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[PMID]:29201304
[Au] Autor:Ko SH; Cha JR; Lee CC; Joo YT; Eom KS
[Ad] Endereço:Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
[Ti] Título:Minimally Invasive Plate Osteosynthesis Using a Screw Compression Method for Treatment of Humeral Shaft Fractures.
[So] Source:Clin Orthop Surg;9(4):506-513, 2017 Dec.
[Is] ISSN:2005-4408
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Background: This study aims to compare the surgical outcomes of open reduction and internal fixation (ORIF) and minimally invasive plate osteosynthesis (MIPO) using a screw compression method in simple humeral shaft fractures. Methods: This retrospective study was performed with 50 patients who had surgical interventions for the treatment of simple humeral shaft fractures and had follow-ups of at least 12 months in Ulsan University Hospital between August 2008 and June 2015. Group 1 included 23 patients treated with ORIF and group 2 included 27 patients treated with the MIPO technique using a locking screw plate. The time to clinical/radiographic union, the joint range of motion (ROM), and function were evaluated. Results: The average time to clinical/radiographic bone union was shorter in group 2 (12.0 ± 3.7 weeks/14.8 ± 2.0 weeks in group 1 and 9.4 ± 1.3 weeks/12.0 ± 3.3 weeks in group 2; = 0.022/ = 0.034). Shoulder and elbow joint function evaluated by joint ROM and visual analogue scale (VAS), Korean Shoulder Elbow Society (KSS), American Shoulder and Elbow Surgeons (ASES), and the University of California at Los Angeles (UCLA) scores was excellent in both groups. On the average shoulder ROM at 12 months after the operation, group 1 had forward elevation of 160°, external rotation of 30° in adduction and lumbar vertebra 10 level in internal rotation and group 2 had forward elevation of 170°, external rotation of 35° in adduction and lumbar vertebra 9 level in internal rotation. The mean VAS, KSS, ASES, and UCLA scores were 2.8, 87.0 ± 0.9, 89.4 ± 0.9, and 31.0 ± 1.4, respectively, in group 1 and 1.7, 89.1 ± 2.7, 91.0 ± 1.6, and 32.4 ± 3.2, respectively, in group 2. There were statistically significant intergroup differences in VAS score ( = 0.011). There were significantly less postoperative infections in group 2 (three cases, 10.7% in group 1 and 0 case in group 2; = 0.041) although all of them were superficial infections and well-treated by an average 4-week course of antibiotics (range, 2 to 6 weeks). Conclusions: MIPO using a screw compression method in simple humeral shaft fractures demonstrated superior efficacy to ORIF in terms of the time to clinical/radiographic union, pain score, and postoperative infection rate.
[Mh] Termos MeSH primário: Fixação Interna de Fraturas/métodos
Fraturas do Úmero/cirurgia
Procedimentos Cirúrgicos Minimamente Invasivos/métodos
Redução Aberta
[Mh] Termos MeSH secundário: Adulto
Idoso
Placas Ósseas
Parafusos Ósseos
Diáfises/lesões
Diáfises/cirurgia
Articulação do Cotovelo/fisiopatologia
Feminino
Fixação Interna de Fraturas/instrumentação
Consolidação da Fratura
Seres Humanos
Fraturas do Úmero/diagnóstico por imagem
Masculino
Meia-Idade
Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos
Redução Aberta/efeitos adversos
Radiografia
Amplitude de Movimento Articular
Estudos Retrospectivos
Rotação
Articulação do Ombro/fisiopatologia
Infecção da Ferida Cirúrgica/etiologia
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.4055/cios.2017.9.4.506


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[PMID]:29201303
[Au] Autor:Rhee SM; Oh JH
[Ad] Endereço:Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
[Ti] Título:Bridging Graft in Irreparable Massive Rotator Cuff Tears: Autogenic Biceps Graft versus Allogenic Dermal Patch Graft.
[So] Source:Clin Orthop Surg;9(4):497-505, 2017 Dec.
[Is] ISSN:2005-4408
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Background: Few comparative studies have reported on the use of biologic grafts for irreparable massive rotator cuff tears. The purpose of this study was to assess the results of arthroscopic bridging graft in irreparable massive rotator cuff tears using an autogenic long head of biceps tendon (LHBT) or an allogenic dermal patch (ADP). Methods: We retrospectively reviewed 24 patients treated using the LHBT (group I) and eight patients with complete rupture of the LHBT treated using an ADP (group II) since 2011. Preoperative Goutallier's fatty degeneration, range of motion (ROM), visual analogue scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, and Quick Disabilities of the Arm, Shoulder, and Hand (DASH) score were assessed and healing failure was evaluated at 1 year after surgery by ultrasonography or magnetic resonance imaging. Results: The mean fatty degeneration in groups I and II was 3.9 and 3.6 for the supraspinatus ( = 0.288), 2.7 and 2.9 for the infraspinatus ( = 0.685), 0.9 and 1.3 for the subscapularis ( = 0.314), and 1.3 and 3.0 for the teres minor ( = 0.005), respectively. Subscapularis tears were found in 8 patients (33.3%) in group I and in 7 patients (87.5%) in group II ( = 0.023). Mean ROMs and functional scores improved significantly in group I (forward flexion: 121.7° to 153.3°, = 0.010; external rotation: 32.7° to 52.7°, = 0.001; external rotation at 90°: 63.3° to 74.5°, = 0.031; internal rotation: T10.5 to T9.3, = 0.045; VAS: 7.0 to 1.1, p < 0.001; ASES score: 45.4 to 81.6, = 0.028; and Quick DASH score: 50.0 to 14.2, = 0.017), whereas only VAS showed significant improvement in group II (from 5.9 to 2.0, = 0.025) and ROMs and other functional scores increased without statistical significance in the group. Healing failure was found in 13 patients (54.2%) in group I and in 6 patients (75.0%) in group II ( = 0.404). Conclusions: The surgeon should prudently choose surgical options for irreparable massive rotator cuff tears, especially in patients with severe fatty degeneration in the teres minor or combined biceps and subscapularis tears.
[Mh] Termos MeSH primário: Tecido Adiposo/patologia
Lesões do Manguito Rotador/fisiopatologia
Lesões do Manguito Rotador/cirurgia
Articulação do Ombro/fisiopatologia
Transplante de Pele
Tendões/transplante
[Mh] Termos MeSH secundário: Idoso
Artroscopia
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Dor Musculoesquelética/etiologia
Amplitude de Movimento Articular
Estudos Retrospectivos
Rotação
Lesões do Manguito Rotador/complicações
Lesões do Manguito Rotador/diagnóstico por imagem
Articulação do Ombro/diagnóstico por imagem
Transplante Autólogo
Transplante Homólogo
Ultrassonografia
Cicatrização
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.4055/cios.2017.9.4.497


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[PMID]:29201302
[Au] Autor:Padegimas EM; Narzikul A; Lawrence C; Hendy BA; Abboud JA; Ramsey ML; Williams GR; Namdari S
[Ad] Endereço:Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
[Ti] Título:Antibiotic Spacers in Shoulder Arthroplasty: Comparison of Stemmed and Stemless Implants.
[So] Source:Clin Orthop Surg;9(4):489-496, 2017 Dec.
[Is] ISSN:2005-4408
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Background: Antibiotic spacers in shoulder periprosthetic joint infection deliver antibiotics locally and provide temporary stability. The purpose of this study was to evaluate differences between stemmed and stemless spacers. Methods: All spacers placed from 2011 to 2013 were identified. Stemless spacers were made by creating a spherical ball of cement placed in the joint space. Stemmed spacers had some portion in the humeral canal. Operative time, complications, reimplantation, reinfection, and range of motion were analyzed. Results: There were 37 spacers placed: 22 were stemless and 15 were stemmed. The stemless spacer population was older (70.9 ± 7.8 years vs. 62.8 ± 8.4 years, = 0.006). The groups had a similar percentage of each gender (stemless group, 45% male vs. stemmed group, 40% male; = 0.742), body mass index (stemless group, 29.1 ± 6.4 kg/m vs. stemmed group, 31.5 ± 8.3 kg/m ; = 0.354) and Charlson Comorbidity Index (stemless group, 4.2 ± 1.2 vs. stemmed group, 4.2 ± 1.7; = 0.958). Operative time was similar (stemless group, 127.5 ± 37.1 minutes vs. stemmed group, 130.5 ± 39.4 minutes). Two stemless group patients had self-resolving radial nerve palsies. Within the stemless group, 15 of 22 (68.2%) underwent reimplantation with 14 of 15 having forward elevation of 109° ± 23°. Within the stemmed group, 12 of 15 (80.0%, = 0.427) underwent reimplantation with 8 of 12 having forward elevation of 94° ± 43° (range, 30° to 150°; = 0.300). Two stemmed group patients had axillary nerve palsies, one of which self-resolved but the other did not. One patient sustained dislocation of reverse shoulder arthroplasty after reimplantation. One stemless group patient required an open reduction and glenosphere exchange of dislocated reverse shoulder arthroplasty at 6 weeks after reimplantation. Conclusions: Stemmed and stemless spacers had similar clinical outcomes. When analyzing all antibiotic spacers, over 70% were converted to revision arthroplasties. The results of this study do not suggest superiority of either stemmed or stemless antibiotic spacers.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Artroplastia do Ombro/efeitos adversos
Infecções Relacionadas à Prótese/tratamento farmacológico
Prótese de Ombro/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Hemiartroplastia/efeitos adversos
Seres Humanos
Masculino
Meia-Idade
Duração da Cirurgia
Infecções Relacionadas à Prótese/microbiologia
Infecções Relacionadas à Prótese/cirurgia
Amplitude de Movimento Articular
Reoperação
Estudos Retrospectivos
Articulação do Ombro/fisiopatologia
Tobramicina/administração & dosagem
Vancomicina/administração & dosagem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 6Q205EH1VU (Vancomycin); VZ8RRZ51VK (Tobramycin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.4055/cios.2017.9.4.489


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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]:28465225
[Au] Autor:Finley MA; Ebaugh D
[Ad] Endereço:Department of Physical Therapy and Rehabilitation Science, Drexel University, Philadelphia, PA. Electronic address: maf378@drexel.edu.
[Ti] Título:Association of Pectoralis Minor Muscle Extensibility, Shoulder Mobility, and Duration of Manual Wheelchair Use.
[So] Source:Arch Phys Med Rehabil;98(10):2028-2033, 2017 10.
[Is] ISSN:1532-821X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the relation of pectoralis minor muscle (PMm) length and extensibility to shoulder pain, shoulder girdle motion, and duration of manual wheelchair (MWC) use, and to compare differences in muscle length, muscle extensibility, peak humeral elevation, and pain among groups based on duration of wheelchair use. DESIGN: Cross-sectional cohort study. SETTING: Laboratory setting. PARTICIPANTS: Individuals with spinal cord injury (SCI) who used an MWC for daily community and home mobility (N=22; 18 men; mean age, 41.7y; duration wheelchair use, 14.6y). Participants were stratified into groups based on duration of wheelchair use: <5 years (n=6), 5 to 15 years (n=8), and >15 years (n=8). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Clinical measures of PMm length and extensibility, shoulder girdle motion, and shoulder pain (Wheelchair User's Shoulder Pain Index). RESULTS: Significant high correlations were found among duration of wheelchair use, passive PMm length, passive PMm extensibility, and peak humerothoracic elevation. Moderate correlation of peak humerothoracic elevation to pain was found. Individuals with >15 years wheelchair use had reduced PMm extensibility and reduced peak humerothoracic elevation than those with <5 years duration of use. CONCLUSIONS: To our knowledge, this is the first investigation to identify the association of reduced PMm extensibility with reduced shoulder girdle mobility, pain, and duration of wheelchair use in individuals with SCI.
[Mh] Termos MeSH primário: Músculos Peitorais/fisiologia
Amplitude de Movimento Articular/fisiologia
Articulação do Ombro/fisiopatologia
Traumatismos da Medula Espinal/fisiopatologia
Cadeiras de Rodas
[Mh] Termos MeSH secundário: Adulto
Fenômenos Biomecânicos/fisiologia
Estudos de Coortes
Estudos Transversais
Feminino
Seres Humanos
Masculino
Dor de Ombro/fisiopatologia
Fatores de Tempo
Escala Visual Analógica
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE


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[PMID]:29205214
[Au] Autor:Faria L; Campos B; Jorge RN
[Ad] Endereço:LAETA, INEGI, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal.
[Ti] Título:Biomechanics of the shoulder girdle: a case study on the effects of union rugby tackles.
[So] Source:Acta Bioeng Biomech;19(3):115-127, 2017.
[Is] ISSN:1509-409X
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The shoulder girdle is a complex system, comprised by a kinematic chain and stabilizers. Due to the delicate equilibrium and synchronism between mobility and stability, high external loads may compromise its physiology, increasing the risk of injuries. Thus, this study intends to fully characterize the effects of a rugby tackle on the shoulder's anatomy and physiology. METHODS: For the experimental procedures, a matrix of pressure sensors was used, based on the Teckscan® pressure in-soles, force plates, an isokinetic dynamometer and sEMG (surface electromyography). RESULTS: The anterosuperior region of the shoulder girdle confirmed the highest pressure values during impact (100 kPa-200 kPa). Also, the right and left feet performed a vertical peak force of 1286 N (1.4 BW) and 1998 N (2.21 BW), respectively. The muscular activity of the shoulder muscles decreased after performing multiple tackles. CONCLUSIONS: During a tackle, the clavicle, scapula, trapezius and acromioclavicular joint are the anatomical structures with higher risk of injury. Also, the strike force on the feet decreases for stability purposes. After performing multiple impacts the muscular activity of the trapezius and rotator cuff muscles decreases, which may lead, in the long-term, to instability of the shoulder and inefficiency of the scapulohumeral rhythm.
[Mh] Termos MeSH primário: Futebol Americano/fisiologia
Modelos Biológicos
Contração Muscular/fisiologia
Músculo Esquelético/fisiologia
Amplitude de Movimento Articular/fisiologia
Articulação do Ombro/fisiologia
[Mh] Termos MeSH secundário: Simulação por Computador
Seres Humanos
Masculino
Articulação do Ombro/anatomia & histologia
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


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[PMID]:29244838
[Au] Autor:Blache Y; Begon M; Michaud B; Desmoulins L; Allard P; Dal Maso F
[Ad] Endereço:Laboratoire Interuniversitaire de Biologie de la Motricité, Université Lyon 1, Université de Lyon, Lyon, France.
[Ti] Título:Muscle function in glenohumeral joint stability during lifting task.
[So] Source:PLoS One;12(12):e0189406, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Ensuring glenohumeral stability during repetitive lifting tasks is a key factor to reduce the risk of shoulder injuries. Nevertheless, the literature reveals some lack concerning the assessment of the muscles that ensure glenohumeral stability during specific lifting tasks. Therefore, the purpose of this study was to assess the stabilization function of shoulder muscles during a lifting task. Kinematics and muscle electromyograms (n = 9) were recorded from 13 healthy adults during a bi-manual lifting task performed from the hip to the shoulder level. A generic upper-limb OpenSim model was implemented to simulate glenohumeral stability and instability by performing static optimizations with and without glenohumeral stability constraints. This procedure enabled to compute the level of shoulder muscle activity and forces in the two conditions. Without the stability constraint, the simulated movement was unstable during 74%±16% of the time. The force of the supraspinatus was significantly increased of 107% (p<0.002) when the glenohumeral stability constraint was implemented. The increased supraspinatus force led to greater compressive force (p<0.001) and smaller shear force (p<0.001), which contributed to improved glenohumeral stability. It was concluded that the supraspinatus may be the main contributor to glenohumeral stability during lifting task.
[Mh] Termos MeSH primário: Remoção
Músculo Esquelético/fisiologia
Articulação do Ombro/fisiologia
[Mh] Termos MeSH secundário: Adulto
Fenômenos Biomecânicos
Feminino
Seres Humanos
Masculino
Contração Muscular
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189406


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[PMID]:29257012
[Au] Autor:Sanchez-Sotelo J; Wagner ER; Sim FH; Houdek MT
[Ad] Endereço:Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
[Ti] Título:Allograft-Prosthetic Composite Reconstruction for Massive Proximal Humeral Bone Loss in Reverse Shoulder Arthroplasty.
[So] Source:J Bone Joint Surg Am;99(24):2069-2076, 2017 Dec 20.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Reverse total shoulder arthroplasty (RTSA) performed in the setting of massive proximal humeral bone loss often requires special reconstructive techniques. Restoration of the proximal part of the humerus with an allograft provides a number of theoretical benefits, including implant support, restoration of humeral length, deltoid tensioning, and an opportunity to repair the posterior aspect of the cuff to improve strength in external rotation and repair of the subscapularis to improve stability. However, reverse allograft-prosthesis composites (APCs) are costly, are technically demanding to use, and can be compromised by progressive allograft resorption. METHODS: Between 2005 and 2012, the lead author used an APC reconstruction in 8 primary and 18 revision RTSAs (26 patients; mean age, 62 years; mean body mass index, 27.9 kg/m). The indications for the primary RTSAs included severe proximal humeral bone loss after trauma (n = 5) and tumor resection (n = 3). The indications in the revision setting were failed hemiarthroplasty (n = 11), anatomic total shoulder arthroplasty (n = 4), and reverse arthroplasty (n = 3). The most common reason for revision was instability (n = 10). A compression plate was used for graft-to-host fixation in all shoulders. Shoulders were assessed for pain, motion, American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST) score, Neer score, revision or reoperation, radiographic evidence of graft union or resorption, and implant fixation. The mean duration of follow-up was 4 years (range, 2 to 10 years). RESULTS: RTSA using an APC construct resulted in substantial improvements in pain scores (p < 0.0001), elevation (p < 0.0001), and external rotation (p = 0.004). With the numbers available, there were no significant differences in clinical outcomes between primary and revision cases. No patients required revision surgery for nonunion at the host-allograft junction. The mean time to union was 7 months, with 1 patient requiring bone-grafting for delayed union. Other complications included dislocation, deep infection, graft fracture, and periprosthetic fracture distal to the previous APC construct in 1 patient each. The 2 and 5-year revision-free survival rate was 96%. CONCLUSIONS: Reconstruction of proximal humeral bone loss with an APC at the time of primary or revision RTSA is safe and effective, with acceptable functional outcomes and complication rates. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Artroplastia do Ombro/efeitos adversos
Reabsorção Óssea/diagnóstico por imagem
Transplante Ósseo/métodos
Instabilidade Articular/prevenção & controle
Articulação do Ombro/diagnóstico por imagem
Prótese de Ombro
[Mh] Termos MeSH secundário: Adulto
Idoso
Artroplastia do Ombro/métodos
Reabsorção Óssea/fisiopatologia
Reabsorção Óssea/cirurgia
Estudos de Coortes
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Desenho de Prótese
Recuperação de Função Fisiológica/fisiologia
Reoperação/métodos
Estudos Retrospectivos
Medição de Risco
Articulação do Ombro/fisiopatologia
Articulação do Ombro/cirurgia
Transplante Homólogo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171220
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.01495


  10 / 16371 MEDLINE  
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[PMID]:29145990
[Au] Autor:Sethi P; Franco WG
[Ad] Endereço:ONS Sports and Shoulder Service, ONS Foundation for Clinical Research and Education, 6 Greenwich Office Park, 40 Valley Drive, Greenwich, CT 06831, USA. Electronic address: sethi@onsmd.com.
[Ti] Título:The Role of Superior Capsule Reconstruction in Rotator Cuff Tears.
[So] Source:Orthop Clin North Am;49(1):93-101, 2018 Jan.
[Is] ISSN:1558-1373
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Massive, irreparable rotator cuff disease is a challenging problem to treat, especially in the younger active patient. This condition allows the deltoid to generate anterosuperior translation and shoulder dysfunction. Ideally, this dysfunction may be improved with rotator cuff repair. However, in the setting of irreparable rotator cuff disease, normal function is challenging to restore. Superior capsule reconstruction theoretically improves function by recentering the humeral head and improving glenohumeral kinematics. This restoration of stability results in a stable fulcrum, and may allow the deltoid and remaining cuff can function more effectively.
[Mh] Termos MeSH primário: Artroplastia
Cápsula Articular/cirurgia
Lesões do Manguito Rotador/cirurgia
Articulação do Ombro/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171204
[Lr] Data última revisão:
171204
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171118
[St] Status:MEDLINE



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