History of rotator cuff surgery.

Purpose: Rotator cuff surgery is a rapidly evolving branch in orthopaedics, which has raised from a minor niche to a fully recognized subspecialty. This article summarizes its history, examining the development of its key principles and the technical advancements.

Methods: Literature was thoroughly searched, and few senior surgeons were interviewed in order to identify the significant steps in the evolution of rotator cuff surgery.

Mid-term results of a metal-backed glenoid component in total shoulder replacement.

Total shoulder replacement is a successful procedure for degenerative or some inflammatory diseases of the shoulder. However, fixation of the glenoid seems to be the main weakness with a high rate of loosening. The results using all-polyethylene components have been better than those using metal-backed components.

Post-operative rehabilitation after surgical repair of the rotator cuff.

Today advances in techniques and materials for rotator cuff surgery allow the repair of a large variety of types or extensions of cuff lesions in patients from a wide range of age groups who have different kinds of jobs and participate in different kinds of sports, and who have widely different expectations in terms of recovery of functions and pain relief. A large number of factors must be taken into account before implementing a rehabilitation protocol after rotator cuff surgery. These mainly include the technique (materials and procedure) used by the surgeon.

Incidence of risk in shoulder surgery : medical-legal repercussions.

It is generally recognised that any medical-surgical activity entails the risk of failure, placing the physician at risk of malpractice claims. In order to protect both the physician and the patient, it is important to identify the risk factors relating to the various pathological situations and assess both the incidence and significance of such risks. Hence, a "Potential Failure Rating" could be devised already during the preliminary stages for every type of medical process.

Reverse HAGL: a possible complication of a tight anterior gleno-humeral stabilization.

Recently the posterior humeral avulsion of the glenohumeral capsule (Reverse HAGL or RHAGL) has been reported in the orthopaedic literature as another possible cause of posterior traumatic shoulder instability. In the present paper we describe three patients in whom a RHAGL was probably a consequence of a tight open anterior shoulder stabilisation. The main complaint of these patients was a stiff shoulder after an open anterior stabilisation.

Glenohumeral osteometry by computed tomography in normal and unstable shoulders.

Past radiologic and anthropometric studies report a high incidence of glenoid anteversion and increased humeral retrotorsion in patients with recurrent anterior dislocation (RAD) of the shoulder. However, recent radiologic studies do not demonstrate significant developmental variations between normal and unstable shoulders. To investigate these conditions, the authors used computed tomography (CT), which offered the advantage of permitting a transverse view at different levels of the glenohumeral joint.

Clinical experience with double contrast medium computerised tomography (arthro-CT) in instability of the shoulder.

The authors discuss the value of computerised tomography combined with double contrast medium arthrography in the various pathological conditions associated with scapulohumeral instability. The results obtained in 18 patients with anterior instability and the findings reported in the literature indicate that arthro-C.T.

Computerised tomography in the investigation of scapulohumeral instability.

Radiological investigation of the shoulder joint in articular instability syndromes often yields inadequate information. Computerised tomography, either with or without a contrast medium, can provide more precise information about the pathological anatomy of the bones and capsuloligamentous structures. The authors report their experience in 50 normal and 33 pathological shoulders.

Recurrent instability of the gleno-humeral joint.

The importance of instability in the determination of painful syndromes of the shoulder is examined, with particular reference to young people who engage in sport. The physiopathology and clinical features are described, and the importance of diagnostic tests is emphasized. These often disclose the underlying pathological anatomy.

Double-blind study of the analgesic effect of indoprofen (K 4277).

In a double-blind study, indoprofen was superior to placebo in decreasing pain in patients with primary and metastatic cancer and with neuralgia. A single oral dose of 200 mg was more active than a 100-mg dose. The preferences of patients proved to be a more sensitive parameter in this study than scores of pain intensity, pain relief, and other related measurements (SPID, TOTPAR, and Peak PID).