Notes

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008) compared with group B. Plain radiographs with arm elevation showed restriction of glenohumeral movement in 49 of 76 shoulders (64.5%) preoperatively, including 36 of the 46 shoulders with fibrosis and 13 of the other 30 shoulders.

Both articular- and bursal-sided PTRCTs showed significant functional improvements after surgery. The articular-sided tears had a lower incidence of an acromial spur, but had a higher incidence of fibrosis in the rotator interval, which led to a limitation in glenohumeral motion.
Both articular- and bursal-sided PTRCTs showed significant functional improvements after surgery. The articular-sided tears had a lower incidence of an acromial spur, but had a higher incidence of fibrosis in the rotator interval, which led to a limitation in glenohumeral motion.
A prerequisite for a satisfying functional result in the treatment of an irreparable rotator cuff rupture is a significant reduction of shoulder pain and better range of motion with an increase in anatomic glenohumeral joint stability.

Prospective study to examine the outcome after superior capsular reconstruction using a porcine extracellular matrix dermal graft. A special emphasis was primarily on the functional outcome, secondarily on radiographic shoulder changes, that superior capsular reconstruction might yield.

Clinical results were evaluated using the Constant score and Western Ontario Rotator Cuff (WORC) index over a 2-year period. All patients had magnetic resonance imaging (MRI) of the injured shoulder after 1 year. Graft integration and durability were qualitatively estimated as well as any graft deterioration or resorption.

Thirteen patients with 13 superior capsular reconstructions were included over a 3-year period. Mean age was 61 years (range 50-70) at the time of surgery. At final fot significant cuff tear arthropathy. The hypothesis that superior capsular reconstruction can be a relevant treatment method for irreparable rotator cuff tears could not be refuted despite a fairly low patient inclusion number. With these results, selected patients can be considered for a different treatment than reverse shoulder arthroplasty, débridement, or tendon transfer.
To study the effect of the coracohumeral interval and orientation of the glenoid for causation of subscapularis tears and literature review for the need of coracoplasty.

This is a retrospective cohort study of patients who underwent arthroscopic shoulder surgery from January 2013 to December 2017. The coracohumeral interval and orientation of the glenoid in patients with arthroscopically diagnosed subscapularis tears (group A, n = 40) were compared with 2 control groups (group B, n = 38 [intact subscapularis with supraspinatus and infraspinatus cuff tears] and group C, n = 39 [intact rotator cuff]). Group A1(n = 23) consisted of the isolated subscapularis and combined subscapularis+ supraspinatus tears, and group A2(n = 17) all the 3 rotator cuff tears. The measurements were made on preoperative axial magnetic resonance imaging. Statistical analysis was performed to compare the groups.

The mean coracohumeral interval was 8.81 ±2.69 mm in group A and 10.62 ±2.21 and 10.39 ±2.59 mm in control groups B and C, respectively; this difference was statistically significant (
= .002 and .01, respectively). The mean glenoid version in patients with subscapularis tears was-3.7°, whereas the mean version in patients with intact cuff was-3.4°, and this difference was not statistically significant (
= .74). The mean glenoid version was-4.69° ±4.22° in group A1 and -3.28° ±4.04° in group B, with no statistically significant difference (
= .07).

The coracohumeral interval was significantly decreased in patients with subscapularis tears. The glenoid was retroverted in the subscapularis group but was not statistically significant.
The coracohumeral interval was significantly decreased in patients with subscapularis tears. The glenoid was retroverted in the subscapularis group but was not statistically significant.
The effect of the acromion index (AI) and critical shoulder angle (CSA) on the short-term healing rate after arthroscopic repair of the supraspinatus tendons is already known. Long-term effects have not been published yet.

Long-term evaluation of the effect of the AI and CSA on the postoperative healing rate and clinical results after arthroscopic repair of the supraspinatus tendon.

Patients with a symptomatic, single-tendon, full-thickness supraspinatus tear in whom nonoperative management had failed were treated with an arthroscopic repair. Preoperative radiographs were used to measure CSA and AI. Eight years postoperatively, magnetic resonance imaging (MRI) studies were performed and evaluated on repair integrity. Patient-reported outcome measurements were collected pre- and postoperatively.

Thirty-one patients were evaluated 8 years postoperatively. The mean age at the time of surgery was 61 ± 9 years. MRI evaluation showed that 20 patients (65%) had an intact repair and 11 (35%) had a full-thicknsignificant. A higher AI significantly increased the retear risk. A higher CSA and AI did not impair the clinical results over time. An AI ≥0.75 was associated with a 6-fold increase in risk of retear after arthroscopic supraspinatus tendon repair.
At long-term follow-up, a higher CSA has the tendency to have an increased rate of retear after arthroscopic supraspinatus tendon repair, but this was not significant. A higher AI significantly increased the retear risk. A higher CSA and AI did not impair the clinical results over time. An AI ≥0.75 was associated with a 6-fold increase in risk of retear after arthroscopic supraspinatus tendon repair.
Superior labrum lesion from anterior to posterior (SLAP) often presents together with other shoulder pathologies such as rotator cuff tear (RCT), but it is uncertain if repairing both SLAP and RCT has superior clinical outcomes over isolated repairs of SLAP and RCT.

This was a retrospective cohort study with prospectively collected data, reviewing 157 patients who underwent arthroscopic repair of either RCT, SLAP (type II lesion), or both. Before surgery and after 6 weeks, 12 weeks, and 24 weeks, shoulder objective range of motion and strength were measured, patient-reported function and pain was assessed by the modified L'Insalata questionnaire with a Likert scale, and complications after each repair were examined.

At 24 weeks after surgery, the combined group (n= 22) and SLAP group (n= 47) had significantly higher forward flexion (165° ± 4° and 167° ± 4° vs. 154° ± 3°,
= .01 and
= .01), external rotation strength (82 ± 6 N, 81 ± 6 N vs. 61 ± 3 N,
= .01 and
= .01), and abduction strength (94 ± 14 N, 78 ± 8 N vs. 53 ± 3 N,
= .001 and
= .02) compared with the rotator cuff tear repair (RCR) group (n=88). selleck kinase inhibitor The combined group also had stronger internal rotation than the RCR group (107 ± 12 N vs. 72 ± 4 N,
= .02). Function and pain improved from "severe-moderate" to "moderate-mild" in all groups after surgery.

Repairing RCT and SLAP tears together results in significant clinical benefits compared to repairing just RCT and analogous results against SLAP-only repair.
Repairing RCT and SLAP tears together results in significant clinical benefits compared to repairing just RCT and analogous results against SLAP-only repair.
Proper anatomic tuberosity reduction and restoration of humeral height during surgical treatment of proximal humerus fractures leads to fewer complications and better outcomes. In the presence of significant displacement and comminution in proximal humerus fractures, the assessment of the correct tuberosity position and humeral height can be challenging. The goal of this cadaveric study was to provide new and useful measurements for intraoperative guidance of proper tuberosity position and humeral height when treating proximal humerus fractures with open reduction internal fixation, anatomic hemiarthroplasty, or reverse total shoulder arthroplasty.

A total of 28 cadaveric shoulders were dissected with a deltopectoral approach. The distance between the insertion of the supraspinatus tendon and the superior aspect of the deltoid tendon was measured (cuff to deltoid distance [CDD]). Secondly, the distance between the superior aspects of the pectoralis major tendon to the medial aspect of the anatomic neck (Pres to aid in tuberosity reduction and humeral height assessment. These measurements were found to be independent of patient height and gender and can be used as a reference tool for most patients.
Among many advances in the treatment of rotator cuff tears, arthroscopic augmentation techniques with patches of various biological and synthetic graft materials have been introduced to reinforce the repair. However, structural and functional outcomes after patch augmentation vary, and reinforcing the tendon healing remains a challenge. The aim of this study was to evaluate clinical and radiologic outcomes 1 year after arthroscopic posterosuperior (PS) rotator cuff repair with bioabsorbable patch augmentation.

From October 2014 to December 2017, all patients with PS rotator cuff tears undergoing arthroscopic repair with patch augmentation using a resorbable, biologically derived poly-4-hydroxybutyrate patch (Biofiber; Wright, Memphis, TN, USA) were enrolled in this study. Only full-thickness PS lesions with ≥1 of the following tear patterns were augmented with a patch and were the subject of this study large U- and L-shaped tear, transtendinous tear, delamination, and fraying of the bursal layer. Patientshes. Good to excellent structural and functional outcomes were observed with a low retear rate (6.7%) and good tendon integrity on 1-year postoperative MRI, and the graft did not cause any complications. The use of bioabsorbable patches could be beneficial when unfavorable PS tear patterns are encountered in which a stable repair of the full tendon thickness at its insertion is otherwise difficult to reach.
This small-sized case series is the first to prospectively assess clinical and radiologic outcomes after patch augmentation of PS rotator cuff tears using bioabsorbable poly-4-hydroxybutyrate patches. Good to excellent structural and functional outcomes were observed with a low retear rate (6.7%) and good tendon integrity on 1-year postoperative MRI, and the graft did not cause any complications. The use of bioabsorbable patches could be beneficial when unfavorable PS tear patterns are encountered in which a stable repair of the full tendon thickness at its insertion is otherwise difficult to reach.
As per some cadaveric studies, blood flow in posterosuperior rotator cuff tendons improves in the abducted shoulder position compared with the neutral position. In a clinical post-rotator cuff repair scenario, the impact of abduction on altered blood flow in and around the posterosuperior rotator cuff tendons is unknown in terms of clinical outcomes and structural healing.

This study included 42 eligible patients aged between 40 and 70 years with clinically diagnosed and radiologically confirmed rotator cuff tears undergoing arthroscopic rotator cuff repair. Patients were randomly allocated to undergo application of either an abduction brace (group 1) or an arm pouch (group 2). On postoperative day 1, power Doppler scanning was performed on the index shoulder in adduction and 30° of abduction in each patient; the allocated treatment (abduction brace or arm pouch) was then applied. Power Doppler scanning was repeated at 6 weeks in the immobilization position assigned to the patient (abduction or adduction).
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