Objectives. Although many clinical and experimental investigations have shed
light on muscle atrophy and intramuscular accumulation of fat after
rotator cuff disruption, none have reported on their onset in the
absence of muscle retraction. Methods. In 30 rabbits, we detached one supraspinatus (SSP) tendon and
repaired it immediately, thus preventing muscle retraction. The
animals were killed in groups of 10 at one, two and six weeks. Both
shoulders of 15 non-operated rabbits served as controls. We measured
the weight and volume of SSP muscles and quantified the cross-sectional
area of intramuscular fat (i-fat) histologically. Results. There was significant loss of muscle weight and volume after
one week (p = 0.004 and 0.003, respectively), and two weeks (both
p <
0.001) in the experimental group; which recovered to control
values after six weeks. I-fat accumulated one week after immediate repair,
greater than in the control group and statistically significant
at the mid-part of the muscle (mean 2.7% vs 1.5%,
p = 0.008). I-fat continued to accumulate up to six weeks at all sites
of the SSP muscle (all 3, p <
0.001). More fat accumulated closer
to the musculotendinous junction than at the mid-part after two
and six weeks (p = 0.012 and 0.019, respectively). Conclusion. Muscle atrophy and i-fat accumulation occur early after SSP tendon
tear and immediate repair. While early repair benefitted muscle
recovery, it did not prevent fat accumulation. SSP muscle retraction
was not essential to the muscle alterations. The divergent evolution
of muscle and fat points to different
The aim of this study was to examine the recent trend in delivery of arthroscopic subacromial decompression (ASD) in Scotland and to determine if this varies by geographical location. Scottish Morbidity Records were reviewed retrospectively between March 2014 and April 2018 to identify records for every admission to each NHS hospital. The Office of Population Censuses and Surveys (OPCS-4) surgical codes were used to identify patients undergoing primary ASD. Patients who underwent acromioclavicular joint excision (ACJE) and rotator cuff repair (RCR) were identified and grouped separately. Procedure rates were age and sex standardized against the European standard population.Aims
Methods
The aim of this study was to compare the osseous reactions elicited by all-suture, polyetheretherketone (PEEK), and two different biodegradable anchors used during rotator cuff repair. Transosseous-equivalent rotator cuff repair was performed in 73 patients. The patients were divided into two groups, in both of which two different medial-row anchors were used. In group 1, anchor A comprised 30% β-tricalcium phosphate (TCP) + 70% fast-absorbing poly lactic-co-glycolic acid copolymer (85% polylactic acid enantiomers + 15% polyglycolic acid) and anchor B comprised all-sutures. In group 2, anchor C comprised 23% micro β-TCP + 77% polylactic acid enantiomers and anchor D comprised PEEK polymer. There were 37 patients in group 1 and 36 patients in group 2. The presence and severity of fluid collection around anchors and healing of the rotator cuff were assessed using MRI scans, approximately one year postoperatively. The severity of the collection was graded as 0 (no perianchor fluid signal), 1 (minimal perianchor fluid), 2 (local collection of fluid), 3 (fluid collection around the whole length of the anchor but of a diameter less than twice the anchor diameter), or 4 (fluid collection around the whole length of the anchor and of a diameter greater than twice the anchor diameter).Aims
Patients and Methods
The crucial role of the radial head in the stability of the elbow in terrible triad injury is acknowledged. This retrospective study aims to compare the results of resection of a severely comminuted radial head with or without prosthetic arthroplasty as part of the reconstruction for this injury. The outcome of radial head resection was compared with prosthetic arthroplasty in 29 and 15 patients with terrible triad injuries, respectively. There were ten female patients (34.5%) in the resection group and six female patients (40%) in the prosthesis group. The mean age was 40.7 years (Aims
Patients and Methods
The aims of this study were to investigate any possible relationship
between a preoperative sensitivity to pain and the degree of pain
at rest and on exertion with postoperative function in patients
who underwent stemless total shoulder arthroplasty (TSA). In this prospective study, we included 63 patients who underwent
stemless TSA and were available for evaluation one year postoperatively.
There were 31 women and 32 men; their mean age was 71 years (53
to 89). The pain threshold, which was measured using a Pain Matcher
(PM) unit, the degree of pain (visual analogue scale at rest and
on exertion, and function using the short version of the Disabilities
of the Arm, Shoulder and Hand questionnaire (QuickDASH), were recorded
preoperatively, as well as three and 12 months postoperatively.Aims
Patients and Methods
Manipulation under anaesthetic (MUA) is a recognised form of
treatment for patients with a frozen shoulder. However, not all
patients benefit. Some have persistent or recurrent symptoms. There
are no clear recommendations in the literature on the optimal management
of recurrent frozen shoulder after a MUA. We aimed to address this
issue in this study. We analysed a prospectively collected, single-surgeon, consecutive
series of patients who underwent MUA for frozen shoulder between
January 1999 and December 2015. The Oxford Shoulder Scores (OSS)
and range of movement were the outcome measures. Aims
Patients and Methods
Our aim was to describe the atypical pattern of increased fatty
degeneration in the infraspinatus muscle compared with the supraspinatus
in patients with a massive rotator cuff tear. We also wished to
describe the nerve conduction and electromyography findings in these
patients. A cohort of patients undergoing surgery for a massive rotator
cuff tear was identified and their clinical records obtained. Their
MRI images were reviewed to ascertain the degree of retraction of
the torn infraspinatus and supraspinatus muscles, and the degree
of fatty degeneration in both muscles was recorded. Nerve conduction studies
were also performed in those patients who showed more degeneration
in the infraspinatus than in the supraspinatus.Aims
Patients and Methods
The purpose of this study was to evaluate the
expression of acid-sensing ion channels (ASICs) in the capsule and synovial
fluid of patients with frozen shoulder. Capsular tissue and synovial
fluid were obtained from 18 patients with idiopathic frozen shoulder
(FS group) and 18 patients with instability of the shoulder (control
group). The expressions of ASIC1, ASIC2, and ASIC3 in the capsule
were determined using the reverse transcriptase-polymerase chain
reaction, immunoblot analysis, and immunohistochemistry (IHC). The
concentrations in synovial fluid were evaluated using an enzyme-linked
immunosorbent assay. The mRNA expression of ASIC1, ASIC2 and ASIC3 in the capsule
were significantly increased in the FS group compared with the control
group. The protein levels of these three ASICs were also increased.
The increased expressions were confirmed by IHC. Of the ASICs, ASIC3
showed the greatest increase in both mRNA and levels of expression
compared with the control group. The levels of ASIC1 and ASIC3 in
synovial fluid were significantly increased in the FS group. This study suggests that ASICs may play a role as mediators of
inflammatory pain and be involved in the pathogenesis of frozen
shoulder. Cite this article:
