S S Burkhart

..CONCLUSIONS: These results show a significant relationship between a narrowed coracohumeral distance and subscapularis pathology. LEVEL OF EVIDENCE: Level III, retrospective cohort study...

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..This procedure has been successfully used in vivo without complications. It is important to note that this procedure will only work in an anchor eyelet that will allow for the passage of 3 suture strands...

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..Biodegradable implants have allowed a paradigm shift away from bionic (mechanical replacement) engineering and toward true biologic solutions to reconstructive problems in arthroscopic surgery...

..6. How to securely repair all sizes of subscapularis tear. 7. A description of postoperative immobilization and rehabilitation to optimize results of arthroscopic subscapularis repair...

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..This report describes how to arthroscopically bone graft these defects with a compaction technique that creates a densely packed bone bed into which suture anchors can be securely placed...

..After repair of the subscapularis tendon, this lateral rotator interval tissue can greatly facilitate repair of the posterosuperior rotator cuff...

..This technique dramatically reduces strain along the "converged" margin, thereby protecting the tendon-bone repair interface during the critical phases of healing...

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..The purpose of this study was to assess the functional results of arthroscopic repair of massive rotator cuff tears in patients who had stage 3 and 4 fatty degeneration of the rotator cuff musculature, according to the Goutallier scale...

..5 years in this study), and to analyze results by tear size and repair technique (margin convergence v direct tendon-to-bone repair). Type of Study: Case series...

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..This report describes the clinical and technical details of arthroscopic excision of calcific deposits of the subscapularis tendon as well as arthroscopic repair of the resulting subscapularis defect...

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..The ability to tenodese the retracted LHBB arthroscopically is a technologic advance that could reduce morbidity in comparison to open tenodesis, thus resulting in a better functional outcome...

..LEVEL OF EVIDENCE: Level 4, case series (no or historical control group)...

..Arthroscopic repair of these massive tears can produce durable reversal of proximal humeral migration and restoration of overhead function...

..The purpose of this study was to identify the presence of intra-articular pathology in patients undergoing shoulder arthroscopy immediately before modified Latarjet reconstruction for recurrent anterior instability with bone deficiency...

..This report describes how to arthroscopically identify and expose these anatomic landmarks...

..Although no complications were seen in this group of patients, both patients and surgeons should be aware of this concern after shoulder arthroscopy and the potential complications related to it...

..CLINICAL RELEVANCE: This study identifies the static and sliding configurations of commonly used arthroscopic knots in order to aid the surgeon in choosing the most biomechanically effective knot for use in arthroscopic surgery...

..Open anterior stabilization surgery should not be used to treat dead arm syndrome...

..Our goal with this procedure is not to obtain healing of the cuff to the biceps, but to optimize the conditions for healing of the rotator cuff to bone...

..However, the simplest technique of all has been ignored until now. Application of Bernoulli's Principle to achieve turbulence control by means of digital pressure over a leaking portal can quickly and easily enhance visualization...

..The etiology, biomechanics, surgical repair, and rehabilitation are discussed in detail...

..This technique uses the eyelets of the 2 suture anchors as pulleys and creates a double-mattress suture...

..The authors have found the "comma sign," an arc formed by a portion of the superior glenohumeral ligament/coracohumeral ligament complex, to be a useful marker of the superolateral corner of the torn subscapularis tendon...

..This technique, in conjunction with arthroscopic rotator cuff repair, may provide patients with improvements in pain, motion, strength, and overall shoulder function. LEVEL OF EVIDENCE: Level IV...

..CLINICAL RELEVANCE: This study shows the safety of standard and accessory glenohumeral arthroscopy portals...

..Achieving optimal motion and function and minimizing the risk of osteoarthritis have become almost as important as stabilizing the joint...

..In patients with an inverted pear glenoid, a bone grafting procedure to restore the normal articular arc of the glenoid should be strongly considered to re-establish normal stability to the shoulder...

..In this report, we describe a transtendon method of repairing partial articular surface lesions that anatomically restores the footprint of the rotator cuff, allowing a broad area for tendon healing to bone...

..CLINICAL RELEVANCE: The study will help the surgeon to assess suture and suture anchor characteristics in order to optimize fixation of biologic tissues during surgical repair and reconstruction...

..LEVEL OF EVIDENCE: Level I, diagnostic study: testing of previously developed criteria in a series of consecutive patients with arthroscopy used as the criterion standard...

..In this report, the authors describe a double-row technique for rotator cuff repair that re-establishes the normal rotator cuff footprint, increases the contact area for healing, and may potentially improve clinical results...

..Such objective measurement of glenoid bone loss can be clinically useful to the surgeon in deciding whether bone grafting is necessary to restore stability to the shoulder with a bone-deficient glenoid...

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..This method is easier to perform than a subacromial approach and allows appropriate orientation of the coracoplasty in the plane of the subscapularis tendon...

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..The long-term outcome of these severe labral lesions remains to be determined, particularly with respect to the development of post-traumatic osteoarthritis. LEVEL OF EVIDENCE: Level IV. Case series, no or historical control group...

..The authors describe the bubble sign, a bulging expansion of the rotator cuff tendon following injection of saline into the suspected lesion, as a useful indicator of an intratendinous tear of the rotator cuff...

..A high index of suspicion for these combined lesions, along with adequate surgical decompression and rotator cuff repair, is essential in providing pain relief and improved function...

..Collectively, these factors may in part contribute to the pathogenesis of subscapularis tears...

..Once a tear is identified, we proceed with a biceps tenodesis and then take down the medial sling from the lesser tuberosity to better delineate the subscapularis footprint. The subscapularis may then be repaired in standard fashion...

..After the lateral row repair is performed, the rotator cuff footprint will be completely reconstituted...

..In this review, we focus on new concepts and techniques related to arthroscopic rotator cuff repair that have been recently introduced...

..CLINICAL RELEVANCE: This study quantifies the relative risk of injury to neurovascular structures during arthroscopic surgery about the coracoid...

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..With these principles in mind, the shoulder surgeon can address disruptions of the anterior rotator cuff by repairing the subscapularis, thus alleviating the disability associated with this overlooked and under-appreciated pathology...

..The purpose of this study was to describe the anatomic footprint of the subscapularis tendon...

..The STS ligament may be incised by use of dissecting scissors through a lateral, accessory lateral, or accessory posterior portal, releasing the suprascapular nerve...

..Adherence to these basic principles should lead to excellent results with arthroscopic stabilization of the unstable shoulder...

..To determine the magnetic resonance imaging (MRI) criteria for predicting rotator cuff tear pattern and method of repair...

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..Part III: The "SICK" Scapula, Scapular Dyskinesis, the Kinetic Chain, and Rehabilitation will be presented in the July-August issue. We hope you find it thought-provoking and compelling...

..CLINICAL RELEVANCE: The arthroscopic shoulder surgeon should be aware of the enhanced footprint coverage offered by double-row rotator cuff fixation as opposed to single-row rotator cuff fixation...

..6 degrees; and internal rotation, 31.1 degrees. We believe that a reduction in joint contact pressures through a greater range of motion is the primary mechanism for pain relief resulting from capsular release...