Differences in Shoulder Internal Rotation Strength Between Baseball Players With Ulnar Collateral Ligament Reconstruction and Healthy Controls

Background: Studies have indicated decreased shoulder internal rotation (IR) and external rotation (ER) strength in the throwing limb of baseball players after ulnar collateral ligament injury. There is limited evidence on the recovery of shoulder rotation strength after primary ulnar collateral ligament reconstruction (UCLR). Hypothesis: At the time of return to throwing, baseball players who underwent UCLR would demonstrate decreased IR and ER shoulder strength in the throwing arm as compared with healthy baseball players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Male competitive high school and collegiate baseball athletes participated in this study. Athletes who underwent UCLR were compared with healthy controls who were matched by age, height, weight, and position. Bilateral isometric shoulder ER and IR strength was measured using a handheld dynamometer for all participants at the time of initial evaluation (UCLR group) and throughout the course of a season (healthy group). Independent t tests were run to calculate mean differences in ER and IR shoulder strength between the groups, with significance set at P < .05. Results: A total of 86 baseball athletes participated in this study (43 UCLR group, 43 healthy group). At the time of return to throwing (mean ± SD, 194 ± 30 days postoperatively), the 2 groups demonstrated no significant differences in nonthrowing arm ER or IR strength ( P = .143 and .994, respectively). No significant difference was found between groups for throwing arm ER strength ( P = .921); however, the UCLR group demonstrated significantly less throwing arm IR strength than the healthy group (144.2 ± 27.8 vs 157.6 ± 27.1 N; P = .023). Conclusion: The results of this study demonstrate that throwing arm rotator cuff strength may not fully recover before the initiation of a return-to-throwing program after UCLR. These data provide a potential framework for clinicians to assist in the management and exercise prescription of the baseball athlete after UCLR and before medical release and the initiation of a return-to-throwing program.

Structural and Functional Results of Subscapularis and Conjoint Tendon After Latarjet Procedure at 8-Year Average Follow-up

Background: The Latarjet procedure involves initial dissection through a longitudinal split of the subscapularis tendon with only a final partial closure to accommodate the transferred coracoid bone. Furthermore, by transferring the coracoid bone block to the anterior glenoid, the surgeon completely alters the resting and dynamic route of the attached conjoint tendon. The eventual structural and functional integrity of the subscapularis and conjoint tendons is currently unknown. Purpose: To examine the structural and functional integrity of the subscapularis and the conjoint tendon after the Latarjet procedure at an 8-year average follow-up. Study design: Case series; Level of evidence, 4. Methods: Twenty patients with anterior shoulder instability at a mean age of 30 years (range, 19-50 years) underwent the open Latarjet procedure. Clinical examination at the final follow-up included quantitative isometric measurement of abduction and internal rotation strength compared with the nonoperative side. Patients were assessed via radiograph examination and preoperative computed tomography. Final position and healing of the transferred coracoid bone block were evaluated using standard radiographs. At follow-up, the subscapularis and conjoint tendon were evaluated via magnetic resonance imaging (MRI) with metal artifact reduction techniques and via ultrasound. Results: Nineteen of the 20 shoulders remained stable at the final follow-up; there was 1 redislocation (5%) after 14 months. The mean Rowe score was 83 points (SD, 17.9 points), the mean Constant score was 85 points (SD, 8.1 points), and the Subjective Shoulder Value was 80% (SD, 18%). The mean abduction strength of the operative shoulder was 7.41 ± 2.06 kg compared with 8.33 ± 2.53 kg for the nonoperative side ( P = .02). The mean internal rotation strength at 0° for the operative shoulder was 8.82 ± 3.47 kg compared with 9.06 ± 3.01 kg for the nonoperative side ( P = .36). The mean internal rotation strength in the belly-press position for the operative shoulder was 8.12 ± 2.89 kg compared with 8.50 ± 3.03 kg ( P = .13). Four of 20 shoulders showed mild tendinopathic changes of the subscapularis tendon but no partial or complete tear. One patient exhibited fatty degeneration Goutallier stage 1. Conjoint tendon was in continuity in all 20 shoulders on MRI scans. Conclusion: Abduction, but not internal rotation strength, was slightly reduced after the Latarjet procedure at a mean of 8 years of follow-up. The subscapularis tendon was intact based on ultrasound examination, and the conjoint tendon was intact based on MRI scans. Subscapularis muscle girth relative to the supraspinatus muscle remained intact from preoperative measurements based on MRI scans.

Experimental Investigation on Turbulent Flow Deviation in a Gas-Particle Corner-Injected Flow

An experimental model of a corner-injected flow is built to investigate the turbulent flow behavior by employing the PIV technique. The influences of the ideal tangential circle, the additive particles and the initial gas mass flux on the corner-injected flow are analyzed systematically. To be specific, the flow deviation, the velocity profile, the vortex evolution and the turbulent flow development are discussed quantitatively. The influences of the increasing ideal tangential circle on the turbulent jet deviation are shortened gradually, and the impinging circles are obviously narrowed with the injection of particles. The gas-particle corner-injected flow can obtain a good rotation when the ideal tangential circle is 0.25 times the width of the impinging chamber. The momentum decay of the corner-injected flow diminishes with the increasing ideal tangential circle and the decreasing initial gas velocity. The rotation strength of the vortex is more affected by the injection of laden particles, while the angular distortion enhances when increasing the ideal tangential circle. The increasing initial gas mass flux plays a dominant role in the development of the corner-injected flow, secondly the increasing ideal tangential circle, and last the injection of particles. All these findings can provide theoretical support in the design of a corner-fired furnace.

Dual vortex breakdown in a two-fluid whirlpool

Looking for an optimal flow shape for culture growth in vortex bioreactors, an intriguing and impressive structure has been observed that mimics the strong swirling flows in the atmosphere (tornado) and ocean (waterspout). To better understand the flow nature and topology, this experimental study explores the development of vortex breakdown (VB) in a lab-scale swirling flow of two immiscible fluids filling a vertical cylindrical container. The rotating bottom disk drives the circulation of both fluids while the sidewall is stationary. The container can be either sealed with the still top disk (SC) or open (OC). As the rotation strength (Re) increases, a new circulation cell occurs in each fluid—the dual VB. In case SC, VB first emerges in the lower fluid at Re = 475 and then in the upper fluid at Re = 746. In case OC, VB first emerges in the upper fluid at Re = 524 and then in the lower fluid at Re = 538. The flow remains steady and axisymmetric with the interface and the free surface being just slightly deformed in the studied range of Re. Such two-VB swirling flows can provide efficient mixing in aerial or two-fluid bioreactors.

Liutex and Third Generation of Vortex Identification

Scientists developed many vortex identification methods and Liu classified the traditional vortex identification methods into two generations. Vorticity and vorticity-based methods belong to the first generation while eigenvalues-based methods are considered as the second generation, such as Q criterion and λci method. However, although these methods are widely used, there is still room for improvements. People used to consider direction of vorticity is the swirling axis and the magnitude of it is the rotation strength, but the predictions by vorticity does not match the experiment very well which drove scientists to develop the second-generation methods. All the second-generation methods are scalar-valued and as a result they are unable to locate the swirling. Another problem is even though second-generation methods can predict vortex better than vorticity, they are more or less contaminated by shear. To solve these problems, Liu innovated Liutex recently. Liutex is a vector quantity whose direction represents rotation axis and whose magnitude represents rotation strength. Firstly, the physical essence of rotation axis is provided coming with the mathematical definition of swirling axis which is the direction of Liutex. Secondly, orthogonal transformations are used to find out the rigid rotation speed and that speed is defined as the strength of Liutex. Wang later proposed an explicit formula to calculate Liutex strength without doing orthogonal transformations which makes it much easier to apply Liutex method. Some theories dependent on Liutex concept have been proposed these years. Liutex core lines represent the core of vortex which can uniquely and clearly show vortex structure. Principal coordinate is a special coordinate in which it is easy to decompose the velocity gradient tensor into rotation, shear and stretching parts correctly. And principal decomposition is the decomposition in principal coordinate. The Liutex theory system is gradually formed and they are considered as the third generation by Liu.