Effect of Acromioplasty on Postoperative Pain Following Rotator Cuff Repair.

The surgical treatment of rotator cuff tears traditionally involves rotator cuff repair (RCR) with concomitant acromioplasty. However, there is some doubt as to whether acromioplasty is of value to this procedure. We sought to evaluate whether RCR with acromioplasty provided better outcomes than RCR without acromioplasty in a cohort of more than 1000 patients.

The association between pain scores and disc height change following discectomy surgery in lumbar disc herniation patients: a systematic review and meta-analysis.

Purpose: To evaluate the impact of discectomy on disc height (DH) in lumbar disc herniation (LDH) patients following discectomy surgery and address the association of DH change with pain score change.

Methods: We searched three online databases for randomized controlled trials (RCTs) and observational studies. In LDH patients, eligible for discectomy surgery, the changes in pre- and post-operative back and/or leg pain score and DH and/or disc height index (DHI) were considered as primary outcomes.

The fate of sutures post rotator cuff repair.

Background: Ultrasonographic imaging has been widely used as a diagnostic tool for rotator cuff tears. Several studies have explored the changes in rotator cuff tendon morphology after arthroscopic cuff repair; however, none have addressed the fate of sutures. The aim of this study was to determine (1) if the sutures migrate through the tendon during the postoperative healing period in patients who have had arthroscopic rotator cuff repair; (2) if the sutures do migrate, the time point at which it does; and (3) if the quality of the tendon, in terms of tendon stiffness, modulus of elasticity, bursal thickness, and anatomic footprint, affects suture migration.

Comparing clinical outcomes between rotator cuff repairs, SLAP repairs, and combined repairs.

Background: Superior labrum lesion from anterior to posterior (SLAP) often presents together with other shoulder pathologies such as rotator cuff tear (RCT), but it is uncertain if repairing both SLAP and RCT has superior clinical outcomes over isolated repairs of SLAP and RCT.

Materials And Methods: This was a retrospective cohort study with prospectively collected data, reviewing 157 patients who underwent arthroscopic repair of either RCT, SLAP (type II lesion), or both. Before surgery and after 6 weeks, 12 weeks, and 24 weeks, shoulder objective range of motion and strength were measured, patient-reported function and pain was assessed by the modified L'Insalata questionnaire with a Likert scale, and complications after each repair were examined.

The glenoid labrum: does labral lesion location matter?

Background: The glenoid labrum can be torn in 1 or more locations. It is undetermined if the location of the labral tear alters patient outcomes after repair.

Methods: A total of 252 labral repair cases were retrospectively reviewed using prospectively collected patient-ranked outcomes and examiner-determined assessments preoperatively, at 1 week, 6 weeks, 24 weeks, and at a minimum of 2 years after surgery.

Do Markers of Inflammation and/or Muscle Regeneration in Lumbar Multifidus Muscle and Fat Differ Between Individuals with Good or Poor Outcome Following Microdiscectomy for Lumbar Disc Herniation?

Study Design: Observational study.

Objective: The aim of this study was to evaluate whether inflammatory and/or muscle regeneration markers in paraspinal tissues (multifidus muscle/fat) during microdiscectomy surgery in patients with lumbar disc herniation (LDH) with radiculopathy, differ between individuals with good or poor outcome.

Summary Of Background Data: Structural back muscle changes, including fat infiltration, muscle atrophy, and fiber changes, are ubiquitous with LBP and are thought to be regulated by inflammatory and regeneration processes.

Factors Predicting Frequency and Severity of Postoperative Pain After Arthroscopic Rotator Cuff Repair Surgery.

Background: Postoperative pain after arthroscopic rotator cuff repair (RCR) is difficult to predict and manage. The experience of pain is thought to be influenced by a range of different factors. Determining which patient factors contribute to the pain may help us to better understand and manage it.

Anteroposterior tear size, age, hospital, and case number are important predictors of repair integrity: an analysis of 1962 consecutive arthroscopic single-row rotator cuff repairs.

Background: Retear or nonhealing of a surgically repaired rotator cuff is common, but the determinants of retear are poorly understood. We aimed to determine the relationship between preoperative and intraoperative factors and retear rate following rotator cuff repair and to formulate a predictive model based on this relationship, including any interaction effects between tear size, patient age, and surgical experience in contributing to the retear rate.

Methods: We performed a post hoc analysis of prospectively collected data from 1962 consecutive patients who underwent a primary arthroscopic single-row rotator cuff repair performed by the senior author from 2007 through 2018 and postoperatively returned for 6-month follow-up ultrasonography.

Acid-sensing ion channels regulate nucleus pulposus cell inflammation and pyroptosis via the NLRP3 inflammasome in intervertebral disc degeneration.

Objective: Lactate accumulation is an important factor in the intervertebral disc degeneration (IVDD). Currently, the effect and underlying mechanism of action of lactate on nucleus pulposus (NP) cell inflammation during IVDD are unclear. Previous studies have found that the NLRP3 inflammasome plays an important role in the regulation of NP inflammation.

Reliability, validity, and responsiveness of multidimensional pain assessment tools used in postoperative adult patients: a systematic review of measurement properties.

Objective: The objective of this systematic review was to synthesize the best available evidence relating to the measurement properties of the multidimensional pain assessment tools used to assess postoperative pain in adults.

Introduction: Pain is a common and poorly managed occurrence in patients during the postoperative period. Currently, postoperative pain is usually evaluated with assessment tools that measure one dimension of pain, namely pain intensity, resulting in inadequate management of postoperative pain.

Stiffness: friend or foe? A cohort study evaluating the effect of early postoperative stiffness on the outcomes of patients who underwent superior labral repair.

Background And Hypothesis: Postoperative stiffness is a commonly reported complication after type II superior labrum anterior-posterior (SLAP) repair. It is unclear whether patients with postoperative stiffness, classified as external rotation to the side of ≤20°, ultimately will have greater functional outcomes at ≥2 years after surgery. We hypothesized that postoperative stiffness would result in improved functional outcomes at ≥2 years after surgery.

Return to Work Following Shoulder Surgery: An Analysis of 1,773 Cases.

Background: There is limited information on patients' ability to return to work (RTW) after the majority of shoulder surgical procedures.

Methods: This study was a retrospective analysis of prospectively collected data on 1,773 consecutive patients who underwent shoulder surgery performed by a single surgeon from 2004 to 2017. A validated L'Insalata Shoulder Questionnaire was used to collect information on 32 preoperative factors, which were used for analysis.

The ultrastructural organization of elastic fibers at the interface of the nucleus and annulus of the intervertebral disk.

There has been no study to describe the ultrastructural organization of elastic fibers at the interface of the nucleus pulposus and annulus fibrosus of the intervertebral disk (IVD), a region called the transition zone (TZ). A previously developed digestion technique was optimized to eliminate cells and non-elastin ECM components except for the elastic fibers from the anterolateral (AL) and posterolateral (PL) regions of the TZ in ovine IVDs. Not previously reported, the current study identified a complex elastic fiber network across the TZ for both AL and PL regions.

Advanced Strategies for the Regeneration of Lumbar Disc Annulus Fibrosus.

Damage to the annulus fibrosus (AF), the outer region of the intervertebral disc (IVD), results in an undesirable condition that may accelerate IVD degeneration causing low back pain. Despite intense research interest, attempts to regenerate the IVD have failed so far and no effective strategy has translated into a successful clinical outcome. Of particular significance, the failure of strategies to repair the AF has been a major drawback in the regeneration of IVD and nucleus replacement.

Growth differentiation factor-6 attenuates inflammatory and pain-related factors and degenerated disc-induced pain behaviors in rat model.

Previous studies have indicated that growth differentiation factor 6 (GDF6) is a potential candidate for intervertebral disc (IVD) degeneration (IDD) treatment. Here, we investigated the effect of GDF6 on IDD by examining changes in disc structure and the expression of inflammatory and pain-related factors. A rat posterior disc puncture model of single segments and three consecutive segments was constructed, and GDF6 or phosphate-buffered solution was administered via intradiscal injection 1 or 2 weeks after surgery.

Biomechanical evaluation of an independent acromioclavicular ligament repair for acromioclavicular joint reconstruction.

Background: A number of surgical techniques for the treatment of acromioclavicular joint separations have been described; however, few have been able to create a strong intra-operative construct that provides minimal joint translation. A biomechanical study was conducted to examine joint translation in an independent acromioclavicular ligament repair.

Methods: Three variations of a novel independent acromioclavicular ligament repair technique underwent testing using a Sawbones model.

Elastic fibers: The missing key to improve engineering concepts for reconstruction of the Nucleus Pulposus in the intervertebral disc.

The increasing prevalence of low back pain has imposed a heavy economic burden on global healthcare systems. Intense research activities have been performed for the regeneration of the Nucleus Pulposus (NP) of the IVD; however, tissue-engineered scaffolds have failed to capture the multi-scale structural hierarchy of the native tissue. The current study revealed for the first time, that elastic fibers form a network across the NP consisting of straight and thick parallel fibers that were interconnected by wavy fine fibers and strands.

Evaluation for noncompliance of recall in patients reporting to oral pathology department: Longitudinal study of 5 years.

Background: Regardless of the form of treatment, long-term follow-up of the patient is an absolute necessity. This study aimed to follow surgically treated patients visiting our department of oral pathology over 5 years (January 2011-December 2015) to monitor recurrence of the condition, patient compliance and reasons for noncompliance.

Materials And Methods: We conducted half-yearly recall for patients visiting our department from January 2011 to December 2015.

Effect Size in Surgical Intervention Into Shoulder: What Procedures Are Game Changers and What Are Not?

Unlabelled: A number of surgical procedures are performed to treat a variety of shoulder pathologies. What is currently not understood is which of these surgical interventions provide the most improvement in patient-reported pain and function.

Questions: We aimed to determine, from a patient's perspective, which were the most effective commonly performed surgical procedures for disorders of the shoulder and which were not.

Predictors of periodontal disease among rural Indian type 2 diabetic population.

Background: Periodontal Disease (PD) is associated with complications of diabetes. Control of the PD reduces glycated hemoglobin (HbA1c) level. This study aimed to evaluate the relationship of PD with duration, severity of diabetes and eGFR.

Complication rates of different discectomy techniques for symptomatic lumbar disc herniation: a systematic review and meta-analysis.

Purpose: This meta-analysis aims to compare the complication rates of discectomy/microdiscectomy (OD/MD), microendoscopic discectomy (MED), percutaneous endoscopic lumbar discectomy (PELD), percutaneous laser disc decompression (PLDD), and tubular discectomy for symptomatic lumbar disc herniation (LDH) using general classification and modified Clavien-Dindo classification (MCDC) schemes.

Methods: We searched three online databases for randomized controlled trials (RCTs) and cohort studies. Overall complication rates and complication rates per the above-mentioned classification schemes were considered as primary outcomes.

Smart orthopaedic implants: A targeted approach for continuous postoperative evaluation in the spine.

Real-time health monitoring systems are emerging in diverse medical fields, tracking biological and physiological signals for direct feedback to the user. Orthopaedics is yet to adapt to innovative trends in health monitoring. Despite an evident entry point during orthopaedic surgeries, clinicians remain unable to objectively examine the structural integrity and biomechanics in the operated region through implantable sensors.

Shoulder stiffness after rotator cuff repair: the fate of stiff shoulders up to 9 years after rotator cuff repair.

Background: Stiffness and retear are 2 common complications of rotator cuff repair. McNamara et al found that postoperative stiffness was associated with lower retear rates at 6 months. This study aimed to determine if stiffness after rotator cuff repair protects the individual from retear up to 9 years after surgery.