Correlación clínico-ecográfica en pacientes operados de reparación artroscópica del manguito rotator / Clinical and echographic correlationship between patients with rotator cuff tear arthroscopic repair

Rotator cuff (RC) is crucial in shoulder’s movement. Lesions due to degenerative changes because of aging and activity are frequent. Surgery is an adequate approach when conservative measures have failed. The aim of this study is to evaluate the clinical and echographic evolution of patients with RC surgical repair. Methods: patients with arthroscopic RC repair underwent pre and postsurgical clinical–echographic evaluation. Results: From 24 evaluated shoulders, 8 were found to have RC tear and 24 were found to not have tear. Clinical evaluation improve substantially in both groups, with no statistical differences among them. Conclusion: There is a significant amount of patients without RC tear after surgical repair. Although there are patients with RC tear on the echographic evaluation, therte are no clinical differences compared with patients with no RC tear. Older has higher risk of retear.

El manguito rotador (MR), es fundamental para el movimiento del hombro. Su lesión es frecuente debido a los cambios degenerativos que ocurren con la edad y la actividad. La cirugía es la alternativa cuando fracasan los tratamientos conservadores. Se plantea un estudio que permita evaluar la evolución clínica y ecográfica de pacientes a los que se le reparó el MR. Metodología: A pacientes operados mediante reparación artroscópica del MR se les realizó ecografías de control y evaluación clínica del dolor pre y postquirúrgico. Resultados: De 24 hombros evaluados se encontró 16 sin rotura y 8 con rotura. La evaluación clínica mejoró sustancialmente en ambos grupos, no encontrándose diferencias estadísticamente significativas entre ellos. Conclusiones: Existe un porcentaje importante de pacientes con MR sin lesión completa posterior a reparación. A pesar de haber pacientes con rotura de MR en la evaluación ecográfica, no hay diferencias clínicas con respecto a los sin rotura. A mayor edad existe una mayor posibilidad de re-rotura.

The Short Term Effect of Ocular Digital Massage and its Echographic Evaluation Following Ahmed Glaucoma Valve Implantation

We performed a prospective study to evaluate the effect of ocular digital massage (ODM) on intraocular pressure (IOP) in eyes that underwent implantation of Ahmed Glaucoma Valve (AGV) for refractory glaucoma. Echographic study(B scan) was also used to visualize the formation of bleb around the implant and change of its size following ODM. There were 14 eyes(13 patients) in which pre-massage IOP was 17.79 +/- 6.19 mmHg and the immediate post-massage lOP showed 11.00 +/- 6.11 mmHg . IOP in 6 hours after ODM was 15.43 +/- 7.32 mmHg . These reductions in lOP were statistically significant (paired t-test, p=0.005). When classified into two groups based on the type of glaucoma and IOP reduction after ODM was compared, there was no statistically significant difference between the group with neovascular glaucoma (NVG) and that with chronic angle closure glaucoma (t-test, p=0.328). The ultrasound study showed well formed bleb around the implant in those eyes with good IOP control. Increase in the size of bleb was shown even in those with marginal/poor IOP control following ODM. There was no significant complication associated with ODM except in one eye with persistent hypotony. In conclusion, ODM showed a significant IOP reduction in short term in eyes with AGV and its relationship with bleb size was well documented with the use of echograph.