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Rotator Cuff Rupture

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1. Clinical Practice Guideline on the Management of Rotator Cuff Injuries

Clinical Practice Guideline on the Management of Rotator Cuff Injuries View background material via the RC CPG eAppendix 1 View data summaries via the RC CPG eAppendix 2 1 MANAGEMENT OF ROTATOR CUFF INJURIES CLINICAL PRACTICE GUIDELINE Adopted by the American Academy of Orthopaedic Surgeons Board of Directors March 11, 2019 Endorsed by: Please cite this guideline as: American Academy of Orthopaedic Surgeons. Management of Rotator Cuff Injuries Clinical Practice Guideline. https://www.aaos.org (...) /rotatorcuffinjuriescpg Published March 11, 2019 View background material via the RC CPG eAppendix 1 View data summaries via the RC CPG eAppendix 2 2 Disclaimer This Clinical Practice Guideline was developed by an AAOS physician volunteer Clinical Practice Guideline development group based on a systematic review of the current scientific and clinical information and accepted approaches to management of rotator cuff injuries. This clinical practice guideline is not intended to be a fixed protocol, as some patients may

2020 American Academy of Orthopaedic Surgeons

2. Risk of latissimus dorsi tendon rupture after arthroscopic transfer for posterior superior rotator cuff tear: a comparative analysis of 3 humeral head fixation techniques. (Abstract)

Risk of latissimus dorsi tendon rupture after arthroscopic transfer for posterior superior rotator cuff tear: a comparative analysis of 3 humeral head fixation techniques. To compare latissimus dorsi tendon rupture rates after arthroscopic transfer for posterior superior rotator cuff tear using 3 different humeral head fixation techniques.One-hundred fifty consecutive latissimus dorsi transfers were included. Inclusion criteria were massive irreparable posterosuperior rotator cuff tear (...) at a fixed distance of 2, 4, and 6 cm from the tip. Immediate postoperative standard anteroposterior radiographs were performed to confirm the position of the clips and to determine whether the clips displaced on subsequent radiographs during follow-up, indicating tendon rupture.Repeat radiographs at 3-month follow-up showed higher risk of latissimus dorsi transfer rupture rate in 27/59 patients in group 1 (46%), 11/47 in group 2 (24%), and 7/44 in group 3 (15%).Posterior anchor fixation

2019 Journal of Shoulder and Elbow Surgery

3. The prevalence of rotator cuff pathology in the setting of acute proximal biceps tendon rupture. (Abstract)

The prevalence of rotator cuff pathology in the setting of acute proximal biceps tendon rupture. The prevalence and severity of concomitant rotator cuff pathology in the setting of proximal biceps tendon ruptures are poorly understood. Concomitant rotator cuff disease may have important implications in the prognosis and natural history of this shoulder condition. Therefore, an observational cohort of patients with an acute rupture of the long head of the biceps tendon (LHBT) was evaluated (...) to determine the prevalence and severity of concomitant rotator cuff disease.Thirty consecutive patients diagnosed with acute proximal biceps tendon rupture were prospectively enrolled. Magnetic resonance imaging of the affected shoulder was obtained in 27 patients and reviewed by a fellowship-trained orthopedic surgeon.The cohort consisted of 20 men (74%) and 7 women (26%) (mean age, 61.0 years [range, 42-78 years]). The dominant side was involved in 20 injuries (74%), and a low-energy trauma mechanism

2018 Journal of Shoulder and Elbow Surgery

4. Proximal Long Head Biceps Rupture: A Predictor of Rotator Cuff Pathology. (Abstract)

Proximal Long Head Biceps Rupture: A Predictor of Rotator Cuff Pathology. To investigate whether acute rupture of the proximal long head biceps is a harbinger of disease of the nearby supraspinatus and subscapularis tendons.A retrospective chart review from February 1, 2008, to August 31, 2016, was performed at our institution identifying patients who presented with an acute (<12-week) history of "Popeye" deformity of the distal biceps and a magnetic resonance imaging (MRI) of the affected (...) shoulder. MRI images were then reviewed in duplicate to determine supraspinatus and subscapularis tendon tear incidence, size, chronicity, and depth. The association between rotator cuff status and acute long head biceps rupture as well as patient age, sex, smoking status, hand dominance, and history of diabetes mellitus or trauma was then evaluated.A total of 116 patients were included in this study (mean age: 61.9 ± 10.9 years). A significant proportion (n = 99; incidence: 85%) were found to have

2018 Arthroscopy

5. Delaminated Rotator Cuff Tears Showed Lower Short-term Retear Rates After Arthroscopic Double-Layer Repair Versus Bursal Layer-Only Repair: A Randomized Controlled Trial (Abstract)

Delaminated Rotator Cuff Tears Showed Lower Short-term Retear Rates After Arthroscopic Double-Layer Repair Versus Bursal Layer-Only Repair: A Randomized Controlled Trial The rotator cuff is known to consist of 2 macroscopically visible layers that have different biomechanical properties. Sometimes the inferior layer may be neglected during rotator cuff repair. However, it is controversial whether double-layer (DL) repair is superior to single-layer (SL) repair in terms of retear rate (...) and outcome.To investigate whether DL as compared with SL repair could decrease retear rates after arthroscopic reconstruction of posterosuperior rotator cuff tears.Randomized controlled trial; Level of evidence, 1.A total of 70 patients were 1:1 randomized to receive an arthroscopic DL reconstruction (study group: DL suture-bridge repair) or SL reconstruction (control group: SL suture-bridge repair) for posterosuperior tears of the rotator cuff between 2.0 and 3.5 cm of the footprint detachment. Exclusion

2020 EvidenceUpdates

6. No difference in long-term development of rotator cuff rupture and muscle volumes in impingement patients with or without decompression. Full Text available with Trip Pro

No difference in long-term development of rotator cuff rupture and muscle volumes in impingement patients with or without decompression. Background and purpose - Arthroscopic acromioplasty is still commonly used in the treatment of shoulder impingement syndrome, even though its benefits are questioned; randomized controlled studies have not shown any benefits when compared to non-operative treatment. In this randomized study, we investigated whether operative treatment protects from later (...) rotator cuff rupture and whether it has any effect on the development of rotator cuff muscle volume. Patients and methods - 140 stage-II impingement patients were randomized to a structured exercise group (n = 70) or to an operative group (n = 70). In the operative group, arthroscopic acromioplasty was performed, after which a similar structured exercise program was begun. MRI of the shoulder was done at baseline and at 5 years. Results - There were no statistically significant differences in either

2017 Acta Orthopaedica Controlled trial quality: uncertain

7. Quantifying Extensibility of Rotator Cuff Muscle with Tendon Rupture Using Shear Wave Elastography: A Cadaveric Study Full Text available with Trip Pro

Quantifying Extensibility of Rotator Cuff Muscle with Tendon Rupture Using Shear Wave Elastography: A Cadaveric Study Surgical repair for large rotator cuff tear remains challenging due to tear size, altered muscle mechanical properties, and poor musculotendinous extensibility. Insufficient extensibility might lead to an incomplete reconstruction; moreover, excessive stresses after repair may result in repair failure without healing. Therefore, estimates of extensibility of cuff muscles can (...) help in pre-surgical planning to prevent unexpected scenarios during surgery. The purpose of this study was to determine if quantified mechanical properties of the supraspinatus muscle using shear wave elastography (SWE) could be used to predict the extensibility of the musculotendinous unit on cadaveric specimens. Forty-five fresh-frozen cadaveric shoulders (25 intact and 20 with rotator cuff tear) were used for the study. Passive stiffness of 4 anatomical regions in the supraspinatus muscle

2017 Journal of biomechanics

9. Inferior outcome of rotator cuff repair in chronic hemodialytic patients. Full Text available with Trip Pro

Inferior outcome of rotator cuff repair in chronic hemodialytic patients. Repair of rotator cuff tears has yielded excellent functional outcomes in recent decades; however, poor outcomes and dissatisfaction have been noted in specific groups. Spontaneous tendon rupture has been reported in patients receiving long-term hemodialysis owing to alteration of tendon structure, which might impede functional recovery after rotator cuff repair. The purpose of the present study was to compare (...) the clinical outcomes between hemodialysis and non-hemodialysis patients after rotator cuff repair.We retrospectively reviewed patients who underwent mini-open rotator cuff repair from Jan 2013 to Jan 2017. A total of 14 patients under chronic hemodialysis (HD) were matched to non-hemodialysis (NHD) patients at a 1:2 ratio according to age, gender, tear size, severity of fatty infiltration and history of diabetes. Pre- and post-operative functional outcome was assessed using the simple shoulder test (SST

2019 BMC Musculoskeletal Disorders

10. Association of Superoxide-Induced Oxidative Stress With Rotator Cuff Tears in Human Patients. Full Text available with Trip Pro

of superoxide-induced oxidative stress to rotator cuff tears. Seventy patients were recruited and divided into two groups: patients with (Ruptured group) and those without (Unruptured group) a rotator cuff tear. Specimens from both groups were collected during surgery. Degeneration morphology was classified according to the degeneration score. Superoxide-induced oxidative stress was assessed according to dihydroethidium (DHE) relative fluorescence intensity, capacity for antioxidation according (...) Association of Superoxide-Induced Oxidative Stress With Rotator Cuff Tears in Human Patients. Rotator cuff degeneration is one of the factors contributing to rotator cuff tears. Oxidative stress is involved in tendon degeneration, and superoxide-induced oxidative stress plays a pathological role in regulating the balance between oxidation and reduction. The role of oxidative stress in rotator cuff tears, however, is unclear. This study, therefore, aimed to investigate the contribution

2019 Journal of Orthopaedic Research

11. Early Arthroscopic Repair of Acute Traumatic Massive Rotator Cuff Tears Leads to Reliable Reversal of Pseudoparesis: Clinical and Radiographic Outcome. Full Text available with Trip Pro

Early Arthroscopic Repair of Acute Traumatic Massive Rotator Cuff Tears Leads to Reliable Reversal of Pseudoparesis: Clinical and Radiographic Outcome. It was the aim of this study to analyze the clinical and radiographic outcome after early arthroscopic repair regardless of the age of patients.Patients with massive traumatic cuff tear and clinical pseudoparesis for forward elevation treated by subsequent early arthroscopic repair from 2011 until 2014 were included in this retrospective study (...) . Exclusion criteria were Goutallier grade ≥3 fatty infiltration and prior shoulder problems or surgery. Magnetic resonance imaging (MRI), radiographs, and functional assessments were performed preoperatively and at follow-up.A total of 21 patients (male/female 15/6; age range: 30-83) were included. Preoperative MRI showed complete 2 tendon tears in 7 patients, 3 tendon tears in 13 patients and all tendons ruptured in one patient. All patients had full passive range of motion and the mean active elevation

2019 Arthroscopy

12. The cost-effectiveness of reverse total shoulder arthroplasty compared with hemiarthroplasty for rotator cuff tear arthropathy

with hemiarthroplasty for rotator cuff tear arthropathy. Journal of Shoulder and Elbow Surgery 2012; 21(10): 1278-1288 PubMedID DOI Original Paper URL Indexing Status Subject indexing assigned by NLM MeSH Aged; Aged, 80 and over; Arthroplasty, Replacement /economics /methods; Cost-Benefit Analysis; Hemiarthroplasty /economics /methods; Humans; Lacerations /complications /surgery; Middle Aged; Range of Motion, Articular; Retrospective Studies; Rotator Cuff /surgery; Rupture /diagnosis /surgery; Shoulder Joint (...) The cost-effectiveness of reverse total shoulder arthroplasty compared with hemiarthroplasty for rotator cuff tear arthropathy The cost-effectiveness of reverse total shoulder arthroplasty compared with hemiarthroplasty for rotator cuff tear arthropathy The cost-effectiveness of reverse total shoulder arthroplasty compared with hemiarthroplasty for rotator cuff tear arthropathy Coe MP, Greiwe RM, Joshi R, Snyder BM, Simpson L, Tosteson AN, Ahmad CS, Levine WN, Bell JE Record Status

2012 NHS Economic Evaluation Database.

13. Scapular Kinematic Changes on Patients With Rotator Cuff Repair

Intervention/treatment Phase Alterations in Scapular Kinematics After RC Repair Other: scapular stabilization exercise Not Applicable Detailed Description: Rotator Cuff (RC) muscles are primary dynamic stabilizers of shoulder joint. Therefore, the repair of rotator cuff ruptures is a common procedure. The primarly goals of the post-surgical rehabilitation are gaining normal ranges of glenohumeral joint and restoring the kinematics of shoulder girdle. The scapular stabilization exercises are important (...) Scapular Kinematic Changes on Patients With Rotator Cuff Repair Scapular Kinematic Changes on Patients With Rotator Cuff Repair - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Scapular Kinematic Changes

2018 Clinical Trials

14. Sonoelastography to Predict Rotator Cuff Tears

for MeSH terms Rotator Cuff Injuries Rupture Wounds and Injuries Shoulder Injuries Tendon Injuries (...) Sonoelastography to Predict Rotator Cuff Tears Sonoelastography to Predict Rotator Cuff Tears - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Sonoelastography to Predict Rotator Cuff Tears The safety

2018 Clinical Trials

15. Superior Glenohumeral Translation in Patients With Degenerative Rotator Cuff Tears

, 2018 Last Update Posted : October 24, 2018 See Sponsor: University Hospital, Basel, Switzerland Information provided by (Responsible Party): University Hospital, Basel, Switzerland Study Details Study Description Go to Brief Summary: Degenerative partial and complete rupture of the rotator cuff is a common injury among elder patients. However, the clinical manifestation varies largely with some patients having severe pain and limiting range of motion and others having no complaints. The basic (...) /treatment Rotator Cuff Tear or Rupture, Not Specified as Traumatic Diagnostic Test: Glenohumeral translation assessment Detailed Description: The study will examine a cohort of 10 patients with isolated complete supraspinatus muscle tear and 10 patients with complete supraspinatus muscle tear and either partial infraspinatus muscle tear or partial subscapularis muscle tear, and a cohort of 10 age-matched healthy control persons. The participants will be recruited from the Clinic of Orthopaedics

2018 Clinical Trials

16. Liposomal Bupivacaine for Pain Control After Rotator Cuff Repair

Liposomal Bupivacaine for Pain Control After Rotator Cuff Repair Liposomal Bupivacaine for Pain Control After Rotator Cuff Repair - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Liposomal Bupivacaine (...) for Pain Control After Rotator Cuff Repair The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03692546 Recruitment Status : Completed First Posted : October 2, 2018 Last Update Posted : October 2, 2018 Sponsor: Orthopaedic & Neurosurgery Specialists Information provided by (Responsible Party): Paul Sethi

2018 Clinical Trials

17. Bone Marrow Derived Stem Cells for the Treatment of Rotator Cuff Tears

for additional information Studies a U.S. FDA-regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Keywords provided by Jason L. Dragoo, Stanford University: Bone marrow aspirate Biologics Additional relevant MeSH terms: Layout table for MeSH terms Rotator Cuff Injuries Rupture Wounds and Injuries Shoulder Injuries Tendon Injuries (...) Bone Marrow Derived Stem Cells for the Treatment of Rotator Cuff Tears Bone Marrow Derived Stem Cells for the Treatment of Rotator Cuff Tears - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Bone Marrow

2018 Clinical Trials

18. Epigenetic regulation of metalloproteinases and their inhibitors in rotator cuff tears. Full Text available with Trip Pro

expression. Here, the mRNA expression and DNA methylation status of MMPs (MMP1, MMP2, MMP3, MMP9, MMP13, and MMP14) and TIMPs (TIMP1-3) and the expression of miR-29 family members in ruptured supraspinatus tendons were compared with non-injured tendons of individuals without this lesion. Additionally, the gene expression and methylation status at the edge of the ruptured tendon were compared with macroscopically non-injured rotator cuff tendon samples from the anterior and posterior regions of patients (...) Epigenetic regulation of metalloproteinases and their inhibitors in rotator cuff tears. Rotator cuff tear is a common orthopedic condition. Metalloproteinases (MMP) and their inhibitors (TIMP) seem to play a role in the development of joint injuries and in the failure of tissue healing. However, the mechanisms of regulation of gene expression in tendons are still unknown. Epigenetic mechanisms, such as DNA methylation and microRNAs regulation, are involved in the dynamic control of gene

2017 PLoS ONE

19. Hidden degloving rotator cuff tears secondary to glenohumeral dislocation. (Abstract)

Hidden degloving rotator cuff tears secondary to glenohumeral dislocation. A rare form of rotator cuff tear (RCT) is observed secondary to glenohumeral dislocation, followed by immediate repositioning, as well as formation of scar tissue between tendons and tuberosities. Radiographic diagnosis of such "degloving" tears is problematic because they are obscured by scar tissue. We aimed to describe characteristics of degloving tears and report outcomes following their arthroscopic repair.Among 67 (...) a particular form of RCT secondary to glenohumeral dislocation, resulting in degloving of the rotator cuff, followed by repositioning of tendons. The formation of scar tissue can obscure tendon tears on ultrasound, in which case further imaging is recommended to ascertain the diagnosis and avoid therapeutic delays.Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

2018 Journal of Shoulder and Elbow Surgery

20. Intra-articular treatment with corticosteroids increases apoptosis in human rotator cuff tears. (Abstract)

and dispersed in all tear zones; while in corticosteroid treated patients, the tendency was similar in all rupture sites.This investigation leads us to conclude that the administration of corticosteroid is associated with a higher amount of apoptosis at the insertion site of the rotator cuff (rupture edge). (...) Intra-articular treatment with corticosteroids increases apoptosis in human rotator cuff tears. The aim of this study is to evaluate in vivo the level of apoptosis in human rotator cuff tears and the relationship it might have with tendon degeneration.Rotator cuff biopsies from 19 male and female patients, ages between 38 and 68 years, with and without previous corticosteroid infiltrations were collected via arthroscopy. Biopsies from seven patients with healthy rotator cuffs were used

2018 Connective Tissue Research

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