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Humeral Head Decentralization of Preoperative Magnetic Resonance Images and the Treatment of Shoulder Dislocations in Large to Massive Rotator Cuff Tears in Elderly over 65 Years Old / 대한정형외과학회잡지
The Journal of the Korean Orthopaedic Association ; : 418-426, 2019.
Artigo em Coreano | WPRIM | ID: wpr-770085
ABSTRACT

PURPOSE:

This study analyzed the features of humeral head decentralization in large to massive rotator cuff tears with a shoulder dislocation in the elderly. Moreover, shoulder instability and treatment were reviewed. MATERIALS AND

METHODS:

From May 2005 to February 2017, Group A containing 45 cases (45 patients) over 65 years old accompanied by a large or massive rotator cuff tear with a shoulder dislocation and Group B containing 45 cases (45 patients) without a shoulder dislocation were enrolled. The mean ages in Groups A and B were 73.2 and 72.1 years old, and the mean follow-up periods were 30.7 and 31.3 months, respectively. Twenty-one cases (46.7%) in Group A underwent rotator cuff repair, and 8 cases (17.8%) underwent concomitant rotator cuff repair with Bankart repair. Sixteen cases (35.6%) underwent reverse total shoulder arthroplasty for cuff tear arthropathy. 45 cases (100%) in Group B underwent rotator cuff repair. The off-the center and head elevation were measured in the preoperative magnetic resonance imaging (MRI) of Groups A and B. The preoperative and postoperative visual analogue scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and University of California Los Angeles (UCLA) score in Groups A and B were compared.

RESULTS:

In Groups A and B, the mean off-the centers were posterior 7.41 mm and posterior 2.02 mm (p=0.03), and the mean head elevations were superior 6.66 mm and superior 2.44 mm (p=0.02), respectively. The mean ASES scores of Groups A and B were 32.8 and 33.4 before surgery, and 77.1 (p=0.02) and 78.1 (p=0.02) after surgery (p=0.18), respectively. The mean UCLA scores of Groups A and B were 13.1 and 12.8 before surgery, and 28.9 (p=0.02) and 29.5 (p=0.01) after surgery (p=0.15), respectively.

CONCLUSION:

Patients over 65 years old with a shoulder dislocation in large to massive rotator cuff tears had higher off-the center and head elevation on the preoperative MRI than those without a shoulder dislocation. This measurement can help predict preceding shoulder instability. Early rotator cuff repairs should be performed and other treatments, such as Bankart repair and reverse total shoulder arthroplasty, should also be considered.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Política / Artroplastia / Ombro / Luxação do Ombro / Lágrimas / Imageamento por Ressonância Magnética / California / Seguimentos / Manguito Rotador / Cotovelo Tipo de estudo: Estudo observacional / Estudo prognóstico Limite: Idoso / Humanos País/Região como assunto: América do Norte Idioma: Coreano Revista: The Journal of the Korean Orthopaedic Association Ano de publicação: 2019 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Política / Artroplastia / Ombro / Luxação do Ombro / Lágrimas / Imageamento por Ressonância Magnética / California / Seguimentos / Manguito Rotador / Cotovelo Tipo de estudo: Estudo observacional / Estudo prognóstico Limite: Idoso / Humanos País/Região como assunto: América do Norte Idioma: Coreano Revista: The Journal of the Korean Orthopaedic Association Ano de publicação: 2019 Tipo de documento: Artigo