SEARCH · PubMed Health

Results for “Rotator Cuff”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 559 records · Page 31Linked to original sources

PubMed2001

On the impact of calcified deposits within the rotator cuff tendons in shoulders of patients with shoulder pain and dysfunction.

We wanted to prove the hypothesis that calcified deposits within the rotator cuff tendons are merely an epiphenomenon of complex morphological alterations in the shoulders of patients with shoulder pain and dysfunction. The shoulders of 92 patients with calcified deposits within the rotator cuff tendons as noted on plain radiographs were investigated by means of magnetic resonance imaging (MRI; mean age of patient 51.1 years), as well as the shoulders of 28 age- and sex-matched patients with similar clinical symptoms but without any signs of such calcified deposits on plain radiographs. The MRI protocol comprised a coronal, oblique, T1-weighted, spin-echo sequence, a T2-weighted, turbo spin-echo sequence, a sagittal, oblique, T2-weighted, turbo spin-echo sequence, and an axial, T1-weighted, spin-echo sequence. Furthermore, a coronal, oblique, short tau-inversion recovery sequence and a gradient echo sequence were used. The results were compared with data from healthy, asymptomatic volunteers as reported in the literature. The MRI investigations showed no substantial differences between patients with or without calcified deposits within the rotator cuff tendons, but distinct differences between such patients and healthy, asymptomatic volunteers. For patients with shoulder pain, shoulder dysfunction, and calcified deposits within the rotator cuff tendons, these calcified deposits are most probably not the main cause of the clinical symptoms. Rather, it seems to be useful to consider the results of MRI investigations whenever planning therapeutic procedures for patients with shoulder pain and dysfunction, irrespective of whether or not there are signs of calcified deposits within the rotator cuff tendons on plain radiographs.

Adult↗

PubMedDate not supplied

Electromyographic evaluation after primary repair of massive rotator cuff tears.

Anatomic dissections have suggested that mobilization of the supraspinatus and infraspinatus tendons greater than 1 cm may cause suprascapular nerve injury. This study evaluated rotator cuff function by use of electromyographic (EMG) analysis after primary repair of massive tears in 9 patients. All subjects had massive rotator cuff tears involving at least the entire supraspinatus and entire infraspinatus tendons. Rotator cuff advancement averaged 2.5 cm (range, 2.0-3.5 cm). No EMG evidence of suprascapular nerve injury was found postoperatively. The UCLA shoulder score improved from a preoperative mean of 11 to a postoperative mean of 28. There was 1 excellent, 6 good, 1 fair, and 1 poor result. The poor result was due to a documented failed repair. The EMG results suggest that mobilization and advancement of the rotator cuff up to 3.5 cm during primary repair may be performed safely without as much risk to the suprascapular nerve as anatomic studies would suggest.

Aged↗

PubMed2026

Editorial Commentary: Stiff Patients After Rotator Cuff Repair: How Many Had Underrecognized Preoperative Adhesive Capsulitis?

Stiffness after rotator cuff repair is one of the most common sources of disability and one of the most common complications. Smoking, diabetes, Workers' compensation status, and traumatic tears are among the strongest risk factors. This is important information in setting appropriate expectations for both the patient and the surgeon preoperatively. Some of these factors are also associated with preoperative stiffness, so surgeons should maintain a high index of suspicion for concomitant adhesive capsulitis in patients presenting with limited motion, particularly in diabetic and non-English speaking populations. In cases where both a rotator cuff tear and adhesive capsulitis coexist, performing a concurrent capsular release or manipulation during the index procedure may improve functional outcomes and reduce the necessity for secondary surgical intervention.

Humans↗

PubMed1997

The incidence of glenohumeral joint abnormalities associated with full-thickness, reparable rotator cuff tears.

To evaluate the incidence of associated glenohumeral lesions in patients with a full-thickness rotator cuff tear, an arthroscopic examination of the glenohumeral joint was performed in 200 shoulders in 195 consecutive patients before arthroscopic rotator cuff repair. One hundred twenty-one (60.5%) had coexisting intraarticular abnormalities. Ninety-six (48%) had minor abnormalities, and 25 patients (12.5%) had major coexisting intraarticular abnormalities. Major lesions (that required operative treatment, changed postoperative rehabilitation, or altered the expected end result) noted at arthroscopic examination were osteoarthritis in nine patients, partial biceps tendon tears in three, labrum tears in three, Bankart lesions in two, superior labrum anterior posterior lesions in five, and glenohumeral synovitis in three patients. Glenohumeral arthroscopy can provide valuable information in patients with a complete rotator cuff tear.

Arthroscopy↗

PubMed2006

Diagnostic performance of MR arthrography after rotator cuff repair.

OBJECTIVE: The objective of this study was to investigate the diagnostic performance of MR arthrography after rotator cuff repair. MATERIALS AND METHODS: MR arthrographic examinations of the shoulder performed after rotator cuff repair and before revision surgery were retrospectively analyzed in 48 patients (31 males, 17 females; mean age, 50.3 years; age range, 17-69 years). Full-thickness and partial-thickness defects of the supraspinatus, infraspinatus, and subscapularis tendons were diagnosed independently by two radiologists. Revision surgery served as the standard of reference. RESULTS: Observer 1 correctly recognized five of eight intact supraspinatus tendons, 10 of 19 partial-thickness defects, and 19 of 21 full-thickness defects. For observer 2, the numbers were three of eight, eight of 19, and 18 of 21. The corresponding numbers for the infraspinatus tendon for observer 1 were 28 of 31, 0 of three, and 14 of 14 tendons. For observer 2, they were 28 of 31, two of three, and 11 of 14. For the subscapularis tendon, observer 1 made the correct diagnosis in 18 of 31, five of six, and nine of 11 tendons. The results for observer 2 were 26 of 31, one of six, and 10 of 11 tendons. Interobserver agreement (weighted kappa) was 0.47 for the supraspinatus, 0.64 for the infraspinatus, and 0.20 for the subscapularis tendons, respectively. CONCLUSION: Postoperative full-thickness defects of the rotator cuff are reliably diagnosed with MR arthrography. The diagnostic performance for partial-thickness defects is only moderate.

Adolescent↗

PubMed2003

Sources of variation in readmission rates, length of stay, and operative time associated with rotator cuff surgery.

BACKGROUND: Variation in readmission rates, length of stay, and operative time associated with rotator cuff surgery should be understood if cost-control strategies are to be considered. We hypothesized that there would be variation in resource utilization as measured in terms of these factors and that surgeon and hospital practice patterns, rather than patient characteristics, would explain this variation. METHODS: We conducted a retrospective analysis of the effects of surgeon, hospital, and patient-related factors on the readmission rates, length of stay, and operative time associated with 1077 rotator cuff repairs performed by thirty-two surgeons in eleven group-model health maintenance organization hospitals, two satellite centers, and one contract facility in southern California. RESULTS: The initial unadjusted analysis of covariance showed moderate-to-strong associations between surgeon and hospital variation and the rate of hospital readmission within thirty days (p = 0.0919 and p = 0.0209, respectively), extended length of stay (p = 0.0016 and p = 0.0016, respectively), and operative time (p < 0.0001 and p < 0.0001, respectively). The hospital effect was no longer significant when patient-related factors (i.e., sociodemographic characteristics and comorbidities) and the surgeon effect were taken into account. The surgeon effect was still significant (except with regard to the readmission rate) after adjustment for patient and hospital-related factors, explaining 23% of the variation in length of stay and 69% of the variation in operative time. There was a significantly increased risk of an extended stay (p = 0.0010) and readmission (p = 0.0260) following procedures performed at hospitals with an orthopaedic residency program. Increased operative time was significantly associated with decreased surgeon volume (p < 0.0001) and the absence of an orthopaedic residency program (p < 0.0001). CONCLUSIONS: Variation in length of stay and operative time associated with rotator cuff surgery is largely explained by surgeon practice patterns. Our results suggest that surgeons have the ability to affect these two factors, which are often identified as drivers of cost.

Adult↗

PubMed1998

Is sonography performed by the rheumatologist as useful as arthrography executed by the radiologist for the assessment of full thickness rotator cuff tears?

OBJECTIVE: Sonography and arthrography are techniques used to detect rotator cuff tears (RCT). The diagnostic value of sonography executed by a rheumatologist versus that of arthrography performed by a radiologist for assessment of RCT was investigated among patients with unilateral chronic shoulder complaints without an underlying inflammatory rheumatic disease. METHODS: Forty-eight patients underwent sonography, arthrography, and surgical inspection, the results of surgical inspection being the gold standard. RESULTS: Sensitivity for assessment of a full thickness RCT was 0.86 for sonography and 0.77 for arthrography, specificity was 0.88 for sonography and 0.92 for arthrography. CONCLUSION: Compared to arthrography performed by the radiologist, sonography executed by the rheumatologist is as useful for assessment of full thickness rotator cuff tears. Sonography performed by the rheumatologist in combination with history taking and the physical examination during a single visit might change the routine daily practice of rheumatologists.

Adult↗

PubMed2000

Sonographic differences in the appearance of acute and chronic full-thickness rotator cuff tears.

This study was undertaken to identify differences in the sonographic appearance of acute and chronic full-thickness rotator cuff tears. The ultrasonograms of 24 patients with an acute rotator cuff tear and 20 with a chronic tear were reviewed for tear size (width), location, and the presence and distribution of fluid. Among these 24 patients, 75% with a midsubstance tear location had an acute tear; 64% of patients with joint or bursal fluid had an acute tear; 80% of patients with a nonvisualized rotator cuff due to a massive tear had a chronic tear; and 73% of patients with no sonographic evidence of bursal or joint fluid had a chronic tear. In conclusion, a midsubstance location and the presence of joint or bursal fluid were more commonly associated with an acute tear. A nonvisualized cuff and the absence of joint and bursal fluid were more commonly observed with a chronic tear.

Acute Disease↗

PubMed1994

Diagnostic performance of magnetic resonance imaging for the diagnosis of rotator cuff tears using supplemental images in the oblique sagittal plane.

RATIONALE AND OBJECTIVES: The authors evaluated the diagnostic utility of supplemental imaging in the oblique sagittal (OS) plane for the magnetic resonance imaging (MRI) diagnosis of rotator cuff tears. METHODS: Two radiologists with varying levels of MRI experience blindly reviewed shoulder MR examinations of 50 patients for rotator cuff tears. Shoulder examinations were interpreted twice, initially using only double-echo spin-echo images obtained in the oblique coronal (OC) plane and later using double-echo spin-echo images obtained in the both the OC and OS planes. Tears were characterized according to size, location, and extent, and levels of diagnostic confidence were evaluated. RESULTS: Sensitivity and specificity of MR for the diagnosis of rotator cuff tear was 85% and 80%, respectively, with the OC series increasing to 95% and 93%, respectively with OCOS scans. However, these increases were not statistically significant. Receiver operating characteristic (ROC) curves suggest a trend toward increased diagnostic confidence when supplemental OS scans are available, especially for the less experienced reader. Characterization of rotator cuff tears was not improved with additional OS images. CONCLUSIONS: Supplemental OS scans did not demonstrate a definite improvement in diagnostic accuracy for rotator cuff tears compared to OC scans alone. Estimations based on sample size calculations indicate that a much larger population of patients would be needed to show a statistically significant difference.

Humans↗

PubMed1991

[Postoperative results of arthrography following suturing of ruptured rotator cuff].

The authors examined 41 shoulder joints by arthrography after the patients had undergone surgery for rotator cuff tears. In 26 cases the arthrographic findings were negative; that is to say the region of the tendon suture was tightly closed. In 10 of these 26 cases the underside of the rotator cuff had a rather irregular border. The arthrograms were positive for 12 of the other 15 patients who had undergone surgery. In 3 cases contrast medium leakage into tendinous tissue on the joint side was seen. The postoperative results, ascertained with reference to the assessment guidelines proposed by Neer and Patte, were largely unrelated to the arthrographic findings. In patients with contrast medium leakage from the rotator cuff only the muscular strength was slightly reduced. There was no correlation with the clinical symptoms. In the comparison of all patients who had undergone postoperative arthrography with the total study population a lower number in the index was striking. It may be that patients with symptoms persisting after surgery were more prepared to undergo control arthrography.

Adult↗

PubMed2005

Outcome of open rotator cuff repair. An analysis of risk factors.

The aim of this study was to evaluate the long-term functional outcome of full thickness rotator cuff tears treated by open repair and acromioplasty and to determine various factors affecting the outcome. This is a prospective clinical study on 42 patients who underwent full thickness rotator-cuff repair by a single surgeon between 2000 and 2003. The mean follow-up was 26 months. In patients with massive rotator cuff tear (n = 15), increase in the mean postoperative Constant score was significantly less compared to patients with small and moderate tears (p < 0.01). In patients older than sixty years, the improvement in postoperative Constant score was significantly less compared to the rest of the patients (p < 0.001). However, the postoperative Constant score significantly improved from the preoperative score in all patient groups (p < 0.0001). There was a significant negative correlation with size of cuff tear, age of the patient and Constant-Murley score (p < 0.05). Body mass index, smoking, gender, and the duration of symptoms did not have a significant effect on either Constant-Murley score or visual analogue score. We conclude that older patients and those with massive rotator cuff tear could benefit from surgical intervention, although not as much as younger patients and those with small/moderate size cuff tears.

Adult↗

PubMed2005

Arthroscopic versus mini-open rotator cuff repair: a comparison of clinical outcome.

PURPOSE: To compare the outcome of patients who underwent rotator cuff repair using all arthroscopic or mini-open repair techniques. TYPE OF STUDY: Retrospective comparative study. METHODS: We retrospectively reviewed 54 patients who underwent either mini-open or arthroscopic rotator cuff repair. Twenty-six patients underwent mini-open repair and 28 patients had arthroscopic repair. Follow-up averaged 33 months (range, 18 to 48 months) for the mini-open group and 19 months (range, 13 to 26 months) for the arthroscopic group. The patient groups were similar with regard to age, activity level, mechanisms of injury, associated findings at surgery, and tear size measured in square centimeters. The outcome for the 2 groups was evaluated using a modified American Shoulder and Elbow Society (ASES) score. Statistical analysis was performed using Pearson correlations and the Student t test. RESULTS: The tear size averaged 2.7 cm2 for the mini-open group and 2.0 cm2 for the arthroscopic group (P = .754). All patients showed significant improvement in their scores for pain, satisfaction, and function at the time of follow-up. The average preoperative and postoperative scores for the mini-open group were as follows: pain 17 and 27 (30 possible points), satisfaction 3 and 9 (10 possible points), function 32 and 53 (60 possible points), and total 52 and 89 (100 possible points) (P < .05). For patients who underwent arthroscopic repair, average preoperative and postoperative scores were as follows: pain 12 and 26, satisfaction 2 and 9, function 28 and 51, and total, 42 and 86 (P < .05). Improvement in scores within each group was significant, but the difference in total scores between the 2 techniques was not statistically significant. CONCLUSIONS: This study confirms that short-term results for arthroscopic and mini-open rotator cuff repair are similar and supports continued use of arthroscopic repair techniques. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

Adult↗

PubMedDate not supplied

Rotator cuff tears in middle-aged tennis players: results of surgical treatment.

BACKGROUND: Tennis players, like participants in other overhead sports, are vulnerable to rotator cuff tears. In players who continue to play into their middle-age years, the incidence of such injury increases. HYPOTHESIS: Surgical treatment of rotator cuff tears in middle-aged tennis players is largely successful in allowing return to tennis. STUDY DESIGN: Retrospective review. METHODS: We evaluated the results of surgical treatment of 51 middle-aged tennis players (average age, 51 years) with a rotator cuff tear in their dominant shoulder. Tennis participation among the group had averaged 3.5 hours per week for an average of 25 years. Forty-two patients underwent open repair of the tear with or without biceps tenodesis, whereas 9 patients underwent arthroscopic debridement of the tear with or without a biceps tenotomy. Patients were reviewed at an average of 57 months after surgery with an activities score, a subjective questionnaire, and a questionnaire regarding their postoperative participation in tennis. RESULTS: The activities score averaged 26.6 of 30 possible points. Forty-seven patients were satisfied with their result, and 40 patients were able to return to tennis at an average of 9.8 months after surgery. No difference was found in the ability to return to tennis between the open repair group and the arthroscopic debridement group. CONCLUSIONS: The results of this study indicate that it is possible for nearly 80% of middle-aged tennis players to return to participation after operative treatment of rotator cuff tears.

Adult↗

PubMed2004

Modified extra rotator-cuff entry point in antegrade humeral nailing.

INTRODUCTION: We describe an extra-articular, extra-rotator cuff entry point for antegrade humeral nailing, which preserves the articular surface and rotator cuff integrity. MATERIAL AND METHODS: Thirty-two patients with humeral shaft fractures underwent antegrade intramedullary nailing using a modified insertion point located 1 cm below the crest of the greater tuberosity, in a region outside the articular surface and rotator cuff area. RESULTS: In all cases, nailing was done successfully, without any perforation of the humeral inner cortex by the nail. Extension of the fracture line to the distal metaphysis happened intraoperatively in one case of a distal diaphysis fracture. In the remainder of the patients, postoperative reduction of the fracture was successful, with no sign of an iatrogenic incident of fracture comminution. Excellent active shoulder function and full early functional recovery of the shoulder joint (to 16th week postoperatively) were established in 98% of the patients. All fractures were united in a mean period of 14 weeks. CONCLUSION: We suggest an extra-articular, extra-rotator cuff entry point for antegrade humeral nailing as a possible and safe technique with beneficial results for the shoulder's postoperative function.

Female↗

PubMed1993

[Value of standard radiographies in the diagnosis of rotator cuff rupture].

To assess the value of the Leclercq maneuver (anteroposterior roentgenogram of the shoulder during resisted active abduction) for the diagnosis of rotator cuff tear, the medical records of 93 patients evaluated by glenohumeral arthrography, standard radiographs, and radiographs taken using the Leclercq maneuver were retrospectively reviewed. The comparison of patients with (n = 53) and without (n = 40) arthrographic evidence of rotator cuff tear demonstrated statistically significant differences for mean acromiohumeral space difference between the normal and affected shoulders, for the acromiohumeral space difference between the standard film and Leclercq maneuver film, and for presence of an inferior glenohumeral diastasis on the Leclercq maneuver film. An acromiohumeral space of 7 mm or less on standard radiographs proved a specific (0.975) but insensitive (0.24) sign of rotator cuff tear. This parameter measured on the Leclercq maneuver film exhibited better sensitivity (0.62) and excellent specificity. Other criteria with good specificity for rotator cuff tear included an acromiohumeral space difference between the normal and abnormal side of 2 mm or more (0.97), an acromiohumeral space difference between standard and Leclercq maneuver films of at least 4 mm, and existence of an inferior glenohumeral diastasis; however, sensitivities of these three parameters were poor (respectively 0.65; 0.20; and 0.19).(ABSTRACT TRUNCATED AT 250 WORDS)

Arthrography↗

PubMedDate not supplied

[Results of surgical therapy of ruptures of the rotator cuff of the shoulder].

OBJECTIVE: This retrospective study was designed to evaluate mid-term results of patients after surgical treatment of rotator-cuff-tears by means of clinical and ultrasonographical examination with special regard to factors influencing the prognosis. METHOD: 126 patients were examined clinically and ultrasonographically at a mean postoperative period of 37 months after surgery for rotator cuff lesions. A conservative therapy failed to be successful for at least 3 months before. All patients received an open decompression of the subacromial space, 68.6% of the patients received an additional reconstruction of the rotator cuff. The results were evaluated by use of the Constant-Score. The ultrasonographical examination was performed according to the technique described by Hedtmann. RESULTS: 69% of the patients showed good and excellent results. The mean Constant-Score was 81.4% of the age- and sex-related normal values. Patients with lesions extending more than 3 cm did significantly worse than those with smaller ruptures (Constant-Score: 74.2% vs. 90.6%). An involvement of the subscapularis-tendon was related with bad results. A rerupture was seen ultrasonographically in 17.3% of the patients. CONCLUSION: Regarding strict criteria of evaluation almost 70% of our patients not responding to conservative treatment achieved good and excellent results after surgery. Smaller lesions and tears solely involving the supraspinatus-tendon were associated with a better prognosis. Ultrasonography allows a reliable examination of the rotator-cuff-anatomy postoperatively performed, too.

Adult↗

PubMedDate not supplied

Repair of rotator cuff tears in tennis players.

Twenty-three tennis players with a symptomatic full-thickness rotator cuff tear underwent anterior acromioplasty and rotator cuff repair. There were 8 small tears (less than 1 cm), 5 moderate tears (1 to 3 cm), 2 large tears (3 to 5 cm), and 8 massive tears (greater than 5 cm). The dominant shoulder was involved in all patients and all were unable to play tennis before surgery. Eleven patients experienced a traumatic event that caused an injury, 6 while playing tennis, and 12 patients had a gradual onset of symptoms. At average follow-up of 42 months, 19 patients (83%) achieved a good result, were pain-free, and were able to play tennis at their presymptomatic competitive level. Three patients (13%), all with massive tears, had a satisfactory result and were able to play tennis, although at a lower competitive level secondary to weakness. One patient (4%), who also had a massive tear, had an unsatisfactory result and was unable to play tennis.

Adult↗

PubMedDate not supplied

Rotator cuff repair after shoulder replacement.

Development of a rotator cuff tear after shoulder arthroplasty can adversely affect outcome. To assess the results of a subsequent procedure to repair the torn cuff, we reviewed all shoulder arthroplasties performed at our institution to identify patients who had a subsequent operation for cuff repair with or without component revision. We identified 19 patients and 20 involved shoulders. One patient was lost to follow-up, and one was excluded because the subsequent cuff repair could not be adequately accomplished. Patients were studied retrospectively a mean of 9.1 years after cuff repair by analysis of prospectively collected data supplemented by use of a questionnaire (10 shoulders). The presence of the tear was diagnosed preoperatively by physical examination or routine radiographs in 13 shoulders, an arthrogram in 3, and surgical exploration in 2. The tear involved the subscapularis in 7 shoulders, the supraspinatus in 15, and the infraspinatus in 8. Rotator cuff repair was successful in only 4 shoulders and was unsuccessful in the remaining 14. Pain was absent in 4 shoulders, slight in 6, occasionally moderate in 5, and moderate in 3. The mean visual analog pain score was 5.6. Range of motion was limited, with mean values for elevation of 78 degrees and external rotation of 54 degrees . Because results of subsequent cuff repair are poor, every attempt should be made to repair the cuff securely and carefully direct postoperative physical therapy.

Aged↗