Pseudoparalysis: a systematic review of term definitions, treatment approaches, and outcomes of management techniques

Tokish, John M.; Alexander, Thomas C.; Kissenberth, Michael J.; Hawkins, Richard J.

doi:10.1016/j.jse.2017.02.024

Cited by 105 publications

(70 citation statements)

References 21 publications

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“…The term "pseudoparalysis" as a clinically described condition of limited shoulder function remains not clearly defined. Tokish et al performed a systematic review and found a wide use of the term "pseudoparalysis" describing clinical shoulder function, reaching from "below 90 degrees in forward flexion" to massive limitation of shoulder function with cranialization of the humeral head with ventral subluxation [1,30]. First of all, a clinical definition of severe shoulder dysfunction as suggested by the term "pseudoparalysis" should be given and pain as a causing factor needs to be excluded.…”

Section: Discussionmentioning

confidence: 99%

“…Subjective evaluation included the American Shoulder and Elbow Surgeons score (ASES, 0-100 points) and the Simple Shoulder Test score (SST, 0-12 points). Additionally, outcome was compared between patients with (abduction and/or flexion of 90°or below, group 1) and without (abduction and/or flexion over 90°, group 2) pseudoparalytic conditions [30]. An MRIverified rupture of the dermal graft was considered as a study endpoint (treatment failure).…”

Section: Radiological Clinical and Subjective Assessmentmentioning

confidence: 99%

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Arthroscopic superior capsular reconstruction using a human dermal allograft in patients with and without preoperative pseudoparalysis

et al. 2019

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Background Massive irreparable rotator cuff tears (RCT) may cause severe functional impairment and pain as a result of loss of superior humeral stability. Reconstruction of the superior capsule (SCR) has been reported to restore glenohumeral stability and function. Objective The purpose of this study was to investigate short-term functional and radiological outcome after arthroscopic SCR with a human dermal allograft for irreparable RCT. Methods In total, 21 patients (mean age 65.9 years, 50–77), who underwent arthroscopic SCR were prospectively enrolled in the present study. Magnetic resonance images (MRI) were obtained before and 12 months after surgery to evaluate graft survival. Functional and subjective outcome including the Constant score (CS), the American Shoulder and Elbow Surgeons score (ASES), and the Simple Shoulder Test (SST) was evaluated preoperatively as well as 3–6 and 12 months postoperatively and was compared between patients with and without preoperative pseudoparalysis. Complications were recorded. Results The MRI evaluation revealed intact grafts in 71.4% of patients 1 year postoperatively; these patients showed significant improvements from baseline to follow-up time points regarding the total CS and its subgroups pain, activity of living, range of motion, strength, ASES, and SST (p < 0.01). Pseudoparalysis was present in 57.1% of cases preoperatively, but was reversed in 100% of cases with intact graft at the 1‑year follow-up. The outcome was similar between groups at final follow-up. Complications occurred in 29% (one infection, five graft failures) of patients and were indications for treatment with reverse shoulder arthroplasty. Conclusion Arthroscopic SCR with a human dermal allograft in patients with irreparable RCT restored shoulder function and relieved pain in patients without and with preoperative pseudoparalysis.

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Section: Discussionmentioning

confidence: 99%

Section: Radiological Clinical and Subjective Assessmentmentioning

confidence: 99%

Arthroscopic superior capsular reconstruction using a human dermal allograft in patients with and without preoperative pseudoparalysis

et al. 2019

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“…Clinical presentations of irreparable RCT include chronic pain, functional limitation, weak external rotation, and even pseudoparalysis [3,4].…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic superior capsule reconstruction using autologous fascia lata and biceps tendon augmentation

Hsu

Chiu

Weng

et al. 2020

Preprint

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Background: While arthroscopic superior capsule reconstruction (SCR) has been recently introduced to treat irreparable rotator cuff tear with encouraging outcomes, graft options and fixation remain debated. The purpose of this article is to describe a novel technique and present preliminary results in using long head of biceps tendon (LHBT) as augmentation for SCR with fascia lata autograft.Methods: Retrospective analysis was performed on 18 patients undergoing arthroscopic SCR with LHBT augmentation for irreparable rotator cuff tear between October 2017 and November 2019. Preoperative radiographic survey confirmed massive rotator cuff tear with moderate to severe muscle fatty infiltration and availability of LHBT. Fascia lata autograft harvested from ipsilateral thigh was folded and securely sutured. The folded fascia graft was then introduced through standard anterolateral portal and fixed to superior glenoid superiorly and greater tuberosity laterally with suture anchors. Anteriorly, fascia lata graft was sutured with proximal portion of LHBT instead of subscapularis tendon. A full coverage of rotator cuff defect by facial graft was then confirmed arthroscopically to allow tension-free suturing between posterior margin of fascia graft and residual infraspinatus tendon. Postoperative abduction brace and regular follow-up was arranged.Results: Being intact in 4 patients and either partially torn or subluxed in 14 patients, LHBT in all 18 patients were available for augmentation surgery. Preliminary functional survey revealed encouraging outcomes with a mean follow-up of 11.5 months. Nine patients with more than one year follow-up regained full forward elevation; ASES improved from 24.3 to 90.2. Acromiohumeral distance improved from 3.3 mm to 8.6 mm with radiographic analysis in those 9 patients.Conclusions: Arthroscopically LHBT augmented SCR is a novel technique and can be one of feasible opinions for irreparable rotator cuff tear.

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“…Se estima que la prevalencia es entre un 10 y un 40 % en la población entre los 50-55 años, llegando a un 60 % en los sujetos mayores de 70 años (2). Su presentación clínica es manifestada por dolor incapacitante, disminución del rango activo de movimiento (AROM) en flexión anterior y rotación externa, impotencia funcional (3,4) y en algunos casos pseudoparálisis (5). Junto a esto, Werner en el año 2005 utilizó el término, definiéndolo como una elevación activa y pasiva del hombro inferior a 90°, causada por un desgarro masivo del manguito rotador.…”

Section: Introductionunclassified

“…Junto a esto, Werner en el año 2005 utilizó el término, definiéndolo como una elevación activa y pasiva del hombro inferior a 90°, causada por un desgarro masivo del manguito rotador. Desde entonces, la literatura ha utilizado el término para abarcar esta restricción de movimiento y que a menudo se asocian a dolor, deterioro degenerativo y pérdida de rotación externa (5). Generalmente estos deterioros son acompañados de un edema óseo e infiltración grasa en el tendón, provocando un ascenso de la cabeza humeral como una de las principales complicaciones médicas (6).…”

Section: Introductionunclassified

Terapia de juicio de lateralidad e imagineria del movimiento y ejercicios de activación muscular selectiva glenohumerales en sujetos con ruptura masiva del manguito rotador: serie de casos

Oyarzún

Araya-Quintanilla

Gutiérrez-Espinoza

et al. 2017

Rev. Soc. Esp. Dolor.

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Introduction: Massive tear of the rotator cuff (DMMR) is a degenerative clinical condition, which corresponds to a 5 cm rupture, or one that compromises two or more tendons of the rotator cuff (MR), generating loss of functionality and disabling pain.Objective: To describe changes in pain and shoulder function following a 6-week program of lateral-imaging and motion imaging therapy and selective glenohumeral activation exercises in subjects with massive rotator cuff tears.Methods: This study is a descriptive research and design of a series of cases, with a sample of 50 participants with diagnosis of rotator cuff mastication. Patients underwent a glenohumeral selective exercise program plus laterality and motion imaging therapy for 6 weeks. The variables of function, pain, abduction ROM and shoulder flexion were measured at sixth week and sixth month of evolution.Results: There were significant differences in pain intensity, shoulder function, AROM flexion and shoulder abduction AROM, after the intervention (p > 0.05). Statistically significant differences were found for all outcome measures between the intervention and the sixth follow-up month (p < 0.05). Only the

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Pseudoparalysis: a systematic review of term definitions, treatment approaches, and outcomes of management techniques

Cited by 105 publications

References 21 publications

Arthroscopic superior capsular reconstruction using a human dermal allograft in patients with and without preoperative pseudoparalysis

Arthroscopic superior capsular reconstruction using a human dermal allograft in patients with and without preoperative pseudoparalysis

Arthroscopic superior capsule reconstruction using autologous fascia lata and biceps tendon augmentation

Terapia de juicio de lateralidad e imagineria del movimiento y ejercicios de activación muscular selectiva glenohumerales en sujetos con ruptura masiva del manguito rotador: serie de casos

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