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Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_11 | Pages 173 - 173
1 Jul 2014
Papalia R Vadalà G Moro L Franceschi F Vasta S Albo E Tecame A Maffulli N Denaro V
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Introduction

recent studies recognised metabolic abnormalities as additional factors in the development of rotator cuff (RC) tendinopathy. It has been hypothesised that the insertional area of this tendon is susceptible to degenerative changes due to intrinsic hypovascularization. The mechanisms underlying this process are not yet clear. In this study we attempted to confirm if larger lesions of the RC are related to impaired vasodilatatory response of the local circulation in conditions of “hemodynamic stress”.

Patients & Methods

it was assumed that impaired vasal reaction to “hemodynamic stress” was a systemic condition. This phenomenon should therefore be not limited to the critical area of the tendon tear. Given this assumption post-ischemic vasodilation of brachial artery was studied through an echo-doppler (US) evaluation. 50 patients (mean 61 ± 4, range 50–65) all scheduled for surgical rotator cuff repair following a tendon tear, were enrolled. Three preoperative measurements of the brachial artery diameter before and after application of an ischemic band were collected. The size of the lesions was later assessed at the time of surgery. A statistical analysis was carried on to investigate the correlation between US assessment of brachial artery diameter and the corresponding size of the RC lesions. UCLA and ASES scores were also measured to assess clinical and functional outcomes.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 264 - 264
1 Mar 2004
Acebal-Cortina G Murcia-Mazòn A Moro-Barrero L García-Menéndez C Suárez-Suárez M
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Aims: To determine whether the use of Biphasic Calcium Phosphate (BCP) plus local autogenous graft modifies our clinical results and fusion rate, in comparison with iliac crest graft alone. Methods: Prospective and nonrandomized study. 40 patients were operated on with pedicle instrumentation and posterolateral fusion. Degenerative lumbar disease was the etiology. 25 patients had one level fusion and 15 two or more. Minimum follow-up: 1 year. 15 patients were smokers (17.4 cig/day). The Oswestry disability index at 0, 3, 6 and 12 months was filled in to see the evolution and final clinical result. To evaluate the fusion, X-ray criteria were used. Results: Oswestry test changed from 63,8 to 16,4 at the end of the study. 3 patients did not achieve fusion (7,5%), none of them smokers. Up to date we have been working with the same idea but trying to increase the fusion rate by adding bone marrow to BCP and grafts. The initial results are very encouraging. Conclusions: We have no difference in our non-union rate between previous historic register and the new technique.

Similar clinical results were obtained but the proportion of excellent/good has improved with iliac crest preservation.