scholarly journals Follow-up on a Biological Revision Technique for Large, Recurrent, Retracted, Rotator Cuff Tears

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Hillel Skoff
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears

scholarly journals The Impact of Smoking on Clinical Results Following the Rotator Cuff and Biceps Tendon Complex Arthroscopic Surgery

2021 ◽  
Vol 10 (4) ◽  
pp. 599
Author(s):  
Jan Zabrzyński ◽  
Gazi Huri ◽  
Maciej Gagat ◽  
Łukasz Łapaj ◽  
Alper Yataganbaba ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Functional Outcomes ◽  
Shoulder Arthroscopy ◽  
Smoking Status ◽  
Biceps Tendon ◽  
Arthroscopic Surgery ◽  
Rotator Cuff Tears ◽  
Shoulder Injuries ◽  
The Impact

The purpose of this study was to investigate the association of smoking and functional outcomes after arthroscopic treatment of complex shoulder injuries: rotator cuff tears (RCTs) with biceps tendon (LHBT) tears. This retrospective case-control study has been conducted on a cohort of patients who underwent shoulder arthroscopy between 2015 and 2017 due to complex injury treatment. The outcomes were assessed using the American Shoulder and Elbow Surgeons Score (ASES), the University of California at Los Angeles (UCLA) Shoulder Score, need for non-steroid anti-inflammatory drugs (NSAIDs) consumption and the visual analog scale (VAS). Complications and changes in smoking status were also noted. A cohort of 59 patients underwent shoulder arthroscopy, due to complex LHBT pathology and RCTs, and were enrolled in the final follow-up examination; with mean duration of 26.03 months. According to smoking status, 27 of patients were classified as smokers, and the remaining 32 were non-smokers. In the examined cohort, 36 patients underwent the LHBT tenotomy and 23 tenodesis. We observed a relationship between smoking status and distribution of various RCTs (p < 0.0001). The mean postoperative ASES and UCLA scores were 80.81 and 30.18 in the smoker’s group and 84.06 and 30.93 in the non-smoker’s group, respectively. There were no statistically significant differences in pre/postoperative ASES and postoperative UCLA scores between smokers and non-smokers (p > 0.05). The VAS was significantly lower in the non-smokers’ group (p = 0.0021). Multi-tendon injuries of the shoulder are a serious challenge for surgeons, and to obtain an excellent functional outcome, we need to limit the negative risk factors, including smoking. Furthermore, there is a significant association between smoking and the occurrence of massive rotator cuff tears, and the pain level measured by the VAS. Simultaneous surgical treatment of RC and LHBT lesions in the smoker population allowed us to obtain the functional outcomes approximated to non-smokers in the long-term follow-up. Of course, we cannot assert that smoking is the real cause of all complications, however, we may assume that this is a very important, negative factor in shoulder arthroscopy.

Clinical and Radiographic Results of Arthroscopic Partial Repairs for Massive Irreparable Rotator Cuff Tears: Deterioration of the Results at Minimum Two Year Follow-Up

2013 ◽  
Vol 22 (10) ◽  
pp. e23-e24
Author(s):  
Jae Chul Yoo ◽  
Min Soo Shon ◽  
Kyoung Hwan Koh ◽  
Tae Kang Lim ◽  
Young Eun Park ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears

Evaluating the Outcomes of Rotator Cuff Repairs With Polytetrafluoroethylene Patches for Massive and Irreparable Rotator Cuff Tears With a Minimum 2-Year Follow-up

2018 ◽  
Vol 46 (13) ◽  
pp. 3155-3164 ◽  
Author(s):  
Vasanth Seker ◽  
Lisa Hackett ◽  
Patrick H. Lam ◽  
George A.C. Murrell
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
External Rotation ◽  
Case Series ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Level Of Evidence ◽  
Irreparable Tear ◽  
Pain At Rest

Background: Massive and irreparable rotator cuff tears are difficult to manage surgically. One technique is to use a synthetic polytetrafluoroethylene (PTFE) patch to bridge the tear. However, there is little information regarding the outcomes of this procedure. Purpose: To determine the ≥2-year outcomes of patients for whom synthetic patches were used as tendon substitutes to bridge irreparable rotator cuff defects. Study Design: Case series; Level of evidence, 4. Methods: This retrospective cohort study used prospectively collected data. Patients included those with a synthetic patch inserted as an interposition graft for large and/or irreparable rotator cuff tears with a minimum 2-year follow-up. Standardized assessment of shoulder pain, function, range of motion, and strength was performed preoperatively, at 6 and 12 weeks, and at 6 months and ≥2 years. Radiograph and ultrasound were performed preoperatively, at 6 months, and ≥2 years. Results: At a mean of 36 months, 58 of 68 eligible patients were followed up, and 53 of 58 (90%) patches remained in situ. Three patches failed at the patch-tendon interface, while 1 patient (2 shoulders/patches) went on to have reverse total shoulder replacements. Patient-ranked shoulder stiffness ( P < .001), frequency of pain with activity and sleep ( P < .0001), level of pain at rest and overhead ( P < .0001), and overall shoulder function improved from bad to very good ( P < .0001) by 6 months. Supraspinatus (mean ± SEM: 29 ± 16 N to 42 ± 13 N) and external rotation (39 ± 13 N to 59 ± 15 N) strength were the most notable increases at the ≥2-year follow-up ( P < .0001). Passive range of motion also improved by 49% to 67%; forward flexion, from 131° to 171°; abduction, from 117° to 161°; external rotation, from 38° to 55°; and internal rotation, from L3 to T10 ( P < .0001) preoperatively to ≥2 years. The most improvement in passive range of motion occurred between 12 months and ≥2 years. The mean (SD) Constant-Murley score was 90 (12), while the American Shoulder and Elbow Surgeons score was 95 (8). Conclusion: At 36 months postoperatively, patients who had synthetic patches used as tendon substitutes to bridge irreparable rotator cuff defects reported less pain and greater overall shoulder function as compared with preoperative assessments. They demonstrated improved range of passive motion and improved strength. The data support the hypothesis that the technique of using a synthetic PTFE patch to bridge a large and/or irreparable tear has good construct integrity and improves patient and clinical outcomes.

scholarly journals Surgeon-operated ultrasonography in a one-stop shoulder clinic

2011 ◽  
Vol 93 (7) ◽  
pp. 528-531 ◽  
Author(s):  
R Seagger ◽  
T Bunker ◽  
P Hamer
Keyword(s):  
Rotator Cuff ◽  
Surgical Repair ◽  
Rotator Cuff Tears ◽  
Financial Cost ◽  
Time Saving ◽  
One Stop ◽  
Group A ◽  
Group B ◽  
Portable Ultrasonography

INTRODUCTION Nearly 1 in 40 of the population seeks medical advice related to a shoulder problem every year. The majority pertain to rotator cuff pathology. Prior to intervention in such patients it is imperative to define whether the tendons are intact or torn. Ultrasonography has become an essential adjunct to clinical assessment in diagnosing rotator cuff tears. This study was designed to investigate if a surgeon using a portable ultrasonography machine in a one-stop shoulder clinic could significantly reduce the time a patient waited from initial outpatient presentation to the end of the treatment episode (be it surgery, injection or conservative management). METHODS A total of 77 patients were allocated to one of two groups: Group A, consisting of 37 patients who were assessed and had ultrasonography as outpatients, and Group B, consisting of 40 patients who were assessed and referred for departmental ultrasonography where appropriate. Three clear outcome groups were defined: those who required surgical repair, those who had irreparable tears and those who declined surgery. RESULTS For all outcomes (surgery, irreparable tears and conservative treatment), the patients in Group A all completed their clinical episodes significantly quicker than those in Group B (p<0.02). As well as the time saving benefits, there was a substantial financial saving for Group A. By performing ultrasonography in the outpatients department, those patients avoided the requirement of departmental imaging (£120) and subsequent follow-up appointments (£73) to discuss results and management, resulting in a saving of nearly £200 per patient. CONCLUSIONS The use of a portable ultrasonography machine by an orthopaedic surgeon can significantly reduce the time to treatment and the financial cost for patients with rotator cuff tears.

Interposition GraftJacket allografts for irreparable rotator cuff tears

2022 ◽  
Vol 104-B (1) ◽  
pp. 91-96
Author(s):  
Amit Modi ◽  
Aziz Haque ◽  
Vijay Deore ◽  
Harvinder Pal Singh ◽  
Radhakant Pandey
Keyword(s):  
Rotator Cuff ◽  
Pain Score ◽  
Reverse Shoulder Arthroplasty ◽  
Young Patients ◽  
Rotator Cuff Tears ◽  
Long Term Outcomes ◽  
Open Reconstruction ◽  
One Year

Aims Long-term outcomes following the use of human dermal allografts in the treatment of symptomatic irreparable rotator cuff tears are not known. The aim of this study was to evaluate these outcomes, and to investigate whether this would be a good form of treatment in young patients in whom a reverse shoulder arthroplasty should ideally be avoided. Methods This prospective study included 47 shoulders in 45 patients who underwent an open reconstruction of the rotator cuff using an interposition GraftJacket allograft to bridge irreparable cuff tears, between January 2007 and November 2011. The Oxford Shoulder Score (OSS), pain score, and range of motion (ROM) were recorded preoperatively and at one year and a mean of 9.1 years (7.0 to 12.5) postoperatively. Results There was significant improvement in the mean OSS from 24.7 (SD 5.4) preoperatively to 42.0 (SD 6.3) at one year, and this improvement was maintained at 9.1 years (p < 0.001), with a score of 42.8 (SD 6.8). Similar significant improvements in the pain score were seen and maintained at the final follow-up from 6.1 (SD 1.6) to 2.1 (SD 2.3) (p < 0.001). There were also significant improvements in the ROM of the shoulder, and patient satisfaction was high. Conclusion The use of an interposition human dermal allograft in patients with an irreparable rotator cuff tear leads to good outcomes that are maintained at a mean of nine years postoperatively. Cite this article: Bone Joint J 2022;104-B(1):91–96.

scholarly journals Rotátorköpeny-szakadás után kialakult zsíros degeneráció változása az ín rekonstrukcióját követően, 65 éves kor után

2019 ◽  
Vol 160 (14) ◽  
pp. 533-539
Author(s):  
Imre Sallai ◽  
Márton Weidl ◽  
Attila Szatmári ◽  
Imre Antal ◽  
Gábor Skaliczki
Keyword(s):  
Rotator Cuff ◽  
Muscle Atrophy ◽  
Rotator Cuff Repair ◽  
Constant Score ◽  
Fatty Degeneration ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Before And After ◽  
Cuff Repair

Abstract: Introduction: In the case of rotator cuff tears, the severity of the muscle atrophy and fatty degeneration has an effect on the success of the repair and on the functional outcome after surgery. Aim: The ability of regeneration reduces with ageing; therefore, the study examined the atrophy and the fatty degeneration after rotator cuff repair in patients over 65. Method: Eleven patients over 65 years of age were involved whose surgery was performed at the Department of Orthopaedics of Semmelweis University between 2012 and 2015. Their average age was 71.9 years and the average follow-up period was 39.9 months. Tear sizes were C1 in 3 cases, C2 in 3 cases, C3 in 4 cases, and C4 in 1 case. Each patient had magnetic resonance examination before and after the repair; the muscle atrophy and fatty degeneration were evaluated together with the type of the tear. Visual analogue scale and Constant score were used for the assessment of the pain and the shoulder function. Results: The average Constant score was 75 points. The occupancy ratio – referring to the severity of the atrophy – did not show significant improvement. The change in fatty degeneration and the atrophy were examined in different groups according to the size of the tears. In each group, the results showed progression. Conclusions: After rotator cuff repair in patients over 65, fatty degeneration and muscle atrophy also show progression. No significant relationship was found between the size of the tear and fatty degeneration or between the size of the tear and muscle atrophy. Orv Hetil. 2019; 160(14): 533–539.

Sign in / Sign up

Export Citation Format

Share Document