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Hwang DW, Yoo DH, Bae IS, Youn JH, Yoon KY, Jang WS, Lee YJ, Park JH, Cho HW, Kim SD, Lee YJ, Yang C, Han CH, Kim D, Park KS, Ha IH. Effectiveness of motion style acupuncture treatment for patients with shoulder disorders: A prospective observational study. Explore (NY) 2023; 19:832-841. [PMID: 37353458 DOI: 10.1016/j.explore.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 04/09/2023] [Accepted: 04/26/2023] [Indexed: 06/25/2023]
Abstract
CONTEXT Shoulder disorders impair the ability to work. In most cases, the primary symptoms caused by shoulder disorders consist of pain and limitations in the range of motion. OBJECTIVES This study aimed to investigate the efficacy of motion style acupuncture treatment (MSAT), a conservative treatment modality for shoulder disorders. DESIGN prospective observational study SETTING: A Korean Medicine hospital PATIENTS: Eighty outpatients with shoulder disorders INTERVENTION: Either MSAT with integrative Korean medicine treatment (MSAT group; n = 40) or integrative Korean medicine treatment only (control group; n = 40). OUTCOME MEASURES The primary outcome was the shoulder range of motion (ROM), and the secondary outcomes were the numeric rating scale (NRS), visual analog scale (VAS), shoulder pain and disability index (SPADI), and 5-level EuroQol 5-dimension (EQ-5D-5L) scores. RESULTS At the primary endpoint (2 weeks from the start of the treatment), the MSAT group showed statistically significantly larger ROM for all motions, except adduction ROM, compared to the control group [Flexion ROM (165.10±4.14 vs. 150.49±4.06; P<0.001), extension ROM (43.24±1.55 vs. 40.56±1.51; P<0.05), abduction ROM (160.92±5.68 vs. 134.95±5.54; P<0.001), internal rotation ROM (73.38±2.96 vs. 65.00±2.89; P<0.001), and external rotation ROM (73.78±3.61 vs. 65.88±3.50; P<0.01)]. Additionally, the MSAT group showed significantly lower NRS, SPADI scores at week 2 than the control group; this trend was maintained until the 3-month follow-up.
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Affiliation(s)
- Dong Wook Hwang
- Haeundae Jaseng Hospital of Korean Medicine, Busan, Republic of Korea
| | - Dong Hwi Yoo
- Haeundae Jaseng Hospital of Korean Medicine, Busan, Republic of Korea
| | - In-Su Bae
- Haeundae Jaseng Hospital of Korean Medicine, Busan, Republic of Korea
| | - Jun-Heum Youn
- Haeundae Jaseng Hospital of Korean Medicine, Busan, Republic of Korea
| | - Kyung-Young Yoon
- Haeundae Jaseng Hospital of Korean Medicine, Busan, Republic of Korea
| | - Won-Suk Jang
- Haeundae Jaseng Hospital of Korean Medicine, Busan, Republic of Korea
| | - Yu-Jin Lee
- Haeundae Jaseng Hospital of Korean Medicine, Busan, Republic of Korea
| | - Ju Hun Park
- Haeundae Jaseng Hospital of Korean Medicine, Busan, Republic of Korea
| | - Hyun Woo Cho
- Haeundae Jaseng Hospital of Korean Medicine, Busan, Republic of Korea
| | - Sang Don Kim
- Haeundae Jaseng Hospital of Korean Medicine, Busan, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Changsop Yang
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Chang-Hyun Han
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea; Korean Convergence Medical Science, University of Science & Technology (UST), School of Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Doori Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea
| | - Kyoung Sun Park
- Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea.
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea.
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Vocelle AR, Weidig G, Bush TR. Shoulder structure and function: The impact of osteoarthritis and rehabilitation strategies. J Hand Ther 2022; 35:377-387. [PMID: 35918274 DOI: 10.1016/j.jht.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 05/31/2022] [Accepted: 06/20/2022] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Invited review. BACKGROUND Shoulder osteoarthritis can result in significant functional deficits. To improve diagnosis and treatment, we must better understand the impact of osteoarthritis on shoulder biomechanics and the known mechanical benefits of currently available treatments. PURPOSE The purpose of this paper is to present up-to-date data on the effects of osteoarthritis and rehabilitation on the biomechanical parameters contributing to shoulder function. With this goal, we also reviewed the anatomy and the ranges of motion of the shoulder. METHODS A search of electronic databases was conducted. All study designs were included to inform this qualitative, narrative literature review. RESULTS This review describes the biomechanics of the shoulder, the impact of osteoarthritis on shoulder function, and the treatment of shoulder osteoarthritis with an emphasis on rehabilitation. CONCLUSIONS The shoulder is important for the completion of activities of daily living, and osteoarthritis of the shoulder can significantly reduce shoulder motion and arm function. Although shoulder rehabilitation is an integral treatment modality to improve pain and function in shoulder osteoarthritis, few high-quality studies have investigated the effects and benefits of shoulder physical and occupational therapies. To advance the fields of therapy and rehabilitation, future studies investigating the effects of therapy intensity, therapy duration, and the relative benefits of therapy subtypes on shoulder biomechanics and function are necessary.
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Affiliation(s)
- Amber R Vocelle
- Physical Medicine and Rehabilitation Department, E.W. Sparrow Hospital, Lansing, MI, USA; Physical Medicine and Rehabilitation Department, Michigan State University, East Lansing, MI, USA
| | - Garrett Weidig
- Mechanical Engineering Department, Michigan State University, East Lansing, MI, USA
| | - Tamara R Bush
- Mechanical Engineering Department, Michigan State University, East Lansing, MI, USA.
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Park I, Lee HJ, Kim SK, Park MS, Kim YS. Factors Related to Preoperative Shoulder Pain in Patients with Atraumatic Painful Rotator Cuff Tears. Clin Shoulder Elb 2019; 22:128-134. [PMID: 33330208 PMCID: PMC7714281 DOI: 10.5397/cise.2019.22.3.128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 01/08/2023] Open
Abstract
Background Patients with rotator cuff tears are usually afflicted with shoulder pain and disability. However, it is unclear which factors are related to shoulder pain in patients with rotator cuff tears. This study was therefore undertaken to determine the factors correlated with shoulder pain in patients with painful rotator cuff tears, but without any history of trauma. Methods We evaluated a cohort of 745 patients with painful rotator cuff tears having no trauma history, and analyzed the relationship between pain and multiple factors including demographic data, tear characteristics, and passive range of motion. Pain was analyzed with a questionnaire concerning the visual analogue scale (VAS) for pain. Tear characteristics were determined by evaluating tear size, muscle atrophy, number of torn tendons, and presence of arthritis. Multivariate linear regression analysis and chi-squared test were applied to evaluate the relationship between the VAS for pain and variable factors. Results Shoulder pain was associated with young age (p=0.01), male sex (p=0.01) and the presence of diabetes mellitus (p<0.001). Measurements of rotator cuff tear characteristics including tear size (p=0.53), muscle atrophy (p=0.16) and the number of torn tendons (p=0.34) did not correlate with shoulder pain. Symptom duration (p=0.60) and range of motion (p>0.05) also showed no correlation with VAS for pain. Conclusions Young age, male sex and the presence of diabetes mellitus correlated positively with preoperative shoulder pain in patients with painful rotator cuff tears without a trauma history. Combined treatment of pain management and risk factor correction could be helpful to control preoperative shoulder pain.
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Affiliation(s)
- In Park
- Department of Orthopedic Surgery, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hyo-Jin Lee
- Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang-Ki Kim
- Yonsei Hangmac Surgical Clinic, Goyang, Korea
| | - Min-Sik Park
- Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yang-Soo Kim
- Department of Orthopedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Yoo JC, Koh KH, Shon MS, Bae KH, Lim TK. Clinical Outcome after Arthroscopic Capsular Release for Adhesive Capsulitis of the Shoulder. Clin Shoulder Elb 2018; 21:127-133. [PMID: 33330165 PMCID: PMC7726396 DOI: 10.5397/cise.2018.21.3.127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 07/10/2018] [Accepted: 07/13/2018] [Indexed: 11/25/2022] Open
Abstract
Background This study was undertaken to evaluate the outcome of the arthroscopic capsular release for adhesive capsulitis of the shoulder. Methods This study retrospectively investigated thirty shoulders in 29 patients who presented with recalcitrant adhesive capsulitis and underwent arthroscopic treatments. Other than typical findings of adhesive capsulitis, combined pathologies in the glenohumeral joint and subacromial space were evaluated by arthroscopy. Clinical evaluations were performed using the Constant’s score and ranges of motion (ROM) at preoperative, 6 months postoperatively and at the final follow-up. Results Our study included 17 women and 12 men with a mean age of 53.8 years (range, 34–74). Mean follow-up duration was 24 months (range, 12–40 months). Assessment of combined pathologies revealed that partial rotator cuff tear of less than 25% thickness, was most common (overall 83.3%; with bursal 57% and articular 23%). Subacromial synovitis and adhesion were also frequent (53.3%). The Constant score and ranges of motion significantly improved at the final follow-up, compared with preoperative levels. However, clinical results at 6 months postoperatively were found to be significantly inferior to those observed at the final follow-up (p≤0.001 for all factors). Functional impairment was the major complaint in 59.3% patients at the 6 months follow-up. Conclusions Although arthroscopic capsular release yielded favorable outcome at the mean 24 months follow-up, pain and motion limitations at 6-month postoperatively persisted in more than 50% of our patients. While combined pathologies were commonly encountered during arthroscopy, although their effects on surgical outcome in adhesive capsulitis remains unclear in this study.
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Affiliation(s)
- Jae Chul Yoo
- Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyoung Hwan Koh
- Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Soo Shon
- Department of Orthopaedic Surgery, National Medical Center, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Kyu Hwan Bae
- Department of Orthopaedic Surgery, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Tae Kang Lim
- Department of Orthopaedic Surgery, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea
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Mazzocca AD, Arciero RA, Shea KP, Apostolakos JM, Solovyova O, Gomlinski G, Wojcik KE, Tafuto V, Stock H, Cote MP. The Effect of Early Range of Motion on Quality of Life, Clinical Outcome, and Repair Integrity After Arthroscopic Rotator Cuff Repair. Arthroscopy 2017; 33:1138-1148. [PMID: 28111006 DOI: 10.1016/j.arthro.2016.10.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 10/04/2016] [Accepted: 10/20/2016] [Indexed: 02/06/2023]
Abstract
PURPOSE To compare the effect of early versus delayed motion protocols on quality of life, clinical outcomes, and repair integrity in patients who have undergone arthroscopic single-tendon rotator cuff repair. METHODS This was a prospective, randomized, investigator-blinded clinical trial. Seventy-three patients from a single surgeon's practice who underwent arthroscopic repair of a single-tendon rotator cuff tear were randomized to either an early motion protocol (starting 2 to 3 days after surgery) or a delayed motion protocol (starting 28 days after surgery). The primary outcome measure was the Western Ontario Rotator Cuff index (WORC). Secondary outcome measures included clinical outcome scores, integrity of the repair on 6-month magnetic resonance imaging scans, pain scores, physical examination data, and ultrasonography. Study participants were followed up at 3, 6, and 12 weeks; 6 months; and 1 year postoperatively. RESULTS There was no statistically significant difference in WORC scores at 6 months (529 ± 472 in delayed group vs 325 ± 400 in early group, P = .08). Mixed-effects analysis indicated the early group maintained lower WORC scores throughout the postoperative period (estimated difference of 191, P = .04). The proportions of patients with tears on the 6-month postoperative magnetic resonance imaging scan were comparable (31% in delayed group vs 34% in early group, P = .78). CONCLUSIONS There was no difference between the delayed and early motion groups in WORC scores at 6 months after surgery. Early motion was associated with lower WORC scores throughout the postoperative period; however, both groups had a similar trajectory of improvement, suggesting both protocols have the same effect on patient-reported improvement. Although failure rates were similar between the groups, the sample size was not sufficient to support a statement regarding the relation between tear morphology and the rehabilitation protocol. LEVEL OF EVIDENCE Level II, lesser-quality randomized controlled trial.
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Affiliation(s)
| | - Robert A Arciero
- University of Connecticut Health Center, Farmington, Connecticut, U.S.A
| | - Kevin P Shea
- University of Connecticut Health Center, Farmington, Connecticut, U.S.A
| | | | - Olga Solovyova
- University of Connecticut Health Center, Farmington, Connecticut, U.S.A
| | - Gregg Gomlinski
- University of Connecticut Health Center, Farmington, Connecticut, U.S.A
| | - Karen E Wojcik
- University of Connecticut Health Center, Farmington, Connecticut, U.S.A
| | - Vincent Tafuto
- University of Connecticut Health Center, Farmington, Connecticut, U.S.A
| | - Harlan Stock
- University of Connecticut Health Center, Farmington, Connecticut, U.S.A
| | - Mark P Cote
- University of Connecticut Health Center, Farmington, Connecticut, U.S.A..
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McNamara WJ, Lam PH, Murrell GAC. The Relationship Between Shoulder Stiffness and Rotator Cuff Healing: A Study of 1,533 Consecutive Arthroscopic Rotator Cuff Repairs. J Bone Joint Surg Am 2016; 98:1879-1889. [PMID: 27852904 DOI: 10.2106/jbjs.15.00923] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Retear and stiffness are not uncommon outcomes of rotator cuff repair. The purpose of this study was to evaluate the relationship between rotator cuff repair healing and shoulder stiffness. METHODS A total of 1,533 consecutive shoulders had an arthroscopic rotator cuff repair by a single surgeon. Patients assessed their shoulder stiffness using a Likert scale preoperatively and at 1, 6, 12, and 24 weeks (6 months) postoperatively, and examiners evaluated passive range of motion preoperatively and at 6, 12, and 24 weeks postoperatively. Repair integrity was determined by ultrasound evaluation at 6 months. RESULTS After rotator cuff repair, there was an overall significant loss of patient-ranked and examiner-assessed shoulder motion at 6 weeks compared with preoperative measurements (p < 0.0001), a partial recovery at 12 weeks, and a full recovery at 24 weeks. Shoulders that were stiff before surgery were more likely to be stiff at 6, 12, and, to a lesser extent, 24 weeks after surgery (r = 0.10 to 0.31; p < 0.0001). A stiffer shoulder at 6 and 12 weeks (but not 24 weeks) postoperatively correlated with better rotator cuff integrity at 6 months postoperatively (r = 0.11 to 0.18; p < 0.001). The retear rate of patients with ≤20° of external rotation at 6 weeks postoperatively was 7%, while the retear rate of patients with >20° of external rotation at 6 weeks was 15% (p < 0.001). CONCLUSIONS In patients who developed stiffness after surgery, a rotator cuff repair was more likely to heal. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- William J McNamara
- Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, New South Wales, Australia
| | - Patrick H Lam
- Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, New South Wales, Australia
| | - George A C Murrell
- Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, New South Wales, Australia
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Bokshan SL, DePasse JM, Eltorai AEM, Paxton ES, Green A, Daniels AH. An Evidence-Based Approach to Differentiating the Cause of Shoulder and Cervical Spine Pain. Am J Med 2016; 129:913-8. [PMID: 27155111 DOI: 10.1016/j.amjmed.2016.04.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 04/09/2016] [Accepted: 04/11/2016] [Indexed: 10/21/2022]
Abstract
Differentiating the cause of pain and dysfunction due to cervical spine and shoulder pathology presents a difficult clinical challenge in many patients. Furthermore, the anatomic region reported to be painful may mislead the practitioner. Successfully treating these patients requires a careful and complete history and physical examination with appropriate provocative maneuvers. An evidence-based selection of clinical testing also is essential and should be tailored to the most likely underlying cause. When advanced imaging does not reveal a conclusive source of pathology, electromyography and selective injections have been shown to be useful adjuncts, although the sensitivity, specificity, and risk-reward ratio of each test must be considered. This review provides an evidence-based review of common causes of shoulder and neck pain and guidelines for assistance in determining the pain generator in ambiguous cases.
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Affiliation(s)
- Steven L Bokshan
- Department of Orthopedics, Warren Alpert Medical School of Brown University, Providence, RI
| | - J Mason DePasse
- Department of Orthopedics, Warren Alpert Medical School of Brown University, Providence, RI
| | - Adam E M Eltorai
- Department of Orthopedics, Division of Spine Surgery, Warren Alpert Medical School of Brown University, Providence, RI
| | - E Scott Paxton
- Department of Orthopedics, Division of Shoulder and Elbow Surgery, Warren Alpert Medical School of Brown University, Providence, RI
| | - Andrew Green
- Department of Orthopedics, Division of Shoulder and Elbow Surgery, Warren Alpert Medical School of Brown University, Providence, RI
| | - Alan H Daniels
- Department of Orthopedics, Division of Spine Surgery, Warren Alpert Medical School of Brown University, Providence, RI.
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Alterations in central motor representation increase over time in individuals with rotator cuff tendinopathy. Clin Neurophysiol 2014; 126:365-71. [PMID: 25043198 DOI: 10.1016/j.clinph.2014.05.035] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 05/22/2014] [Accepted: 05/26/2014] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate whether rotator cuff tendinopathy leads to changes in central motor representation of a rotator cuff muscle, and to assess whether such changes are related to pain intensity, pain duration, and physical disability. METHODS Using transcranial magnetic stimulation, motor representation of infraspinatus muscle was assessed bilaterally in patients with unilateral rotator cuff tendinopathy. RESULTS Active motor threshold is significantly larger for the affected shoulder comparatively to the unaffected shoulder (n=39, p=0.01), indicating decreased corticospinal excitability on the affected side compared to unaffected side. Further, results suggest that this asymmetry in corticospinal excitability is associated with duration of pain (n=39; r=0.45; p=0.005), but not with pain intensity (n=39; r<0.03; p>0.43). In contrast with findings in other populations with musculoskeletal pain, no significant inter-hemispheric asymmetry was observed in map location (n=16; p-values ⩾ 0.91), or in the amplitude of motor responses obtained at various stimulation intensities (n=16; p=0.83). CONCLUSION Chronicity of pain, but not its intensity, appears to be a factor related to lower excitability of infraspinatus representation. SIGNIFICANCE These results support the view that while cortical reorganization correlates with magnitude of pain in neuropathic pain syndromes, it could be more related to chronicity in the case of musculoskeletal disorders.
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Functional results and patient satisfaction after arthroscopic capsular release of idiopathic and post-traumatic stiff shoulder. INTERNATIONAL ORTHOPAEDICS 2014; 38:1205-11. [PMID: 24469306 DOI: 10.1007/s00264-014-2283-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 01/10/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The purpose of this prospective study was to compare the functional results and patient satisfaction after arthroscopic shoulder capsular release in patients with idiopathic and posttraumatic stiff shoulder. METHODS The study included 50 patients who underwent arthroscopic capsular release after failure of conservative treatment. The etiology of stiffness was either idiopathic (25 patients) or post-traumatic (25 patients). There were 28 women and 22 men with an average age of 49 years (range, 32-70 years). All patients were treated with physical therapy for a mean of six months (range, 3-12 months) before surgery. Range of motion was measured three times: 48 hours after surgery, then one month and six months after surgery. RESULTS Constant score showed improvement for both groups of patients in the period of six months after surgery. In the group with idiopathic stiffness the score increased from 36 to 86, while in the group with post-traumatic stiff shoulder the score advanced from 32 to 91. The idiopathic stiff shoulder group had an improved active forward flexion from 90 to 161°, external rotation from 10 to 40°, and internal rotation from L5 to L1. In the post-traumatic stiff shoulder groupthe forward flexion was improved from 95 to 170°, external rotation from 13 to 40° and internal rotation from L4 to L1. CONCLUSION There was an improvement of range of motions and patients' satisfaction after arthroscopic shoulder capsular release and manipulation under anesthesia, equally in idiopathic and post-traumatic stiff shoulder, compared to the situation before surgery. Post-traumatic contracture patients expressed higher level of satisfaction with their shoulder function than the idiopathic stiff shoulder patients.
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Comparison of Massage Based on the Tensegrity Principle and Classic Massage in Treating Chronic Shoulder Pain. J Manipulative Physiol Ther 2013; 36:418-27. [DOI: 10.1016/j.jmpt.2013.06.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Revised: 01/14/2012] [Accepted: 01/22/2012] [Indexed: 11/22/2022]
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Thompson SR, LeBel ME. Use of a hip arthroscopy flexible radiofrequency device for capsular release in frozen shoulder. Arthrosc Tech 2012; 1:e75-8. [PMID: 23766980 PMCID: PMC3678626 DOI: 10.1016/j.eats.2012.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 03/08/2012] [Indexed: 02/03/2023] Open
Abstract
Adhesive capsulitis is a common and challenging condition to treat. Arthroscopic capsular release is usually contemplated when conservative treatment fails or when there is severe and/or chronic loss of range of motion. This procedure can be difficult to perform because of difficult access to the joint, poor visualization, and loss of working space from retraction of the joint capsule. The articular surfaces and the axillary nerve are also at higher risk of injury. Arthroscopic scissors, shavers, and electrocautery are typically used to perform the capsular release. To perform a safer and more precise arthroscopic shoulder capsular release, a creative and innovative use of a flexible hip arthroscopy radiofrequency ablator is described.
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Affiliation(s)
| | - Marie-Eve LeBel
- Address correspondence to Marie-Eve LeBel, M.D., F.R.C.S.C., Fowler-Kennedy Sport Medicine Clinic, 3M Centre, University of Western Ontario, London, Ontario N6A 3K7, Canada
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The factors affecting stiffness occurring with rotator cuff tear. J Shoulder Elbow Surg 2012; 21:304-9. [PMID: 21778071 DOI: 10.1016/j.jse.2011.04.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Revised: 04/06/2011] [Accepted: 04/07/2011] [Indexed: 02/01/2023]
Abstract
BACKGROUND Stiffness after a rotator cuff tear is common, and it affects postoperative prognosis. This study aims to define the factors affecting stiffness that accompanies rotator cuff tear. MATERIALS AND METHODS From June 2002 to May 2009 (84 months), 143 patients underwent arthroscopic rotator cuff repair. Of these, 119 were enrolled as subjects in this study. Preoperative range of motion was measured in all patients. Stiffness of the shoulder was defined as restriction of active and passive motion of 100° of elevation or less, less than 50% of external rotation, and internal rotation only to the sacrum. Factors that can affect stiffness were evaluated, including the type, size, and direction of rotator cuff; duration of symptoms; gender; age; presence of accompanying medical disease; degenerative factors (Goutallier classification); and presence of trauma. Retrospective analysis was conducted accordingly. RESULTS A statistically significantly higher degree of stiffness was seen for full-thickness tears than for partial-thickness tears (P = .0187). Between 2 groups that were divided by direction of rotator cuff tear, posterosuperior cuff tears showed a statistically significantly higher prevalence of stiffness (P = .0415). Patients with trauma had a statistically higher prevalence of stiffness (P = .0264). The other factors did not show significant differences. CONCLUSION In patients with rotator cuff tear, the type and direction of rotator cuff tear and the presence of trauma seem to increase the limitation of preoperative joint range of motion.
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Kang JH, Tseng SH, Jaw FS, Lai CH, Chen HC, Chen SC. Comparison of ultrasonographic findings of the rotator cuff between diabetic and nondiabetic patients with chronic shoulder pain: a retrospective study. ULTRASOUND IN MEDICINE & BIOLOGY 2010; 36:1792-1796. [PMID: 20870349 DOI: 10.1016/j.ultrasmedbio.2010.08.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 07/28/2010] [Accepted: 08/11/2010] [Indexed: 05/29/2023]
Abstract
It is still unclear whether diabetic mellitus (DM) is associated with rotator cuff lesions. The object of this retrospective study was to compare the ultrasonographic (US) findings of rotator cuffs in diabetic patients with those of nondiabetic patients with chronic shoulder pain. In total, 419 patients (80 diabetic, 339 nondiabetic) who had chronic shoulder pain and had been referred to receive US examination between January 2005 and January 2008 in a medical center were included in this study. The US findings of rotator cuff lesions were classified into two main categories: rotator cuff tears (RCTs) and calcifying tendinopathy (CT). In total, 114 (25.2%) shoulders with CT of the rotator cuff and 160 (35.3%), 15 (3.3%) and 5 (1.1%) shoulders with supraspinatus, infraspinatus and subscapularis tears, respectively, were noted. No difference in the ratio of tears of RCTs was found on US examinations between two groups. The crude odds ratio (OR) for CT of diabetic patients was 1.85 (p = 0.014); however, the adjusted OR for CT in diabetic patients became insignificant after controlling for the other variables (OR = 1.59, p = 0.08). To our knowledge, this is the first study to explore US findings among diabetic and nondiabetic patients with chronic shoulder pain. Further study is advised to confirm our findings.
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Affiliation(s)
- Jiunn-Horng Kang
- Institute of Biomedical Engineering, College of Engineering, National Taiwan University, Taipei, Taiwan
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Rookmoneea M, Dennis L, Brealey S, Rangan A, White B, McDaid C, Harden M. The effectiveness of interventions in the management of patients with primary frozen shoulder. ACTA ACUST UNITED AC 2010; 92:1267-72. [PMID: 20798446 DOI: 10.1302/0301-620x.92b9.24282] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
There are many types of treatment used to manage the frozen shoulder, but there is no consensus on how best to manage patients with this painful and debilitating condition. We conducted a review of the evidence of the effectiveness of interventions used to manage primary frozen shoulder using the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, the Physiotherapy Evidence Database, MEDLINE and EMBASE without language or date restrictions up to April 2009. Two authors independently applied selection criteria and assessed the quality of systematic reviews using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. Data were synthesised narratively, with emphasis placed on assessing the quality of evidence. In total, 758 titles and abstracts were identified and screened, which resulted in the inclusion of 11 systematic reviews. Although these met most of the AMSTAR quality criteria, there was insufficient evidence to draw firm conclusions about the effectiveness of treatments commonly used to manage a frozen shoulder. This was mostly due to poor methodological quality and small sample size in primary studies included in the reviews. We found no reviews evaluating surgical interventions. More rigorous randomised trials are needed to evaluate the treatments used for frozen shoulder.
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Affiliation(s)
- M Rookmoneea
- James Cook University Hospital, Marton Road, Middlesbrough, Teeside, UK
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16
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Abstract
Background and Purpose—
No previous study has described the association between stroke and previous adhesive capsulitis (AC). This study aims to investigate the risk of stroke after AC with a population-based database.
Method—
Records for 10 935 with a principal diagnosis of AC and 32 805 randomly selected controls were collected between 2000 and 2003. The log-rank test was performed to analyze the differences in accumulated stroke-free survival rates between the 2 groups. Cox proportional hazard regressions were performed to calculate the longitudinal hazard of stroke.
Results—
During the follow-up period, 575 patients from the study group (5.3%) and 1201 from the comparison group (3.7%) had strokes. The crude hazard ratio for stroke for patients with AC was 1.46-times greater than for controls (95% CI, 1.32–1.62;
P
<0.001), and the adjusted hazard ratio was 1.22 (95% CI, 1.06–1.40;
P
=0.002).
Conclusions—
Our study demonstrates increased prevalence and risk of stroke after AC. Further study is needed to confirm our findings and explore underlying mechanisms.
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Affiliation(s)
- Jiunn-Horng Kang
- From Department of Physical Medicine and Rehabilitation and Neuroscience Research Center (J.-H.K.), Department of Neurology (J.-J.S.), School of Health Care Administration (H.-C.L.), Taipei Medical University Hospital, Taipei, Taiwan
| | - Jau-Jiuan Sheu
- From Department of Physical Medicine and Rehabilitation and Neuroscience Research Center (J.-H.K.), Department of Neurology (J.-J.S.), School of Health Care Administration (H.-C.L.), Taipei Medical University Hospital, Taipei, Taiwan
| | - Herng-Ching Lin
- From Department of Physical Medicine and Rehabilitation and Neuroscience Research Center (J.-H.K.), Department of Neurology (J.-J.S.), School of Health Care Administration (H.-C.L.), Taipei Medical University Hospital, Taipei, Taiwan
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17
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Distal clavicle fracture as a complication of arthroscopic distal clavicle resection. Arthroscopy 2009; 25:929-33. [PMID: 19664514 DOI: 10.1016/j.arthro.2009.02.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2009] [Revised: 02/12/2009] [Accepted: 02/12/2009] [Indexed: 02/02/2023]
Abstract
Arthroscopic resection of the distal clavicle has been advocated as a surgical treatment option for acromioclavicular (AC) joint pathology. To our knowledge, iatrogenic fracture of the distal clavicle during distal clavicle resection has never been reported. This report describes distal clavicle fracture as a complication of misidentification of the AC joint and subsequent aggressive burring of the distal clavicle during shoulder arthroscopy. This case is further complicated by the development of symptomatic delayed union and adhesive capsulitis. Ultimately, a revision distal clavicle resection was performed, underscoring the fact that special care must be taken to properly identify the AC joint and rule out pre-existing distal clavicle stress fracture or osteolysis before performing the arthroscopic Mumford procedure.
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18
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Extra! Extra! Read all about it: the features-shoulder stiffness, humerus greater tuberosity fractures, and hip arthroscopy. Arthroscopy 2008; 24:857-8. [PMID: 18657732 DOI: 10.1016/j.arthro.2008.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2008] [Accepted: 06/10/2008] [Indexed: 02/02/2023]
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