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  1. Wahab AHA, Saad APM, Harun MN, Syahrom A, Ramlee MH, Sulong MA, et al.
    J Mech Behav Biomed Mater, 2019 03;91:406-415.
    PMID: 30684888 DOI: 10.1016/j.jmbbm.2018.12.033
    Intact glenoid labrum is one of passive stabilizer for glenohumeral joint, which have various stiffness at different region. The aim of this study is to develop new artificial glenoid labrum from Polyvinyl Alcohol (PVA) hydrogel, which known as good biomaterial due to its biocompatibility and ability to tailor its modulus. PVA hydrogel was formed using freeze-thaw (FT) method and the stiffness of PVA was controlled by manipulating the concentration of PVA and number of FT cycles. Then, the gradual stiffness was formed using simple diffusion method by introducing the pre-freeze-and-thaw steps. The results showed 20% PVA with three FT cycles suit to highest stiffness of glenoid labrum while 10% PVA with three FT cycles suit to lowest stiffness of glenoid labrum. The functionally graded PVA hydrogel was then developed using the same method by diffusing two mixture (20% PVA and 10% PVA). Mechanical compression test showed, the highest modulus (0.41 MPa) found at the 20% PVA region and lowest modulus (0.1 MPa) found at 10% PVA region. While, at intermediate region, the compressive modulus was in between 20% and 10%, 0.2 MPa. The existence of gradual stiffness was further prove by checking crystallinity of material at each region using Differential Scanning Calorimetry (DSC) and Wide Angle X-ray Diffraction (WAXD). Microstructure of material was obtained from Scanning Electron Microscopy (SEM). This functionally graded PVA hydrogel also able to reduce about 51% of stress at glenoid implant and up to 17% for micromotion at the interfaces. Existence of artificial glenoid labrum could minimize the occurrence of glenoid component loosening.
    Matched MeSH terms: Shoulder Joint*
  2. Wong ELW, Kwan MK, Loh WYC, Ahmad TS
    Med J Malaysia, 2005 Jul;60 Suppl C:72-7.
    PMID: 16381288
    Shoulder arthrodesis is a secondary reconstructive option for patients with brachial plexus injuries requiring a stable shoulder. This study was undertaken to evaluate the clinical and radiological outcomes of shoulder fusion in six patients with flail upper limbs following complete brachial plexus injuries. The shoulder was fused in 30 degrees abduction, 30 degrees internal rotation and 30 degrees flexion via a direct lateral approach by using a 4.5 mm reconstruction plate without bone grafting. The average follow-up was 10.3 months. Radiological union was obtained in all patients. Five patients (83%) had relief of pain after the shoulder fusion. Improvement of function was observed in all patients with a mean improvement of 56.6 degrees (range 30 degrees-75 degrees) and 47.5 degrees (range 30 degrees-60 degrees) active flexion and abduction respectively. One patient developed humeral fracture distal to the plate and the fracture eventually healed with a splint. Successful stable fusion of the shoulder in patients with brachial plexus injuries requires rigid fixation with a single 4.5 mm reconstruction plate, protection of bone healing with a triangular abduction brace for 12 weeks and functional trapezius, levator scapulae, serratus anterior and rhomboid muscles for optimizing the functional result.
    Matched MeSH terms: Shoulder Joint/surgery*
  3. Muttalib, A., Zaidi, M., Khoo, C.
    Malays Orthop J, 2009;3(2):8-11.
    MyJurnal
    The aim of this descriotive study is to determine the incidence of injuries among recreational badminton players. We evaluated 86 recreational badminton players in the city of Malacca; 35 were excluded for fitting the exclusion criteria. The average recreational badminton player was 36.13 years old and had been playing badminton for the past 17.84 years at a frequency of 2.11 times per week. 39.21% of the recreational badminton players complained of recent injuries in relation to playing badminton. Our data showed that the most common injury sustained by recreational badminton players was pain and stiffness at the shoulder joint. None of the injuries sustained by the players in our data were serious enough to warrant any form of surgical intervention. We conclude that badminton is a sport of relatively low risk and that the majority of related injuries were chronic overuse injuries.
    Matched MeSH terms: Shoulder Joint
  4. Shaharudin S, Rahim MFA, Muhamad AS
    Int J Prev Med, 2018;9:90.
    PMID: 30450173 DOI: 10.4103/ijpvm.IJPVM_42_17
    Background: The study investigated the effects of isokinetic versus isotonic training among adolescent state-level weightlifters in terms of total leukocytes, total lymphocytes, and its subsets following 24 sessions of training program and a month following training program cessation.

    Methods: Nineteen adolescent state-level weightlifters were assigned into isokinetic or isotonic groups. All participants were recruited from a pool of weightlifters with standardized training program provided by their coach. Series of immunological tests were carried out before the commencement, immediately upon the completion, and a month after the cessation of the additional training program to evaluate total leukocytes and lymphocytes count.

    Results: The results revealed a significant time and group interaction and main effects of time on mean total leukocytes (P < 0.05). Mean total leukocytes count at posttest decreased in both groups. In isotonic group, it was further decreased following 1 month of training cessation (P < 0.05) but not in the isokinetic group. However, the decrement was not high and the values were in the normal range. No significant time and group interaction was observed in total lymphocytes and its subsets count.

    Conclusions: Eight weeks of isokinetic and isotonic additional training with emphasis on shoulder joint only affect mean total leukocytes count in state-level adolescent weightlifters.

    Matched MeSH terms: Shoulder Joint
  5. 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: Shoulder Joint
  6. 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: Shoulder Joint
  7. Joseph LH, Hussain RI, Pirunsan U, Naicker AS, Htwe O, Paungmali A
    Acta Orthop Traumatol Turc, 2014;48(2):169-74.
    PMID: 24747625 DOI: 10.3944/AOTT.2014.3184
    The aim of this study was to investigate the intra- and inter-rater reliability of ultrasonography (US) to measure anterior translation of the humeral head (ATHH) among healthy subjects and patients with sacroiliac joint dysfunction.
    Matched MeSH terms: Shoulder Joint/ultrasonography*
  8. 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: Shoulder Joint*
  9. Wahab AHA, Saad APM, Syahrom A, Kadir MRA
    Comput Methods Biomech Biomed Engin, 2020 Apr;23(5):182-190.
    PMID: 31910663 DOI: 10.1080/10255842.2019.1709828
    Glenoid perforation is not the intended consequence of the surgery and must be avoided. The analysis on biomechanical aspect of glenoid vault perforation remains unknown. The purpose of this study is to determine the impact of glenoid perforation towards stress distribution and micromotion at the interfaces. Eight glenoid implant models had been constructed with various size, number and type of fixation. A load of 750 N was applied to centre, superior-anterior and superior-posterior area. Implant perforation had minimal impact on stress distribution and micromotion at the interfaces. However, cement survival rate for implant without perforation was the highest with a difference of up to 37% compared to other perforated models. Besides that, implant fixation and high stresses at the implant had more of an impact on implant instability than implant perforation. As a conclusion, glenoid perforation did not influence the stress distribution and micromotion, but, it reduced cement survival rate and increase the stress critical volume.
    Matched MeSH terms: Shoulder Joint/surgery*
  10. Collin P, Hervé A, Walch G, Boileau P, Muniandy M, Chelli M
    J Shoulder Elbow Surg, 2019 Oct;28(10):2023-2030.
    PMID: 31405717 DOI: 10.1016/j.jse.2019.03.002
    BACKGROUND: Results of anatomic shoulder arthroplasty for glenohumeral osteoarthritis with severe glenoid retroversion are unpredictable with a high rate of glenoid loosening. Reverse shoulder arthroplasty (RSA) has been suggested as an alternative, with good early results. We sought to confirm this at longer follow-up (minimum 5 years). The study hypothesis was that early results would endure over time.

    METHODS: We retrospectively reviewed all RSAs performed in 7 centers from 1998 to 2010. The inclusion criteria were primary glenohumeral osteoarthritis with B1, B2, B3, or C glenoid. Forty-nine shoulders in 45 patients fulfilled the criteria. Bone grafting was performed in 16 cases. Clinical outcomes were evaluated with the Constant score (CS) and shoulder range of motion.

    RESULTS: The mean total CS increased from 30 preoperatively to 68 points (P < .001) with significant improvements in all the subsections of the CS and range of motion. Scapular notching was observed in 20 shoulders (43%), grade 1 in 5 (11%), grade 2 in 7 (15%), grade 3 in 5 (11%), and grade 4 in 3 (6%). The glenoid bone graft healed in all the shoulders. Partial inferior lysis of the bone graft was present in 8 cases (50%). Scapular notching and glenoid bone graft resorption had no influence on the CS (P = .147 and P = .798).

    CONCLUSION: RSA for the treatment of primary glenohumeral osteoarthritis in patients with posterior glenoid deficiency and humeral subluxation without rotator cuff insufficiency resulted in excellent clinical outcomes at a minimum of 5 years of follow-up.

    Matched MeSH terms: Shoulder Joint/physiopathology; Shoulder Joint/surgery*
  11. 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: Shoulder Joint
  12. Sharma A, Jindal S, Narula MS, Garg S, Sethi A
    Malays Orthop J, 2017 Mar;11(1):74-76.
    PMID: 28435581 DOI: 10.5704/MOJ.1703.011
    The incidence of bilateral gleno-humeral joint dislocation is rare, is almost always posterior and is usually caused by sports injuries, epileptic seizures, electrical shock, or electroconvulsive therapy. Bilateral fracture-dislocation is even rarer, with a few cases reported in the literature. We report an unusual case with dislocation of the both glenohumeral joints in opposite direction after a seizure episode, with fracture of greater tuberosity on one side and of the lesser tuberosity on the contralateral side. Although there have been a few reports of bilateral asymmetric fracture dislocations of the shoulder in the past, an injury pattern resembling our case has, to the best of our knowledge, not been described in the literature so far. This report includes a detailed discussion regarding the mechanism of injury in a case of asymmetrical dislocation following a seizure episode. At final follow-up, the patient had healed fractures, painless near normal range of motion with no redislocations.
    Matched MeSH terms: Shoulder Joint
  13. Nagarajan M, Vijayakumar P
    J Back Musculoskelet Rehabil, 2013;26(3):227-42.
    PMID: 23893137 DOI: 10.3233/BMR-130373
    Recent evidences suggest functional thoracic hyperkyphosis (FTH) could be a different approach in the management of subacromial impingement syndrome (SIS). This case study aims firstly with the development of evidence informed FTH model for SIS. Secondly this study aimed to develop well defined multimodal physical therapy intervention for FTH and its related mechanical consequences in elderly patient with chronic SIS. As a result, Level IV positive evidence was found in both the short and long-term pain and disability of chronic SIS, using FTH model with 26 months of follow-up.
    Matched MeSH terms: Shoulder Joint/pathology
  14. Widiastuti-Samekto M, Sianturi GP
    Med J Malaysia, 2004 Aug;59(3):312-6.
    PMID: 15727375
    Twenty-six patients with frozen shoulder syndrome (Stage 2 and 3) were included in this study conducted at Dr. Kariadi General Hospital, Semarang, Indonesia and randomly allocated into 2 groups: 40 mg triamcinolone intra-articular injection and triamcinolone oral tablets. The result showed that triamcinolone intra-articular injection group "cured" rate was 5.8 times higher at week one compared to the triamcinolone tablet group. Sixty-two percent of the cases with triamcinolone intra-articular injection achieved their "cured" condition after one week of therapy, compared with only 14% of the triamcinolone tablets group. We conclude that, intra-articular corticosteroid injection provide faster improvement compared to oral route.
    Matched MeSH terms: Shoulder Joint/pathology*
  15. 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: Shoulder Joint/physiology*
  16. 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: Shoulder Joint
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