Résumé
Background@#This study evaluated the clinical and radiologic outcomes of onlay patch augmentation in rotator cuff repair for moderate-to-large tears in elderly patients. @*Methods@#We reviewed 24 patients who underwent onlay augmentation with dermal allograft after arthroscopic rotator cuff repair from January 2017 to March 2020. Inclusion criteria were patients aged >65 years with tears >2.5 cm, who were followed for >12 months after surgery, and patients who could raise their arms above 90° preoperatively. American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score, Pain visual analog scale (VAS), and VAS for satisfaction were used as clinical outcomes. For the evaluation of cuff integrity, magnetic resonance imaging scans were performed every 3 months after surgery. The results were compared before and after surgery in all patients and between the retear and intact groups. @*Results@#The average follow-up period was 16.38 months, and the mean age of patients was 71.05 years. All patients showed significant improvement in ASES score, Constant-Murley score, and pain VAS at the last evaluation. The average value of satisfaction VAS was 7.27/10. The retear rate was 25% (6/24) if Sugaya type 3 was categorized in the retear group, otherwise 16.7% (4/24), if Sugaya type 3 was categorized into the intact group. Irrespective of Sugaya type 3 being included in the retear group, there was no significant difference in outcome variables between the intact and retear groups during follow-up. @*Conclusions@#In moderate-to-large rotator cuff tear in elderly patients, onlay patch augmentation improved clinical outcomes. Retear did not adversely affect clinical outcomes.
Résumé
In order to observe the responses of the periodintal tissue on the tension side following the experimental tooth movement, 35 Guinea pigs were divided into the control group (5 animals) and 6 experimental groups (3 movement groups and 3 retention groups) consisting of each 5 animals. The experimental tooth movement of Guinea pig's upper incisors installing open helical loop were carried out by rendering continuous force: 5g (1st groups) 35g (2nd groups), 100g (3rd groups), respectively for 7 days. 3 mocement groups (15 animals) were sacrificed soon after the continuous force, and 3 retention groups (15 animals) were sacrificed after the retention period of another 7 days. The following results were obtained from the observation of the surrounding tissues of teeth on the tension side through light microscopy any transmission electron microscopy. 1. The vessel walls in th experimental groups were thinner than those of the control group, the number of blood vessel had the tendency to increase. The greater the strong force applied to each group, the more the destruction of cells and fibers was found and the more the number of the red bloof cell of vessel outside appeared. 2. New collagen fibers were produced from fibroblasts in the 1st groups (light force), but were produced rather less in the 2nd groups (medium force) and the 3rd groups (heavy force). 3. In the forming patterns of the new alveolar bone of the 3rd groups (heavy force), the bone trabeculae were formed towards the direction of the force to be applied, but the new alveolar bone in the 1st groups (light force) was produced evenly throughout the all surfaces of the alveolar bone rather than the patterns of bone trabeculae ; therefore, the patterns of new alveolar bone were observed differently according to the magnitude of the force applied. 4. In the retention group, it was observed that the collagen fibers were produced from the osteoblasts in the marginal areas of the periodontal ligaments being widely opened and were deposited on the alveolar bone surface but the production of collagen fibers from the osteoblasts in the other area of the periodontal ligaments was almost ceased, and a rest line on the new alveolar bone surface was found.