In this first study comparing double- and single-row anchorage techniques, we found no significant difference in clinical results, but tendon healing rates were better with the double-row anchorage. Improvements in the double-row technique might lead to better clinical and tendon healing results.
CT arthrography and arthroscopy were used to assess tears of the rotator cuff in 259 shoulders. Tear size was determined in the frontal and sagittal planes according to the classification of the French Arthroscopy Society. CT arthrography had a sensitivity of 99% and a specificity of 100% for the diagnosis of tears of supraspinatus. For infraspinatus these figures were 97.44% and 99.52%, respectively and, for subscapularis, 64.71% and 98.17%. For lesions of the long head of the biceps, the sensitivity was 45.76% and the specificity was 99.57%. Our study showed an excellent correlation between CT arthrography and arthroscopy when assessing the extent of a rotator cuff tear. CT arthrography should, therefore, be an indispensable part of pre-operative assessment. It allows determination of whether a tear is reparable (retraction of the tendon and fatty degeneration of the corresponding muscle) and whether this is possible by arthroscopy (degree of tendon retraction and extension to subscapularis).
Osseous lesions of the glenoid cavity and humeral head are predictive of recurrence after Bankart arthroscopic procedures. The objective of this study was to analyze, for each glenoid and humeral defect plain x-ray criteria of the Instability Severity Index Score (ISIS), two aspects: inter- and intraobserver reliability of their qualitative and quantitative assessment and correlations between positive criteria and their quantitative measurement. Thirty-one medical files were retained for evaluation of the glenoid and 26 for humeral notch assessment. The yes or no response for the ISIS criterion was completed by its quantitative measurement using the Griffiths and Sugaya CT methods for the glenoid and the P/R index calculation on plain x-rays with internal rotation for the Hill-Sachs lesion. Three observers provided two consecutive readings for each criterion. The analysis of the glenoid radiological criterion of the ISIS seems sufficiently reproducible for daily practice. When the evaluation is positive, bone loss is greater than 15%, without a maximum value established. In this study, the analysis of the ISIS humeral notch criterion was not reproducible. It can be improved using the P/R index and should be completed by CT imaging.
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