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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

J Nepal Health Res Counc 2021 Apr 23;19(1):39-43. Epub 2021 Apr 23.

Department of Orthopedics, TU Teaching Hospital, Nepal.

Background: The aim of study is to evaluate the shoulder by sonography in patients presenting with shoulder pain and correlate the findings observed with the diabetic patient.

Methods: Study was done in 60 patients who presented in the Department of Orthopedics with a history of the shoulder pain. Shoulder ultrasound was performed according to standard protocol, thickness of the supraspinatus tendon, presence of the tear, biceps tendon subacromial subdeltoid effusion and subacromial impingement were assessed. Read More

BMJ Open 2021 04 22;11(4):e045702. Epub 2021 Apr 22.

Orthopaedic Surgery and Traumatology, University Hospital Basel, Basel, Switzerland.

Introduction: In the field of arthroscopic rotator cuff repair (ARCR), reporting standards of published studies differ dramatically, notably concerning adverse events (AEs). In addition, prognostic studies are overall methodologically poor, based on small data sets and explore only limited numbers of influencing factors. We aim to develop prognostic models for individual ARCR patients, primarily for the patient-reported assessment of shoulder function (Oxford Shoulder Score (OSS)) and the occurrence of shoulder stiffness 6 months after surgery. Read More

BMC Musculoskelet Disord 2021 Apr 22;22(1):378. Epub 2021 Apr 22.

Department of Orthopedic Sports Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.

Background: While supraspinatus atrophy can be described according to the system of Zanetti or Thomazeau there is still a lack of characterization of isolated subscapularis muscle atrophy. The aim of this study was to describe patterns of muscle atrophy following repair of isolated subscapularis (SSC) tendon.

Methods: Forty-nine control shoulder MRI scans, without rotator cuff pathology, atrophy or fatty infiltration, were prospectively evaluated and subscapularis diameters as well as cross sectional areas (complete and upper half) were assessed in a standardized oblique sagittal plane. Read More

JBJS Rev 2021 04 22;9(4). Epub 2021 Apr 22.

The Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.

»: Ultrasonography (US) is valued for its availability, tolerability, low cost, and utility in real-time dynamic evaluation. Its use in diagnosing upper-extremity shoulder injury has expanded, but several features require definition before more widespread adoption can be realized.

»: In particular, the evaluation of rotator cuff tears (RCTs) with US has been extensively studied, and authors generally agree that US is comparable with magnetic resonance imaging for the detection of full-thickness RCTs, whereas partial-thickness RCTs are more difficult to accurately identify with US. Read More

Rev Med Suisse 2021 Apr;17(735):794-797

Centre orthopédique d'Ouchy, Medicol Hirslanden, Avenue d'Ouchy, 41, 1006 Lausanne.

Partial rotator cuff lesions are a common feature. The radiological assessment of choice is MRI with arthrography accompanied by ABER (abduction, external rotation) images. At present, there is no consensus on the management of these lesions and surgery remains a second-line treatment for patients who do not respond to conservative treatment. Read More

Orthop Traumatol Surg Res 2021 06 16;107(4):102936. Epub 2021 Apr 16.

Centre Hospitalier Universitaire d'Angers, Département de Chirurgie Osseuse, 4, rue Larrey, 49100 Angers, France.

Introduction: Critical shoulder angle (CSA) is measured on AP view in neutral rotation as the angle subtended by the tangent to the glenoid and the lateral edge of the acromion. CSA >35° is a risk factor for primary rotator cuff tear and iterative tear after cuff repair. The aim of the present study was to assess change in CSA following arthroscopic anterior acromioplasty. Read More

BMC Musculoskelet Disord 2021 Apr 5;22(1):331. Epub 2021 Apr 5.

Unité de chirurgie du membre supérieur, Clinique Saint Jean l'Ermitage, 272 avenue Marc Jacquet, 77000, Melun, France.

Background: Irreparable rotator cuff tears are common and difficult to treat. Techniques for "filling the loss of substance" require fixation to the rotator cuff stump (tendon augmentation) or to the glenoid (superior capsular reconstruction), which are complicated by the narrow working zone of the subacromial space. The main objective of this study was to determine whether a braided graft of gracilis (GR) and semitendinosus (ST) could fill a loss of tendon substance from an irreparable rupture of the supra- and infraspinatus, by fixing the graft to the greater tuberosity and the spine of the scapula. Read More

Orthop Traumatol Surg Res 2021 06 1;107(4):102917. Epub 2021 Apr 1.

CHU Purpan, Hôpital Pierre Paul Riquet, Place du Dr Baylac, 31059 Toulouse, France; Institut de Recherche Riquet (I2R), Balma, France.

Introduction: During a L'Episcopo transfer procedure, the tendons of the latissimus dorsi and teres major are reinserted on the posterolateral side of the humeral shaft to restore active external rotation. The aim of this study was to monitor the radiological changes at the insertion point of this transfer and to evaluate its impact on the clinical outcomes.

Materials And Methods: In this retrospective, single-center study, 13 patients (mean age 56 years; 19-84) were reviewed after a minimum follow-up of 2 years. Read More

Orthop Traumatol Surg Res 2021 06 31;107(4):102915. Epub 2021 Mar 31.

Service de chirurgie orthopédique, Clinique Monticelli-Vélodrome Groupe RGDS (Ramsay Générale de Santé), 10, allée Marcel-Leclerc, 13008 Marseille, France; Service de chirurgie orthopédique, Nouvelle Clinique de La Ciotat, groupe ESM (Établissements Sainte Marguerite), boulevard Lamartine, 13600 La Ciotat, France.

Background: Arthroscopic surgery has earned its place as the reference standard treatment for rotator cuff calcific tendinopathy refractory to conservative medical treatment. Adhesive capsulitis of the shoulder is the most common complication (12%). Standard practice involves routine gleno-humeral exploration before calcification removal. Read More

Orthop Traumatol Surg Res 2021 06 30;107(4):102911. Epub 2021 Mar 30.

Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, U.S.A.

Background: Massive rotator cuff surgical management can be challenging. Controversy exists in the literature regarding the potential benefit of full head coverage for arthroscopic rotator cuff repair. The purpose of this study was to compare re-tear rate and clinical outcome of arthroscopic repair of massive rotator cuff tears in relation to the achievement of full humeral head footprint coverage or not. Read More

Orthop Traumatol Surg Res 2021 06 26;107(4):102902. Epub 2021 Mar 26.

Service de chirurgie orthopédique 1, hopital Roger-Salengro, centre hospitalier régional universitaire, 59037 Lille, France.

Introduction: The teres minor (TM) participates in active external rotation (ER) after reverse shoulder arthroplasty (RSA). The TM index of trophicity (T2/G) measured on CT scan is a predictor of poor results in patients who have irreparable rotator cuff tears. The aim of this study was to evaluate how T2/G impacts the functional outcomes of RSA in the context of massive rotator cuff tears. Read More

BMC Musculoskelet Disord 2021 Mar 26;22(1):305. Epub 2021 Mar 26.

Department of Orthopedics, Zhuhai People's hospital, Guangdong Province, Zhuhai City, China.

Background: Arthroscopic repair is recommended for young patients with full-thickness rotator cuff tears (RCTs), but the healing rates have raised concerns. The Southern California Orthopedic Institute (SCOI) row method has been developed based on greater than 3 decades of experience with excellent clinical outcomes; however, studies with a focus on the younger patient population are limited in number. The current study assessed the short-term clinical outcome and the initial tendon-to-bone healing in a young cohort after repair of a full-thickness RCT using the SCOI row method. Read More

BMC Musculoskelet Disord 2021 Mar 20;22(1):292. Epub 2021 Mar 20.

Department of Rehabilitation, The Affiliated Hospital of Southwest Medical University, 25 Tai Ping Road, Luzhou, Sichuan, 646000, People's Republic of China.

Background: The study aims to identify whether Platelet-rich plasma (PRP) combined with early physiotherapy has an advantage over PRP alone for rotator cuff injury patients, regarding pain release, function score, tear size, and quality of life improvement.

Methods: This is a single-center prospective non-randomized study implemented in July 2019 at the Affiliated Hospital of Southwest Medical University in Sichuan. Three hundred-forteen patients with rotator cuff injury aged over 18 years were recruited. Read More

J Clin Orthop Trauma 2021 Apr 20;15:76-82. Epub 2020 Oct 20.

Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, USA.

Background: Smoking is a poor prognostic factor for healing after rotator cuff repair and is associated with inferior results. We hypothesized that smokers would have higher recurrent tear rates and more postoperative myotendinous junction (MTJ) retraction in healed repairs than nonsmokers three months postoperatively.

Methods: Rotator cuff repairs (RCRs) were retrospectively reviewed over a 2-year period. Read More

J Shoulder Elbow Surg 2021 Mar 4. Epub 2021 Mar 4.

Orthopedics and Traumatology Department, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.

Background: The shoulder physical examination is frequently performed to diagnose rotator cuff tears in clinical practice; however, there is insufficient evidence on which physical tests are efficient for shoulder impingements in primary care settings. The purposes of this study were (1) to analyze the accuracy of 8 clinical tests to diagnose supraspinatus tendon lesions and investigate whether the combination of these tests can improve the diagnostic values; (2) to assess which are the best positivity criteria for shoulder maneuvers-pain and/or weakness; and (3) to investigate the ability of these tests to distinguish between partial- and full-thickness tears.

Methods: A total of 733 consecutive patients were prospectively evaluated by 4 shoulder surgeons in this multicenter diagnostic study from May 2017 to December 2018, and 8 clinical tests (empty-can, full-can test, drop arm, painful arc, Neer sign, Hawkins test, Patte test, and resisted external rotation) were compared with magnetic resonance imaging performed by blinded radiologists. Read More

Pediatr Radiol 2021 Mar 5. Epub 2021 Mar 5.

Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Background: Avulsion fractures of the humeral lesser tuberosity are rare injuries in skeletally immature patients and can pose a diagnostic challenge that often leads to delayed identification.

Objective: To describe the demographics, mechanism of injury and magnetic resonance imaging (MRI) findings of lesser tuberosity avulsion fractures in children.

Materials And Methods: A retrospective search of children with lesser tuberosity avulsion fractures on MRI was done. Read More

Int J Surg Case Rep 2021 Mar 15;80:105624. Epub 2021 Feb 15.

Graduate Medical Education, Orthopaedic Surgery Residency Program, Community Memorial Health System, Ventura, CA, USA.

Introduction: Septic arthritis is an orthopedic emergency that requires rapid diagnosis and treatment. It is typically caused by occult bacteremia which allows bacteria to seed the joint or local invasion of a soft tissue infection. Most cases of septic arthritis are caused by gram-positive bacteria, with the most common culprit being Staphylococcus Aureus. Read More

BMC Musculoskelet Disord 2021 Feb 18;22(1):202. Epub 2021 Feb 18.

Orthopaedic Center, the Affiliated Hospital of Qingdao University, NO.16 Jiangsu road, Qingdao, 266100, China.

Purpose: In the present study, we aimed to determine whether decompression of suprascapular nerve (SSN) at the spinoglenoid notch could lead to a better functional outcome for the patients who underwent repairment of rotator cuff due to posterosupeior massive rotator cuff tear (MRCT) and suprascapular neuropathy.

Methods: A total of 20 patients with posterosuperior MRCT and suprascapular neuropathy were analyzed in the present work. The preoperative magnetic resonance imaging (MRI) showed rotator cuff tear in supraspinatus and infraspinatus. Read More

BMC Musculoskelet Disord 2021 Feb 16;22(1):190. Epub 2021 Feb 16.

Department of Orthopedics, St. Vincent Hospital Vienna, Hartmanngasse 15/9, 1050, Vienna, Austria.

Background: Irreparable massive rotator cuff tears (IMRCTs) are a well-known cause for functional limitation and difficult to treat. Although several joint-preserving as well as joint-replacing procedures were found to provide pain relief and gain of function, midterm results are scarce, particularly in pseudoparetic shoulder joints unaccompanied by severe osteoarthritis. The purpose of this study was to compare the midterm functional outcomes of arthroscopic procedures to those of reverse total shoulder arthroplasty (RTSA) in pseudoparetic shoulders with IMRCTs unaccompanied by severe osteoarthritis. Read More

Arthroscopy 2021 02;37(2):447-449

University of Utah, Liestal, Switzerland.

The critical shoulder angle (CSA) has been the focus of significant research related to the etiology and prognosis of rotator cuff tears in recent years, but the accuracy of CSA measurements on plain anteroposterior (Grashey) radiographs has been questioned. Research to better understand what qualifies as a "tolerable" radiograph for reliable measurement of the CSA can inform best practices for obtaining plain radiographs. Optimal measurements rely on optimal images, and knowing how much room for error there is regarding malrotation provides surgeons with unbiased criteria to rule out inadequate images. Read More

Unfallchirurg 2021 Feb 4;124(2):87-88. Epub 2021 Feb 4.

Sektion Schulter- und Ellenbogenchirurgie, LMU Klinikum, Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Ludwig-Maximilians-Universität München, Nußbaumstraße 20, 80336, München, Deutschland.

Am J Sports Med 2021 02;49(2):298-304

Ramsay Sante, Hopital Prive de l'Estuaire, Le Havre, France.

Background: Rotator cuff tears are common shoulder injuries that often cause pain and loss of function. Nonanatomic side-to-side techniques facilitate repair by minimizing tensions within tendons to improve healing and optimize the thickness of sutured tissues.

Purpose/hypothesis: The purpose was to evaluate long-term clinical and radiographic outcomes of arthroscopic side-to-side repair of massive rotator cuff tears (mRCTs). Read More

JBJS Case Connect 2020 12 10;10(4):e20.00308. Epub 2020 Dec 10.

Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran.

Case: We report an unusual combination of injuries, terrible triad elbow fracture dislocation with ipsilateral avulsion of the triceps, and radial shaft fracture in a 23-year-old man. He was managed surgically and had good postoperative outcomes.

Conclusion: Evaluation of the triceps tendon avulsion injury is difficult in this context, such as problems evaluating the rotator cuff injuries after a shoulder fracture dislocation. Read More

Skeletal Radiol 2021 Aug 23;50(8):1647-1655. Epub 2021 Jan 23.

Department of Orthopedic Surgery, Seoul National University Bundang Hospital, 82 Gumiro 173 Beon-gil, Bundang-gu, Seongnam, 13620, South Korea.

Objective: To evaluate the diagnostic performance and reliability of magnetic resonance of arthrography (MRA) in diagnosis of subscapularis (SSC) tendon tears between two reviewers with varying levels of experience, and compare the results with clinical tests.

Materials And Methods: SSC tendons were retrospectively evaluated in a total of 272 patients with arthroscopic confirmations. A total of 548 shoulder MRAs were evaluated by two musculoskeletal radiologists, and SSC tendon pathologies were classified into three groups: intact tendon (n = 149), partial-thickness tear (n = 92), or full-thickness tear (n = 31). Read More

Clin Rheumatol 2021 Jul 21;40(7):2897-2905. Epub 2021 Jan 21.

Division of Musculoskeletal Radiology, Department of Radiology, Henry Ford Hospital, Detroit, MI, USA.

Objectives: To compare the incidence of rotator cuff (RC) tears on shoulder ultrasounds of patients with RC calcific tendinopathy (CaT) to that of a control group without CaT.

Method: In this retrospective case-control study, 50 shoulder ultrasounds of patients with CaT were compared independently by 2 musculoskeletal radiologists to 50 patients from a control group without CaT to catalog the number and type of RC tears. RC tears in the CaT group were further characterized based on location, into tears in the specific tendon(s) containing calcium versus all tendon tears. Read More

JBJS Case Connect 2020 12 21;10(4):e20.00511. Epub 2020 Dec 21.

Department of Orthopaedic Surgery, Kitasato University School of Medicine, Sagamihara, Japan.

Case: We performed arthroscopic superior capsule reconstruction (ASCR) for cuff tear arthropathy (CTA) with humeral head deformity. A 62-year-old man presented with severely limited shoulder motion and recalcitrant omalgia. He had a history of dental implant removal due to metal allergy, and his Constant score was 21 points. Read More

Am J Phys Med Rehabil 2021 04;100(4):331-336

From the Vanderbilt University School of Medicine, Nashville, Tennessee (AZG); Department of Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee (AS, NBJ); Department of Physical Medicine and Rehabilitation, Vanderbilt University School of Medicine, Nashville, Tennessee (PK); Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee (GDA, JEK, NBJ); Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee (GDA); King Edward Memorial Hospital, Hamilton, Bermuda (LDH); Orthopedic Institute of Sioux Falls, Sioux Falls, South Dakota (KMB); Department of Orthopaedic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (EM); and Departments of Physical Medicine and Rehabilitation, Orthopaedics, and Population and Data Sciences, University of Texas Southwestern, Dallas, Texas (NBJ).

Objective: Although rotator cuff tear is one of the most common musculoskeletal disorders, its etiology is poorly understood. We assessed factors associated with the presence of rotator cuff tears in a cohort of patients with shoulder pain.

Design: From February 2011 to July 2016, a longitudinal cohort of patients with shoulder pain was recruited. Read More

BMC Musculoskelet Disord 2021 Jan 8;22(1):50. Epub 2021 Jan 8.

Department of Orthopaedics and Trauma Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy.

Background: This study aims to compare conservative versus surgical management for patients with full-thickness RC tear in terms of clinical and structural outcomes at 1 and 2 years of follow-up.

Methods: A comprehensive search of CENTRAL, MEDLINE, EMBASE, CINAHL, Google Scholar and reference lists of retrieved articles was performed since the inception of each database until August 2020. According to the Cochrane Handbook for Systematic Reviews of Interventions, two independent authors screened all suitable studies for the inclusion, extracted data and assessed risk of bias. Read More