Decreased Synovial Fluid Biomarkers Levels Are Associated with Rehabilitation of Function and Pain in Rotator Cuff Tear Patients Following Electroacupuncture Therapy

High-energy injuries, combined ligamentous injuries, and joint incongruity as predictors of postoperative shoulder dysfunction in AC joint dislocation surgery

OBJECTIVE

To identify risk factors associated with postoperative shoulder joint dysfunction in patients who underwent surgical intervention for acromioclavicular (AC) joint dislocation, with the aim of enhancing preoperative counselling, surgical planning, and postoperative management to optimize functional outcomes.

METHODS

Patients who underwent surgery for AC joint dislocation between January 2018 and January 2023 at a hospital orthopaedic centre were enrolled into this retrospective study. Inclusion criteria were patients aged ≥18 years with a documented AC joint dislocation who underwent surgical treatment and had a minimum follow-up period >1 year. Patients with pre-existing shoulder conditions, prior shoulder surgeries, or incomplete medical records were excluded. Visual Analog Scale pain score ≥5 and Constant-Murley Score ≤70 was considered indicative of shoulder joint dysfunction. Statistical analyses included univariate and multivariate logistic regression to identify independent risk factors for postoperative shoulder joint dysfunction.

RESULTS

Among 208 included patients, 56 (27%) exhibited shoulder joint dysfunction at the final follow-up. High-energy injury mechanisms, combined coracoclavicular ligament injuries, and lack of coronal plane congruity were identified as significant predictors of postoperative dysfunction. Specifically, high-energy injuries (odds ratio [OR] 5.493, 95% confidence interval [CI] 2.068, 14.590), combined coracoclavicular ligament injuries (OR 0.118, 95% CI 0.032, 0.432), and lack of coronal plane congruity (OR 2.540, 95% CI 1.197, 5.387) were associated with an increased risk of poor shoulder function postoperatively. Other factors, such as age, injury mechanism, and postoperative exercise compliance also contributed to the outcomes. Level of evidence: iv.

CONCLUSIONS

Injury mechanism, ligamentous injuries, and joint congruity are important in determining postoperative shoulder function. Accurate joint reduction and diligent postoperative rehabilitation are crucial for optimal recovery. These findings provide valuable insights for improving patient care and surgical outcomes in AC joint dislocation treatment. Further research is needed to validate these findings and explore additional factors that may influence postoperative shoulder function.

Effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries

BACKGROUND

The rotator cuff is located below the acromion and deltoid muscles and comprises multiple tendons that wrap around the humeral head, maintaining shoulder joint stability.

AIM

To explore the effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries.

METHODS

We selected 97 patients with rotator cuff injuries treated in the People's Hospital of Yuhuan from February 2020 to May 2023. Patients were grouped using the envelope method.

RESULTS

After treatment, the study group's treatment effective rate was 94.90% (46/49 patients), significantly higher than that in the control group (79.17%, 38/48 cases; P < 0.05). Before treatment, there was no difference in Constant Murley Score (CMS) scores, shoulder mobility, or 36-Item Short Form Health Survey (SF-36) scale scores (P > 0.05). Compared with those before treatment, the CMS scores (including pain, daily living ability, shoulder mobility, and muscle strength), all aspects of shoulder mobility (forward flexion, posterior extension, external rotation, internal rotation), and SF-36 scale scores (including physiological, psychological, emotional, physical, vitality, and health status) were higher in both groups after treatment and significantly higher in the study group (P < 0.05). There was no difference in the occurrence of complications between the two treatment groups (P > 0.05).

CONCLUSION

Electroacupuncture combined with rehabilitation techniques has a good treatment effect on patients with rotator cuff injuries, helps accelerate the recovery of shoulder function, improves the quality of life, and is highly safe.

Guidelines for the Diagnosis and Treatment of Rotator Cuff Tear with Integrated Traditional Chinese and Western Medicine

Rotator cuff tear is a common injury among middle-aged and elderly people, and it has a great impact on patients' physical and mental health and quality of life. Integrative medicine based on Traditional Chinese Medicine (TCM) has certain advantages in the diagnosis and treatment of rotator cuff tears. TCM, which mainly involves the use of plant-based products, has relatively stable and reliable curative effects. It is of great significance to formulate a combined diagnosis and treatment plan for rotator cuff tear based on evidence-based medicine, which can help to standardize the clinical diagnosis and treatment techniques of TCM and Western medicine and achieve better therapeutic effects. This guideline standardizes the diagnosis and treatment process of rotator cuff tear from the aspects of range, terminology and definition, diagnosis, TCM syndrome differentiation, treatment, functional exercise, and prevention and care. It makes recommendations that cover the adoption of manual therapy, acupuncture, and other integrative medicine based on TCM. Users of these guidelines are most likely to include clinicians and health managers in healthcare settings.

The major pain source of rotator cuff-related shoulder pain: A narrative review on current evidence

BACKGROUND

Rotator cuff-related shoulder pain (RCRSP) was proposed to have a complex pain mechanism, but the exact aetiology is still unclear. A recent review summarised the updated research to analyse the traditional concept of shoulder impingement which may not be accurate. Current studies have demonstrated that mechanical factors including a reduction in subacromial space, scapular dyskinesia and different acromial shapes are unlikely directly contributing to RCRSP.

AIMS

Since the precise RCRSP pain mechanism remains unclear, the aim of this narrative review is to discuss possible sources of pain contributing to RCRSP according to the mechanisms-based pain classifications.

RESULTS AND DISCUSSION

Research findings on potential mechanical nociceptive factors of RCRSP are conflicting; investigations of neuropathic and central pain mechanisms of RCRSP are limited and inconclusive. Overall, available evidence has indicated moderate to strong correlations between RCRSP and chemical nociceptive sources of pain.

CONCLUSION

Results from current research may provide new directions for future studies on the aetiology of RCRSP and its clinical management towards a biochemical view instead of the traditional mechanical hypothesis.

Evidence-Based Complementary and Alternative Orthopedic Veterinary Medicine

The use of complementary and alternative veterinary medicine (CAVM) continues to become more widespread, especially for the management of chronic pain conditions such as canine osteoarthritis. Many patients have comorbidities that preclude traditional medical options, have not adequately responded to conventional therapies, or have owners interested in pursuing a complementary approach. Evidence-based CAVM can serve as a safe and effective adjunct to manage chronic pain conditions. There is growing evidence in the veterinary literature for the use of acupuncture and some herbal supplements in the multimodal management of canine osteoarthritis. The majority of evidence supporting chiropractic is limited to equine and human literature.