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Role of biomechanical assessment in rotator cuff tear repair: Arthroscopic vs mini-open approach

World Journal of Orthopedics 2021年第12期12卷 991-1000页

作者： Giuseppe Solarino Ilaria Bortone Giovanni Vicenti Davide Bizzoca michele coviello Giuseppe Maccagnano Biagio Moretti Fabio D'Angelo Department of Basic Medical Sciences Neuroscience and Sense OrgansUniversity of Bari"Aldo Moro"Bari 70124Italy Department of Biomedical Sciences and Human Oncology University of Bari"Aldo Moro"Bari 70124Italy Orthopaedic and Trauma Unit Department of Clinical and Experimental MedicineFaculty of Medicine and SurgeryUniversity of FoggiaGeneral HospitalFoggia 76545Italy Division of Orthopaedics and Traumatology ASST Sette LaghiDepartment of Biotechnologies and Life SciencesUniversitàdegli Studi dell'InsubriaVarese 21100Italy

BACKGROUND Rotator cuff(RC)tears are one of the most frequent pathologies within the shoulder *** dominance and older age are associated with RC *** different surgical procedures,the mini-open(MO)and all-arthroscopic(AA)approach,represented the standard of *** To compare the clinical and biomechanical outcomes of two surgical techniques(AA vs MO procedure)performed to address the painful shoulder syndrome with partial or total supraspinatus tendon *** Eighty-eight participants,50 following RC repair with AA and 38 with MO approach,were recruited in the present cross-sectional case-control study(ORTHO-SHOULDER,Prot.0054602).All patients underwent postoperative clinical evaluation for pain(Visual analogic scale),impairment,and disability(disability of the arm,shoulder,and hand)and limitation in daily activity(Constant-Murley score).Patients’shoulder mobility was also assessed in our Laboratory of Functional Movement through a wearable inertial sensor and surface electromyography to monitor kinematics and muscle activity during the movement on the frontal(abduction/adduction)and sagittal(flexion-extension)*** No statistically significant differences between the two procedures were observed in either main clinical score or range of motion.A significant increase in velocity during the movement execution and a higher contribution of upper trapezius muscles were found in the AA group compared with MO *** In terms of clinical scores,our findings were in line with previous ***,the use of technology-based assessment of shoulder mobility has revealed significant differences between the two techniques in terms of mean velocity and pattern of muscle activation.

关键词： Rotator cuff tear Arthroscopic Mini-open Wearable sensors Surface electromyography

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Plate vs reverse shoulder arthroplasty for proximal humeral fractures:The psychological health influence the choice of device?

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World Journal of Orthopedics 2022年第3期13卷 297-306页

作者： Giuseppe Maccagnano Giuseppe Solarino Vito Pesce Giovanni Vicenti michele coviello Vittorio Saverio Nappi Orazio Valerio Giannico Angela Notarnicola Biagio Moretti Department of Clinical and Experimental Medicine Faculty of Medicine and SurgeryUniversity of FoggiaOrthopaedics UnitGeneral HospitalFoggia 71122Italy Department of Basic Medical Science Neuroscience and Sensory OrgansFaculty of Medicine and SurgeryUniversity of BariOrthopaedics UnitGeneral HospitalBari 70124Italy Orthopaedics Unit Di Venere General HospitalBari 70124Italy Department of Biomedical Sciences and Human Oncology University of Bari Aldo MoroBari 70124Italy

BACKGROUND Proximal humeral fractures represent the third most common observed osteoporotic fracture;the treatment in three and four-part proximal humeral fractures in patients over 65 years is still *** the treatments described in literature,open reduction and internal fixation(O.R.I.F)and reverse shoulder arthroplasty(RSA)are gaining an increasing *** To investigate the correct treatment for three and four-part proximal humeral fractures according to psychological *** It was conducted a prospective study with a series of 63 patients treated with O.R.I.F.(group A)and with RSA(group B)for three and four-part proximal humeral fractures according to Neer classification system.A conservative treatment group,as control,was finally *** independent observer performed clinical and a psychological evaluation at one(T0),six(T1)and twelve months(T2)*** Constant’s score and The Disabilities of the Arm,Shoulder and Hand(DASH score)were used for clinical evaluation,while General Anxiety Disorder-7(GAD-7)and Caregiver Strain Scale(CSS)were used for psychological *** At one month follow up in group A the mean values were DASH score 50.8,Constant score 36.1,GAD-7 score 5.4,CSS *** the group B,the average values at T0 were:DASH score 54.6,Constant score 32.0;GAD-7 score 6.4,CSS *** six months in group A the average values were DASH score 42.1,Constant score 47.3,GAD-7 score 4.3,CSS *** the group B,the average values at T1 were:DASH score 39.1,Constant score 43.2,GAD-7 score 5.7,CSS *** twelve months in the group A,the mean values were DASH score 32.8,Constant score 60.0,GAD-7 score 3.2,CSS *** the group B shown these mean values:DASH score 33.6,Constant score 52.9,GAD-7 score 4.3,CSS *** demonstrated a better clinical and psychological outcome at T2 in the group treated with osteosynthesis compared to the group treated with arthroplasty(Constant P=0.049,GAD-7 P=0.012 and CSS P=0.005

关键词： Proximal humerus fractures Open reduction and fixation Reverse shoulder arthroplasty Psychological health General Anxiety Disorder-7 scale Caregiver Strain scale

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