Anterosuperior impingement of the shoulder as a result of pulley lesions: a prospective arthroscopic study

“…Habermeyer et al [17] suggested combined full-thickness tears of the supraspinatus and subscapularis tendons led to progressive anterior and superior migration of the humeral head resulting in glenohumeral arthritis. Although there is a lack of preoperative axillary views in our study, we noted an absence of anterosuperior eccentricity of the humeral head in the majority of shoulders at last followup.…”

Section: Discussionmentioning

confidence: 99%

Does Open Repair of Anterosuperior Rotator Cuff Tear Prevent Muscular Atrophy and Fatty Infiltration?

Schino

Augereau

Nich

2012

Clinical Orthopaedics &Amp; Related Research

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BackgroundRepair of cuff tears involving rotator interval reportedly improves function. However, it is unclear whether successful repair prevents shoulder degenerative changes. Questions/purposes Therefore, we (1) documented the minimal 4-year function of patients who underwent open surgical repair for rotator interval tears; (2) evaluated repaired tendon healing with postoperative MRI; and (3) sought to determine the influence of tendon healing on muscular and glenohumeral joint changes. Methods We retrospectively analyzed 22 patients (23 shoulders) treated by open transosseous reinsertion of supraspinatus and subscapularis tendons. The mean age of the patients was 53 years (range, 37-64 years). The tear was traumatic in four cases. Repair healing and muscular changes were assessed using MRI. The minimum followup was 46 months (mean, 75 months; range, 46-103 months).Results We observed an improvement in the absolute Constant-Murley score from 63 points preoperatively to 76 points postoperatively. With the last followup MRI, the supraspinatus tendon repair had failed in two of the 23 shoulders, whereas the subscapularis tendon repair had healed in all cases.

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“…38 Because the intrinsic tendon vessels are accompanied by sympathetic nerve fibres, 39 damage to this portion of the LHBT is almost always accompanied by characteristic pain, 40,41 often localized to the sulcus region during motion but often diffuse in the anterior compartment of the arm at rest. The close anatomical-mechanical relationship between the strong cord of the LHBT and the two pillars of the lateral aperture of the rotator interval during respective rotation of the humeral head 42 suggests a potential feedback mechanism involving afferent information from the LHBT (under tensile load and working with the pillars) complementing that of the distal cuff tendons in determining the joint position and motion detection during the wind-up, cocking and follow-through phases of a throwing action. 43 The fibrous endoskeleton therefore provides a framework for muscular attachment; a linkage between the front and back of the rotator cuff, to 'co-ordinate', in a mechanical sense, the activity of the cuff across the supra equatorial regions of the humeral head; and contributes to the effectiveness of afferent feedback from the cuff tendons for optimal cuff activation.…”

Section: Size Is Not (Always) Criticalmentioning

confidence: 99%

Assessment and treatment strategies for rotator cuff tears

2014

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Tears of the rotator cuff are common and becoming an increasingly frequent problem. There is a vast amount of literature on the merits and limitations of the various methods of clinical and radiological assessment of rotator cuff tears. This is also the case with regard to treatment strategies. Certain popular beliefs and principles practiced widely and the basis upon which they are derived may be prone to inaccuracy. We provide an overview of the historical management of rotator cuff tears, as well as an explanation for how and why rotator cuff tears should be managed, and propose a structured methodology for their assessment and treatment.

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Anterosuperior impingement of the shoulder as a result of pulley lesions: a prospective arthroscopic study

Cited by 295 publications

References 20 publications

Use of a Movement System Impairment Diagnosis for Physical Therapy in the Management of a Patient With Shoulder Pain

Use of a Movement System Impairment Diagnosis for Physical Therapy in the Management of a Patient With Shoulder Pain

Does Open Repair of Anterosuperior Rotator Cuff Tear Prevent Muscular Atrophy and Fatty Infiltration?

Assessment and treatment strategies for rotator cuff tears

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