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Biomedical subjects

Patrice Tétreault

Publications and source records attributed to Patrice Tétreault.

4 recordsLinked to original sources

Arthroscopic versus mini-open rotator cuff repair: a cohort comparison study.

PURPOSE: To critically compare arthroscopic and mini-open rotator cuff repair. TYPE OF STUDY: Retrospective case control study. METHODS: Nine patients who had an arthroscopic rotator cuff repair (ARCR) were matched for age, gender, dominance, side of injury, history of trauma, duration of symptoms, and type of rotator cuff injury, with 12 patients who had a mini-open rotator cuff repair (MOR). Comparison included a preoperative and postoperative physical examination as well as a completed Simple Shoulder Test (SST) questionnaire at the latest follow-up at a minimum of 27 months. RESULTS: Both groups had significant reductions in pain scores (P < .01) and there was no significant difference in preoperative or postoperative active flexion or external rotation between both groups (P > .20). Although the ARCR group showed a significant improvement in strength (P < .01) and the MOR group did not, no patient had less than 4/5 strength. The impingement sign remained positive in 1 MOR patient, but all patients had a negative Jobe's test result. Pain and Tasks assessment by SST questionnaire showed that neither group had night pain or discomfort when using their arms overhead. There were no significant differences in the overall SST scores between groups. CONCLUSIONS: Because all patients in each group were satisfied with the procedure and there were no objective differences in outcome, we conclude that there is no difference in outcome between ARCR and MOR. Thus, the choice of one approach over the other is best based on surgeon or patient preference. LEVEL OF EVIDENCE: Level III, Retrospective Case Control Study.

Activities of Daily Living↗

Imaging of the overhead throwing athlete.

Knowledge of overhead throwing biomechanics is crucial to understand specific injuries encountered in throwing athletes on diagnostic imaging. Most specific injuries of overhead throwing athletes occur at the shoulder and elbow. Throwing athletes are susceptible to rotator cuff tears from tensile overload and external and internal impingement. The labrum is also commonly degenerated or torn secondary to overuse syndrome, internal impingement, and microtrauma. The elbow is typically injured secondary to excessive valgus forces during throwing. The ulnar collateral ligament, ulnar nerve, and common flexor tendon origin are all at increased risk of injury. Capitellar osteochondral injuries and loose intra-articular bodies are also frequent. Knowledge of injury pathophysiology is crucial to understanding the treatment rationale in throwing athletes.

Athletic Injuries↗

Glenoid version and rotator cuff tears.

The purpose of this study was to determine the relationship between rotator cuff (RC) tear and the orientation of the glenoid. Ninety-six shoulders (94 patients) that underwent open RC repair were grouped according to the type of tear. We measured on MRI the acromio-glenoid angle (AG) and the supraspinatus fossa glenoid angle on the anterior-posterior (SGAP) and axial (SGAX) views. RC patients had a smaller AG angle (76+/-7 degrees vs. 86+/-10 degrees ) and a larger SGAP angle (112+/-6 degrees vs. 102+/-7 degrees ) compared to controls (p<0.001). We also found a highly significant difference (p<0.001) in glenoid version measured by SGAX between anterior cuff tears (-5+/-4 degrees ) and posterior cuff tears (3+/-3 degrees ). Furthermore, we identified an association between RC tear and the orientation of the glenoid relative to the axis of the supraspinatus fossa. Greater retroversion is predictive of an anterior cuff injury and greater anteversion is predictive of a posterior cuff injury.

Humans↗