scholarly journals Pre- and Postoperative Isokinetic Strength Test in Rotator Cuff Tear

1970 ◽  
Vol 14 (2) ◽  
pp. 179-186 ◽  
Author(s):  
Jin Young Kim ◽  
Suk Kee Tae ◽  
Do Hyun Yeo ◽  
Ho Min Lee ◽  
Jong Soo Oh
Keyword(s):  
Rotator Cuff ◽  
External Rotation ◽  
Peak Torque ◽  
Fatty Degeneration ◽  
Isokinetic Strength ◽  
Total Work ◽  
Cuff Tear ◽  
Isokinetic Muscle Strength ◽  
Tear Size

PURPOSE: This study investigated whether (i) isokinetic muscle strength correlated with (ii) anatomical assessment of rotator cuff tear size, fatty degeneration of the supraspinatus muscle or postoperative cuff integrity.MATERIALS & METHODS: Among patients who underwent arthroscopic rotator cuff repair, 32 patients in whom magnetic resonance imaging (MRI) and isokinetic muscle strength tests were performed preoperatively and, at an average of 10 months after repair, took part in this study. We measured the isokinetic strength (peak torque and total work) deficit in external rotation and internal rotation at a 60degrees/sec load.RESULTS: Preoperative isokinetic strength deficits correlated with tear size (p<0.001) but correlated weakly with fatty degeneration of supraspinatus muscle (p<0.001). In patients with healed rotator cuffs, preoperative peak torque and total work deficits were 39% and 62% for external rotation. At final follow up, they were decreased to 17% and 32%, respectively. In the re-tear group, preoperative peak torque and total work deficit were 44% and 61% in external rotation. At final follow up, they were decreased to 23% and 35%, respectively. But there was no significant difference between the two groups (p>0.05).CONCLUSION: Preoperative isokinetic strength correlates with tear size but not fatty degeneration of the supraspintus muscle or postoperative cuff integrity. Postoperative cuff integrity did not have an effect on postoperative isokinetic strength.

scholarly journals Is limited external rotation after reverse shoulder arthroplasty associated with glenoidal notching?

2021 ◽  
Author(s):  
Alexandra Grob ◽  
Samy Bouaicha ◽  
Marco Germann ◽  
Sabra Germann ◽  
Christian Gerber ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Arthroplasty ◽  
Radiographic Progression ◽  
External Rotation ◽  
Constant Score ◽  
Reverse Shoulder Arthroplasty ◽  
Scapular Notching ◽  
Cuff Tear ◽  
Over Time

Abstract Background Reverse shoulder arthroplasty (RSA) is a valuable solution for patients with shoulder pain or injury primarily due to a rotator cuff tear or secondary to traumatic events. Nevertheless, several complications are known to appear, with the most frequent being scapular notching (SN) on the inferior and posterior scapular neck. Controversial data exist about the clinical relevance of SN. Since further consequences are still not clearly understood, we aimed to provide more clarity on which factors, especially external rotation (ER), contribute to the appearance and progress of notching. Methods Constant Score (CS), Subjective Shoulder Value (SSV), flexion, abduction, and ER were evaluated retrospectively in 153 shoulders of 147 patients (mean age 79±7.7 years; 62% women) who underwent RSA between 2005 and 2010. Anteroposterior radiographs were evaluated before and 1, 2, 3, and 5 years after RSA for SN according to the Sirveaux classification. The evaluation was performed by two independent surgeons. Spearman’s coefficient and t-test were used. Results CS, SSV, flexion, and abduction increased significantly 1 year after RSA compared to before (all p < 0.0001). No improvement was shown for ER between the same timepoints. Between 2 and 5 years of follow-up, only flexion decreased by 5°(p = 0.02) while CS, SSV, abduction, and ER remained constant. After RSA, notching increases over time. There was no association between SN and CS, SSV, flexion, abduction or ER at any of the measured timepoints. Higher flexion correlated with higher abduction after RSA at every follow-up (1 year r = 0.88, 2 years r = 0.89, 3 years r = 0.86, 5 years r = 0.86). The interrater correlation test showed a strong correlation (r = 0.7). Conclusion We verified the functional benefits of RSA for patients. Additionally, our findings show that despite radiographic progression of notching and unchanged limited ER, the postoperative improvements in CS, SSV, flexion, and abduction are preserved over 5 years.

A Rotator Cuff Tear Concomitant With Shoulder Stiffness Is Associated With a Lower Retear Rate After 1-Stage Arthroscopic Surgery

2018 ◽  
Vol 46 (8) ◽  
pp. 1909-1918 ◽  
Author(s):  
In-Bo Kim ◽  
Dong-Wook Jung
Keyword(s):  
Rotator Cuff ◽  
External Rotation ◽  
Arthroscopic Surgery ◽  
Fatty Infiltration ◽  
Symptom Duration ◽  
Shoulder Stiffness ◽  
Tear Size ◽  
Retear Rate

Background: Few studies have reported on the radiological characteristics and repair integrity of coexistent rotator cuff tears (RCTs) and shoulder stiffness after simultaneous arthroscopic rotator cuff repair and capsular release. Purpose: To evaluate the radiological characteristics and repair integrity of 1-stage arthroscopic surgery of RCTs concomitant with shoulder stiffness. Study Design: Cohort study; Level of evidence, 3. Methods: Among patients who underwent arthroscopic repair of full-thickness RCTs, the stiff group underwent simultaneous capsular release for shoulder stiffness, and the nonstiff group had no stiffness. Symptom duration, prevalence of diabetes, tear size, tendon involvement (type 1, supraspinatus; type 2, supraspinatus and subscapularis; and type 3, supraspinatus and infraspinatus; type 4, supraspinatus, subscapularis, and infraspinatus), and fatty infiltration (Goutallier stages 0-4) were evaluated. A retear was appraised using magnetic resonance imaging, and clinical outcomes were assessed using range of motion, the Korean Shoulder Scoring System (KSS), and the University of California, Los Angeles (UCLA) shoulder score. Results: The stiff group showed a significantly lower retear rate (1/39, 2.6%) than the nonstiff group (47/320, 14.7%) ( P = .043). There were significant differences in symptom duration (7.4 ± 6.6 vs 15.0 ± 23.7 months, respectively; P < .001), mediolateral tear size (18.9 ± 8.9 vs 24.1 ± 12.0 mm, respectively; P = .002), tendon involvement (94.9%, 5.1%, 0.0%, and 0.0% vs 85.3%, 6.9%, 7.8%, and 0.0%, respectively; P = .048), and fatty infiltration of the subscapularis (66.7%, 33.3%, 0.0%, 0.0%, and 0.0% vs 31.9%, 61.3%, 5.6%, 1.3%, and 0.0%, respectively; P < .001) and teres minor (74.4%, 20.5%, 5.1%, 0.0%, and 0.0% vs 47.2%, 48.8%, 3.8%, 0.0%, and 0.3%, respectively; P = .007) between the stiff and nonstiff groups. Preoperatively, the stiff group showed significantly worse forward flexion (95.9° ± 23.6° vs 147.7° ± 4.2°, respectively; P < .001), external rotation (17.4° ± 10.1° vs 51.6° ± 12.1°, respectively; P < .001), and internal rotation (L5 vs L2, respectively; P < .001) and lower KSS (52.1 ± 13.8 vs 66.3 ± 13.5, respectively; P < .001) and UCLA scores (18.7 ± 4.8 vs 22.5 ± 4.5, respectively; P < .001) than the nonstiff group. However, these differences became insignificant from 3 months postoperatively for forward flexion ( P > .05) and KSS ( P > .05) and UCLA scores ( P > .05), from 1 year postoperatively for external rotation ( P > .05), and at the last follow-up for internal rotation ( P > .05). A multiple logistic regression analysis revealed that only mediolateral tear size (odds ratio, 1.043; P = .014) and type 2 tendon involvement (odds ratio, 4.493; P = .003) were independent predictors of a retear. Conclusion: RCTs concomitant with shoulder stiffness showed a smaller mediolateral tear size, anterosuperior tendon involvement, and less severe fatty infiltration preoperatively and better repair integrity postoperatively than RCTs without stiffness. Furthermore, the clinical outcomes and range of motion at final follow-up were similar between the 2 groups.

scholarly journals Relationship of Posterior Decentering of the Humeral Head with Tear Size and Fatty Degeneration in Rotator Cuff Tear

2019 ◽  
Vol 22 (3) ◽  
pp. 121-127
Author(s):  
Jung-Han Kim ◽  
Hyeong-Won Seo
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Humeral Head ◽  
Fatty Degeneration ◽  
Subscapularis Tendon ◽  
Tendon Tear ◽  
Level Of Evidence ◽  
Cuff Tear ◽  
Subscapularis Tendon Tear ◽  
Tear Size

Background: Posterior decentering is not an uncommon finding on rotator cuff tear patients’ shoulder magnetic resonance imaging. No previous study has reported on the relationship between posterior decentering and rotator cuff tear.Methods: We assessed patients’ rotator cuff tear humeral head positions based on humeral?scapular alignment (HSA). Subjects were classified into centering and decentering groups based on a <2 mm or >2 mm HSA value, respectively. Differences in rotator cuff tear size, degree of tear, and fatty degeneration between the two groups were evaluated.Results: One hundred seventy-five patients (80 males, 95 females; mean age: 59.7 ± 6.5 years old) were selected as subjects (casecontrol study; level of evidence: 3). Tear size, degree of subscapularis tendon tear, and fatty degeneration of the supraspinatus, infraspinatus, and subscapularis muscles were significantly different between the two groups (<i>p</i><0.001, <i>p</i><0.001, <i>p</i><0.001).Conclusions: The occurrence of decentering was related to rotator cuff tear size, degree of subscapularis tendon tear, and fatty degeneration of the rotator cuff muscles.

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.

scholarly journals Relationship of the Sagittal Extent of Rotator Cuff Tears to the Grade of Fatty Degeneration of the Rotator Cuff Muscles

1970 ◽  
Vol 14 (2) ◽  
pp. 159-164 ◽  
Author(s):  
Joong Bae Seo ◽  
Myung Ho Kim ◽  
Je Min Yi
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Fatty Degeneration ◽  
Rotator Cuff Tears ◽  
Cuff Tear ◽  
Anteroposterior Diameter ◽  
Shoulder Mri ◽  
Group 5 ◽  
Group 2 ◽  
Tear Size

PURPOSE: To investigate the relationship between the size of a rotator cuff tear and the grade of fatty degeneration of the supraspinatus and infraspinatus muscles.MATERIALS AND METHODS: From a database of 541 patients who underwent a shoulder MRI between September 2004 and September 2010, we enrolled 148 patients that had a full-thickness rotator cuff tear. The anteroposterior diameter of the tear was measured in sagittal views on an MRI. The patients were divided into 6 groups reflecting the anteroposterior diameter: group 1 (a width of <10 mm), group 2 (10 mm< or =width<15 mm), group 3 (15 mm< or =width<20 mm), group 4 (20 mm< or =width<25 mm), group 5 (25 mm< or =width<30 mm) and group 6 (a width<30 mm). Fatty degeneration was rated according to Goutallier et al.RESULTS: Fatty degeneration in the supraspinatus and infraspinatus muscles increased with the severity of the rotator cuff tear. The supraspinatus fatty degeneration increased prominently as the tear size increased from 15~19 mm to 20~24 mm and from 25~29 mm to over 30 mm. The infraspinatus fatty degeneration increased prominently as the tear size increased from 25~29 mm to over 30 mm. Seventeen patients had tear widths under 10 mm and 8 patients among them had fatty degeneration of the infraspinatus.CONCLUSION: Fatty degeneration in supraspinatus and infraspinatus muscles increases prominently at specific tear sizes. The presence of tears under 10 mm with infraspinatus fatty degeneration indicates that the infraspinatus tendon may have an anatomical or functional effect even in small tears.

scholarly journals Comparing Clinical Outcomes After Subacromial Spacer Insertion Versus Other Reconstruction Methods in the Treatment of Irreparable Massive Rotator Cuff Tears

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711986960
Author(s):  
Joo Han Oh ◽  
Joo Hyun Park ◽  
Hyeon Jang Jeong ◽  
Sung-Min Rhee
Keyword(s):  
Rotator Cuff ◽  
Fatty Degeneration ◽  
Rotator Cuff Tears ◽  
Massive Rotator Cuff Tears ◽  
Reconstruction Methods ◽  
Functional Scores ◽  
Group 2 ◽  
Tear Size ◽  
Group 1

Background: Previous studies on subacromial spacer (SAS) insertion have been limited to case series that did not compare the effectiveness of this technique with other techniques. Hypothesis: Outcomes after SAS insertion for the treatment of irreparable massive rotator cuff tears (IMRCTs) will be similar to those of other techniques. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study was based on data collected from patients who underwent correction of IMRCTs between January 2010 and October 2017. Group 1 patients (n = 17) received SAS insertion with or without partial repair; group 2 patients (n = 36) were treated with other techniques (isolated partial repairs or bridging grafts). Preoperative tear size and global fatty degeneration index values were evaluated. Range of motion, visual analog scale for pain, American Shoulder and Elbow Surgeons (ASES) score, Constant score, Simple Shoulder Test (SST), Disabilities of the Arm, Shoulder and Hand score, and acromiohumeral distance (AHD) were assessed preoperatively and at final follow-up at least 2 years after the surgery (range, 24-60 months). In both groups, ultrasonographic examination was performed at 3 and 6 months postoperatively, and magnetic resonance imaging (MRI) was performed at 1 year. Results: Tear size and preoperative global fatty degeneration index were not significantly different between the groups (all P > .05). There were no differences in functional scores between the groups at final follow-up (all P > .05). AHD was maintained at final follow-up in group 1 (mean ± SD: 6.2 ± 2.1 mm [postoperatively] vs 6.7 ± 2.3 mm [final follow-up]; P = .678), and there was no difference compared with group 2 (7.2 ± 3.2 mm; P = .244). Patients with retears in group 2 (23 of 36, 63.9%) had lower ASES ( P = .041) and SST ( P = .027) scores at final follow-up when compared with patients in group 1. Six patients (35.3%) in group 1 had partial repairs; these patients had better external rotation at 90° ( P = .047), better SST scores ( P = .036), and higher AHDs at final follow-up ( P = .046) than those in group 1 who had no repair. Three patients (50%) showed retears of partially repaired tendons on MRI. Of 13 patients (76.5%) in group 1 with postoperative MRI, 12 (92.3%) showed fibrotic tissue in the subacromial space not seen preoperatively. Conclusion: There was no difference in outcomes between SAS and the other reconstruction methods for treating IMRCTs. However, given the high retear rate associated with other techniques and poor functional outcomes after retear, SAS insertion could be a viable option for treating IMRCTs.

scholarly journals Magnetic resonance imaging analysis of rotator cuff tear after shoulder dislocation in a patient older than 40 years

2020 ◽  
Vol 23 (3) ◽  
pp. 144-151
Author(s):  
Jung-Han Kim ◽  
Jin-Woo Park ◽  
Si-Young Heo ◽  
Young-Min Noh
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Shoulder Dislocation ◽  
Age Groups ◽  
Fatty Degeneration ◽  
Resonance Imaging ◽  
Cuff Tear ◽  
Tear Size

Background: This study was designed to evaluate characters of the rotator cuff tear (RCT) recognized after primary shoulder dislocation in patients older than 40. Methods: From 2008 to 2019, patients who visited two hospitals after dislocation were retrospectively reviewed. Inclusion criteria were patients over 40 who had dislocation, with magnetic resonance imaging (MRI) undergone. Exclusion criteria were patients who lost to follow-up, combined with any proximal humerus fracture, brachial plexus injury, and previous operation or dislocation history in the ipsilateral shoulder. Also patients who had only bankart or bony bakart lesion in MRI were excluded. We evaluated RCTs that were recognized by MRI after the primary shoulder dislocation with regard to tear size, degree, involved tendons, fatty degeneration, the age when the first dislocation occurred, and the duration until the MRI was evaluated after the dislocation. Results: Fifty-five RCTs were included. According to age groups, the tear size was increased in coronal and sagittal direction, the number of involved tendons was increased, and the degree of fatty degeneration was advanced in infraspinatus muscle. Thirty-two cases (58.2%) conducted MRI after 3 weeks from the first shoulder dislocation event. Conclusions: This group showed that the retraction size of the coronal plane was increased significantly and the fatty accumulation of the supraspinatus muscle had progressed significantly. Age is also a strong factor to affect the feature of RCT after the shoulder dislocation in patients over 40. And the delay of the MRI may deteriorate the degree of tear size and fatty degeneration.

scholarly journals Revision Rotator Cuff Repair Versus Primary Repair for Large to Massive Tears Involving the Posterosuperior Cuff: Comparison of Clinical and Radiological Outcomes

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712199879
Author(s):  
Prashant Meshram ◽  
Bei Liu ◽  
Sang Woo Kim ◽  
Kang Heo ◽  
Joo Han Oh
Keyword(s):  
Risk Factors ◽  
Rotator Cuff ◽  
Odds Ratio ◽  
Fatty Degeneration ◽  
High Grade ◽  
Cuff Tear ◽  
Revision Rotator Cuff Repair ◽  
Cuff Repair ◽  
Retear Rate

Background: The retear rate after revision rotator cuff repair (rRCR) ranges from 50% to 90%. Patients who undergo primary RCR (pRCR) for large to massive rotator cuff tear (mRCT) also have unpredictable outcomes. Purpose: To compare the clinical outcomes after rRCR for a posterosuperior rotator cuff tear of any size with those after pRCR for mRCT and to identify the risk factors for poor outcomes and retear after rRCR. Study Design: Cohort study; Level of evidence, 3. Methods: Among patients with posterosuperior cuff tear treated between 2010 and 2017, the clinical outcomes of 46 patients who underwent rRCR were compared with 106 patients who underwent pRCR for mRCT. Between-group differences in patient-reported outcomes (visual analog scale [VAS] for pain, VAS for satisfaction and American Shoulder and Elbow Surgeons [ASES] and Constant scores) at final follow-up were evaluated and compared with previously published minimal clinically important difference (MCID) values. Radiological outcomes were evaluated using magnetic resonance imaging or ultrasonography at a minimum 1-year follow-up. Multivariate linear regression analysis was performed to identify the risk factors for poor ASES score, and multivariate logistic regression analysis was used to assess the risk factors for retear after rRCR. Results: The mean follow-up was 26.4 months (range, 24-81 months). Although final VAS for pain, VAS for satisfaction, and ASES scores in the rRCR group were significantly worse than those in the pRCR group, the Constant score was similar between the groups. These differences in outcomes did not exceed the MCID threshold. The retear rate in the rRCR group was 50% compared with 39% for the pRCR group ( P = .194). In the rRCR group, risk factors for worse ASES score were retear ( P = .043; r = –11.3), lower body mass index ( P = .032; r = 1.9), and lower preoperative VAS for pain ( P = .038; r = 2.3), and risk factors for retear were preoperative high-grade fatty degeneration (Goutallier grades 3 and 4) of the supraspinatus muscle ( P = .026; odds ratio, 5.2) and serum hyperlipidemia ( P = .035; odds ratio, 11.8). Conclusion: Both study groups had similar clinical and radiological outcomes. Patients with symptomatic failed rotator cuff repairs having high-grade fatty degeneration of the supraspinatus muscle and/or serum hyperlipidemia had a greater likelihood of retear after rRCR.

scholarly journals The Association Between the Rotator Cuff Status and the Severity and Recovery of Weakness in the Shoulder Abductor Strength in a Case of Proximal Type Cervical Spondylotic Amyotrophy

2020 ◽  
pp. 219256822098044
Author(s):  
Sho Ishiwata ◽  
Yoichi Iizuka ◽  
Hitoshi Shitara ◽  
Tokue Mieda ◽  
Eiji Takasawa ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Biceps Brachii ◽  
Case Series ◽  
Manual Muscle Test ◽  
Cuff Tear ◽  
Cervical Spondylotic Amyotrophy ◽  
Case Series Study ◽  
Shoulder Abductor ◽  
Series Study

Study Design: Case series study. Objective: We aimed to clarify the prevalence of rotator cuff tear (RCT), and the association between RCT and the severity and prognosis in patients with proximal type cervical spondylotic amyotrophy (CSA). Methods: We retrospectively analyzed 35 proximal type CSA patients who were treated conservatively. The following data was collected: age, rotator cuff status on MRI, manual muscle test (MMT) score of shoulder abductor and biceps brachii muscles both at the first visit and final follow-up. We investigated the prevalence of RCT and the association between the rotator cuff status, and the severity and recovery of upper extremity weakness in patients with proximal type CSA. Results: Of the 35 patients, 21 had an RCT on MRI, indicating that the prevalence of RCT in patients with proximal type CSA was 60%. An age-adjusted analysis showed that the presence of RCT was significantly associated with the MMT score of the shoulder abductor muscles both at the first visit and at the final follow-up. The presence of RCT was significantly associated with the recovery of the shoulder abductor muscles. The size of the RCT was negatively correlated with the MMT score of the shoulder abductor muscles at the final follow-up. The size of the RCT was independently correlated with the change of the MMT score of the shoulder abductor muscles. Conclusion: RCT was detected in >50% in patients with proximal type CSA, and the presence and severity of RCT can be used as prognostic factors for proximal type CSA patients who are treated conservatively.

The Effects of Tourniquet Application in Total Knee Arthroplasty on the Recovery of Thigh Muscle Strength and Clinical Outcomes

2020 ◽  
Author(s):  
Omer Ayik ◽  
Mehmet Demirel ◽  
Fevzi Birisik ◽  
Ali Ersen ◽  
Halil I. Balci ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Muscle Strength ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Peak Torque ◽  
Thigh Muscle ◽  
Controlled Study ◽  
Total Work ◽  
Isokinetic Muscle Strength ◽  
Total Knee

AbstractThe present randomized controlled study aims to evaluate whether tourniquet application during total knee arthroplasty (TKA) has an effect on (1) thigh muscle strength (quadriceps and hamstring muscle strength) and (2) clinical outcomes (postoperative knee range of motion [ROM], postoperative pain level, and Knee Society Score [KSS]). The effects of tourniquet application during TKA were investigated in 65 patients randomly allocated to one of two groups: TKA with a tourniquet and TKA without a tourniquet. Patients in both groups were comparable in terms of the demographic and clinical data (p > 0.05 for age, number of patients, sex, radiographic gonarthrosis grade, American Society of Anesthesiologists [ASA] classification, and body mass index [BMI]). All patients in both groups were operated by the same surgeon using one type of prosthesis. Isokinetic muscle strength (peak torque and total work) of knee extensors (quadriceps) and flexors (hamstrings) was measured in Newton meters (Nm) using a CYBEX 350 isokinetic dynamometer (HUMAC/CYBEX 2009, Stoughton, MA). The combined KSS (knee score + function score), visual analog scale (VAS), and knee ROM were measured preoperatively and at 1 and 3 months postoperatively to evaluate clinical outcomes. There were no significant differences between the two groups in preoperative and postoperative values of isokinetic muscle strength (peak torque and total work) and aforementioned clinical outcomes (p < 0.05). The present study has shown that quadriceps strength and clinical outcomes were not improved in the early postoperative period (3 months) when a tourniquet was not used during TKA.

Sign in / Sign up

Export Citation Format

Share Document