SEARCH · Search PubMed

Results for “Rotator Cuff”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources

PubMed2003

Etiologic and pathogenetic factors for rotator cuff tendinopathy.

Etiologic and pathogenetic factors for rotator cuff tendinopathy, although often compartmentalized to intrinsic or extrinsic causes, have multifactorial roots. The development of animal models for the study of rotator cuff disease has increased the fund of knowledge regarding this disease and has paved the way for future studies. Further multidisciplinary studies at molecular, biomechanical, and clinical levels should be undertaken to enhance the understanding of this common disorder. Ultimately, the goals of improved care, increased comprehension, and prevention of rotator cuff tendinopathy are attainable.

Animals↗

PubMed1992

Rotator cuff disease: current trends in orthopedic management.

Rotator cuff disease is a clinical entity that is frequently encountered in the typical primary care office. Of particular importance to the chiropractic physician is the close proximity of the shoulder joint to the cervical spine. Due to the relatively high level of morbidity in the population, rotator cuff disease should be looked at carefully on both the physical and advanced diagnostic level. Several factors contributing to rotator cuff pathology include subacromial impingement, the relative microvascular pattern of the cuff mechanism and prior trauma. The natural history of attrition and aging also play a role in rotator cuff disease. Advanced disease is successfully diagnosed through the efficient utilization and proper sequencing of advanced orthopedic imaging studies.

Clinical Protocols↗

PubMedDate not supplied

Rotator cuff tears: clinical, radiographic, and US findings.

Rotator cuff tears are a common cause of shoulder pain. Clinical and radiographic findings can suggest the presence of a rotator cuff tear. The most sensitive clinical findings are impingement and the "arc of pain" sign. Radiographic findings are usually normal in the acute setting, although the "active abduction" view may show decreased acromiohumeral distance. In more chronic cases, an outlet view may show decreased opacity and decreased size of the supraspinatus muscle due to atrophy. In late cases, the humeral head may become subluxated superiorly, and secondary degenerative arthritis of the glenohumeral joint may ensue. Ultrasonography (US), with over 90% sensitivity and specificity, can help confirm the diagnosis in clinically or radiographically equivocal cases. US can also reveal the presence of other abnormalities that may mimic rotator cuff tear at clinical examination, including tendinosis, calcific tendinitis, subacromial subdeltoid bursitis, greater tuberosity fracture, and adhesive capsulitis.

Diagnosis, Differential↗

PubMed1995

Arthroscopic evaluation and treatment of the rotator cuff.

Arthroscopy has improved our diagnostic assessment of rotator cuff disease, especially in understanding patterns of articular surface partial-thickness tears. Arthroscopic subacromial decompression is a proven and reliable alternative to open acromioplasty. Despite continued controversy, most partial-thickness rotator cuff tears may be satisfactorily treated by arthroscopic debridement and decompression. The role for debridement and decompression without repair for full-thickness rotator cuff tears seems less than initially suggested, as several recent independent studies have documented results inferior to open repair. Arthroscopically assisted mini-open repair of small, full-thickness rotator cuff tears is a reliable procedure. Arthroscopic repair appears promising, but is not yet well enough documented to be considered a standard treatment.

Arthroscopy↗

PubMed2005

[Hyperechoic rotator cuff tendon tear].

PURPOSE: To describe unusual rotator cuff tendon tears which are hyperechoic at ultrasonography (US). MATERIALS AND METHOD: We retrospectively reviewed the shoulder US examinations of 100 patients with rotator cuff tear demonstrated by CT arthrogram with bursography. We included in this study hyperechoic foci without surrounding hypoechoic zone. A second US examination was performed after bursal distension. RESULTS: Six (6%) hyperechoic foci were detected. The initial US diagnosis was tendinosis in five cases (n=5) and full thickness tear in one case (n=1). At repeat US examination, the hyperechoic area was completely or partially hypoechoic, probably because the tears were filled with the injected hypoechoic fluid. CONCLUSION: Some rotator cuff tears, filled with fibrinoid fragments, are probably underdiagnosed at US.

Adult↗

PubMed1999

Arthroscopic debridement and acromioplasty versus mini-open repair in the treatment of significant partial-thickness rotator cuff tears.

Partial tears of the rotator cuff, especially of the articular side, have received attention only with the recent ability of magnetic resonance imaging (MRI) and arthroscopy to diagnose these lesions. Several early reports showed nearly 100% success in managing these lesions with arthroscopic debridement with or without acromioplasty. This series compares 32 patients with significant partial-thickness rotator cuff tears treated with debridement and acromioplasty versus 33 patients with mini-open repair. Follow-up was from 2 to 7 years. Preoperative MRI was not useful; when positive, preoperative arthrography was useful for articular side tears. Of the tears, 12% were bursal side tears and the remainder were articular side tears; all were at least 50% or more of the thickness of the tendon. A significant number of the arthroscopic group had fair results by UCLA score criteria. Three patients reruptured the remaining cuff later despite adequate acromioplasty. Healing of the partial tear was never observed at second-look arthroscopy. Although postoperative pain was significantly greater and recovery slower with open repair, no patient was reoperated on and rerupture of the repair did not occur. The outstanding results of prior studies of cuff debridement were not duplicated in this series of cuff debridements with long-term follow-up. Adequate acromioplasty alone does not prophylactically prevent rotator cuff tear progression. Recognition and repair of these significant partial tears may be advisable for the long-term function of the shoulder despite short-term improvement in morbidity with arthroscopic treatment.

Acromion↗

PubMed1995

Fatty infiltration of disrupted rotator cuff muscles.

The extent of fatty infiltration of rotator cuff muscles was evaluated on computed tomography displays using a five-point scoring system in 63 shoulders before surgery for a rotator cuff tear and in 57 of these shoulders after surgical repair of the tear (the quality of cuff repair was evaluated in these 57 shoulders by arthrography, usually coupled with computed tomography, after a mean time interval of 8 months since the procedure). Preoperatively, significant fatty infiltration of the supraspinatus muscle was uncommon. Severe fatty infiltration of the infraspinatus and subscapularis muscles was seen in some patients. In most instances, fat accumulated in those muscles whose tendons were torn; however, tendon cleavage was associated with mild fatty infiltration of the corresponding muscle in some instances, and wide tears of the supraspinatus and subscapularis muscles were sometimes accompanied with severe fatty infiltration of the infraspinatus muscle. In half the cases, fatty degenerescence of the infraspinatus muscle occurred within six months of the tendon rupture. After surgery, in most shoulders without evidence of rotator cuff leakage on the postoperative arthrogram, no further accumulation of fat occurred. However, a decrease in the amount of existing fat was rarely documented and occurred only in the supraspinatus muscle. Before and after surgery, increasing severity of the fatty infiltration of the infraspinatus muscle was associated with increasing functional impairment of the same muscle. Recurrent rotator cuff tears, which involved only the supraspinatus muscle, were considerably more common when there was severe preoperative fatty infiltration of the infraspinatus muscle.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗

PubMed2005

Disintegration of an absorbable rotator cuff anchor six weeks after implantation.

Rotator cuff failure by suture-bone or suture anchor pull-out, suture breakage, knot slippage, and tendon pull-out are well described. I report a case of early disintegration of a bioabsorbable suture anchor. A 77-year-old woman underwent arthroscopic rotator cuff repair. On suspecting failure, the repair was repeated 40 days later. Arthroscopy revealed disintegration of the suture loop from the anchor. Open rotator cuff repair was then performed with transosseous suture and metallic anchors.

Absorbable Implants↗

PubMed1995

Association of sonographically detected subacromial/subdeltoid bursal effusion and intraarticular fluid with rotator cuff tear.

OBJECTIVE: Although an association between sonographically detected joint fluid and rotator cuff disease has been reported, the significance of sonographically detected subacromial/subdeltoid bursal effusion has not been studied. We examined a group of patients who had shoulder sonography and surgery to determine the association between bursal and joint effusion and surgically proved tears of the rotator cuff. MATERIALS AND METHODS: We retrospectively reviewed the preoperative shoulder sonography reports of 163 patients for the presence of fluid within the subacromial/subdeltoid bursa or glenohumeral joint. Surgical reports were obtained to determine the status of the rotator cuff. The sonographic reports of 232 asymptomatic shoulders were also reviewed to determine the prevalence of fluid within the subacromial/subdeltoid bursa or the glenohumeral joint. RESULTS: Sixty-seven (41%) of the 163 patients had a joint effusion, bursal fluid, or both. Joint effusion alone was seen in 35 patients. Fourteen of these had a normal rotator cuff at surgery, and 21 had a rotator cuff tear (sensitivity, 22%; specificity, 79%; positive predictive value, 60%). Bursal fluid alone was seen in 10 patients, seven of whom had a rotator cuff tear (sensitivity, 7%; specificity, 96%; positive predictive value, 70%). In 22 patients, fluid was seen in both the bursa and the joint; 21 had surgically proved rotator cuff tears (sensitivity, 22%; specificity, 99%; positive predictive value, 95%). Of the 232 asymptomatic shoulders, 16 (6.9%) had isolated joint effusions, eight (3.4%) had isolated bursal effusions, and four (1.7%) had both joint and bursal effusions. CONCLUSION: The sonographic finding of intraarticular fluid alone (without bursal fluid) has both a low sensitivity and a low specificity for the diagnosis of rotator cuff tears. However, the finding of fluid in the subacromial/subdeltoid bursa, especially when combined with a joint effusion, is highly specific and has a high positive predictive value for associated rotator cuff tears. Sonographically detected fluid in both the joint and the bursa is an uncommon finding in asymptomatic shoulders. The sonographic observation of fluid in the subacromial bursa, either isolated or combined with a joint effusion, should prompt a careful evaluation of the supraspinatus tendon for tear.

Acromion↗

PubMed1995

Arthroscopic rotator cuff repairs using suture anchors.

Arthroscopic rotator cuff repairs using titanium-alloy suture anchors are a new treatment option for active patients with shoulder injuries. Shoulder arthroscopy and arthroscopic repair procedures are alternative treatments to traditional open surgical procedures for Bankart lesions and rotator cuff tears. Distinct advantages of arthroscopic repair techniques include decreased patient tissue trauma and morbidity rates and shortened recovery and rehabilitation periods.

Alloys↗

PubMed1992

[Ultrasound assessment of reconstructed rotator cuffs].

The evaluation of recurrent shoulder symptoms in patients who have had rotator cuff repair is a diagnostic challenge. Pain and limitation of motion may be caused by a recurrence of the rotator cuff tear. Arthrography is not considered to be helpful in postoperative cases, since it is false-positive in most of them. Pre-operative ultrasonography of the shoulder is regarded as a highly accurate diagnostic tool for rotator cuff tears. The diagnostic criteria used are: the continuity of the rotator cuff, its contour, its thickness and its echogenicity. Our study was aimed at determining which ultrasonographic criteria were significant for a retear. In addition, the "normal" postoperative sonographic appearance of the rotator cuff was established. Of 133 patients with a full thickness rotator cuff tear, 110 were evaluated 4-48 months (mean in 21 months) after surgery. A total of 85 cuffs were reconstructed, in 46 cases by direct suture, in 33 cases by suture to the major tubercle and in 6 cases by tendon transfer (Cofield technique). In 25 cases cuffs the could not be reconstructed. Subacromial decompression was performed routinely. The patients were evaluated clinically by range of movement, force and isometric and impingement tests. The subjective outcome was assessed by the algo-functional index of Patte. Ultrasonography was performed using a 7.5-MHz linear scanner. Each sonographic criterion was referred to the clinical and subjective findings. Ultrasonographic evaluation of the rotator cuffs that could not be reconstructed revealed non-visualization of the tendons. In 13 of the 85 patients in whom reconstruction of the cuff was possible a normal sonographic pattern was seen.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

[Traumatic rupture of the rotator cuff in an adolescent--case report].

A traumatic rotator cuff tear is a very rare condition, especially in the adolescent. We report about a 14-year-old boy who fell onto the right arm while riding his bicycle. Immediately after the accident he described some kind of click in his right shoulder. he was referred to our institution 3 days after the trauma. The MRI showed a huge defect of the labrumligament complex including the rotator interval. Intraoperatively, we found a complete disruption of the subscapularis and supraspinatus tendons as well as of the anterior stabilizers. We performed a modified Bankart repair and a reconstruction of the ruptured rotator cuff. The patient returned to his former sports as cyclist 3 months after surgery. This case is of clinical relevance because of the traumatic disruption of an intact rotator cuff in a young patient. Not the bone but rather the tendons and ligaments were the weakest link in this situation. In cases of primary traumatic shoulder dislocation, we have to look for bony and soft-tissue damage including the rotator cuff. With the present high standards in ultrasound and MR imaging we have to keep these techniques in mind in order not to overlook this type of accompanying injury.

Adolescent↗

PubMed1994

[Simultaneous lesions of the rotator cuff and the brachial plexus].

INTRODUCTION: A simultaneous lesion of the rotator cuff can be associated with a lesion of the brachial plexus and should be considered when treating the lesion of the brachial plexus. The author assesses the value of isolated rotator cuff repair. MATERIAL AND METHODS: 22 patients presented a rotator cuff tear associated with axillary nerve palsy. All of these lesions were traumatic in origin and in 20 cases were secondary to anterior shoulder dislocation. The clinical presentation was that of a "floating shoulder" with a reduction of the scapulo-humeral angle when attempting to elevate the arm. This differed from a pseudo-paralytic shoulder due to massive rotator cuff tear in which the scapulo-humeral angle remains open and from isolated paralysis of the deltoid in which active elevation of the arm is possible due to the intact rotator cuff. All of the patients had surgical repair of the rotator tear without any procedures on the deltoid. The delay from accident to surgery was on the average 65 days (range: 7 days to 9.5 months). 22 cases were followed for an average of 25 months (range: 12 to 45 months). RESULTS: 20 of the 22 cases recovered an active elevation of the arm of 120 degrees despite persistent deltoid paralysis in four cases. DISCUSSION: Our results show that the rotator cuff, especially the supraspinatus constitutes the main "motor" for shoulder elevation.

Adult↗

PubMed1999

Ultrasonographic analysis of shoulder rotator cuff tears.

Seventy-nine shoulders suspected of rotator cuff tears were examined by ultrasonography (US) and forty-three received surgery. Long and short axis scans were performed and findings of each were separately classified according to a five-grade system, and the results were correlated with the actual extent of tear observed during surgery. Internal echogenicity and subacromial impingement were analyzed before and after surgery. A accuracy of US in detecting rotator cuff tears was analyzed. In addition, the correlation between cuff shape observed by US before surgery and actual shape observed during surgery was assessed. It was noted that cuff thinning and abnormalities in shape did not recover to normal after surgery. However, in the cases of discontinuities observed by US before surgery, US findings indicated that the torn cuff was anchored to the greater tuberosity and functional during active motion. Although post-operative US findings were not normal, clinical results were good in most cases. Sensitivity of US for detecting rotator cuff tear was 100% and specificity 94%. US is non-invasive, cost effective and allows the physician to examine the joint while it is in motion. Therefore, at this time, we use US as a screening method for detecting rotator cuff tears. Furthermore, US allows us to check for re-tears while the joint is in motion, which is essential for accurate diagnosis.

Adult↗

PubMed1990

Arthroscopic acromioplasty for lesions of the rotator cuff.

Arthroscopic acromioplasty was done for a lesion of the rotator cuff in 165 patients: 100 who had stage-II impingement syndrome (no actual tear of the rotator cuff) (group 1), forty who had a partial tear (group 2), and twenty-five who had a full-thickness tear (group 3). The operation consisted of acromioplasty, resection of the coracoacromial ligament and subacromial bursa, and removal of osteophytes, when present, near the inferior aspect of the acromioclavicular joint. In the patients who had a partial or complete tear, minimum debridement of the rotator cuff also was performed. In group 1, eighty-six patients (eighty-nine shoulders) were available for review at a minimum follow-up to two years (average, 31.2 months). The preoperative ratings for pain, activities of daily living, work, and sports improved markedly in eighty-one patients postoperatively. The most common findings at operation were proliferative subacromial bursitis and an acromial protuberance. Two complications were recorded. Seven patients had a subsequent open operation on the shoulder. In group 2, the average follow-up was 28.9 months (range, twenty-four to forty-eight months). Of the forty patients, thirty-three had a major improvement in the ratings for pain, activities of daily living, work, and sports. One complication, transient palsy of the lateral femoral cutaneous nerve, was noted. Two patients who had an unsatisfactory result had a second operation: one, open acromioplasty and the other, repair of the rotator cuff. In group 3, the average follow-up was 30.8 months (range, twenty-four to fifty-five months). There were fourteen satisfactory and eleven unsatisfactory results. Of the twenty-five patients, seven later had open repair of the rotator cuff, and six had a satisfactory result from that procedure. No complications were recorded. It was concluded that arthroscopic acromioplasty is effective in the treatment of isolated stage-II impingement and partial tears of the rotator cuff. Arthroscopic treatment of complete tears produced over-all results that were inferior to those of traditional open repair. Arthroscopic subacromial decompression cannot be supported as treatment for complete tears of the rotator cuff.

Acromioclavicular Joint↗

PubMed2006

MR imaging of the rotator cuff.

MR imaging is the optimal method for evaluating suspected rotator cuff pathology. Current techniques of fast spin-echo imaging without and with fat suppression allow accurate identification and characterization of tendinous and myotendinous abnormalities of the rotator cuff. Impingement disorders, tendon degeneration, instability,and trauma comprise the multifactorial nature of rotator cuff disease. This article addresses the role of MR imaging in evaluating the rotator cuff and the importance of MR imaging in identifying other lesions that may mimic rotator cuff pathology. A rationale for protocol design, including MR arthrography and the use of specialized positioning, such as abduction and external rotation (ABER), are discussed.

Humans↗

PubMedDate not supplied

[Histomorphology versus three-dimensional ultrasound morphology of the rotator cuff].

AIM: Sonographic evaluation is a reliable method for the detection of rotator cuff tears. However, the diagnostic value of the different echogenic patterns of the rotator cuff, especially in elderly patients, has led to a controversial discussion. The present study elucidates whether three-dimensional ultrasound can increase the diagnostic significance of different sonographic echogenicity patterns of tendons compared to histopathological tissue degeneration. METHOD: To evaluate the sonographic appearance of tendons in elderly patients, the sonographic echogenicity of 33 rotator cuff specimens with macroscopic absence of rotator cuff lesions was classified in three groups and compared with the histopathological morphology. RESULTS: The sonographic appearance of the degenerated rotator cuff in elder patients correlates with a reduced sonographic echogenicity. The two-dimensional ultrasound evaluation of the rotator cuff led to a sensitivity of 84.0%, a specificity of 42.9%, a positive predictive value of 63.6%, a negative predictive value of 69.2%, and an accuracy of 65.2%. The three-dimensional ultrasound evaluation of the rotator cuff led to a sensitivity of 91.6%, a specificity of 50.0%, a positive predictive value of 66.6%, a negative predictive value of 84.6% and an accuracy of 71.%, respectively. CONCLUSION: As a high incidence of false positive results has to be taken into consideration, neither the two-dimensional, nor the three-dimensional ultrasound evaluation seems to lead to a reliable correlation.

Aged↗

PubMed2005

Repair of full-thickness rotator cuff tears in professional baseball players.

BACKGROUND: Despite the relative frequency of partial-thickness rotator cuff tears seen in baseball players, full-thickness rotator cuff tears in baseball players are uncommon. HYPOTHESIS: Return to competitive baseball is difficult after surgical treatment of a full-thickness rotator cuff tear. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: We evaluated the results of 16 professional baseball players after a mini-open repair of a full-thickness rotator cuff tear. Twelve patients were pitchers with injury to their dominant shoulders. Four patients were position players; 2 had injuries involving their dominant shoulders, and 2 had injuries to their nondominant shoulders. RESULTS: At a mean follow-up of 66.6 months for the pitchers, only 1 player (8%) was able to return to a high competitive level of baseball with no significant shoulder dysfunction after mini-open repair of a full-thickness rotator cuff tear. Of the 2 position players with mini-open repairs of the full-thickness rotator cuff tear of their dominant shoulders, 1 was able to return to professional baseball. Of the 2 position players with mini-open repairs of the full-thickness rotator cuff tear of their nondominant shoulders, both were able to return to professional baseball at the same or higher level. CONCLUSION: It is very difficult for a professional baseball pitcher to return to a competitive level of pitching after a full-thickness rotator cuff repair with a mini-open approach.

Adult↗