Previous functional magnetic resonance imaging (fMRI) findings indicate that shoulder apprehension is more complex than a pure mechanical problem of the shoulder, showing a direct modification in functional brain networks associated with motor inhibition and emotional regulation. The current study extends these findings by investigating further structural alterations in patients with shoulder apprehension compared to controls. 14 aged patients with shoulder apprehension (27.3 ± 2.0 years) and 10 matched healthy controls (29.6 ± 1.3 years) underwent clinical and fMRI examination including fMRI and diffusion tensor imaging (DTI). Tract-based spatial statistics procedure was used to analyze white matter (WM) alterations. Functional images were analyzed investigating resting state network connectivity. DTI results were correlated with different shoulder clinical scores and functional connectivity networks. Fractional anisotropy (FA), representing white matter integrity, is increased in the left internal capsule and partially in the thalamus in patients compared to controls. Moreover, FA correlates negatively with simple shoulder test (SST) scores (p < .05) and positively with a functional connectivity network qualitatively replicating previous results (p < .01). This study extends previous findings, showing that in addition to functional changes, structural white matter changes are also present in patients with shoulder apprehension.
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http://dx.doi.org/10.1038/srep42327 | DOI Listing |
Am J Sports Med
January 2025
Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Background: Anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesions are associated with recurrent shoulder instability and higher rates of failure after capsulolabral repair compared with similarly treated Bankart lesions. Although these lesions can portend poor outcomes, there are limited data on the associated conditions and postoperative course in a young, active population.
Purpose: To evaluate the mid- to long-term clinical course and failure rates after ALPSA repairs and assess features associated with these outcomes.
Orthop J Sports Med
December 2024
University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Background: Managing an in-season anterior shoulder instability poses a special challenge for team physicians, as they need to balance the aim of promptly returning the athlete to play while mitigating the chances of recurrence and further injury to the shoulder.
Purpose: To investigate and report on the treatment preferences of National Hockey League (NHL) team physicians when managing in-season first-time anterior shoulder instability in professional hockey players.
Study Design: Cross-sectional study.
J Shoulder Elbow Surg
December 2024
Service de chirurgie orthopédique et traumatologique, CHU de Clermont-Ferrand, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
Background: After a first shoulder dislocation, the rate of recurrence varies according to age and type of activity. The rule of bony lesions is logical but not demonstrated. We conducted a study to analyze bony lesions observed after a first episode of anterior shoulder dislocation in patients younger than 50 years of age.
View Article and Find Full Text PDFIntroduction: This article presents a simultaneous operative technique, which allowed to successfully treat a Cuff Tear Arthropathy (CTA), instability and Levy-type III scapular spine fracture non-union with 90°-double plating, humerus-to-scapula grafting and simultaneous reverse shoulder arthroplasty.
Case Report: We present a 64year-old woman with previously known cuff arthropathy (2012/53yo). She fell in 2017 (58 years old with minor shoulder disability) before dislocating the shoulder in 2020 (60 years old) with evidence of a medial Levy-type III scapular spine fracture non-union and severe apprehension, unable to anterior elevate her arm more than 90°.
Cureus
September 2024
Orthopaedics and Traumatology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, BRA.
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