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[PMID]:29229593
[Au] Autor:Craig R; Holt T; Rees JL
[Ad] Endereço:Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Oxford OX3 7LD, UK.
[Ti] Título:Acute rotator cuff tears.
[So] Source:BMJ;359:j5366, 2017 12 11.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Lesões do Manguito Rotador/diagnóstico por imagem
Manguito Rotador/diagnóstico por imagem
Lesões do Ombro/diagnóstico por imagem
[Mh] Termos MeSH secundário: Doença Aguda
Conscientização
Diagnóstico Diferencial
Gerenciamento Clínico
Serviço Hospitalar de Emergência
Feminino
Seres Humanos
Meia-Idade
Debilidade Muscular/etiologia
Dor/etiologia
Manguito Rotador/patologia
Manguito Rotador/cirurgia
Lesões do Manguito Rotador/epidemiologia
Lesões do Manguito Rotador/patologia
Lesões do Manguito Rotador/cirurgia
Lesões do Ombro/complicações
Lesões do Ombro/patologia
Lesões do Ombro/cirurgia
Ultrassonografia/métodos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5366


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[PMID]:28460192
[Au] Autor:Karampinos DC; Holwein C; Buchmann S; Baum T; Ruschke S; Gersing AS; Sutter R; Imhoff AB; Rummeny EJ; Jungmann PM
[Ad] Endereço:Department of Radiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany.
[Ti] Título:Proton Density Fat-Fraction of Rotator Cuff Muscles Is Associated With Isometric Strength 10 Years After Rotator Cuff Repair: A Quantitative Magnetic Resonance Imaging Study of the Shoulder.
[So] Source:Am J Sports Med;45(9):1990-1999, 2017 Jul.
[Is] ISSN:1552-3365
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Quantitative muscle fat-fraction magnetic resonance (MR) imaging techniques correlate with semiquantitative Goutallier scores with failure after rotator cuff (RC) repair. PURPOSE: To investigate the relationship of proton density fat fraction (PDFF) of the RC muscles with semiquantitative MR scores, cartilage T2 relaxation times, and clinical isometric strength measurements in patients 10 years after unilateral RC repair. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: Bilateral shoulder MR imaging was performed in 13 patients (11 male, 2 female; age, 72 ± 8 years) 10.9 ± 0.4 years after unilateral autologous periosteal flap augmented RC repair (total shoulders assessed, N = 26). Goutallier classification, muscle atrophy, RC tendon integrity, and cartilage defects were determined based on morphological MR sequences. A paracoronal 2D multi-slice multi-echo sequence was used for quantitative cartilage T2 mapping. A chemical shift-encoding-based water-fat separation technique (based on a 6-echo 3D spoiled gradient echo sequence) was used for quantification of the PDFF of RC muscles. Isometric shoulder abduction strength was measured clinically. Mean and SD, Pearson correlation, and partial Spearman correlation were calculated. RESULTS: There were 6 RC full-thickness retears in ipsilateral shoulders and 6 RC full-thickness tears in contralateral shoulders. Isometric shoulder abduction strength was not significantly different between ipsilateral and contralateral shoulders (50 ± 24 N vs 54 ± 24 N; P = .159). The mean PDFF of RC muscles was 11.7% ± 10.4% (ipsilateral, 14.2% ± 8.5%; contralateral, 9.2% ± 7.8%; P = .002). High supraspinatus PDFF correlated significantly with higher Goutallier scores ( R = 0.75, P < .001) and with lower isometric muscle strength ( R = -0.49, P = .011). This correlation remained significant after adjustment for muscle area measurements and tendon rupture ( R = -0.41, P = .048). More severe cartilage defects at the humerus were significantly associated with higher supraspinatus PDFF ( R = 0.44; P = .023). Cartilage T2 values did not correlate with muscle PDFF ( P > .05). CONCLUSION: MR imaging-derived RC muscle PDFF is associated with isometric strength independent of muscle atrophy and tendon rupture in shoulders with early and advanced degenerative changes. It therefore provides complementary, clinically relevant information in tracking RC muscle composition on a quantitative level.
[Mh] Termos MeSH primário: Cartilagem Articular/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
Manguito Rotador/diagnóstico por imagem
Articulação do Ombro/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Artroplastia
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Força Muscular
Atrofia Muscular/diagnóstico por imagem
Prótons
Manguito Rotador/cirurgia
Lesões do Manguito Rotador/cirurgia
Artropatia de Ruptura do Manguito Rotador/diagnóstico por imagem
Ombro/cirurgia
Articulação do Ombro/cirurgia
Traumatismos dos Tendões/cirurgia
Tendões/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Protons)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.1177/0363546517703086


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[PMID]:28448728
[Au] Autor:Kim YS; Sung CH; Chung SH; Kwak SJ; Koh YG
[Ad] Endereço:Department of Orthopaedic Surgery, Center for Stem Cell & Arthritis Research, Yonsei Sarang Hospital, Seoul, Republic of Korea.
[Ti] Título:Does an Injection of Adipose-Derived Mesenchymal Stem Cells Loaded in Fibrin Glue Influence Rotator Cuff Repair Outcomes? A Clinical and Magnetic Resonance Imaging Study.
[So] Source:Am J Sports Med;45(9):2010-2018, 2017 Jul.
[Is] ISSN:1552-3365
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The mesenchymal stem cell (MSC)-based tissue engineering approach has been developed to improve the treatment of rotator cuff tears. Hypothesis/Purpose: The purpose was to determine the effect of an injection of adipose-derived MSCs loaded in fibrin glue during arthroscopic rotator cuff repair on clinical outcomes and to evaluate its effect on structural integrity using magnetic resonance imaging (MRI). The hypothesis was that the application of adipose-derived MSCs would improve outcomes after the surgical repair of a rotator cuff tear. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Among 182 patients treated with arthroscopic surgery for a rotator cuff tear, 35 patients treated with arthroscopic rotator cuff repair alone (conventional group) were matched with 35 patients who underwent arthroscopic rotator cuff repair with an injection of adipose-derived MSCs loaded in fibrin glue (injection group) based on sex, age, and lesion size. Outcomes were assessed with respect to the visual analog scale (VAS) for pain, range of motion (ROM) (including forward flexion, external rotation at the side, and internal rotation at the back), and functional measures of the Constant score and University of California, Los Angeles (UCLA) shoulder rating scale. Repaired tendon structural integrity was assessed by using MRI at a minimum of 12 months after surgery, and the mean clinical follow-up was 28.8 ± 4.2 months in the conventional group and 28.3 ± 3.8 months in the injection group. RESULTS: The mean VAS score at rest and during motion improved significantly in both groups after surgery. However, there were no significant differences between the groups at the final follow-up ( P = .256 and .776, respectively). Compared with preoperative measurements, forward flexion and external rotation at the side significantly improved at the final follow-up in both groups (all P < .05). However, no significant improvements in internal rotation at the back were observed in either group ( P = .625 and .834 for the conventional and injection groups, respectively). There were also no significant differences between the groups at the final follow-up for any of the 3 ROM positions (all P > .05). The mean Constant score and UCLA score improved significantly in both groups after surgery, but there were no significant differences between the groups at the final follow-up ( P = .634 and .302, respectively). MRI indicated a retear rate of 28.5% in the conventional group and 14.3% in the injection group ( P < .001). CONCLUSION: This study revealed that an injection of adipose-derived MSCs loaded in fibrin glue during rotator cuff repair could significantly improve structural outcomes in terms of the retear rate. There were, however, no clinical differences in the 28-month period of follow-up. Although still in the early stages of application, MSC augmentation of surgical rotator cuff repair appears useful for providing an adequate biological environment around the repair site.
[Mh] Termos MeSH primário: Artroscopia/métodos
Adesivo Tecidual de Fibrina/administração & dosagem
Transplante de Células-Tronco Mesenquimais
Lesões do Manguito Rotador/cirurgia
Adesivos Teciduais/administração & dosagem
[Mh] Termos MeSH secundário: Tecido Adiposo/citologia
Adulto
Idoso
Artroplastia
Estudos de Coortes
Feminino
Seres Humanos
Injeções
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Medição da Dor
Amplitude de Movimento Articular
Manguito Rotador/diagnóstico por imagem
Manguito Rotador/cirurgia
Ombro/cirurgia
Articulação do Ombro/diagnóstico por imagem
Articulação do Ombro/cirurgia
Engenharia Tecidual
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fibrin Tissue Adhesive); 0 (Tissue Adhesives)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1177/0363546517702863


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[PMID]:29212688
[Au] Autor:Chou WY; Wang CJ; Wu KT; Yang YJ; Ko JY; Siu KK
[Ad] Endereço:Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
[Ti] Título:Prognostic factors for the outcome of extracorporeal shockwave therapy for calcific tendinitis of the shoulder.
[So] Source:Bone Joint J;99-B(12):1643-1650, 2017 Dec.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: We conducted a study to identify factors that are prognostic of the outcome of extracorporeal shockwave therapy (ESWT) for calcific tendinitis of the shoulder. PATIENTS AND METHODS: Since 1998, patients with symptomatic calcific tendinitis of the rotator cuff have been treated with ESWT using an electrohydraulic mode shockwave device. One year after ESWT, patients were grouped according to the level of resorption of calcification. RESULTS: Of 241 symptomatic shoulders, complete resorption (CR) of calcification occurred in 134 (CR group). The remaining 107 shoulders had incomplete resorption (ICR) (ICR group). Gartner type I calcification was most common (64.5%) in the ICR group. The mean duration of symptoms before ESWT was significantly longer in the ICR group. Overall, 81% of the CR group and 23.4% of the ICR group were symptom free. There was a strong relationship between subsidence of symptoms and remission of calcification. Poor prognosis was significantly related to Gartner type I calcification, calcification extent > 15 mm and duration of symptoms > 11 months. CONCLUSION: Patients with calcific tendinitis of the shoulder who have the factors identified for a poor outcome after ESWT should undergo a different procedure. Cite this article: 2017;99-B:1643-50.
[Mh] Termos MeSH primário: Calcinose/terapia
Tratamento por Ondas de Choque Extracorpóreas
Manguito Rotador
Dor de Ombro/terapia
Ombro
Tendinopatia/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Calcinose/diagnóstico por imagem
Feminino
Seres Humanos
Masculino
Meia-Idade
Prognóstico
Amplitude de Movimento Articular
Manguito Rotador/diagnóstico por imagem
Ombro/diagnóstico por imagem
Dor de Ombro/etiologia
Tendinopatia/diagnóstico por imagem
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171213
[Lr] Data última revisão:
171213
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B12.BJJ-2016-1178.R1


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[PMID]:28880113
[Au] Autor:Rashid MS; Cooper C; Cook J; Cooper D; Dakin SG; Snelling S; Carr AJ
[Ad] Endereço:a Botnar Research Centre , Nuffield Department of Orthopedics Rheumatology and Musculoskeletal Sciences , University of Oxford , Oxford , UK.
[Ti] Título:Increasing age and tear size reduce rotator cuff repair healing rate at 1 year.
[So] Source:Acta Orthop;88(6):606-611, 2017 Dec.
[Is] ISSN:1745-3682
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Background and purpose - There is a need to understand the reasons why a high proportion of rotator cuff repairs fail to heal. Using data from a large randomized clinical trial, we evaluated age and tear size as risk factors for failure of rotator cuff repair. Patients and methods - Between 2007 and 2014, 65 surgeons from 47 hospitals in the National Health Service (NHS) recruited 447 patients with atraumatic rotator cuff tendon tears to the United Kingdom Rotator Cuff Trial (UKUFF) and 256 underwent rotator cuff repair. Cuff integrity was assessed by imaging in 217 patients, at 12 months post-operation. Logistic regression analysis was used to determine the influence of age and intra-operative tear size on healing. Hand dominance, sex, and previous steroid injections were controlled for. Results - The overall healing rate was 122/217 (56%) at 12 months. Healing rate decreased with increasing tear size (small tears 66%, medium tears 68%, large tears 47%, and massive tears 27% healed). The mean age of patients with a healed repair was 61 years compared with 64 years for those with a non-healed repair. Mean age increased with larger tear sizes (small tears 59 years, medium tears 62 years, large tears 64 years, and massive tears 66 years). Increasing age was an independent factor that negatively influenced healing, even after controlling for tear size. Only massive tears were an independent predictor of non-healing, after controlling for age. Interpretation - Although increasing age and larger tear size are both risks for failure of rotator cuff repair healing, age is the dominant risk factor.
[Mh] Termos MeSH primário: Artroscopia/efeitos adversos
Lesões do Manguito Rotador/diagnóstico
Manguito Rotador/cirurgia
Cicatrização
[Mh] Termos MeSH secundário: Fatores Etários
Feminino
Seguimentos
Seres Humanos
Masculino
Período Pós-Operatório
Estudos Retrospectivos
Fatores de Risco
Lesões do Manguito Rotador/epidemiologia
Lesões do Manguito Rotador/cirurgia
Fatores de Tempo
Falha de Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170908
[St] Status:MEDLINE
[do] DOI:10.1080/17453674.2017.1370844


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[PMID]:28816895
[Au] Autor:Collin P; Kempf JF; Molé D; Meyer N; Agout C; Saffarini M; Godenèche A; Société Française de Chirurgie Orthopédique et Traumatologique (SoFCOT)
[Ad] Endereço:CHP Saint Grégoire VIVALTO Santé, Saint Grégoire, France
[Ti] Título:Ten-Year Multicenter Clinical and MRI Evaluation of Isolated Supraspinatus Repairs.
[So] Source:J Bone Joint Surg Am;99(16):1355-1364, 2017 08 16.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Early repair of isolated supraspinatus tears could prevent further deterioration of the rotator cuff; however, there is no consensus on the management of such tears because of a lack of long-term outcome studies. The purposes of this study were to report the 10-year outcomes of isolated supraspinatus repairs and to investigate the factors that favor healing and recovery. METHODS: We retrieved the records of all 511 patients who, in 2003, underwent repair of full-thickness isolated supraspinatus tears, performed by 15 surgeons at 15 centers. In 2014, the patients were asked to return for evaluation at a minimum follow-up of 10 years. One hundred and eighty-eight patients could not be reached, and 35 were excluded because they had a reoperation (17 had a retear, 7 had conversion to an arthroplasty, and 11 had other causes). A total of 288 patients (50% were men) who had a mean age (and standard deviation) at index surgery of 56.5 ± 8.3 years (range, 32 to 77 years) were evaluated clinically, and 210 of them were also evaluated using magnetic resonance imaging (MRI). RESULTS: Thirty shoulders (10.4%) had complications, including stiffness (20 shoulders), infection (1 shoulder), and other complications (9 shoulders). The total Constant score improved from a mean of 51.8 ± 13.6 points (range, 19 to 87 points) preoperatively to 77.7 ± 12.1 points (range, 37 to 100 points) at 10 years. At the 10-year follow-up evaluation, the mean Subjective Shoulder Value (SSV) was 84.9 ± 14.8 (range, 20 to 100), and the mean Simple Shoulder Test (SST) was 10.1 ± 2.2 (range, 3 to 12). Of the 210 shoulders evaluated using MRI, the repair integrity was Sugaya type I in 26 shoulders (12%), type II in 85 (41%), type III in 59 (28%), type IV in 27 (13%), and type V in 13 (6%). The total Constant score at the final follow-up was significantly associated with tendon healing (p < 0.005) and was inversely associated with preoperative fatty infiltration (p < 0.001). Neither the surgical approach nor the preoperative retraction influenced the outcomes. CONCLUSIONS: Repairs of isolated supraspinatus tears maintained considerable improvement in clinical and radiographic outcomes at 10 years. Preoperative fatty infiltration and postoperative retear have a significantly detrimental effect on the long-term functional outcome of rotator cuff repair. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Lesões do Manguito Rotador/cirurgia
Manguito Rotador/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Artroscopia/métodos
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Amplitude de Movimento Articular
Estudos Retrospectivos
Manguito Rotador/diagnóstico por imagem
Lesões do Manguito Rotador/diagnóstico por imagem
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.01267


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[PMID]:28719559
[Au] Autor:Diebold G; Lam P; Walton J; Murrell GAC
[Ad] Endereço:1Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, New South Wales, Australia.
[Ti] Título:Relationship Between Age and Rotator Cuff Retear: A Study of 1,600 Consecutive Rotator Cuff Repairs.
[So] Source:J Bone Joint Surg Am;99(14):1198-1205, 2017 Jul 19.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The prevalence of rotator cuff tears increases with age, and many patients undergo surgical repair. Retears are not uncommon, with rates ranging between 9% and 36% in recent studies, and are a major concern. The aim of this study was to investigate the relationship between patient age and the chance of healing following rotator cuff repair. METHODS: This was a retrospective cohort study of patients who had undergone arthroscopic rotator cuff repair performed by a single surgeon. All patients had an ultrasound performed by a musculoskeletal sonographer 6 months after rotator cuff repair to assess the repair integrity. RESULTS: The cohort of 1,600 patients was normally distributed in terms of age, with a mean age (and standard error of the mean) of 59 ± 0.3 years and a range of 15 to 91 years. The 212 patients (13%) who had a retear at 6 months were also normally distributed in terms of age, with a mean age of 65 ± 0.8 years and a range of 15 to 88 years. The retear rate in patients <50 years old was 5%. This increased to 10% in patients aged 50 to 59 years, 15% in those aged 60 to 69 years, 25% in those aged 70 to 79 years, and 34% in those aged ≥80 years. Multiple logistic regression analysis showed that patient age was an independent factor strongly associated with retears. CONCLUSIONS: The rate of rotator cuff retears is low in patients <50 years of age. The relationship between age and rotator cuff retears is linear in patients 50 to 69 years of age, with an increase of 5% between decades, and increases substantially in patients ≥70 years old. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Lesões do Manguito Rotador/cirurgia
Manguito Rotador/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Área Sob a Curva
Feminino
Seres Humanos
Masculino
Meia-Idade
Cuidados Pré-Operatórios
Recidiva
Estudos Retrospectivos
Ruptura/cirurgia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170719
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.00770


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[PMID]:28707534
[Au] Autor:Kolo FC; Schwitzguébel AJ; Kourhani A; Denard PJ; Charbonnier C; Lädermann A
[Ad] Endereço:1 Department of Radiology, Rive Droite Radiology Center , Geneva , Switzerland.
[Ti] Título:Fosbury flop tear of the rotator cuff: diagnostic assessment with magnetic resonance arthrography.
[So] Source:Br J Radiol;90(1077):20170146, 2017 Aug.
[Is] ISSN:1748-880X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The aim was to assess the diagnostic performance of magnetic resonance arthrography (MRA) of the shoulder for the detection of "Fosbury flop" tears. METHODS: All patients undergoing arthroscopic rotator cuff repair were considered as potentially eligible for inclusion in this prospective case series. Preoperative MRAs were consecutively performed and compared with intraoperative findings being the gold standard control. Two experienced musculoskeletal radiologists, blinded to the arthroscopic findings, independently analysed all MRAs for the presence of typical signs of Fosbury flop tears. RESULTS: 423 patients were included. Among this group, 11 presented a Fosbury flop tear with a prevalence of 2.6%. Interobserver agreement was considered as excellent for thickened tendon, tendon stump, fluid accumulation, abnormal fibres orientationand adherences between tendon and bursa. The most sensitive and specific criterion was the tendon thickness[90.9% CI(62.3-98.4) and97.1% CI(95.0-98.3), respectively].  Conclusions: Fosbury flop tear is an uncommon condition that should be recognized to allow optimal anatomic repair. MRA is a valuable tool in making the diagnosing of this lesser recognized type of rotator cuff tear. An abnormally thickened supraspinatus tendon tear should especially raise suspicion for a Fosbury flop tear of the posterosuperior rotator cuff. Advances in knowledge: MRA is a valuable tool in making the diagnosing of Fosbury flop tears. An abnormally thickened supraspinatus tendon tear should especially raise suspicion for such lesion.
[Mh] Termos MeSH primário: Artrografia/métodos
Imagem por Ressonância Magnética/métodos
Lesões do Manguito Rotador/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Reprodutibilidade dos Testes
Manguito Rotador/diagnóstico por imagem
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170715
[St] Status:MEDLINE
[do] DOI:10.1259/bjr.20170146


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[PMID]:28694535
[Au] Autor:Bond EC; Maher A; Hunt L; Leigh W; Brick M; Young SW; Caughey M
[Ad] Endereço:Orthopaedic Trainee, Wellington Hospital.
[Ti] Título:The role of acromioplasty when repairing rotator cuff tears-no difference in pain or functional outcome at 24 months in a cohort of 2,441 patients.
[So] Source:N Z Med J;130(1458):13-20, 2017 Jul 07.
[Is] ISSN:1175-8716
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:AIM: The role of acromioplasty with rotator cuff repair remains unclear. This study aims to test the null hypothesis-that acromioplasty in conjunction with rotator cuff repair has no effect on improvement in pain or shoulder function at two years follow up. METHODS: Data was obtained from a collaborative nationwide project between March 2009 and December 2010, and consisted of a total of 2,441 patients undergoing primary repair of superior rotator cuff tears. Multivariate analysis was performed to assess the effect of the inclusion of acromioplasty at the time of rotator cuff repair on visual analogue scale (VAS) pain scores and Flex Shoulder Function (Flex SF) scores at 24-month follow up. RESULTS: On univariate analysis there was a significantly higher Flex SF score in the acromioplasty group (40.5) compared to the no acromioplasty group (38.7) and a lower mean pain score at 24 months in the acromioplasty group (1.44 vs 1.74). There was a significant difference in tear area and surgical repair technique between the two groups. On multivariate analysis there was no statistically significant difference in Flex SF or VAS pain scores between the two groups. CONCLUSION: There was no difference in pain or function scores at two years following rotator cuff repair regardless of whether or not acromioplasty was performed. This paper represents the largest study to date comparing acromioplasty to no acromioplasty in the setting of cuff repair. It supports previous literature in showing no significant difference in pain or shoulder function between the two groups.
[Mh] Termos MeSH primário: Artroplastia/métodos
Lacerações/cirurgia
Dor/fisiopatologia
Lesões do Manguito Rotador/cirurgia
Manguito Rotador/cirurgia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seguimentos
Seres Humanos
Modelos Lineares
Masculino
Meia-Idade
Análise Multivariada
Dor/etiologia
Medição da Dor
Resultado do Tratamento
Cicatrização
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170724
[Lr] Data última revisão:
170724
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170712
[St] Status:MEDLINE


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[PMID]:28687319
[Au] Autor:Park GY; Park JH; Kwon DR; Kwon DG; Park J
[Ad] Endereço:Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
[Ti] Título:Do the Findings of Magnetic Resonance Imaging, Arthrography, and Ultrasonography Reflect Clinical Impairment in Patients With Idiopathic Adhesive Capsulitis of the Shoulder?
[So] Source:Arch Phys Med Rehabil;98(10):1995-2001, 2017 Oct.
[Is] ISSN:1532-821X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate the correlation between arthrography, magnetic resonance imaging (MRI), and ultrasonography (US) findings in patients with idiopathic adhesive capsulitis (IAC) of the shoulder and their clinical presentation as well as functional impairment. DESIGN: Cross-sectional observational study. SETTING: Institutional practice. PARTICIPANTS: Patients (N=75) with a clinical diagnosis of unilateral IAC. INTERVENTIONS: Contrast-enhanced MRI, single-contrast arthrography, and US were performed in all patients. MAIN OUTCOME MEASURES: The thickness of the axillary recess, coracohumeral ligament (CHL), and enhanced portion in the rotator cuff interval was measured using MRI. Arthrography was used to calculate the total score of shoulder arthrographic criteria. US was used to measure the thickness of the inferior glenohumeral ligament (IGHL) and CHL, and the IGHL ratio and CHL ratio were calculated by comparing those of the unaffected side. RESULTS: None of the MRI parameters was correlated with clinical assessment scores. The total score of shoulder arthrographic criteria was negatively correlated with passive range of motion of the total shoulder motion (P<.05), shoulder forward flexion (P<.05), and abduction (P<.05). The total Constant-Murley score was well correlated with the total score of shoulder arthrographic criteria (P<.05). The total shoulder joint space capacity was positively correlated with passive range of motion of the total shoulder motion (P<.05) and shoulder forward flexion (P<.05). The IGHL thickness, IGHL ratio, CHL thickness, and CHL ratio were negatively correlated with shoulder external rotation (P<.05). CONCLUSIONS: The findings of arthrography and US in patients with IAC of the shoulder were correlated with clinical assessment scores, whereas all measuring parameters on MRI were not. US is recommended as the preferred option for diagnosing IAC of the shoulder because it is noninvasive, reflects the clinical features of IAC, and provides anatomical accuracy.
[Mh] Termos MeSH primário: Bursite/diagnóstico por imagem
Avaliação da Deficiência
Força Muscular/fisiologia
Amplitude de Movimento Articular/fisiologia
Articulação do Ombro/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Artrografia
Bursite/fisiopatologia
Meios de Contraste
Estudos Transversais
Feminino
Fluoroscopia
Seres Humanos
Ligamentos Articulares/diagnóstico por imagem
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Rotação
Manguito Rotador/diagnóstico por imagem
Articulação do Ombro/fisiopatologia
Ultrassonografia
Escala Visual Analógica
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Contrast Media)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170709
[St] Status:MEDLINE



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