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Objective To compare the early curative effects of arthroscopic modified suture bridge and single-row modified Mason-Allen suture in repair of supraspinatus tendon tears.Methods A retrospective case-control analysis was made on 28 patients with supraspinatus tendon tears admitted between June 2012 and June 2015.There were 16 males and 12 females,aged 43-63 years (mean,54.2 years).Thirteen patients (13 shoulders) were repaired using the arthroscopic modified suture bridge technique (Group A),and 15 patients (15 shoulders) were treated using the single-row modified Mason-Allen technique (Group B).Operation time and intraoperative blood loss were recorded.American shoulder and elbow surgeons (ASES) score,Constant score and visual analogue score (VAS) were used to evaluate the function and subjective outcomes preoperatively.Meanwhile,MRI was used for analysis of tendon integrity postoperatively.Results The operation time of Group A and B were (56.1 ± 23.2) minutes and (36.1 ± 15.6) minutes,respectively (P ＜ 0.05).The intraoperative blood loss was (30.3 ± 20.5) ml and (28.5 ± 18.2) ml,respectively (P ＞ 0.05).The average follow-up time for Groups A and B were 12 months and 12.6 months,respectively.The symptoms of 28 cases were alleviated after surgery,and the functions were obviously recovered.In Group A,thc VAS was decreased significantly from (7.0 ± 0.8) points preoperatively to (0.8 ± 0.8) points at final follow-up,ASES score was improved from (39.8 ± 3.1) points to (88.1 ± 4.8) points,and Constant score was improved from (54.8 ± 2.7) points to (88.2 ± 3.1) points (all P ＜ 0.05).In Group B,the VAS was decreased significantly from (6.8 ± 0.8) points preoperatively to (0.9 ± 0.8) points at final follow-up,ASES score was improved from (40.7 ± 2.5) points to (89.5 ± 3.2) points,and Constant score was improved from (56.0 ± 4.5) points to (89.3 ± 3.4) points (all P ＜ 0.05).There was no significant difference in the clinical outcomes between the two groups (P ＞ 0.05).The retear rate in Group B was 20％ (3/15),while no retear was presented in Group A (P ＜ 0.05).Conclusion Arthroscopic modified suture bridge technique and single-row modified Mason-Allen technique are both clinically effective for function recovery and pain relief in patients with supraspinatus tendon tears,but the former associated with lower incidence of tendon re-tear is preferred for moderate to large rotator cuff injury or rotator cuff injury with large insertion avulsion.
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Objective To investigate the long-term effects of modified Bristow-Latarjet operation for treatment of recurrent inferoanterior shoulder dislocation.Methods A retrospective case series study was done on 90 patients with recurrent inferoanterior shoulder dislocation treated by modified Bristow-Latarjct procedure from January 2001 to January 2016.There were 72 males and 18 females,with an average age of 36.8 years.There were 59 fight shouders and 31 left shoulders,with dislocation for 4-32 times (mean,13 times).Shoulder instability severity index score (ISIS) was 3-10 points (mean,6.4 points).The duration of disease was 6-26 months (mean,13 months).The operation methods were coracoid lateral incision with modification,rotator cuff interval approach,double hollow compression screw fixation,and bone congruent-arc technique in standing position.Clinical evaluation was done on postoperative recurrence of shoulder joint dislocation/subluxation,bone healing evaluated by X-ray and CT,Rowe score,simple shoulder function Test (SST) score,shoulder osteoarthritis score (Samilson-Prieto),bodv side shoulder external rotation angle and the subscapularis muscle strength.Results All patients were followed up for 1-15 years (mean,5.6 years).The rate of redislocation or subluxation during follow-up was zero.All transpositions of the coracoid got bone healing at postoperative 3-6 months.The Rowe score was increased significantly from (45.6 ± 9.4) points preoperatively to (92.6 ± 3.5) points postoperatively (P ＜0.01);SST score was increased significantly from (5.6 ± 1.2)points preoperatively to (9.6 ± 2.8) points postoperatively at final follow-up) (P ＜ 0.01).Samilson-Prieto score was mild in 2 patients (2％).The body side shoulder external rotation angles were (56.7 ± 13.9) ° preoperatively and (54.6 ±14.1) ° postoperatively (P ＞ 0.05).With regards to subscapularis strength,the lift-off and belly-press in injured side were (4.9 ± 0.9) kg and (4.4 ± 1.0) kg,respectively (P ＞ 0.05).Lift-off and belly-off in normal side were (5.1 ± 0.5) kg and (4.7 ± 1.1) kg,respectively (P ＞ 0.05).Conclusion The modified Bristow-Latarjet operation is a reproducible and effective technique that can restore shoulder stability,with advantages of sound bone healing,free shoulder external rotation,low incidence of shoulder joint osteoarthritis,remaining of myodynamia under scapula and hence has long-term effects and is worth of clinical applicaiton.
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Objective To evaluate the short-term effects of total knee arthroplasty ( TKA) , and to detect the causes and prevention of major complications. Methods It was a retrospective study since January 2010 to December 2013. There were 63 patients with 70 knees re-ceived primary TKA. KSS knee scores, HSS knee scores, and range of motion ( ROM) before the operation and during the follow-up were as-sessed and analysed. Results According to the results of follow-up and the X-ray observation, the anteroposterior radiographs showed that the artificial prosthesis were placed well and the joint gap were balanced;the lateral radiographs showed that the artificial joint prosthesis we-rer of appropriate size, good tilt angle, and good package effect. There were two cases developed peroneal nerve palsy and they gradually re-stored in 4 to 6 months after surgery. 5 cases were of poor postoperative ROM (0~60 ± 10)°. Strong analgesic medication-assisted release were conducted in 2 to 3 weeks after surgery. 1 case had patellar pain and resorted by arthroscopic lateral ligament of patellar releasing sur-gery. During the follow-up period, TKA significantly improved HSS and KSS scores compared to preoperative scores. ROM was increased from (78. 3 ± 18. 6)° preoperatively to (109. 2 ± 19. 9)° postoperative (P<0. 01). Conclusion TKA was effective to release knee pain, improve ROM and reduce the incidence of postoperative complications.
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Objective To evaluate the clinical results of proximal humeral internal locking sys-tem(PHILOS)self-locking plates in treatment of proximal humeral fractures. Methods There were 35 patients including 19 males and 16 females(at mean age of 53.5 years,ranging from 29 to 92 years)with proximal humeral fractures treated with PHILOS plate.According to the Neer's classification sys-tem,there were two-part fractures in 19 patients,three-part fractures in 15 and four-part fractures in 1.Surgery was performed with PHILOS serf-locking plate via dehopectoral approach.All patients were fol-lowed up for mean 18.9 months(6-46 months)and evaluated by using Constant score and X-rays. Re-suits X-rays proved that all fractures got good reduction and complete healing during 8-12 weeks.The latest Constant scores was mean 89.5 points(82-94 points).There were no complications including plate loosing.humenral head necrosis or gleno-humeral ioint osteoarthritis. Conclusion PHILOS plate is a good choice for treatment of proximal humeral fractures because of its advantages including easy operation,stable fixation,good clinical results and few complications.
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Objective To introduce a new modified Bristow operation with mini-open incision and evaluate jts clinical outcomes in treatment of recurrent anteroinferior shoulder dislocation. Methods A total of 11 patients with recurrent anteroinferior shoulder dislocation were treated with modified Bristow op-eration with mini-open incision.The anterior skin incision with 3-5 mm was made to explore the coracoid process with"moving window"technique.Then.the coracoid process and its short head of biceps were os-teotornjed.transferred and fixed on the anteroinferior potion of scapular neck through the rotator cuff inter-space.All patients were followed up for an average period of 15.8 months(6-48 months)by using modified Rowe score. Results The average operation time was 45 minutes(40-65 minutes).The modified Rowe 8core ranged from 80 to 95 points.excellent in all patients, with SUCCESS rate of 100% and without any re-currence or complication. Conclusions Compared with traditional operation.the modified Bristow oper-ation has smaller incision,less trauma.shorter operation duration and better clinical results.