Subscapularis tendon tears: Management and arthroscopic repair.

Tears of the subscapularis tendon have been under-recognised until recently. Therefore, a high index of suspicion is essential for diagnosis.A directed physical examination, including the lift-off, belly-press and increased passive external rotation can help identify tears of the subscapularis.

Olecranon physeal nonunion in the adolescent athlete: identification of two patterns.

Background: This study aimed to present the outcomes of patients undergoing surgical management of persistent, symptomatic olecranon physes.

Methods: Consecutive patients undergoing surgical management for symptomatic persistent olecranon physeal abnormalities were reviewed. Preoperative data, intraoperative findings, and postoperative clinical outcomes including physical examination findings, radiographs, complications, and reoperations were analyzed.

Total shoulder arthroplasty with an augmented component for anterior glenoid bone deficiency.

Background: Glenoid bone loss is a challenging problem when performing total shoulder arthroplasty (TSA). Posterior glenoid bone deficiency is more common than anterior deficiency, and so the literature on methods to treat anterior glenoid deficiency in the setting of TSA is not common. The purpose of this case series was to describe preoperative factors, surgical technique, and clinical outcomes in select patients who underwent placement of an anteriorly augmented glenoid component during TSA.

Treatment of massive and recurrent rotator cuff tears augmented with a poly-l-lactide graft, a preliminary study.

Background: The incidence of failed rotator cuff repairs remains high, especially in the setting of massive tears or revision repairs. The purpose of this study was to evaluate patient outcomes and repair integrity after augmentation with the repair patch, a poly-l-lactide synthetic polymer.

Methods: Sixteen consecutive patients with massive or recurrent rotator cuff tears underwent open repair with synthetic poly-l-lactide patch augmentation.

Magnetic resonance imaging evaluation of normal glenoid length and width: an anatomic study.

Purpose: The purpose of this study was to evaluate the measured dimensions of the normal glenoid on sagittal magnetic resonance (MR) imaging to determine whether a fixed ratio of glenoid length and width can be determined.

Methods: MR images of 90 glenoids in 84 patients were analyzed. The mean age was 54.

Histological features of endplates of the mammalian spine: from mice to men.

Study Design: Histological features of the intervertebral disc (IVD)-endplate interface were analyzed.

Objective: To define cartilaginous and bony vertebral endplate in commonly used laboratory animals and compare with that of the humans.

Summary Of Background Data: Endplates are crucial for the IVD nutrient supply: the IVDs have limited blood supply; most nutrients diffuse through endplates to nourish the discs.

Cytotoxicity of local anesthetics and nonionic contrast agents on bovine intervertebral disc cells cultured in a three-dimensional culture system.

Background Context: Carragee et al. reported an accelerated progression of lumbar intervertebral disc (IVD) degeneration after discography in a human trial. Local anesthetics and contrast agents have exhibited toxicity to cardiac, renal, and neuronal cells.

Suprascapular nerve entrapment isolated to the spinoglenoid notch: surgical technique and results of open decompression.

Background: Entrapment of the suprascapular nerve (SSN) at the spinoglenoid notch (SGN) specifically affects the infraspinatus, and isolated external rotation (ER) weakness can result. We describe the technique of open SSN decompression at the SGN for infraspinatus involvement and report the results of a consecutive series.

Materials And Methods: Twenty-nine shoulders underwent SSN decompression at the SGN.

Arthroscopic repair for posterior shoulder instability.

Purpose: The purpose of this study was to evaluate outcomes of a consistent arthroscopic stabilization technique for recurrent posterior instability.

Methods: Thirty-four consecutive shoulders with symptomatic recurrent posterior instability were treated with arthroscopic repair and evaluated at a mean follow-up of 36 months (range, 12 to 67 months). Two patients were excluded because of prior surgery, leaving 32 for further analysis.

Function after injection of benign bone lesions with a bioceramic.

Background: A novel calcium sulfate-calcium phosphate composite injectable bone graft substitute has been approved by the FDA for filling bone defects in a nonweightbearing application based on preclinical studies. Its utility has not been documented in the literature.

Questions/purposes: We therefore determined postoperative function and complications in patients with benign bone lesions treated with this bioceramic.

Histological features of the degenerating intervertebral disc in a goat disc-injury model.

Study Design: An in vivo study to develop a goat large-animal model for intervertebral disc (IVD) degeneration.

Objective: To determine an optimal method for inducing goat IVD degeneration suitable for testing disc regeneration therapies.

Summary Of Background Data: Although rodent, rabbit, and other small animal studies are useful, the narrow dimensions of IVDs in these species limit studies requiring injection of a relevant volume of therapeutics or implantation of engineered tissue constructs.

Long head of the biceps tendinopathy: diagnosis and management.

Tendinopathy of the long head of the biceps brachii encompasses a spectrum of pathology ranging from inflammatory tendinitis to degenerative tendinosis. Disorders of the long head of the biceps often occur in conjunction with other shoulder pathology. A thorough patient history, physical examination, and radiographic evaluation are necessary for diagnosis.

Low-energy femoral shaft fractures associated with alendronate use.

Objective: Increasing evidence suggests long-term alendronate use may overly suppress bone metabolism, limiting repair of microdamage and creating risk for insufficiency fractures. The purpose of this study is to demonstrate an association between alendronate use and a specific pattern of low-energy femoral shaft fracture.

Design, Setting, And Patients: A retrospective review was performed of patients with femoral shaft fractures admitted to a Level 1 trauma center between January 2002 and March 2007.

Fibrillins 1 and 2 perform partially overlapping functions during aortic development.

Fibrillin-rich microfibrils are extracellular assemblies that impart structural properties to the connective tissue. To elucidate the contribution of fibrillin-rich microfibrils to organogenesis, we have examined the vascular phenotype of a newly created strain of mice that completely lacks fibrillin-1 and the consequences of combined deficiency of fibrillins 1 and 2 on tissue formation. The results demonstrated that fibrillins 1 and 2 perform partially overlapping functions during aortic development.

Na-K-Cl cotransporter-mediated intracellular Na+ accumulation affects Ca2+ signaling in astrocytes in an in vitro ischemic model.

Na-K-Cl cotransporter isoform 1 (NKCC1) plays an important role in maintenance of intracellular Na+, K+, and Cl- levels in astrocytes. We propose that NKCC1 may contribute to perturbations of ionic homeostasis in astrocytes under ischemic conditions. After 3-8 hr of oxygen and glucose deprivation (OGD), NKCC1-mediated 86Rb influx was significantly increased in astrocytes from NKCC1 wild-type (NKCC1+/+) and heterozygous mutant (NKCC1+/-) mice.

Increased tolerance to oxygen and glucose deprivation in astrocytes from Na(+)/H(+) exchanger isoform 1 null mice.

The ubiquitously expressed Na(+)/H(+) exchanger isoform 1 (NHE1) functions as a major intracellular pH (pH(i)) regulatory mechanism in many cell types, and in some tissues its activity may contribute to ischemic injury. In the present study, cortical astrocyte cultures from wild-type (NHE1(+/+)) and NHE1-deficient (NHE1(-/-)) mice were used to investigate the role of NHE1 in pH(i) recovery and ischemic injury in astrocytes. In the absence of HCO(3)(-), the mean resting pH(i) levels were 6.

Na-K-Cl cotransporter contributes to glutamate-mediated excitotoxicity.

We hypothesized that cation-dependent Cl- transport protein Na-K-Cl cotransporter isoform 1 (NKCC1) plays a role in the disruption of ion homeostasis in cerebral ischemia. In the current study, a role for NKCC1 in neuronal death was elucidated in neurotoxicity induced by glutamate and oxygen and glucose deprivation (OGD). Incubation of cortical neurons cultured for 14-15 d in vitro (DIV) with 100 microm glutamate for 24 hr resulted in 50% cell death.