here we show that partially learning to reduce shoulder muscle activity following shoulder fixation generalizes to other movement conditions, but it does not generalize globally. These findings suggest that the partial learning of new intersegmental dynamics is not sufficient for modifying a general internal model of the arm’s dynamics.

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