Diagnostics

Research

12 pages, 980 KiB

Open AccessArticle

Shoulder Proprioception and Its Correlation with Pain Intensity and Functional Disability in Individuals with Subacromial Impingement Syndrome—A Cross-Sectional Study

by Fareed F. Alfaya, Ravi Shankar Reddy, Batool Abdulelah Alkhamis, Praveen Kumar Kandakurti and Debjani Mukherjee

Diagnostics 2023, 13(12), 2099; https://doi.org/10.3390/diagnostics13122099 - 17 Jun 2023

Cited by 3 | Viewed by 2356

Abstract

Subacromial Impingement Syndrome (SAIS) is a common shoulder condition characterized by pain and functional impairment. Proprioception, the sense of joint position and movement, is crucial in maintaining joint stability and coordinating movements. The relationship between shoulder proprioception, pain intensity, and functional disability in [...] Read more.

Subacromial Impingement Syndrome (SAIS) is a common shoulder condition characterized by pain and functional impairment. Proprioception, the sense of joint position and movement, is crucial in maintaining joint stability and coordinating movements. The relationship between shoulder proprioception, pain intensity, and functional disability in individuals with SAIS remains unclear, with conflicting findings in the literature. This cross-sectional study aimed to evaluate shoulder proprioception, examine its correlation with pain intensity and functional disability, and contribute to our understanding of the clinical implications of proprioceptive deficits in individuals with SAIS. Forty-two individuals were diagnosed with SAIS, and an equal number of asymptomatic controls were recruited. Shoulder proprioception was assessed using a digital inclinometer, measuring joint position sense at various angles of flexion and rotation. Pain intensity was measured using the Visual Analog Scale (VAS), and functional disability was assessed using the Shoulder Pain and Disability Index (SPADI). Results: Individuals with SAIS exhibited significantly higher joint position error (JPE) values compared to asymptomatic controls in all measured angles of flexion and rotation (p < 0.001). Strong positive correlations were observed between JPE and pain intensity (r = 0.61 to 0.71, p < 0.01) and disability (r = 0.56 to 0.68, p < 0.01). These findings suggest impaired shoulder proprioception is associated with higher pain intensity and functional disability in SAIS. This study provides evidence of impaired shoulder proprioception in individuals with SAIS and its correlation with pain intensity and functional disability. The results highlight the clinical relevance of proprioceptive deficits in SAIS and emphasize the importance of incorporating proprioceptive assessment and targeted rehabilitation interventions into managing this condition. Future research should focus on longitudinal studies with larger and more diverse samples to further understand the underlying mechanisms and evaluate the effectiveness of proprioceptive interventions in improving outcomes for individuals with SAIS. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Shoulder and Elbow Disease and Trauma 2.0)

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11 pages, 5249 KiB

Open AccessArticle

A Comparison of Clinical Outcomes in Rotator Cuff Re-Tear Patients Who Had Either an Arthroscopic Primary Repair or Arthroscopic Patch Augmentation for Large-to-Massive Rotator Cuff Tears

by Ki-Tae Kim, Gwan-Ho Kim, Dong-Heon Cha, Jae-Hoo Lee and Yong-Beom Lee

Diagnostics 2023, 13(11), 1961; https://doi.org/10.3390/diagnostics13111961 - 04 Jun 2023

Cited by 3 | Viewed by 1240

Abstract

Background and Purpose: Despite the prevalent incidence of re-tear following rotator cuff repair, there is a notable lack of comparative studies investigating the outcomes between patients with re-tear who underwent primary repair versus those who received patch augmentation for large-to-massive tears. We assessed [...] Read more.

Background and Purpose: Despite the prevalent incidence of re-tear following rotator cuff repair, there is a notable lack of comparative studies investigating the outcomes between patients with re-tear who underwent primary repair versus those who received patch augmentation for large-to-massive tears. We assessed clinical outcomes of these techniques through a retrospective, randomized controlled trial. Methods: 134 patients diagnosed with large-to-massive rotator cuff tears from 2018 to 2021 underwent surgery; 65 had primary repair and 69 had patch augmentation. A total of 31 patients with re-tears were included, split into two groups; Group A (primary repair, 12 patients) and Group B (patch augmentation, 19 patients). Outcomes were evaluated using several clinical scales and MRI imaging. Results: Most clinical scores improved postoperatively in both groups. No significant difference in clinical outcomes was observed between groups, except for pain visual analog scale (P-VAS) scores. P-VAS scores showed greater decrease in the patch-augmentation group, a statistically significant difference. Conclusions: for large-to-massive rotator cuff tears, patch augmentation led to greater decreases in pain than primary repair, despite similar radiographic and clinical results. Greater tuberosity coverage of the supraspinatus tendon footprint may impact P-VAS scores. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Shoulder and Elbow Disease and Trauma 2.0)

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8 pages, 560 KiB

Open AccessArticle

Is Routine Screening Using Duplex Ultrasonography for Deep Vein Thrombosis Necessary after Shoulder Arthroplasty?

by Du-Han Kim, Sang-Soo Na, Ui-Jun Park and Chul-Hyun Cho

Diagnostics 2023, 13(4), 636; https://doi.org/10.3390/diagnostics13040636 - 08 Feb 2023

Cited by 1 | Viewed by 1176

Abstract

The aims of this study were to examine the incidence, risk factors, and outcomes of deep vein thrombosis (DVT) after shoulder arthroplasty in Korean patients. A total of 265 patients who underwent shoulder arthroplasty were included. The mean age of the patients was [...] Read more.

The aims of this study were to examine the incidence, risk factors, and outcomes of deep vein thrombosis (DVT) after shoulder arthroplasty in Korean patients. A total of 265 patients who underwent shoulder arthroplasty were included. The mean age of the patients was 74.6 years, and there were 195 females and 70 males. Clinical data including patient demographics, blood tests, and previous and current medical history were investigated. For screening of DVT, duplex ultrasonography of the operative arm was performed 2 to 5 days after surgery. Of the 265 patients, 10 patients (3.8%) were diagnosed with DVT using postoperative duplex ultrasonography. There were no cases of pulmonary embolism. There were no significant differences between the DVT and no DVT groups regarding all clinical data, except for the Charlson comorbidity index (CCI), which was significantly higher in the DVT group than in the no DVT group (5.0 vs. 4.1; p = 0.029). All patients had asymptomatic DVT that showed complete resolution after administration of antithrombotic agents or close observation without medications. The overall incidence of DVT was 3.8% during a period of 3 months after shoulder arthroplasty in Korean patients, and most cases were asymptomatic. Routine screening for DVT using duplex ultrasonography after shoulder arthroplasty may not be necessary except in patients with high CCI. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Shoulder and Elbow Disease and Trauma 2.0)

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8 pages, 653 KiB

Open AccessArticle

Can We Apply Snyder’s Arthroscopic Classification to Ultrasound for Evaluating Rotator Cuff Tears? A Comparative Study with MR Arthrography

by Marco Porta, Salvatore La Marca, Nicola Carapella, Alessandra Surace, Cristiana Fanciullo, Roberto Simonini, Sandro Sironi, Domenico Albano, Carmelo Messina, Luca Maria Sconfienza and Alberto Aliprandi

Diagnostics 2023, 13(3), 483; https://doi.org/10.3390/diagnostics13030483 - 28 Jan 2023

Viewed by 1317

Abstract

We aimed to demonstrate the applicability of Snyder’s arthroscopic classification of rotator cuff tears (RCT) in shoulder ultrasound (US) and to compare it with MR arthrography (MRA). Forty-six patients (34 males; mean age:34 ± 14 years) underwent shoulder US and MRA. Two radiologists [...] Read more.

We aimed to demonstrate the applicability of Snyder’s arthroscopic classification of rotator cuff tears (RCT) in shoulder ultrasound (US) and to compare it with MR arthrography (MRA). Forty-six patients (34 males; mean age:34 ± 14 years) underwent shoulder US and MRA. Two radiologists (R1 = 25 years of experience; R2 = 2 years of experience) assigned A1–4, B1–4, or C1–4 values depending on the extent of RCT in both US and MRA. Inter-reader intra-modality and intra-reader inter-modality agreement were calculated using Cohen’s kappa coefficient. US sensitivity and specificity of both readers were calculated using MRA as the gold standard. Patients were divided into intact cuff vs. tears, mild (A1/B1) vs. moderate (A2–3/B2–3) tears, mild-moderate (A2/B2) vs. high-moderate (A3/B3) cuff tears, moderate (A2–3/B2–3) vs. advanced (A4/B4) and full-thickness (C) tears. The highest agreement values in inter-reader US evaluation were observed for mild-moderate vs. high-moderate RCT (K = 0.745), in inter-reader MRA evaluation for mild vs. moderate RCT (K = 0.821), in R1 inter-modality (US-MRA) for mild-moderate vs. high-moderate and moderate vs. advanced/full-thickness RCT (K = 1.000), in R2 inter-modality (US-MRA) for moderate vs. advanced/full-thickness RCT (K = 1.000). US sensitivity ranged from 88.89%(R1)–84.62%(R2) to 100% (both readers), while specificity from 77.78%(R1)–90.00%(R2) to 100% (both readers). Snyder’s classification can be used in US to ensure the correct detection and characterization of RCT. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Shoulder and Elbow Disease and Trauma 2.0)

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Review

Jump to: Research, Other

14 pages, 9880 KiB

Open AccessReview

Delaminated Tears of the Rotator Cuff: MRI Interpretation with Clinical Correlation

by Jun-Ho Kim and Seul Ki Lee

Diagnostics 2023, 13(6), 1133; https://doi.org/10.3390/diagnostics13061133 - 16 Mar 2023

Cited by 3 | Viewed by 10541

Abstract

(1) Background: A delaminated tear is described as a horizontal split in the tendon substance. This review summarizes the clinical and radiologic characteristics of delaminated tears of the rotator cuff. (2) Methods: Initial radiological characteristics of a delaminated tear include the horizontal component [...] Read more.

(1) Background: A delaminated tear is described as a horizontal split in the tendon substance. This review summarizes the clinical and radiologic characteristics of delaminated tears of the rotator cuff. (2) Methods: Initial radiological characteristics of a delaminated tear include the horizontal component of a partial-thickness tear determined using magnetic resonance (MR) arthrography. As demonstrated using indirect MR arthrography, the tear gradually progresses to be defined as either horizontal intrasubstantial splitting of the bursal and articular layers or differential retraction of the bursal and articular layers. (3) Results: The existence of delaminated tears is a poor prognostic factor in functional and morphologic outcomes after the repair of rotator cuff tendons and many surgical techniques have been introduced to solve this problem. Although the presence of a delaminated tear does not affect the arthroscopic repair outcome, the presence of medium-to-large, retracted delaminated tears may be an adverse negative prognostic factor after single-row repair. (4) Conclusion: Advances in imaging and surgical techniques have improved the detection of delaminated rotator cuff tears. Preoperative identification of delaminated tears on magnetic resonance imaging is clinically important because tailored surgical repair techniques must be chosen for successful outcomes. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Shoulder and Elbow Disease and Trauma 2.0)

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Other

Jump to: Research, Review

11 pages, 718 KiB

Open AccessSystematic Review

Clinical Outcomes Following Arthroscopic Decompression and Repair versus Repair Alone in Patients with a Concomitant Spinoglenoid Cyst and SLAP Lesion: A Systematic Review

by Du-Han Kim, Hyuk-Joon Sohn, Ji-Hoon Kim and Chul-Hyun Cho

Diagnostics 2023, 13(14), 2364; https://doi.org/10.3390/diagnostics13142364 - 13 Jul 2023

Viewed by 784

Abstract

(1) Background: Patients with a superior-labrum-from-anterior-to-posterior (SLAP) tear associated with a spinoglenoid ganglion cyst have undergone various procedures. The purpose of this study is to evaluate clinical outcomes following arthroscopic treatment in patients with a concomitant spinoglenoid ganglion cyst and SLAP lesion. (2) [...] Read more.

(1) Background: Patients with a superior-labrum-from-anterior-to-posterior (SLAP) tear associated with a spinoglenoid ganglion cyst have undergone various procedures. The purpose of this study is to evaluate clinical outcomes following arthroscopic treatment in patients with a concomitant spinoglenoid ganglion cyst and SLAP lesion. (2) Methods: This study followed PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines, utilizing the PubMed, EMBASE, Cochrane Library, and Scopus databases. The keywords included shoulder, SLAP, labral tear, spinoglenoid notch, paralabral cyst, arthroscopy, and treatment. (3) Results: A total of 14 articles (206 patients) were included. Repair alone was administered in 114 patients (Group R), and 92 patients underwent additional cyst decompression (Group RD). Both groups showed excellent and similar clinical scores. The rate of the complete resorption of the cyst was 95.5% in Group RD, and 92.2% in Group R. The complication rate was 3.5% in Group RD, and 11.4% in Group R. The reoperation rate was 0% in Group RD, and 5.3% in Group R. (4) Conclusion: Reliable clinical outcomes without serious complications were obtained from the use of both procedures. The decompression of the cyst is a safe method that will alleviate pressure on the suprascapular nerve. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Shoulder and Elbow Disease and Trauma 2.0)

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13 pages, 2369 KiB

Open AccessSystematic Review

Comparison of Outcomes after Arthroscopic Rotator Cuff Repair between Elderly and Younger Patient Groups: A Systematic Review and Meta-Analysis of Comparative Studies

by Yu-Chieh Hsieh, Liang-Tseng Kuo, Wei-Hsiu Hsu, Yao-Hung Tsai and Kuo-Ti Peng

Diagnostics 2023, 13(10), 1770; https://doi.org/10.3390/diagnostics13101770 - 17 May 2023

Cited by 3 | Viewed by 1461

Abstract

This study aimed to compare the outcomes of arthroscopic rotator cuff repair (ARCR) surgery between younger and older patients. We performed this systematic review and meta-analysis of cohort studies comparing outcomes between patients older than 65 to 70 years and a younger group [...] Read more.

This study aimed to compare the outcomes of arthroscopic rotator cuff repair (ARCR) surgery between younger and older patients. We performed this systematic review and meta-analysis of cohort studies comparing outcomes between patients older than 65 to 70 years and a younger group following arthroscopic rotator cuff repair surgery. We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and other sources for relevant studies up to 13 September 2022, and then assessed the quality of included studies using the Newcastle–Ottawa Scale (NOS). We used random-effects meta-analysis for data synthesis. The primary outcomes were pain and shoulder functions, while secondary outcomes included re-tear rate, shoulder range of motion (ROM), abduction muscle power, quality of life, and complications. Five non-randomized controlled trials, with 671 participants (197 older and 474 younger patients), were included. The quality of the studies was all fairly good, with NOS scores ≥ 7. The results showed no significant differences between the older and younger groups in terms of Constant score improvement, re-tear rate, or other outcomes such as pain level improvement, muscle power, and shoulder ROM. These findings suggest that ARCR surgery in older patients can achieve a non-inferior healing rate and shoulder function compared to younger patients. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Shoulder and Elbow Disease and Trauma 2.0)

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8 pages, 13114 KiB

Open AccessBrief Report

Cadaveric and Ultrasound Validation of Percutaneous Electrolysis Approach at the Distal Biceps Tendon: A Potential Treatment for Biceps Tendinopathy

by Laura Calderón-Díez, José L. Sánchez-Sánchez, Pedro Belón-Pérez, Miguel Robles-García, Fátima Pérez-Robledo and César Fernández-de-las-Peñas

Diagnostics 2022, 12(12), 3051; https://doi.org/10.3390/diagnostics12123051 - 05 Dec 2022

Viewed by 2511

Abstract

Distal biceps brachii tendinopathy is a musculoskeletal pain condition—comprising chronic intrasubstance degeneration with alterations of the tendon structure—that is difficult to treat. Preliminary evidence suggests a positive effect for pain and related disability of percutaneous electrolysis treatment in patients with tendinopathy. Ultrasound is [...] Read more.

Distal biceps brachii tendinopathy is a musculoskeletal pain condition—comprising chronic intrasubstance degeneration with alterations of the tendon structure—that is difficult to treat. Preliminary evidence suggests a positive effect for pain and related disability of percutaneous electrolysis treatment in patients with tendinopathy. Ultrasound is an excellent diagnostic tool to identify tendon injuries, such as tendinopathy, and to guide treatment approaches. Different approaches using ultrasound evaluation of the biceps tendon have been described. Our aim was to determine the validity and safety of a percutaneous electrolysis approach, targeting insertion of the distal tendon of biceps brachii, in both human (ultrasound-guided) and Thiel-embalmed cadaver (not ultrasound-guided) models. There were two approaches evaluated: an anterior approach with the elbow in extension and the forearm in supination and a posterior approach with the elbow in flexion and the forearm in pronation. A needle was inserted following the tendon up to its insertion into the radial tuberosity. The anterior approach, both in cadaveric study and US-guided intervention, revealed a close relationship between the distal biceps tendon and the brachial artery. The mean distance of the depth of the biceps tendon distal to the brachial artery was 0.21 ± 0.021 cm in the cadavers and 0.51 ± 0.024 cm in subjects. It was also found that the anterior approach has a potential technical difficulty due to the anatomical location of the brachial artery. With the posterior approach, it was possible to safely identify the tendon insertion and the needle approach, since no important vascular and nervous structures were visualized in the window of insertion of the needle. The clinician rated the posterior approach as low difficulty in all subjects. Current results would support a posterior approach with US guidance as a safe approach for applying the percutaneous electrolysis technique for insertional tendinopathies of the distal biceps brachii tendon. The current study did not assess the effectiveness of the proposed intervention; accordingly, future studies investigating the clinical effectiveness of the proposed intervention are needed. Full article

(This article belongs to the Special Issue Diagnosis and Treatment of Shoulder and Elbow Disease and Trauma 2.0)

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