ABSTRACT
Background@#Massive rotator cuff tears (MRCTs) with subscapularis (SSC) tears cause severe shoulder dysfunction. In the present study, the influence of SSC tears on three-dimensional (3D) shoulder kinematics during scapular plane abduction in patients with MRCTs was examined. @*Methods@#This study included 15 patients who were divided into two groups: supraspinatus (SSP) and infraspinatus (ISP) tears with SSC tear (torn SSC group: 10 shoulders) or without SSC tear (intact SSC group: 5 shoulders). Single-plane fluoroscopic images during scapular plane elevation and computed tomography (CT)-derived 3D bone models were matched to the fluoroscopic images using two-dimensional (2D)/3D registration techniques. Changes in 3D kinematic results were compared. @*Results@#The humeral head center at the beginning of arm elevation was significantly higher in the torn SSC group than in the intact SSC group (1.8±3.4 mm vs. −1.1±1.6 mm, p<0.05). In the torn SSC group, the center of the humeral head migrated superiorly, then significantly downward at 60° arm elevation (p<0.05). In the intact SSC group, significant difference was not observed in the superior-inferior translation of the humeral head between the elevation angles. @*Conclusions@#In cases of MRCTs with a torn SSC, the center of the humeral head showed a superior translation at the initial phase of scapular plane abduction followed by inferior translation. These findings indicate the SSC muscle plays an important role in determining the dynamic stability of the glenohumeral joint in a superior-inferior direction in patients with MRCTs.
ABSTRACT
<b>Purpose & Methods</b>: With the aim of investigating how early palliative care intervention should be provided, we conducted questionnaire-based screening and QOL evaluations of patients undergoing first-line chemotherapy before and at 3 to 4 weeks after the initiation of treatment, using "a questionnaire on the ease of daily living" and the EuroQol (EQ5D), respectively. <b>Results</b>: Of the 66 patients who participated in this investigation, 56 completed the second survey. With respect to "Concerns and Worries", more than half of the respondents complained concernes/worries about "Conditions and/or Treatments" both before and after chemotherapy, but there were changes in content between the first and second surveys. "Physical Symptoms" were experienced by more than 80 percent of patients before treatment. After treatment, 13 patients saw improvement or disappearance of their symptoms and 22 patients experienced new symptoms. "Emotional Distress" decreased after treatment. This decrease was more pronounced among patients who expressed concerns about their conditions and/or treatments in the first survey. EQ5D health utility scores tended to decrease in patients who had presented with adverse reactions, but improved in those free of adverse reactions. <b>Conclution</b>: Changes were observed in patients' palliative care needs before and after the initiation of first-line chemotherapy, which indicates a need for sequential screening over the course of treatment.