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Biomedical subjects

R M Gross

Publications and source records attributed to R M Gross.

6 recordsLinked to original sources
PubMed1996

Captured shoulder: a complication of rotator cuff surgery.

Thirteen patients who developed restrictive subdeltoid adhesions after rotator cuff repair were identified. These patients underwent second-look arthroscopy and takedown of adhesions at an average of 37 weeks after their index surgery. Clinical findings include pain and restricted motion that does not yield to manipulation under anesthesia. Arthroscopic findings are subdeltoid adhesions and a chondral lesion (companion lesion) of the humeral head articular surface. Patients were reevaluated at 26 weeks after their release of adhesions. Prerelease and postrelease University of California, Los Angeles (UCLA) scores average 14.8 and 30.1, respectively. Prerelease and postrelease UCLA pain scores averaged 2.6 and 7.7, respectively. Prerelease and postrelease range of motion was as follows: Flexion, 141/158; abduction, 123/141; internal rotation, 47/69; and external rotation, 53/74. The authors have proposed a theory to explain the clinical and arthroscopic findings in this subgroup of patients who are dissatisfied after rotator cuff repair. A technique for and the results of release of the subdeltoid adhesions also are reported.

Arthroscopy↗
PubMed1993

Arthroscopy. Basic setup and equipment.

Shoulder arthroscopy necessitates attention to detail. Adopting a comfortable setup that includes a plan for every detail, including the surgeon's position, the patient's position, the draping techniques, and the types of fluid and equipment necessary, adds to the smooth flow of the operation even when the surgical plan changes. I have described my method of basic arthroscopic setup and equipment, which has helped me to deal with the many frustrations faced during arthroscopy on the shoulder. It is hoped this article may enable the reader to avoid some of these problems if this or a similar basic setup is adopted.

Arthroscopes↗
PubMed1985

Shoulder arthroscopy: a modified approach.

This paper proposes a modification of the classical position for shoulder arthroscopy. Two changes are proposed to improve visualization, accentuate pathology, and give better access to the inferior one half to one third of the shoulder joint. The direct lateral position is changed to a semilateral position in which the patient is allowed to rotate 30 to 40 degrees posteriorly, thus putting the shoulder joint on a horizontal plane. This allows for more comfortable arthroscopy and instrumentation. Also, if capsulorrhaphy is desired, better penetration of the scapula is possible since the scapula is vertical; thus, the angle of the approaching staple is less severe. The second change is to apply traction in a plane perpendicular to the long axis of the humerus rather than parallel to it. This modification elevates the humerus out of the glenoid rather than distracts the humerus into a subluxed position. The result accentuates labral pathology and gives a significantly improved view of the inferior one half to one third of the glenoid capsule. This new plane of traction allows excellent visualization with very little traction; thus, the problem of traction neuropraxia has been eliminated.

Adolescent↗
PubMedDate not supplied

Arthroscopic shoulder capsulorraphy: does it work?

The purpose of this project was to answer the question, "Can shoulder instability be dealt with safely and effectively arthroscopically?" This study, which began in December 1982 and concluded in February 1985, involved 12 patients, 3 females and 9 males whose ages ranged from 14 to 40 years. Followup ranged from 31 to 63 months, the average being 44.8 months. The arthroscopic procedure was based on the use of a tool designed to capture the capsule, thus allowing placement of either one or two low profile extraarticular staples in the capsule. Two cases were failures. The remaining 10 patients were pleased with their operation. Based on the classification of Rowe et al., functional results were six excellent, two good, two fair, and two poor. The six patients with excellent results had shoulders of normal appearance. They were fully active and had neither pain nor limitation of motion. All six patients had negative apprehension signs. The two patients with good results had similar outcomes, but they had occasional morning stiffness and intermittent mild pain, as well as a 10 degrees limitation of external rotation in both adduction and abduction. One patient who had a fair result had a positive apprehension sign and occasional pain with quick motion. The other patient with a fair result was hampered by more significant pain on an intermittent basis, yet the pain was not a constant issue. None of these patients had radiographic evidence of increased degenerative changes of the shoulder or staple migration. There were two complications and two failures.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗