scholarly journals Synovial Chondromatosis of the Subacromial Bursa Causing a Bursal-Sided Rotator Cuff Tear

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Julie A. Neumann ◽  
Grant E. Garrigues
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Synovial Chondromatosis ◽  
Loose Bodies ◽  
Complete Excision ◽  
Cuff Tear ◽  
Results Of Treatment ◽  
Partial Thickness ◽  
Shoulder Scores

Synovial chondromatosis is an uncommon condition, and involvement of the shoulder is even more rare. We report on a 39-year-old female who presented with symptoms, radiographic features, and intraoperative findings consistent with multiple subacromial loose bodies resulting in a partial-thickness, bursal-sided rotator cuff tear of the supraspinatus muscle. She was treated with an arthroscopic removal of loose bodies, complete excision of the subacromial/subdeltoid bursa, acromioplasty, and rotator cuff repair. To our knowledge, this is the first report of arthroscopic treatment for a bursal-sided, partial-thickness rotator cuff tear treated with greater than two-year clinical and radiographic follow-up. We utilized shoulder scores, preoperative and postoperative range of motion, and imaging to assess the results of treatment and surveillance for recurrence in our patient after two-year follow-up.

scholarly journals Does a Partial Rotator Cuff Tear Affect Pitching Ability? Results From an MRI Study

2019 ◽  
Vol 7 (11) ◽  
pp. 232596711987969
Author(s):  
Jin-Young Park ◽  
Junhyun Kim ◽  
Jae-Hyung Lee ◽  
Kyung-Soo Oh ◽  
Seok Won Chung ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Performance Indicators ◽  
Athletic Performance ◽  
Rotator Cuff Tears ◽  
Abnormal Finding ◽  
Cuff Tear ◽  
Partial Thickness ◽  
Baseball Pitchers

Background: Numerous studies have examined changes in the athletic performance of baseball pitchers after rotator cuff surgery. However, only a few studies have evaluated changes in athletic performance caused by partial rotator cuff tears that are not treated surgically. Purpose: To examine the course of partial-thickness rotator cuff tears and its possible effect on the athletic performance of professional pitchers. Study Design: Case series; Level of evidence, 4. Method: Of 191 professional pitchers who attended our clinic between January 2009 and October 2018, 52 individuals had partial-thickness tears with at least 2 years of follow-up magnetic resonance imaging (MRI) scans and were included in this study. All initial MRI examinations were performed when a season was finished or during the off-season for regular medical check-up purposes. Hence, any abnormal finding on MRI, which suggests damage to the rotator cuff tendon, was assumed to have occurred during the previous season. The mean follow-up MRI period was 40.8 months (range, 24.4-100.9 months). We defined the year before an athlete’s first MRI at our clinic as the year of damage, and we evaluated athletic performance during the season before the damage (pre-damage year 1), the season of the damage (damage year), and 1 and 2 seasons after the damage (post-damage years 1 and 2). We evaluated the changes in 5 statistical performance indicators: earned run average (ERA), fielding independent pitching (FIP), walks plus hits divided by innings pitched (WHIP), winning percentage (WPCT), and innings pitched (IP). Results: The partial-thickness tears progressed in 39 of 52 (75%) patients. Of these 39 patients, 34 (87%) were grade 1 in severity and 5 (12.8%) were grade 2 or higher. The ERA of the pitchers did not increase significantly immediately after damage or at post-damage years 1 and 2. WPCT increased significantly compared with pre-damage year 1 ( P < .001), and IP decreased significantly during the follow-up period ( P < .001). Although no significant decrease in pitching ability was noted based on these 3 indices, significant increases were observed for FIP and WHIP. Conclusion: A partial-thickness rotator cuff tear does not have significant influence on the athletic performance of professional baseball pitchers in the short term based on conventional performance indicators. Our findings suggest that WHIP and IP decline significantly at 2 years after damage is noticed.

scholarly journals Longitudinal follow up of patients undergoing mini-open repair of rotator cuff tear

2019 ◽  
Vol 5 (2) ◽  
pp. 295
Author(s):  
Mohammed Shabir Kassim ◽  
Amlan Mohapatra ◽  
Karthikraj Kuberakani
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Functional Outcome ◽  
Rotator Cuff Tear ◽  
Open Repair ◽  
Full Thickness ◽  
Cuff Tear ◽  
Partial Thickness ◽  
Mini Open

<p class="abstract"><strong>Background:</strong> Shoulder pain is a common presenting complaint. This study is aimed to understand the role of mini-open repair in the treatment of rotator cuff tear and to assess the functional outcome in such patients over a period of two years.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted on patients who were operated by mini-open repair for rotator cuff tear at the Department of Orthopedics, AJ Institute of Medical Sciences January 2017 till June 2018. Using a pre-designed case report form, demographic and clinical information was noted for all patients. Functional outcome of the patients was assessed by the Constant and Murley score at post-operative follow up at 3 weeks, 6 weeks, 12 weeks, 6 months, 1 year and 2 years.<strong></strong></p><p class="abstract"><strong>Results:</strong> Partial thickness tear was present in 57% of the pateints and rest had a full thickness tear. Mean Constant and Murley score at the time of presentation was 59.50 which improved during the follow up period and at the final follow up the score was 91.80. The score was not significantly different at one year and second year follow up. The score was consistently higher among patients with partial thickness as compared to those with full thickness, though the difference was significantly different only at 6 month follow up (p=0.007).</p><p class="abstract"><strong>Conclusions:</strong> Significant improvement in range of motion was seen in our patients at 6 months post-operatively. Full range of motion was observed at the end of 1 year and functional outcome did not improve after that.</p>

scholarly journals Clinical and functional outcomes of a novel transosseous device to treat rotator cuff tears: A minimum 2-year follow-up

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987517 ◽  
Author(s):  
Mehmet Arican ◽  
Yalçın Turhan ◽  
Zekeriya Okan Karaduman ◽  
Tacettin Ayanoğlu
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Functional Outcomes ◽  
Dash Score ◽  
Open Approach ◽  
Full Thickness ◽  
Gold Standard Method ◽  
Cuff Tear ◽  
The Mean

Purpose: Despite the improvements in the repair equipment techniques of rotator cuff, a gold standard method has not been defined yet and transosseous fixation through deltoid-splitting (mini-open) approach is still regarded as a good option. The primary purpose of this study is to present satisfactory clinical and functional outcomes with a novel transosseous device in full-thickness rotator cuff tear through deltoid-splitting. Materials and Methods: This retrospective study was performed on 70 consecutive patients who underwent surgery by a single surgeon from June 2014 to June 2016 for a full-thickness rotator cuff tear and was managed with a novel transosseous device. Total number of patients, mean age, percentage of male and female patients, mean duration of follow-up, percentage of involvement of the dominant extremity, affected shoulder, and tear size were recorded. Functional and clinical outcomes were assessed baseline and postoperatively at 3 and 6 months and final follow-up using Disabilities of the Arm, Shoulder and Hand (Q-DASH) and Constant-Murley scores. Results: A total of 70 (49 (70%) female, 21 (30%) male) patients whose mean age was 58.66 ± 9.19 (38–77) years were included. The mean surgery time was 35.33 ± 5.34 (28–55) min. The mean follow-up time was 28.31 ± 3.03 (24–36) months. According to the DeOrio and Cofield classification, 15 (21.43%) tears were small, 33 (47.14%) medium, 16 (22.86%) large, and 6 (8.57%) massive. By the final follow-up, the mean Constant-Murley score had significantly improved from 27.67 ± 7.46 (13–41) to 81.25 ± 3.77 (74–87; p = 0.0001) and the Q-DASH score had decreased from 82.34 ± 10.37 (65.91–100) to 10.28 ± 6.88 (0–23.45; p = 0.0001). There were no significant differences in the Constant-Murley or Q-DASH score at baseline–final follow-up between the small, medium, large, and massive tear groups ( p > 0.05). Conclusions: Treatment of full-thickness rotator cuff tear using this novel transosseous device significantly improved functional and clinical scores. However, further long-term prospective randomized multicenter trials involving comparative studies are necessary to confirm these findings.

10-year follow-up of non-operatively treated full thickness rotator cuff tear

2016 ◽  
Vol 32 (1) ◽  
pp. 67-72 ◽  
Author(s):  
Shivam Upadhyaya ◽  
Andrew Nathan Pike ◽  
Scott D. Martin
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Full Thickness ◽  
Cuff Tear

Comparison of Clinical and Structural Outcomes by Subscapularis Tendon Status in Massive Rotator Cuff Tear

2017 ◽  
Vol 45 (11) ◽  
pp. 2555-2562 ◽  
Author(s):  
Sung Hyun Lee ◽  
Dae Jin Nam ◽  
Se Jin Kim ◽  
Jeong Woo Kim
Keyword(s):  
Magnetic Resonance Imaging ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Tears ◽  
Subscapularis Tendon ◽  
Resonance Imaging ◽  
Massive Rotator Cuff Tear ◽  
Cuff Tear ◽  
Massive Rotator Cuff Tears

Background: The subscapularis tendon is essential in maintaining normal glenohumeral biomechanics. However, few studies have addressed the outcomes of tears extending to the subscapularis tendon in massive rotator cuff tears. Purpose: To assess the clinical and structural outcomes of arthroscopic repair of massive rotator cuff tears involving the subscapularis. Study Design: Cohort study; Level of evidence, 3. Methods: Between January 2010 and January 2014, 122 consecutive patients with massive rotator cuff tear underwent arthroscopic rotator cuff repair. Overall, 122 patients were enrolled (mean age, 66 years; mean follow-up period, 39.5 months). Patients were categorized into 3 groups based on subscapularis tendon status: intact subscapularis tendon (I group; n = 45), tear involving less than the superior one-third (P group; n = 35), and tear involving more than one-third of the subscapularis tendon (C group; n = 42). All rotator cuff tears were repaired; however, subscapularis tendon tears involving less than the superior one-third in P group were only debrided. Pain visual analog scale, Constant, and American Shoulder and Elbow Surgeons scores and passive range of motion were measured preoperatively and at the final follow-up. Rotator cuff integrity, global fatty degeneration index, and occupation ratio were determined via magnetic resonance imaging preoperatively and 6 months postoperatively. Results: We identified 37 retears (31.1%) based on postoperative magnetic resonance imaging evaluation. Retear rate in patients in the C group (47.6%) was higher than that in the I group (22.9%) or P group (20.0%) ( P = .011). Retear subclassification based on the involved tendons showed that subsequent subscapularis tendon retears were noted in only the C group. The improvement in clinical scores after repair was statistically significant in all groups but not different among the groups. Between-group comparison showed significant differences in preoperative external rotation ( P = .021). However, no statistically significant difference was found in any shoulder range of motion measurements after surgery. Conclusion: Arthroscopic repair of massive tears results in substantial improvements in shoulder function, despite the presence of combined subscapularis tears. However, this study showed a high failure rate of massive posterosuperior rotator cuff tear repair extending more than one-third of the subscapularis tendon. When combined subscapularis tendon tear was less than the superior one-third of the subscapularis tendon, arthroscopic debridement was a reasonable treatment method where comparable clinical and anatomic outcomes could be expected.

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