scholarly journals Adhesive Capsulitis of the Shoulder in Patients with Diabetes

2014 ◽  
Vol 4 (1) ◽  
pp. 24-26
Keyword(s):  
Rotator Cuff ◽  
Internal Rotation ◽  
Adhesive Capsulitis ◽  
Symptomatic Improvement ◽  
Diabetic Patients ◽  
Imaging Studies ◽  
Level Of Evidence ◽  
Forward Flexion ◽  
Patients With Diabetes ◽  
The Right

ABSTRACT Background Adhesive capsulitis of the shoulder is common in patients with diabetes. The exact etiology is unknown. The aim of this study is to evaluate the results of subacromial bursal corticosteroid injections and a home program of Codman's exercises in a cohort of diabetic patients with adhesive capsulitis. Materials and methods Twelve diabetic patients with adhesive capsulitis treated from November, 2011 to February, 2013 in an outpatient clinic were evaluated. The age range was 40 to 64 years with a mean age of 52. There were six males and six females. Six patients had involvement of the right shoulder, four had involvement of the left and two patients had bilateral shoulder involvement. The dominate upper extremity was affected in nine patients. There were 11 patients with type 2 diabetes and one with type 1 diabetes. All patients had an insidious onset of pain and stiffness in the affected shoulder. There was poorly localized tenderness about the shoulder with restricted abduction, forward flexion and internal rotation limited to the level of the buttocks or below. There were abnormal imaging studies in seven of the 12 patients. Five patients did not have imaging studies. Edema and thickening of rotator cuff tissue was the most frequent finding on magnetic resonance imaging (MRI). There was one small rotator cuff tear and one small labral tear. Patients were treated with a subacromial bursal space injection with 2 to 3 ml of 2% lidocaine and one milliliter of betamethasone sodium phosphate and sodium acetate (6 mg/ ml). Following the injection, passive stretching of the involved shoulder was done for a few minutes. The patients were instructed in Codman's exercises and wall climbing. Results Good pain relief was experienced by 11 patients with only fair relief in one. The average range of motion post-treatment was greater than 110° forward flexion and greater than 140° abduction. Internal rotation was possible to the L3 level. Two patients had a recurrence of symptoms at 6 and 12 months, and both were treated with reinjection and subsequent symptomatic improvement. There were no complications, though some patients had a transient rise in their blood sugar following injection. Conclusion Subacromial bursal injections coupled with Codman's exercises are effective in treating adhesive capsulitis of the shoulder in diabetic patients. Level of evidence IV Nasca RJ. Adhesive Capsulitis of the Shoulder in Patients with Diabetes. The Duke Orthop J 2014;4(1):24-26.

Força dos Músculos Rotadores do Ombro em Indivíduos Saudáveis/ Rotator Cuff Muscle Strength in Healthy Individuals

1970 ◽  
Vol 1 (1) ◽  
pp. 78-82
Author(s):  
Paulo José Oliveira Cortez ◽  
José Elias Tomazini ◽  
Mauro Gonçalves
Keyword(s):  
Rotator Cuff ◽  
Muscle Strength ◽  
Internal Rotation ◽  
Upper Limb ◽  
Statistical Difference ◽  
External Rotation ◽  
Healthy Individuals ◽  
Average Strength ◽  
Strength Tests ◽  
The Right

Introdução: A diminuição da capacidade de exercer esforços por parte dos músculos rotadores pode criar uma variedade de problemas. O conhecimento preciso do nível de força muscular de um indivíduo é importante, tanto para a avaliação da capacidade funcional ocupacional, como para uma apropriada prescrição de exercícios atléticos e de reabilitação. Percebe-se escassez de informação sobre as articulações do ombro, bem como os fatores envolvidos na força muscular dessa região. O objetivo deste estudo foi comparar a força gerada pelos músculos do manguito rotador entre o membro superior direito e o membro superior esquerdo em indivíduos saudáveis. Métodos: Participaram do estudo 22 sujeitos do sexo masculino, com idade de 18 e 19 anos, militares, saudáveis e sem história clínica de patologia ortopédica ou qualquer tipo de lesão no sistema musculoesquelético. Foram aplicados dois testes de força: Rotação Interna e Rotação Externa. Resultado : A força média de rotação interna no membro superior direito (MSD) foi maior que a força média de rotação interna no membro superior esquerdo (MSE) (p=0,723) e a força de rotação externa no MSD foi menor que a força média de rotação externa no MSE (p=0,788). Não houve diferença estatística na comparação dos valores de força de todos os testes de força isométrica. Conclusão: Para amostra estudada e metodologia utilizada na avaliação da força muscular, não houve diferença estatística na comparação da força gerada pelos músculos do manguito rotador do membro superior direito e do membro superior esquerdo.Rotator Cuff Muscle Strength in Healthy Individuals Introduction: Decreased ability to exert efforts by the rotator muscles can create a variety of problems. The precise knowledge of the level of muscular strength of an individual is important for both the functional capacity evaluation for occupational as an appropriate exercise prescription and rehabilitation of athletic. It is perceived scarcity of information on the shoulder joints as well as factors involved in muscle strength in this region. Objective: Develop a device for measuring the strength generated by the muscles of the upper limbs and the verification of efficiency and adaptability of this device through a comparative study of muscle strength in healthy subjects. Methods: The study included 22 male subjects, aged 18 and 19 years, military personnel, body mass between 57.7 and 93 kg (71.8 ± 9.45 kg) and height between 1.67 and 1.90 m (1.75 ± 0.06 m), healthy and without a history of orthopaedic disease or any kind of damage to the musculoskeletal system. Three strength tests were applied: Internal Rotation and External Rotation. For each type of effort three maximum voluntary contractions were required for 10 seconds, with an interval of 30 seconds between each contraction.  Results: Internal rotation in the right upper limb (RUL) was higher than the average strength of internal rotation in the left upper limb (LUL) (p = 0, 723) and the external rotation strength in RUL was lower than the average strength of external rotation in the LUL (p=0,788).  No statistical difference in comparing the strength values of all isometric strength tests. Conclusion: For sample and methodology used to assess muscle strength, there was no statistical difference in comparing the force generated by the muscles of the rotator cuff of the right and left upper limb.

Outcomes and complications after percutaneous release for trigger digits in diabetic and non-diabetic patients

2015 ◽  
Vol 40 (7) ◽  
pp. 735-739 ◽  
Author(s):  
H.-K. Huang ◽  
J.-P. Wang ◽  
S.-T. Wang ◽  
Y.-A. Liu ◽  
Y.-C. Huang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Patients ◽  
Short Term ◽  
Level Of Evidence ◽  
Evidence Level ◽  
Percutaneous Release ◽  
Patients With Diabetes

We compared the short-term (3 months) and long-term (2 years) outcomes and complications of percutaneous release of 187 trigger digits of 154 patients treated between 2009 and 2012, all treated by a single surgeon. The 154 patients included 48 patients with diabetes mellitus and 106 non-diabetic patients. The only short-term complication was pain, occurring in three digits (5%) in the diabetic patients and six digits (5%) in the non-diabetic patients. The long-term complications were pain in 15 digits (25%) in the diabetic patients and 18 digits (14%) in the non-diabetic patients. This was not significant ( p = 0.058). Recurrent triggering occurred in nine digits (15%) in the diabetic patients, which was significantly greater than the six digits (5%) in the non-diabetic patients ( p = 0.013). The non-diabetic patients were significantly more satisfied. Level of Evidence: level III

scholarly journals Factors Affecting the Outcomes of Arthroscopic Capsular Release for Idiopathic Adhesive Capsulitis

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711986762 ◽  
Author(s):  
Syed M. Rizvi ◽  
Ahmed J. Harisha ◽  
Patrick H. Lam ◽  
George A.C. Murrell
Keyword(s):  
Range Of Motion ◽  
Internal Rotation ◽  
External Rotation ◽  
Adhesive Capsulitis ◽  
Linear Regression Analysis ◽  
Frozen Shoulder ◽  
Level Of Evidence ◽  
Duration Of Symptoms ◽  
Capsular Release ◽  
Arthroscopic Capsular Release

Background: Arthroscopic capsular release has been shown to provide excellent short- and long-term outcomes in patients with idiopathic frozen shoulder. Some surgeons delay surgery in the belief that operating in the early stages of adhesive capsulitis results in a poorer prognosis. However, it is unclear which factors, particularly the stage of the disorder, affect the surgical outcome of this procedure. Hypothesis: Patients who undergo capsular release during the early symptomatic stage of idiopathic adhesive capsulitis would have less improvement in range of motion compared with those who undergo surgery at a later stage. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 189 shoulders with idiopathic adhesive capsulitis that underwent arthroscopic capsular release were evaluated. All patients completed a L’Insalata questionnaire and had their range of motion and strength tested prior to surgery and at 1, 6, and 12 weeks and 6 months post–capsular release. Post hoc, patients were grouped by whether they had symptoms lasting <10 months (shorter symptoms group; n = 131) or ≥10 months (longer symptoms group; n = 38). Multiple linear regression analysis was performed to determine which preoperative factors were independently associated with a favorable outcome. Results: Patients in the shorter symptoms group were more restricted prior to surgery than were those in the longer symptoms group (mean ± SEM: external rotation, 17° ± 2° vs 27° ± 4° [ P = .04]; abduction, 78° ± 3° vs 92° ± 6° [ P = .04]; internal rotation, S3 ± 1 vs S1 ± 1 [ P = .03]). The shorter symptoms group had greater postoperative improvement in internal rotation (from S3 ± 1 preoperatively to T12 ± 1 vertebral levels) compared with the longer symptoms cohort (from S1 ± 1 to L2 ± 1) ( P = .02). Conclusion: Patients with a frozen shoulder and a duration of symptoms <10 months made greater improvements in internal rotation and had similar final results for flexion, abduction, and external rotation following arthroscopic capsular release when compared with patients who had a longer duration of symptoms, so there is no reason to delay surgery.

scholarly journals Arthroscopic lower trapezius tendon transfer provides equivalent outcomes to latissimus dorsi transfer in the treatment of massive posterosuperior rotator cuff tears

2020 ◽  
Vol 5 (5) ◽  
pp. 269-274
Author(s):  
Jarret M Woodmass ◽  
Eric R Wagner ◽  
Michelle J Chang ◽  
Kathryn M Welp ◽  
Florian Grubhofer ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Latissimus Dorsi ◽  
Tendon Transfer ◽  
Adhesive Capsulitis ◽  
Rotator Cuff Tears ◽  
Forward Flexion ◽  
Patient Reported ◽  
Cutibacterium Acnes ◽  
Lower Trapezius

ObjectivesThe purpose of this study is to compare early postoperative recovery following open and arthroscopic-assisted latissimus dorsi tendon (aa-LDT) transfer to arthroscopic-assisted lower trapezius tendon (aa-LTT) transfer for patients with massive irreparable posterosuperior rotator cuff pathology.MethodsA multicentre retrospective analysis comparing the postoperative outcomes after open LDT, arthroscopic-assisted LDT (aa-LDT) or arthroscopic-assisted LTT (aa-LTT) was performed. Active range of motion and patient-reported subjective outcomes were reported preoperatively and postoperatively. Overall, there were 10 patients who underwent open LDT transfer, 16 aaLDT transfers and 8 aa-LTT transfers with mean age of 55±3, 57±6 and 53±13, respectively. Mean follow-up was 22±10 months.ResultsArthroscopic-assisted LDT had significantly improved postoperative forward flexion (85–124, p<0.003) and external rotation (29–38, p<0.005), whereas aa-LTT had significantly improved postoperative forward flexion (101–146, p<0.04). Arthroscopic-assisted LDT and aa-LTT transfers improved American Shoulder and Elbow Surgeons (ASES) Shoulder Function scores and Single Assessment Numeric Evaluation (SANE) at 2 years (p<0.03). Arthroscopic-assisted LTT compared with open LDT demonstrated significantly improved ASES Shoulder Index score (20.0 vs 12.6; 84.8 vs 55.6) and visual analogue scale (VAS) (0.66 vs 4.14; 1.17 vs 3.88) at postoperative 6 months and 2 years, respectively. Arthroscopic-assisted LDT transfer compared with open LDT had improved VAS at 6 months (0.66 vs 2.11, p<0.05). In total, 6 (17.6%) complications were noted. These included two infections with Cutibacterium acnes, two axillary nerve injuries, complex regional pain syndrome and a postsurgical adhesive capsulitis.ConclusionsArthroscopic-assisted LDT and aa-LTT transfers provided improvement in pain and function at 2-year follow-up. The aa-LTT transfer provided significantly improved outcomes at 2 years compared with the open-LDT (latissimus dorsi tendon transfer) transfer. This study demonstrates superiority of arthroscopic-assisted tendon transfer techniques over traditional open techniques while establishing the aa-LTT transfer as a safe and effective alternative in the management of massive irreparable rotator cuff tears.Level of evidenceIV.

Auditory Brainstem Response Differences in Diabetic and Non-diabetic Veterans

2007 ◽  
Vol 18 (10) ◽  
pp. 863-871 ◽  
Author(s):  
Nancy Vaughan ◽  
Kenneth James ◽  
Daniel McDermott ◽  
Susan Griest ◽  
Stephen Fausti
Keyword(s):  
Auditory Brainstem Response ◽  
Medical Center ◽  
Auditory Brainstem ◽  
Diabetic Patients ◽  
Patients With Diabetes ◽  
Brainstem Response ◽  
The Subject ◽  
The Right ◽  
Response Testing ◽  
Los Grupos

A number of studies have found statistically significant delays in auditory brainstem latencies of patients with diabetes compared with non-diabetic controls. However, the mechanisms ascribed as responsible for the latency differences between diabetic and non-diabetic patients vary among studies, and the latency differences, while significant, are small. In this 5-year prospective study, auditory brainstem response testing was conducted with 416 non-diabetic and 375 diabetic veterans from the Portland Veterans Affairs Medical Center as part of a larger study. Patients with diabetes had significantly delayed latencies of Wave III and V in the right ear and significantly prolonged interpeak I-III and I-V latencies in both ears. Stimulus polarity difference yielded slightly different results. None of the diabetes-related clinical characteristics were associated with the latency differences between the subject groups after accounting for hearing loss and age. Effect size was calculated and clinical significance of these differences is discussed. Un número de estudios han encontrado retardos estadísticamente significativos en las latencias auditivas del tallo cerebral en pacientes diabéticos comparados con controles no diabéticos. Sin embargo, los mecanismos atribuidos como responsables de las diferencias en las latencias entre pacientes diabéticos y no diabéticos varían entre estudios, y las diferencias en las latencias, aunque significativas, fueron pequeñas. En este estudio prospectivo a 5 años, se condujeron las pruebas de respuestas auditivas del tallo cerebral en 416 veteranos no diabéticos y 375 diabéticos, del Centro Médico de Asuntos de Veteranos de Portland, como parte de un estudio mayor. Los pacientes con diabetes tuvieron latencias significativamente retardadas para las ondas III y V en el oído derecho, y latencias inter-pico I-III y I-V significativamente retardadas en ambos oídos. Diferencias en la polaridad del estímulo rindieron resultados levemente diferentes. Ninguna de las características clínicas relacionadas con la diabetes se asoció con las diferencias en las latencias entre los grupos de sujetos, luego de considerar la pérdida auditiva y la edad. Se calculó el efecto del tamaño y se discutió el significado clínico de estas diferencias.

scholarly journals Shoulder disorders in an outpatient clinic: an epidemiological study

2017 ◽  
Vol 25 (3) ◽  
pp. 78-80 ◽  
Author(s):  
Eduardo Angeli Malavolta ◽  
Mauro Emilio Conforto Gracitelli ◽  
Jorge Henrique Assunção ◽  
Gustavo de Mello Ribeiro Pinto ◽  
Arthur Zorzi Freire da Silveira ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Adhesive Capsulitis ◽  
Case Series ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Glenohumeral Instability ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Partial Tears ◽  
Shoulder Disorders

ABSTRACT OBJECTIVE: To describe shoulder disorders in patients evaluated by two shoulder and elbow surgeons. METHODS: This cross-sectional study analyzed patients evaluated by two authors, excluding acute fractures and dislocations and patients with symptoms not involving the shoulder. Age and sex distribution was determined for the different diagnoses. RESULTS: We evaluated 1001 patients. Mean age was 51.43±15.15 years and 51.0% were female. Disorders of the rotator cuff occurred in 64.3% (41.2% tendinopathy, 11.0% partial tears and 12.2% full-thickness tears). Adhesive capsulitis occurred in 13.5% of cases and glenohumeral instability in 8.1%. Rotator cuff disorders were more common in women, with a peak between 50 and 59 years for tendinopathy and partial tears and between 60 and 69 years for full-thickness tears. Glenohumeral instability was more frequent in men, with a peak between 30 and 39 years. CONCLUSION: The most frequent diagnosis was rotator cuff tendinopathy, followed by adhesive capsulitis, full-thickness rotator cuff tears, partial rotator cuff tears and glenohumeral instability. Rotator cuff lesions were more common in women, with a peak between 60 and 69 years for full-thickness tears. Level of Evidence IV, Case Series.

scholarly journals Effect of anxiety and depression on early pain and range of motion after rotator cuff repair - measured by HADS (Hospital Anxiety and Depression Scale) -

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0040
Author(s):  
Joo Hyun Park ◽  
Hyeon Jang Jeong ◽  
Sung Min Rhee ◽  
Joo Han Oh
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Internal Rotation ◽  
Rotator Cuff Repair ◽  
Psychological Status ◽  
Anxiety And Depression ◽  
Forward Flexion ◽  
Group I ◽  
Group Ii ◽  
Cuff Repair

Objectives: According to previous studies, the prevalence of anxiety and depression was approximately 25% in patients with rotator cuff tear, and psychological status may be an important predictor for clinical outcomes after rotator cuff repair. Considering continuous steady rehabilitation is essential for recovery of postoperative pain and range of motion (ROM), the anxiety or depression would affect this process. The aim of this study was to evaluate the effect of anxiety and depression measured by HADS (Hospital Anxiety and Depression Scale) on early pain and ROM after rotator cuff repair. Methods: Consecutive 156 patients who underwent arthroscopic rotator cuff repair were prospectively enrolled, and divided into two groups defined by HADS scores; Group I with normal psychological status (n = 105, anxiety ≤ 7 and depression ≤ 7), Group II with psychological distress (n = 51, anxiety ≥ 8 or depression ≥ 8). Same rehabilitation protocols were applied to all patients: 4 ˜ 6 weeks of brace according to tear size, and then ROM exercises. Clinical outcomes were measured with pain VAS and ROM at 3, 6 months and 1 year after surgery. Results: There were no significant differences in age, cuff tear size, preoperative external and internal rotation angle between two groups, but more female patients, higher preoperative pain VAS, and lower range of preoperative forward flexion in Group II (all p < 0.05). At 3 months after surgery, the average of pain VAS was 2.2 ± 1.3 in Group I, which was statistically lower than 3.5 ± 2.0 in Group II. The average forward flexion was 145.4° ± 23.4° in Group I, and 122.5° ± 30.3° in Group II. The average external rotation was 42.3° ± 16.1° in Group I, and 34.7° ± 17.6° in Group II. The mean level of internal rotation at back was T11.6 ± 2.8 in Group I, and L1.9 ± 2.4 in Group II (all p < 0.05). At 6 months after surgery, there was no significant difference in forward flexion (148.9° ± 23.2° in Group I compared with 144.9° ± 25.2° in Group II) and external rotation (59.5° ± 13.4° in Group I compared with 54.5° ± 17.5° in Group II). The mean level of internal rotation at back was T9.4 ± 1.8 in Group I, and T10.0 ± 1.5 in Group II (p < 0.05). The average of pain VAS was 0.8 ± 1.6 in Group I, which was statistically lower than 1.6 ± 2.0 in Group II (p < 0.05). However, there was no significant difference in ROM and pain VAS at 1 year after surgery. Conclusion: The recovery of pain and ROM was faster in patients with normal psychological status after arthroscopic rotator cuff repair. Therefore, psychologic intervention including medication should be collaborated to improve early clinical outcomes after rotator cuff repair through the encouragement of rehabilitation, as well as mitigation of anxiety and depression moods. [Figure: see text]

scholarly journals Short-term Comparison of Supervised Rehabilitation and Home-based Rehabilitation for Earlier Recovery of Shoulder Motion, Pain, and Function after Rotator Cuff Repair

2018 ◽  
Vol 21 (1) ◽  
pp. 15-21
Author(s):  
Si Jung Song ◽  
Tae Ho Jeong ◽  
Jung Wha Moon ◽  
Han Vit Park ◽  
Si Yung Lee ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Internal Rotation ◽  
Rotator Cuff Repair ◽  
External Rotation ◽  
Exercise Group ◽  
Short Term ◽  
Forward Flexion ◽  
Supervised Exercise ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

BACKGROUND: This study was undertaken to compare the outcome of supervised and home exercises with respect to range of motion (ROM), pain, and Single Assessment Numeric Evaluation (SANE). We further correlated the ROM recovery and pain reduction as well.METHODS: The study included 49 patients who underwent arthroscopic rotator cuff repair. Rehabilitation was initiated after 4 weeks of immobilization. A total of 29 patients performed supervised exercise 3 times a week. Standardized education and brochures for review were provided to the remaining 20 patients who insisted on home rehabilitation. Statistical analysis was performed for comparing pain Numerical Rating Scale (NRS), SANE, and ROM. In addition, we also evaluated the correlation between pain and ROM.RESULTS: Comparison of the two groups revealed no significant differences in forward flexion, internal rotation, abduction, and pain NRS. However, SANE at the 9th week (63.8 vs. 55.0, p=0.038) and improvement of external rotation from the 5th to the 9th week (17.6 vs. 9.3, p=0.018) were significantly higher in the supervised exercise group as compared to the home exercise group. Correlation of pain NRS with forward flexion, external rotation, internal rotation and abduction were statistically not significant (correlation coefficient=0.032 [p=0.828], ?0.255 [p=0.077], 0.068 [p=0.642], and ?0.188 [p=0.196], respectively).CONCLUSIONS: The supervised rehabilitation after arthroscopic rotator cuff repair showed better improvement in external rotation and higher SANE score after 4 weeks of rehabilitation exercise. However, no statistically significant correlation was observed between the recovery of ROM and short-term pain relief.

scholarly journals The benefit of platelet-rich plasma injection over institution-based physical therapy program in adhesive capsulitis patients with diabetes mellitus: prospective observational cohort study

2021 ◽  
Author(s):  
Apurba Barman ◽  
Somanth Mukherjee ◽  
Mithilesh K Sinha ◽  
Jagannatha Sahoo ◽  
Amrutha Viswanath
Keyword(s):  
Diabetes Mellitus ◽  
Physical Therapy ◽  
Range Of Motion ◽  
Shoulder Pain ◽  
Glenohumeral Joint ◽  
Platelet Rich Plasma ◽  
Adhesive Capsulitis ◽  
Diabetic Patients ◽  
Single Shot ◽  
Patients With Diabetes

Background: The objective of this study was to compare the efficacy of platelet-rich plasma (PRP) injection with an institution-based physical therapy (PT) program for adhesive capsulitis (AC) of the shoulder in patients with diabetes mellitus (DM).Methods: A total of seventy diabetic patients with AC of the shoulder for <6 months were assigned to two groups: PRP group and PT group. In the PRP group, 35 patients were administered a single shot of PRP (4 mL) into the glenohumeral joint. In the PT group, 35 patients were given institution-based PT that included 10 30-minute sessions of planned PT over a 2-week period. After the interventions, all patients were prospectively followed for 12 weeks. Intensity of shoulder pain, function, and range of motion were assessed at baseline and then at 3, 6, and 12 weeks. Results: Thirty-three patients in the PRP group and 32 in the PT group completed the 12-week study. At 12 weeks, patients who received PRP injections showed greater improvement in shoulder pain (p<0.001) than those recruited to the PT group. In the range of motion and shoulder function activities, patients in the PRP group showed significant improvement compared with the institution-based PT group (p<0.001). No significant complications were reported from any groups.Conclusions: In a diabetic population, PRP injections significantly improved shoulder pain and function compared with an institution-based PT program for shoulder AC. Additionally, it is a safe and well-tolerated method for AC management for diabetic patients.

scholarly journals Two-year results of double row repair for medium sized rotator cuff tear in elderly patients

2019 ◽  
Vol 6 (2) ◽  
pp. 423
Author(s):  
Afsar T. Ozkut
Keyword(s):  
Rotator Cuff ◽  
Internal Rotation ◽  
Rotator Cuff Tear ◽  
External Rotation ◽  
Constant Score ◽  
Rotator Cuff Tears ◽  
Double Row ◽  
Cuff Tear ◽  
Forward Flexion

Background: Rotator cuff tears are treated surgically when conservative treatment methods fail. Since osteoporosis is common and the cuff is degenerative in nature, it may be a challenge to treat the tears surgically in the elderly. The objective of this study was to evaluate the results rotator cuff repair with double row two anchors (one medial and one lateral) for middle sized tears in patients over 65years old.Methods: 18 patients who are over 65years old treated arthroscopically for medium sized rotator cuff tear were included in the study. Inclusion criteria were patients with MR findings and physical findings consistent with medium sized (1-3cm) rotator cuff tears, patients with follow up period of at least 2years. All of the patients were repaired using (two anchors, one medially and one laterally placed) double row technique arthroscopically.  The patients were evaluated with constant Murley score and ASES scores. All these measurements (both ROM and functional tests) were performed preoperatively and at postoperative third sixth months, first year and after second year.Results: Mean age of the patients was 69.3 (±2.6). The mean follows up period was 34months (±4.1) Preoperative mean forward flexion and external rotation were 127.3±25.3º and 48.9±14.6º respectively. The preoperative mean internal rotation was 9.1±6.9º. Preoperative mean ASES score was 59.1º (±9.6) and mean constant score was 53.7º (±11.2). At the last follow up mean forward flexion was 158.3º (±17.9), external rotation was 63.2º (±11.4) and internal rotation was 9.3º (±7.3).  Mean ASES score and constant score of the patients were 84.3 (±9.1) and 77.3 (±10.8) in the last follow up.Conclusions: It is possible to obtain good results in medium sized rotator cuff tears in patients over 65years old particularly if fatty degeneration over grade II has not prevailed.

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