Abstract:
BACKGROUND:The purpose of this study is to help define the indications for rotator cuff repair by identifying predictors of failure of nonoperative treatment. METHODS:A prospective, multicenter, cohort study design was used. All patients with full-thickness rotator cuff tears on magnetic resonance imaging were offered participation. Baseline data from this cohort were used to examine risk factors for failing a standard rehabilitation protocol. Patients who underwent surgery were defined as failing nonoperative treatment. A Cox proportional hazards model was fit to determinethe baseline factors that predicted failure. The dependent variable was time to surgery. The independent variables were tear severity and baseline patient factors: age, activity level, body mass index, sex, Single Assessment Numeric Evaluation score, visual analog scale score for pain, education, handedness, comorbidities, duration of symptoms, strength, employment, smoking status, and patient expectations. RESULTS:Of the 433 subjects in this study, 87 underwent surgery with 93% follow-up at 1 year and 88% follow-up at 2 years. The median age was 62 years, and 49% were female patients. Multivariate modeling, adjusted for the covariates listed previously, identified patient expectations regarding physical therapy (P < .0001) as the strongest predictor of surgery. Higher activity level (P = .011) and not smoking (P = .023) were also significant predictors of surgery. CONCLUSION:A patient's decision to undergo surgery is influenced more by low expectations regarding the effectiveness of physical therapy than by patient symptoms or anatomic features of the rotator cuff tear. As such, patient symptoms and anatomic features of the chronic rotator cuff tear may not be the best features to use when deciding on surgical intervention.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Dunn WR,Kuhn JE,Sanders R,An Q,Baumgarten KM,Bishop JY,Brophy RH,Carey JL,Harrell F,Holloway BG,Jones GL,Ma CB,Marx RG,McCarty EC,Poddar SK,Smith MV,Spencer EE,Vidal AF,Wolf BR,Wright RW,MOON Shoulder Group.doi
10.1016/j.jse.2016.04.030subject
Has Abstractpub_date
2016-08-01 00:00:00pages
1303-11issue
8eissn
1058-2746issn
1532-6500pii
S1058-2746(16)30119-7journal_volume
25pub_type
杂志文章,多中心研究abstract::Preoperative knowledge of full-thickness rotator cuff tear size is important in counseling patients because tear size affects the choice of surgical techniques and the functional outcome of surgery. Twenty-six shoulders of twenty-five consecutive patients were included in a prospective study that compared the preopera...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2003.10
更新日期:2003-03-01 00:00:00
abstract:HYPOTHESIS AND BACKGROUND:Complex glenoid bone loss and deformity present a challenge for the shoulder arthroplasty surgeon. Eccentric reaming, bone grafting, augmented glenoid components, and salvage hemiarthroplasty are common strategies for managing these patients. The glenoid vault reconstruction system (VRS; Zimme...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.08.002
更新日期:2020-08-24 00:00:00
abstract:BACKGROUND AND HYPOTHESIS:IDEAL (Iterative Decomposition of Echoes of Asymmetrical Length) imaging is a magnetic resonance imaging sequence that precisely measures rotator cuff muscle fatty infiltration. The influence of lower levels of fatty infiltration on outcomes after rotator cuff repair remains unclear. We hypoth...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.05.018
更新日期:2019-10-01 00:00:00
abstract::Stereophotogrammetry was used to investigate the functional relations between the articular surface geometry, contact patterns, and kinematics of the glenohumeral joint. Nine normal shoulder specimens were elevated in the scapular plane by using simulated muscle forces in neutral rotation (NR) and starting rotation (S...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2001.111959
更新日期:2001-01-01 00:00:00
abstract::An anterior glenoid labrum reconstruction in conjunction with a modified anterior-inferior capsular shift is described and was performed in 64 patients (69 shoulders) with traumatic anterior or anterior-inferior glenohumeral instability. Sixty-three operations were performed for recurrent dislocation and six for recur...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/1058-2746(93)90076-S
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:Glenoid replacement is challenging due to the difficult joint exposure and visualization of anatomical reference landmarks. Improper positioning of the glenoid component or inadequate correction of the retroversion using currently available instrumentation may lead to early failure. The objective of this stu...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jse.2009.02.022
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Reverse shoulder arthroplasty (RSA) has gained increasing popularity in the treatment of rotator cuff tear arthropathy (CTA). The purpose of this study was to evaluate the survival of RSA and the risk factors for revision following RSA. METHODS:RSA patients with CTA or osteoarthritis were identified from th...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.02.060
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Repair of proximal humeral fractures with locking plates has greatly improved outcomes. However, an alarming rate of complications including screw cutout and impingement under the acromion has recently been reported. A novel locking plate with smooth pegs was developed to reduce these risks. The purpose of t...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.04.005
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:If the balance of the rotator cuff force couple is disrupted, pseudoparalysis may occur, but the exact mechanism remains unknown. This study investigated the effect of rotator cuff force couple disruption on active range of motion in massive rotator cuff tear (mRCT) by rotator cuff muscle volume analysis. M...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.03.017
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:A variety of measurements can be used to assess radiographic osteoarthritic changes of the shoulder. This study aimed to analyze the correlation between the radiographic humeral-sided Samilson and Prieto classification system and 3 different radiographic classifications describing the changes of the glenoid ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.07.007
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:Mobile technology offers the prospect of delivering high-value care with increased patient access and reduced costs. Advances in mobile health (mHealth) and telemedicine have been inhibited by the lack of interconnectivity between devices and software and inability to process consumer sensor data. The object...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.01.013
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Shear forces at the bone-implant interface lead to a loss of reduction after locking plate fixation of proximal humeral fractures. The aim of the study was to analyze the roles of medial support screws and screw augmentation in failure loads and motion at the bone-implant interface after locking plate fixati...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jse.2015.06.028
更新日期:2015-12-01 00:00:00
abstract::Two cases of long thoracic nerve palsy associated with thoracic outlet syndrome are reported. Both patients had abnormal posture, with low-set shoulders and winged scapulae. Clinically there was weakness of the serratus anterior muscle with partial denervotion on electromyography. The diagnosis of thoracic outlet synd...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/S1058-2746(09)80005-0
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Low-cost motion analysis systems (LCMASs) have emerged as easy and practical methods to measure the functional workspace (FWS). Thus, we ventured to apply an LCMAS, the Kinect2 gaming camera, to evaluate the FWS in patients with shoulder osteoarthritis (OA) and patients who underwent total shoulder arthropla...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.03.029
更新日期:2019-11-01 00:00:00
abstract::Practice is the repetition of an action to improve its quality. The value of the practice effect is recognized in sports, music, and surgery. The number of times a surgical procedure is performed may have a bearing on how well it is done. We investigated the relative frequency with which hip, knee, and shoulder replac...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2003.23
更新日期:2003-03-01 00:00:00
abstract::Over the years, we have observed a shifting among loose shoulder, voluntary dislocation, habitual dislocation, and sustained subluxation, leading us to the conclusion that they are all varieties of the same condition: atraumatic shoulder instability. For this study, we followed the natural course of atraumatic shoulde...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2001.111962
更新日期:2001-03-01 00:00:00
abstract::A review of 30 patients who underwent a primary repair of their rotator cuff 10 years previously was performed. The average age of the patients at the time the operation was performed was 51 years (range 20 to 65 years). Twenty-seven men and three women were reviewed. An acromioplasty was performed in all patients. No...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/1058-2746(93)90001-W
更新日期:1993-03-01 00:00:00
abstract:HYPOTHESIS:The nonanatomical design of reverse shoulder prostheses induce medial displacement of the center of rotation, impingements and may reduce the mobility of the shoulder. The aim of this study is to test the hypothesis that during activities of daily living functional mobility of the shoulder can be restored by...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.09.014
更新日期:2013-07-01 00:00:00
abstract::This study evaluated the functional outcomes of proximal humeral fractures treated with locking plates and determined the prognostic factors for successful clinical outcomes. We included 44 patients with 45 unstable proximal humeral fractures. There were 19 two-part, 22 three-part, and 4 four-part fractures. Outcomes ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2008.06.014
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to propose the modified trochleocapitellar index (mTCI), assess its reliability, and evaluate its correlation with post-traumatic elbow stiffness in type C2-3 distal humeral fractures among adults. METHODS:From January 2013 to June 2017, a total of 141 patients with type C2-3 d...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.02.016
更新日期:2020-09-01 00:00:00
abstract::In theory, a prolonged, local infusion of anesthetic into a surgical field should reduce postoperative pain. Recently, disposable products have become available to implement this, but the balance between cost and benefit is controversial. This study evaluated such a device in two specific types of arthroscopic surgery...
journal_title:Journal of shoulder and elbow surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1058-2746(03)00207-6
更新日期:2003-11-01 00:00:00
abstract::A modified technique of scapulothoracic fusion was used in 6 patients who did not have muscular dystrophy and who were later evaluated clinically. The cause of the painful winging of the scapula was traumatic disruption of the trapezius and the accessory nerve in 3 patients, injury to the brachial plexus in 2, and Spr...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2004.09.008
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Reverse shoulder arthroplasty leads to arm lengthening. Different techniques have been described to determine postoperative lengthening. The purpose of this study was to evaluate the reliability of the acromiohumeral distance (AHD) in determining arm lengthening after reverse shoulder arthroplasty. METHODS:...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jse.2016.02.017
更新日期:2016-09-01 00:00:00
abstract::We tested the hypothesis that functional malcentering of the humeral head during arm elevation exists in patients with glenohumeral osteoarthritis and influences long-term glenoid loading. Twenty-eight healthy volunteers and 10 patients with primary osteoarthritis, 10 with cuff-arthropathy, and 1 with dysplastic gleno...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2008.02.008
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:The Oxford Shoulder Score (OSS) is an internationally-used patient-based outcome score. Up to now, it was not validated in Dutch. The purpose of this study was to produce a Dutch translation of the OSS and to test this version in terms of reliability and validity. METHODS:Translation of the OSS was done acc...
journal_title:Journal of shoulder and elbow surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jse.2010.01.017
更新日期:2010-09-01 00:00:00
abstract::Restoration of painless and satisfactory elbow function after a fracture of the distal humerus requires anatomic reconstruction of the articular surface, restitution of the overall geometry of the distal humerus, and stable fixation of the fracture fragments to allow early and full rehabilitation. Although these goals...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2004.09.033
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Further studies are required to determine the effectiveness of conservative treatment of partial-thickness rotator cuff tear (PTRCT). Here, we aim to identify the predictors of failure after conservative treatment in a large series of patients with symptomatic PTRCT. METHODS:The outcome of conservative trea...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.05.009
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Defining a simple and reliable classification for acromial and bursal impingement lesions is necessary to standardize terminology, to improve communication, and to allow better evaluation of the proper treatment of impingement lesions and rotator cuff tears. The purpose of this study was to assess orthopedic...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.07.018
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:This study investigated if patients with an intact tendon repair or partial-thickness retear early after rotator cuff repair display differences in clinical evaluations and whether early tendon healing can be predicted using these assessments. METHODS:We prospectively evaluated 60 patients at 16 weeks after...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.09.019
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:The repetitive overhand throwing can potentially cause physiologic or pathologic changes in musculoskeletal and vascular structures. The purpose of this study was to investigate the effects of throwing on upper extremity arterial blood flow before and after a controlled pitching session. The hypothesis is th...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.09.007
更新日期:2011-04-01 00:00:00