This study presents the subacromial contact pressure findings in 25 patients who underwent an arthroscopic acromioplasty for impingement syndrome. All patients failed a course of conservative management before surgery. Patients were evaluated, both before and after acromioplasty, by examination, UCLA functional score, and radiographic assessment of acromial morphology. At the time of surgery, a 4 x 10 mm air-filled catheter was placed beneath the anterior aspect of the acromion under arthroscopic visualization. Subacromial contact pressures were recorded throughout an arc of shoulder motion. Mean pressure and standard deviation were derived from three trials. This protocol was performed on all patients and the results were statistically evaluated. The mean subacromial pressure before acromioplasty was 11.7, 35.6, 50.1, 51.1, and 57.4 mm Hg at abduction arcs of 0 degrees , 90 degrees , and 180 degrees, hyperabduction (forced passive limit of abduction), and cross-reach (arm adducted across the patient's chest with the shoulder internally rotated), respectively. The pressure after acromioplasty decreased to 1.6, 7.8, 15.9, 22.8, and 16.5 mm Hg, respectively. This decrease was significant in all positions (P = .016 at 0 degrees and <.001 in all other positions). At 90 degrees of abduction, pressure always decreased in internal rotation and increased in external rotation. Maximal contact pressure developed in either hyperabduction or cross-reach in all patients except two. Preoperative testing for the position of maximum impingement pain generally correlated with the position of maximum contact pressure.
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http://dx.doi.org/10.1053/ar.1999.v15.015012 | DOI Listing |
Knee Surg Sports Traumatol Arthrosc
December 2024
Department of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Purpose: To explore if recentering the humeral head could improve shoulder abduction in shoulders with irreparable massive rotator cuff tears (IMRCTs).
Methods: Nine fresh-frozen cadaveric shoulders were used to simulate the intact condition and IMRCTs as controls. Four 'recenter' interventions were then sequentially applied: subacromial interposition (SI) using 4- and 8-mm spacers and superior capsule reconstruction (SCR) using two- and four-layer fascia lata grafts.
J Appl Biomech
December 2024
Program in Physical Therapy, Washington University School of Medicine, St Louis, MO, USA.
Mechanical impingement of the rotator cuff tendons against the acromion (subacromial) and glenoid (internal) during shoulder motions has long been thought to contribute to tears. Clinically, the risk for impingement is thought to be influenced by scapular movement impairments. Therefore, our purpose was to determine the extent to which simulated changes in scapular orientation impact the proximity between the rotator cuff tendon footprint and the acromion and glenoid during scapular plane abduction.
View Article and Find Full Text PDFArthrosc Tech
October 2024
Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri, U.S.A.
Recent attention has turned toward the prevention of acromiohumeral abutment in the treatment of irreparable rotator cuff tears (IRCTs). This can be achieved through tendon transfer with a bridging allograft, superior capsular reconstruction, dermal allograft application to the greater tuberosity (biologic tuberoplasty), bursal acromial reconstruction, or subacromial balloon spacer placement. Recent literature has demonstrated increased graft thickness is associated with improved clinical outcomes after superior capsular reconstruction, suggesting a potential role of a direct bone-to-bone contact between the greater tuberosity and acromion in symptom generation in patients with IRCTs.
View Article and Find Full Text PDFLasers Med Sci
October 2024
Avant Wellness Systems, Thousand Oaks, CA, United States of America.
The purpose of this review was to evaluate the effect of Photobiomodulation (PBM) in managing shoulder and neck pain and disability. A literature search was conducted using the PubMed and ScienceDirect/EMBASE databases. The keywords used were "Low-level laser therapy", "photobiomodulation", "LASER", combined with "shoulder" or "neck".
View Article and Find Full Text PDFArthroscopy
October 2024
AZBSC Orthopedics, Scottsdale, Arizona. Electronic address:
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