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At least 1,009 records · Page 56Linked to original sources
PubMed2000

Characteristics of polyarthritis in rabbits by hyperimmunization with attenuated Enterococcus faecalis.

To produce polyarthritis and rheumatoid factor like substance (RFLS), rabbits were hyperimmunized intravenously with 0.02% thimelosal (TMS)-treated Enterococcus faecalis (E. faecalis) as a persistent bacterial flora. Swelling of knee joints occurred at a rate of 41% (27/66), and of shoulder joints at a rate of 25% (17/66) while that of elbow joints occurred at a rate of 4.5% (3/66). On culturing of knee joint fluids, no colonies appeared while 2/4 fluid specimens from the shoulder joints gave positive colonies for 78 days after the first immunization; thereafter, no colonies appeared. On histological examination, in early stages, acute inflammatory reactions with degenerative changes of synovial tissue was observed. In later stages, chronic inflammatory changes, proliferation of synovial cells with pannus formation, destruction of articular cartilage and subchondral bone were observed. RFLS titer showed bi-phasic peaks at 11 days and 41 days after the first immunization. A high incidence of polyarthritis, particularly knee joints, occurred. Thus, hyperimmunization with attenuated E. faecalis as a normal intestinal flora may provide an animal model of chronic polyarthritis.

Agglutinins↗
PubMedDate not supplied

[Postoperatively recurring instability of the shoulder--a fault analysis in 46 cases].

AIM: The successful operative stabilization of the shoulder joint is a demanding surgical procedure. The causality of shoulder instability is complex with in some cases multiple lesions in different anatomical structures. The surgeon has to understand the complexity of factors causing instability in order to be therapeutically successful. The aim of the study was to document the intraoperative pathology in revision instability surgery. METHOD: 46 patients with recurrent postoperative instability were included (8 female, 38 male, follow-up > 12 months). After diagnostic arthroscopy an open revision surgery was performed in all cases. RESULTS: In 19 cases (40%) an insufficient surgical procedure was performed (inadequate capsular shift with worn out labral tissue). Selection of an incorrect surgical technique was the reason for revision in 12 patients (25%). Anamnestically 5 patients reported a re-injury, whereas objectively only one patient described an adequate trauma. The most frequent finding was an open rotator interval (persisting Foramen Weitbrecht), which was seen in 22 cases (46%). CONCLUSION: A stable range of motion of the shoulder is achieved by a variety of different factors, which leads in most instances to a combination of pathological changes in case of a dislocated shoulder. To understand the contributing factors of an instable shoulder joint is a necessity to carry out a successful surgical procedure.

Adult↗
PubMed1993

Arthroscopic treatment of synovial chondromatosis of the shoulder and biceps tendon sheath.

We present a case of synovial chondromatosis of the shoulder in a 22-year-old man. The patient was initially treated with arthroscopic debridement and partial synovectomy of the shoulder joint. Eighteen months later, the patient returned with similar symptoms. However, repeat radiographic studies showed involvement of both the shoulder and biceps tendon sheath. The patient was taken back to the operating room for an arthroscopic debridement of the shoulder joint and debridement of the biceps tendon sheath through an open approach. Use of the arthroscope to evaluate and treat this patient allowed him to return to normal activities much sooner than a formal open synovectomy would have allowed. Additionally, the morbidity associated with arthroscopic techniques is much lower than that of open procedures. In cases of synovial chondromatosis, the results in terms of efficacy and recurrence rates of each method appear comparable.

Adult↗
PubMed2000

Cerebellar ataxia: torque deficiency or torque mismatch between joints?

Prior work has shown that cerebellar subjects have difficulty adjusting for interaction torques that occur during multi-jointed movements. The purpose of this study was to determine whether this deficit is due to a general inability to generate sufficient levels of phasic torque inability or due to an inability to generate muscle torques that predict and compensate for interaction torques. A second purpose was to determine whether reducing the number of moving joints by external mechanical fixation could improve cerebellar subjects' targeted limb movements. We studied control and cerebellar subjects making elbow flexion movements to touch a target under two conditions: 1) a shoulder free condition, which required only elbow flexion, although the shoulder joint was unconstrained and 2) a shoulder fixed condition, where the shoulder joint was mechanically stabilized so it could not move. We measured joint positions of the arm in the sagittal plane and electromyograms (EMGs) of shoulder and elbow muscles. Elbow and shoulder torques were estimated using inverse dynamics equations. In the shoulder free condition, cerebellar subjects made greater endpoint errors (primarily overshoots) than did controls. Cerebellar subjects' overshoot errors were largely due to unwanted flexion at the shoulder. The excessive shoulder flexion resulted from a torque mismatch, where larger shoulder muscle torques were produced at higher rates than would be appropriate for a given elbow movement. In the shoulder fixed condition, endpoint errors of cerebellar subjects and controls were comparable. The improved accuracy of cerebellar subjects was accompanied by reduced shoulder flexor muscle activity. Most of the correct cerebellar trials in the shoulder fixed condition were movements made using only muscles that flex the elbow. Our findings suggest that cerebellar subjects' poor shoulder control is due to an inability to generate muscle torques that predict and compensate for interaction torques, and not due to a general inability to generate sufficient levels of phasic torque. In addition, reducing the number of muscles to be controlled improved cerebellar ataxia.

Adult↗
PubMed2005

Biomechanics of youth windmill softball pitching.

BACKGROUND: Limited research attention has been paid to the potentially harmful windmill softball pitch. No information is available regarding lower extremity kinetics in softball pitching. HYPOTHESIS: The stresses on the throwing arm of youth windmill pitchers are clinically significant and similar to those found for college softball pitchers. STUDY DESIGN: Descriptive laboratory study. METHODS: Three-dimensional, high-speed (240-Hz) video and stride foot force plate (1200 Hz) data were collected on fastballs from 53 youth softball pitchers. Kinematic parameters related to pitching mechanics and resultant kinetics on the throwing-arm elbow and shoulder joints were calculated. Kinetic parameters were compared to those reported for baseball pitchers. RESULTS: Elbow and shoulder joint loads were similar to those found for baseball pitchers and college softball pitchers. Shoulder distraction stress averaged 94% body weight for the youth pitchers. Stride foot ground reaction force patterns were not similar to those reported for baseball pitchers. Vertical and braking force components under the stride foot were in excess of body weight. CONCLUSIONS: Excessive distraction stress and joint torques at the throwing-arm elbow and shoulder are similar to those found in baseball pitchers, which suggests that windmill softball pitchers are at risk for overuse injuries. Normative information regarding upper and lower extremity kinematics and kinetics for 12- to 19-year-old softball pitchers has been established.

Adolescent↗
PubMed1995

Chronic bicipital tenosynovitis in dogs: 29 cases (1985-1992).

Medical records of 23 dogs with unilateral and 3 dogs with bilateral chronic bicipital tenosynovitis were reviewed. Mean age of affected dogs was 4.6 years (SD, 2.0 years), and mean body weight was 32.6 kg (SD, 14.5 kg). Neither a breed nor a gender predilection was detected. All dogs had a history of intermittent or progressive weight-bearing lameness that became worse after exercise. Mean duration of lameness prior to medical or surgical treatment was 6.5 months (range, 0.25 to 24 months). In all dogs, signs of pain were evident during palpation of the biceps tendon within the intertubercular groove. Radiography revealed sclerosis or osteophytosis of the intertubercular groove in all 29 shoulder joints. Mild degenerative joint disease was evident radiographically in 17. Arthrography was performed in 12 joints, and in 11 there were irregularities of or filling defects along the biceps tendon. Arthrocentesis was performed on 17 joints; 14 synovial fluid samples had cytologic abnormalities consistent with degenerative joint disease. Medical treatment, consisting of injection of methylprednisolone acetate into the biceps tendon and its synovial sheath, was attempted in 21 of the 29 affected shoulder joints. Surgery, which consisted of tenodesis of the biceps tendon, was attempted in 14 joints; 8 of these had not been treated medically; the remaining 6 had poor results following medical treatment. Gross and histologic findings consistent with chronic bicipital tenosynovitis were observed in all 14 joints in which surgery was performed. Seventeen of the medically treated shoulders were available for clinical evaluation, and results were excellent or good in 7.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2006

Traumatic pseudoaneurysm of the subclavian artery following anterior dislocation of the shoulder: a report of a surgical case.

Vascular complications associated with simple anterior dislocation of the shoulder joint are rare. We report on a patient with a pseudoaneurysm of the right subclavian artery following anterior dislocation of the right shoulder. Complaints of progressive neurological deficit and swelling in the right upper extremity were initially attributed to hemarthrosis of the right shoulder joint, but pseudoaneurysm of the right subclavian artery was identified during an emergent operation on the right shoulder. Uncontrollable arterial hemorrhaging from the skin incision erupted during the operation and was treated using a double surgical approach.

Accidental Falls↗
PubMed2005

Persistence of inter-joint coupling during single-joint elbow flexions after shoulder fixation.

Single-joint elbow flexions are associated with muscle activity at the shoulder that opposes interaction torques arising from rotation of the elbow. We have previously shown that this activity is linearly related to elbow muscle torque and is robust in the presence of novel dynamic loads. Here we examined this relationship in the context of shoulder joint fixation. We tested the hypothesis that after mechanically fixing the shoulder the relationship between shoulder muscle activity and elbow muscle torque will be preserved. In contrast, proposals in which energetic variables are optimized predict that shoulder muscle activity should cease. Subjects performed single-joint elbow flexions in a horizontal plane while interacting with the KINARM robotic exoskeleton. After repeated movements with the shoulder joint fixed we observed a slight and gradual decrease in the activity of pectoralis major relative to movements in which the shoulder was free to rotate. However the strength of the coupling between the shoulder and elbow did not change after shoulder fixation. This is consistent with our previous findings and suggests that the nervous system maintains this inter-joint coupling relationship even when activity at the fixed joint is no longer needed for movement accuracy.

Adult↗
PubMed2000

Thawing of frozen shoulder in menopausal women treated with a Japanese herbal medicine, Kanzo-to extract: report of two cases.

We report here two patients with frozen shoulder syndrome and severe menopausal symptoms. Short-term administration of Kanzo-to extract thawed the shoulders completely enough for the patients to move their cervical and shoulder joints without any restriction or pain. Their menopausal symptoms were cured simultaneously. Kanzo and Shakuyaku were found to have different effects on shoulder stiffness and disability in shoulder joints.

Humans↗
PubMed2006

[Observation on therapeutic effect of Shaoshanhuo needling method on periarthritis of shoulder].

OBJECTIVE: To observe therapeutic effect of Shaoshanhuo needling method on periarthritis of shoulder. METHODS: One hundred and twenty cases were randomly divided into two groups: a treatment group of 57 cases and a control group of 63 cases. The treatment group were treated with Shaoshanhuo needling method and massage combined with functional exercise of shoulder joint, and the control group were treated with warming acupuncture and moxibustion combined with massage and functional exercise of shoulder joint. Their therapeutic effects were evaluated after 2 courses. RESULTS: The effective rate and the cured rate were 96.5% and 70.2% in the treatment group, and 88.9% and 50.8% in the control group respectively, with no significant difference between the two groups in the effective rate (P>0.05), but with a significant difference between the two groups in the cured rate (P<0.05), the treatment group being higher than the control group. CONCLUSION: Shaoshanhuo needling method has a better therapeutic effect on periarthritis of shoulder.

Acupuncture Therapy↗
PubMed2003

MR imaging of complications of loose surgical tacks in the shoulder.

OBJECTIVE: Loose surgical tacks in the shoulder joint are a potential cause of new-onset shoulder pain after arthroscopic repair of an anterior-to-posterior lesion of the superior labrum. We report the MR imaging appearance of loose surgical tacks in this anatomic location. CONCLUSION: MR imaging is valuable in the evaluation of postoperative shoulder pain. Synovitis is a commonly considered clinical diagnosis; our report illustrates that loose tacks are another potential complication after shoulder surgery

Adolescent↗
PubMed2004

Changes in corticomotor excitability of hand muscles in relation to static shoulder positions.

We examined whether the recruitment properties of the corticospinal pathway to intrinsic hand muscles are influenced by variations of the shoulder joint angle. Abductor digiti minimi (ADM) motor evoked potentials (MEPs) in response to transcranial magnetic stimulation were examined during different static positions of the shoulder joint in the horizontal plane from 30 degrees adduction to 30 degrees abduction with respect to the neutral position at 0 degrees, while elbow and wrist joints were constrained statically at 90 degrees and 180 degrees respectively. We found that 30 degrees abduction of the shoulder significantly depressed MEP size and prolonged MEP latency in comparison with 30 degrees shoulder adduction. The neutral shoulder angle position (at 0 degrees ) significantly reduced MEP size but had no effect on MEP latency in comparison with 30 degrees shoulder abduction. The input-output relationship between MEP size and stimulus intensity was sigmoidal. The plateau value and maximum slope were significantly lower at 30 degrees abduction than at 30 degrees adduction of the shoulder. However, the threshold value did not differ significantly between the two positions. To differentiate excitability changes at cortical versus subcortical sites, intracortical inhibition (ICI) and intracortical facilitation (ICF) were assessed using a paired-magnetic pulse paradigm. A significant decrease in ICF was observed after changing shoulder position from 30 degrees adduction to 30 degrees abduction. In contrast, no variation in the amount of ICI occurred in relation to the same changes in shoulder position. ADM F-waves elicited by electrical stimulation of the ulnar nerve at the wrist were significantly decreased at 30 degrees shoulder abduction in comparison with 30 degrees adduction. A similar pattern was observed in one subject in whom the H-reflex could be exceptionally elicited in ADM. We conclude that shoulder position influences the recruitment efficiency (gain) of the corticospinal volleys to motoneurons of intrinsic hand muscles. It is proposed that activity of peripheral receptors signalling static shoulder position influences corticomotor excitability of hand muscles both at the cortical and at the spinal level. This modulation may be functionally relevant when reaching to grasp objects.

Action Potentials↗
PubMed1999

Shoulder MRI after surgical treatment of instability.

OBJECTIVE: To analyze magnetic resonance imaging (MRI) findings of the shoulder after an instability operation. MATERIALS AND METHODS: Physical examinations, radiographs and MRI of 10 patients after anterior glenoid bone block insertion for ventral instability were compared. MRI included T1-weighted spin-echo (TR = 600, TE = 20 ms) and T2*-weighted gradient-echo sequences (TE = 600, TE = 18, Flip = 30 degrees) in the axial, oblique-coronal and oblique-sagittal planes. RESULTS: No patient suffered from recurrent subluxation. We found fusion of the bone block with the anterior glenoid in seven cases, dislocation of the bone block without contact to the glenoid in one case, and no visible bone block in two cases. On MRI, the bone block showed either signal intensity equivalent to fatty bone marrow (n = 4) or was devoid of signal consistent with cortical bone or bone sclerosis (n = 4). In all patients, a low signal intensity mass, 2-4 cm in diameter, was visible next to the glenoid insertion site. CONCLUSION: Insertion of a bone block onto the anterior glenoid induces formation of scar tissue, increasing the stability of the shoulder joint. This scar is well visible on MRI and forms independently of the behavior of the bone block itself. MRI is ideally suited for evaluating postoperative shoulder joints after bone-grafting procedures.

Adult↗
PubMed1991

Clinical reliability of shoulder function assessment in patients with rheumatoid arthritis.

A model for functional assessment and a dynamic test of the shoulder joint were designed and tested for normal variation and clinical inter- and intra-rater reliability. The functional assessments, which covered four common shoulder functions, were compared with assessments of pain, recordings of active motion range and the results of a Health Assessment Questionnaire, in eight patients with rheumatoid arthritis according to the ARA criteria. Intra-rater reliability was satisfactory for all four functions and inter-rater reliability was satisfactory for the hand-raising and hand-to-opposite-shoulder functions but less so for hand-behind-back and hand-to-neck. A second test-retest study in 15 patients, with a slight modification of one of the functional tests, confirmed the results and improved the reliability of the modified test. The reliability of the dynamic test and of the active motion range measurement was less satisfactory or not satisfactory. No significant correlation was found between shoulder functional assessment and the Fries index, but there were positive significant correlations between active motion range and shoulder functions. It is concluded that the method presented for evaluating shoulder functions has satisfactory reliability and in the first test-retest study was more reliable than conventional motion range measurement of the shoulder joint.

Adult↗
PubMed1999

Early rehabilitation program in postmastectomy patients: a prospective clinical trial.

The purpose of this study was to determine whether 20 patients who received an early postmastectomy rehabilitation treatment program showed more improvement in range of shoulder motion and functional activities than 13 patients who received instruction for exercise only. Data were obtained at preoperatively, three days after operation, at discharge and at postdischarge one month for each patient on parameters such as range of motion of the ipsilateral shoulder joint, upper extremity circumferential measurements, as well as 10 elements of shoulder function. Postoperatively, both groups showed an increased range of motion of the shoulder joint and improved functional activities, but the group that received postoperative rehabilitation management had a better range of shoulder motion and less difficulty in five items for functional assessment. This study also showed that an early rehabilitation program did not increase postoperative complications. We concluded that an early rehabilitation program or intensive instruction program only by a well-trained physical therapist or physiatrist was beneficial to postmastectomy patients in regaining the function and range of shoulder motion, and significantly better in a rehabilitation group.

Adult↗
PubMedDate not supplied

Arthroscopy of the shoulder: technique and normal anatomy.

We present our technique of diagnostic and surgical arthroscopy of the shoulder and describe the normal and normal variational arthroscopic anatomy of the structures within the shoulder joint. To ensure accuracy, strict attention is given to consistent patient position and technical detail. Posterior and anterior portals are consistently located with the aid of bony anatomic landmarks. Using a large diameter angled arthroscope, structures within the shoulder joint are identified and examined in sequential order. Diagnostic arthroscopy of the shoulder can be systematic and reproducible when the surgeon is knowledgeable of the normal and normal variational anatomy of the shoulder and when attention is given to accurate placement of the arthroscopic portals and to consistent surgical technique.

Arthroscopy↗
PubMed2006

Sensorimotor contribution to shoulder stability: effect of injury and rehabilitation.

Shoulder joint stability is the humeral head remaining or promptly returning to proper alignment within the glenoid fossa. This is mediated by both mechanical and dynamic restraint mechanisms. Coordination of these restraint systems is required for shoulder joint stability. The sensorimotor system is defined as all of the sensory, motor, and central integration and processing components involved in maintaining joint stability. The sensorimotor system is comprised of several components including proprioception, joint position sense, kinesthesia, sensation of force, and neuromuscular control. With joint injury, not only are the mechanical restraints disrupted (joint capsule, glenoid labrum, etc.) but also, the sensorimotor system is affected. Restoration of the sensorimotor system has been shown to occur through both surgical and conservative intervention and rehabilitation. Surgery has been shown to restore both mechanical restraints and the sensorimotor system. Specific rehabilitation techniques have also been effective at improving the sensorimotor system in healthy and pathological patients.

Humans↗
PubMed1984

"Zero-position" functional shoulder orthosis.

The "zero-position" of the shoulder joint described by Saha (1961) is recognized as a mechanical position between scapula and humerus, and the "scapular plane" is widely accepted as a mechanical plane at the shoulder joint. On the basis of biomechanical concepts of the "zero-position" and the "scapular plane", the authors designed the "zero-position" functional shoulder orthosis. This orthosis has been successfully fitted to more than 75 patients for the postoperative management of rotator cuff injuries, and to 3 patients for the treatment of scapular neck fractures. It is introduced here, together with biomechanical considerations, structure, functional and clinical results.

Biomechanical Phenomena↗