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Nazzal EM, Mattar LT, Winkler PW, Popchak AJ, Irrgang JJ, Lin A, Musahl V, Debski RE. Scapular morphology does not predict supraspinatus tendon tear propagation following an individualised exercise therapy programme. J Exp Orthop 2024; 11:e12072. [PMID: 38966184 PMCID: PMC11222707 DOI: 10.1002/jeo2.12072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 07/06/2024] Open
Abstract
Purpose To determine whether scapular morphology could predict isolated supraspinatus tendon tear propagation after exercise therapy. We hypothesised that a larger critical shoulder angle (CSA) and type III acromial morphology predict a positive change in tear size. Methods Fifty-nine individuals aged 40-70 years with isolated symptomatic high-grade partial or full-thickness supraspinatus tendon tears were included. Individuals participated in a structured, individualised 12-week exercise therapy programme and underwent ultrasound to measure tear size at baseline and 12 months following therapy. Computed tomography images were segmented to create three-dimensional subject-specific bone models and reviewed by three trained clinicians to measure CSA and to determine acromion morphology based on the Bigliani classification. A binary logistic regression was performed to determine the predictive value of CSA and acromion morphology on tear propagation. Results The CSA was 30.0 ± 5.4°. Thirty-one individuals (52.5%) had type II acromial morphology, followed by type III and type I morphologies (25.4% and 22.0%, respectively); 81.4% experienced no change in tear size, four (6.8%) individuals experienced tear propagation and seven (11.9%) individuals had a negative change in tear size. No significant difference in tear propagation rates based on CSA or acromion morphology (not significant [NS]) was observed. The model predicted tear size status in 81.4% of cases but only predicted tear propagation 8.3% of the time. Overall, CSA and acromion morphology only predicted 24.3% (R 2 = 0.243) of variance in tear propagation (NS). Conclusions CSA and acromion morphology were NS predictors of tear propagation of the supraspinatus tendon 12 months following an individualised exercise therapy programme. Level of Evidence II.
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Affiliation(s)
- Ehab M. Nazzal
- Orthopaedic Robotics LaboratoryPittsburghPennsylvaniaUSA
- Department of Orthopaedic SurgeryUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
| | - Luke T. Mattar
- Orthopaedic Robotics LaboratoryPittsburghPennsylvaniaUSA
- Department of Bioengineering, Swanson School of EngineeringUniversity of PittsburghPittsburghPennsylvaniaUSA
| | | | - Adam J. Popchak
- Department of Orthopaedic SurgeryUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
- Department of Physical TherapyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Orthopaedic SurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - James J. Irrgang
- Department of Orthopaedic SurgeryUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
- Department of Physical TherapyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Department of Orthopaedic SurgeryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Albert Lin
- Orthopaedic Robotics LaboratoryPittsburghPennsylvaniaUSA
- Department of Orthopaedic SurgeryUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
| | - Volker Musahl
- Orthopaedic Robotics LaboratoryPittsburghPennsylvaniaUSA
- Department of Orthopaedic SurgeryUniversity of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA
| | - Richard E. Debski
- Orthopaedic Robotics LaboratoryPittsburghPennsylvaniaUSA
- Department of Bioengineering, Swanson School of EngineeringUniversity of PittsburghPittsburghPennsylvaniaUSA
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Chatterji R, Foote J, Fry M, Erwin A, Crutcher J, Kesto W. Simulated subacromial injection instruction improves accuracy and skill level: a model for musculoskeletal procedural training. BMC MEDICAL EDUCATION 2024; 24:535. [PMID: 38745152 PMCID: PMC11094937 DOI: 10.1186/s12909-024-05456-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/22/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Musculoskeletal (MSK) complaints often present initially to primary care physicians; however, physicians may lack appropriate instruction in MSK procedures. Diagnostic and therapeutic injections are useful orthopedic tools, but inaccuracy leads to unnecessary costs and inadequate treatment. The authors hypothesized that trainees afforded the opportunity to practice on a cadaver versus those receiving visual-aided instruction on subacromial injections (SAI) will demonstrate differences in accuracy and technique. METHODS During Spring of the year 2022, 24 Internal Medicine and Family Medicine residents were randomly divided into control and intervention groups to participate in this interventional randomized cadaveric study. Each group received SAI instruction via lecture and video; the intervention group practiced on cadavers under mentored guidance. Subjects underwent a simulated patient encounter culminating in injection of latex dye into a cadaveric shoulder. Participants were evaluated based on a technique rubric, and accuracy of injections was assessed via cadaver dissection. RESULTS Twenty-three of twenty-four participants had performed at least one MSK injection in practice, while only 2 (8.3%) of participants had performed more than 10 SAIs. There was no difference in technique between control 18.4 ± 3.65 and intervention 19.2 ± 2.33 (p = 0.54). Dissections revealed 3 (25.0%) of control versus 8 (66.7%) of intervention injections were within the subacromial space. Chi-Square Analysis revealed that the intervention affected the number of injections that were within the subacromial space, in the tissues bordering the subacromial space, and completely outside the subacromial space and bordering tissues (p = 0.03). The intervention group had higher self-confidence in their injection as opposed to controls (p = 0.04). Previous SAI experience did not affect accuracy (p = 0.76). CONCLUSIONS Although primary care physicians and surgeons develop experience with MSK procedures in practice, this study demonstrates a role for early integrated instruction and simulation to improve accuracy and confidence. The goal of improving accuracy in MSK procedures amongst all primary care physicians may decrease costs and avoid unnecessary referrals, diagnostic tests, and earlier than desired surgical intervention.
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Affiliation(s)
- Rishi Chatterji
- Department of Orthopedic Surgery, Ascension Providence Hospital - MSU, 16001 W. Nine Mile Rd., 4th Floor Fisher Building, Rm. #405, Southfield, MI, 48075, USA.
| | - Jake Foote
- Department of Orthopedic Surgery, Ascension Providence Hospital - MSU, 16001 W. Nine Mile Rd., 4th Floor Fisher Building, Rm. #405, Southfield, MI, 48075, USA
| | - Mike Fry
- Department of Orthopedic Surgery, Ascension Providence Hospital - MSU, 16001 W. Nine Mile Rd., 4th Floor Fisher Building, Rm. #405, Southfield, MI, 48075, USA
| | - Ashley Erwin
- Department of Family Medicine, Ascension Providence Hospital - MSU, 16001 W. Nine Mile Rd., 4th Floor Fisher Building, Rm. #405, Southfield, MI, 48075, USA
| | - Joe Crutcher
- Simulation and Education Center Van Eslander Surgical Innovation Center, Ascension Providence Hospital - MSU, Novi, MI, USA
| | - William Kesto
- Ascension Providence Hospital - MSU, 16001 W. Nine Mile Rd., 4th Floor Fisher Building, Rm. #405, Southfield, MI, 48075, USA
- The Core Institute, Novi, MI, USA
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Kizilay YO, Güneş Z, Turan K, Aktekin CN, Uysal Y, Kezer M, Camurcu Y. Volumetric Analysis of Subacromial Space After Superior Capsular Reconstruction for Irreparable Rotator Cuff Tears. Indian J Orthop 2023; 57:967-974. [PMID: 37214362 PMCID: PMC10192490 DOI: 10.1007/s43465-023-00881-y] [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: 09/09/2021] [Accepted: 03/24/2023] [Indexed: 05/24/2023]
Abstract
Purpose Subacromial volume measurement on magnetic resonance images is relatively new. It has been shown that decreased subacromial volume increases after surgical repair of full-thickness rotator cuff tears. There is no study examining subacromial volume changes after superior capsular reconstruction (SCR). The purpose of this study was to compare subacromial volume changes on magnetic resonance images (MRI) after superior capsular reconstruction performed for primary irreparable rotator cuff tears. Methods Patients who underwent an SCR procedure between 2017 and 2019 with a minimum 2-year postoperative follow-up were included in this retrospective study. Subacromial volume was measured on MRI using software. The preoperative and postoperative acromiohumeral distance, Constant Scores, graft thickness, and Hamada grades of the patients were evaluated. Results A total of 18 patients with a mean age of 59.7 years (range: 49-74 years) underwent an SCR for massive irreparable cuff tear. The mean preoperative subacromial volume was 3.54 ± 0.39 cm3 (range 2.88-4.36 cm3), which increased to 4.46 ± 0.39 cm3 (range 3.75-5.32 cm3) postoperatively (p = < 0.001). The increase in subacromial volume and acromiohumeral distance did not correlate with Constant scores and graft thickness. We observed a significantly higher subacromial volume increase among Hamada grade 1 patients, compared to those with Hamada grade 2 (p = 0.011). Conclusions We observed that subacromial volume significantly increased after superior capsular reconstruction. However, the increase in subacromial volume did not correlate with clinical scores, acromiohumeral distance changes, or graft thickness.Level of evidence: Level III - Retrospective Cohort Study.
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Affiliation(s)
- Yusuf Onur Kizilay
- Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul Atlas University, Anadolu Caddesi 40, Kagithane, 34408 Istanbul, Turkey
| | - Zafer Güneş
- Ankara, Turkey Department of Orthopedics and Traumatology, Ankara Training and Research Hospital
| | - Kayhan Turan
- Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul Atlas University, Istanbul, Turkey
| | - Cem Nuri Aktekin
- Ankara, Turkey Faculty of Medicine, Department of Orthopedics and Traumatology, Ankara Yıldırım Beyazıt University
| | - Yunus Uysal
- Department of Orthopedics and Traumatology, Bursa Osmangazi Aritmi Hospital, Bursa, Turkey
| | - Murat Kezer
- Department of Orthopedics and Traumatology, Bursa Osmangazi Aritmi Hospital, Bursa, Turkey
| | - Yalkin Camurcu
- Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul Atlas University, Istanbul, Turkey
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Kocadal O, Tasdelen N, Yuksel K, Ozler T. Volumetric evaluation of the subacromial space in shoulder impingement syndrome. Orthop Traumatol Surg Res 2022; 108:103110. [PMID: 34649000 DOI: 10.1016/j.otsr.2021.103110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 12/06/2020] [Accepted: 02/10/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Shoulder impingement syndrome is evaluated radiologically with two-dimensional measurement parameters. None of these measurement parameters accurately reflect the three-dimensional geometry. The purpose of this study was to evaluate the volumetric status of the subacromial space in patients with shoulder impingement syndrome and to investigate its relationship with two-dimensional parameters. HYPOTHESIS The primary hypothesis of this study is that subacromial volume is reduced in patients with impingement syndrome. The second hypothesis is that the sagittal plane morphology of the acromion reflects the subacromial volume better than the coronal plane morphology. PATIENTS AND METHODS This retrospective study consisted of a total of 52 participants: 26 patients with impingement syndrome and 26 controls. Volumetric measurements were performed with using magnetic resonance imaging. The relationship between humerus and acromion was evaluated by acromiohumeral distance. The sagittal plane morphology of the acromion was evaluated with an objective acromial angle, while the coronal plane morphology was evaluated with a lateral acromial angle. The radiological parameters between groups were compared. RESULTS The mean subacromial volume was significantly smaller in the impingement group compared to the control group (p=0.01). The subacromial volume had a negative correlation with the objective acromial angle (R=-0.46; p=0.01) The mean tendon volume was significantly higher in the impingement group (p<0.001). The mean acromiohumeral distance in the impingement group (6.8mm±1.0mm), was calculated to be significantly lower than the control group (10.1mm±1.5mm) (p<0.001). There was a positive moderate correlation between subacromial volume and acromiohumeral distance (R=0.61; p=0.01). DISCUSSION This is the first study to demonstrate a reduction in subacromial volume in patients with impingement syndrome. The sagittal plane morphology of the acromion, rather than the coronal plane, appears to be more closely related to the subacromial volume. LEVEL OF EVIDENCE III; case-control study.
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Affiliation(s)
- Onur Kocadal
- Yeditepe University, Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul, Turkey.
| | - Neslihan Tasdelen
- Yeditepe University, Faculty of Medicine, Department of Radiology, Istanbul, Turkey
| | - Korcan Yuksel
- Bayindir Hospital, Department of Orthopedics and Traumatology, Istanbul, Turkey
| | - Turhan Ozler
- Yeditepe University, Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul, Turkey
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Bingöl O, Deveci A, Başkan S, Özdemir G, Kılıç E, Arslantaş E. Comparison of local infiltration analgesia and interscalene block for postoperative pain management in shoulder arthroscopy: a prospective randomized controlled trial. Turk J Med Sci 2021; 51:1317-1323. [PMID: 33512814 PMCID: PMC8283434 DOI: 10.3906/sag-2008-57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 01/28/2021] [Indexed: 11/04/2022] Open
Abstract
Background/aim The aim of this study was to compare the effects of local infiltration analgesia and interscalene brachial plexus block techniques on postoperative pain control and shoulder functional scores in patients undergoing arthroscopic rotator cuff repair. Materials and methods Sixty patients who underwent arthroscopic rotator cuff repair were prospectively included in the study. Patients were randomly divided into two groups. Group 1 was comprised of patients who had interscalene brachial plexus block, while group 2 was comprised of patients who had local infiltration analgesia. In group 1, interscalene block was applied with 20 mL 0.5% bupivacaine. In group 2, the Ranawat cocktail was used for local infiltration analgesia. Sixty milliliters of Ranawat cocktail was applied to the subacromial space and glenohumeral joint in equal amounts. Postoperative pain was assessed by the VAS score. Functional scores of the shoulder were also evaluated by Constant–Murley and UCLA scores. The time of first analgesic requirement and total analgesic consumption in the postoperative period were assessed. Results The first analgesic requirement was significantly late in the interscalene brachial plexus block group (p = 0.000). There was no statistically significant difference between the groups in terms of total analgesic consumption (p = 0.204). In the postoperative 6th h, the VAS score was 2.43 in the interscalene brachial plexus block group, whereas 2.86 in the local infiltration analgesia group (p = 0.323). There was no statistically significant difference between the groups in terms of Constant–Murley shoulder and UCLA scores in the 3rd postoperative month (respectively, p = 0.929, p = 0.671). Besides, postoperative VAS scores and functional scores were negatively correlated (p < 0.01). Conclusion Local infiltration analgesia is an effective alternative to interscalene brachial plexus block for postoperative pain management and total analgesic consumption in arthroscopic rotator cuff repair. However, the interscalene brachial plexus block provides a longer postoperative painless period.
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Affiliation(s)
- Olgun Bingöl
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Alper Deveci
- Department of Orthopedics and Traumatology, Private Ortadogu Hospital, Ankara, Turkey
| | - Semih Başkan
- Department of Anesthesiology, Ankara City Hospital, Ankara, Turkey
| | - Güzelali Özdemir
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Enver Kılıç
- Department of Orthopedics and Traumatology, Ankara City Hospital, Ankara, Turkey
| | - Emrah Arslantaş
- Department of Orthopedics and Traumatology, Sinop Boyabat 75. Yıl Hospital, Sinop, Turkey
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Wang D, Zhang X, Huang S, Liu Y, Fu BSC, Mak KKL, Blocki AM, Yung PSH, Tuan RS, Ker DFE. Engineering multi-tissue units for regenerative Medicine: Bone-tendon-muscle units of the rotator cuff. Biomaterials 2021; 272:120789. [PMID: 33845368 DOI: 10.1016/j.biomaterials.2021.120789] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/13/2022]
Abstract
Our body systems are comprised of numerous multi-tissue units. For the musculoskeletal system, one of the predominant functional units is comprised of bone, tendon/ligament, and muscle tissues working in tandem to facilitate locomotion. To successfully treat musculoskeletal injuries and diseases, critical consideration and thoughtful integration of clinical, biological, and engineering aspects are necessary to achieve translational bench-to-bedside research. In particular, identifying ideal biomaterial design specifications, understanding prior and recent tissue engineering advances, and judicious application of biomaterial and fabrication technologies will be crucial for addressing current clinical challenges in engineering multi-tissue units. Using rotator cuff tears as an example, insights relevant for engineering a bone-tendon-muscle multi-tissue unit are presented. This review highlights the tissue engineering strategies for musculoskeletal repair and regeneration with implications for other bone-tendon-muscle units, their derivatives, and analogous non-musculoskeletal tissue structures.
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Affiliation(s)
- Dan Wang
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR; Ministry of Education Key Laboratory for Regenerative Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Xu Zhang
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR
| | - Shuting Huang
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR
| | - Yang Liu
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Bruma Sai-Chuen Fu
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | | | - Anna Maria Blocki
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Patrick Shu-Hang Yung
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR
| | - Rocky S Tuan
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR
| | - Dai Fei Elmer Ker
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR; School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR; Ministry of Education Key Laboratory for Regenerative Medicine, School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR; Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR.
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Andrade R, Correia AL, Nunes J, Xará-Leite F, Calvo E, Espregueira-Mendes J, Sevivas N. Is Bony Morphology and Morphometry Associated With Degenerative Full-Thickness Rotator Cuff Tears? A Systematic Review and Meta-analysis. Arthroscopy 2019; 35:3304-3315.e2. [PMID: 31785763 DOI: 10.1016/j.arthro.2019.07.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/28/2019] [Accepted: 07/03/2019] [Indexed: 02/02/2023]
Abstract
PURPOSE To scope the scientific literature and analyze the influence of bony risk factors for degenerative full-thickness primary rotator cuff tear. METHODS A systematic review of databases PubMed, Scopus, EMBASE, and Cochrane Library was performed up to June 30, 2018. Meta-analysis was performed with mean difference (MD) or risk ratio for degenerative full-thickness rotator cuff injury, and when there were ≥3 studies for the considered potential risk factor. Methodologic quality was assessed using the Newcastle-Ottawa scale. RESULTS We analyzed 34 studies comprising 5,916 shoulders (3,369 shoulders with rotator cuff tear and 2,546 controls) and identified 19 potential risk factors for degenerative full-thickness rotator cuff tears. There was moderate evidence that a higher critical shoulder angle (MD = 4.41, 95% confidence interval [CI] 3.43 to 5.39), higher acromion index (MD = 0.06, 95% CI 0.04 to 0.09), and lower lateral acromion angles (MD = -7.11, 95% CI -8.32 to -5.90) were associated with degenerative full-thickness rotator cuff tears compared with controls. Moderate evidence showed that a type III acromion significantly increases the risk for full-thickness degenerative rotator cuff tear (risk ratio = 2.26, 95% CI 1.38 to 3.70). CONCLUSION There is moderate evidence that larger critical shoulder angle, higher acromion index, lower lateral acromion angles, and a type III acromion are significantly associated with degenerative full-thickness rotator cuff tears. Other potential risk factors identified showed insufficient evidence. LEVEL OF EVIDENCE Level IV, systematic review of level II to IV studies.
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Affiliation(s)
- Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal; Faculty of Sports, University of Porto, Porto, Portugal; Orthopaedics Department, Centro Hospitalar do Porto, Porto, Portugal
| | - Ana Lucinda Correia
- School of Medicine, Life and Health Sciences Research Institute/3B's - PT Government Associate Laboratory, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Joni Nunes
- Orthopaedics Department, Hospital de Braga, Braga, Portugal
| | | | - Emilio Calvo
- Fundacion Jimenez Diaz, Universidad Autonoma de Madrid, Madrid, Spain
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; School of Medicine, Life and Health Sciences Research Institute/3B's - PT Government Associate Laboratory, University of Minho, Campus de Gualtar, Braga, Portugal.
| | - Nuno Sevivas
- Clínica do Dragão, Espregueira-Mendes Sports Centre, FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; School of Medicine, Life and Health Sciences Research Institute/3B's - PT Government Associate Laboratory, University of Minho, Campus de Gualtar, Braga, Portugal; Trofa Saúde Hospital Sr Bonfim - Trofa Saúde Group, Touguinhó, Portugal
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Pepe M, Kocadal O, Gunes Z, Calisal E, Aksahin E, Aktekin CN. Subacromial space volume in patients with rotator cuff tear: The effect of surgical repair. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2018; 52:419-422. [PMID: 30268741 PMCID: PMC6318497 DOI: 10.1016/j.aott.2018.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 05/12/2018] [Accepted: 08/29/2018] [Indexed: 11/28/2022]
Abstract
Objective The aim of this study was to evaluate the effect of the rotator cuff tear repair on subacromial space volume. Methods We retrospectively identified 21 eligible patients (5 males and 16 females; mean age: 56.4 (range; 46–71) years) who had shoulder arthroscopy for unilateral full-thickness small to medium rotator cuff tear and normal controlateral shoulder joint. The mean follow-up time was 16.1 (range; 12–25) months. Preoperative and postoperative 1 year bilateral shoulder MRIs and Constant scores were reviewed. Subacromial volume was calculated by using Osirix software. Pre-, postoperative and healthy side (contralateral control group) subacromial volumes were recorded. Paired sample and t-tests were used to compare the pre- and postoperative groups. Independent sample t-tests were used to compare the healthy and pre- and postoperative groups. The correlation between the changes in the subacromial volume and the shoulder Constant score were analyzed using Pearson correlation analyses. Results The mean subacromial volume of the preoperative group was 2.95 cm3 (range; 1.53–4.23) and the postoperative group was 3.59 cm3 (range; 2.12–4.84). The volume increase was statistically significant (p < 0.05). The mean subacromial volume of the control group was 3.93 cm3 (range; 2.77–5.03), and the difference between the preoperative group and the control group was statistically significant. There was no significant difference found between the postoperative group and the control group (p = 0.156). There was no significant correlation found between the volume and the constant score changes (r = 0.170, p = 0.515). Conclusion The subacromial space volume significantly decreases in full-thickness rotator cuff tears smaller than 3 cm and the surgical repair increases the subacromial volume significantly. Level of evidence Level IV; Diagnostic Study.
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Affiliation(s)
- Murad Pepe
- Department of Orthopaedics and Traumatology, University of Amasya, Amasya, Turkey.
| | - Onur Kocadal
- Department of Orthopaedics and Traumatology, University of Yeditepe, Istanbul, Turkey
| | - Zafer Gunes
- Department of Orthopaedics and Traumatology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Emre Calisal
- Department of Orthopaedics and Traumatology, University of Amasya, Amasya, Turkey
| | - Ertugrul Aksahin
- Orthopaedics and Traumatology, Medical Park Hospital, Ankara, Turkey
| | - Cem Nuri Aktekin
- Department of Orthopaedics and Traumatology, Ankara Yildirim Beyazit University, Ankara, Turkey
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Saito H, Harrold ME, Cavalheri V, McKenna L. Scapular focused interventions to improve shoulder pain and function in adults with subacromial pain: A systematic review and meta-analysis. Physiother Theory Pract 2018; 34:653-670. [DOI: 10.1080/09593985.2018.1423656] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Hiroki Saito
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University of Technology, Perth, WA, Australia
| | - Meg E. Harrold
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University of Technology, Perth, WA, Australia
| | - Vinicius Cavalheri
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University of Technology, Perth, WA, Australia
| | - Leanda McKenna
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University of Technology, Perth, WA, Australia
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