Background: Exposure of the insertion site of the anterior cruciate ligament (ACL) is important for appropriate tunnel placement in ACL reconstruction surgery. However, observing the femoral ACL insertion site via the...Background: Exposure of the insertion site of the anterior cruciate ligament (ACL) is important for appropriate tunnel placement in ACL reconstruction surgery. However, observing the femoral ACL insertion site via the standard anterolateral portal is sometimes difficult. In this study, we compared views of the femoral ACL insertion site between 30-degree and the 45-degree arthroscopes. Methods: We first inserted the 30-degree and the 45-degree arthroscope into the anterolateral portal of a knee simulator in which we had drawn a lattice pattern on the lateral intercondylar notch based on the quadrant method. Next, we compared the arthroscopic views provided by the 30-degree and 45-degree arthroscopes during ACL reconstruction surgery by measuring the area of the lateral intercondylar notch visible through each of the arthroscopes. Results: In the knee simulator, the 45-degree arthroscope showed the entire area of the lateral intercondylar notch, whereas the 30-degree arthroscope had to be introduced more deeply to show the most superior and posterior quadrant, where the attachment of the anteromedial bundle of ACL is located. During the ACL reconstruction, the area of the lateral intercondylar notch in the field of view was larger through the 45-degree arthroscope than through the 30-degree arthroscope. Conclusion: The 45-degree arthroscope provides a better view of the femoral ACL insertion site via the anterolateral portal, which may be helpful during ACL reconstruction.展开更多
BACKGROUND Rotator cuff tears are a chief cause of shoulder pain and disability,and surgical repair is often required when conservative management fails.As digital health technologies have expanded,especially since th...BACKGROUND Rotator cuff tears are a chief cause of shoulder pain and disability,and surgical repair is often required when conservative management fails.As digital health technologies have expanded,especially since the coronavirus disease 2019 pandemic,digitally augmented rehabilitation programs emerged as a potential alternative to conventional physical therapy.AIM To determine if digitally assisted rehabilitation could be as practical,or even more effective,than the traditional methods most patients currently follow.METHODS Six electronic databases,including PubMed,Scopus,Cochrane Library,Google Scholar,EMBASE,and Web of Science,were searched to find articles that compare digital-based rehabilitation and conventional treatment.Outcomes of interest were Disabilities of the Arm,Shoulder and Hand(DASH)score and range of motion.The quality assessment of the included studies was performed using the risk-of-bias tool for randomized trials tool.RESULTS Three randomized controlled trial studies were enrolled in this study,including 195 cases.We did not find any significant differences between the two groups in terms of DASH score,flexion range of motion,and external rotation range of motion.There was a significant difference between the two groups for abduction range of motion.CONCLUSION Digital home-based rehab seems to be a strong alternative to traditional methods,offering similar results for people recovering from rotator cuff surgery.This approach might also make rehab more accessible and engaging for patients.That said,further research is needed to fully understand the potential of digital rehabilitation and ensure it works effectively for everyone.展开更多
Rotator cuff tears are highly prevalent,and there is an urgent need to understand their healing mechanisms to improve treatment outcomes for patients.This editorial aims to summarize the roles and limitations of commo...Rotator cuff tears are highly prevalent,and there is an urgent need to understand their healing mechanisms to improve treatment outcomes for patients.This editorial aims to summarize the roles and limitations of common animal models(including rodents,rabbits,sheep,dogs,and primates)and second-look arthroscopy in rotator cuff healing research.Different animal models offer distinct advantages and disadvantages.For example,rodent models are cost-effective and suitable for genetic studies but have anatomical differences from humans.Rabbit models are favored for their relatively large tendon size and ease of surgical manipulation,yet they still deviate from human shoulder anatomy in some aspects.Larger animals like sheep and dogs have more similar shoulder structures to humans but come with high costs and challenges in maintaining consistent experimental conditions.Second-look arthroscopic studies have provided evidence for the effectiveness of current surgical techniques.Animal models will continue to play a crucial role in further exploring the local microenvironment of the rotator cuff,which is expected to help develop more effective strategies to promote healing.展开更多
To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus i...To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months （range 12-30 months）. The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation （P〈0. 01）, the total excellent and fine rate was 91.86%. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.展开更多
BACKGROUND Osteochondral lesion of talus is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone.It arises from diverse causes,and although trauma is implicated in ...BACKGROUND Osteochondral lesion of talus is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone.It arises from diverse causes,and although trauma is implicated in many cases,it does not account for the etiology of every lesion.Gout is a chronic arthritic disease caused by excess levels of uric acid in blood.Intraosseous deposition of monosodium urate in the clavicle,femur,patella and calcaneus was reported previously.Gout is common disease but rare at a young age,especially during teenage years.Osteochondral lesion caused by intra-articular gouty invasion is very rare.CASE SUMMARY We encountered a rare case of a 16-year-old male who has osteochondral lesion of the talus(OLT)with gout.He had fluctuating pain for more than 2 years.We could see intra-articular tophi with magnetic resonance image(MRI)and arthroscopy.We performed arthroscopic exploration,debridement and microfracture.Symptoms were resolved after operation,and bony coverage at the lesion was seen on postoperative images.We had checked image and uric acid levels for 18 mo.CONCLUSION It is rare to see OLT with gouty tophi in young adults.While it is challenging,the accuracy of diagnosis can be improved through history taking,MRI and arthroscopy.展开更多
Objective: To analyze postoperative therapeutic effects of patients with fractured anterior cruciate ligament (ACL) that underwent autologous tendon reconstruction at early and late period. Methods: A total of 60 pati...Objective: To analyze postoperative therapeutic effects of patients with fractured anterior cruciate ligament (ACL) that underwent autologous tendon reconstruction at early and late period. Methods: A total of 60 patients underwent autologous tendon reconstruction were enrolled and retrospectively analyzed via arthroscopes from December, 2015 to December, 2017 in our hospital, in which 30 patients treated with ACL reconstruction within 6 weeks of injury were selected as the early reconstruction group (Group A), and the other 30 cases with ACL reconstruction between 6 weeks and 6 months were as late reconstruction group (Group B);the therapeutic effect of early and late ACL reconstruction was analyzed by recording and comparing of several indexes, such as knee lysholm score, knee IKDC score, intraoperative hemorrhage, operation time, pre- and post-operative range of motion (ROM) of the knee, etc. Results: The pre- and post-operative lysholm scores and IKDC scores were compared between the two groups, without statistically significant results (P > 0.05). The knee ROM scores of the late reconstruction group were higher than those of the early group (P < 0.05), and the intraoperative blood loss in the late stage was less than that in the early group (P < 0.05), which exhibits that the short-term clinical efficacy of early and late arthroscopic autologous tendon reconstruction for knee ACL injury was similar, but the late reconstruction group was with less intraoperative bleeding, and better postoperative joint mobility recovery;in conclusion, it is recommended that patients can be operated between 6 weeks and 6 months after injury.展开更多
Frozen shoulder is a common disease which causes significant morbidity. Despite over a hundred years of treating this condition the definition, diagnosis, pathology and most efficacious treatments are still largely un...Frozen shoulder is a common disease which causes significant morbidity. Despite over a hundred years of treating this condition the definition, diagnosis, pathology and most efficacious treatments are still largely unclear. This systematic review of current treatments for frozen shoulder reviews the evidence base behind physiotherapy, both oral and intra articular steroid, hydrodilatation, manipulation under anaesthesia and arthroscopic capsular release. Key areas in which future research could be directed are identified, in particular with regard to the increasing role of arthroscopic capsular release as a treatment.展开更多
Treatment options for meniscal tears fall into three broad categories;non-operative,meniscectomy or meniscal repair.Selecting the most appropriate treatment for a given patient involves both patient factors(e.g.,age,c...Treatment options for meniscal tears fall into three broad categories;non-operative,meniscectomy or meniscal repair.Selecting the most appropriate treatment for a given patient involves both patient factors(e.g.,age,co-morbidities and compliance)and tear characteristics(e.g.,location of tear/age/reducibility of tear).There is evidence suggesting that degenerative tears in older patients without mechanical symptoms can be effectively treated non-operatively with a structured physical therapy programme as a first line.Even if these patients later require meniscectomy they will still achieve similar functional outcomes than if they had initially been treated surgically.Partial meniscectomy is suitable for symptomatic tears not amenable to repair,and can still preserve meniscal function especially when the peripheral meniscal rim is intact.Meniscal repair shows 80%success at 2 years and is more suitable in younger patients with reducible tears that are peripheral(e.g.,nearer the capsular attachment)and horizontal or longitudinal in nature.However,careful patient selection and repair technique is required with good compliance to post-operative rehabilitation,which often consists of bracing and non-weight bearing for 4-6 wk.展开更多
BACKGROUND Arthroscopic debridement is a mature treatment for knee osteoarthritis(KOA).Due to the differences in the research subjects,methods,and efficacy evaluation indexes,there are great differences in the surgica...BACKGROUND Arthroscopic debridement is a mature treatment for knee osteoarthritis(KOA).Due to the differences in the research subjects,methods,and efficacy evaluation indexes,there are great differences in the surgical efficacy reported in the literature.AIM To compare the medium-term efficacy of arthroscopic debridement and conservative treatment for KOA of Kellgren-Lawrence grades I-III.METHODS Patients with KOA of Kellgren-Lawrence grades I-III who were admitted to the orthopedic clinic of our hospital from July 2018 to December 2018 and agreed to undergo arthroscopic surgery were included in an arthroscopic debridement group,and those who refused surgical treatment were included in a conservative treatment group.Gender,age,body mass index(BMI),side of KOA,American hospital for special surgery knee score(HSS score)before treatment,visual analogue scale(VAS)score during walking and rest before treatment,conservative treatment content,and surgical procedure were recorded.Outpatient visits were conducted at the 1st,3rd,6th,12th,and 24th mo after treatment in the two groups.The changes of HSS score and VAS score in each group before and after treatment were statistically analyzed,and the differences of HSS score and VAS score in different treatment stages between the two groups were also compared.RESULTS In the conservative treatment group,there were 80 patients with complete followup data,including 20 males and 60 females,aged 58.75±14.66 years old.And in the knee arthroscopic debridement group,there were 98 patients with complete follow-up data,including 24 males and 74 females,aged 59.27±14.48 years old.There was no statistically significant difference in the general data(gender,age,BMI,side of KOA,Kellgren-Lawrence grade distribution,HSS score,and VAS score)between the two groups before treatment.The HSS scores of the conservative treatment group at the 1st,3rd,6th,12th,and 24th mo after treatment were significantly higher than that before treatment(P<0.05).There was no statistical difference in HSS score of the conservative treatment group among the 1st,3rd,6th,12th,and 24th mo(P>0.05).The HSS score of the knee arthroscopic debridement group at the 1st mo after surgery was significantly higher than that before surgery(P<0.05).HSS scores of the knee arthroscopic debridement group at the 3rd,6th,12th,and 24th mo were significantly higher than those before surgery and at the 1st mo after surgery(P<0.05).There were no statistically significant differences in HSS scores at the 3rd,6th,12th,and 24th mo after surgery(P>0.05).HSS scores at the 3rd,6th,12th,and 24th mo were significantly higher in the arthroscopic debridement group than in the conservative treatment group(P<0.05).There was no statistical difference in HSS scores between the two groups before treatment and at the 1st mo of follow-up(P>0.05).VAS scores during walking and rest were significantly decreased in both groups,and the VAS score during rest was significantly lower in the arthroscopic debridement group than in the conservative treatment group,but there was no significant difference in the VAS score during walking between the two groups after treatment.CONCLUSION Compared with conservative treatment,arthroscopic debridement can significantly improve the knee resting pain and knee functional status of patients with KOA of Kellgren-Lawrence grades I-III within 2 years after treatment.展开更多
A direct force on the superior aspect of the shoulder may cause acromioclavicular(AC) dislocation or separation. Severe dislocations can lead to chronic impairment, especially in the athlete and high-demand manual lab...A direct force on the superior aspect of the shoulder may cause acromioclavicular(AC) dislocation or separation. Severe dislocations can lead to chronic impairment, especially in the athlete and high-demand manual laborer. The dislocation is classified according to Rockwood. Types Ⅰ?and Ⅱ are treated nonoperatively, while types Ⅳ, Ⅴ and Ⅵ are generally treated operatively. Controversy exists regarding the optimal treatment of type Ⅲ dislocations in the high-demand patient. Recent evidence suggests that these should be treated nonoperatively initially. Classic surgical techniques were associated with high complication rates, including recurrent dislocations and hardware breakage. In recent years, many new techniques have been introduced in order to improve the outcomes. Arthroscopic reconstruction or repair techniques have promising short-term results. This article aims to provide a current concepts review on the treatment of AC dislocations with emphasis on recent developments.展开更多
AIM To compare the results of arthroscopic capsular release with intra-articular steroid injections in patients of frozen shoulder.METHODS Fifty-six patients with frozen shoulder were randomised to one of two treatmen...AIM To compare the results of arthroscopic capsular release with intra-articular steroid injections in patients of frozen shoulder.METHODS Fifty-six patients with frozen shoulder were randomised to one of two treatment groups: Group 1, complete 360 degree arthroscopic capsular release and group 2, intra-articular corticosteroid injection(40 mg methyl prednisolone acetate). Both groups were put on active and passive range of motion exercises following the intervention. The outcome parameters were visual analogue scale(VAS) score for pain, range of motion and Constant score which were measured at baseline, 4, 8, 12, 16 and 20 wk after intervention.RESULTS All the parameters improved in both the groups. The mean VAS score improved significantly more in the group 1 as compared to group 2 at 8 wk. This greater improvement was maintained at 20 wk with P value of 0.007 at 8 wk, 0.006 at 12 wk, 0.006 at 16 wk and 0.019 at 20 wk. The Constant score showed a more significant improvement in group 1 compared to group 2 at 4 wk, which was again maintained at 20 wk with P value of 0.01 at 4, 8, 12 and 16 wk. The gain in abduction movement was statistically significantly more in arthroscopy group with P value of 0.001 at 4, 8, 12, 16 wk and 0.005 at 20 wk. The gain in external rotation was statistically significantly more in arthroscopy group with P value of 0.007 at 4 wk, 0.001 at 8, 12, and 16 wk and 0.003 at 20 wk. There was no statistically significant difference in extension and internal rotation between the two groups at any time. CONCLUSION Arthroscopic capsular release provides subjective and objective improvement earlier than intra-articular steroid injection.展开更多
Arthroscopic surgery of the posterior compartment ofthe knee is difficult when only two anterior portals are used for access because of the inaccessibility of the back of the knee. Since its introduction, the posterio...Arthroscopic surgery of the posterior compartment ofthe knee is difficult when only two anterior portals are used for access because of the inaccessibility of the back of the knee. Since its introduction, the posterior transseptal portal has been widely employed to access lesions in the posterior compartment. However, special care should be taken to avoid neurovascular injuries around the posteromedial, posterolateral, and transseptal portals. Most importantly, popliteal vessel injury should be avoided when creating and using the transseptal portal during surgery. Purpose of the present study is to describe how to avoid the neurovascular injuries during establishing the posterior three portals and to introduce our safer technique to create the transseptal portal. To date, we have performed arthroscopic surgeries via the transseptal portal in the posterior compartments of 161 knees and have not encountered nerve or vascular injury. In our procedure, the posterior septum is perforated with a 1.5-3.0-mm Kirschner wire that is protected by a sheath inserted from the posterolateral portal and monitored from the posteromedial portal to avoid popliteal vessel injury.展开更多
BACKGROUND Osteoarthritis(OA)is the most prevalent form of degenerative whole-joint disease.Before the final option of knee replacement,arthroscopic surgery was the most widely used joint-preserving surgical treatment...BACKGROUND Osteoarthritis(OA)is the most prevalent form of degenerative whole-joint disease.Before the final option of knee replacement,arthroscopic surgery was the most widely used joint-preserving surgical treatment.Emerging regenerative therapies,such as those involving platelet-rich plasma,mesenchymal stem cells,and microfragmented adipose tissue(MFAT),have been pushed to the forefront of treatment to prevent the progression of OA.Currently,MFAT has been successfully applied to treat different types of orthopedic diseases.AIM To assess the efficacy and safety of MFAT with arthroscopic surgery in patients with knee OA(KOA).METHODS A randomized,multicenter study was conducted between June 2017 and November 2022 in 10 hospitals in Zhejiang,China.Overall,302 patients diagnosed with KOA(Kellgren-Lawrence grades 2-3)were randomized to the MFAT group(n=151,were administered MFAT following arthroscopic surgery),or the control group(n=151,were administered hyaluronic acid following arthroscopic surgery).The study outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score,the visual analog scale(VAS)score,the Lequesne index score,the Whole-Organ Magnetic Resonance Imaging Score(WORMS),and safety over a 24-mo period from baseline.RESULTS The changes in the WOMAC score(including the three subscale scores),VAS pain score,and Lequesne index score at the 24-mo mark were significantly different in the MFAT and control groups,as well as when comparing values at the posttreatment visit and those at baseline(P<0.001).The MFAT group consistently demonstrated significant decreases in the WOMAC pain scores and VAS scores at all follow-ups compared to the control group(P<0.05).Furthermore,the WOMAC stiffness score,WOMAC function score,and Lequesne index score differed significantly between the groups at 12 and 24 mo(P<0.05).However,no signicant between-group differences were observed in the WORMS at 24 mo(P=0.367).No serious adverse events occurred in both groups.CONCLUSION The MFAT injection combined with arthroscopic surgery treatment group showed better mid-term clinical outcomes compared to the control group,suggesting its efficacy as a therapeutic approach for patients with KOA.展开更多
BACKGROUND The critical shoulder angle(CSA)is a radiographic measurement that provides an assessment of both glenoid inclination and acromial length.Higher values may correlate with the presence of rotator cuff tears....BACKGROUND The critical shoulder angle(CSA)is a radiographic measurement that provides an assessment of both glenoid inclination and acromial length.Higher values may correlate with the presence of rotator cuff tears.However,it is difficult to obtain a high-quality true anteroposterior(AP)radiograph of the shoulder,with any excess scapular version or flexion/extension resulting in deviation from the true CSA value.Three-dimensional(3D)bony reconstructions of computed tomography(CT)shoulder scans may be able to be rotated to obtain a similar view to that of true AP radiographs.AIM To compare CSA measurements performed on 3D bony CT reconstructions,with those on corresponding true AP radiographs.METHODS CT shoulder scans were matched with true AP radiographs that were classified as either Suter-Henninger type A or C quality.3D bony reconstructions were segmented from the CT scans,and rotated to replicate an ideal true AP view.Two observers performed CSA measurements using both CT and radiographic images.Measurements were repeated after a one week interval.Reliability was assessed using intraclass correlation coefficients(ICCs)and Bland-Altman plots[bias,limits of agreement(LOA)].RESULTS Twenty CT shoulder scans were matched.The mean CSA values were 32.55°(±4.26°)with radiographs and 29.82°(±3.49°)with the CT-based method[mean difference 2.73°(±2.86°);P<0.001;bias+2.73°;LOA-2.17°to+7.63°].There was a strong correlation between the two methods(r=0.748;P<0.001).Intra-observer reliability was similar,but the best intra-observer values were achieved by the most experienced observer using the CT-based method[ICC:0.983(0.958-0.993);bias+0.03°,LOA-1.28°to+1.34°].Inter-observer reliability was better with the CT-based method[ICC:0.897(0.758-0.958),bias+0.24°,LOA-2.93°to+3.41°].CONCLUSION The described CT-based method may be a suitable alternative for critical shoulder angle measurement,as it overcomes the difficulty in obtaining a true AP radiographic view.展开更多
BACKGROUND Synovial chondromatosis is a disease originating from the synovium and characterized by the presence of metaplastic cartilaginous nodules in synovial cavities.The exact prevalence of synovial chondromatosis...BACKGROUND Synovial chondromatosis is a disease originating from the synovium and characterized by the presence of metaplastic cartilaginous nodules in synovial cavities.The exact prevalence of synovial chondromatosis remains unknown,and the involvement of the shoulder joint is very rare.Synovial chondromatosis accompanied by subluxation of the humeral head without a history of trauma is rarely encountered,and to our knowledge,no published reports describe this condition.CASE SUMMARY We present two cases of synovial chondromatosis in the shoulder joint,accompanied by subluxation of the humeral head,in two arthroscopically managed adult patients.We performed arthroscopic labrum fixation and removal of the loose body from the shoulder joint.To identify primary and secondary categories,pathological analysis was arranged.Clinical and radiographic evaluations at the 1-mo follow-up were satisfactory.CONCLUSION The biomechanical function of the shoulder joint requires attention,especially following the detection of loose bodies,as observed with synovial chondroma occurring in rare sites.Arthroscopic management is successful in patients with synovial chondromatosis combined with shoulder subluxation.展开更多
BACKGROUND Osteoarthritis(OA)is the most common cause of pain and disability,predominantly affecting the knee.The current management of knee OA falls short of completely stopping disease progression,particularly in Ke...BACKGROUND Osteoarthritis(OA)is the most common cause of pain and disability,predominantly affecting the knee.The current management of knee OA falls short of completely stopping disease progression,particularly in Kellgren-Lawrence(KL)grade 3 and 4 knee OA.As such,joint replacement is often recommended,although only 15%-33%of candidates accept it.Alternative therapeutic options are still needed to prevent the progression of joint damage and delay the need for knee arthroplasty.AIM To investigate the effect of adjunctive platelet rich plasma(PRP)and hyaluronic acid(HA)after arthroscopic debridement in KL grade 3 and 4 knee OA.METHODS This retrospective cohort study used the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score and WOMAC sub-scores(pain,stiffness,and function)to assess 21 patients,grouped according to medical record data of treatment received:Arthroscopic debridement(n=7);arthroscopic debridement with PRP(n=7);or arthroscopic debridement with HA(n=7).WOMAC scores and sub-scores at baseline and at 3 mo and 5 mo posttreatment were recorded.The three-group data were statistically analyzed using the tests of paired t,one-way analysis of variance,and post hoc least significant difference.RESULTS All three treatment groups showed significant improvements in WOMAC score and sub-scores from before treatment to 3 mo and 5 mo after treatment.However,the arthroscopic debridement with PRP treatment group,in particular,showed a significantly lower WOMAC pain score than the group who received arthroscopic debridement alone at 5 mo after the procedure(P=0.03).CONCLUSION Compared to arthroscopic debridement alone,adjunctive PRP after arthroscopic debridement significantly lessened the patients’pain symptom.展开更多
BACKGROUND Tibial avulsion fractures of the posterior cruciate ligament(PCL)are challenging to treat and compromise knee stability and function.Traditional open surgery often requires extensive soft tissue dissection,...BACKGROUND Tibial avulsion fractures of the posterior cruciate ligament(PCL)are challenging to treat and compromise knee stability and function.Traditional open surgery often requires extensive soft tissue dissection,which may increase the risk of morbidity.In response to these concerns,arthroscopic techniques have been evolving.The aim of this study was to introduce a modified arthroscopic tech-nique utilizing an M-shaped suture fixation method for the treatment of tibial avulsion fractures of the PCL and to evaluate its outcomes through a case series.AIM To evaluate the effects of arthroscopic M-shaped suture fixation on treating tibia avulsion fractures of the PCL.METHODS We developed a modified arthroscopic M-shaped suture fixation technique for tibia avulsion fractures of the PCL.This case series included 18 patients who underwent the procedure between January 2021 and December 2022.The patients were assessed for range of motion(ROM),Lysholm score and International knee documentation committee(IKDC)score.Postoperative complications were also recorded.RESULTS The patients were followed for a mean of 13.83±2.33 months.All patients showed radiographic union.At the final follow-up,all patients had full ROM and a negative posterior drawer test.The mean Lysholm score significantly improved from 45.28±8.92 preoperatively to 91.83±4.18 at the final follow-up(P<0.001),and the mean IKDC score improved from 41.98±6.06 preoperatively to 90.89±5.32 at the final follow-up(P<0.001).CONCLUSION The modified arthroscopic M-shaped suture fixation technique is a reliable and effective treatment for tibia avulsion fractures of the PCL,with excellent fracture healing and functional recovery.展开更多
BACKGROUND Rotator cuff pathology is a very common source of shoulder pain.Similarly,osteoarthritis of the glenohumeral joint can cause shoulder pain and produce similar symptoms.Surgical management can be indicated f...BACKGROUND Rotator cuff pathology is a very common source of shoulder pain.Similarly,osteoarthritis of the glenohumeral joint can cause shoulder pain and produce similar symptoms.Surgical management can be indicated for both pathologies,however,outcomes data is limited when examining rotator cuff repair(RCR) in the setting of glenohumeral arthritis(GHOA).Thus,this study sought to determine outcomes for patients who undergo RCR in the setting of GHOA.AIM To evaluate if a relationship exists between outcomes of RCR in the setting of GHOA.METHODS This was a retrospective analysis of patients who underwent arthroscopic rotator cuff repair with concurrent glenohumeral osteoarthritis between 2010-2017.Patients were stratified based on rotator cuff tear size and glenohumeral osteoarthritis severity.Cohorts were paired 1:1 with patients without glenohumeral osteoarthritis.Patients included had a minimum two year follow-up.Rate of conversion to total shoulder arthroplasty,complication rates following initial surgery,and patient-reported outcome measures were collected.RESULTS A total of 142 patients were included.The number of patients that required total shoulder arthroplasty within two years after index surgery was low.2/71(2.8%) patients with GHOA,and 1/71(1.4%) without GHOA.Following rotator cuff repair,both groups showed favorable patientreported outcomes.CONCLUSION Patients with glenohumeral osteoarthritis who underwent arthroscopic rotator cuff repair showed comparable outcomes to patients without glenohumeral osteoarthritis.展开更多
文摘Background: Exposure of the insertion site of the anterior cruciate ligament (ACL) is important for appropriate tunnel placement in ACL reconstruction surgery. However, observing the femoral ACL insertion site via the standard anterolateral portal is sometimes difficult. In this study, we compared views of the femoral ACL insertion site between 30-degree and the 45-degree arthroscopes. Methods: We first inserted the 30-degree and the 45-degree arthroscope into the anterolateral portal of a knee simulator in which we had drawn a lattice pattern on the lateral intercondylar notch based on the quadrant method. Next, we compared the arthroscopic views provided by the 30-degree and 45-degree arthroscopes during ACL reconstruction surgery by measuring the area of the lateral intercondylar notch visible through each of the arthroscopes. Results: In the knee simulator, the 45-degree arthroscope showed the entire area of the lateral intercondylar notch, whereas the 30-degree arthroscope had to be introduced more deeply to show the most superior and posterior quadrant, where the attachment of the anteromedial bundle of ACL is located. During the ACL reconstruction, the area of the lateral intercondylar notch in the field of view was larger through the 45-degree arthroscope than through the 30-degree arthroscope. Conclusion: The 45-degree arthroscope provides a better view of the femoral ACL insertion site via the anterolateral portal, which may be helpful during ACL reconstruction.
文摘BACKGROUND Rotator cuff tears are a chief cause of shoulder pain and disability,and surgical repair is often required when conservative management fails.As digital health technologies have expanded,especially since the coronavirus disease 2019 pandemic,digitally augmented rehabilitation programs emerged as a potential alternative to conventional physical therapy.AIM To determine if digitally assisted rehabilitation could be as practical,or even more effective,than the traditional methods most patients currently follow.METHODS Six electronic databases,including PubMed,Scopus,Cochrane Library,Google Scholar,EMBASE,and Web of Science,were searched to find articles that compare digital-based rehabilitation and conventional treatment.Outcomes of interest were Disabilities of the Arm,Shoulder and Hand(DASH)score and range of motion.The quality assessment of the included studies was performed using the risk-of-bias tool for randomized trials tool.RESULTS Three randomized controlled trial studies were enrolled in this study,including 195 cases.We did not find any significant differences between the two groups in terms of DASH score,flexion range of motion,and external rotation range of motion.There was a significant difference between the two groups for abduction range of motion.CONCLUSION Digital home-based rehab seems to be a strong alternative to traditional methods,offering similar results for people recovering from rotator cuff surgery.This approach might also make rehab more accessible and engaging for patients.That said,further research is needed to fully understand the potential of digital rehabilitation and ensure it works effectively for everyone.
文摘Rotator cuff tears are highly prevalent,and there is an urgent need to understand their healing mechanisms to improve treatment outcomes for patients.This editorial aims to summarize the roles and limitations of common animal models(including rodents,rabbits,sheep,dogs,and primates)and second-look arthroscopy in rotator cuff healing research.Different animal models offer distinct advantages and disadvantages.For example,rodent models are cost-effective and suitable for genetic studies but have anatomical differences from humans.Rabbit models are favored for their relatively large tendon size and ease of surgical manipulation,yet they still deviate from human shoulder anatomy in some aspects.Larger animals like sheep and dogs have more similar shoulder structures to humans but come with high costs and challenges in maintaining consistent experimental conditions.Second-look arthroscopic studies have provided evidence for the effectiveness of current surgical techniques.Animal models will continue to play a crucial role in further exploring the local microenvironment of the rotator cuff,which is expected to help develop more effective strategies to promote healing.
文摘To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months （range 12-30 months）. The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation （P〈0. 01）, the total excellent and fine rate was 91.86%. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.
基金the Korea Health Technology R&D Project through the National Research Foundation of Korea(NRF)grant funded by the Korea government,No.NRF-2017R1C1B5017705。
文摘BACKGROUND Osteochondral lesion of talus is a broad term used to describe an injury or abnormality of the talar articular cartilage and adjacent bone.It arises from diverse causes,and although trauma is implicated in many cases,it does not account for the etiology of every lesion.Gout is a chronic arthritic disease caused by excess levels of uric acid in blood.Intraosseous deposition of monosodium urate in the clavicle,femur,patella and calcaneus was reported previously.Gout is common disease but rare at a young age,especially during teenage years.Osteochondral lesion caused by intra-articular gouty invasion is very rare.CASE SUMMARY We encountered a rare case of a 16-year-old male who has osteochondral lesion of the talus(OLT)with gout.He had fluctuating pain for more than 2 years.We could see intra-articular tophi with magnetic resonance image(MRI)and arthroscopy.We performed arthroscopic exploration,debridement and microfracture.Symptoms were resolved after operation,and bony coverage at the lesion was seen on postoperative images.We had checked image and uric acid levels for 18 mo.CONCLUSION It is rare to see OLT with gouty tophi in young adults.While it is challenging,the accuracy of diagnosis can be improved through history taking,MRI and arthroscopy.
文摘Objective: To analyze postoperative therapeutic effects of patients with fractured anterior cruciate ligament (ACL) that underwent autologous tendon reconstruction at early and late period. Methods: A total of 60 patients underwent autologous tendon reconstruction were enrolled and retrospectively analyzed via arthroscopes from December, 2015 to December, 2017 in our hospital, in which 30 patients treated with ACL reconstruction within 6 weeks of injury were selected as the early reconstruction group (Group A), and the other 30 cases with ACL reconstruction between 6 weeks and 6 months were as late reconstruction group (Group B);the therapeutic effect of early and late ACL reconstruction was analyzed by recording and comparing of several indexes, such as knee lysholm score, knee IKDC score, intraoperative hemorrhage, operation time, pre- and post-operative range of motion (ROM) of the knee, etc. Results: The pre- and post-operative lysholm scores and IKDC scores were compared between the two groups, without statistically significant results (P > 0.05). The knee ROM scores of the late reconstruction group were higher than those of the early group (P < 0.05), and the intraoperative blood loss in the late stage was less than that in the early group (P < 0.05), which exhibits that the short-term clinical efficacy of early and late arthroscopic autologous tendon reconstruction for knee ACL injury was similar, but the late reconstruction group was with less intraoperative bleeding, and better postoperative joint mobility recovery;in conclusion, it is recommended that patients can be operated between 6 weeks and 6 months after injury.
文摘Frozen shoulder is a common disease which causes significant morbidity. Despite over a hundred years of treating this condition the definition, diagnosis, pathology and most efficacious treatments are still largely unclear. This systematic review of current treatments for frozen shoulder reviews the evidence base behind physiotherapy, both oral and intra articular steroid, hydrodilatation, manipulation under anaesthesia and arthroscopic capsular release. Key areas in which future research could be directed are identified, in particular with regard to the increasing role of arthroscopic capsular release as a treatment.
文摘Treatment options for meniscal tears fall into three broad categories;non-operative,meniscectomy or meniscal repair.Selecting the most appropriate treatment for a given patient involves both patient factors(e.g.,age,co-morbidities and compliance)and tear characteristics(e.g.,location of tear/age/reducibility of tear).There is evidence suggesting that degenerative tears in older patients without mechanical symptoms can be effectively treated non-operatively with a structured physical therapy programme as a first line.Even if these patients later require meniscectomy they will still achieve similar functional outcomes than if they had initially been treated surgically.Partial meniscectomy is suitable for symptomatic tears not amenable to repair,and can still preserve meniscal function especially when the peripheral meniscal rim is intact.Meniscal repair shows 80%success at 2 years and is more suitable in younger patients with reducible tears that are peripheral(e.g.,nearer the capsular attachment)and horizontal or longitudinal in nature.However,careful patient selection and repair technique is required with good compliance to post-operative rehabilitation,which often consists of bracing and non-weight bearing for 4-6 wk.
基金Shanghai Jing'an District Health Research Project,China,No.2018MS09.
文摘BACKGROUND Arthroscopic debridement is a mature treatment for knee osteoarthritis(KOA).Due to the differences in the research subjects,methods,and efficacy evaluation indexes,there are great differences in the surgical efficacy reported in the literature.AIM To compare the medium-term efficacy of arthroscopic debridement and conservative treatment for KOA of Kellgren-Lawrence grades I-III.METHODS Patients with KOA of Kellgren-Lawrence grades I-III who were admitted to the orthopedic clinic of our hospital from July 2018 to December 2018 and agreed to undergo arthroscopic surgery were included in an arthroscopic debridement group,and those who refused surgical treatment were included in a conservative treatment group.Gender,age,body mass index(BMI),side of KOA,American hospital for special surgery knee score(HSS score)before treatment,visual analogue scale(VAS)score during walking and rest before treatment,conservative treatment content,and surgical procedure were recorded.Outpatient visits were conducted at the 1st,3rd,6th,12th,and 24th mo after treatment in the two groups.The changes of HSS score and VAS score in each group before and after treatment were statistically analyzed,and the differences of HSS score and VAS score in different treatment stages between the two groups were also compared.RESULTS In the conservative treatment group,there were 80 patients with complete followup data,including 20 males and 60 females,aged 58.75±14.66 years old.And in the knee arthroscopic debridement group,there were 98 patients with complete follow-up data,including 24 males and 74 females,aged 59.27±14.48 years old.There was no statistically significant difference in the general data(gender,age,BMI,side of KOA,Kellgren-Lawrence grade distribution,HSS score,and VAS score)between the two groups before treatment.The HSS scores of the conservative treatment group at the 1st,3rd,6th,12th,and 24th mo after treatment were significantly higher than that before treatment(P<0.05).There was no statistical difference in HSS score of the conservative treatment group among the 1st,3rd,6th,12th,and 24th mo(P>0.05).The HSS score of the knee arthroscopic debridement group at the 1st mo after surgery was significantly higher than that before surgery(P<0.05).HSS scores of the knee arthroscopic debridement group at the 3rd,6th,12th,and 24th mo were significantly higher than those before surgery and at the 1st mo after surgery(P<0.05).There were no statistically significant differences in HSS scores at the 3rd,6th,12th,and 24th mo after surgery(P>0.05).HSS scores at the 3rd,6th,12th,and 24th mo were significantly higher in the arthroscopic debridement group than in the conservative treatment group(P<0.05).There was no statistical difference in HSS scores between the two groups before treatment and at the 1st mo of follow-up(P>0.05).VAS scores during walking and rest were significantly decreased in both groups,and the VAS score during rest was significantly lower in the arthroscopic debridement group than in the conservative treatment group,but there was no significant difference in the VAS score during walking between the two groups after treatment.CONCLUSION Compared with conservative treatment,arthroscopic debridement can significantly improve the knee resting pain and knee functional status of patients with KOA of Kellgren-Lawrence grades I-III within 2 years after treatment.
文摘A direct force on the superior aspect of the shoulder may cause acromioclavicular(AC) dislocation or separation. Severe dislocations can lead to chronic impairment, especially in the athlete and high-demand manual laborer. The dislocation is classified according to Rockwood. Types Ⅰ?and Ⅱ are treated nonoperatively, while types Ⅳ, Ⅴ and Ⅵ are generally treated operatively. Controversy exists regarding the optimal treatment of type Ⅲ dislocations in the high-demand patient. Recent evidence suggests that these should be treated nonoperatively initially. Classic surgical techniques were associated with high complication rates, including recurrent dislocations and hardware breakage. In recent years, many new techniques have been introduced in order to improve the outcomes. Arthroscopic reconstruction or repair techniques have promising short-term results. This article aims to provide a current concepts review on the treatment of AC dislocations with emphasis on recent developments.
文摘AIM To compare the results of arthroscopic capsular release with intra-articular steroid injections in patients of frozen shoulder.METHODS Fifty-six patients with frozen shoulder were randomised to one of two treatment groups: Group 1, complete 360 degree arthroscopic capsular release and group 2, intra-articular corticosteroid injection(40 mg methyl prednisolone acetate). Both groups were put on active and passive range of motion exercises following the intervention. The outcome parameters were visual analogue scale(VAS) score for pain, range of motion and Constant score which were measured at baseline, 4, 8, 12, 16 and 20 wk after intervention.RESULTS All the parameters improved in both the groups. The mean VAS score improved significantly more in the group 1 as compared to group 2 at 8 wk. This greater improvement was maintained at 20 wk with P value of 0.007 at 8 wk, 0.006 at 12 wk, 0.006 at 16 wk and 0.019 at 20 wk. The Constant score showed a more significant improvement in group 1 compared to group 2 at 4 wk, which was again maintained at 20 wk with P value of 0.01 at 4, 8, 12 and 16 wk. The gain in abduction movement was statistically significantly more in arthroscopy group with P value of 0.001 at 4, 8, 12, 16 wk and 0.005 at 20 wk. The gain in external rotation was statistically significantly more in arthroscopy group with P value of 0.007 at 4 wk, 0.001 at 8, 12, and 16 wk and 0.003 at 20 wk. There was no statistically significant difference in extension and internal rotation between the two groups at any time. CONCLUSION Arthroscopic capsular release provides subjective and objective improvement earlier than intra-articular steroid injection.
文摘Arthroscopic surgery of the posterior compartment ofthe knee is difficult when only two anterior portals are used for access because of the inaccessibility of the back of the knee. Since its introduction, the posterior transseptal portal has been widely employed to access lesions in the posterior compartment. However, special care should be taken to avoid neurovascular injuries around the posteromedial, posterolateral, and transseptal portals. Most importantly, popliteal vessel injury should be avoided when creating and using the transseptal portal during surgery. Purpose of the present study is to describe how to avoid the neurovascular injuries during establishing the posterior three portals and to introduce our safer technique to create the transseptal portal. To date, we have performed arthroscopic surgeries via the transseptal portal in the posterior compartments of 161 knees and have not encountered nerve or vascular injury. In our procedure, the posterior septum is perforated with a 1.5-3.0-mm Kirschner wire that is protected by a sheath inserted from the posterolateral portal and monitored from the posteromedial portal to avoid popliteal vessel injury.
基金the National Natural Science Foundation of China,No.82274547the Major Program of the National Natural Science Foundation of Zhejiang Province,No.LD22C060002+1 种基金the State Administration of Traditional Chinese Medicine of Zhejiang Province,No.GZY-ZJ-KJ-23064the Zhejiang Provincial Research Foundation for Basic Public Welfare Research,No.LGF20H270005.
文摘BACKGROUND Osteoarthritis(OA)is the most prevalent form of degenerative whole-joint disease.Before the final option of knee replacement,arthroscopic surgery was the most widely used joint-preserving surgical treatment.Emerging regenerative therapies,such as those involving platelet-rich plasma,mesenchymal stem cells,and microfragmented adipose tissue(MFAT),have been pushed to the forefront of treatment to prevent the progression of OA.Currently,MFAT has been successfully applied to treat different types of orthopedic diseases.AIM To assess the efficacy and safety of MFAT with arthroscopic surgery in patients with knee OA(KOA).METHODS A randomized,multicenter study was conducted between June 2017 and November 2022 in 10 hospitals in Zhejiang,China.Overall,302 patients diagnosed with KOA(Kellgren-Lawrence grades 2-3)were randomized to the MFAT group(n=151,were administered MFAT following arthroscopic surgery),or the control group(n=151,were administered hyaluronic acid following arthroscopic surgery).The study outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score,the visual analog scale(VAS)score,the Lequesne index score,the Whole-Organ Magnetic Resonance Imaging Score(WORMS),and safety over a 24-mo period from baseline.RESULTS The changes in the WOMAC score(including the three subscale scores),VAS pain score,and Lequesne index score at the 24-mo mark were significantly different in the MFAT and control groups,as well as when comparing values at the posttreatment visit and those at baseline(P<0.001).The MFAT group consistently demonstrated significant decreases in the WOMAC pain scores and VAS scores at all follow-ups compared to the control group(P<0.05).Furthermore,the WOMAC stiffness score,WOMAC function score,and Lequesne index score differed significantly between the groups at 12 and 24 mo(P<0.05).However,no signicant between-group differences were observed in the WORMS at 24 mo(P=0.367).No serious adverse events occurred in both groups.CONCLUSION The MFAT injection combined with arthroscopic surgery treatment group showed better mid-term clinical outcomes compared to the control group,suggesting its efficacy as a therapeutic approach for patients with KOA.
文摘BACKGROUND The critical shoulder angle(CSA)is a radiographic measurement that provides an assessment of both glenoid inclination and acromial length.Higher values may correlate with the presence of rotator cuff tears.However,it is difficult to obtain a high-quality true anteroposterior(AP)radiograph of the shoulder,with any excess scapular version or flexion/extension resulting in deviation from the true CSA value.Three-dimensional(3D)bony reconstructions of computed tomography(CT)shoulder scans may be able to be rotated to obtain a similar view to that of true AP radiographs.AIM To compare CSA measurements performed on 3D bony CT reconstructions,with those on corresponding true AP radiographs.METHODS CT shoulder scans were matched with true AP radiographs that were classified as either Suter-Henninger type A or C quality.3D bony reconstructions were segmented from the CT scans,and rotated to replicate an ideal true AP view.Two observers performed CSA measurements using both CT and radiographic images.Measurements were repeated after a one week interval.Reliability was assessed using intraclass correlation coefficients(ICCs)and Bland-Altman plots[bias,limits of agreement(LOA)].RESULTS Twenty CT shoulder scans were matched.The mean CSA values were 32.55°(±4.26°)with radiographs and 29.82°(±3.49°)with the CT-based method[mean difference 2.73°(±2.86°);P<0.001;bias+2.73°;LOA-2.17°to+7.63°].There was a strong correlation between the two methods(r=0.748;P<0.001).Intra-observer reliability was similar,but the best intra-observer values were achieved by the most experienced observer using the CT-based method[ICC:0.983(0.958-0.993);bias+0.03°,LOA-1.28°to+1.34°].Inter-observer reliability was better with the CT-based method[ICC:0.897(0.758-0.958),bias+0.24°,LOA-2.93°to+3.41°].CONCLUSION The described CT-based method may be a suitable alternative for critical shoulder angle measurement,as it overcomes the difficulty in obtaining a true AP radiographic view.
基金Supported by the Natural Science Foundation of Jilin Province,No.20200201536JC.
文摘BACKGROUND Synovial chondromatosis is a disease originating from the synovium and characterized by the presence of metaplastic cartilaginous nodules in synovial cavities.The exact prevalence of synovial chondromatosis remains unknown,and the involvement of the shoulder joint is very rare.Synovial chondromatosis accompanied by subluxation of the humeral head without a history of trauma is rarely encountered,and to our knowledge,no published reports describe this condition.CASE SUMMARY We present two cases of synovial chondromatosis in the shoulder joint,accompanied by subluxation of the humeral head,in two arthroscopically managed adult patients.We performed arthroscopic labrum fixation and removal of the loose body from the shoulder joint.To identify primary and secondary categories,pathological analysis was arranged.Clinical and radiographic evaluations at the 1-mo follow-up were satisfactory.CONCLUSION The biomechanical function of the shoulder joint requires attention,especially following the detection of loose bodies,as observed with synovial chondroma occurring in rare sites.Arthroscopic management is successful in patients with synovial chondromatosis combined with shoulder subluxation.
文摘BACKGROUND Osteoarthritis(OA)is the most common cause of pain and disability,predominantly affecting the knee.The current management of knee OA falls short of completely stopping disease progression,particularly in Kellgren-Lawrence(KL)grade 3 and 4 knee OA.As such,joint replacement is often recommended,although only 15%-33%of candidates accept it.Alternative therapeutic options are still needed to prevent the progression of joint damage and delay the need for knee arthroplasty.AIM To investigate the effect of adjunctive platelet rich plasma(PRP)and hyaluronic acid(HA)after arthroscopic debridement in KL grade 3 and 4 knee OA.METHODS This retrospective cohort study used the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score and WOMAC sub-scores(pain,stiffness,and function)to assess 21 patients,grouped according to medical record data of treatment received:Arthroscopic debridement(n=7);arthroscopic debridement with PRP(n=7);or arthroscopic debridement with HA(n=7).WOMAC scores and sub-scores at baseline and at 3 mo and 5 mo posttreatment were recorded.The three-group data were statistically analyzed using the tests of paired t,one-way analysis of variance,and post hoc least significant difference.RESULTS All three treatment groups showed significant improvements in WOMAC score and sub-scores from before treatment to 3 mo and 5 mo after treatment.However,the arthroscopic debridement with PRP treatment group,in particular,showed a significantly lower WOMAC pain score than the group who received arthroscopic debridement alone at 5 mo after the procedure(P=0.03).CONCLUSION Compared to arthroscopic debridement alone,adjunctive PRP after arthroscopic debridement significantly lessened the patients’pain symptom.
文摘BACKGROUND Tibial avulsion fractures of the posterior cruciate ligament(PCL)are challenging to treat and compromise knee stability and function.Traditional open surgery often requires extensive soft tissue dissection,which may increase the risk of morbidity.In response to these concerns,arthroscopic techniques have been evolving.The aim of this study was to introduce a modified arthroscopic tech-nique utilizing an M-shaped suture fixation method for the treatment of tibial avulsion fractures of the PCL and to evaluate its outcomes through a case series.AIM To evaluate the effects of arthroscopic M-shaped suture fixation on treating tibia avulsion fractures of the PCL.METHODS We developed a modified arthroscopic M-shaped suture fixation technique for tibia avulsion fractures of the PCL.This case series included 18 patients who underwent the procedure between January 2021 and December 2022.The patients were assessed for range of motion(ROM),Lysholm score and International knee documentation committee(IKDC)score.Postoperative complications were also recorded.RESULTS The patients were followed for a mean of 13.83±2.33 months.All patients showed radiographic union.At the final follow-up,all patients had full ROM and a negative posterior drawer test.The mean Lysholm score significantly improved from 45.28±8.92 preoperatively to 91.83±4.18 at the final follow-up(P<0.001),and the mean IKDC score improved from 41.98±6.06 preoperatively to 90.89±5.32 at the final follow-up(P<0.001).CONCLUSION The modified arthroscopic M-shaped suture fixation technique is a reliable and effective treatment for tibia avulsion fractures of the PCL,with excellent fracture healing and functional recovery.
文摘BACKGROUND Rotator cuff pathology is a very common source of shoulder pain.Similarly,osteoarthritis of the glenohumeral joint can cause shoulder pain and produce similar symptoms.Surgical management can be indicated for both pathologies,however,outcomes data is limited when examining rotator cuff repair(RCR) in the setting of glenohumeral arthritis(GHOA).Thus,this study sought to determine outcomes for patients who undergo RCR in the setting of GHOA.AIM To evaluate if a relationship exists between outcomes of RCR in the setting of GHOA.METHODS This was a retrospective analysis of patients who underwent arthroscopic rotator cuff repair with concurrent glenohumeral osteoarthritis between 2010-2017.Patients were stratified based on rotator cuff tear size and glenohumeral osteoarthritis severity.Cohorts were paired 1:1 with patients without glenohumeral osteoarthritis.Patients included had a minimum two year follow-up.Rate of conversion to total shoulder arthroplasty,complication rates following initial surgery,and patient-reported outcome measures were collected.RESULTS A total of 142 patients were included.The number of patients that required total shoulder arthroplasty within two years after index surgery was low.2/71(2.8%) patients with GHOA,and 1/71(1.4%) without GHOA.Following rotator cuff repair,both groups showed favorable patientreported outcomes.CONCLUSION Patients with glenohumeral osteoarthritis who underwent arthroscopic rotator cuff repair showed comparable outcomes to patients without glenohumeral osteoarthritis.
