For the treatment of concomitant LHBT lesions in patients with rotator cuff tears, both a funnel tenotomy and an intracuff tenodesis showed good clinical outcomes. Even though the incidence of Popeye deformity in the funnel tenotomy group tended to be higher, there was no significant difference in the overall incidence of cosmetic deformity between the 2 groups.
BackgroundThere has been no report to date regarding retraction patterns of delaminated rotator cuff tears. The purpose of this study was to evaluate the incidence and tearing patterns of delamination and repair integrity after the dual-layer repair of delaminated cuff tears.Methods/designA consecutive series of 64 patients with posterosuperior rotator cuff tears underwent arthroscopic rotator cuff repair from August 2011 to September 2012. Among the patients, 53 who received either dual-layer double-row (DLDR) repair or dual-layer suture bridge (DLSB) repair and 11 who received a single-layer repair were evaluated. The mean follow-up period after surgery was 26.5 months. The retraction direction of the deep and superficial layers was analyzed, and the integrity of the repaired constructs was determined in 37 patients through magnetic resonance imaging at a mean of 12.1 months after surgery.ResultsThe incidence of delamination was 82.8 %. Posteromedial retraction of the deep and superficial layers was observed in 98.1 and 88.5 % of cases, respectively. The Constant score and UCLA score increased preoperatively to postoperatively, showing no significant differences between the dual-layer repair group and single-layer repair group. Retear was found in two (7.6 %) patients in the dual-layer repair group and three (27.2 %) patients in the single-layer repair group (p = 0.016).ConclusionsDifferential rotator cuff repair strategies are needed to address rotator cuff tears, since recent studies have changed our concept of rotator cuff tears. We have focused on three areas: incidence, retraction patterns, and clinical outcomes. The incidence of delamination was extremely high. Both the superficial layer and deep layer were mainly retracted posteromedially. The retraction of the deep layer and superficial layer may be affected by the infraspinatus. Dual-layer rotator cuff repair based on the retraction pattern of delamination is recommended for improvement of repair integrity and of clinical outcomes.
[Purpose] This study aimed to elucidate the effects of a novel walking training program
with postural correction and visual feedback on walking function in patients with
post-stroke hemiparesis. [Subjects] Sixteen subjects were randomly allocated to either the
experimental group (EG) or the control group (CG), with eight subjects in each. [Methods]
EG and CG subjects performed a 30-min treadmill walking training exercise twice daily for
2 weeks. EG subjects also underwent postural correction using elastic bands and received
visual feedback during walking. The 10-m walk test was performed, and gait parameters were
measured using a gait analysis system. [Results] All parameters showed significant main
effects for the group factor and time-by-group interactions. Significant main effects for
the time factor were found in the stride length and stance phase ratios. [Conclusion] The
novel walking training program with postural correction and visual feedback may improve
walking function in patients with post-stroke hemiparesis.
Between open and arthroscopic repair for severely retracted, large to massive rotator cuff tears, there was no significant difference in detachment of the deltoid origin and alterations of the deltoid muscle after repair. Postoperative alterations of the deltoid occurred in arthroscopic surgery as well as in open surgery. For immobile massive rotator cuff tear, open repair is an acceptable technique as long as the deltoid muscle is meticulously reattached after surgery.
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