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  • 1
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    Online Resource
    Clinical Outcomes after Subpectoral Biceps Tenodesis with an Interference Screw
    SAGE Publications ; 2008
    In:  The American Journal of Sports Medicine Vol. 36, No. 10 ( 2008-10), p. 1922-1929
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 36, No. 10 ( 2008-10), p. 1922-1929
    Abstract: Subpectoral biceps tenodesis with an interference screw has been shown to be an effective procedure from both an anatomic and biomechanical perspective. There have been no clinical outcome data on this procedure to date. Hypothesis Subpectoral biceps tenodesis is an effective procedure in eliminating biceps tendinosis symptoms. Study Design Case series; Level of evidence, 4. Methods Patients who underwent subpectoral biceps tenodesis with a minimum follow-up of 1 year were evaluated using a battery of clinical outcome measures, biceps apex difference, and pain scores. A diagnosis of biceps tendinosis was made using a specific diagnostic protocol coupled with observation of biceps tendon fraying and increased erythema on dry arthroscopy. Results Between November 2002 and August 2005, 50 patients underwent subpectoral biceps tenodesis. Complete follow-up examinations were performed in 41 of 50 (82%). There were 16 women and 25 men (mean age, 50 years). Follow-up averaged 29 months (range, 12–49 months). The mean scores were 86, Rowe; 81, American Shoulder and Elbow Surgeons (ASES); 9, Simple Shoulder Test (SST); 87, Constant Murley; and 84, Single Assessment Numeric Evaluation (SANE). There was 1 failure as demonstrated by pull-out of the tendon from the bone tunnel resulting in a “Popeye” deformity on physical examination. The mean value for biceps apex distance was 0.15 cm, with 35 of 41 patients demonstrating no difference on physical examination. Twenty-three of 41 patients had complete preoperative and postoperative examinations. All clinical outcome measures demonstrated a statistically significant improvement at follow-up when compared with the preoperative scores. Thirty-one patients had identified lesions of the rotator cuff at time of arthroscopy. The mean ASES score in patients without rotator cuff lesion (89.2 ± 10.3) was significantly greater than the mean ASES for those with rotator cuff lesion (78.0 ± 21.0) ( P = .0324). The mean SST score in patients without rotator cuff lesion (10.6 ± 1.5) was significantly greater than the mean ASES score for those with rotator cuff lesion (8.8 ± 2.7) ( P = .0132). Conclusion Subpectoral biceps tenodesis with an interference screw is a viable treatment option for patients with symptomatic biceps tendinosis. Anterior shoulder pain and biceps symptoms were resolved with this technique. Patients with coexistent rotator cuff lesion had less favorable outcomes.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546508318192
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
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  • 2
    Online Resource
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    Tendon and bone responses to a collagen-coated suture material
    Elsevier BV ; 2007
    In:  Journal of Shoulder and Elbow Surgery Vol. 16, No. 5 ( 2007-9), p. S222-S230
    Details
    In: Journal of Shoulder and Elbow Surgery, Elsevier BV, Vol. 16, No. 5 ( 2007-9), p. S222-S230
    Type of Medium: Online Resource
    ISSN: 1058-2746
    URL: Article
    DOI: 10.1016/j.jse.2007.02.113
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2007
    detail.hit.zdb_id: 2046901-9
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  • 3
    Online Resource
    Online Resource
    Biologics in Shoulder Surgery: The Role of Adult Mesenchymal Stem Cells in Tendon Repair
    Ovid Technologies (Wolters Kluwer Health) ; 2007
    In:  Techniques in Orthopaedics Vol. 22, No. 1 ( 2007-03), p. 2-9
    Details
    In: Techniques in Orthopaedics, Ovid Technologies (Wolters Kluwer Health), Vol. 22, No. 1 ( 2007-03), p. 2-9
    Type of Medium: Online Resource
    ISSN: 0885-9698
    URL: Article
    DOI: 10.1097/01.bto.0000261728.04529.0b
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2007
    detail.hit.zdb_id: 2055188-5
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  • 4
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    Online Resource
    Treating the Athlete with Anterior Shoulder Instability
    Elsevier BV ; 2008
    In:  Clinics in Sports Medicine Vol. 27, No. 4 ( 2008-10), p. 631-648
    Details
    In: Clinics in Sports Medicine, Elsevier BV, Vol. 27, No. 4 ( 2008-10), p. 631-648
    Type of Medium: Online Resource
    ISSN: 0278-5919
    URL: Article
    DOI: 10.1016/j.csm.2008.06.003
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2008
    SSG: 31
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  • 5
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    Online Resource
    The Recognition and Treatment of First-Time Shoulder Dislocation in Active Individuals
    Journal of Orthopaedic & Sports Physical Therapy (JOSPT) ; 2009
    In:  Journal of Orthopaedic & Sports Physical Therapy Vol. 39, No. 2 ( 2009-02), p. 118-123
    Details
    In: Journal of Orthopaedic & Sports Physical Therapy, Journal of Orthopaedic & Sports Physical Therapy (JOSPT), Vol. 39, No. 2 ( 2009-02), p. 118-123
    Type of Medium: Online Resource
    ISSN: 0190-6011 , 1938-1344
    URL: Article
    DOI: 10.2519/jospt.2009.2804
    Language: English
    Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
    Publication Date: 2009
    detail.hit.zdb_id: 2113650-6
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  • 6
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    Online Resource
    Arthroscopic Management of 270° Labral Tears
    Elsevier BV ; 2008
    In:  Operative Techniques in Orthopaedics Vol. 18, No. 1 ( 2008-1), p. 46-52
    Details
    In: Operative Techniques in Orthopaedics, Elsevier BV, Vol. 18, No. 1 ( 2008-1), p. 46-52
    Type of Medium: Online Resource
    ISSN: 1048-6666
    URL: Article
    DOI: 10.1053/j.oto.2008.07.005
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2008
    detail.hit.zdb_id: 2150384-9
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  • 7
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    Arthroscopic Single-Row versus Double-Row Suture Anchor Rotator Cuff Repair
    SAGE Publications ; 2005
    In:  The American Journal of Sports Medicine Vol. 33, No. 12 ( 2005-12), p. 1861-1868
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 33, No. 12 ( 2005-12), p. 1861-1868
    Abstract: Recurrent defects after open and arthroscopic rotator cuff repair are common. Double-row repair techniques may improve initial fixation and quality of rotator cuff repair. Purpose To evaluate the load to failure, cyclic displacement, and anatomical footprint of 4 arthroscopic rotator cuff repair techniques. Hypothesis Double-row suture anchor repair would have superior structural properties and would create a larger footprint compared to single-row repair. Study Design Controlled laboratory study. Methods Twenty fresh-frozen cadaveric shoulders were randomly assigned to 4 arthroscopic repair techniques. The repair was performed as either a single-row technique or 1 of 3 double-row techniques: diamond, mattress double anchor, or modified mattress double anchor. Angle of loading, anchor type, bone mineral density, anchor distribution, angle of anchor insertion, arthroscopic technique, and suture type and size were all controlled. Footprint length and width were quantified before and after repair. Displacement with cyclic loading and load to failure were determined. Results There were no differences in load to failure and displacement with cyclic loading between the single-row repair and each double-row repair. All repair groups demonstrated load to failure greater than 250 N. A significantly greater supraspinatus footprint width was seen with double-row techniques compared to single-row repair. Conclusions The single-row repair technique was similar to the double-row techniques in load to failure, cyclic displacement, and gap formation. The double-row anchor repairs consistently restored a larger footprint than did the single-row method. Clinical Relevance The arthroscopic techniques studied have strong structural properties that approached the reported performance of open repair techniques. Double-row techniques provide a larger footprint width; although not addressed by this study, such a factor may improve the biological quality of repair.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546505279575
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2005
    detail.hit.zdb_id: 2063945-4
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  • 8
    Online Resource
    Online Resource
    Intra-Articular Partial-Thickness Rotator Cuff Tears : Analysis of Injured and Repaired Strain Behavior
    SAGE Publications ; 2008
    In:  The American Journal of Sports Medicine Vol. 36, No. 1 ( 2008-01), p. 110-116
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 36, No. 1 ( 2008-01), p. 110-116
    Abstract: There are few biomechanical studies regarding partial-thickness rotator cuff tears and subsequent repair. Hypothesis Partial-thickness intra-articular supraspinatus tendon tears increase articular-sided tendon strain as they increase in size. Repair of these tears will return strain to the intact state. Study Design Controlled laboratory study. Methods Twenty fresh-frozen human cadaveric shoulders were prepared by dissecting to the supraspinatus tendon and leaving the native footprint intact. The tendon footprint was measured with digital calipers and divided into thirds (anterior, middle, and posterior). The middle third was the area where a consistent partial tear was created based on the thickness of the specimens’ particular footprint. Created were 25%, 50%, and 75% tears. Image analysis software and differential variable reluctance transducers strain gauges were used to measure strain. A 100 N load at 1 Hz for 30 cycles was conducted for glenohumeral angles of 45°, 60°, and 90°. This was completed for the intact tendon, 25%, 50%, and 75% tears. Shoulders were then repaired using the in situ fixation method. The in situ method consisted of either a parachute anchor or metal corkscrew anchor. Eight shoulders were examined for load-to-failure testing with the Materials Testing System. Results There was a significant difference ( P 〈 .05) in rotator cuff strain between the intact rotator cuff tendon and 50% and 75% partial-thickness tears. The cuff strain was returned to the intact state with repair. This was consistent for 3 different glenohumeral abduction angles and for all 3 intra-articular tendon areas. The bursal strain did not have any significant differences between groups. Conclusion Articular-sided tendon strain increases consistently across the supraspinatus tendon with greater partial tears. Repair returned strain close to the intact state. Clinical Relevance This study may add credence to the clinical practice of repairing intra-articular partial-thickness rotator cuff tears greater than 50%.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546507307502
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
    detail.hit.zdb_id: 2063945-4
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  • 9
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    Online Resource
    Letters to the Editor
    SAGE Publications ; 2007
    In:  The American Journal of Sports Medicine Vol. 35, No. 3 ( 2007-03), p. 493-496
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 35, No. 3 ( 2007-03), p. 493-496
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/036354650703500319
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
    detail.hit.zdb_id: 2063945-4
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  • 10
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    Online Resource
    A Biomechanical Evaluation of an Anatomical Coracoclavicular Ligament Reconstruction
    SAGE Publications ; 2006
    In:  The American Journal of Sports Medicine Vol. 34, No. 2 ( 2006-02), p. 236-246
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 34, No. 2 ( 2006-02), p. 236-246
    Abstract: Despite numerous surgical techniques described, there have been few studies evaluating the biomechanical performance of acromioclavicular joint reconstructions. Purpose To compare a newly developed anatomical coracoclavicular ligament reconstruction with a modified Weaver-Dunn procedure and a recently described arthroscopic method using ultrastrong nonabsorbable suture material. Study Design Controlled laboratory study. Methods Forty-two fresh-frozen cadaveric shoulders (72.8 ± 13.4 years) were randomly assigned to 3 groups: arthroscopic reconstruction, anatomical coracoclavicular reconstruction, and a modified Weaver-Dunn procedure. Bone mineral density was obtained on all specimens. Specimens were tested to 70 N in 3 directions, anterior, posterior, and superior, comparing the intact to the reconstructed states. Superior cyclic loading at 70 N for 3000 cycles was then performed at a rate of 1 Hz, followed by a load to failure test (120 mm/min) to simulate physiologic states at the acromioclavicular joint. Results In comparison to the intact state, the modified Weaver-Dunn procedure had significantly (P 〈 . 05) greater laxity than the anatomical coracoclavicular reconstruction or the arthroscopic reconstruction. There were no significant differences in bone mineral density (g/cm2), load to failure, superior migration over 3000 cycles, or superior displacement. The anatomical coracoclavicular reconstruction had significantly less (P 〈 . 05) anterior and posterior translation than the modified Weaver-Dunn procedure. The arthroscopic reconstruction yielded significantly less anterior displacement (P 〈 . 05) than the modified Weaver-Dunn procedure. Conclusion The anatomical coracoclavicular reconstruction has less anterior and posterior translation and more closely approximates the intact state, restoring function of the acromioclavicular and coracoclavicular ligaments. Clinical Relevance A more anatomical reconstruction using a free tendon graft of both the trapezoid and conoid ligaments may provide a stronger, permanent biologic solution for dislocation of the acromioclavicular joint. This reconstruction may minimize recurrent subluxation and residual pain and permit earlier rehabilitation.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546505281795
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2006
    detail.hit.zdb_id: 2063945-4
    SSG: 31
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