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At least 1,243 records · Page 69Linked to original sources
PubMed1994

[Enthesopathy of the coraco-acromial ligament and rupture of the rotator cuff].

Ossification of the coracoacromial ligament was looked for routinely on the roentgenograms of 50 patients with arthrographically-documented rotator cuff tear and of 25 controls free of clinical evidence of shoulder disease. Ossification of the coracoacromial ligament was seen in none of the 25 controls versus 12 of the 50 patients. The ossification consistently arose from the acromial attachment site. A few patients developed ossification of the entire ligament bridging the gap between the acromion and coracoid process.

Female↗
PubMed1994

Mechanical strength of repairs of the rotator cuff.

We have studied the mechanical properties of several current techniques of tendon-to-bone suture employed in rotator-cuff repair. Non-absorbable braided polyester and absorbable polyglactin and polyglycolic acid sutures best combined ultimate tensile strength and stiffness. Polyglyconate and polydioxanone sutures failed only at high loads, but elongated considerably under moderate loads. We then compared the mechanical properties of nine different techniques of tendon grasping, using 159 normal infraspinatus tendons from sheep. The most commonly used simple stitch was mechanically poor: repairs with two or four such stitches failed at 184 N and 208 N respectively. A new modification of the Mason-Allen suture technique improved the ultimate tensile strength to 359 N for two stitches. Finally, we studied the mechanical properties of several methods of anchorage to bone using typically osteoporotic specimens. Single and even double transosseous sutures and suture anchor fixation both failed at low tensile loads (about 140 N). The use of a 2 mm thick, plate-like augmentation device improved the failure strength to 329 N. The mechanical properties of many current repair techniques are poor and can be greatly improved by using good materials, an improved tendon-grasping suture, and augmentation at the bone attachment.

Animals↗
PubMed2001

Treatment options in full thickness rotator cuff tears.

Increasing interest in shoulder pathology during the last decades has considerably diversified the possible treatment options of full thickness rotator cuff tears. This review of the recent literature combined with information gathered during recent European shoulder meetings attempts to summarize present trends. Every full thickness cuff tear, except for the acute traumatic tear in younger patients, should always benefit first from a conservative rehabilitation program. In case of failure of the latter, reparable tears should be repaired, except perhaps in a low-demand population. This latter group of patients, presenting with a massive, irreparable tear may be satisfied with an arthroscopic debridement, but interposition techniques provide better results in activities of daily living and also give better strength. Salvage procedures such as muscle tendon transfers are technically demanding and must be reserved for the younger age group. For arthroplasty, the choice between a nonconstrained total prosthesis and a hemiprosthesis can be difficult; the early functional results of the reversed prosthesis seem to be very promising in an elderly but still active population.

Adolescent↗
PubMed1996

Isolated subacromial decompression for the treatment of chronic shoulder pain with rotator cuff calcification. A review of twenty-seven shoulders, including eighteen evaluated by magnetic resonance imaging after surgery.

We conducted a retrospective study of functional results and imaging study changes after isolated anterosuperior decompression of 27 chronically painful shoulders with calcification of the supraspinatus tendon at the time of surgery (n = 22) or at an earlier date (n = 5). Mean duration of pain at surgery was 4.5 years. Mean time between surgery and evaluation of results was three years. Absence of pain and full range of motion were noted in most cases (70%), usually after four to six months. There were no postoperative exacerbations of pain. The best results were obtained in those patients with a heterogeneous supraspinatus calcification. Most calcifications (18/22) disappeared within one year of surgery. Magnetic resonance imaging findings at last follow-up are reported for 18 shoulders. Functional results were nearly as good as those reported after calcification removal. In patients with shoulder pain and rotator cuff tendon calcifications who fail to respond to conservative therapy and aspiration with lavage, anterosuperior decompression may be the treatment of choice when the calcification is either heterogeneous and located within the tendon or no longer visible. In contrast, curettage may be the best treatment for superficial homogeneous calcifications that can be removed without damaging the rotator cuff.

Adult↗
PubMed1992

[Radiological exploration of the shoulder rotator cuff].

Plain X-rays and Lecler's manoeuvre constitute the essential basic assessment in the diagnostic approach to lesions of the rotator cuff. The preoperative assessment of the lesions and the search for associated lesions are based on more or less invasive investigations. For many years, arthrography was the reference examination to establish a precise assessment, but was sometimes insufficient for the diagnosis of small partial non-communicating lesions and certain longstanding massive ruptures. Ultrasonography is an attractive non-invasive technique, but the quality of the results depends on the operator's experience. Although computed tomography and CT arthrography provide a perfect analysis of the anterior aspect of the cuff and evaluate the trophicity of the muscles, they are difficult to interpret, irradiating and sometimes incomplete. MRI, a non-invasive and non-irradiating technique, is the modality of choice due to its excellent contrast resolution and the possibility of multidirectional studies and a spatial resolution which is continually improved by new acquisition sequences and the use of better adapted surface coils.

Arthrography↗
PubMedDate not supplied

Calcific tendinitis of the rotator cuff showing a contracted state of abduction: a report of four cases.

This report describes four patients with calcific tendinitis of the rotator cuff that resulted in an abduction contracture. Similarities included an acute onset, lack of tenderness in the shoulder, x-ray demonstration of large calcific deposits in the supraspinatus tendon, and the radiographic appearance of the greater tuberosity under the acromion. The abduction contracture is presumably caused by mechanical blocking by the calcified deposits and the coracoacromial arch and by reflex muscle spasm caused by pain.

Adult↗
PubMed1997

Treatment of chronic rotator-cuff impingement by arthroscopic subacromial decompression.

We report a prospective study of 49 patients who had arthroscopic subacromial decompression for chronic rotator-cuff impingement. All patients were assessed preoperatively and at 3, 6 and 12 months using the modified UCLA shoulder score. The dominant arm was affected in 35 patients, but only 13 recognised overuse as a cause of their shoulder pain. Before operation, the UCLA shoulder score was poor or fair in all patients. After three months only 28% of patients had satisfactory relief of symptoms but at one year 85% of patients examined had a good or excellent result. Patients with calcific tendonitis recovered more quickly: 93% reported a good result at six months. We conclude that arthroscopic subacromial decompression is an effective form of treatment, but that patients should be warned that recovery from surgery may be prolonged.

Adult↗
PubMed1999

[The phenomena of irradiating pain in rotator cuff tear: quantitative analysis].

The aim of this study was the quantitative analysis of the phenomena of pain radiation in the case of rotator cuff tear. The clinical material concerns 97 patients, age range from 45 to 86 years. Radiating pain was noted in 33 cases; radiation into distal part of arm--12.4%, elbow--9.3%, forearm--6.2%, hand--1%, hand and thumb 2.1%, 5th finger--1.0%, neck--1.0% and into axilla--1.0%. The radiation of pain was provoked by one finger pressure over tender point (84.8%) or by impingement sign (15.2%). Next the impingement test was performed and additionally supplemented by intraarticular lidocaine injection in 5 cases. Radiation of pain disappeared completely in 26 cases, partly in 6 and persisted in one.

Aged↗
PubMed1990

Magnetic resonance imaging in acute and chronic rotator cuff tears.

Magnetic resonance imaging has been assessed in patients with acute rotator cuff tears and normal radiographs (9 cases) and those with chronic tears and changes of cuff arthropathy (9 cases). All images were obtained using a low field strength system (FONAR 0.3 T). Particular attention was placed on the appearances of the tendon and the cuff muscles themselves. Six complete acute tears were clearly identified, but MRI failed to demonstrate two partial tears. Muscle bulk was preserved in all patients in this group. In contrast, all patients with cuff arthropathy had complete tears of the supraspinatus tendon with marked tendon retraction and associated muscle atrophy: these changes precluded primary surgical repair. MRI should be used to assess muscle atrophy preoperatively in those patients with acute tears. When plain radiographs demonstrate cuff arthropathy, the MRI appearances are predictable and primary repair is unlikely to be successful. Further imaging is therefore not indicated.

Acute Disease↗