BackgroundSome studies have shown significant functional improvement after rotator cuff (RC) repair in elderly patients. However, few studies have reported the healing potential of RC tears in elderly patients.MethodsTwenty-five patients aged ≥ 75 years who underwent RC repair were enrolled. The mean age at the time of surgery was 78.3 years (range, 75 to 88 years) while the mean follow-up was 36.3 months (range, 18 to 114 months). We evaluated clinical and structural outcomes after RC repair in the retear and healed groups.ResultsOf 25 patients, 16 (64%) had healed RC lesions and 9 (36%) had retorn cuff lesions. The retear rate increased significantly with increasing initial tear size (small to medium, 13%; large, 60%; massive, 80%; p = 0.024) but not with increasing age (p = 0.072). The mean visual analog scale (VAS), University of California Los Angeles (UCLA), and Constant scores significantly improved from 5.2, 15.8, and 49.3 preoperatively to 1.4, 31.1, and 71.9 in the healed group and from 6.0, 14.4, and 39.5 preoperatively to 2.4, 28.3, and 63.6 in the retear group at the final follow-up (p < 0.05, respectively). There were no significant differences in clinical outcomes between the 2 groups at the final follow-up. Retear was significantly correlated with initial tear size (p = 0.001; odds ratio [OR], 2.771; 95% confidence interval [CI], 1.394 to 5.509 for large to massive tears) (p = 0.001; OR, 0.183; 95% CI, 0.048 to 0.692 for small to medium tears).ConclusionsThere were significant improvements in clinical outcomes after RC repair in patients ≥ 75 years. Structural integrity after cuff repair did not affect the final clinical outcome. Even in elderly patients aged ≥ 75 years, healing of repaired RC can be expected in cases of small to medium tears. Although the retear rate was relatively high for large to massive tears, clinical outcomes still showed significant improvement.

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Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

The most common symptom of knot-induced pain after SLAP repair was persistent sharp pain followed by clicking. The knot appears to be a cause of pain in failed SLAP repairs, and arthroscopic knot removal can provide dramatic pain relief and significant improvement of clinical outcomes.

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Background: Kirschner's wire (K-wire) transfixation and locking hook plate fixation techniques are widely used in the treatment of acute acromioclavicular joint (ACJ) dislocation. The purpose of this study was to compare the clinical and radiologic outcomes between K-wires transfixation and a locking hook plate fixation technique. Methods: Seventy-seven patients with acute ACJ dislocation managed with K-wire (56 shoulders) and locking hook plate (21 shoulders) were enrolled for this study. The mean follow-up period was 61 months. Results: At the last follow-up, the shoulder rating scale of the University of California at Los Angeles (UCLA) was higher in patients treated with locking hook plate than with K-wires (33.2 ± 2.7 vs. 31.3 ± 3.4, p=0.009). In radiologic assessments, coracoclavicular distance (CCD) (7.9 mm vs. 7.7 mm, p=0.269) and acromioclavicular distance (ACD) (3.0 mm vs. 1.9 mm, p=0.082) were not statistically different from contralateral unaffected shoulder in locking hook plate fixation group, but acromioclavicular interval (ACI) was significant difference. However, there were significant differences in ACI, CCD, and ACD in K-wire fixation group (p<0.001). Eleven complications (20%) occurred in K-wire transfixation group and 2 subacromial erosions on computed tomography scan occurred in locking hook plate fixation group. Conclusions: ACJ stabilization was achieved in acute ACJ dislocations treated with K-wires or locking hook plates. Locking hook plate can provide higher UCLA shoulder score than K-wire and maintain CCD, and ACD without ligament reconstruction. K-wire transfixation technique resulted in a higher complication rate than locking hook plate. (Clin Shoulder Elbow 2014;17(4):159-165)

-For analysis of the relationship among blueberry cultivars, the growth period and morphological characteristics were investigated in 28 blueberry cultivars, and cluster analysis using the SAS program was conducted based on the morphological data. The harvest period was later and longer in rabbiteye blueberry cultivars (Austin, Brightwell, Powderblue, Southland, Tifblue) than in highbush blueberry cultivars. The L/D ratio of flower was more than 2.0 in the Austin, Brightwell, Powderblue, Southland, Tifblue, and Brigitta cultivars, and this could be disadvantageous for pollination. The 28 blueberry cultivars were classified into two groups by the cluster analysis based on growth period and morphological characteristics. Group I included rabbiteye blueberries and Group II included highbush blueberries. However, the northern, southern, and half-highbush blueberry cultivars were not differentiated.