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Clinical Decision Making in Open vs Arthroscopic rotator cuff repair: Evidence for Preoperative Decision Making

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Open Journal of Orthopedics 2022年第7期12卷 297-302页

作者： Katon Harwood Zachary Hubler James Cappola III School of Osteopathic Medicine Campbell University Lillington USA

Objective: To further understand what factors should be considered when deciding to do mini-open versus arthroscopic rotator cuff repair. Methods: A systematic literature search on the computer was done with the help of the PubMed database. Of the articles searched through, three have been chosen to specifically address topics of interest concerning the factors affecting arthroscopic vs mini-open RCR surgical approaches. Discussion: As we continue to progress down the line of factors impacting a clinician’s decision making, we begin to see how postoperative management is unchanged. Tear severity lacks sufficient evidence to base a decision on, but financial, educational, and logistical factors are proven to play a significant role in this decision. Conclusion: As of right now it seems that mini-open RCR is the most cost and time efficient method, especially amongst non-fellowship trained surgeons or ones with lower volume of shoulder scopes. However, further studies should be done to examine cost and efficiency in Sport Medicine fellowship trained orthopedic surgeons to validate these findings.

关键词： rotator cuff repair Shoulder Arthroscopy Mini-Open rotator cuff repair Arthroscopic rotator cuff repair

Degradable magnesium alloy suture promotes fibrocartilaginous interface regeneration in a rat rotator cuff transosseous repair model

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Journal of Magnesium and Alloys 2024年第1期12卷 384-393页

作者： Baoxiang Zhang Wen Zhang Fei Zhang Chao Ning Mingyang An Ke Yang Lili Tan Qiang Zhang Department of Sports Medicine Chinese PLA General HospitalBeijing 100853China Shi-changxu Innovation Center for Advanced Materials Institute of Metal ResearchChinese Academy of SciencesShenyang 110016China School of Materials Science and Engineering University of Science and Technology of ChinaShenyang 110016China Medical School of PLA Beijing 100853China Institute of Orthopedics Chinese PLA General HospitalBeijing Key Lab of Regenerative Medicine in OrthopedicsKey Lab of Musculoskeletal Trauma&War Injuries of Chinese PLABeijing 100853China

Despite transosseous rotator cuff tear repair using sutures is widely accepted for tendon-bone fixation,the fibrocartilaginous enthesis regeneration is still hardly achieved with the traditional *** the present work,degradable magnesium(Mg)alloy wire was applied to suture supraspinatus tendon in a rat acute rotator cuff tear model with Vicryl Plus 4±0 absorbable suture as *** shoulder joint humerus-supraspinatus tendon complex specimens were retrieved at 4,8,and 12 weeks after *** Mg alloy suture groups showed better biomechanical properties in terms of ultimate load to *** observation showed that hyperplastic response of the scar tissue at the tendon-bone interface is progressively alleviated over time in the both Mg alloy suture and Vicryl suture *** the histological analysis,for Mg alloy suture groups,chondrocytes appear to proliferate at 4 weeks postoperatively,and the tendon-bone interface showed an orderly structural transition zone at 8 weeks *** collagenous fiber tended to be aligned and the tendon-bone interlocking structures apparently formed,where transitional structure from unmineralized fibrocartilage to mineralized fibrocartilage was closer to the native fibrocartilaginous *** vivo degradation of the magnesium alloy wire was completed within 12 *** results indicated that Mg alloy wire was promising as degradable suture with the potential to promotes fibrocartilaginous interface regeneration in rotator cuff repair.

关键词： rotator cuff repair Mg alloy wire Tendon-bone healing Fibrocartilaginous interface

Assessing clinical and patient reported outcomes of Sironix suture anchors in rotator cuff and Bankart repair surgeries

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World Journal of Orthopedics 2024年第12期15卷 1183-1190页

作者： Puthumanapully Vinod Kumar Subin Sugath Vijay Mohan Ashok Kumar Moharana Sachin Angrish Deepak TS Department of Orthopedics Aster MedcityKochi 682027KeralaIndia Department of Orthopedic Oncology Aster MedcityKochi 682027KeralaIndia Department of Clinical Affairs Healthium Medtech LimitedBangalore 560058KarnātakaIndia

BACKGROUND rotator cuff tears and Bankart lesions significantly affect shoulder function and quality of *** rotator cuff repair and Bankart repair has become the standard treatment for restoring function and reducing *** advancements include new suture anchor technologies,such as the Sironix suture anchor known for its biomechanical strength and promising ***,there are limited real-world data on its effectiveness and safety,particularly in the Indian *** To evaluate the effectiveness and safety of Sironix suture anchors in rotator cuff and Bankart repair *** Sixty participants underwent surgery between January 2021 and December 2022,and demographic data and postoperative outcomes were collected through retrospective reviews and telephonic *** scales,including the PENN Shoulder Score(PSS),Disabilities of the Arm,Shoulder,and Hand(DASH)score,and Single Assessment Numeric Evaluation(SANE),were utilized for *** Treatment with Sironix suture anchor devices,including Ceptre Knotted UHMWPE Suture Titanium Anchor,Spyke Knotted UHMWPE Suture Peek Anchor,Stativ Knotted UHMWPE Suture Anchor,and Viplok Knotless Peek Screw Anchor with Titanium Tip,revealed no repair *** demonstrated high satisfaction and functional improvement,as evidenced by the mean Quick DASH score(32.01)and PSS(71.65)and the satisfactory SANE scores for both injured joints(74.33)and non-injured(83.67)shoulder *** The study yielded favorable outcomes for rotator cuff tear repair and Bankart *** repair failures were observed,supporting the safety and efficacy of these devices in shoulder injury management.

关键词： Arthroscopic Bankart repair rotator cuff repair Shoulder injuries Suture anchor Treatment outcome

Outcomes after arthroscopic repair of rotator cuff tears in the setting of mild to moderate glenohumeral osteoarthritis

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World Journal of Orthopedics 2022年第7期13卷 631-643页

作者： Ian S Hong Allison J Rao Tyler L CarlLee Joshua D Meade Daniel J Hurwit Gregory Scarola David P Trofa Shadley C Schiffern Nady Hamid Patrick M Connor James E Fleischli Bryan Michael Saltzman Department of Orthopedic Surgery Atrium Health Musculoskeletal InstituteCharlotteNC 28207United States Department of Sports Medicine Orthocarolina Research InstituteCharlotteNC 28207United States Department of Orthopedic Surgery Columbia University Irving Medical CenterNew York CityNY 10032United States Department of Orthopaedic Surgery Carolinas Medical CenterCharlotteNC 28207United States Department of Orthopedic Surgery OrthoCarolina Sports Medicine CenterCharlotteNC 28207United States

BACKGROUND rotator cuff pathology is a very common source of shoulder ***,osteoarthritis of the glenohumeral joint can cause shoulder pain and produce similar *** management can be indicated for both pathologies,however,outcomes data is limited when examining rotator cuff repair(RCR) in the setting of glenohumeral arthritis(GHOA).Thus,this study sought to determine outcomes for patients who undergo RCR in the setting of *** To evaluate if a relationship exists between outcomes of RCR in the setting of *** This was a retrospective analysis of patients who underwent arthroscopic rotator cuff repair with concurrent glenohumeral osteoarthritis between *** were stratified based on rotator cuff tear size and glenohumeral osteoarthritis *** were paired 1:1 with patients without glenohumeral *** included had a minimum two year *** of conversion to total shoulder arthroplasty,complication rates following initial surgery,and patient-reported outcome measures were *** A total of 142 patients were *** number of patients that required total shoulder arthroplasty within two years after index surgery was low.2/71(2.8%) patients with GHOA,and 1/71(1.4%) without *** rotator cuff repair,both groups showed favorable patientreported *** Patients with glenohumeral osteoarthritis who underwent arthroscopic rotator cuff repair showed comparable outcomes to patients without glenohumeral osteoarthritis.

关键词： rotator cuff repair rotator cuff tear Glenohumeral osteoarthritis Shoulder Arthroscopic Outcomes

3D cell-printing of gradient multi-tissue interfaces for rotator cuff regeneration

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Bioactive Materials 2023年第1期19卷 611-625页

作者： Suhun Chae Uijung Yong Wonbin Park Yoo-mi Choi In-Ho Jeon Homan Kang Jinah Jang Hak Soo Choi Dong-Woo Cho Department of Mechanical Engineering Pohang University of Science and Technology77 Cheongam-roNam-guGyeongsangbuk-doPohang37673South Korea EDmicBio Inc. 111 Hoegi-roDongdaemun-guSeoul 02445South Korea Institute for Convergence Research and Education in Advanced Technology Yonsei University50 Yonsei-roSeodaemun-guSeoul03722South Korea Gordon Center for Medical Imaging Department of RadiologyMassachusetts General Hospital&Harvard Medical School14913th StreetBostonMA02114USA Department of Convergence IT Engineering Pohang University of Science and Technology77 Cheongam-roNam-guGyeongsangbuk-doPohang37673South Korea School of Interdisciplinary Bioscience and Bioengineering Pohang University of Science and Technology77 Cheongam-roNam-guGyeongsangbuk-doPohang37673South Korea Department of Orthopaedic Surgery Asan Medical CenterCollege of MedicineUniversity of Ulsan86 Asanbyeongwon-gilSongpa-guSeoul05505South Korea

Owing to the prevalence of rotator cuff(RC)injuries and suboptimal healing outcome,rapid and functional regeneration of the tendon-bone interface(TBI)after RC repair continues to be a major clinical *** the essential role of the RC in shoulder movement,the engineering of biomimetic multi-tissue constructs presents an opportunity for complex TBI reconstruction after RC ***,we propose a gradient cell-laden multi-tissue construct combined with compositional gradient TBI-specific bioinks via 3D cell-printing *** vitro studies demonstrated the capability of a gradient scaffold system in zone-specific inducibility and multi-tissue formation mimicking *** regenerative performance of the gradient scaffold on RC regeneration was determined using a rat RC repair *** particular,we adopted nondestructive,consecutive,and tissue-targeted near-infrared fluorescence imaging to visualize the direct anatomical change and the intricate RC regeneration progression in real time in ***,the 3D cell-printed implant promotes effective restoration of shoulder locomotion function and accelerates TBI healing in *** summary,this study identifies the therapeutic contribution of cell-printed constructs towards functional RC regeneration,demonstrating the translational potential of biomimetic gradient constructs for the clinical repair of multi-tissue interfaces.

关键词： 3D cell-printing Tissue-specific bioink Gradient tissue scaffolds Near-infrared fluorophores rotator cuff repair

Long head of biceps tendon transposition for massive and irreparable rotator cuff tears:A systematic review and meta-analysis

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World Journal of Orthopedics 2023年第11期14卷 813-826页

作者： Ren-Wen Wan Zhi-Wen Luo Yi-Meng Yang Han-Li Zhang Jia-Ni Chen Shi-Yi Chen Xi-Liang Shang Department of Sports Medicine Huashan HospitalFudan UniversityShanghai 200040China

BACKGROUND Superior capsular reconstruction(SCR)with long head of biceps tendon(LHBT)transposition was developed to massive and irreparable rotator cuff tears(MIRCTs);however,the outcomes of this technique remain *** To perform a systematic review of biomechanical outcomes and a meta-analysis of clinical outcomes after LHBT transposition for *** We performed a systematic electronic database search on PubMed,EMBASE,and Cochrane *** of SCR with LHBT transposition were included according to the inclusion and exclusion *** studies were assessed for main results and *** clinical studies were evaluated for quality of *** including study characteristics,cohort demographics,and outcomes were extracted.A meta-analysis was conducted of the clinical *** According to our inclusion and exclusion criteria,a total of six biomechanical studies were identified and reported an overall improvement in subacromial contact pressures and prevention of superior humeral migration without limiting range of motion(ROM)after LHBT transposition for MIRCTs.A total of five clinical studies were included in the meta-analysis of LHBT transposition outcomes,consisting of 253 *** results indicated that compared to other surgical methods for MIRCTs,LHBT transposition had advantages of more significant improvement in ROM(forward flexion mean difference[MD]=6.54,95%confidence interval[CI]:3.07-10.01;external rotation[MD=5.15,95%CI:1.59-8.17];the acromiohumeral distance[AHD][MD=0.90,95%CI:0.21-1.59])and reducing retear rate(odds ratio=0.27,95%CI:0.15-0.48).No significant difference in American Shoulder and Elbow Surgeons score,visual analogue scale score,and University of California at Los Angles score was demonstrated between these two groups for *** In general,SCR with LHBT transposition was a reliable and economical technique for treating MIRCTs,both in terms of biomechanical and clinica

关键词： Massive and irreparable rotator cuff tears Long head of biceps tendon transposition rotator cuff repair Superior capsular reconstruction