Adhesive Capsulitis Secondary to COVID-19 Vaccination - A Case Series

@#Introduction: Shoulder injury related to vaccine administration (SIRVA) is a group of pathologies defined by pain and stiffness after intramuscular administration of vaccine to the upper arm and has been reported after COVID-19 vaccination. We aim to discuss its pathophysiology, clinical presentation, treatment and outcomes. Materials and methods: We retrospectively identified patients presenting with adhesive capsulitis within four weeks of administration of COVID-19 vaccine to the affected arm at our tertiary institution from March 2021 to December 2022. Result: Based on the above criteria, we identified seven cases of adhesive capsulitis, comprising one male and six female patients, with average age of 60 years. We present initial symptoms, signs and the duration from when the vaccine was administered. We have highlighted our treatment strategies as well as the clinical and functional outcomes reported by these patients after treatment. We have reported improvement in both Visual Analogue Scale (VAS) and range of motion (ROM) in all our patients after nonsurgical management which included physiotherapy and, in some cases, hydrodilatation. Conclusion: SIRVA related adhesive capsulitis is rare and under-reported with limited information in current literature. This study highlights that adhesive capsulitis is a potential complication arising from improper COVID-19 vaccine administration and reinforces traditional wisdom of administering vaccinations on the non-dominant arm. Conservative treatment strategies appear to be effective, particularly hydrodilatation combined with physiotherapy, and patients are expected to have a good return of function.

Introducing a Novel Method of Patella Tendon Defunctioning using Suture Anchors after a Tibial Tuberosity Avulsion Repair: Report of Three Cases

@#Tibial tuberosity avulsion injuries are rare and result from direct trauma to the tibial tuberosity or forceful and repetitive contraction of the quadriceps muscles. In this case series, we describe a novel method of defunctioning the patella tendon using a suture anchor after a tibial tuberosity avulsion fracture repair was performed. We present three consecutive patients with tibial tuberosity avulsion fractures who were treated by the same surgeon using the technique described. Pre and post-operative range of motion of the knee joint were then reviewed retrospectively. All patients achieved preinjury range of motion within three months post-operatively. In conclusion, defunctioning the patellar tendon with a suture anchor is a reliable and reproducible technique. The new technique yielded excellent functional outcomes which allowed patients to regain their pre-injury range of motion and the strength of the construct allows early range of motion.