Publisher: Karger Medical and Scientific Publishers
A valuable collection of up-to-date information by leading international experts The history of rotator cuff tendinopathy started more than 150 years ago, when some types of shoulder pain were attributed to rupture of the rotator cuff tendon'. In the third millennium, the pathogenetic mechanisms leading to rotator cuff problems are still debated. Although conservative measures are the first-line therapy, poor spontaneous tendon healing and progression from partial- thickness to full-thickness tears may mandate surgery. Biological, biomechanical and clinical studies have been conducted to establish the superiority of one technique over the other, but no clinical differences have been found. Although we know more about the pathogenesis, diagnosis and management of rotator cuff pathology, our efforts should be directed at trying to find the treatment that best fits the specific needs of each patient. This book collects current reviews on rotator cuff problems, with regard to both biological and clinical aspects, and provides practical hints on management and rehabilitation for sports physicians, surgeons, physiotherapists and athletic trainers.
In this issue of Clinics in Sports Medicine, Dr. Stephen Brockmeier from the University of Virginia has assembled a group of experts to provide the latest updates on Rotator Cuff Surgery.
Author: Stephen Brockmeier
Publisher: Elsevier Health Sciences
In this issue of Clinics in Sports Medicine, Dr. Stephen Brockmeier from the University of Virginia has assembled a group of experts to provide the latest updates on Rotator Cuff Surgery. This issue begins with the epidemiology and natural history of rotator cuff tears, followed by articles on: Imaging Evaluation of the Rotator Cuff; Arthroscopic Rotator Cuff Repair: Techniques in 2012; Biologics in the Management of Rotator Cuff Surgery; Outcomes of Rotator Cuff Surgery: What Does the Evidence Tell Us?; Rotator Cuff Injury in the Overhead Athlete; Failed Rotator Cuff Surgery, Evaluation and Decision-Making; Revision Rotator Cuff Repair; Non-Arthroplasty Options for the Management of Massive and Irreparable Rotator Cuff Tears; and Reverse Total Shoulder Arthroplasty for Irreparable Rotator Cuff Tears and Cuff Tear Arthroplasty.
Purpose: To determine the effect of rotator cuff tear pattern (crescent, U-shape, L-shape) on patient-reported outcomes after rotator cuff repair. Study Design: Cohort study; Level of evidence, 3.
Background: Limited literature exists regarding the influence of rotator cuff tear morphology on patient outcomes. Purpose: To determine the effect of rotator cuff tear pattern (crescent, U-shape, L-shape) on patient-reported outcomes after rotator cuff repair. Study Design: Cohort study; Level of evidence, 3. Methods: Patients undergoing arthroscopic repair of known full-thickness rotator cuff tears were observed prospectively at regular intervals from baseline to 1 year. The tear pattern was classified at the time of surgery as crescent, U-shaped, or L-shaped. Primary outcome measures were the Western Ontario Rotator Cuff Index (WORC), the American Shoulder and Elbow Surgeons (ASES), and a visual analog scale (VAS) for pain. The tear pattern was evaluated as the primary predictor while controlling for variables known to affect rotator cuff outcomes. Mixed-methods regression and analysis of variance (ANOVA) were used to examine the effects of tear morphology on patient-reported outcomes after surgical repair from baseline to 1 year. Results: A total of 82 patients were included in the study (53 male, 29 female; mean age, 58 years [range, 41-75 years]). A crescent shape was the most common tear pattern (54%), followed by U-shaped (25%) and L-shaped tears (21%). There were no significant differences in outcome scores between the 3 groups at baseline. All 3 groups showed statistically significant improvement from baseline to 1 year, but analysis failed to show any predictive effect in the change in outcome scores from baseline to 1 year for the WORC, ASES, or VAS when tear pattern was the primary predictor. Further ANOVA also failed to show any significant difference in the change in outcome scores from baseline to 1 year for the WORC (P = .96), ASES (P = .71), or VAS (P = .86). Conclusion: Rotator cuff tear pattern is not a predictor of functional outcomes after arthroscopic rotator cuff repair.
Provides exercises and routines from beginners to advanced to treat and prevent rotator cuff and other shoulder related problems.
Author: Jim Johnson
Publisher: Dog Ear Publishing
Category: Health & Fitness
Treat your own rotator cuff? Who needs to worry about that? According to the medical research, a lot of people. The rotator cuff, a group of four, flat tendons that connect to the critical muscles that stabilize your shoulder, can cause a lot more problems than you might think. Whether you already suffer from a rotator cuff problem, or simply want to prevent one, Treat Your Own Rotator Cuff will guide you step-by-step through an evidence-based program that can iron-plate your shoulders in just minutes a week.
A massive rotator cuff tear is not necessarily irreparable. Number of tendons involved, muscle-tendon unit quality, and decreased acromionhumeral distance (AHD) are as important as tear size in determining reparability of lesion.
A massive rotator cuff tear is not necessarily irreparable. Number of tendons involved, muscle-tendon unit quality, and decreased acromionhumeral distance (AHD) are as important as tear size in determining reparability of lesion. Massive and irreparable rotator cuff tears cannot be anatomically repaired to the bone and are a common source of pain and disability even in middle-aged patients. In these patients when conservative management has failed, it is possible to perform different surgical techniques. A functional repair can help to restore the horizontal force couple of the cuff on the humeral head and to increase the AHD. Debridement of irreparable tears and biceps tenotomy or tenodesis can have a role in low functional demand patients but results deteriorate over time. Recently, several commercially available tissue-engineered biological and synthetic scaffolds have been developed to augment rotator cuff repairs. The aim is to provide a mechanical improvement in case of poor quality tissue at time zero and give a support to have a better cuff healing. In selected cases, the scaffold can be used also to bridge tendon defect. Patients who not have pseudoparalysis, cuff tear arthropathy and with intact deltoid function can benefit from tendon transfers with satisfactory outcomes. These different procedures should be chosen for each patient with selected criteria and after a satisfactory explanation about the really possible expectation after surgery.
AUTHORS: Marie-Pierre Ingham (Universitu00e9 de Montru00e9al), Mahsa Shakeri (Polytechnique Montru00e9al), Shirin Shakeri (Polytechnique Montru00e9al), Karim Saydy (Universitu00e9 de Montru00e9al), Samuel Kadoury (Polytechnique ...
Author: Nathalie Bureau
AUTHORS: Marie-Pierre Ingham (Universitu00e9 de Montru00e9al), Mahsa Shakeri (Polytechnique Montru00e9al), Shirin Shakeri (Polytechnique Montru00e9al), Karim Saydy (Universitu00e9 de Montru00e9al), Samuel Kadoury (Polytechnique Montru00e9al), Nathalie J Bureau (Centre hospitalier de lu2019Universitu00e9 de Montru00e9al).OBJECTIVE: To assess supraspinatus muscle volumetric and 3D shape alterations in patients with full-thickness rotator cuff tears (RCT).METHOD: Retrospective study in 47 patients with RCT (mean age, 57 years; range, 39-67 years) and 30 asymptomatic volunteers (mean age, 56 years; range, 35-64 years). Morphometric assessment of the entire supraspinatus muscle was performed by 2 independent readers, with good interobserver reliability (ICC=0.916), on large field-of-view coronal oblique T1-weighted MR scans. The supraspinatus muscle was segmented using ITK-SNAP tool. Volume, length, surface area, surface-to-volume ratio (S/V), and 3D shape statistical analysis were computed in Matlab. ANOVA with covariates (height, sex and BMI), multiple comparisons and a non-parametric permutation testing scheme were used to test for significant differences (p
The presence or absence of a full-thickness rotator cuff tear on scan was compared with intra-operative findings as the gold standard. Results: Two hundred and ten shoulders were scanned over three equal learning periods.
Background: The present study aims to add to the body of evidence delineating the learning curve for a shoulder surgeon to become proficient in focussed ultrasound for the detection of full-thickness rotator cuff tears, as well as to describe a learning method for this skill. Methods: Consecutive patients who were scheduled to undergo an arthroscopy for rotator cuff disease were scanned immediately before surgery by a senior shoulder surgeon with limited previous experience of shoulder ultrasound. The presence or absence of a full-thickness rotator cuff tear on scan was compared with intra-operative findings as the gold standard. Results: Two hundred and ten shoulders were scanned over three equal learning periods. Comparing predictive values from the first to the third training period, sensitivity improved from 0.86 to 0.95, specificity from 0.92 to 0.98, negative predictive value from 0.94 to 0.98, and positive predictive value from 0.82 to 0.95. Conclusions: The high predictive values obtained in the present study for surgeon-led detection of cuff tears using ultrasound are comparable with those quoted for musculoskeletal radiologists in the literature. The present study adds evidence that a shoulder surgeon can achieve accelerated learning of this skill and offers some potentially time-saving and patient-friendly alternatives to existing guidelines.
Gumina S, Di Giorgio G, Bertino A, Della Rocca C, Sardella B, Postacchini F (
2006) Inflammatory infiltrate of the edges of a torn rotator cuff. Int Orthop 30:371–
374 Burkhart SS (1991) Arthroscopic treatment of massive rotator cuff tears:
Author: Stefano Gumina
This handbook provides detailed, state of the art information on simple and complex rotator cuff tears that will be of value in daily clinical practice. It covers all relevant aspects, including basic science, pathogenesis, clinical and instrumental evaluation, and treatment techniques. Drawing on the results of recent studies, the book will enable the reader to better understand how tears occur and what treatment should be employed in different circumstances. Rotator cuff tear has always attracted great interest because it may cause shoulder pain, loss of strength, simple or complex disabilities, and partial or total inability to work, reducing quality of life. The goals of cuff repair are to restore footprint anatomy with biomechanically secure, tension-free construction that promotes biological healing at the tendon-to-bone interface. Even today, there is cause for discussion about when and how to perform surgical repair and on what to do in cases of irreparable rupture. This book casts light on such issues. It is especially designed for shoulder surgeons and rehabilitation specialists and will also be of value for residents and shoulder fellows.
This book documents current knowledge on the mechanisms involved in sports injuries to the shoulder and elbow, reviews essential physical examinations, and explains the role of diagnostic imaging.
Author: Jin-Young PARK
This book documents current knowledge on the mechanisms involved in sports injuries to the shoulder and elbow, reviews essential physical examinations, and explains the role of diagnostic imaging. Above all, it describes in detail the treatment modalities that are appropriate to the injuries encountered in throwing and overhead athletes, including chronic repetitive and acute traumatic injuries. Both conservative and surgical treatments are covered; the author’s own preferred operative techniques are identified and explained, and helpful treatment algorithms offer guidance in selecting an approach fitting to the circumstances. In addition, the inclusion of instructive case reviews will assist readers in achieving a full understanding of the implementation of treatment protocols. Methods of rehabilitation are also described with the aid of demonstration videos, and advice is provided on appropriate timing. The book will be invaluable for all professionals who deal with sports injuries of the shoulder and elbow, including surgeons, physiotherapists, other medical practitioners, and trainers.
12. 13. 14. 15. 16. Wening JD, Hollis Zingg PO, Jost B, Sukthankar A, Buhler M,
Pfirrmann CW, Gerber C. Clinical and structural outcomes of nonoperative
management of massive rotator cuff tears. J Bone Joint Surg Am. 2007;89(9):
Author: Lawrence V. Gulotta
Presenting a logical, comprehensive approach to the patient with a massive rotator cuff tear, this book begins with the pathoanatomy and diagnostic work-up for this common injury, including imaging. Both non-operative and operative treatment options for massive tears follow, including arthroscopy, the use of biologics and patches, tendon transfers, and hemiarthroplasty and reverse total shoulder arthroplasty. A practical treatment algorithm for clinicians treating patients with massive rotator cuff tears is also included. Each chapter opens with pearls and pitfalls covering the main key points for quick reference. The overarching theme of this book is that patients with similar imaging findings may demonstrate very different clinical presentations, and the final treatment recommendation should be made based on their complaints and expectations. As such, it will be an excellent resource for orthopedic surgeons, sports medicine and shoulder physicians, physiatrists, physical medicine and rehab specialists, and occupational therapists.
... specified as traumatic Rotator cuff syndrome Supraspinatus syndrome Supraspinatus tear or rupture, not specified as traumatic Excludes1 tear of rotator
cuff, traumatic (S46.01-) Gradual onset due to repetitive stress to rotator cuff
Author: Carol J. Buck
Category: International statistical classification of diseases and related health problems
Select diagnosis codes accurately with Carol J. Buck's 2018 ICD-10-CM for Physicians: Professional Edition. Designed by coders for coders, this practical manual includes all the ICD-10 codes needed for basic outpatient and physician office coding. As coders need more extensive knowledge to code with ICD-10-CM -- and to choose from the thousands of possible codes -- this edition provides an essential background in A&P, pathology, and medical terminology, along with colorful Netter's Anatomy illustrations and clear instructions for using the book. Together, these features make diagnosis coding faster and easier. Also included is a companion website with the latest coding news and updates! Convenient Guide to the Updates in the front of the book lists all new, revised, and deleted codes, providing at-a-glance lookup of the coding changes. Official Guidelines for Coding and Reporting (OGCRs) are listed in full in the Introduction, at the beginning of each chapter, and integrated within the code set, providing easier reference to coding rules when they are needed most. UNIQUE! Full-color Netter's Anatomy art is included in a separate section for easy reference and cross-referenced within the Tabular List of Diseases and Injuries, to help users understand anatomy and how it may affect choosing codes. Full-color design includes consistent color-coded symbols and text, providing easier access to codes and coding information. American Hospital Association's Coding Clinic(R) citations include official ICD-10-CM coding advice relating to specific codes and their usage. 175 illustrations provide visual orientation and enhance understanding of specific coding situations. Items are included throughout the Tabular List to ensure accurate coding, providing additional information on common diseases and conditions. Additional elements within specific codes define terms and add coding instructions relating to difficult terminology, diseases and conditions, or coding in a specific category. Symbols and highlights draw attention to codes that may require special consideration before coding, including: New, Revised, and Deleted Codes that call for the use of additional character(s) Includes, Excludes 1 and Excludes 2 Use Additional Unspecified Code First and Code Also Placeholder X symbol reminds users to assign placeholder X for codes less than 6 characters that require a 7th character. Manifestation code identifies conditions for which it is important to record both the etiology and the symptom of the disease. Age and Sex edits from the Definition of Medicare Code Edits help to ensure accuracy by denoting codes that are used only with patients of a specific age or sex.
For those without considerable arthroscopic expertise or sufficient rotator cuff tear
patient volume, the prospect of transitioning to arthroscopic repair may seem
more imprudent than daunting. Yet despite such disincentives, arthroscopic
Author: Jeffrey S. Abrams
Publisher: Springer Science & Business Media
This text takes a comprehensive approach to rotator cuff disorders, including tears and arthroscopic techniques in surgical management. It addresses the latest topics, such as the conversion of mini-open repair to all arthroscopic repair, and answers key questions raised at instructional courses. Experts in the field present not only arthroscopic shoulder anatomy, cuff tear patterns, repair concepts, and other fundamentals, but also provide coverage of state-of-the-art techniques. The step-by-step approach is supplemented by a wealth of anatomical drawings and color photos.
13 Arthroscopy : Complications of Rotator Cuff Repair INTRODUCTION lems is
somewhat different when the surgery is performed arthroscopically . Other
complications , such as those related to fluid extravasation or to the management
Author: Thomas J. Gill
Publisher: Lippincott Williams & Wilkins
Written by internationally recognized master surgeons, this book is a comprehensive, practical guide to prevention, diagnosis, and management of complications in shoulder surgery. Major sections focus on open and arthroscopic surgery, and each section includes chapters on specific procedures, such as surgery for anterior shoulder instability, surgery for posterior/multidirectional instability, rotator cuff repair, arthroplasty, fracture management, arthrodesis, subacromial decompression, acromioclavicular joint resection, and thermal capsulorrhaphy. For each procedure, the authors discuss the full range of potential complications and present their preferred approaches to prevention, diagnosis, and treatment of these problems. More than 200 illustrations complement the text.
TREATMENT OF MASSIVE ROTATOR CUFF TEARS : POSTERIOR - SUPERIOR
AND ANTERIOR - SUPERIOR JON J . P . WARNER , MD CHRISTIAN GERBER ,
MD The purpose of this chapter is to consider treat - There is no universal ...
Author: Louis U. Bigliani
Publisher: Amer Academy of Orthopaedic
Discusses the recent research and understanding of these complex issues: - Biomechanics of the coracoacromial arch - Kinematics of subacromial space- Arthroscopic acromioplasty- Arthroscopic distal clavicle repair- Massive rotator cuff repairs- Techniques and results of tendon transfers for irreparable tears- Complications of rotator cuff surgery
In the last twenty-five years the diagnosis and treatment of rotator cuff tears have
seen tremendous progress. Whereas in the 1960ies surgeons believed that all
ruptures are reparable and are amenable to a successful outcome, experience ...
Author: Philippe Valenti
Publisher: Springer Science & Business Media
Treatment of symptomatic irreparable cuff tear is rare, but represents a difficult challenge for the surgeon. Tendon transfer from periscapular muscles group is a therapeutic option. Many tendon transfers are reported as latissimus dorsi, teres major, split of anterior deltoid and pectoralis major. The goal of this book is to remind the biomechanical and anatomical basis of these tendon transfers and to report tips and tricks and results of these techniques. A treatment algorithm is proposed in patients who have both pain and weakness or have loss of active forward elevation or external rotation. Moreover, tendon transfer can be combined with reverse shoulder prosthesis in patients with an unstable gleno humeral arthritis.
Tears of the rotator cuff are associated with pain and weakness and can result in
significant disability.1 However, it is also known that asymptomatic rotator cuff tears exist in a large percentage of patients, and the presence of asymptomatic ...
Author: Giles R. Scuderi
Publisher: Springer Science & Business Media
Minimally invasive surgery has evolved as an alternative to the traditional approaches in orthopedic surgery and has gathered a great deal of attention. Many surgeons are now p- forming all types of procedures through smaller surgical felds. Along with changes in the surgical technique, there have been rapid advances in computer navigation and robotics as tools to enhance the surgeon’s vision in the limited operative felds. With these new techniques and technologies, we must ensure that these procedures are performed safely and effectively with predictable clinical outcomes. This book has been expanded from our previous publi- tions to include spine and foot and ankle surgery, along with updated sections on knee arth- plasty, hip arthroplasty, and upper extremity surgery. The clinical information and surgical techniques, along with tips and pearls, provided by experts in the feld allows the reader to grasp a comprehensive understanding of the nuances of MIS. It is our intention that this text will be a valuable reference for all orthopedic surgeons. New York, NY Giles R. Scuderi, MD Piscataway, NJ Alfred J. Tria, MD v BookID 127440_ChapID FM_Proof# 1 - 14/09/2009 Contents Section I The Upper Extremities 1 What Is Minimally Invasive Surgery and How Do You Learn It? . . . . . . . . . . . . . . . . . . . . . 3 Aaron G. Rosenberg 2 Overview of Shoulder Approaches: Choosing Between Mini-incision and Arthroscopic Techniques . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Raymond A. Klug, Bradford O. Parsons, and Evan L. Flatow 3 Mini-incision Bankart Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Edward W. Lee, Kenneth Accousti, and Evan L. Flatow 4 Mini-open Rotator Cuff Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Outcomes assessed were clinical impingement syndrome or rotator cufftear (full,
partial or any). Only cohort studies were included . . Inthe included studies, the
prevalence of rotatorcuff disorders wasgenerally high, partial verification of ...
Author: Sics Editore
Publisher: SICS Editore
Rest, patient instruction and NSAIDs suffice for treatment in the majority of painful conditions of the rotator cuff. Prolonged inflammatory conditions are treated with glucocorticoid injections. Rupture of the rotator cuff should be identified. Major ruptures should be operated on within a few months of the trauma for a good result.
Considerable debate continues concerning the underlying cause of rotator cuff tears and also concerning their management. Treatment options for full-thickness rotator cuff tears include nonoperative treatment with exercises, subacromial ...
Author: Daniel J. Berry
Publisher: Lippincott Williams & Wilkins
Written by leading experts from the Mayo Clinic, this volume of our Orthopaedic Surgery Essentials Series presents all the information residents need on hip, knee, shoulder, and elbow reconstruction in adults. It can easily be read cover to cover during a rotation or used for quick reference before a patient workup or operation. The user-friendly, visually stimulating format features ample illustrations, algorithms, bulleted lists, charts, and tables. Coverage of each region includes physical evaluation and imaging, evaluation and treatment of disorders, and operative treatment methods. The extensive coverage of operative treatment includes primary and revision arthroplasty and alternatives to arthroplasty.
Current Concepts of Rotator Cuff Repair Stephen S. Burkhart and Wesley M.
Nottage NI Arthroscopic Management of Rotator Cuff Tear : Burkhart Technique.
CHAPTER 4 The rapidly expanding field of shoulder arthroscopy has led to a ...
Author: James C.Y. Chow
Publisher: Springer Science & Business Media
Focusing on the most current, cutting-edge, innovative, and advanced arthroscopic techniques for wrist and hand, elbow, shoulder, hip, knee, ankle, foot, and spine, this book presents orthopaedic surgeons with the detailed procedures needed to stay competitive in the age of managed care. With contributions from specialist leaders in orthopaedic and arthroscopic surgery, the text is supplemented by full-color arthroscopic views and custom illustrations, detailing complex procedures for rotator cuff tear, TFCC repair, meniscus repair, ACL reconstruction, intraarticular fractures and many others. Special sections on laser applications in arthroscopy and office arthroscopy make this volume a must for every practicing orthopaedic surgeon.
If the partialthickness rotator cuff tear is minor, it is reasonable to treat it with de
́bridement alone. If the partial-thickness rotator cuff tear is grade 2 or 3, I mark it
with a needle and suture and view the lesion from the subacromial space.
Author: Gary M. Gartsman
Publisher: Elsevier Health Sciences
The new edition of this step-by-step guide covers the entire spectrum of operative shoulder arthroscopy from initial operation room set-up through advanced reconstructive procedures. View all-new illustrations and apply the latest treatment options for Bankart repair, SLAP repair, and repair of a full range of rotator cuff lesions, along with strategies for stiff shoulders and osteoarthritis. Whether you are a novice or an experienced shoulder surgeon, improve your technique with the expertise of Dr. Gartsman. Provides detailed step-by-step descriptions of Dr. Gartsman’s approach—including variations and complications—so that you can reproduce his results. Emphasizes re-operative planning and associated outcome data to give you a scientific basis for treatment recommendations. Provides revised content and new illustrations, with coverage of the latest instrumentation so you get a fresh, up-to-date approach to the subject matter. Presents the most current scientific data on the treatment outcomes of specific conditions and techniques so you make the best-informed decisions. Features two new chapters on Diagnostic Ultrasound and Suprascapular Nerve Release for state-of-the-art arthroscopic diagnostic and management tools, including arthroscopic Latarjet for recurrent dislocation.