Ageing was found to be the major factor in progressive degeneration of the rotator cuff, and should be considered the single most important contributing factor in the pathogenesis of rotator cuff tears. In addition, degenerative tendonopathy appeared the primary pathology in rotator cuff tear, preceding hypertrophic spur formation. Rotator cuff tears are therefore unlikely to be initiated by impingement; rather, they develop as an intrinsic degenerative tendonopathy.
Objective To evaluate the proportion of non-ambulatory dogs with cervical intervertebral disc herniation (IVDH) in a private clinic and to compare signalment and outcome between those that underwent single or multiple ventral slot decompression (VSD).Design Retrospective cohort study.Methods After screening 43,378 medical records (January 2010-September 2016), those of 185 dogs with non-ambulatory tetraparesis or tetraplegia along with cervical IVDH that had undergone single (123) or multiple (62) VSD were included in this study. Data on signalment, preoperative neurological status, location of affected intervertebral disc(s), time to ambulation and short-term outcome were compared between single and multiple VSD groups.
ResultsThe proportion of non-ambulatory dogs with IVDH was 35.3%. The prevalence of non-ambulation was higher in male dogs (0.56%) than in female dogs (0.26%; P < 0.001) and in neutered dogs than in unneutered dogs (0.51% and 0.27%, respectively, P < 0.001). After surgery, 96.2% of the dogs reached ambulatory status. Dogs with multiple IVDH were older than those with single IVDH. Sex, neutering status or size did not affect the outcome or ambulation status postsurgery. The Pekingese was the most commonly affected breed in both groups. There was no difference in the time to reach ambulation and the presence of neurological deficits after surgery between dogs that underwent single and multiple VSD.Conclusions In this cohort, dogs undergoing multiple VSD had a good postoperative outcome, and their short-term functional recovery was equal to that of dogs undergoing single ventral slot compression.
Background: A “double-pulley” dual-row technique had been applied for arthroscopic fixation of large bony Bankart lesion in which the fragment has a wide base. Purpose: To investigate clinical outcomes and glenoid healing after arthroscopic fixation of bony Bankart lesion using the double-pulley dual-row technique. Study Design: Case series; Level of evidence, 4. Methods: A total of 25 patients were included in this retrospective study. The American Shoulder and Elbow Surgeons (ASES) score, pain visual analog scale (VAS) score, and range of motion of the affected shoulder were assessed. Radiographs and computed tomography (CT) scans (preoperatively, immediately after surgery, and at 1 year postoperatively) were performed to evaluate arthritic changes (Samilson-Prieto classification) and glenoid size. The intraobserver reliability of the CT measurements was analyzed. Results: At a mean follow-up of 3.4 years, the mean ASES and VAS scores were 94.87 ± 5.02 and 0.48 ± 0.59, respectively. Active forward elevation, external rotation with the arm at the side, and internal rotation were 165.80° ± 11.70°, 33.20° ± 8.02°, and T9 (range, T6-S1), respectively. No patient reported a history of redislocation or instability. The intraobserver reliability of the CT measurements was moderate to excellent. The mean preoperative size of the bony fragment was measured as 23.4% ± 7.8% of the glenoid articular surface. The quality of the reduction was judged to be excellent in 13 (52%) cases, good in 8 (32%), and fair in 4 (16%). The mean immediate postoperative glenoid size was 96.8% ± 4.3%, and bone union was found in all cases. There were no significant differences between reconstructed and immediate postoperative glenoid size or between preoperative and final Samilson-Prieto grades. Conclusion: The arthroscopic double-pulley method was a reliable technique for the fixation of large bony Bankart lesions with a wide base. Satisfactory results can be expected regarding the restoration of the glenoid morphology and stability of the shoulder. High healing rate and good shoulder function can be achieved. No radiological evidence of cartilage damage caused by suture abrasion was found at 2- to 5-year follow-up.
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