Abstract:
BACKGROUND:Although massive rotator cuff tears occasionally lead to severe impairment of shoulder function, the criteria for losing the ability to elevate the arm are unclear. This study aimed to analyze the features of both tear size and 3-dimensional (3D) shoulder kinematics that correspond to the loss of the ability to elevate the arm in patients with large and massive rotator cuff tears. METHODS:We prospectively enrolled patients with rotator cuff tears, including the supraspinatus and more than half of the subscapularis or more than two-thirds of the infraspinatus, without severe pain. A total of 13 patients (15 shoulders) were divided into 2 groups: 9 shoulders in the pseudoparesis (P) group and 6 shoulders in the non-pseudoparesis (NP) group. Fluoroscopic images were collected during active scapular-plane elevation, and 3D shoulder kinematics was analyzed using 2-dimensional-3D registration techniques. The radiographic findings and 3D kinematic results were compared between the groups. The correlation between tear size and 3D kinematics was also investigated. RESULTS:The most superior position of the humeral head center was significantly higher in the P group (6.7 ± 3.0 mm in P group vs. 3.6 ± 1.3 mm in NP group, P = .0321). Superior migration, which was defined as the most superior position > 5 mm, was significantly more frequent in the P group (7 shoulders and 1 shoulder in the P and NP groups, respectively; P = .0201). Thoracohumeral external rotation was significantly smaller in the P group (16° ± 31° in P group vs. 91° ± 21° in NP group, P < .0001). The total tear size and the tear sizes of the anterior and posterior rotator cuffs were significantly correlated with the superior (r = 0.68, P = .0056), anterior (r = 0.68, P = .0058), and posterior (r = -0.80, P = .0004) positions of the humeral head center. The tear size of the posterior rotator cuff also tended to be correlated with glenohumeral external rotation (r = -0.48, P = .0719). CONCLUSION:Anterior and posterior rotator cuff tears cause significant superior and anteroposterior translations of the humeral head, and posterior cuff tears may lead to loss of glenohumeral external rotation. With these abnormal kinematics, superior migration and loss of thoracohumeral external rotation were identified as features of pseudoparesis.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Sahara W,Yamazaki T,Inui T,Konda Sdoi
10.1016/j.jse.2020.07.021subject
Has Abstractpub_date
2020-08-01 00:00:00eissn
1058-2746issn
1532-6500pii
S1058-2746(20)30616-9pub_type
杂志文章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:The purpose of this study was to introduce the procedure value index (PVI) and apply this value instrument to shoulder arthroplasty. The PVI uses the value equation in units of minimal clinically important difference (MCID) to provide an objective system of quantifying value-driven care. Secondarily, we desc...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.07.031
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Little is known about the role that a torn superior labrum (SLAP) plays in glenohumeral stability after biceps tenodesis. This biomechanical study evaluated the contribution of a type II SLAP lesion to glenohumeral translation in the presence of biceps tenodesis. The authors hypothesize that subsequent to bi...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.07.036
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to perform a cross-sectional analysis of diversity among academic shoulder and elbow surgeons in the United States. METHODS:US shoulder and elbow surgeons who participated in shoulder and elbow fellowship and/or orthopedic surgery resident education as of November 2018 were inc...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.11.035
更新日期:2020-04-01 00:00:00
abstract:HYPOTHESIS:Arthroscopic osteocapsular arthroplasty for stage III osteoarthritis (advanced stage) shows worse clinical and radiologic outcomes compared with stage I or II according to computed tomography (CT)-based classification. METHODS:Clinical and radiologic outcomes in 65 patients treated with arthroscopic osteoca...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.09.036
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:There is very little information on the incidence of and usual recovery period for posterior interosseous nerve (PIN) palsies after distal biceps repair. This study examined the incidence and the time to resolution of PIN palsies in a large consecutive series of primary distal biceps repairs. MATERIALS AND ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.08.001
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate the long-term functional and cosmetic results as well as the sagittal and coronal plane remodeling of displaced supracondylar humerus fractures treated with open reduction and internal fixation. METHODS:In total, 49 patients (11 boys and 38 girls) with Gartland type III...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.12.010
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND/HYPOTHESIS:Muscular fatty infiltration (FI) represents an important prognostic factor in rotator cuff repair. The goal of this study was to analyze the natural history of infraspinatus FI in rotator cuff tears to determine the timing of the appearance and the speed of progression of this phenomenon. METHOD:...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2009.12.002
更新日期:2010-07-01 00:00:00
abstract::The surgical management of patients with recurrent anterior instability after failed surgery can be complicated by the loss of capsular tissue and, in some cases, irreparable tears of the subscapularis tendon. We describe a new surgical technique for reconstruction of the capsular ligaments using the iliotibial band (...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2002.126763
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:Medicare Part A provides similar resources for coverage of inpatient hospitalization costs for patients treated with total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA). This is based on an assumption that TSA and RSA are used to treat similar patient populations with comparable disease...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.09.004
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:After isolated subscapularis repair, improvement in shoulder function has been reported at short-term review. The purpose of this study was to determine whether arthroscopic subscapularis repair provides durable improvement in objective and subjective shoulder function with a low structural retear rate. MET...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.03.024
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Loss of motion is common after intercondylar fracture of the distal humerus despite proper management. The purpose of the current study was to report the results of contracture release for stiffness that developed after open reduction and internal fixation (ORIF) of distal humeral intercondylar fractures. M...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.10.024
更新日期:2013-02-01 00:00:00
abstract:INTRODUCTION:Patients may experience a loss of internal rotation (IR) and external rotation (ER) after reverse total shoulder arthroplasty (RTSA). We hypothesized that alterations in the glenosphere position will affect the amount of impingement-free IR and ER. MATERIALS AND METHODS:Computed tomography (CT) scans of t...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.07.013
更新日期:2013-06-01 00:00:00
abstract::We describe the insertional variations of supporting ligaments of the acromioclavicular joint, especially with respect to gender. We analyzed 41 cadaveric clavicles (22 female and 19 male) with attached ligaments. The distance between the insertion of the trapezoid ligament and the distal end of the clavicle was not s...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(03)00029-6
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:When fixed with bone ingrowth, a tight diaphyseal press fit, or cement, the humeral component of a shoulder arthroplasty may present problems of malposition, stress shielding, or periprosthetic fracture or difficulty with removal at revision arthroplasty. We have avoided the need for these fixation methods b...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.03.008
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Accurate assessment of glenoid inclination is of interest for a variety of conditions and procedures. The purpose of this study was to develop an accurate and reproducible measurement for glenoid inclination on standardized anterior-posterior (AP) radiographs and on computed tomography (CT) images. MATERIAL...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2011.07.010
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Pain is a complex and subjective reality and can be magnified by nonorganic or nonanatomic sources. Multiple studies have demonstrated a correlation between psychological factors and patients' perceptions of musculoskeletal pain and disability. In addition, nonorganic findings as part of the physical examina...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.02.056
更新日期:2018-07-01 00:00:00
abstract::Several studies have documented an association between the type III acromion and rotator cuff tears. However, controversy exists as to whether the shape of the acromion is an innate anatomic characteristic. The purpose of this study was to evaluate the prevalence of the type III acromion in young asymptomatic athletes...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1067/mse.2001.117124
更新日期:2001-09-01 00:00:00
abstract::The effectiveness of arthroscopic surgery, supervised exercises, and placebo was compared in 125 patients with rotator cuff disease (impingement syndrome stage II) in a randomized clinical trial. The median age was 48 years, and the median duration of complications was 1 to 2 years. The treatments were arthroscopic su...
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(99)90001-0
更新日期:1999-03-01 00:00:00
abstract::Between July 1991 and February 1995, 33 patients underwent bipolar shoulder arthroplasty for painful rotator cuff arthropathy of the shoulder. Twenty-two of these patients have been followed for an average of 28 months (range 24 to 48 months) and comprised the study group. All patients had massive, irreparable rotator...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(97)90083-5
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:The current treatment of partial distal biceps tears is a period of nonoperative management, followed by surgery, if symptoms persist. Little is known about the success rate and outcomes of nonoperative management of this illness. METHODS:We identified 132 patients with partial distal biceps tears through a...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.12.010
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND/HYPOTHESIS:Open reduction and internal fixation (ORIF) using locked plating has demonstrated promise in the treatment of displaced proximal humerus fractures. The purpose of this article is to describe the surgical technique and to report early clinical results with this technique. METHODS:Important surgica...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.01.001
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Deep prosthetic infection is a potentially devastating complication after total elbow arthroplasty, with an incidence of up to 12%. This study examined the demographics, microbiologic profile, and outcomes of infected total elbow arthroplasty treated with 2-stage revision in a tertiary referral unit. METHOD...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.12.033
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Surgical reconstruction of the ulnar collateral ligament after rupture has evolved substantially since the original description. Reconstruction techniques vary significantly at the ulnar and humeral interface. The purpose of this study was to develop a model to isolate, test, and compare the ulnar fixation o...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.03.017
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Ulnar neuritis (UN) is a common complication of open elbow arthrolysis for elbow stiffness. The purpose of this study was to evaluate the outcome of subcutaneous anterior transposition of the ulnar nerve during open elbow arthrolysis and to describe the risk factors for UN. METHODS:We retrospectively studie...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.01.013
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Displaced intra-articular distal humeral fractures are a challenging injury in elderly patients. High rates of complications have led to the increasing use of total elbow arthroplasty (TEA) for primary treatment. This study presents US nationwide trends in primary TEA for distal humeral fractures in elderly ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.05.030
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:The DASH (Disabilities of the Arm, Shoulder and Hand) is a scored questionnaire that is widely used to evaluate the health-related quality-of-life of patients with upper-limb musculoskeletal disorders. However, numerical changes in the measure scores lack clinical significance without meaningful threshold ch...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.11.027
更新日期:2021-01-20 00:00:00
abstract:BACKGROUND/HYPOTHESIS:Surgical management of displaced unstable proximal humerus fracture remains a challenge due to poor proximal bone quality and significant deforming forces. We hypothesized that the technique of application and mechanical properties of the proximal humeral locking plate would allow successful treat...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2009.08.008
更新日期:2010-06-01 00:00:00
abstract:HYPOTHESES:We hypothesized that body mass index (BMI) would be negatively associated with self-reported shoulder function/pain. A second objective was to investigate the significance of other potential contributing factors: age, sex, smoking status, tear size, and workers' compensation (WC) involvement. METHODS:In thi...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.06.011
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Pediatric patients with olecranon fractures are uncommon. The tension band suture technique was introduced to reduce the burden of implant removal and other complications. However, to our knowledge, early range of motion (ROM) exercise has not been introduced in this population of patients. Double Vicryl loo...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.03.004
更新日期:2017-07-01 00:00:00