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At least 1,207 records · Page 67Linked to original sources
PubMed1993

A new approach to the subacromial space. Technique and 2-year results in 28 rotator-cuff repair cases.

We present a new approach to the subacromial space, consisting essentially of an osseous detachment of the deltoid muscle from the anterior and lateral rim of the acromion including the osseous origin of the coraco-acromial ligament. After acromioplasty and an eventual reconstruction of a torn rotator cuff, Kessler-sutures provide stable transosseous repair of the deltoid muscle. This method generally allows immediate active shoulder motion. 25 of 28 patients with rotator cuff ruptures alone or in combination with an impingement syndrome had good results according to the UCLA-score 2 years postoperatively. No serious complications regarding the function of the deltoid muscle or any failure of the accompanying acromioplasty occurred.

Acromion↗
PubMed1986

Rotator cuff lesions of the shoulder: evaluation by direct sagittal CT arthrography.

Direct sagittal computed tomographic scanning (DSCT) of the shoulder was performed in 42 symptomatic patients, six healthy volunteers, and two cadaver shoulders. Axial CT scanning and double-contrast arthrography with plain radiographs were performed in 41 patients for comparison. DSCT enabled correct identification of 27 of 29 lesions in 24 patients. Seventeen patients had normal shoulders. Axial CT scanning and DSCT together enabled correct identification of all lesions and were markedly superior to plain-film arthrography. DSCT enabled diagnosis of all cases of complete rotator cuff tear plus three cases of incomplete tear and three of rotator cuff atrophy not identified by the other techniques. Axial CT scanning was better than DSCT for diagnosis of Bankart lesions.

Adolescent↗
PubMed1995

Rotator cuff.

Explore the source record for details and available documents.

Adult↗
PubMed1993

Results of nonoperative management of full-thickness tears of the rotator cuff.

The results of nonoperative management of 53 patients with full-thickness tears of the rotator cuff proven by arthroscopic examination was as follows. Patients were treated with nonsteroidal antiinflammatory medication, stretching, strengthening, and occasional steroid injections. Average age at presentation was 62.2 years. Patients were evaluated at an average of 7.6 years. Forty patients were male, and the dominant limb was involved in 40 cases. Thirty-four patients were reviewed by questionnaire and physical examination, whereas 19 patients were evaluated by telephone interview only. In 40 patients, the onset of symptoms was associated with an injury. In 12 patients, workmen's compensation was involved. At follow-up evaluation, the 34 shoulders that were available for examination were evaluated for pain, range of motion, strength, and function. Thirty-nine of the 53 patients (74%) assessed subjectively had only slight or no shoulder discomfort. Of the 28 shoulders presenting within three months of injury, 24 (86%) were rated as satisfactory at the time of latest evaluation. Of the 16 patients who initially had had shoulder pain for over 6 months, only nine (56%) were rated as satisfactory. Most patients showed improvement with regard to their ability to perform activities of daily living. Average active total elevation was 149 degrees compared with 121 degrees at initial presentation. Thirty-two of the 34 patients examined (94%) had evidence of weakness on muscle testing and 19 (56%) had demonstrable muscle atrophy.

Activities of Daily Living↗
PubMed1986

Rotator cuff tendinitis: comparison of subacromial injection of a long acting corticosteroid versus oral indomethacin therapy.

Using a prospective, double blind, double dummy protocol, we compared the efficacy of subacromial injection of 40 mg of triamcinalone acetonide versus oral indomethacin, 100 mg/day, in 40 patients with acute rotator cuff tendinitis. Repeat injection and refill of medication was given after 3 weeks, if necessary. At 6 weeks, there was no significant difference between the 2 groups with respect to the percentage of patients who improved (60 vs 66%) or the magnitude of the change of pain and motion variables. This study suggests that there is essentially no difference in the short term efficacy of oral nonsteroidal therapy compared to local corticosteroid injection(s) in the treatment of rotator cuff tendinitis.

Administration, Oral↗
PubMed1975

[Combined traumatic rupture of the rotator cuff and nerve lesions (author's transl)].

Traumatic damage to the rotator cuff was diagnosed in 13 patients by clinical, electromyographic and arthrographic studies. The main features were failure to rotate, elevate or abduct the affected shoulder joint. Eight patients also had peripheral nerve lesions: axillary nerve lesion was present in five, partial brachial plexus lesion in three.

Adult↗
PubMed2006

The strength of suture configurations in arthroscopic rotator cuff repair.

PURPOSE: This study evaluated the strength of different suture configurations with the use of a recently introduced arthroscopic suture passer (ExpressSew; Surgical Solutions, Valencia, CA). METHODS: The ultimate tensile strength and mode of failure of each suture configuration were repeatedly tested on a validated porcine rotator cuff tendon model, with the use of standard suture material (No. 2 FiberWire [Arthrex, Naples, FL]) passed with ExpressSew and tested on a Hounsfield digital tensiometer type H20K-W (Tinius Olsen, Hersham, PA). RESULTS: The strongest construct was 2 mattress sutures (mean, 169 N; standard deviation, 56.1 N); this was followed in strength by a single modified Kessler suture (mean, 161 N; standard deviation, 16.9 N), 4 simple sutures (mean, 155 N; standard deviation, 27.3 N), and finally, a single Mason-Allen suture (mean, 140 N; standard deviation, 28.6 N). CONCLUSIONS: Study results show little difference in strength for varying complexities of suture configurations. In simple terms, no demonstrable difference was seen in the strength of construct, whether the surgeon used 4 simple sutures, 2 mattress sutures, or 1 grasping suture. CLINICAL RELEVANCE: This study allows the surgeon to justify use of the simplest configuration of suture passage that works in his hands, for the purpose of attaining a reliable and repeatable repair of the rotator cuff through arthroscopic methods.

Animals↗
PubMedDate not supplied

[Surgical therapy and results in rupture of the rotator cuff].

Follow up evaluations of 57 patients with surgically treated rotator cuff tears are presented and valued with regard to the literature. A short anterior exposure and cuff anchorage to the humerus is the method of choice. Anterior acromioplasty should not be a routine. Attention should be paid to adhesions of the sub-coracoidal space, they should be separated if necessary. Patients being of older age, with a short history and a long time interval between operation and final evaluation do have the best results.

Aged↗
PubMed2005

[Histological lesions of supraspinatus tendons in full thickness tears of the rotator cuff].

PURPOSE OF THE STUDY: Iterative tears after simple tendon bone suture of transfixiant ruptures of the rotator cuff are frequent. The frequency of iterative ruptures had seemed to be correlated to the importance of the preoperative fatty degenerations of the cuff muscles. But fatty degeneration cannot account for iterative ruptures occurring with no or little preoperative muscle fatty degeneration. The authors have tried to know if iterative ruptures could also be accounted for by the presence on repaired tendinous stumps of histological lesions which are known to lower their mechanical quality, and if such was the case, they have tried to know what could be the impact of these lesions on the repairing technique by suturing cuff ruptures. MATERIAL AND METHOD: Thirty-two distal stumps of ruptured supraspinatus, resected on more than 1 cm to eliminate macroscopic tendinous lesions (thin, lacerated, cleaved, hardened or whitish tendons) and to reach a new stump, slightly bleeding and thick enough to hold the stitches correctly, have been studied on longitudinal histological slides. RESULTS: All the tendinous resected stumps had histological anomalies: dilacerations lesions of the conjunctive tissue, fatty infiltrations, necrosis, scar lesions and micro calcifications were found. The histological lesions were often associated. The histological lesions were an average 4 mm shorter than those of the tendinous resection. In 18 cases however the whole of the resected tendon was histologically abnormal. DISCUSSION: Tendinous histological lesions found on the whole or almost the whole length of the macroscopically abnormal tendinous stumps diminish the mechanical quality of the tendons. Insufficient resection of the tendinous stumps leaving macroscopical lesions and therefore histological lesions could account for iterative ruptures in the first post operative year. Yet complete resection of the macroscopically abnormal tendinous stump does not entail that the neo tendinous stump to be repaired is histologically normal. This encourages to put the stitches well within the zone of the tendinous resection and to bury the tendinous stumps into a highly vascular bony trough. But tendinous resection although logical from the histological and mechanical point of view widens the rupture of the cuff to be repaired. It can make sutures under tension, which can entail iterative ruptures. Musculo-tendinoplasty appears then necessary to perform sutures without tension. CONCLUSION: Histological lesions of tendinous stumps of cuff ruptures correspond roughly to tendinous macroscopic lesions. They could be at the origin of iterative ruptures that take place after simple tendon-bone sutures of ruptured cuffs which are not accounted for by muscular fatty degeneration. They could also partly account for iterative ruptures taking place when pre operative fatty degeneration is evident. It seems logical to resect macroscopically abnormal tendinous stumps before performing a suture. But the tendon-bone suture without tension is then often possible only with musculo-tendinoplasties.

Aged↗
PubMed2005

[Subacromial hematoma due to rotator cuff rupture].

This is an unusual case report of an elderly patient with spontaneous acute rupture of rotator cuff complicated by large subacromial hematoma. The hematoma fluid was aspirated with significant reduction of pain. The shoulder movements were restored after one month with conservative therapy. The compensatory role of preserved deltoid muscle is considered in the rehabilitation of normal shoulder movement, which may replace aggressive immobilization or surgical procedures in the elderly population. Investigation of hematoma fluid compared with blood 24 hours after the event revealed severe lactic acidosis with low glucose level, preserved red blood cell count and significant decrease of white blood cells. There were normal values of CBC, pH, lactate and glucose in blood. These results showed high susceptibility of leukocytes to anaerobic and acid environment and its dependence on oxygen supplement.

Aged↗