ObjectiveTo analyze the results from arthroscopic suturing of large and extensive rotator cuff injuries, according to the patient's degree of osteopenia.Method138 patients who underwent arthroscopic suturing of large and extensive rotator cuff injuries between 2003 and 2011 were analyzed. Those operated from October 2008 onwards formed a prospective cohort, while the remainder formed a retrospective cohort. Also from October 2008 onwards, bone densitometry evaluation was requested at the time of the surgical treatment. For the patients operated before this date, densitometry examinations performed up to two years before or after the surgical treatment were investigated. The patients were divided into three groups. Those with osteoporosis formed group 1 (n = 16); those with osteopenia, group 2 (n = 33); and normal individuals, group 3 (n = 55).ResultsIn analyzing the University of California at Los Angeles (UCLA) scores of group 3 and comparing them with group 2, no statistically significant difference was seen (p = 0.070). Analysis on group 3 in comparison with group 1 showed a statistically significant difference (p = 0.027).ConclusionThe results from arthroscopic suturing of large and extensive rotator cuff injuries seem to be influenced by the patient's bone mineral density, as assessed using bone densitometry.

r e v b r a s o r t o p . 2 0 1 5;5 0(1):83-88 w w w . r b o . o r g . b r Artigo OriginalAnálise comparativa da sutura artroscópica de lesões grandes e extensas do manguito rotador com relação ao grau de osteopenia ଝ

Objective To verify whether reverse baseplate positioning without the support of intraoperative three-dimensional technology is within the acceptable parameters in the literature and whether glenoid bone deformity (GBD) compromises this positioning. Methods Sixty-nine reverse shoulder arthroplasties were evaluated with volumetric computed tomography (CT). Two radiologists performed blinded CT scan analysis and evaluated baseplate position within 2mm of the inferior glenoid; the inclination and version of the baseplate in relation to the Friedman line; and upper and lower screw and baseplate metallic peg end point positionings. The patients were divided according to the presence of GBD for statistical analyses. Results The two radiologists concurred reasonably in their interpretations of the following analyzed parameters: baseplate position within 2mm of the inferior glenoid rim (97.1% and 95.7%), baseplate inclination (82.6% and 81.2%), baseplate version (69.6% and 56.5%), the upper screw reaching the base of the coracoid process (71% and 79.7%), the inferior screw remaining inside the scapula (88.4% and 84.1%), and the metallic peg of the baseplate considered intraosseous (88.4% and 72.5%). Conclusion Reverse baseplate positioning without intraoperative three-dimensional technology is within the acceptable parameters of the literature, except for baseplate version and upper screw position. GBD did not interfere with baseplate positioning in reverse shoulder arthroplasty.

The aim was to establish a correlation between the integrity of a suture made in the subscapular tendon (SST), as assessed by an ultrasound examination, and its functionality, as assessed by clinical tests during the postoperative period following reverse shoulder arthroplasty (RSA). A secondary goal is to evaluate the presence and viability of the sutured SST. Methods: This is a retrospective study of 18 RSA patients in whom the SST was repositioned to the anterior face of the humeral osteotomy. The median time of the postoperative evaluation was 31 months. The clinical evaluation consisted of the Gerber lift-off test, the internal rotation (IR) lag sign test, and the abdominal compression test, as well as forward flexion (FF), external rotation (ER), and IR. All patients underwent shoulder ultrasounds to evaluate the SST presence and viability. Results: The SST was visualized in 13 patients (72.2%; 95% confidence interval [CI], 51.5-92.9). Of these 13 patients, the SST presented an altered fibrillar pattern in 5 patients (38.4%; 95% CI, 12.0-64.9) and was considered nonviable. There were no associations between SST viability and a positive Gerber's lift-off test (P ¼.480), a positive IR lag sign test (P ¼.480), or a positive abdominal compression test (P ¼.618). There were no significant differences in FF (P ¼.104), ER (P ¼.196), or IR (P ¼.374) mobility between patients with viable SSTs and those without viable SSTs. Conclusion: It was not possible to demonstrate a correlation between the integrity of the SST repair based on the ultrasound and its functionality as assessed by clinical tests in the postoperative period following an RSA. The SST repair has a high failure rate, as demonstrated by the high incidence of nonviable or absent tendons.