Osteoarthritis of the shoulder in under-50 year-olds: A multicenter retrospective study of 273 shoulders by the French Society for Shoulder and Elbow (SOFEC).

Introduction: Osteoarthritis (OA) of the shoulder in under-50 year-olds is rare, and treatment is delicate. Shoulder replacement incurs frequent long-term risk of progression and a high revision rate, making it unsuited to young active patients. The aim of the present study was to determine the epidemiology of shoulder OA in under-50 year-olds and to assess the clinical results of the various treatment options.

Neuropathy of the suprascapular nerve and massive rotator cuff tears: a prospective electromyographic study.

Background: An association between massive rotator cuff tear (RCT) and suprascapular nerve neuropathy has previously been suggested. The anatomic course of the suprascapular nerve is relatively fixed along its passage. Thus, injury to the nerve by trauma, compression, and iatrogenic reasons is well documented.

The impact of recurrent dislocation on shoulder rotator muscle balance (a prospective study of 102 male patients).

Purpose Of The Study: We performed an isokinetic analysis of both shoulders in 102 male patients suffering from shoulder instability after several trauma-related anterior or anterior-inferior dislocations. The analysis was part of a comprehensive medical and radiological assessment (with standard X-rays and cross-sectional imaging) prior to surgery. The study's objective was to measure the strength of the patients' internal and external rotators after recurrent dislocations (by comparing injured and healthy sides) and to evaluate the dislocations' impact on the muscles on the injured side.

Total shoulder arthroplasty - arthroplasty for glenohumeral arthropathies: results and complications after a minimum follow-up of 8 years according to the type of arthroplasty and etiology.

Introduction: Arthroplasty for glenohumeral arthropathies have specific complications and the final results are sometimes more dependent upon the type of shoulder arthroplasty than the initial etiology. The aim of our study was to evaluate the rate of complications and the functional improvement with different types of shoulder arthroplasties after a minimum follow-up of 8 years.

Materials And Methods: This was a multicenter retrospective study of 198 shoulders including 85 primary osteoarthritis of the shoulder, 76 cuff tear arthropathies, 19 avascular necrosis and 18 rheumatoid arthritis.

Pain management in the rehabilitation of stiff shoulder: prospective multicenter comparative study of 193 cases.

Introduction: The present study investigated the impact of respecting pain threshold on clinical recovery in stiff shoulder.

Patients And Methods: A prospective multicenter comparative study followed up 193 cases of shoulder stiffness for a mean 12-month period (range, 8-31 months) after four different treatment protocols: (1) conventional sub-pain-threshold rehabilitation (58 cases); (2) self-rehabilitation exceeding the pain threshold (59 cases); (3) supervised suprathreshold rehabilitation (31 cases); and (4) capsulotomy with sub-threshold rehabilitation (45 cases). Follow-up was daily for the first 6 weeks then weekly for the next 6; each session included assessment of the painfulness, feasibility and duration of each rehabilitation and self-rehabilitation exercise and of pain status, disability and psychological status.

Management of the stiff shoulder. A prospective multicenter comparative study of the six main techniques in use: 235 cases.

Introduction: Stiffness in the shoulder is a frequent symptom associated with a number of clinical entities whose management remains inadequately defined.

Patients And Methods: This prospective study of 235 cases of stiffness in the shoulder compared six therapeutic techniques with a mean follow-up of 13 months (range, 3-28 months) (T1: 58 cases, conventional rehabilitation under the pain threshold, T2: 59 cases, self-rehabilitation over the pain threshold, T3: 31 cases, T2 + supervision, T4: 11 cases, T1 + capsular distension, T5: 31 cases, T1 + locoregional anesthesia, T6: 45 cases, T1 + T5 + capsulotomy). The therapeutic power of each technique and its impact on the result were assessed at each self-rehabilitation and rehabilitation session during the first 6 weeks and then at 3 months, 6 months, and at the final revision depending on subjective criteria (pain, discomfort, and morale) and objective criteria (Constant score, goniometric measurements).

Massive rotator cuff tears in patients younger than 65 years. Epidemiology and characteristics.

Currently, there is little information on the clinical, radiographic and electric profile of patients younger than 65 years of age with large rotator cuff tear. According to our hypothesis, massive rotator cuff tear, when discovered after recent traumatism, do not provide typical radiographic findings and suprascapular nerve impairment in large rotator cuff tears is uncommon. This is a prospective, descriptive, multicenter study of a series of 112 patients younger than 65 years, including 66 males and 46 females with extensive or massive cuff tear.

High-energy extracorporeal shock-wave therapy for calcifying tendinitis of the rotator cuff: a randomised trial.

In a prospective randomised trial of calcifying tendinitis of the rotator cuff, we compared the efficacy of dual treatment sessions delivering 2500 extracorporeal shock waves at either high- or low-energy, via an electromagnetic generator under fluoroscopic guidance. Patients were eligible for the study if they had more than a three-month history of calcifying tendinitis of the rotator cuff, with calcification measuring 10 mm or more in maximum dimension. The primary outcome measure was the change in the Constant and Murley Score.

[Transtrochanteric rotation osteotomies for osteonecrosis of the femoral head. Apropos of 20 cases].

Purpose Of The Study: Twenty consecutive rotation osteotomies for idiopatic necrosis of the femoral head were reviewed with an average follow-up of 6,5 years, in order to evaluate an original technique (which uses a nail plate for rotation and fixation of the fragments), and to determine the middle term results (and therefore indications) of anterior and posterior rotation osteotomies.

Technique: rotations were achieved by rotating the femoral head with the nail of the nail plate, and without dissection of the posterior vascular bundle. We performed 16 anterior rotation osteotomies (according to Sugioka, with an average rotation of 52 degrees) and 4 posterior rotation osteotomies (described by Kempf, with an average rotation of 77 degrees).

[Femoral loosening of total hip prosthesis caused by pseudarthrosis resulting from trochanterotomy].

Purpose Of The Study: This survey of 48 cases of trochanteric non-union in THR showed that this complication had not only functional consequences (one patient out of three complains of some instability and mild pain) but may also lead to stem loosening (3/48) through an original mechanism. The movements of the trochanter produce wear debris, mainly from the broken metal wires fixing the trochanter (and from rubbing of the cement on the femoral side of the osteotomy). These debris create an osteolytic granuloma between the proximal lateral endocortex and the cement, which extends progressively to the distal tip of the stem.

[An unusual dislocation of the elbow: convergent dislocation].

A case of dislocation of the elbow, combining convergent dislocation of the proximal radio-ulnar joint with posterior dislocation of the ulno-humeral joint was reported. This particular combination has not, to the knowledge of the authors, been reported previously. Diagnosis was based on anterioposterior X ray of the joint associated with a clinical finding of a loss of supination following reduction of the ulno-humeral joint.