The role of degenerative changes in rotator cuff musculature with respect to the functional outcomes repair have only recently been recognized and are still not well understood. In addition, reversibility these tendons is questionable.Poorer preoperative muscle quality negatively affects outcome, a successful outcome (in terms healed repair) might demonstrate improvements fatty infiltration atrophy.Cohort study; Level evidence, 2.Thirty-eight patients (mean age, 62 years) were prospectively...

Background: Recent publications suggest that arthroscopic and open rotator cuff repairs have had comparable clinical results, although each technique has distinct advantages disadvantages. National hospital ambulatory surgery databases were reviewed to identify practice patterns for repair. Methods: The rates of medical visits pathology, the repair, examined years 1996 2006 in United States. national incidence related data obtained from inpatient (National Hospital Discharge Survey, NHDS)...

Abstract The tensile properties of the inferior glenohumeral ligament have been determined in 16 freshly frozen cadaver shoulders. gleno‐humeral was divided into three anatomical regions: a superior band, an anterior axillary pouch, and posterior pouch. This yielded 48 bone‐ligament‐bone specimens, which were tested to failure uniaxial tension. band consistently thickest region, averaging 2.79 mm. thickness decreased from antero‐superiorly postero‐inferiorly. resting length all regions not...

Nine fresh-frozen, human cadaveric shoulders were el evated in the scapular plane two different humeral rotations by applying forces along action lines of rotator cuff and deltoid muscles. Stereophotogrammetry deter mined possible regions subacromial contact using a proximity criterion; radiographs measured acromio interval position greater tuberosity. Con tact starts at anterolateral edge acromion 0° elevation; it shifts medially with arm elevation. On surface, from proximal to dis tal on...

Little quantitative data exists defining the true shape of humeral head and glenoid articular surfaces. This study uses a precise stereophotogrammetry (SPG) technique provides highly accurate results for determining three-dimensional geometry glenohumeral joint surfaces, including their "sphericity", surface areas, cartilage thickness, difference in these quantities between genders. Results indicate that surfaces may be approximated by section sphere with small deviations from sphericity...

Sixty-eight shoulders in 63 athletic patients with anterior-inferior glenohumeral instability underwent an capsular shift procedure. Shoulders glenoid fractures, predominantly posterior instability, or routine, unidirectional anterior were not included this study. There 42 men and 21 women, average age of 23 years. Forty-two repairs performed on the dominant arm. All 31 overhead throwing athletes had their arms repaired. Forty-six histories recurrent dislocations, while 22 subluxation. 68...

Forty-four patients, ranging in age from 17 to 57 years (average, 32), were evaluated an average of 4 (range, 2 9) after surgical reconstruction for Allman-Tossy Grade III acromioclavicular dislocations. Twenty-seven patients underwent repair acute injuries (< 3 weeks injury) and reconstructions chronic (> weeks). Coracoclavicular fixation with heavy nonabsorbable sutures was used correct superior displacement all cases. In addition, transfer the coracoacromial ligament distal clavicle...

Background Open rotator cuff repairs have led to excellent clinical results; however, several studies linked postoperative structural integrity patient outcomes. The purpose of this study is prospectively assess after open repair and its relationship outcome. Hypothesis Preoperative tear size are important factors in overall Study Design Prospective nonrandomized outcomes study. Methods Forty-seven consecutive patients undergoing full-thickness tears by a single surgeon were enrolled...

Background: Recreation of normal anatomical relationships may be important to optimize the outcome proximal humeral arthroplasty. With use computerized tomographic data and three-dimensional computer modeling, we concurrently studied both extramedullary intramedullary morphology, including canal shape, related these findings design prostheses. Methods: Sixty cadaveric humeri (thirty pairs: fifteen from male donors female donors) were studied. Three-dimensional models built periosteal...

The shoulder is characterized foremost by its mobility and large range of motion. glenohumeral joint notable for relative lack bony constraint, relying heavily on the congruent articulating surfaces surrounding soft tissue envelope static dynamic stability. Effective function in articulation achieved a complex interaction between various articular restraints. rotator cuff muscles center humeral head glenoid fossa through midrange motion, when capsuloligamentous structures are lax. However,...

In 63 anatomic specimens of the shoulder, coracohumeral ligament was found to be a clear, well-developed structure in 59 and absent or vestigial four. The origin consistently at base coracoid process. insertion more variable, between rotator interval, supraspinatus, subscapularis. fresh specimens, tight with maximal external rotation, which increased an average 32 degrees on sectioning this only. has been shortened various pathologic states. Its release may required restore restricted motion...

Twelve patients, ranging in age from thirty-four to seventy-two years (average, fifty-three years), were evaluated an average of five (range, two eight years) after open reduction and internal fixation a two-part displaced fracture the greater tuberosity proximal part humerus. The indication for operative was one centimeter or more displacement as seen on diagnostic radiographs. anterosuperior deltoid-splitting approach, combined with rotation humerus, allowed adequate exposure retracted...

Abstract Glenohumeral arthritis may result from abnormal articular mechanics, and shoulder reconstructive procedures often rely implicitly on the belief that restoration of normal mechanics is required to obtain satisfactory clinical results. Despite this, limited knowledge or pathologic glenohumeral joint contact available. This study uses a stereophotogrammetry technique determine areas in cadaver joints with intact ligaments capsule through large range motion using simulated forces four...

Background Management of the cuff-deficient arthritic shoulder has long been challenging. Early unconstrained arthroplasty systems were associated with high complication and implant failure rates. The evolution toward modern reverse includes many variables constrained designs. Questions/purposes This review explores development arthroplasty, specifically describing (1) designs, (2) biomechanical variations in this (3) current issues relevant to today. Methods Using a PubMed search,...

Arthroscopy serves as a useful adjunct to manipulation under anesthesia in the treatment of resistant frozen shoulder. In this technique shoulder is manipulated interscalene brachial plexus block anesthesia, followed by arthroscopic examination and debridement glenohumeral joint subacromial space. The addition arthroscopy allows identification associated pathology, such impingement lesions secondary space inflammation, calcific deposits, acromioclavicular arthritis. Range motion can also be...