Purpose: To evaluate the concomitance of rotator cuff disease in patients with symptomatic anterior shoulder instability and its impact on the severity of lesions. Materials and Methods: Retrospective data were collected from 326 patients from a single institution for a 16-year period. The demographic characteristics of the patients were selected randomly. The leading diagnosis was shoulder instability. Excluded from the study were patients with posterior (n=24) or mixed instability (n=5). Primary diagnosis was confirmed with clinical findings and MRI imaging studies. All patients from the group underwent arthroscopic surgery. A throughout analysis was performed of the collected materials. Results: 297 patients with primary anterior instability underwent arthroscopic stabilization in the clinic. 25% (n=75) presented with different grade rotator cuff lesions, of which only 33% (n=25) were discovered on MRI preoperatively. In these patients, rotator cuff tenoplasty was performed. In 27% (n=79) of the patients, an evident subacromial space narrowing without rotator cuff lesions was found during arthroscopy. In these cases, a subacromial decompression was performed, and in some of the cases - acromioplasty. In 52% (n=154) of patients who underwent an arthroscopic stabilization for anterior shoulder instability, additional treatment was necessary. Conclusions: The complex analysis of shoulder pathology can shield the surgeon from diagnostic misses and unsatisfactory results. Coexisting rotator cuff disease may have a role in symptomatic anterior shoulder instability as it is often neglected in clinical evaluations due to the main diagnosis of instability.
Introduction: The functional outcome in patients after limb salvage surgery, and in particular reconstructions with modular tumor endoprostheses, has been the subject of many international series, but only a few publications mention the functionality in a Bulgarian patient group.
Aim: The aim of the present study was to analyze the functional outcome in a Bulgarian group of patients with malignant bone tumors that underwent resection and reconstruction with modular tumor endoprostheses.
Materials and methods: Our series consists of 14 patients with malignant bone tumors who underwent limb salvage surgery and reconstruction with modular tumor endoprostheses between February 2012 and January 2021. Staging was done using the AJCC staging system for bone sarcoma. The MSTS score system was used to evaluate the functional results.
Results: The mean follow-up time was 38.5 months (range, 8 to 96). The mean MSTS score for our series was 70%. Distant metastases were found in 4 (28%) patients. Local recurrence occurred in 3 (21%) patients. The most severe late complication was a mechanical failure of the expanding mechanism in 1 patient.
Conclusions: Reconstruction with modular tumor endoprostheses offer superb functionality and improved life quality in patients with primary malignant bone tumors.
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