Bilateral rotator cuff tears requiring repair are not uncommon. Typically, these tears have been treated with staged surgeries. However, in appropriately selected cases, single-stage repair is preferable because it reduces costs, the number of admissions, total hospitalization, and rehabilitation time. It can also reduce patient suffering by providing relief with a single procedure. The authors compared 10 patients with a mean age of 55 years who had bilateral symptomatic rotator cuff tear and underwent single-stage bilateral arthroscopic cuff repair (group A) with 17 patients with a mean age of 55 years who had unilateral symptomatic rotator cuff tear and underwent unilateral arthroscopic cuff repair (group B). Clinical assessment was performed preoperatively and at 3, 6, and 12 months postoperatively with the visual analog scale, the University of California Los Angeles (UCLA) score, and the Korean shoulder score. Overall function, pain, and strength were improved significantly in both groups. Although the difference in visual analog scale score between both groups decreased during follow-up, this score was significantly lower in group B (P=.026). At initial follow-up, the UCLA score was higher in group A. However, at the last follow-up, this score was significantly higher in group B (P<.001). The Korean shoulder score was significantly higher in group A at all follow-up times (P<.001). The study findings showed that single-stage bilateral rotator cuff repair is a preferable option in appropriately selected patients. It can provide satisfactory results without additional complications, and it does not lead to longer hospitalization or rehabilitation than unilateral repair.
Introduction: This study aims to evaluate the results of plate augmentation and bone grafting without removing the nail in the treatment of nonunited, nailed femoral shaft fractures. Methods: Twenty patients with atrophic nonunion femoral shaft fractures initially fixed by intramedullary nail were treated by augmentation plating and iliac bone graft with retention of the nail. Patients were evaluated at regular intervals using an X-ray and Wu scoring system, which assesses clinical and radiological signs of healing. Results: All 20 patients achieved bony union at a mean time of 4.9 months (3–8 months). According to Wu’s score, 12 cases showed excellent results, and 8 cases obtained good results with no complications recorded. Conclusion: augmentation plating and iliac bone graft provide a good and safe method of treatment of previously nailed and non-united femoral shaft fractures.
Level of evidence: Level 4; Case Series.
BACKGROUND: In a previous study undertaken to quantify capsular volume in rotator cuff interval or axillary pouch, significant differences were found between controls and patients with instability. However, the results obtained were derived from two-dimensional cross sectional areas. In our study, we sought correlation between three-dimensional (3D) capsular volumes, as measured by magnetic resonance arthrography (MRA), and multidirectional instability (MDI) of the shoulder.METHODS: The MRAs of 21 patients with MDI of the shoulder and 16 control cases with no instability were retrospectively reviewed. Capsular areas determined by MRA were translated into 3D volumes using 3D software Mimics ver. 16 (Materilise, Leuven, Belgium), and glenoid surface area was measured in axial and coronal MRA views. Then, the ratio between capsular volume and glenoid surface area was calculated, and evaluated with control group.RESULTS: The ratio between 3D capsular volume and glenoid surface area was significantly increased in the MDI group (3.59 ± 0.83 cm³/cm²) compared to the control group (2.53 ± 0.62 cm³/cm²) (p < 0.01).CONCLUSIONS: From these results, we could support that capsular volume enlargement play an important role in MDI of the shoulder using volume measurement.
Introduction: The objective of this study is to evaluate the outcomes of arthroscopic rotator interval release for the treatment of frozen shoulder and compare the results in patients with and without diabetes. Methods: thirty-two patients with frozen shoulders were divided into two groups; 19 diabetics and 13 non-diabetics. All patients underwent arthroscopic rotator interval release. The VAS and UCLA score were assessed pre-operatively and post-operatively; after 1, 3, and 12 months and compared between groups. Results: The VAS and UCLA score was significantly improved in both groups during follow-up intervals (p < 0.01). There was no significant difference between diabetic and non-diabetic patients in VAS and UCLA scores during follow-up times (p-values > 0.05). Conclusion: Arthroscopic rotator interval release provides significant improvement of frozen shoulder with no difference in results between diabetic and non-diabetic patients.
Level of evidence: Level 2; Prospective Comparative study.
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