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Joseph C Tauro

Publications and source records attributed to Joseph C Tauro.

5 recordsLinked to original sources

Stiffness and rotator cuff tears: incidence, arthroscopic findings, and treatment results.

PURPOSE: Although stiffness of the shoulder has been evaluated after rotator cuff repair, it has not been studied in patients with cuff tears that occurred before repair. The primary purpose of this study was to determine whether preoperative stiffness persists after cuff repair. We also evaluated the incidence and possible causes of stiffness in patients who underwent arthroscopic rotator cuff repair. METHODS: This was a retrospective evaluation of 72 arthroscopic patients who underwent rotator cuff repair. Preoperative range-of-motion (ROM) deficits in abduction, forward flexion, external rotation, and internal rotation were recorded and were added together to determine the total ROM deficit (TROMD). Patients were then divided into 3 groups on the basis of TROMD. Group 1 comprised 42 patients with 0 degrees to 20 degrees TROMD. Group 2 consisted of 24 patients with 25 degrees to 70 degrees TROMD, and group 3 included 6 patients with a TROMD greater than 70 degrees. Preoperative medical history, intraoperative condition of the capsule and bursa, and cuff tear size were recorded. RESULTS: Capsular and bursal abnormalities were more common in stiffer patients, but arthroscopic evidence of adhesive capsulitis was found only in group 3 (3 of 6 patients). Postoperatively, average TROMD deficit decreased from 10 degrees to 4 degrees in group 1, from 36 degrees to 12 degrees in group 2, and from 89 degrees to 31 degrees in group 3. No reoperations or postoperative manipulations were reported in group 1 or 2. In group 3, 3 patients (the only 3 with adhesive capsulitis) showed no or minimal improvement in postoperative ROM. These 3 patients required a secondary arthroscopic capsular release. After all 3 repairs had completely healed, the TROMD averaged 35 degrees in this subgroup. CONCLUSIONS: Preoperative stiffness is common in patients who undergo rotator cuff repair. Mild and moderate stiffness generally resolve after surgery followed by routine therapy. Patients with a TROMD of 70 degrees or more may have adhesive capsulitis as well as a cuff tear and may not do well with cuff repair alone. LEVEL OF EVIDENCE: Level IV, case series.

Adult↗

Arthroscopic repair of large rotator cuff tears using the interval slide technique.

PURPOSE: In some cases of larger and chronic rotator cuff tears, the supraspinatus tendon may be held in a retracted position by the contracted tissue of the rotator interval and the attached coracohumeral ligament. This study was performed to evaluate the utility and clinical effectiveness of an arthroscopic release of the rotator interval from the supraspinatus tendon combined with repair of the rotator cuff. TYPE OF STUDY: Prospective clinical follow-up study. METHODS: Forty-three arthroscopic rotator cuff repairs were performed and followed up for an average of 32 months. All of these patients had large, contracted tears that could not be adequately mobilized without a rotator interval release. In each case, an arthroscopic rotator interval release and superior capsular release were performed to improve cuff mobility. End-to-bone and side-to-side repair was performed depending on the configuration of the tear. Postoperatively, the patients were evaluated using a modified University of California Los Angeles (UCLA) rating system. RESULTS: Forty-two repairs were available for at least 2-year follow-up. No cases of deltoid morbidity or progressive superior migration of the humeral head were seen. The average overall preoperative score was 17.4 (range, 9-26). The average postoperative score was 36.4 (range, 20-45). We saw 21 excellent, 6 good, 11 fair, and 4 poor results based on prior criteria established for smaller tears. All of the average postoperative scoring categories were improved from preoperative scores. Only 3 patients were not satisfied with their results. CONCLUSIONS: The use of the interval slide technique greatly improves supraspinatus mobility in the case of large retracted tears. Although average improvements were less than in our previous study of smaller tears, complete or partial repair of these tears yields good results and high patient satisfaction.

Aged↗

Arthroscopic biceps tenodesis.

Arthroscopic biceps tenodesis is indicated for the treatment of severe biceps tendonopathy, partial- or full-thickness tendon tears, or biceps instability typically associated with rotator cuff tear, although there has been considerable debate on tenotomy versus tenodesis. We advocate tenodesis, for the following reasons: to re-establish the resting muscle length so as to avoid scaring and spasm, to allow biceps use for complex elbow motion, and to avoid cosmetic defects in cases in which deformity can sometimes equal disability. This technical note provides illustrations and detailed descriptions of our arthroscopic tenodesis technique using a Arthrex (Naples, FL) biotenodesis system.

Absorbable Implants↗