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AJR Am J Roentgenol 2021 Jun 23. Epub 2021 Jun 23.

The University of British Columbia Medicine, Vancouver, BC, Canada.

Rotator cuff tears are the most likely source of shoulder pain in adults and may cause protracted disability. Management of rotator cuff tears is associated with considerable costs. Accurate diagnosis can guide surgical planning and help achieve a favorable clinical outcome. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Jun;35(6):667-672

Department of Orthopedic Sports Medicine, the Affiliated Hospital of Qingdao University, Qingdao Shandong, 266100, P.R.China.

Objective: To investigate the effect of asymptomatic hyperuricemia on the effectiveness of arthroscopic rotator cuff repair.

Methods: The clinical data of 80 patients who underwent arthroscopic rotator cuff repair and met the selection criteria between March 2018 and December 2019 were retrospectively analyzed. According to the serum uric acid level, the patients were divided into hyperuric acid group (46 cases, the serum uric acid level was more than 417 μmol/L in males and was more than 357 μmol/L in females) and normal group (34 cases, serum uric acid level was lower than the above standard). Read More

Int J Clin Pract 2021 Jun 17:e14549. Epub 2021 Jun 17.

Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.

Background: Calcific tendinopathy of the rotator cuff is a common cause of painful disability in the shoulder with unclear etiology. Diabetes mellitus (DM) is associated with calcific tendinopathy; however, large epidemiological data is lacking. Thus, we conducted a nationwide population-based matched cohort study to investigate the risk for calcific tendinopathy of the shoulder in diabetic patients. Read More

JSES Int 2021 May 10;5(3):532-539. Epub 2021 Feb 10.

Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA, USA.

Background: The outcomes and complication rates of patients with isolated greater tuberosity fractures are not well documented. The present study aimed to evaluate the reoperation rates, types of reoperations, and complications for patients undergoing open reduction internal fixation and those undergoing initial nonoperative treatment of isolated greater tuberosity fractures.

Methods: An administrative claims database was queried from 2010 to 2018 for adult patients treated with open reduction internal fixation or initial nonoperative treatment within 6 weeks of sustaining a closed isolated greater tuberosity fracture. Read More

J ISAKOS 2021 Jun 16. Epub 2021 Jun 16.

Radiology, Universidad de Antioquia, Medellin, Colombia.

Acute massive rotator cuff tears and posterior shoulder dislocations are an extremely rare association, and a vast majority are treated by open surgery. We present a case of a man in his 20s who suffered closed left shoulder trauma after a road traffic accident. He was initially diagnosed with posterior shoulder dislocation and a reduction was successfully performed. Read More

Knee Surg Sports Traumatol Arthrosc 2021 Jun 15. Epub 2021 Jun 15.

Shoulder and Elbow Unit, Department of Orthopedic and Trauma Surgery, Humanitas Clinical and Research Center, IRCCS, via Manzoni 56, Rozzano, 20089, Milan, Italy.

Purpose: The aim of this study is to evaluate the return to sport after surgical treatment of shoulder injuries in professional goalkeepers in relationship with the mechanism of injury and the pattern of related shoulder lesions.

Methods: Twenty-six shoulders in nineteen elite male professional soccer goalkeepers were retrospectively analyzed considering multiple diseases (instability, rotator cuff, biceps or other tendon injuries). Data was collected for injury modality and context, pathological findings, surgical procedures, time, level of return to sport, and complications. Read More

Indian J Orthop 2021 May 22;55(Suppl 1):27-37. Epub 2020 Oct 22.

Advanced Reconstructive Osseous Surgery, San Juan de Dios Hospital, Pamplona, Spain.

Background: With the advances of modern medicine and technology there has been an increase of indications of shoulder reconstruction techniques and shoulder arthroplasty. Consequently, the number of complications and failures have increased in parallel. Not negligible number of cases are driven to an end-stage situation where salvage procedures, such as glenohumeral arthrodesis (GHA) and shoulder resection arthroplasty (SRA), are the only remaining solution. Read More

Front Neurol 2021 28;12:668370. Epub 2021 May 28.

Canadian Advances in Neuro-Orthopedics for Spasticity Congress, Victoria, BC, Canada.

Hemiplegic shoulder pain (HSP) is the most common pain disorder after stroke with incidence estimates of 30-70% and associated with reductions in function, interference with rehabilitation, and a reduced quality of life. Onset may occur as soon as a week after stroke in 17% of patients. Management of HSP represents a complex treatment pathway with a lack of evidence to support one treatment. Read More

Musculoskelet Surg 2021 Jun 8. Epub 2021 Jun 8.

Department of Orthopaedics, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India.

Purpose: Acute traumatic and chronic non-traumatic rotator cuff tears are etiologically distinguishable entities. However, prospective studies comparing tear characteristics and outcomes between these two types of tears are lacking. The purpose of this study was to compare the tear characteristics, clinical and functional outcomes, and tendon healing as assessed on magnetic resonance imaging (MRI), between traumatic and non-traumatic rotator cuff tears. Read More

Pain Manag 2021 Jun 9. Epub 2021 Jun 9.

Physioterapeutics Resources Laboratory, Department of Physical Therapy, Federal University of Sao Carlos (UFSCar), Rod. "Washington Luis, km 235, Sao Carlos", São Paulo, Brazil.

The aim of the present study is to determine whether adding shockwave therapy (SWT) to a progressive exercise program improves shoulder pain and function in individuals with rotator cuff tendinopathy (RC tendinopathy). Ninety patients diagnosed with rotator cuff tendinopathy will be randomly allocated into two groups: active SWT plus a progressive exercise program or placebo SWT plus a progressive exercise program. Primary outcomes will be measured using the Constant-Murley Score function questionnaire and by assessing patient-reported pain intensity with the numerical pain rating scale. Read More

Curr Sports Med Rep 2021 Jun;20(6):298-305

Orthopedic Surgery and Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN.

Abstract: Treatment of musculoskeletal conditions in athletes with extracorporeal shockwave therapy (ESWT) is gaining popularity as greater evidence supports its use. ESWT protocols (describing energy flux density, number of impulses, type of shockwave (focused or radial), number/frequency/duration of treatment session, area of application, and postprocedural therapy protocols) can be adjusted in the clinical setting. Protocols vary across studies, and optimal protocols for most indications are yet to be determined. Read More

J Shoulder Elbow Surg 2021 Jun 2. Epub 2021 Jun 2.

The Second Afliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Province Hospital of Traditional Chinese Medicine), Guangzhou 510120, China; Research Team on Bone and Joint Degeneration and Injury, Guangdong Academy of Traditional Chinese Medicine, Guangzhou 510120, China. Electronic address:

Background: Retear after arthroscopic rotator cuff repair (ARCR) consistently challenges medical staff and patients, and the incidence of retear after surgery is 10-94%. The purpose of this study was to identify the risk factors that cause retear after ARCR and provide theoretical guidance for clinical intervention to reduce the occurrence of postoperative rotator cuff retear.

Study Design: Systematic review and meta-analysis. Read More

Am J Sports Med 2021 Jun;49(7):1892-1903

Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Background: Tendons heal by fibrotic repair, increasing the likelihood of reinjury. Animal tendon injury and overuse models have identified transforming growth factor beta (TGF-β) and bone morphogenetic proteins (BMPs) as growth factors actively involved in the development of fibrosis, by mediating extracellular matrix synthesis and cell differentiation.

Purpose: To understand how TGF-β and BMPs contribute to fibrotic processes using tendon-derived cells isolated from healthy and diseased human tendons. Read More

J Orthop Res 2021 Jun 3. Epub 2021 Jun 3.

Department of Orthopaedic Surgery, Columbia University Irving Medical Center, New York, New York, USA.

Rotator cuff disease pathogenesis is associated with intrinsic (e.g., age, joint laxity, muscle weakness) and extrinsic (e. Read More

Clin Shoulder Elb 2021 Jun 31;24(2):88-92. Epub 2021 May 31.

Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Background: Patients who have rotator cuff arthropathy experience a limited range of motion (ROM) of the shoulder joint and experience problems in performing their daily activities; however, no evidence is available to suggest the exact ROM of the shoulder joint in this population. Therefore, this study sought to determine the degree of motion of the shoulder joint in three planes during different activities.

Methods: Five subjects with rotator cuff injuries participated in this study. Read More

Clin Shoulder Elb 2021 Jun 18;24(2):80-87. Epub 2021 May 18.

Department of Orthopedic Surgery, Kurume University Medical Center, Fukuoka, Japan.

Background: Complex regional pain syndrome (CRPS)-related hand lesions are one of the complications following arthroscopic rotator cuff repair (ARCR). This study aimed to investigate the clinical outcomes of patients with CRPS-related hand lesions following ARCR.

Methods: Altogether, 103 patients with ARCR were included in this study (mean age, 63. Read More

Medicina (Kaunas) 2021 May 13;57(5). Epub 2021 May 13.

Department of Physical Therapy, Sahmyook University, Seoul 01795, Korea.

: The purpose of this study was to investigate the effects of microcurrent stimulation on pain, shoulder function, and grip strength in patients with rotator cuff repair. This randomized single-blind controlled trial was conducted on inpatients of the rehabilitation department, and included 28 patients who underwent rotator cuff repair. Participants were randomly assigned to the experimental group (n = 14), treated with microcurrent stimulation, and the control group (n = 14), treated with false microcurrent stimulation. Read More

BMC Musculoskelet Disord 2021 May 29;22(1):499. Epub 2021 May 29.

Illinois Sportsmedicine and Orthopaedic Centers, 1714 Milwaukee Ave, 60025, Glenview, IL, USA.

Background: Surgical treatment of full-thickness rotator cuff (RC) tears is associated with generally good results. There is no consensus regarding treatment of partial thickness tears that fail conservative treatment. The purpose of this study was to look at the efficacy and confirm the safety of dual injection PRP into the shoulder of patients with rotator cuff pathology who have failed conservative treatment with followup to two years. Read More

BMC Health Serv Res 2021 May 28;21(1):516. Epub 2021 May 28.

Department of Health Services Policy and Management, University of South Carolina, 915 Greene Street Suite 302, Columbia, SC, 29205, USA.

Background: How much does the medical malpractice system affect treatment decisions in orthopaedics? To further this inquiry, we sought to assess whether malpractice liability is associated with differences in surgery rates among elderly orthopaedic patients.

Methods: Medicare data were obtained for patients with a rotator cuff tear or proximal humerus fracture in 2011. Multivariate regressions were used to assess whether the probability of surgery is associated with various state-level rules that increase or decrease malpractice liability risks. Read More

Phys Sportsmed 2021 Jun 23:1-6. Epub 2021 Jun 23.

Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

: Baseball players are highly susceptible to shoulder injuries due to repetitive overhead throwing. The purpose of this study was to investigate men's collegiate baseball shoulder injury rates and associated risk factors.: Using the NCAA Injury Surveillance Program (ISP) database, shoulder injury data for men's baseball players was analyzed from 2009-2010 through 2013-2014. Read More

J Clin Orthop Trauma 2021 Aug 21;19:118-124. Epub 2021 May 21.

Tulane University School of Medicine, Department of Orthopaedics, 1430 Tulane Avenue, SL-32, New Orleans, LA, 70112, USA.

Rotator cuff tears are common shoulder injuries expected to increase with the growth of the aging population. Although a small subset of patients with low functional demands can be treated nonoperatively, surgical intervention is a cost-effective solution, which can restore shoulder function and help patients return to activity sooner. While multiple surgical options are available, rotator cuff repair is a highly utilized procedure with varying success. Read More

J Clin Orthop Trauma 2021 Aug 14;19:62-66. Epub 2021 May 14.

Upper Limb Unit, Wrightington Hospital, Wigan, UK.

Background: Recent evidence continues to confirm the effectiveness of arthroscopic superior capsular reconstruction (SCR) in relieving pain and improving function in an irreparable cuff deficient shoulder. This paper presents an up-to-date literature review on SCRand a tertiary referral unit experience in the United Kingdom.

Methods: Data was prospectively collected on patients undergoing SCR for irreparable rotator cuff tears using a dermal allograft. Read More

EFORT Open Rev 2021 Apr 1;6(4):225-235. Epub 2021 Apr 1.

Trauma & Orthopaedics, Salford Royal Hospital, Salford, UK.

The aim of this article was to synopsize platelet-rich plasma (PRP) use in musculoskeletal pathologies through evidence-based assessment of the preparation, classification, mechanism of action and applications of PRP, thereby answering which PRP type is best for each clinical indication.The literature search was performed using Medline, EMBASE and Cochrane Reviews databases for papers containing the key terms "platelet-rich plasma" AND "orthopaedics" AND ("classification" OR "mechanism of action" OR "preparation" OR "clinical application"). Generated papers were evaluated for pertinence in following areas: preparation, classification, mechanism of action, clinical application within orthopaedics. Read More

Expert Opin Biol Ther 2021 May 31:1-14. Epub 2021 May 31.

Academic Surgical Unit, South West London Elective Orthopaedic Centre, Epsom, UK.

: The use of cell-based therapies in the management of sports injuries of the upper limb is increasingly popular despite the limited scientific evidence available for their use. We aim to evaluate the evidence for the use of cell-based therapies in these injuries and recommend areas for further research.: In accordance with a published protocol (PROSPERO; Registration No. Read More

Orthop J Sports Med 2021 May 13;9(5):23259671211007734. Epub 2021 May 13.

Department of Radiology, School of Medicine, Gyeongsang National University, and Gyeongsang National University Hospital, Jinju, Republic of Korea.

Background: Metabolic factors have been linked to tendinopathies, yet few studies have investigated the association between metabolic factors and lateral epicondylitis.

Purpose: To evaluate risk factors for lateral epicondylitis, including several metabolic factors.

Study Design: Case-control study; Level of evidence, 3. Read More

Acta Ortop Mex 2020 Nov-Dec;34(6):399-402

Facultad Mexicana de Medicina de la Universidad La Salle-Hospital Ángeles Pedregal-GASS. Ciudad de México. México.

Introduction: In rotator cuff rupture, the supraspinatus tendon ranks first in frequency. MRI is the study of choice for preoperative diagnosis and planning. The objective of this study was to assess the concordance between findings observed with MRI and transoperative in patients with supraspinatus tendon rupture. Read More

Arch Orthop Trauma Surg 2021 May 21. Epub 2021 May 21.

Department of Orthopaedics, All India Institute of Medical Sciences, Virbhadra Marg, Rishikesh, 248201, India.

Purpose: Natural history of rotator cuff tears is poorly understood. Repair of rotator cuff tears has shown to improve functional outcomes in full-thickness tears. However, high re-tear rates have been reported in literature, which does not correlate with poorer outcomes. Read More

J Clin Orthop Trauma 2021 Jul 26;18:150-156. Epub 2021 Apr 26.

Upper Limb Unit, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, WN6 9EP, UK.

The rotator cuff has an important role in the stability and function of the glenohumeral joint. It is a complex anatomic structure commonly affected by injury such as tendinopathy and cuff tears. The rotator cuff helps to provide a stabilising effect to the shoulder joint by compressing the humeral head against the glenoid cavity via the concavity compression mechanism. Read More

IISE Trans Occup Ergon Hum Factors 2021 Jun 14:1-12. Epub 2021 Jun 14.

Industrial and Management Systems Engineering, West Virginia University, Morgantown, WV, USA.

Occupational ApplicationsDespite the frequency and cost of rotator cuff injuries among male and female workers, very little is known about the strength, endurance, and perceived exertion and electromyographic response of rotator cuff muscles to different exertion levels. In this study, sex differences were studied using muscle-specific maximal and submaximal exertions of the supraspinatus, infraspinatus, and teres minor muscles. Females showed lower strength and endurance, but higher muscle activity and perceived exertion compared to males. Read More

J Biomech Eng 2021 Oct;143(10)

School of Mechanical Engineering, Federal University of Uberlândia, João Naves de Avila Avenue, Uberlândia, MG 38400-902, Brazil.

Rotator cuff (RC) tears cause pain and functional disability of the shoulder. Despite advances in suture anchors, there are still reports about the incidence of surgical-related injuries to RC mainly associated with sutures. The purpose of this study was to design and evaluate the mechanical behavior of sutureless implants to repair RC tears. Read More