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Knee Surgery, Sports Traumatology,... Jun 2024The aim of the present study is to provide a comprehensive review on the surgical outcomes following arthroscopic treatments of partial-thickness rotator cuff tears...
PURPOSE
The aim of the present study is to provide a comprehensive review on the surgical outcomes following arthroscopic treatments of partial-thickness rotator cuff tears (PT-RCTs) and to compare the postoperative American Shoulder and Elbow Surgeons (ASES) score following in situ transtendon repair and tear completion, followed by repair.
METHODS
Medline, EMBASE, Scopus, CINAHL and CENTRAL bibliographic databases were searched. Papers including patients with PT-RCTs of any grade who underwent treatment using debridement, in situ transtendon repair, tear completion and repair or bioinductive collagen implants were reviewed. Primary PT-RCTs were the sole indication for surgery. Primary postoperative outcomes assessed included the ASES score, the Absolute Constant-Murley score, the Simple Shoulder Test, the Visual Analogue Scale, the University of California-Los Angeles Shoulder Scale, the Western Ontario Rotator Cuff Score, range of motion, complications and revisions. A meta-analysis of comparative studies compared the postoperative ASES score between patients treated with in situ transtendon repair versus tear completion repair.
RESULTS
Twenty-eight studies were included. The ASES score was reported by four comparative studies with contrasting results. The heterogeneity was high (I = 86%), and effect sizes ranged from -0.49 in favour of the tear completion and repair technique to an effect size of +1.07 favouring in situ transtendon repair. The overall effect size of 0.02 suggests an equivalence between the two techniques in terms of the ASES score. Two studies with a total sample size of 111 patients reported on debridement, and four studies with a total sample size of 155 patients reported on bioinductive collagen implants.
CONCLUSION
Debridement alone is suitable for Ellman grades I-II PT-RCTs. In situ transtendon and tear completion repair techniques yield similar postoperative outcomes. Bioinductive collagen implants hold promise but lack long-term efficacy data. High-quality comparative studies are needed to determine the best treatment for PT-RCTs.
LEVEL OF EVIDENCE
Level IV.
PubMed: 38932614
DOI: 10.1002/ksa.12326 -
Knee Surgery, Sports Traumatology,... Jun 2024Glenohumeral instability with combined bone lesion in contact and overhead athletes with subcritical bone loss is challenging to treat with high recurrent instability....
Glenoid bone loss and Hill-Sachs width percentage score are useful to select optimal operation for the treatment of glenohumeral instability in overhead athletes: Arthroscopic Bankart repair with remplissage versus open Latarjet.
PURPOSE
Glenohumeral instability with combined bone lesion in contact and overhead athletes with subcritical bone loss is challenging to treat with high recurrent instability. Treatment options are arthroscopic Bankart repair with remplissage and Latarjet operations. However, there is no consensus on their effectiveness. This study aims to compare the clinical outcomes and return to sports after both operations and whether evaluating the glenoid bone loss and Hill-Sachs width to calculate the total bone loss can help determine the appropriate operation.
METHODS
In this retrospective comparative analysis, 30 athletes who underwent index arthroscopic Bankart repair with remplissage (n = 16) or Latarjet procedure (n = 14) between 2017 and 2020 were included. Computed tomography (CT) and magnetic resonance imaging (MRI) were routinely performed. The quick Disabilities of the Arm, Shoulder and Hand (qDASH), American Shoulder and Elbow Surgeons (ASES), instability severity index (ISI) scores and range of motion (ROM) were recorded preoperatively and at a mean follow-up of 53 months (SD = 12). Follow-up included time-to-return sports, self-perceived sports performance level and complications/recurrent dislocations.
RESULTS
Preoperative qDASH, ASES, ISI scores, ages and genders were similar. The Latarjet group had significantly larger glenoid bone loss, Hill-Sachs width and total bone loss (p < 0.01). Both groups had significant improvement in patient-reported outcomes (PROs) after the operations (p < 0.01). Athletes with a total bone loss <25% underwent arthroscopic Bankart repair with remplissage and total bone loss ≥25% underwent Latarjet procedure, and there were no differences between the groups in terms of postoperative PROs, ROM, time-to-return sports and performance. There were no re-dislocations.
CONCLUSION
Arthroscopic Bankart repair with remplissage or Latarjet procedure can adequately address glenohumeral instability with combined bone lesions. Patients with total bone loss scores greater than or equal to 25 may particularly benefit from the Latarjet procedure, while the minimally invasive arthroscopic Bankart repair with remplissage can yield equally satisfying scores for total bone loss less than 25.
LEVEL OF EVIDENCE
Level III.
PubMed: 38932604
DOI: 10.1002/ksa.12333 -
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi =... Jun 2024Self-powered wearable piezoelectric sensing devices demand flexibility and high voltage electrical properties to meet personalized health and safety management needs....
Self-powered wearable piezoelectric sensing devices demand flexibility and high voltage electrical properties to meet personalized health and safety management needs. Aiming at the characteristics of piezoceramics with high piezoelectricity and low flexibility, this study designs a high-performance piezoelectric sensor based on multi-phase barium titanate (BTO) flexible piezoceramic film, namely multi-phase BTO sensor. The substrate-less self-supported multi-phase BTO films had excellent flexibility and could be bent 180° at a thickness of 33 μm, and exhibited good bending fatigue resistance in 1 × 10 bending cycles at a thickness of 5 μm. The prepared multi-phase BTO sensor could maintain good piezoelectric stability after 1.2 × 10 piezoelectric cycle tests. Based on the flexibility, high piezoelectricity, wearability, portability and battery-free self-powered characteristics of this sensor, the developed smart mask could monitor the respiratory signals of different frequencies and amplitudes in real time. In addition, by mounting the sensor on the hand or shoulder, different gestures and arm movements could also be detected. In summary, the multi-phase BTO sensor developed in this paper is expected to develop convenient and efficient wearable sensing devices for physiological health and behavioral activity monitoring applications.
Topics: Titanium; Humans; Barium Compounds; Monitoring, Physiologic; Wearable Electronic Devices; Equipment Design
PubMed: 38932526
DOI: 10.7507/1001-5515.202404016 -
Molecules (Basel, Switzerland) Jun 2024Flexible strain sensors have a wide range of applications in the field of health monitoring of seismic isolation bearings. However, the nonmonotonic response with...
Flexible strain sensors have a wide range of applications in the field of health monitoring of seismic isolation bearings. However, the nonmonotonic response with shoulder peaks limits their application in practical engineering. Here we eliminate the shoulder peak phenomenon during the resistive-strain response by adjusting the dispersion of conductive nanofillers. In this paper, carbon black (CB)/methyl vinyl silicone rubber (VMQ) composites were modified by adding a silane coupling agent (KH550). The results show that the addition of KH550 eliminates the shoulder peak phenomenon in the resistive response signal of the composites. The reason for the disappearance of the shoulder peak phenomenon was explained, and at the same time, the mechanical properties of the composites were enhanced, the percolation threshold was reduced, and they had excellent strain-sensing properties. It also exhibited excellent stability and repeatability during 18,000 cycles of loading-unloading. The resistance-strain response mechanism was explained by the tunneling effect theoretical model analysis. It was shown that the sensor has a promising application in the health monitoring of seismic isolation bearings.
PubMed: 38930805
DOI: 10.3390/molecules29122740 -
Micromachines May 2024Carbon monoxide (CO) gas sensors are widely used, especially for environmental monitoring in confined spaces such as the landscape of mining cave ruins in mining parks,...
Carbon monoxide (CO) gas sensors are widely used, especially for environmental monitoring in confined spaces such as the landscape of mining cave ruins in mining parks, which is essential for ensuring the health and safety of tourists and staff. In this paper, a flexible CO gas sensor based on polyimide, interdigital electrodes, and reduced graphene oxide (RGO)/cuprous chloride (CuCl) composite film is designed and manufactured for reliable room temperature detection of high-concentration CO gas. The structure size of RGO/CuCl gas-sensitive film is 5 × 5 mm. The RGO with a 62.65% C-C bond is prepared by the thermal reduction method. The test results show that the sensor has a high response in the range of 400-2000 ppm CO gas concentration, and the maximum response is 1.56. The linear correlation coefficient of the sensor is 0.981, which indicates that the sensor has good output response characteristics. The response time of the sensor for 400 ppm CO gas is 332 s, which indicates that the sensor has a fast response rate. Furthermore, compared with other gases, the sensor shows higher gas selectivity for CO gas. This sensor has the characteristics of small size and easy attachment; therefore, it can be installed on the shoulder or helmet of tourists' safety suits, providing personalized real-time warning prompts for tourists' physical health status.
PubMed: 38930707
DOI: 10.3390/mi15060737 -
Journal of Clinical Medicine Jun 2024Shorter hip stems have shown promising mid-term results but lack long-term data. High rates of distal cortical hypertrophy (CH) have been described, suggesting a more...
The Migration Pattern of a Short-Tapered Femoral Stem Correlates with the Occurrence of Cortical Hypertrophies: A 10-Year Longitudinal Study Using Ein Bild Röntgen Analyse-Femoral Component Analysis.
Shorter hip stems have shown promising mid-term results but lack long-term data. High rates of distal cortical hypertrophy (CH) have been described, suggesting a more diaphyseal load transmission. This study aimed to determine patient-specific and surgery-related factors influencing CH and their impact on 10-year outcomes. : It included 100 consecutive total hip arthroplasties (THAs) using the Fitmore stem (Zimmer, Warsaw, Indiana), with clinical and radiographic follow-ups at 1, 2, 5, and at least 10 years post-surgery. : No revisions were performed due to aseptic loosening after a mean of 11.6 years (range: 10-13.5 years). CH was observed in 26% of hips, primarily in Gruen zones 3 and 5. There was no significant difference in the Harris Hip Score between patients with and without CH. Larger stem sizes and greater axial subsidence significantly correlated with CH occurrence (OD 1.80, (1.13-1.92), = 0.004; OD 1.47, (1.04-2.08), = 0.028). The Fitmore stem demonstrated excellent survival rates and favorable outcomes over 10 years. : Despite a lower CH rate compared to other studies, significant correlations with stem size and subsidence were identified. This study underscores the importance of patient selection and achieving high primary stability to maintain the metaphyseal anchoring concept.
PubMed: 38930145
DOI: 10.3390/jcm13123616 -
Journal of Clinical Medicine Jun 2024The clavicle remains one of the most fractured bones in the human body, despite the fact that little is known about the MR imaging of it and the adjacent...
The clavicle remains one of the most fractured bones in the human body, despite the fact that little is known about the MR imaging of it and the adjacent sternoclavicular joint. This study aims to establish standardized values for the diameters of the clavicle as well as the angles of the sternoclavicular joint using whole-body MRI scans of a large and healthy population and to examine further possible correlations between diameters and angles and influencing factors like BMI, weight, height, sex, and age. This study reviewed whole-body MRI scans from the Study of Health in Pomerania (SHIP), a German population-based cross-sectional study in Mecklenburg-Western Pomerania. Descriptive statistics, as well as median-based regression models, were used to evaluate the results. We could establish reference values based on a shoulder-healthy population for each clavicle parameter. Substantial differences were found for sex. Small impacts were found for height, weight, and BMI. Less to no impact was found for age. This study provides valuable reference values for clavicle and sternoclavicular joint-related parameters and shows the effects of epidemiological features, laying the groundwork for future studies. Further research is mandatory to determine the clinical implications of these findings.
PubMed: 38930127
DOI: 10.3390/jcm13123598 -
Journal of Clinical Medicine Jun 2024: Hand burns are involved in 80-90% of severe burn injuries. Even though hands correspond to a small total burn surface area (TBSA) of less than 5%, the loss of their...
: Hand burns are involved in 80-90% of severe burn injuries. Even though hands correspond to a small total burn surface area (TBSA) of less than 5%, the loss of their functionality has a significant impact on the patient's life. Studies that provide long-term results regarding hand functionality after hand burns are scarce. Therefore, this study aimed to investigate functional long-term results in a patient-centric approach regarding burn depth, unilateral and bilateral hand involvement, and (non-)isolated hand burns as potential influencing factors in patients with hand burns. : We conducted a controlled cohort study of patients with burned hands treated at our department between 2005 and 2022. Healthy age-, sex-, and handedness-matched participants were used as controls. Data on the demographics, burn-related injuries, and treatments were collected. For a patient-centric approach, we used the Disabilities of the Arm, Shoulder, and Hand Questionnaire (Quick-DASH) and the Michigan Hand Questionnaire (MHQ) as patient-reported outcome measures for functional long-term evaluation, and the Patient and Observer Scar Assessment Scale (patient scale) for assessing long-term scar quality. : We enrolled 61 patients with 88 affected hands and 63 matched control participants. Up to 77.1% of the participants were male, with a mean age of 50.7 (±15.5) years and a follow-up of 8.1 (±4.7) years. The mean TBSA was 13.9% (±15.8), with 72.4% of the hands presenting with deep partial-thickness and full-thickness burns and most of the patients had only one hand affected (55.7%). The hand burn patients perceived significantly worse long-term functional scores in every domain of the MHQ as well as in the "overall function" and "work" of the Quick-DASH. Superficial hand burns negatively affected the two-handed activities of daily living ( = 0.013) and aesthetic appearance ( = 0.005) when both hands were involved. Isolated hand burns were associated with more difficulties in work performance ( = 0.03), whereas patients with bilateral hand involvement perceived more pain ( = 0.025). : The patients with hand burns can achieve satisfactory long-term functional outcomes over time, but they do not reach the same long-term hand functionality as the healthy matched control group. Our study revealed that factors such as burn depth, unilateral or bilateral hand involvement, and (non-)isolated hand burns indeed have an impact on certain aspects of perceived long-term hand functionality.
PubMed: 38930038
DOI: 10.3390/jcm13123509 -
Journal of Clinical Medicine Jun 2024Patients suffering from osteoarthritis particularly complain about pain during day and night as well as loss of function. This consequently leads to impaired quality of...
Patients suffering from osteoarthritis particularly complain about pain during day and night as well as loss of function. This consequently leads to impaired quality of life and therefore psychological stress. The surgical therapy of choice is joint replacement. Regarding the outcome after operation, expectations might differ between the patient and the surgeon. This can lead to dissatisfaction on both sides. This study aimed to document patients' expectations of a planned shoulder joint replacement. The results were compared with assessments made by shoulder surgeons. In total, 50 patients scheduled for operative shoulder joint replacement were included in this study, as well as 10 shoulder surgeons. Patients were requested to fill out questionnaires preoperatively to provide sociodemographic data, PROMS (Patient-Reported Outcome Measures) with regard to the pathology and their expectations about surgery in terms of pain relief, gain of range of motion, strength as well as the impact on activities of daily and professional life and sports. In addition, surgeons were asked what they thought their patients expect. The most important goal to achieve for patients was to relieve daytime pain, followed by improvement of self-care and the ability to reach above shoulder level. The most important factors for patients to achieve after operation were 'pain relief' in first place, 'movement' in second and 'strength' in third. This also applied to shoulder surgeons, who ranked 'pain relief' first, followed by 'movement' and 'strength'. When patients where asked what is most important when it comes to choosing their surgeon, 68% voted for 'surgical skills', 28% for 'age/experience', followed by 'empathy', 'sympathy' and 'appearance'. For surgeons, 'age/experience' obtained rank one, 'surgical skills' was ranked second, followed by 'sympathy', 'empathy' and 'appearance'. Surgeons significantly underrated the factor 'empathy' in favor of 'sympathy'. This study shows that patients' expectations for shoulder joint replacement and surgeons' assessments do not differ significantly. Relief from pain and better shoulder movement were crucial for patients to achieve after operation, which was in line with surgeons' expectations. The most important factor for choosing the surgeon was 'surgical skills' for patients, while surgeons thought they would care more about 'age and experience'. This underlines that patients' expectations should be taken into account within the preoperative medical interview. This might allow an optimization of compliance of the patients and lead to a better satisfaction on both sides.
PubMed: 38930018
DOI: 10.3390/jcm13123489 -
Journal of Clinical Medicine Jun 2024Shoulder pain is one of the most important musculoskeletal conditions affecting the upper extremities. Glenohumeral osteoarthritis (GHOA) and rotator cuff injuries...
Shoulder pain is one of the most important musculoskeletal conditions affecting the upper extremities. Glenohumeral osteoarthritis (GHOA) and rotator cuff injuries (RCIs) are notable for their high prevalence. The critical shoulder angle (CSA) is a significant radiological measure for determining the diagnosis and progression of patients with these conditions. Although there are reports in the international literature about this measure, in our country, guideline values considering these two pathologies are unknown. Our objective was to assess patients diagnosed with GHOA and RCI using an AP X-ray view and the CSA. To conduct this, we identified differences between sexes and age categories. Fifty-nine adult patients with GHOA and RCI were included. CSA grades varied depending on the age category and type of injury evaluated. Significant differences between the age ranges of 40 and 54 ( = 0.05), 55-69 ( = 0.001), and 70-84 ( = 0.017) were observed. Patients with RCI tended to be younger and have a higher CSA compared to those with GHOA. It is important to have more normative values and to continue monitoring the critical shoulder angle in these patients.
PubMed: 38929939
DOI: 10.3390/jcm13123408