The kringle suture: maximizing tendon repair stability while limiting hardware utilization-description of the technique and preliminary results.

BACKGROUND: Arthroscopic repair currently represents the gold standard surgical treatment for rotator cuff tears, despite several aspects that are still matter of discussion between surgeons, and it is not clear yet what technique is better with respect to the others. Several evidences, however, support the assumption that the suture configuration is most important than the number of suture anchors used. MATERIALS AND METHODS: In this work, we describe a new suture technique for arthroscopic supraspinatus tendon repair using a single double-loaded common suture anchor, and based on a continue and multi-passage suture configuration, with final gross resemblance to the nordic kringle pastries or to the kringle protein domain. Between June 2015 and July 2016, 44 patients (44 shoulders) were treated for supraspinatus tendon tear by means of the kringle suture. Of these, 36 patients have been evaluated from the clinical and radiographic site in the setting of this study, with a follow-up time ranging from 18 to 30 months. RESULTS: During the follow-up period, no major complications were recorded. Two patients reported a transient postoperative stiffness, which completely resolved upon 6 months from surgery. All of the patients referred complete subjective satisfaction and return to their daylife activities without pain. No sign of radiographic subsidence of the suture anchors was found at the radiographic analysis. CONCLUSION: The kringle suture technique is cost saving, easy to perform, versatile and provides excellent initial fixation strength as required for tendon to bone healing of the reinserted cuff.

[Effectiveness and tolerability of celecoxib in outpatient department practice]. / Efficacia e tollerabilità del celecoxib nella pratica clinica ambulatoriale.

OBJECTIVES: Object of this work is to evaluate activity and tolerance of Celecoxib in out-patient's department practice. PATIENTS AND METHODS: In this study we enlisted 46 patients, affected by pain of inflammatory or degenerative origin; any of them ever did continued therapy with NSAIDs before. We administered 200 mg daily dose of Celecoxib for at least three months. Each patient has been evaluated by the Visual Analogic Score (VAS) Scale before and after the therapy. RESULTS: The data We obtained agree with those of multicenter studies like CLASS. Celecoxib had similar efficacy respect with traditional NSAIDs, with good control of pain in both osteoarthrosic and arthritic pain (p < 0.000). Not good results were obtained for control of acute-onset pain. In our population We didn't find side-effects different from those included in the technical-form of the drug. The only patient who complained of epigastric pain did not stop the treatment, because the symptom resolved with assumption of the drug during meals. CONCLUSIONS: By the analysis of the results We consider Celecoxib useful for the control of pain in the treatment of osteoarthrosis and autoimmune diseases like Rheumatoid Arthritis. Anyway, treatment with Celecoxib (as with all Coxib-family drugs) should be reserved for long-lasting treatments in patients at risk for gastrointestinal bleeding.