Comparison of Two Arthroscopic Coracoplasty Approaches in Subscapularis Tears

BACKGROUND: Few studies have reported the results of arthroscopic coracoplasty concomitantly conducted with subscapularis tear. Therefore, this study was conducted to examine and compare the outcomes of arthroscopic subscapularis repair after arthroscopic coracoplasty using either the subacromial approach or rotator interval approach. METHODS: We retrospectively reviewed 51 patients who underwent coracoplasty with subscapularis repair. The patients were grouped according to whether the subacromial approach group (24 patients) or rotator interval approach group (27 patients) was used during coracoplasty. Preoperative and postoperative visual analogue scale scores, American shoulder and elbow surgeons scores, Korean shoulder scores, and range of motion (ROM) were assessed. Assessment of repaired rotator cuff tendon integrity was performed at 1 year after surgery using either magnetic resonance imaging or ultrasonography. RESULTS: At final follow-up, overall functional scores and ROM improved significantly in both groups when compared with preoperative values (p>0.05). The re-tear rates were not significantly different between groups; however, the rotator interval approach group showed a significant increase in ROM compared with that in the subacromial approach group (p<0.05). CONCLUSIONS: Arthroscopic coracoplasty conducted concomitantly with subscapularis repair can provide a satisfactory outcome. There were no significant differences between the two approach groups regarding final functional scores and re-tear rates. However, the rotator interval approach group showed a greater increase in ROM at final follow-up, especially in external rotation.

Comparison of Two Arthroscopic Coracoplasty Approaches in Subscapularis Tears

BACKGROUND: Few studies have reported the results of arthroscopic coracoplasty concomitantly conducted with subscapularis tear. Therefore, this study was conducted to examine and compare the outcomes of arthroscopic subscapularis repair after arthroscopic coracoplasty using either the subacromial approach or rotator interval approach. METHODS: We retrospectively reviewed 51 patients who underwent coracoplasty with subscapularis repair. The patients were grouped according to whether the subacromial approach group (24 patients) or rotator interval approach group (27 patients) was used during coracoplasty. Preoperative and postoperative visual analogue scale scores, American shoulder and elbow surgeons scores, Korean shoulder scores, and range of motion (ROM) were assessed. Assessment of repaired rotator cuff tendon integrity was performed at 1 year after surgery using either magnetic resonance imaging or ultrasonography. RESULTS: At final follow-up, overall functional scores and ROM improved significantly in both groups when compared with preoperative values (p>0.05). The re-tear rates were not significantly different between groups; however, the rotator interval approach group showed a significant increase in ROM compared with that in the subacromial approach group (p<0.05). CONCLUSIONS: Arthroscopic coracoplasty conducted concomitantly with subscapularis repair can provide a satisfactory outcome. There were no significant differences between the two approach groups regarding final functional scores and re-tear rates. However, the rotator interval approach group showed a greater increase in ROM at final follow-up, especially in external rotation.

Arthroscopic Excision of Intra-articular Osteochondroma of the Elbow: A Case Report

Osteochondromas are one of the most common benign bone tumors usually involving extraarticular metaphysis of long bone. Solitary intra-articular osteochondroma arising from the elbow joint has rarely been reported. We present a case of 23-year-old female who had pain and limited motion of the left elbow as a result of intraarticular osteochondroma of the distal humerus. Arthroscopic excision of the osteochondroma yielded complete relief of symptoms. Absence of recurrence was confirmed radiographically at two years after surgery. To the best of our knowledge, this is the first report of osteochondroma of the elbow successfully treated arthroscopically.

Arthroscopic Excision of Intra-articular Osteochondroma of the Elbow: A Case Report

Osteochondromas are one of the most common benign bone tumors usually involving extraarticular metaphysis of long bone. Solitary intra-articular osteochondroma arising from the elbow joint has rarely been reported. We present a case of 23-year-old female who had pain and limited motion of the left elbow as a result of intraarticular osteochondroma of the distal humerus. Arthroscopic excision of the osteochondroma yielded complete relief of symptoms. Absence of recurrence was confirmed radiographically at two years after surgery. To the best of our knowledge, this is the first report of osteochondroma of the elbow successfully treated arthroscopically.

Biomechanical Analysis of a Novel Wedge Locking Plate in a Porcine Tibial Model

BACKGROUND: The purpose of this study was to analyze biomechanical properties of a novel wedge locking plate in medial open wedge high tibial osteotomy (OWHTO) in a porcine tibial model. METHODS: A uniform 8-mm OWHTO was performed in 12 porcine tibiae. Six of them were subsequently fixed with the plate without a wedge, whereas the other 6 were additionally reinforced with a metal wedge of 8 mm. Biomechanical properties (stiffness, displacement of the osteotomy gap, and failure load) were evaluated under axial load. The different modes of failure were also investigated. RESULTS: The plate showed an axial stiffness of 2,457 ± 450 N/mm with a wedge and 1,969 ± 874 N/mm without a wedge. The maximum failure load was 5,380 ± 952 N with a wedge and 4,354 ± 607 N without a wedge. The plate with a wedge had a significantly greater failure load and significantly less displacement of medial gap at failure than that without a wedge (p = 0.041 and p = 0.002, respectively). The axial stiffness was not different between the two types of fixation. Most failures were caused by lateral cortex breakage and there was no implant failure. CONCLUSIONS: The novel wedge locking plate showed excellent biomechanical properties and an additional wedge provided significant improvement. This plate can be a good fixation method for OWHTO.