Osteoporosis is a known risk factor for rotator cuff tears(RCTs),but the causal correlation and underlying mechanisms remain unclear.This study aims to evaluate the impact of osteoporosis on RCT risk and investigate t...Osteoporosis is a known risk factor for rotator cuff tears(RCTs),but the causal correlation and underlying mechanisms remain unclear.This study aims to evaluate the impact of osteoporosis on RCT risk and investigate their genetic associations.Using data from the UK Biobank(n=457871),cross-sectional analyses demonstrated that osteoporosis was significantly associated with an increased risk of RCTs(adjusted OR[95%CI]=1.38[1.25–1.52]).A longitudinal analysis of a subset of patients(n=268117)over 11 years revealed that osteoporosis increased the risk of RCTs(adjusted HR[95%CI]=1.56[1.29–1.87]),which is notably varied between sexes in sex-stratified analysis.Causal inference methods,including propensity score matching,inverse probability weighting,causal random forest and survival random forest models further confirmed the causal effect,both from cross-sectional and longitudinal perspectives.展开更多
BACKGROUND Shoulder arthroscopy is commonly used for the repair of glenohumeral ligament avulsions or tendon tears.The success of the operation depends on the ability of the ligaments or rotator cuff tendon to heal to...BACKGROUND Shoulder arthroscopy is commonly used for the repair of glenohumeral ligament avulsions or tendon tears.The success of the operation depends on the ability of the ligaments or rotator cuff tendon to heal to their original attachment site.Soft tissue healing can be evaluated with imaging methods or alternatively with second-look arthroscopy.AIM To investigate shoulder tendon and capsule healing after arthroscopic rotator cuff and instability repair using second-look arthroscopy.METHODS In this study,24 adult patients with rotator cuff tears(13 patients)or anterior shoulder instability(11 patients)were included.All patients were initially subjected to arthroscopic repair using suture anchors and were re-evaluated with second-look arthroscopy for reasons not related to the original pathology.The second operation was performed in 8 patients due to mild but persistent pain or stiffness,in 3 patients for recalcitrant stiffness,in 5 patients for secondary biceps tenotomy,in 6 patients for persistent acromioclavicular joint pain and in 2 patients for suture anchor prominence causing shoulder grinding.Soft tissue healing was evaluated visually and by probing,whereas clinical outcomes were evaluated using the University of California–Los Angeles(UCLA)and Rowe rating scales.RESULTS In almost all patients,complete soft tissue healing occurred at the site of tissue reattachment,either on the glenoid articular surface or the greater humeral tuberosity.The strongest repair,as confirmed by probe palpation,was encountered at the site of suture passage through the soft tissue.All suture material was covered with bursal synovial tissue,with no cases of knot impingement or cartilage fraying.The mean preoperative and postoperative UCLA scores for rotator cuff repair patients were 1354±3205 and 2931±2898,respectively(P<0.001),whereas for shoulder instability patients,the mean Rowe scores preoperatively and postoperatively were 2591±1338 and 9272±754,respectively(P<0.001).The use of bioabsorbable implants did not cause synovitis or other tissue reactions.CONCLUSION Soft tissue healing in the shoulder is successful and strongest at the site of suture anchor placement.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
BACKGROUND Long head of biceps tendon(LHBT)transposition is a novel technique based on the double-row suture bridge method,utilizing autologous reconstruction to treat massive rotator cuff tears.AIM To evaluate the mi...BACKGROUND Long head of biceps tendon(LHBT)transposition is a novel technique based on the double-row suture bridge method,utilizing autologous reconstruction to treat massive rotator cuff tears.AIM To evaluate the mid-to-long-term clinical outcomes following the double-row repair method for massive rotator cuff tears.METHODS This retrospective analysis included data from 53 patients with massive rotator cuff tears treated at our hospital between 2020 and 2021.The patients were divided into the double-row repair group(conventional group)and the doublerow repair combined with the LHBT transposition group(transposition group).Postoperative pain was assessed using the visual analogue scale at one week,one year,and the final follow-up.Shoulder function was evaluated using the American Shoulder and Elbow Surgeons and Constant-Murley scores at one year and the final follow-up.Rotator cuff healing was assessed postoperatively for one year using the Sugaya classification,which categorizes tendon integrity based on magnetic resonance imaging findings.RESULTS No perioperative complications were observed in any of the patients at any time.There were no significant differences between the groups regarding operative time and intraoperative blood loss.The transposition group had significantly lower visual analogue scale scores than the conventional group at one week postoperatively;however,there were no significant differences between the groups at one year or the final follow-up.At one year postoperatively,the transposition group showed significantly higher American Shoulder and Elbow Surgeons and Constant-Murley scores than the conventional group;no significant differences were observed at the final followup.There were no significant differences in rotator cuff healing between the groups at one year postoperatively.CONCLUSION Compared to double-row repair alone,double-row repair combined with LHBT transposition for treating massive rotator cuff tears more effectively alleviates short-term postoperative pain and improves shoulder function within the first year.展开更多
BACKGROUND Sub-acromial injections are a therapeutic option for rotator cuff injuries;however,evidence regarding the most effective drug in this context is unclear,which needs to be investigated.AIM To evaluate the ef...BACKGROUND Sub-acromial injections are a therapeutic option for rotator cuff injuries;however,evidence regarding the most effective drug in this context is unclear,which needs to be investigated.AIM To evaluate the effectiveness of various sub-acromial injections for rotator cuff injuries.METHODS We conducted a systematic review and pair-wise and network meta-analyses of randomized clinical trials(RCTs)comparing sub-acromial injections for rotator cuff injuries.The interventions evaluated were hyaluronic acid(HA),platelet-rich plasma(PRP),prolotherapy,and corticosteroids.The outcomes of interest were pain and functional improvement,which were evaluated with standardized scores.The Risk of Bias 2 tool and the Grading of Recommendations,Assessment,Development and Evaluation methodology were used to assess data quality.RESULTS Twenty RCTs,comprising 1479 participants,were included.In the short term,HA achieved the best outcomes[pain mean difference(MD)=-1.48,95%confidence interval(CI)-2.37 to-0.59;function MD=10.18,95%CI:4.96-15.41].In the medium term,HA,PRP,HA+PRP,and corticosteroids were not superior to placebo in improving pain.Based on function,HA+PRP was superior to placebo,corticosteroids,and PRP(MD=26.72;95%CI:8.02-45.41).In the long term,HA,PRP,and corticosteroids were not superior to placebo in reducing pain.However,based on function,HA+PRP,PRP,and HA were superior to placebo,and HA+PRP had the best result(MD=36.64;95%CI:31.66-33.62).CONCLUSION HA provides satisfactory short-term results,while HA with PRP demonstrates functional improvement in the medium and long terms.However,no intervention maintained the pain-relief effect on>3-month follow-up.展开更多
BACKGROUND Despite laparoscopic total hysterectomy provided more benefits to patients and has become one of the most commonly used surgical methods for total hysterectomy.However,vaginal cuff dehiscence is a serious c...BACKGROUND Despite laparoscopic total hysterectomy provided more benefits to patients and has become one of the most commonly used surgical methods for total hysterectomy.However,vaginal cuff dehiscence is a serious complication after laparoscopic total hysterectomy and so far,there are limited studies on vaginal cuff dehiscence after a total hysterectomy.AIM To investigate the factors influencing vaginal cuff dehiscence after laparoscopic hysterectomy and the psychological state of the patients.METHODS This study retrospectively,univariately,and multivariately analyzed the clinical data of patients who experienced vaginal cuff dehiscence after laparoscopic hysterectomy in Yuyao People’s Hospital from January 2015 to December 2021.Logistic regression was utilized to analyze the high-risk factors of vaginal cuff dehiscence.RESULTS Among 1459 cases with laparoscopic hysterectomy,9 reported vaginal cuff dehiscence postoperatively,with an incidence of 0.617%.Univariate logistic regression analysis revealed that preoperative hemoglobin value[odds ratio(OR)=5.12,P=0.016],vaginal cuff suture method(OR=0.26,P=0.048),and postoperative first sexual lifetime(OR=15.86,P=0.002)were associated with vaginal cuff dehiscence following laparoscopic hysterectomy.Multivariate logistic regression analysis revealed that preoperative hemoglobin value of<90 g/L(OR=5.17,P=0.015)and time interval between postoperative first sexual life and operation of<3 months(OR=54.00,P=0.004)are independent risk factors for vaginal cuff dehiscence after laparoscopic hysterectomy.CONCLUSION Postoperative hemoglobin and the time interval between postoperative first sexual life and operation were the independent factors of developing vaginal cuff dehiscence after laparoscopic hysterectomy.展开更多
BACKGROUND Massive rotator cuff tears(RCTs)result in impaired shoulder function and quality of life.These tears lead to structural changes in the rotator cuff muscles,which compromise recovery after repair and increas...BACKGROUND Massive rotator cuff tears(RCTs)result in impaired shoulder function and quality of life.These tears lead to structural changes in the rotator cuff muscles,which compromise recovery after repair and increase re-tear rates.AIM To investigate the potential inhibitory effects of alpha-tocopherol(vitamin E)and OTR-4131 on muscle atrophy,fatty infiltration,and fibrosis in rotator cuff muscles following a massive RCT using a Wistar rat model,and establish a standardized methodology for evaluating potential therapeutic agents.METHODS This protocol outlines a controlled animal study using 40 male Wistar rats,randomized into five groups.The experimental groups will receive either systemic administration of alpha-tocopherol or local administration of OTR-4131 via intramuscular injection into the supraspinatus and infraspinatus muscles.Two sham groups will receive systemic and local saline injections respectively,while a control group will undergo no intervention.The interventions will be administered after surgical transection of the supraspinatus and infraspinatus tendons.Outcomes will be assessed via wet muscle weight measurements,muscle fiber diameter,fatty infiltration percentage,and fibrosis evaluation using histological methods.RESULTS The study anticipates that alpha-tocopherol and OTR-4131 will reduce muscle atrophy,fatty infiltration,and fibrosis compared to control and sham groups,supporting their potential protective role in rotator cuff muscle degeneration.CONCLUSION The results are expected to improve the understanding on the role of alpha-tocopherol and OTR-4131 in rotator cuff muscle protection after massive RCT and may serve as a foundation for further preclinical and clinical research aimed at improving rotator cuff repair outcomes.展开更多
Background:Rehabilitation typically restores shoulder function after a common rotator cuff repair;however,it is unclear when to initiate physical therapy(PT)post-surgery.To understand effective start times,this study ...Background:Rehabilitation typically restores shoulder function after a common rotator cuff repair;however,it is unclear when to initiate physical therapy(PT)post-surgery.To understand effective start times,this study analyzed PT start times and their effect on shoulder function.The most effective shoulder outcomes were hypothesized to occur when PT started 0-4 weeks post-surgery.Methods:Data from 1002 patients who underwent rotator cuff repair were analyzed retrospectively from 52 outpatient clinics in the years of 2016-2021.The primary data of timings between surgery and the start of PT(0-2 weeks[0-14 days],2-4 weeks[15-28 days],4-6 weeks[29-42 days],and 6-14 weeks[43-100 days]),change in functional shoulder scores,number of PT visits utilized,and functional scores changed per visit were analyzed.Regression analyses of the impact of age,sex,payor source,and tear size were completed.Results:The change in functional scores and functional scores changed per visit are not affected by the initiation timing of PT postrotator cuff surgery,when controlling for baseline functional scores.This result is revealed despite initial functional scores being significantly different.Functional scores change per visit may have been affected by payor source(R^(2)=0.004,p≤0.010).PT start times may have been impacted by age(R^(2)=0.010,p=0.007),payor source(R^(2)=0.016,p=0.001),and tear size(R^(2)=0.007,p=0.026).Payor source may have influenced the number of PT visits(R^(2)=0.060,p<0.001).Conclusions:After rotator cuff surgery,patients should choose to complete rehabilitation to optimize shoulder function.However,the initiation timing of PT may not affect functional shoulder outcomes.展开更多
Objective:The aim of this study was to find the optimal force that should be applied to control urine leakage using a non-hydraulic cuff design,and to investigate the relationship between the number of cuffs used in u...Objective:The aim of this study was to find the optimal force that should be applied to control urine leakage using a non-hydraulic cuff design,and to investigate the relationship between the number of cuffs used in urinary control and the change in demand force.Method:In this study,five sheep bladders were used to design and build a biomechanical evaluation system.The biomechanical system included the bladder,pressure gauge,pressure regulator system of the bladder,and force application system by the cuff.In this study,we increased the fluid pressure inside the bladder from 0 cmH_(2)O to 200 cmH_(2)O(1 cmH_(2)O=0.098 kPa),and at each point,the force applied by the cuff to prevent fluid leakage was measured and recorded.Results:The study revealed that a mean tensile force of 2.81(standard deviation 0.23)N for a single cuff and 1.63(standard deviation 0.16)N for double cuffs with symmetrical pressure effectively prevented bladder fluid leakage in the pressure range from 75 cmH_(2)O to 100 cmH_(2)O(p<0.001).However,there were no significant differences in results when comparing the applied tensile force required by double cuffs with asymmetric tensile force to that of the single cuff use.Furthermore,using three cuffs instead of two did not yield significantly different outcomes.Conclusion:Using double cuffs with symmetrical pressure had a greater effect compared with a single cuff with the same tensile force.Although multiple cuffs with varying tensile forces were not found to be useful in controlling urine leakage in this study,it is suggested that applying variable forces alternately and rotationally among several cuffs may reduce long-term risks such as atrophy and necrosis.Future in vivo studies are recommended to further evaluate efficiency.展开更多
BACKGROUND Kidney transplantation is increasingly more common due to the ongoing shortage of deceased donors.However,anatomical challenges,such as a short renal artery,can complicate surgical procedures and increase c...BACKGROUND Kidney transplantation is increasingly more common due to the ongoing shortage of deceased donors.However,anatomical challenges,such as a short renal artery,can complicate surgical procedures and increase complication risk,including thrombosis and anastomotic stenosis.To address these issues and optimize graft outcomes,innovative surgical techniques are essential.CASE SUMMARY We present a case of kidney transplantation complicated by a short donor renal artery.To address the discrepancy between arterial length and diameter mismatch,the recipient’s inferior epigastric artery was used as a cuff interposition for arterial reconstruction.Following standard laparoscopic donor nephrectomy,vascular reconstruction was performed on the back table.The use of the inferior epigastric artery as a cuff allowed for successful elongation and size matching of the donor renal artery,enabling a tension-free anastomosis to the recipient’s external iliac artery.Postoperative Doppler ultrasound and angiography confirmed excellent graft perfusion.The patient experienced an uneventful recovery with immediate graft function and maintained stable renal function at 6 months post-transplant.To our knowledge,this is the first reported use of the inferior epigastric artery as a cuff interposition in renal artery reconstruction,offering a novel and effective technique for managing short renal arteries in kidney transplantation.CONCLUSION Interposition of the epigastric artery offers an innovative technique for managing short donor renal arteries,reducing the risk of early thrombosis and long-term complications as size mismatch and intimal hyperplasia.展开更多
Recently,we read a retrospective study by Chen et al,which demonstrated that electroacupuncture is highly effective in relieving pain due to rotator cuff injuries and accelerating the recovery of shoulder function,pro...Recently,we read a retrospective study by Chen et al,which demonstrated that electroacupuncture is highly effective in relieving pain due to rotator cuff injuries and accelerating the recovery of shoulder function,promoting repair of rotator cuff injuries.This study provides a new way to the conservative treatment of early rotator cuff injuries.In the present letter,we review the current treatment of rotator cuff injury with electroacupuncture combined with rehabilitation techniques and propose our views.展开更多
Despite transosseous rotator cuff tear repair using sutures is widely accepted for tendon-bone fixation,the fibrocartilaginous enthesis regeneration is still hardly achieved with the traditional sutures.In the present...Despite transosseous rotator cuff tear repair using sutures is widely accepted for tendon-bone fixation,the fibrocartilaginous enthesis regeneration is still hardly achieved with the traditional sutures.In the present work,degradable magnesium(Mg)alloy wire was applied to suture supraspinatus tendon in a rat acute rotator cuff tear model with Vicryl Plus 4±0 absorbable suture as control.The shoulder joint humerus-supraspinatus tendon complex specimens were retrieved at 4,8,and 12 weeks after operation.The Mg alloy suture groups showed better biomechanical properties in terms of ultimate load to failure.Gross observation showed that hyperplastic response of the scar tissue at the tendon-bone interface is progressively alleviated over time in the both Mg alloy suture and Vicryl suture groups.In the histological analysis,for Mg alloy suture groups,chondrocytes appear to proliferate at 4 weeks postoperatively,and the tendon-bone interface showed an orderly structural transition zone at 8 weeks postoperatively.The collagenous fiber tended to be aligned and the tendon-bone interlocking structures apparently formed,where transitional structure from unmineralized fibrocartilage to mineralized fibrocartilage was closer to the native fibrocartilaginous enthesis.In vivo degradation of the magnesium alloy wire was completed within 12 weeks.The results indicated that Mg alloy wire was promising as degradable suture with the potential to promotes fibrocartilaginous interface regeneration in rotator cuff repair.展开更多
BACKGROUND The rotator cuff is located below the acromion and deltoid muscles and comprises multiple tendons that wrap around the humeral head,maintaining shoulder joint stability.AIM To explore the effect of electroa...BACKGROUND The rotator cuff is located below the acromion and deltoid muscles and comprises multiple tendons that wrap around the humeral head,maintaining shoulder joint stability.AIM To explore the effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries.METHODS We selected 97 patients with rotator cuff injuries treated in the People's Hospital of Yuhuan from February 2020 to May 2023.Patients were grouped using the envelope method.RESULTS After treatment,the study group’s treatment effective rate was 94.90%(46/49 patients),significantly higher than that in the control group(79.17%,38/48 cases;P<0.05).Before treatment,there was no difference in Constant Murley Score(CMS)scores,shoulder mobility,or 36-Item Short Form Health Survey(SF-36)scale scores(P>0.05).Compared with those before treatment,the CMS scores(including pain,daily living ability,shoulder mobility,and muscle strength),all aspects of shoulder mobility(forward flexion,posterior extension,external rotation,internal rotation),and SF-36 scale scores(including physiological,psychological,emotional,physical,vitality,and health status)were higher in both groups after treatment and significantly higher in the study group(P<0.05).There was no difference in the occurrence of complications between the two treatment groups(P>0.05).CONCLUSION Electroacupuncture combined with rehabilitation techniques has a good treatment effect on patients with rotator cuff injuries,helps accelerate the recovery of shoulder function,improves the quality of life,and is highly safe.展开更多
BACKGROUND Arthroscopic rotator cuff repair is a common surgical treatment for rotator cuff injuries(RCIs).Although this procedure has certain clinical advantages,it requires rehabilitation management interventions to...BACKGROUND Arthroscopic rotator cuff repair is a common surgical treatment for rotator cuff injuries(RCIs).Although this procedure has certain clinical advantages,it requires rehabilitation management interventions to ensure therapeutic efficacy.AIM To investigate the effect of integrated traditional Chinese medicine and Western medicine(TCM-WM)under the multidisciplinary team(MDT)model on the postoperative recovery of patients undergoing arthroscopic surgery for RCIs.METHODS This study enrolled 100 patients who underwent arthroscopic rotator cuff repair for RCIs at the Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine between June 2021 and May 2024.They were divided into a control group(n=48)that received routine rehabilitation treatment and an experimental group(n=52)that received TCM-WM under the MDT model(e.g.,acupuncture,TCM traumatology and orthopedics,and rehabilitation).The results of the Constant–Murley Shoulder Score(CMS),Visual Analogue Scale(VAS),Shoulder Pain and Disability Index(SPADI),muscular strength evaluation,and shoulder range of motion(ROM)assessments were analyzed.RESULTS After treatment,the experimental group showed significantly higher CMS scores in terms of pain,functional activity,shoulder joint mobility,and muscular strength than the baseline and those of the control group.The experimental group also exhibited significantly lower VAS and SPADI scores than the baseline and those of the control group.In addition,the experimental group showed significantly enhanced muscular strength(forward flexor and external and internal rotator muscles)and shoulder ROM(forward flexion,abduction,and lateral abduction)after treatment compared with the control group.CONCLUSION TCM-WM under the MDT model improved shoulder joint function,relieved postoperative pain,promoted postoperative functional recovery,and facilitated the recovery of muscular strength and shoulder ROM in patients with RCIs who underwent arthroscopic rotator cuff repair.展开更多
BACKGROUND:Ultrasound guidance is commonly used for accessing difficult peripheral veins.For successful access,a tourniquet is required for venodilation.Tourniquets decrease the compressibility and increase the diamet...BACKGROUND:Ultrasound guidance is commonly used for accessing difficult peripheral veins.For successful access,a tourniquet is required for venodilation.Tourniquets decrease the compressibility and increase the diameter of veins;they also obfuscate artery-vein differentiation on ultrasound.We aimed to establish the upper limit of sphygmomanometer cuff pressure that facilitates artery-vein differentiation during ultrasound-guided peripheral intravenous access.METHODS:We employed the sphygmomanometer cuff as a tourniquet for venodilation and tested it on seven participants at six different levels as follows:0 mmHg,DBP/2,DBP,(DBP+SBP)/2,SBP,and SBP+20 mmHg.We used an ultrasound probe attached to a pressure-measuring instrument to record cross-sectional images of the cubital artery and vein.During ultrasonography,compression was applied to the blood vessels through the skin.The following day,we measured the wrist pulse pressure and observed the oximeter pulse wave at six different tourniquet pressure levels.Repeated-measures analysis of variance(ANOVA)on ranks and Tukey’s post-hoc analysis were used for multiple comparisons.RESULTS:Arterial pulsation was maintained at tourniquet pressures between 0 mmHg and(DBP+SBP)/2.However,arterial pulsation decreased or disappeared when the tourniquet pressure reached or exceeded the SBP.Moreover,at this pressure level,the superior compressibility of veins compared to that of arteries was no longer observed.Compression of the artery to 75% and 50% of its original diameter increased arterial pulsation.CONCLUSION:Arterial pulsation and the superior compressibility are useful indicators for differentiating veins from arteries until the tourniquet pressure reaches(DBP+SBP)/2.However,these indicators are not reliable once the tourniquet pressure exceeds the SBP.展开更多
BACKGROUND Rotator cuff tears and Bankart lesions significantly affect shoulder function and quality of life.Arthroscopic rotator cuff repair and Bankart repair has become the standard treatment for restoring function...BACKGROUND Rotator cuff tears and Bankart lesions significantly affect shoulder function and quality of life.Arthroscopic rotator cuff repair and Bankart repair has become the standard treatment for restoring function and reducing pain.Recent advancements include new suture anchor technologies,such as the Sironix suture anchor known for its biomechanical strength and promising outcomes.However,there are limited real-world data on its effectiveness and safety,particularly in the Indian population.AIM To evaluate the effectiveness and safety of Sironix suture anchors in rotator cuff and Bankart repair surgeries.METHODS Sixty participants underwent surgery between January 2021 and December 2022,and demographic data and postoperative outcomes were collected through retrospective reviews and telephonic interviews.Validated scales,including the PENN Shoulder Score(PSS),Disabilities of the Arm,Shoulder,and Hand(DASH)score,and Single Assessment Numeric Evaluation(SANE),were utilized for assessment.RESULTS Treatment with Sironix suture anchor devices,including Ceptre Knotted UHMWPE Suture Titanium Anchor,Spyke Knotted UHMWPE Suture Peek Anchor,Stativ Knotted UHMWPE Suture Anchor,and Viplok Knotless Peek Screw Anchor with Titanium Tip,revealed no repair failures.Participants demonstrated high satisfaction and functional improvement,as evidenced by the mean Quick DASH score(32.01)and PSS(71.65)and the satisfactory SANE scores for both injured joints(74.33)and non-injured(83.67)shoulder joints.CONCLUSION The study yielded favorable outcomes for rotator cuff tear repair and Bankart repair.No repair failures were observed,supporting the safety and efficacy of these devices in shoulder injury management.展开更多
Objective: To explore the clinical efficacy of shoulder arthroscopic one-knot-two-wire suture bridge technique in the treatment of small and medium-sized rotator cuff tears. Methods: The clinical data of 22 patients w...Objective: To explore the clinical efficacy of shoulder arthroscopic one-knot-two-wire suture bridge technique in the treatment of small and medium-sized rotator cuff tears. Methods: The clinical data of 22 patients with small and medium-sized rotator cuff injuries treated with the one-knot-two-wire suture bridge technique from February 2022 to June 2023 in the Department of Orthopaedics of Jingzhou Hospital Affiliated to Yangtze University were retrospectively analysed, among which 14 cases were male and 8 cases were female;the age ranged from 35 to 68 years old, with an average of (50.86 ± 10.80) years old. All cases underwent an MRI examination of the shoulder joint to understand the type and degree of injury. The duration of the disease ranged from 120 to 166 d, with a mean of (141.23 ± 13.46) d. The evaluation of the operation time, intraoperative bleeding, visual analogue scale (VAS) of pain, Constant-Murley score and Sugaya grading of shoulder MRI were performed at the last follow-up. Results: All 22 patients were followed up for 12 - 18 months, with a mean of (14.68 ± 1.89 d). The operation time was 38 - 58 min, mean (48.18 ± 5.92) min;intraoperative bleeding was 5 - 15 mL, mean (10.00 ± 3.45) mL. All patients achieved normal healing without re-tear, vascular and nerve injury, incision infection, anchor nail loosening and dislodgement and other complications. At the last follow-up, both shoulders were normal in shape and symmetrical on both sides. The VAS score was 0 - 1.2 points, with an average of 0.61 ± 0.42 points, and the Constant-Murley score was 70 - 98 points, with an average of 86.09 ± 8.56 points. The Sugaya classification of MRI examination was 17 cases of grade I, 4 cases of grade II, and 1 case of grade III. Conclusion: One-knot-two-wire suture bridge technique is used for the treatment of small and medium-sized rotator cuff tears with short operative time, low bleeding, and good clinical outcome.展开更多
基金the Scientific Research Innovation Capability Support Project for Young Faculty(ZYGXQNJSKYCXNLZCXM-H8)Fundamental Research Funds for the Central Universities(2024ZYGXZR077)+3 种基金Guangdong Basic and Applied Basic Research Foundation(2023B1515120006)Guangzhou Basic and Applied Basic Research Foundation(2024A04J5776)the Research Fund(2023QN10Y421)Guangzhou Talent Recruitment Team Program(2024D03J0004),all related to this study.
文摘Osteoporosis is a known risk factor for rotator cuff tears(RCTs),but the causal correlation and underlying mechanisms remain unclear.This study aims to evaluate the impact of osteoporosis on RCT risk and investigate their genetic associations.Using data from the UK Biobank(n=457871),cross-sectional analyses demonstrated that osteoporosis was significantly associated with an increased risk of RCTs(adjusted OR[95%CI]=1.38[1.25–1.52]).A longitudinal analysis of a subset of patients(n=268117)over 11 years revealed that osteoporosis increased the risk of RCTs(adjusted HR[95%CI]=1.56[1.29–1.87]),which is notably varied between sexes in sex-stratified analysis.Causal inference methods,including propensity score matching,inverse probability weighting,causal random forest and survival random forest models further confirmed the causal effect,both from cross-sectional and longitudinal perspectives.
文摘BACKGROUND Shoulder arthroscopy is commonly used for the repair of glenohumeral ligament avulsions or tendon tears.The success of the operation depends on the ability of the ligaments or rotator cuff tendon to heal to their original attachment site.Soft tissue healing can be evaluated with imaging methods or alternatively with second-look arthroscopy.AIM To investigate shoulder tendon and capsule healing after arthroscopic rotator cuff and instability repair using second-look arthroscopy.METHODS In this study,24 adult patients with rotator cuff tears(13 patients)or anterior shoulder instability(11 patients)were included.All patients were initially subjected to arthroscopic repair using suture anchors and were re-evaluated with second-look arthroscopy for reasons not related to the original pathology.The second operation was performed in 8 patients due to mild but persistent pain or stiffness,in 3 patients for recalcitrant stiffness,in 5 patients for secondary biceps tenotomy,in 6 patients for persistent acromioclavicular joint pain and in 2 patients for suture anchor prominence causing shoulder grinding.Soft tissue healing was evaluated visually and by probing,whereas clinical outcomes were evaluated using the University of California–Los Angeles(UCLA)and Rowe rating scales.RESULTS In almost all patients,complete soft tissue healing occurred at the site of tissue reattachment,either on the glenoid articular surface or the greater humeral tuberosity.The strongest repair,as confirmed by probe palpation,was encountered at the site of suture passage through the soft tissue.All suture material was covered with bursal synovial tissue,with no cases of knot impingement or cartilage fraying.The mean preoperative and postoperative UCLA scores for rotator cuff repair patients were 1354±3205 and 2931±2898,respectively(P<0.001),whereas for shoulder instability patients,the mean Rowe scores preoperatively and postoperatively were 2591±1338 and 9272±754,respectively(P<0.001).The use of bioabsorbable implants did not cause synovitis or other tissue reactions.CONCLUSION Soft tissue healing in the shoulder is successful and strongest at the site of suture anchor placement.
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.
基金Supported by the General Program of the Hubei Provincial Natural Science Foundation of China Key Project,No.2021CFB520.
文摘BACKGROUND Long head of biceps tendon(LHBT)transposition is a novel technique based on the double-row suture bridge method,utilizing autologous reconstruction to treat massive rotator cuff tears.AIM To evaluate the mid-to-long-term clinical outcomes following the double-row repair method for massive rotator cuff tears.METHODS This retrospective analysis included data from 53 patients with massive rotator cuff tears treated at our hospital between 2020 and 2021.The patients were divided into the double-row repair group(conventional group)and the doublerow repair combined with the LHBT transposition group(transposition group).Postoperative pain was assessed using the visual analogue scale at one week,one year,and the final follow-up.Shoulder function was evaluated using the American Shoulder and Elbow Surgeons and Constant-Murley scores at one year and the final follow-up.Rotator cuff healing was assessed postoperatively for one year using the Sugaya classification,which categorizes tendon integrity based on magnetic resonance imaging findings.RESULTS No perioperative complications were observed in any of the patients at any time.There were no significant differences between the groups regarding operative time and intraoperative blood loss.The transposition group had significantly lower visual analogue scale scores than the conventional group at one week postoperatively;however,there were no significant differences between the groups at one year or the final follow-up.At one year postoperatively,the transposition group showed significantly higher American Shoulder and Elbow Surgeons and Constant-Murley scores than the conventional group;no significant differences were observed at the final followup.There were no significant differences in rotator cuff healing between the groups at one year postoperatively.CONCLUSION Compared to double-row repair alone,double-row repair combined with LHBT transposition for treating massive rotator cuff tears more effectively alleviates short-term postoperative pain and improves shoulder function within the first year.
文摘BACKGROUND Sub-acromial injections are a therapeutic option for rotator cuff injuries;however,evidence regarding the most effective drug in this context is unclear,which needs to be investigated.AIM To evaluate the effectiveness of various sub-acromial injections for rotator cuff injuries.METHODS We conducted a systematic review and pair-wise and network meta-analyses of randomized clinical trials(RCTs)comparing sub-acromial injections for rotator cuff injuries.The interventions evaluated were hyaluronic acid(HA),platelet-rich plasma(PRP),prolotherapy,and corticosteroids.The outcomes of interest were pain and functional improvement,which were evaluated with standardized scores.The Risk of Bias 2 tool and the Grading of Recommendations,Assessment,Development and Evaluation methodology were used to assess data quality.RESULTS Twenty RCTs,comprising 1479 participants,were included.In the short term,HA achieved the best outcomes[pain mean difference(MD)=-1.48,95%confidence interval(CI)-2.37 to-0.59;function MD=10.18,95%CI:4.96-15.41].In the medium term,HA,PRP,HA+PRP,and corticosteroids were not superior to placebo in improving pain.Based on function,HA+PRP was superior to placebo,corticosteroids,and PRP(MD=26.72;95%CI:8.02-45.41).In the long term,HA,PRP,and corticosteroids were not superior to placebo in reducing pain.However,based on function,HA+PRP,PRP,and HA were superior to placebo,and HA+PRP had the best result(MD=36.64;95%CI:31.66-33.62).CONCLUSION HA provides satisfactory short-term results,while HA with PRP demonstrates functional improvement in the medium and long terms.However,no intervention maintained the pain-relief effect on>3-month follow-up.
文摘BACKGROUND Despite laparoscopic total hysterectomy provided more benefits to patients and has become one of the most commonly used surgical methods for total hysterectomy.However,vaginal cuff dehiscence is a serious complication after laparoscopic total hysterectomy and so far,there are limited studies on vaginal cuff dehiscence after a total hysterectomy.AIM To investigate the factors influencing vaginal cuff dehiscence after laparoscopic hysterectomy and the psychological state of the patients.METHODS This study retrospectively,univariately,and multivariately analyzed the clinical data of patients who experienced vaginal cuff dehiscence after laparoscopic hysterectomy in Yuyao People’s Hospital from January 2015 to December 2021.Logistic regression was utilized to analyze the high-risk factors of vaginal cuff dehiscence.RESULTS Among 1459 cases with laparoscopic hysterectomy,9 reported vaginal cuff dehiscence postoperatively,with an incidence of 0.617%.Univariate logistic regression analysis revealed that preoperative hemoglobin value[odds ratio(OR)=5.12,P=0.016],vaginal cuff suture method(OR=0.26,P=0.048),and postoperative first sexual lifetime(OR=15.86,P=0.002)were associated with vaginal cuff dehiscence following laparoscopic hysterectomy.Multivariate logistic regression analysis revealed that preoperative hemoglobin value of<90 g/L(OR=5.17,P=0.015)and time interval between postoperative first sexual life and operation of<3 months(OR=54.00,P=0.004)are independent risk factors for vaginal cuff dehiscence after laparoscopic hysterectomy.CONCLUSION Postoperative hemoglobin and the time interval between postoperative first sexual life and operation were the independent factors of developing vaginal cuff dehiscence after laparoscopic hysterectomy.
基金thank the staff of the accredited animal facility of the laboratory of anatomy,Histology and Embryology of Aristotle University of Thessaloniki’s veterinary school for their assistance in animal handling and care.
文摘BACKGROUND Massive rotator cuff tears(RCTs)result in impaired shoulder function and quality of life.These tears lead to structural changes in the rotator cuff muscles,which compromise recovery after repair and increase re-tear rates.AIM To investigate the potential inhibitory effects of alpha-tocopherol(vitamin E)and OTR-4131 on muscle atrophy,fatty infiltration,and fibrosis in rotator cuff muscles following a massive RCT using a Wistar rat model,and establish a standardized methodology for evaluating potential therapeutic agents.METHODS This protocol outlines a controlled animal study using 40 male Wistar rats,randomized into five groups.The experimental groups will receive either systemic administration of alpha-tocopherol or local administration of OTR-4131 via intramuscular injection into the supraspinatus and infraspinatus muscles.Two sham groups will receive systemic and local saline injections respectively,while a control group will undergo no intervention.The interventions will be administered after surgical transection of the supraspinatus and infraspinatus tendons.Outcomes will be assessed via wet muscle weight measurements,muscle fiber diameter,fatty infiltration percentage,and fibrosis evaluation using histological methods.RESULTS The study anticipates that alpha-tocopherol and OTR-4131 will reduce muscle atrophy,fatty infiltration,and fibrosis compared to control and sham groups,supporting their potential protective role in rotator cuff muscle degeneration.CONCLUSION The results are expected to improve the understanding on the role of alpha-tocopherol and OTR-4131 in rotator cuff muscle protection after massive RCT and may serve as a foundation for further preclinical and clinical research aimed at improving rotator cuff repair outcomes.
文摘Background:Rehabilitation typically restores shoulder function after a common rotator cuff repair;however,it is unclear when to initiate physical therapy(PT)post-surgery.To understand effective start times,this study analyzed PT start times and their effect on shoulder function.The most effective shoulder outcomes were hypothesized to occur when PT started 0-4 weeks post-surgery.Methods:Data from 1002 patients who underwent rotator cuff repair were analyzed retrospectively from 52 outpatient clinics in the years of 2016-2021.The primary data of timings between surgery and the start of PT(0-2 weeks[0-14 days],2-4 weeks[15-28 days],4-6 weeks[29-42 days],and 6-14 weeks[43-100 days]),change in functional shoulder scores,number of PT visits utilized,and functional scores changed per visit were analyzed.Regression analyses of the impact of age,sex,payor source,and tear size were completed.Results:The change in functional scores and functional scores changed per visit are not affected by the initiation timing of PT postrotator cuff surgery,when controlling for baseline functional scores.This result is revealed despite initial functional scores being significantly different.Functional scores change per visit may have been affected by payor source(R^(2)=0.004,p≤0.010).PT start times may have been impacted by age(R^(2)=0.010,p=0.007),payor source(R^(2)=0.016,p=0.001),and tear size(R^(2)=0.007,p=0.026).Payor source may have influenced the number of PT visits(R^(2)=0.060,p<0.001).Conclusions:After rotator cuff surgery,patients should choose to complete rehabilitation to optimize shoulder function.However,the initiation timing of PT may not affect functional shoulder outcomes.
文摘Objective:The aim of this study was to find the optimal force that should be applied to control urine leakage using a non-hydraulic cuff design,and to investigate the relationship between the number of cuffs used in urinary control and the change in demand force.Method:In this study,five sheep bladders were used to design and build a biomechanical evaluation system.The biomechanical system included the bladder,pressure gauge,pressure regulator system of the bladder,and force application system by the cuff.In this study,we increased the fluid pressure inside the bladder from 0 cmH_(2)O to 200 cmH_(2)O(1 cmH_(2)O=0.098 kPa),and at each point,the force applied by the cuff to prevent fluid leakage was measured and recorded.Results:The study revealed that a mean tensile force of 2.81(standard deviation 0.23)N for a single cuff and 1.63(standard deviation 0.16)N for double cuffs with symmetrical pressure effectively prevented bladder fluid leakage in the pressure range from 75 cmH_(2)O to 100 cmH_(2)O(p<0.001).However,there were no significant differences in results when comparing the applied tensile force required by double cuffs with asymmetric tensile force to that of the single cuff use.Furthermore,using three cuffs instead of two did not yield significantly different outcomes.Conclusion:Using double cuffs with symmetrical pressure had a greater effect compared with a single cuff with the same tensile force.Although multiple cuffs with varying tensile forces were not found to be useful in controlling urine leakage in this study,it is suggested that applying variable forces alternately and rotationally among several cuffs may reduce long-term risks such as atrophy and necrosis.Future in vivo studies are recommended to further evaluate efficiency.
文摘BACKGROUND Kidney transplantation is increasingly more common due to the ongoing shortage of deceased donors.However,anatomical challenges,such as a short renal artery,can complicate surgical procedures and increase complication risk,including thrombosis and anastomotic stenosis.To address these issues and optimize graft outcomes,innovative surgical techniques are essential.CASE SUMMARY We present a case of kidney transplantation complicated by a short donor renal artery.To address the discrepancy between arterial length and diameter mismatch,the recipient’s inferior epigastric artery was used as a cuff interposition for arterial reconstruction.Following standard laparoscopic donor nephrectomy,vascular reconstruction was performed on the back table.The use of the inferior epigastric artery as a cuff allowed for successful elongation and size matching of the donor renal artery,enabling a tension-free anastomosis to the recipient’s external iliac artery.Postoperative Doppler ultrasound and angiography confirmed excellent graft perfusion.The patient experienced an uneventful recovery with immediate graft function and maintained stable renal function at 6 months post-transplant.To our knowledge,this is the first reported use of the inferior epigastric artery as a cuff interposition in renal artery reconstruction,offering a novel and effective technique for managing short renal arteries in kidney transplantation.CONCLUSION Interposition of the epigastric artery offers an innovative technique for managing short donor renal arteries,reducing the risk of early thrombosis and long-term complications as size mismatch and intimal hyperplasia.
基金Supported by Zhejiang Administration of Traditional Chinese Medicine,No.2023ZF019Natural Science Foundation of Zhejiang Province,No.(2020)56+1 种基金Cultivation of Health High-level Talents in Zhejiang Province in 2022,No.(2019)58and National Natural Science Foundation of China,No.H02710.
文摘Recently,we read a retrospective study by Chen et al,which demonstrated that electroacupuncture is highly effective in relieving pain due to rotator cuff injuries and accelerating the recovery of shoulder function,promoting repair of rotator cuff injuries.This study provides a new way to the conservative treatment of early rotator cuff injuries.In the present letter,we review the current treatment of rotator cuff injury with electroacupuncture combined with rehabilitation techniques and propose our views.
基金the National Key Research and Development Program of China(No.2020YFC1107501)the National Natural Science Foundation of China(No.51971222,51801220)+4 种基金the Natural Science Foundation of Liaoning Province of China(No.2020-MS-001)the Dong Guan Innovative Research Team Program(No.2020607134012)the Military Translational Medicine Fund of Chinese PLA General Hospital(ZH19008)Capital’s Funds for Health Improvement and Research(CFH 2022-2-5051)the Dong Guan Science and Technology Service Network Initiative(20201600200042)。
文摘Despite transosseous rotator cuff tear repair using sutures is widely accepted for tendon-bone fixation,the fibrocartilaginous enthesis regeneration is still hardly achieved with the traditional sutures.In the present work,degradable magnesium(Mg)alloy wire was applied to suture supraspinatus tendon in a rat acute rotator cuff tear model with Vicryl Plus 4±0 absorbable suture as control.The shoulder joint humerus-supraspinatus tendon complex specimens were retrieved at 4,8,and 12 weeks after operation.The Mg alloy suture groups showed better biomechanical properties in terms of ultimate load to failure.Gross observation showed that hyperplastic response of the scar tissue at the tendon-bone interface is progressively alleviated over time in the both Mg alloy suture and Vicryl suture groups.In the histological analysis,for Mg alloy suture groups,chondrocytes appear to proliferate at 4 weeks postoperatively,and the tendon-bone interface showed an orderly structural transition zone at 8 weeks postoperatively.The collagenous fiber tended to be aligned and the tendon-bone interlocking structures apparently formed,where transitional structure from unmineralized fibrocartilage to mineralized fibrocartilage was closer to the native fibrocartilaginous enthesis.In vivo degradation of the magnesium alloy wire was completed within 12 weeks.The results indicated that Mg alloy wire was promising as degradable suture with the potential to promotes fibrocartilaginous interface regeneration in rotator cuff repair.
文摘BACKGROUND The rotator cuff is located below the acromion and deltoid muscles and comprises multiple tendons that wrap around the humeral head,maintaining shoulder joint stability.AIM To explore the effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries.METHODS We selected 97 patients with rotator cuff injuries treated in the People's Hospital of Yuhuan from February 2020 to May 2023.Patients were grouped using the envelope method.RESULTS After treatment,the study group’s treatment effective rate was 94.90%(46/49 patients),significantly higher than that in the control group(79.17%,38/48 cases;P<0.05).Before treatment,there was no difference in Constant Murley Score(CMS)scores,shoulder mobility,or 36-Item Short Form Health Survey(SF-36)scale scores(P>0.05).Compared with those before treatment,the CMS scores(including pain,daily living ability,shoulder mobility,and muscle strength),all aspects of shoulder mobility(forward flexion,posterior extension,external rotation,internal rotation),and SF-36 scale scores(including physiological,psychological,emotional,physical,vitality,and health status)were higher in both groups after treatment and significantly higher in the study group(P<0.05).There was no difference in the occurrence of complications between the two treatment groups(P>0.05).CONCLUSION Electroacupuncture combined with rehabilitation techniques has a good treatment effect on patients with rotator cuff injuries,helps accelerate the recovery of shoulder function,improves the quality of life,and is highly safe.
基金General Project of Health and Family Planning Scientific Research of Pudong New Area Health Commission:Evaluation of the Clinical Effectiveness of the Integrated Traditional Chinese and Western Medicine Clinical Program for Accelerating Postoperative Recovery of Patients with Rotator cuff Injury under the Multidisciplinary Team Mode,No.PW2021A-66Shanghai Municipal Health Commission Key Department of Integrated Traditional Chinese and Western MedicinePeak Discipline of Traditional Chinese Medicine(Orthopedics and Traumatology Department of Integrated Traditional Chinese and Western Medicine),Shanghai Pudong New Area Health Commission,No.YC-2023-0601.
文摘BACKGROUND Arthroscopic rotator cuff repair is a common surgical treatment for rotator cuff injuries(RCIs).Although this procedure has certain clinical advantages,it requires rehabilitation management interventions to ensure therapeutic efficacy.AIM To investigate the effect of integrated traditional Chinese medicine and Western medicine(TCM-WM)under the multidisciplinary team(MDT)model on the postoperative recovery of patients undergoing arthroscopic surgery for RCIs.METHODS This study enrolled 100 patients who underwent arthroscopic rotator cuff repair for RCIs at the Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine between June 2021 and May 2024.They were divided into a control group(n=48)that received routine rehabilitation treatment and an experimental group(n=52)that received TCM-WM under the MDT model(e.g.,acupuncture,TCM traumatology and orthopedics,and rehabilitation).The results of the Constant–Murley Shoulder Score(CMS),Visual Analogue Scale(VAS),Shoulder Pain and Disability Index(SPADI),muscular strength evaluation,and shoulder range of motion(ROM)assessments were analyzed.RESULTS After treatment,the experimental group showed significantly higher CMS scores in terms of pain,functional activity,shoulder joint mobility,and muscular strength than the baseline and those of the control group.The experimental group also exhibited significantly lower VAS and SPADI scores than the baseline and those of the control group.In addition,the experimental group showed significantly enhanced muscular strength(forward flexor and external and internal rotator muscles)and shoulder ROM(forward flexion,abduction,and lateral abduction)after treatment compared with the control group.CONCLUSION TCM-WM under the MDT model improved shoulder joint function,relieved postoperative pain,promoted postoperative functional recovery,and facilitated the recovery of muscular strength and shoulder ROM in patients with RCIs who underwent arthroscopic rotator cuff repair.
基金supported by the Department of Advanced Acute Medicine at Nagoya City University.
文摘BACKGROUND:Ultrasound guidance is commonly used for accessing difficult peripheral veins.For successful access,a tourniquet is required for venodilation.Tourniquets decrease the compressibility and increase the diameter of veins;they also obfuscate artery-vein differentiation on ultrasound.We aimed to establish the upper limit of sphygmomanometer cuff pressure that facilitates artery-vein differentiation during ultrasound-guided peripheral intravenous access.METHODS:We employed the sphygmomanometer cuff as a tourniquet for venodilation and tested it on seven participants at six different levels as follows:0 mmHg,DBP/2,DBP,(DBP+SBP)/2,SBP,and SBP+20 mmHg.We used an ultrasound probe attached to a pressure-measuring instrument to record cross-sectional images of the cubital artery and vein.During ultrasonography,compression was applied to the blood vessels through the skin.The following day,we measured the wrist pulse pressure and observed the oximeter pulse wave at six different tourniquet pressure levels.Repeated-measures analysis of variance(ANOVA)on ranks and Tukey’s post-hoc analysis were used for multiple comparisons.RESULTS:Arterial pulsation was maintained at tourniquet pressures between 0 mmHg and(DBP+SBP)/2.However,arterial pulsation decreased or disappeared when the tourniquet pressure reached or exceeded the SBP.Moreover,at this pressure level,the superior compressibility of veins compared to that of arteries was no longer observed.Compression of the artery to 75% and 50% of its original diameter increased arterial pulsation.CONCLUSION:Arterial pulsation and the superior compressibility are useful indicators for differentiating veins from arteries until the tourniquet pressure reaches(DBP+SBP)/2.However,these indicators are not reliable once the tourniquet pressure exceeds the SBP.
文摘BACKGROUND Rotator cuff tears and Bankart lesions significantly affect shoulder function and quality of life.Arthroscopic rotator cuff repair and Bankart repair has become the standard treatment for restoring function and reducing pain.Recent advancements include new suture anchor technologies,such as the Sironix suture anchor known for its biomechanical strength and promising outcomes.However,there are limited real-world data on its effectiveness and safety,particularly in the Indian population.AIM To evaluate the effectiveness and safety of Sironix suture anchors in rotator cuff and Bankart repair surgeries.METHODS Sixty participants underwent surgery between January 2021 and December 2022,and demographic data and postoperative outcomes were collected through retrospective reviews and telephonic interviews.Validated scales,including the PENN Shoulder Score(PSS),Disabilities of the Arm,Shoulder,and Hand(DASH)score,and Single Assessment Numeric Evaluation(SANE),were utilized for assessment.RESULTS Treatment with Sironix suture anchor devices,including Ceptre Knotted UHMWPE Suture Titanium Anchor,Spyke Knotted UHMWPE Suture Peek Anchor,Stativ Knotted UHMWPE Suture Anchor,and Viplok Knotless Peek Screw Anchor with Titanium Tip,revealed no repair failures.Participants demonstrated high satisfaction and functional improvement,as evidenced by the mean Quick DASH score(32.01)and PSS(71.65)and the satisfactory SANE scores for both injured joints(74.33)and non-injured(83.67)shoulder joints.CONCLUSION The study yielded favorable outcomes for rotator cuff tear repair and Bankart repair.No repair failures were observed,supporting the safety and efficacy of these devices in shoulder injury management.
文摘Objective: To explore the clinical efficacy of shoulder arthroscopic one-knot-two-wire suture bridge technique in the treatment of small and medium-sized rotator cuff tears. Methods: The clinical data of 22 patients with small and medium-sized rotator cuff injuries treated with the one-knot-two-wire suture bridge technique from February 2022 to June 2023 in the Department of Orthopaedics of Jingzhou Hospital Affiliated to Yangtze University were retrospectively analysed, among which 14 cases were male and 8 cases were female;the age ranged from 35 to 68 years old, with an average of (50.86 ± 10.80) years old. All cases underwent an MRI examination of the shoulder joint to understand the type and degree of injury. The duration of the disease ranged from 120 to 166 d, with a mean of (141.23 ± 13.46) d. The evaluation of the operation time, intraoperative bleeding, visual analogue scale (VAS) of pain, Constant-Murley score and Sugaya grading of shoulder MRI were performed at the last follow-up. Results: All 22 patients were followed up for 12 - 18 months, with a mean of (14.68 ± 1.89 d). The operation time was 38 - 58 min, mean (48.18 ± 5.92) min;intraoperative bleeding was 5 - 15 mL, mean (10.00 ± 3.45) mL. All patients achieved normal healing without re-tear, vascular and nerve injury, incision infection, anchor nail loosening and dislodgement and other complications. At the last follow-up, both shoulders were normal in shape and symmetrical on both sides. The VAS score was 0 - 1.2 points, with an average of 0.61 ± 0.42 points, and the Constant-Murley score was 70 - 98 points, with an average of 86.09 ± 8.56 points. The Sugaya classification of MRI examination was 17 cases of grade I, 4 cases of grade II, and 1 case of grade III. Conclusion: One-knot-two-wire suture bridge technique is used for the treatment of small and medium-sized rotator cuff tears with short operative time, low bleeding, and good clinical outcome.
