BackgroundOf all the most frequent soft tissue disorders of the shoulder, idiopathic frozen shoulder (IFS) offers the greatest potential for studying proprioception. Studies concerning the presence of proprioception dysfunctions have failed to determine the potential for spontaneous healing of passive shoulder stabilizers (anterior and posterior capsule, middle and inferior gleno-humeral ligaments), its relationship with passive (PJPS) and active (AJPS) shoulder proprioception for internal and external rotation (IR, ER), as well as the isokinetic muscle performance of the internal and external rotators. This study investigates these dependencies in the case of arthroscopic release of IFS.MethodsThe study group comprised 23 patients (average aged 54.2) who underwent arthroscopic release due to IFS and 20 healthy volunteers. The average follow-up time was 29.2 months. The Biodex system was used for proprioception measurement in a modified neutral arm position and isokinetic evaluation. The results were analysed using the T-test, Wilcoxon and interclass correlation coefficient. P-values lower than 0.05 were considered significant.ResultsStatistically significant differences were found between involved (I) and uninvolved (U) shoulders only in the cases of PJPS and AJPS, peak torque, time to peak torque and acceleration time for ER (p < 0.05). No statistically significant difference was noted between PJPS IR and PJPS ER or between AJPS IR and AJPS ER (p > 0.05) for the U shoulders.ConclusionsThe anatomical structure of anterior (capsule, middle and anterior band of inferior gleno-humeral ligament) and posterior (capsule and posterior band of inferior gleno-humeral ligament) passive shoulder restraints has no impact on the difference in PJPS values between ER and IR in a modified neutral shoulder position. The potential for spontaneous healing of the anterior and posterior passive shoulder restraints influences PJPS recovery after arthroscopic release of IFS. ER peak torque deficits negatively affect AJPS values. PJPS and AJPS of ER and IR can be measured with a high level of reproducibility using an isokinetic dynamometer with the arm in a modified neutral shoulder position. Differences greater than 15 % for PJPS and >24 % for AJPS for ER and IR can be helpful for future studies as baseline data for identification of particular passive and active shoulder stabilizers at risk.

STRESZCZENIEW pra cy przed sta wia my rzad ki przy pa dek kli nicz nej po pra wy po dwóch la tach od jed no cza so wej, obu stron nej, otwar tej re po zy cji za sta rza łych zwich nięć sta wów ra mien nych z we wnętrz ną sta bi li za cją zła mań guz ków więk szych. Pa cjent do znał zwich nię cia obu sta wów ra mien nych ze zła ma nia mi guz ków więk szych w wy ni ku po ra że nia prą dem elek trycz nym. Po ura zie był ho spi ta li zo wa ny na od dzia le we wnętrz nym, gdzie nie roz po zna no zwich nięć w sta wach ra mien nych. Czte ry ty go dnie póź niej dia gno za obu stron ne go zwich nię cia obu sta wów ra mien nych ze zła ma nia mi guz ków więk szych zo sta ła po twier dzo na ra dio lo gicz nie. U pa cjen ta wy ko na no jed no cza so wą, obu stron ną, otwar tą re po zy cję za sta rza łych zwich nięć sta wów ra mien nych z we wnętrz ną sta bi li za cją zła mań guz ków więk szych z do stę -pu w bruź dzie pier sio wo -na ra mien nej. Po za bie gu bar ki unie ru cho mio no przez 6 ty go dni, na stęp nie pa cjent był reha bi li to wa ny. Wy nik le cze nia oce nio no po upły wie jed ne go oraz dwóch lat od za bie gu. Stwier dzo no bar dzo do bry, nie bo le sny za kres ru chów w obu bar kach. Wy ni ki uzy ska ne w zmo dy fi ko wa nej ska li Con stan ta by ły bar dzo do bre (95 punk tów). We dług na szej wie dzy, po dob ny przy pa dek nie zo stał jesz cze opi sa ny w li te ra tu rze. Do wo dzi on, że za sta rza łe, obu stron ne zwich nię cia sta wów ra mien nych mo gą być le czo ne z do brym wy ni kiem jed no cza so wą, otwartą re po zy cją, pod wa run kiem od po wied nie go do bo ru pa cjen tów oraz po uzy ska niu zgo dy. Po za tym, po pra wy klinicz nej mo żna spo dzie wać się na wet po dwóch la tach od za bie gu.Słowa kluczowe: zastarzałe obustronne przednie zwichnięcia stawów ramiennych; jednoczasowa otwarta repozycja SUMMARYWe report an unusual case of clinical improvement two years after one-stage bilateral open reduction of chronic anterior shoulder dislocations with internal fixation of greater tuberosity fractures. The chronic bilateral anterior shoulder dislocations with greater tuberosity fractures were caused by an electric shock. After the injury the patient was hospitalized in a medical ward and the dislocations were not diagnosed. Four weeks later, the diagnosis of bilateral anterior shoulder dislocation with greater tuberosity fractures was confirmed by X-ray. The patient was treated with one-stage bilateral open reduction of chronic shoulder dislocations with internal fixation of greater tuberosity fractures from a deltopectoral approach. The shoulders were immobilized for six weeks, following which the patient underwent rehabilitation. He underwent a thorough first evaluation at one year after the procedure and a second evaluation after two years. At the follow-up visit, he had a very good and comfortable range of motion in both shoulders. The modified Constant score was very good in both shoulders (95 points). To the best of our knowledge, such a case has not yet been described in the literature. O...

BackgroundKnowledge of the impact of viable medial meniscus allograft and autograft transplantation on biochemical and mechanical properties of cartilage is needed to understand the development of joint osteoarthritis. The purpose of this study was to evaluate this relationship 6 months after viable medial meniscal autograft and allograft transplantation.MethodsTwenty rabbits were chosen for the study. The medial menisci were excised from 14 animals and stored under tissue culture conditions for 2 weeks. Seven menisci were implanted as autografts (group A) and seven as allografts (group B). The control group consisted of six animals which underwent arthrotomy. The tibial cartilage was used for mechanical and biochemical evaluation.ResultsThe respective decreases of glycosaminoglycans (GAGs) and elasticity were 13.4 and 14.8 % for group A and 30.4 and 32.6 % for group B. The differences between group A and B and between each group and the control were statistically significant. The total collagen content was significantly lower in group B.ConclusionsThe type of viable meniscal graft has an influence on the biochemical composition of the extracellular matrix (ECM) and biomechanical properties of the underlying tibial cartilage. A 1 % decrease of glycosaminoglycan content is associated with a 1.1 % decrease of cartilage elasticity. The average ratio of decrease of cartilage elasticity to that of the meniscus was 0.77 regardless of the type of meniscus graft. The viable allograft causes irreversible ECM disorder of the cartilage. Knowledge of the biochemical composition of the ECM meniscal grafts may serve as a predictor of their chondroprotective properties.