scholarly journals The Effect of the Soft Tissue Structures Injury on the Development of Shoulder Joint Arthrosis

2020 ◽  
Vol 106 (3) ◽  
pp. 41-52
Author(s):  
S.S. Strafun ◽  
S.V. Bohdan ◽  
R.O. Serhiienko ◽  
V.H. Lieskov
Keyword(s):  
Articular Cartilage ◽  
Surgical Treatment ◽  
Soft Tissue ◽  
Rotator Cuff ◽  
Early Diagnosis ◽  
Shoulder Joint ◽  
Long Term Results ◽  
Glenoid Labrum ◽  
Significant Dependence ◽  
Tissue Structures

Summary. Injury of the soft tissue structures of the shoulder joint (rotator cuff, scapula labrum, etc.) is a common cause of omarthrosis. Objective: to investigate the changes in the articular cartilage of the shoulder head and the scapula glenoid in case of the soft tissue structures of the shoulder joint injury. Materials and Methods. We studied the long-term results of conservative and surgical treatment of 330 patients with soft tissue injuries of the shoulder joint, who were treated in the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine” (Kyiv) from 2009 to 2019. The age of patients ranged from 27 to 68 years (mean age 42.7±19.5 years); 225 were males (68.2%) and 105 females (31.8%). Surgical treatment was performed in 160 patients (48.5%); 170 patients (51.5%) underwent conservative treatment. For evaluation of the influence of the shoulder soft tissue structures injury on the articular cartilage, the degree of the articular cartilage damage was determined by R. Outerbridge and the obtained data were compared with the period from the onset of the disease to surgery. Conclusions: 1. The largest number of secondary omarthroses develops after ruptures of the rotator cuff tendons, both in conservative and surgical groups. Thus, a rupture of rotator cuff tendons is the most arthrosogenic factor among all soft tissue pathology of a shoulder joint. 2. Another arthrosogenic factor for the shoulder joint is rupture of the glenoid labrum in the anterior-inferior part in case of anterior shoulder dislocation and rupture of the posterior glenoid labrum without posterior dislocation (unrealized posterior instability), probably due to high energy trauma and trophic disorders of humeral head after dislocation. 3. A weak but significant dependence was found of the effect of the time from the beginning of the disease to surgery in various Pulley lesions on the degree of damage to the articular cartilage according to R. Outerbridge (r=0.4; p<0.05). Thus, early diagnosis and surgical treatment of Pulley lesions is a major prevention of omarthrosis. 4. A weak but significant dependence of the influence of the period from the onset of the disease to surgery was revealed in patients with isolated injury of the supraspinatus tendon (r=0.38; p<0.05). Early diagnosis and surgical treatment of rotator cuff tendon injuries is the main prevention of omarthrosis.

scholarly journals Long-term results after surgical treatment of subacromial pain syndrome with or without rotator cuff tear

2018 ◽  
Vol 15 (3) ◽  
pp. 757-760 ◽  
Author(s):  
Eivind Inderhaug ◽  
Maiken Kalsvik ◽  
Kristin H. Kollevold ◽  
Janne Hegna ◽  
Eirik Solheim
Keyword(s):  
Surgical Treatment ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Pain Syndrome ◽  
Long Term Results ◽  
Cuff Tear ◽  
Subacromial Pain Syndrome

scholarly journals Wound Complications After Multimodal Treatment of Soft Tissue Sarcomas

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 218s-218s
Author(s):  
M. Khanevich ◽  
A. Khazov
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Radical Surgery ◽  
Soft Tissue Sarcomas ◽  
Endovascular Embolization ◽  
Main Group ◽  
Long Term Results ◽  
Wound Complications ◽  
Control Group ◽  
Quick Freezing

Background: Surgical removal of the tumor remains the only 1 radical treatment of patients with soft tissue sarcomas of the extremities. However, the parameters of total and disease-free survival after this type of treatment cannot be considered satisfactory. Currently the active search and introduction into clinical practice of additional impact methods that can improve the immediate and long-term results of treatment of such patients is being conducted. Aim: To evaluate the risk of the wound process complications after surgical treatment of soft tissue sarcomas using endovascular embolization and cryosurgery. Methods: We have assessed the quantity and quality of postoperative complications of wound process in 199 patients with soft tissue sarcomas and their recurrences. The study group consisted of 53 patients, who underwent radical surgery with selective preoperative endovascular embolization and intraoperative cryosurgery. The control group consisted of 146 patients who had radical surgery without any additional methods. Preoperative embolization and cryosurgery on the wound bed after tumor removal was used to prevent local recurrence of soft tissue sarcomas. Preoperative angiography with selective embolization of vessels feeding the tumor was performed 1-1.5 hours before the main surgical treatment. Cryosurgery was carried out by the method of “Olympic rings” with 3 minutes duration. The temperature of exposure was −186°C. In the course of cryosurgery we adhere to the principle of “quick freezing - an independent slow thawing”. All postoperative wounds tightly sutured with silicone drains by Redon, if necessary. Results: Complications of wound healing have been diagnosed in 15 (28.3%) patients of the main group and in 34 (23.3%) control group patients. Inflammatory-suppurative complications were observed in the remaining 8 (15.1%) patients of the main group and in 18 (12.3%) control group patients ( P > 0.05). Long lymphorrhea was observed in 6 (11.3%) patients of the main group and 11 (7.5%) control group patients. Bleeding in the postoperative period was observed in 1 (1.9%) case of main group patients and in 5 (3.4%) cases of control group. Conclusion: The additional using of selective preoperative endovascular embolization and cryosurgery is safe and does not worsen immediate results of surgical treatment of soft tissue sarcomas.

scholarly journals Operative Trearment Unoperative Chronic and Massive Rotator Cuff Tendon Rupture of the Shoulder

2017 ◽  
Vol 2 (1) ◽  
pp. 398
Author(s):  
Lanshakov V.A.
Keyword(s):  
Surgical Treatment ◽  
Rotator Cuff ◽  
Shoulder Joint ◽  
Tendon Rupture ◽  
Positive Outcomes ◽  
Rotator Cuff Tendon

In clinic of traumatology and orthopedics GBOU DPO NGIUV was treated 125 patients with tendon rupture rotators of the shoulder joint, in which treatment was used as the classic methods of surgical treatment, and we have developed approaches and methods of surgical treatment with the use of sutures and staples of nickelid titanium allowing to bring the number of positive outcomes to 84.8%.

scholarly journals New approaches to the use of therapeutic gymnastics and pelotherapy in the rehabilitation of patients after arthroscopic shoulder joint operations

2019 ◽  
Vol 21 (4) ◽  
pp. 70-74
Author(s):  
A V Mikhaleva ◽  
A G Kulikov ◽  
I N Makarova
Keyword(s):  
Surgical Treatment ◽  
Rotator Cuff ◽  
Thin Layer ◽  
Shoulder Joint ◽  
Clinical Symptoms ◽  
Muscle Tension ◽  
Basic Therapy ◽  
Rotator Cuff Rupture ◽  
New Approaches ◽  
Regeneration Processes

To increase the effectiveness of the rehabilitation of patients after surgical treatment of a rotator cuff rupture, 98 patients were examined and treated. It was revealed that the inclusion of exercises with dynamic controlled muscle tension in combination with thin layer pelotherapy in the medical complex, has an impact on the main clinical symptoms of the disease, regeneration processes, and contributes to an earlier restoration of the impaired functions of the shoulder joint, which is more significant than basic therapy.

scholarly journals Cervical intervertebral disc denervation during rotator cuff tendon plasty

2021 ◽  
Vol 18 (1) ◽  
pp. 39-46
Author(s):  
A. V. Peleganchuk ◽  
O. N. Leonova ◽  
A. A. Alekperov
Keyword(s):  
Cervical Spine ◽  
Surgical Treatment ◽  
Rotator Cuff ◽  
Intervertebral Disc ◽  
Rotator Cuff Tear ◽  
Functional Activity ◽  
Shoulder Joint ◽  
Pain Syndrome ◽  
Intervertebral Discs ◽  
Cuff Tear

Objective. To analyze the effect of denervation of intervertebral discs in the cervical spine on the results of surgical treatment of patients with injuries to rotator cuff tendons of the shoulder joint.Material and Methods. Study design: descriptive hypothesis-generating study. The study included patients requiring surgical treatment of rotator cuff tear.  Two groups were identified: Group A included 28 patients who underwent plastic repair of rotator cuff tear with additional denervation of intervertebral discs, and Group B – 30 patients who underwent only plastic surgery for rotator cuff tear. The intensity of pain according to the VAS, functional activity due to neck pain (NDI), functionality of the shoulder joint (UCLA), and the degree of intervertebral disc degeneration according to MRI were assessed, and the effectiveness of treatment was determined. Statistical calculations were performed using the RStudio program.Results. In the group of patients with denervation of intervertebral discs, a more pronounced decrease in the intensity of pain syndrome at 3, 6, and 12 months (p < 0.001; p < 0.001; and p = 0.002), a more proportion of effectively treated patients at 3 months (p = 0.003), and significant increase in functional activity according to NDI at 3, 6 and 12 months of follow-up period (p < 0.001; p = 0.010; and p = 0.045) were observed.Conclusions. There is an underestimation of the role of degenerative cervical spine pathology in the occurrence of shoulder joint pain. In the case of rotation cuff plasty the additional denervation reduces the intensity of pain syndrome in the shoulder joint in the postoperative period.

scholarly journals Effects of Different Myofascial Trigger Point Release Techniques on Pain, Function and Quality of Lifef for Patients after Surgical Treatment of the Rotator Cuff

2019 ◽  
Vol 1 (20) ◽  
Author(s):  
Greta Grigėnaitytė ◽  
Edgaras Lapinskas
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Soft Tissue ◽  
Rotator Cuff ◽  
Muscle Strength ◽  
Trigger Point ◽  
Myofascial Trigger Point ◽  
Functional Changes ◽  
Isometric Muscle

Research background. Musculoskeletal pain in the shoulder joint is a major cause of non-traumatic upper limb pain (Tejera-Falcón et al., 2017). Miofascial release is a fast-moving form of manual therapy to reduce pain and restore soft tissue functions. Chronic pain relief in the movement apparatus is a major burden on health care systems and state economics due to the deteriorating quality of life of people experiencing these problems (Laimi et al., 2018). Research aim was to determine the effect of different myofascial trigger release techniques on pain, function and quality of life in patients after surgical treatment of rotator cuff. Methods. The study included volunteers (n = 14) who met the selection criteria. Research methods included a VAS pain scale, active range of motion, isometric muscle strength and subjective assessment of functional changes (PSFS) and quality of life (SF-36). Results. After 14 days of physiotherapy exercises involving the release of myofascial trigger points, the intensity of pain decreased signifcantly from 5.6 ± 1.4 points to 1.8 ± 1.5 points (p < 0.05). After treatment of the range of motion, isometric muscle strength signifcantly increased (p < 0.05). The treatment used had a positive effect on subjective functional changes (before 3.1 ± 0.8 points, followed by 7.8 ± 1.4 points, p < 0.05) and quality of life. Conclusion. The use of different myofascial trigger release techniques is effective in reducing myofascial trigger pain, improving function and quality of life in patients after surgical treatment of rotator cuffs. However, there were no statistically signifcant differences between the groups after treatment.Keywords: myofascial pain syndrome, myofascial trigger point, ischemic compression, soft tissue mobilization.

scholarly journals PHYSICAL REHABILITATION AFTER SURGICAL TREATMENT OF RUPTURE OF THE ROTATOR CUFF OF THE SHOULDER

2017 ◽  
Vol 16 (6) ◽  
pp. 307-309
Author(s):  
Alina Vladimirovna Mikhalyova ◽  
A. G Kulikov ◽  
I. N Makarova
Keyword(s):  
Surgical Treatment ◽  
Rotator Cuff ◽  
Standard Method ◽  
Shoulder Joint ◽  
Clinical Symptoms ◽  
Muscle Tension ◽  
Physical Rehabilitation ◽  
Basic Therapy ◽  
Basic Treatment ◽  
Regeneration Processes

The examination and treatment of 62 patients operated on for damage to the rotator cuff of the shoulder and received basic therapy, including symptomatic medications and curative gymnastics according to the standard method were made. Patients of the main group in addition to basic treatment were given an exercise course with dynamic controlled muscle tension in the immobilization and postimmobilization period. It has been revealed that the inclusion of exercises with dynamic controlled muscle tension in the therapeutic complex has a more significant effect on the main clinical symptoms of the disease, the regeneration processes, and also contributes to an earlier restoration of impaired functions of the shoulder joint.

scholarly journals The impact of glenoid labrum damages on condition of the cartilage of the shoulder joint

2019 ◽  
pp. 62-67
Author(s):  
S.S. Strafun ◽  
R.A. Sergienko
Keyword(s):  
Articular Cartilage ◽  
Shoulder Joint ◽  
Cartilage Damage ◽  
Joint Damage ◽  
Posterior Part ◽  
Clinical Diagnostics ◽  
Cartilage Defects ◽  
Glenoid Labrum ◽  
Joint Surfaces ◽  
The Impact

The joint labrum is an anatomical structure of the shoulder joint, one of the functions of which is to ensure the stability of the shoulder. It has been proven that instability, direct trauma and surgery of any joint eventually lead to cartilage damage and osteoarthritis. It is still unknown whether and how the damage to the joint labrum affect the condition of the cartilage of the shoulder joint. Aim of study – investigation of impact of glenoid labrum damages on condition of the cartilage of the shoulder joint. For the period from 2006 to 2016, on the basis of State Institution “Institute of Traumatology and Orthopedics of AMS of Ukraine”, MC “Modern Orthopedics”, Kyiv, a study was conducted on an array of 467 patients. Used clinical diagnostics, MRI diagnostics, arthroscopic diagnostics. Fact verification and localization of joint damage was performed during arthroscopic examination. Localization of cartilage damage was divided into separate areas on the articular surfaces of the shoulder scapula and head. The degree of cartilage damage was classified by Outerbridge. Quantitative analysis of the results was performed using Microsoft Excel in the summary tables. It has been found that damage to the shoulder labrum is the cause of cartilage defects in the joint surfaces of the shoulder. The incidence and severity of cartilage defects increase over time since the injury. The worst prognosis for the development of damage to the articular cartilage is characteristic of patients with damage to the posterior part of the labrum. Thus, damage to the joint labrum is a significant factor in the occurrence of defects in the articular cartilage of the shoulder. Early active surgical tactics for the treatment of damage to the joint labrum are necessary to prevent deterioration of the condition of the joint surfaces and the prevention of osteoarthrosis.

Arthroscopic Management of Talar Dome Lesions Using a Transmalleolar Approach

2006 ◽  
Vol 96 (3) ◽  
pp. 260-263 ◽  
Author(s):  
John Grady ◽  
David Hughes
Keyword(s):  
Articular Cartilage ◽  
Surgical Treatment ◽  
Soft Tissue ◽  
Operative Technique ◽  
Operative Intervention ◽  
Osteochondral Defects ◽  
Talar Dome ◽  
Surrounding Soft Tissue ◽  
Arthroscopic Management ◽  
Direct Exposure

Surgical treatment of posteromedial talar dome lesions is frequently necessary for Berndt and Harty grade IV osteochondral defects and nondisplaced osteochondral fragments resistant to conservative modalities. When operative intervention is indicated, the approach and management can be complicated by the location and extent of the injury. The operative technique we advocate allows direct exposure of the lesion and minimizes damage to healthy articular cartilage and surrounding soft tissue. Use of a drill guide assists the surgeon in precisely placing a transmalleolar portal through the tibia for subchondral drilling of osteochondral defects when the lesions are inaccessible through traditional arthroscopic portals. (J Am Podiatr Med Assoc 96(3): 260–263, 2006)

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