Saratov JOURNAL of Medical and Scientific Research

arthroscopy

Evaluation results of arthroscopic reconstruction of rotator cuff using single-row anchor fixation

Year: 2018, volume 14 Issue: №3 Pages: 401-407
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Chirkov А.А., Spiridonova O.V., Yakovlev V.N.
Organization:
Summary:

The purpose was to evaluate the results of arthroscopic reconstruction of the rotator cuff of a shoulder using the single-row anchor fixation method, to evaluate the dependence of the results of treatment on the size of the rupture of the rotator cuff of the shoulder. Material and Methods. This report provides an analysis of results of surgical treatment of 84 patients with the damage of the rotator cuff of a shoulder, who underwent arthroscopic reconstruction of the rotational cuff of a shoulder using single-row anchor fixation. The size of rupture of the rotator cuff of the shoulder was measured with the use of MRI and during surgery itself. All ruptures were subdivided into small (less than 1 cm), medium (1-3 cm) and large (3-5 cm). The exclusion criteria were patients with a massive rupture of the rotator cuff of a shoulder, with retraction of the tendon to the level of the articular process of the scapula or fatty degeneration of the muscles of the short shoulder rotators. The paper presents the features of operative technique and original algorithm for postoperative rehabilitation at different stages of treatment. Evaluation of the results of treatment was performed according to the rating scale of the Constant score, ASES, UCLA. Results. The average age of the patients was 56.0±7.4 (36-71 years). Of these, 22.6% patients had a small degree of rupture of the rotator cuff of a shoulder, 50% middle and 27.4% patients had a large degree of rupture. The nearest results (up to one year) were evaluated in 5 patients, long-term results in 79 patients (more than a year). The average rating score according to the Constant score was 89,8±9,2; the average value according to the ASES scale was 83,7±17,6; the average value according to the UCLA scale was 29.3±5.9. In all other patients complete recovery was observed in the period from 6 months to a year after the operation, there was a decrease in the pain syndrome, an increase in the volume of movements, an improvement in the quality of life. Conclusion. Arthroscopic reconstruction of the rotator cuff of a shoulder using the method of single-row anchor fixation, if necessary, with the help of seams which reapproximate the edges of the rupture, and with the help of the accompanying procedures, provides good results. Reduction in pain, increase in movement and in muscle strength in the arm were noted in all patients, regardless of the size of the damage to the rotator cuff of the shoulder. The rehabilitative protocol used ensures the creation of favorable conditions for engraftment of the restored tendon and, at the same time, provides prevention of the development of the stiffness of the shoulder joint.

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Optimization of surgical treatment tactics at a customary shoulder dislocation

Year: 2018, volume 14 Issue: №2 Pages: 240-243
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Norkin A.l., Klimov S.S., Levchenko K.K., Shormanov A.M., Alieva A.M., Katerusha A.M., Amanova M.M., Ulyanov V.Yu.
Organization: Saratov State Medical University
Summary:

 Saratov Journal of Medical Scientific Research 2018; 14 (2): 240-243. The aim: the optimization of surgical treatment tactics at a customary shoulder dislocation, based on "on-track Hill-Sachs / off-track Hill-Sachs" concept. Material and Methods. The research group consists of 42 patients aged from 19 to 52 years with chronic recurrent anterior shoulder instability, who underwent a surgical treatment to restore previous shoulder anatomic and topographic correlations. Patients were divided into two subgroups according to diagnostic arthroscopy results. The first subgroup includes 14 patients with impaction visualized (off-track Hill-Sachs), the second one — 28 patients with head shoulder stability (on-track Hill-Sachs). Patients of the first subgroup underwent open surgical intervention according to Bristow — Latarjetand shoulder arthroscopic repair was carried out in the second group. Results. One month after the surgical treatment median total estimated figure exceeded by 1.8 times in patients of the first subgroup and by 1.2 times, by Rowe, in patients of the second subgroup and decreased by 2.1 times in patients of the first subgroup and by 1.7 times, by DASH, in the second subgroup in comparison with the indices before the operation, that was illustrative of a good treatment result. Six months after the operation median total estimated figure exceeded by 1.2 times, by Rowe, in patients both of the first subgroup and the second subgroup and decreased by 2 and 2.1 times, by DASH, in patients of the first and the second group, relatively in comparison with the indices found one month after the operation, that was illustrative of an excellent treatment result in the late postoperative period. Conclusion. Patients with anterior shoulder instability caused by a glenoid fossa deficiency less than 25% in combination with off-track Hill-Sachs lesion, the most convenient way is the replacement of the bone loss by coracoid process transposition. In patients with on-track Hill-Sachs lesion arthroscopic repair is preferable.

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The state of the vegetative nervous system in patients with gonarthrosis for surgical treatment before and after surgical treatment

Year: 2012, volume 8 Issue: №4 Pages: 975-979
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Dolganova T.I., Biriukova M.lu., Karasev E.A., Buravtsov P.P., Karaseva T.lu.
Organization: Russian Ilizarov Scientific Center «Restorative Traumatology and Orthopaedics»
Summary:

Aim. Analyzing the vegetative tensity of organism» functional systems before and after surgical treatment of elderly patients with metabolic-and-dystrophic gonarthrosis. Methods. The evaluation of vegetative homeostasis, reactivity of the vegetative nervous system by the data of variation pulsometry («REAN-POLY» RGPA-6/12, Taganrog) in 60 patients with gonarthrosis at the age of 50-72 years and the disease duration — 9+1.5 years before and after surgical treatment: total tunnelization (Group I), tunnelization with osteotomy of leg bones for correction of limb biomechanical axis (Group II), treatment-and-diagnostic arthroscopy (Group III). Results. The reduction of the level of hypoxia tolerance and the decrease of the processes of general adaptation one month after surgery in Group I was registered in 40% of patients. As for patients of Group II, by the end of the period of fixation with the llizarov device — in 50%. As for those of Group III after arthroscopy — in 10% of patients. Among the patients whose 1С / 1С calculated parameter after surgical treatment was registered 10.0 before treatment in 70% of cases. At rest, marked vagotonia was registered with hypersympathicotonic reaction to orthotest, as well as with sharp decrease of the proportion of second-order slow waves while transition to standing position (VLF proportion

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