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  1. Collin P, Abdullah A, Kherad O, Gain S, Denard PJ, Lädermann A
    J Shoulder Elbow Surg, 2015 Mar;24(3):439-45.
    PMID: 25441555 DOI: 10.1016/j.jse.2014.08.014
    BACKGROUND: This study aimed to report the outcome of patients who underwent arthroscopic rotator cuff repair (ARCR) and to determine the factors associated with return to work and activity.
    MATERIALS: Three hundred sixty-five patients who underwent ARCR were prospectively evaluated. The cohort was divided into 2 groups based on clinical results at 6 months. Group A consisted of patients who were considered to have a satisfactory outcome based on return to their previous professional or spare-time activities. Group B consisted of patients with an unsatisfactory outcome based on a lack of return to normal work or activities.
    RESULTS: Of the patients, 305 had a satisfactory outcome (group A) and 60 were categorized as having an unsatisfactory outcome (group B). On multivariate analysis, preoperative factors associated with group B included female gender and heavy manual labor. Postoperative bursitis on ultrasound at 6 months was associated with being in group B. Lack of tendon healing was not associated with group B. However, if a patient without healing had persistent pain at 6 months, the pain persisted at 9 months.
    CONCLUSION: ARCR is an effective procedure that leads to significant improvement in pain, function, and tendon healing in most cases. However, in 1 of 5 cases, patients were unable to resume normal activity at 6 months postoperatively. Persistent limitation at 6 months was associated with female gender, heavy manual workers, and the presence of postoperative persistent bursitis.
    KEYWORDS: Arthroscopic rotator cuff repair; double row; recovery of function; return to work; tendon non-healing or retear; treatment outcome; ultrasound; workers' compensation claim
    Matched MeSH terms: Rotator Cuff/injuries; Rotator Cuff/radiography; Rotator Cuff/surgery*
  2. Ahmad S, Haber M, Bokor DJ
    J Shoulder Elbow Surg, 2015 Feb;24(2):229-35.
    PMID: 25240808 DOI: 10.1016/j.jse.2014.06.050
    The purpose of this study was to determine when cuff re-tear commonly occurs in the postoperative period and to investigate the clinical factors that might predispose to an early cuff re-tear.
    Matched MeSH terms: Rotator Cuff/injuries*; Rotator Cuff/surgery*; Rotator Cuff/ultrasonography
  3. Loh YC, Trail IA
    Med J Malaysia, 2002 Jun;57(2):205-8.
    PMID: 24326652
    Fourteen fit and healthy patients underwent arthroscopic subacromial decompression (ASD) of shoulder for rotator cuff impingement. Their blood chemistry was analysed pre-operatively, 24 hours post-operatively and 2-3 weeks post-operatively. Levels of haematocrit, sodium, potassium, creatinine and urea were measured. The blood chemistry returned almost to the pre-operative level at 2-3 weeks post-operatively. There was no statistically significant differences found. This study concludes that arthroscopic subacromial decompression is a safe technique when considering the blood parameters despite the haemodilution seen in all patients.
    Matched MeSH terms: Rotator Cuff
  4. Sam CX, Anwar AZ, Ahmad AR, Solayar GN
    Malays Orthop J, 2021 Mar;15(1):119-123.
    PMID: 33880158 DOI: 10.5704/MOJ.2103.018
    Introduction: Reverse total shoulder arthroplasty provides a surgical alternative to standard total shoulder arthroplasty for the treatment of cuff tear arthropathy, arthritis and fracture sequelae. This study aimed to assess the short-term outcomes following reverse total shoulder arthroplasty for patients in a large public hospital in Malaysia.

    Materials and Methods: We identified and performed five primary reverse total shoulder arthroplasties between 1 May 2019 and 1 June 2020. All patients were contactable and available for analysis. Assessment of functional outcomes was performed using the Constant-Murley score, the patient satisfaction score (PSS), and imaging studies. The mean follow-up from operation to the time of reporting was 9.6 months (range, 3 to 14 months).

    Results: The median age for our patients was 58 years (±11.91). The most common indication for surgery was post-traumatic arthritis, followed by rotator cuff arthropathy and osteoarthritis. The mean Constant score improved from 9.0 pre-operatively to 52.3 post-operatively at a mean of 9.6 months. The majority of the patients were satisfied with the surgery as the post-operative range of motion, especially anterior elevation and abduction, improved in four of our patients and there were no short-term complications, for example, of infection or revisions, reported at the last follow-up.

    Conclusion: This study has shown that reverse total shoulder arthroplasty can yield good short-term outcomes for the treatment of complex shoulder problems in addition to cuff tear arthropathy. It should be considered a treatment for rotator cuff tears, severe arthritis and ≥ 3 parts proximal humeral fractures.

    Matched MeSH terms: Rotator Cuff; Rotator Cuff Injuries; Rotator Cuff Tear Arthropathy
  5. Miswan MF, Saman MS, Hui TS, Al-Fayyadh MZ, Ali MR, Min NW
    J Orthop Surg (Hong Kong), 2017 01;25(1):2309499017690317.
    PMID: 28215115 DOI: 10.1177/2309499017690317
    INTRODUCTION: We conducted a study to elucidate the correlation between the anatomy of the shoulder joint with the development of rotator cuff tear (RCT) and glenohumeral osteoarthritis (GHOA) by using acromioglenoid angle (AGA).

    MATERIALS AND METHODS: The AGA is a new measured angle formed between the line from midglenoid to lateral end of the acromion with the line parallel to the glenoid surface. The AGA was measured in a group of 85 shoulders with RCT, 49 with GHOA and 103 non-RCT/GHOA control shoulders. The AGA was compared with other radiological parameters, such as, the critical shoulder angle (CSA), the acromion index (AI) and the acromiohumeral interval (AHI). Correlational and regression analysis were performed using SPSS 20.

    RESULTS: The mean AGA was 50.9° (45.2-56.5°) in the control group, 53.3° (47.6-59.1°) in RCT group and 45.5° (37.7-53.2°) in OA group. Among patients with AGA > 51.5°, 61% were in the RCT group and among patients with AGA < 44.5°, 56% were in OA group. Pearson correlation analysis had shown significant correlation between AGA and CSA ( r = 0.925, p < 0.001). It was also significant of AHI in RCT group with mean 6.6 mm (4.7-8.5 mm) and significant AI in OA group with mean 0.68 (0.57-0.78) with p value < 0.001 respectively.

    CONCLUSION: The AGA method of measurement is an excellent predictive parameter for diagnosing RCT and GHOA.

    Matched MeSH terms: Rotator Cuff Injuries/epidemiology*; Rotator Cuff Injuries/diagnostic imaging
  6. Altan E, Nayman A, Yildirim A, Ozbaydar MU, Ciftci S, Karahan M
    Malays Orthop J, 2020 Jul;14(2):23-27.
    PMID: 32983374 DOI: 10.5704/MOJ.2007.007
    Introduction: Many factors could affect the supraspinatus (SSP) muscle after tendon rupture. We aimed to determine how infraspinatus and subscapularis tendon problems affect supraspinatus muscle atrophy associated with tears, in a retrospective cohort study conducted in a tertiary-level centre.

    Material and Methods: Fifty-eight patients with a full-thickness SSP tendon tear who fulfilled the inclusion criteria were enrolled in the study. They were evaluated for tear retraction, fatty degeneration, and other rotator cuff tendon pathologies. Supraspinatus muscle was assessed using the Goutallier classification, and its average area was also measured. Accompanying lesions of the subscapularis and infraspinatus tendons and degree of supraspinatus muscle atrophy were evaluated using magnetic resonance imaging.

    Results: Our results showed that supraspinatus tendon tears ranged between 3mm and 41mm, and the estimated average cross-sectional area of the SSP muscle was 247.6mm2. Any degree of infraspinatus tendon pathology, ranging from tendinosis to full-thickness tears, was significantly correlated with the SSP muscle area (P < 0.05). The subscapularis tendon pathologies did not show a similar correlation. The interobserver and intraobserver reliabilities of the measurements were graded as excellent.

    Conclusion: Impairment of any of the rotator cuff muscles may affect the other muscles inversely. Our study showed that all infraspinatus tendon pathologies and partial subscapularis tears affect and alter the SSP muscle belly. We suggest early intervention for supraspinatus tears to avoid further fatty degeneration, as muscle atrophy and fatty degeneration progress in combination with the accompanying lesions.

    Matched MeSH terms: Rotator Cuff
  7. Khoo, S.W., Khoo, S.M., Yeong, Y.K., Towil, B.
    Malays Orthop J, 2009;3(2):29-32.
    MyJurnal
    According to recently reported outcome studies, functional outcomes after arthroscopic rotator cuff repair are reasonable and comparable to open or mini-open techniques. We report the functional outcomes after arthroscopic rotator cuff repair of 10 consecutive patients. The average age was 53.9(range 46-59) years. There was a significant improvement of the function of the shoulder when the preoperative scores were compared with those at the time of at least six months follow-up (range of 6 months to 18 months). With the UCLA rating scale, the average total score increased from preoperative 9.8 (range, 6-15) to postoperative 32.6 (range,23-35). With the use of ASES shoulder index, the average total score improved from 14.6 range, 1.6-35) to 92.3 (range,66.6 to 100). We concluded that arthroscopic rotator cuff repair is a treatment method in selective patients with symptomatic rotator cuff pathology to alleviate shoulder pain and improve function.
    Matched MeSH terms: Rotator Cuff
  8. Leonar, J.H., Siti Salmiah, M.D., Das, S., Ayiesah, H.R.
    MyJurnal
    Arthroscopic sub acromial debridement surgery with acromioplasty is one of the shoulder surgeries performed to treat chronic shoulder pain. This surgical procedure is usually indicated in sub acromial impingement syndrome of shoulder, degenerative rotator cuff tears, severe functional limitation of shoulder joint and often surgery was performed in cases where all the conservative management had failed in the treatment of chronic shoulder pain. Even though the patient would be referred for early rehabilitation, post operative management of this surgical condition is highly challenging. Movement of the shoulder joint is often related with scapulo-thoracic joint, acromio-clavicular joint and sternoclavicular joint and the shoulder movements are governed by various different muscular forces from these joints. Failure to understand this biomechanical complexity of shoulder joint during post operative rehabilitation results in failure of the surgical outcome and might cause severe functional limitation with recurrent shoulder pain. Often in clinical practice, greater emphasis is given to achieve and regain movements in shoulder joint at the expense of the joint stability. However, inadequate scapular stability might further predispose the shoulder joint to excessive loading and results in repetitive injuries leading to chronic shoulder pain. This might affect the surgical and clinical outcome of the acromioplasty and result in surgical failure. Hence, surgeons and clinicians need to understand the biomechanical contributions in the post operative rehabilitation of the shoulder joint. The present case report emphasises the biomechanical model of post operative rehabilitation of a patient who had arthroscopic sub acromial debridement with acromioplasty.
    Matched MeSH terms: Rotator Cuff
  9. Hazwan Ab. Wahid, Khairul Nizam bin Siron, Ahmad Zakiran
    MyJurnal
    Displaced and unstable proximal humerus fractures are difficult to treat
    and they have high morbidity. The main goal is to achieve painless shoulder with full
    recovery of the shoulder joint motion. Impingement syndrome is one of the commonest
    postoperative complication. This study aim is to appreciate the functional outcomes of
    Philos-plate fixation for proximal humerus fractures and to establish association with
    high plate positioning with impingement syndrome of the shoulder after Philos-plate
    fixation. (Copied from article).
    Matched MeSH terms: Rotator Cuff
  10. Abate M, Salini V, Schiavone C
    Malays Orthop J, 2016 Jul;10(2):53-55.
    PMID: 28435563 DOI: 10.5704/MOJ.1607.011
    We report the efficacy of the ultrasound-guided percutaneous treatment in the management of elbow extensor tendons calcific tendinopathy. The ultrasound-guided percutaneous treatment is broadly used with positive results in patients suffering from rotator cuff calcific tendinopathy. However, this interventional method has been reported only in one patient in the medical literature. A 34 years-old female who complained pain, swelling and severe functional limitation of the right elbow was referred to our unit. Elbow radiographs and ultrasound examination showed a soft-fluid calcification above the origin of the extensor tendons. Ultrasound-guided percutaneous treatment was therefore performed. After one year, the patient reported no pain and regained complete range of elbow motion. This method, in well trained hands, is an alternative treatment in the management of the uncommon elbow calcific deposit.

    Study done in Italy
    Matched MeSH terms: Rotator Cuff
  11. Gupta R, Elamvazuthi I, Dass SC, Faye I, Vasant P, George J, et al.
    Biomed Eng Online, 2014;13:157.
    PMID: 25471386 DOI: 10.1186/1475-925X-13-157
    Disorders of rotator cuff tendons results in acute pain limiting the normal range of motion for shoulder. Of all the tendons in rotator cuff, supraspinatus (SSP) tendon is affected first of any pathological changes. Diagnosis of SSP tendon using ultrasound is considered to be operator dependent with its accuracy being related to operator's level of experience.
    Matched MeSH terms: Rotator Cuff/pathology; Rotator Cuff/ultrasonography*
  12. Abdul Rahim MF, Shaharudin S
    J Taibah Univ Med Sci, 2018 Dec;13(6):572-575.
    PMID: 31435380 DOI: 10.1016/j.jtumed.2018.08.001
    Objectives: This study aimed to determine isokinetic profiles of rotator cuff muscle strength and power in adolescent state-level weightlifters.

    Methods: Nineteen young state-level weightlifters performed concentric strength tests of the upper limbs using an isokinetic dynamometer. Peak torque/body weight was measured for each weightlifter in dominant and non-dominant limbs.

    Results: Peak torque/body weight was significantly different in external rotation (p  0.05). Time to peak torque in external rotation was less in the dominant than in the non-dominant limb. However, opposite results were obtained in external rotation, whereby time to peak torque was longer in the dominant limb compared to the non-dominant limb. Similarly, no significant difference was found between dominant and non-dominant limbs in terms of average power (p > 0.05).

    Conclusions: The findings of this study may help in establishing potential imbalance in variables of muscular contractions between dominant and non-dominant limbs of weightlifters. This may help to maximise performance and minimise potential shoulder injury.

    Matched MeSH terms: Rotator Cuff
  13. Saeed OA, Sazili AQ, Akit H, Ebrahimi M, Alimon AR, Samsudin AA
    BMC Vet Res, 2019 Jul 08;15(1):233.
    PMID: 31286932 DOI: 10.1186/s12917-019-1976-8
    BACKGROUND: The increasing costs of feed has subsequently increased the costs of production of livestock, thereby decreasing the profit margin of this sector. The utilization of agro-industrial by-products has to some extent substitute some of the corn grains and soyabean meal, commonly used in animal feeds. In Malaysia, palm kernel cake (PKC) is a by-product of the oil palm industry and is frequently used to supply both crude protein (14-16% CP) and energy (11 MJ/kg) in ruminants. The energy and protein content are adequate for maintenance in the majority of ruminants. However, highly available energy supplementation is known to improve growth performance and protein deposition. This study was carried out to determine the effect on the quality of meat and fatty acid composition of the semitendinosus (ST), supraspinatus (SS), and longissimus lumborum (LL) muscles of Dorper lambs by including corn as an energy source in a basal diet of PKC urea-treated rice straw.

    RESULTS: The results show that the LL muscle-drip loss was greater in animals supplemented with 5% corn compared to the other groups. Higher pH values of SS and LL muscles were observed in animals supplemented with 5 and 10% corn. Furthermore, the L* value of ST muscle was increased in lambs fed on 5% corn while, reduced in those fed on 0% corn, but the a* and b* values were not significantly different in the treatment groups. The fatty acid composition of the SS muscles showed that lambs fed on 10% corn had higher levels of sum PUFA n-3 compared to those fed on 0% corn. The concentration of C18:1trans11 and CLA c12 t10 in ST muscle from the lambs fed on supplemented diets were higher than those of the controls.

    CONCLUSION: This study has concluded the supplementation of corn as a source of energy into a PKC urea-treated rice straw-based diet increased the PUFA concentrations of muscles as compared to control groups.

    Matched MeSH terms: Rotator Cuff
  14. Raymond DK Yeak, Peter T Campbell
    MyJurnal
    Combined latissimus dorsi transfer, subscapularis repair and Latarjet surgery is rare and has never been reported. A 35-year-old man with chronic shoulder pain had a long history of instability of his right shoulder. The first episode occurred during a game of touch rugby followed by multiple episodes of subluxation. MRI was done which showed complete tear of the subscapularis anteriorly which was retracted and atrophied indicating a longstanding tear. There was also significant mid substance supraspinatus tendon tear. Patient then underwent two surgeries. The initial sur- gery found the rotator cuff to be irreparable with glenoid bone loss and only acromioplasty with acromioclavicular joint resection were performed. He then had a single stage surgery consisting of latissimus dorsi transfer, Latarjet procedure and subscapularis repair. A two-stage surgery can be avoided, and good results can be obtained provided that the patient undergo correct rehabilitation regime after undergoing a single stage surgery.

    Matched MeSH terms: Rotator Cuff
  15. Kapil-Mani KC, Acharya P, Arun S
    Malays Orthop J, 2018 Mar;12(1):15-20.
    PMID: 29725507 DOI: 10.5704/MOJ.1803.003
    Introduction: Various treatment modalities are available but no consensus has been reached for optimal treatment of lateral third clavicle fractures. Precontoured locking plates with broad lateral end for multiple screws fixation is a newly designed plate for lateral third clavicle fractures. The objective of our study was to analyse the functional outcomes as well as complications of this technique in a significant number of cases with long follow-up duration. Materials and Methods: Forty-six patients with distal third clavicle fractures were treated by precontoured clavicular locking plate with broad lateral end. Functional outcomes were assessed on the basis of Constant-Murley Shoulder Outcome Score and University of California, Los Angeles (UCLA) Shoulder Rating Score, active shoulder range of motion, time for fracture union and coraco-clavicular distance. Results: The mean Constant-Murley score was 92.56±4.47 (range: 79-98) for injured side and 96.22±2.23 (range: 90-100) for normal side with p-Value 0.56. Mean coraco-clavicular distance at final follow-up was 10.52±1.13 mm (range 9.7 to 11.7 mm) in injured side and 10.25±0.98 mm (range 9.6 to 11.2 mm) in normal side. Mean UCLA Shoulder Rating Score was 32.55±2.12 (range: 27-34) for injured side and 33.46±1.88 (range: 31- 35) on normal side with p value 0.58. No major complications that necessitated revision of surgery occurred in our study. Conclusion: This newly designed plate seemed extremely useful in successful union of lateral third clavicle fractures, with reduced rate of complications like fixation failures, iatrogenic rotator cuff injury, AC joint osteoarthritis and sub-acromial bursitis, with good functional outcomes.
    Matched MeSH terms: Rotator Cuff Injuries
  16. Zulfikri N, Selvanayagam VS, Yusof A
    J Sport Rehabil, 2021 Jan 19;30(5):717-724.
    PMID: 33465761 DOI: 10.1123/jsr.2019-0483
    CONTEXT: Badminton continues to be a highly competitive sport where training is introduced at an early age and load has intensified. This exposes players to a greater risk of injuries, in particular when assessing related training outcomes such as strength, agonist-antagonist ratio, and bilateral deficit among adolescents where age- and sex-associated growth and development should be considered.

    OBJECTIVE: To evaluate strength profile of the upper and lower limbs among adolescent elite Malaysian badminton players.

    DESIGN: Cross-sectional study.

    SETTING: Laboratory.

    PARTICIPANTS: Forty-eight asymptomatic athletes (24 males and 24 females) were grouped into early and late adolescence (13-14 y old and 15-17 y old, respectively).

    MAIN OUTCOME MEASURE(S): Strength (absolute and normalized) of the external/internal rotators of the shoulder and flexor/extensor of the knee and strength derivatives, conventional strength ratio (CSR), dynamic control ratio (DCR), and bilateral deficits were measured.

    RESULTS: Males showed greater strength in all strength indices (P < .05). The older group had greater strength compared to younger for most of the upper and lower limb indices (P < .05); these effects diminished when using normalized data. For females, there was no age group effect in the shoulder and knee strength. All players displayed lower shoulder and knee normative values for CSR and DCR. Dominant and non-dominant knee strength were comparable between sex and age groups.

    CONCLUSIONS: For males, growth and maturation had a greater contribution to strength gained compared to training, whereas for females, growth, maturation, and training did not improve strength. The normalized data indicated that training did not improve all indices measured apart from external rotator strength in females. All players also displayed lower normative values of CSR and DCR. These results suggest that training in elite adolescent Malaysian badminton players lacks consideration of strength gain and injury risk factors.

    Matched MeSH terms: Rotator Cuff/physiology
  17. Raymond DK Yeak, Nasir M Nizlan
    MyJurnal
    A 29-year-old man, who was a medical intern presented with history of recurrent shoulder dislocation. Radiographs
    and computed tomography imaging revealed a bony bankart lesion with glenoid bone loss of 25% with moderate
    Hill- Sachs lesion. Latarjet surgery was performed. At post-operative 8 months, the patient experienced pain and
    clicking in the left shoulder while performing cardiopulmonary resuscitation. At post-operative 1 year, magnetic resonance arthrography showed a united coracoid graft and intact posterior labrum. Left shoulder diagnostic arthroscopy and removal of Latarjet screws through a limited anterior deltopectoral approach were performed. The symptoms
    pain, clicking and instability sense was caused by either the prominent distal screw or the remnant suture material
    from the anchor which resulted in impingement of the infraspinatus muscle. We recommend the use of image intensifier to check on the position and length of the screw at the end of the surgery to avoid this complication
    Matched MeSH terms: Rotator Cuff
  18. Odhaib KJ, Adeyemi KD, Sazili AQ
    Asian-Australas J Anim Sci, 2018 Aug;31(8):1345-1357.
    PMID: 29103284 DOI: 10.5713/ajas.17.0468
    Objective: This study examined the influence of dietary supplementation of Nigella sativa seeds, Rosmarinus officinalis leaves and their combination on carcass attributes, fatty acid (FA) composition, gene expression, lipid oxidation and physicochemical properties of longissimus dorsi (LD), semitendinosus (ST), and supraspinatus (SS) muscles in Dorper lambs.

    METHODS: Twenty-four Dorper lambs (18.68±0.6 kg, 4 to 5 months old) were randomly assigned to a concentrate mixture containing either, no supplement (control, T1), 1% Rosmarinus officinalis leaves (T2), 1% Nigella sativa seeds (T3), or 1% Rosmarinus officinalis leaves+1% Nigella sativa seeds (T4) on a dry matter basis. The lambs were fed the treatments with urea-treated rice straw for 90 days, slaughtered and the muscles were subjected to a 7 d postmortem chill storage.

    RESULTS: The T2 lambs had greater (p<0.05) slaughter and cold carcass weights than the control lambs. Dietary supplements did not affect (p>0.05) chill loss, dressing percentage, carcass composition, intramuscular fat and muscle pH in Dorper lambs. Meat from supplemented lambs had lower (p<0.05) cooking and drip losses, shear force, lightness, and lipid oxidation and greater (p<0.05) redness compared with the control meat. The impact of dietary supplements on muscle FA varied with muscle type. Diet had no effect (p>0.05) on the expression of stearoyl-CoA desaturase and lipoprotein lipase genes in LD and ST muscles in Dorper lambs. The T2 and T3 diets up regulated the expression of AMP-activated protein kinase alpha 2 gene in LD and ST muscles and up regulated the expression of sterol regulatory element-binding protein 1 in ST muscle in Dorper lambs.

    CONCLUSION: Dietary supplementation of Nigella sativa seeds and Rosmarinus officinalis leaves had beneficial effects on meat quality in Dorper lambs.

    Matched MeSH terms: Rotator Cuff
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