Rotator cuff (RC) tears are a common presentation in day-to-day clinical settings. Majority of the symptomatic patients are treated by a surgical repair. Before considering a surgical intervention, it is vital to understand the anatomy of RC footprint and restore it, in order to achieve an optimal tension-free repair, better healing and subsequently good clinical outcomes. Concepts pertaining to the RC footprint over the greater tuberosity (GT) have been constantly changing in the past two decades with meticulous anatomical studies. Traditional concepts of individual insertions of supraspinatus (SSP) and infraspinatus (ISP), SSP alone playing the vital role in shoulder abduction, now stand obsolete. Similarly, being the largest muscle-tendon unit, subscapularis (SSC) has been studied extensively and is now known to have a three dimensional insertion over lesser tuberosity. This article reviews the evolution of concepts pertaining to RC insertion and their clinical application. Keywords: Rotator cuff; Footprint; Three-dimensional insertion.
{"title":"Evolving concepts in the rotator cuff footprint","authors":"Ajinkya Achalare, Nilesh Kamat, M.P. Ramraju Mudunuri","doi":"10.13107/aja.2021.v06i01.019","DOIUrl":"https://doi.org/10.13107/aja.2021.v06i01.019","url":null,"abstract":"Rotator cuff (RC) tears are a common presentation in day-to-day clinical settings. Majority of the symptomatic patients are treated by a surgical repair. Before considering a surgical intervention, it is vital to understand the anatomy of RC footprint and restore it, in order to achieve an optimal tension-free repair, better healing and subsequently good clinical outcomes. Concepts pertaining to the RC footprint over the greater tuberosity (GT) have been constantly changing in the past two decades with meticulous anatomical studies. Traditional concepts of individual insertions of supraspinatus (SSP) and infraspinatus (ISP), SSP alone playing the vital role in shoulder abduction, now stand obsolete. Similarly, being the largest muscle-tendon unit, subscapularis (SSC) has been studied extensively and is now known to have a three dimensional insertion over lesser tuberosity. This article reviews the evolution of concepts pertaining to RC insertion and their clinical application.\u0000Keywords: Rotator cuff; Footprint; Three-dimensional insertion.","PeriodicalId":331352,"journal":{"name":"Asian Journal of Arthroscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116314002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-10DOI: 10.13107/aja.2021.v06i01.021
V. Pandey
Rotator cuff tear is a leading cause of shoulder pain resulting in varying degree of disability to perform activities of daily living. A methodical history taking and focussed clinical examination helps in establishing the clinical diagnosis. A number of tests are mentioned in the literature to test the integrity of rotator cuff. This narrative review will focus upon methodology of each test, and their diagnostic accuracy. Keywords: Rotator cuff tear; Impingement; Clinical tests; Diagnosis.
{"title":"Diagnostic Clinical Tests in Rotator Cuff Tear: Which and Why?","authors":"V. Pandey","doi":"10.13107/aja.2021.v06i01.021","DOIUrl":"https://doi.org/10.13107/aja.2021.v06i01.021","url":null,"abstract":"Rotator cuff tear is a leading cause of shoulder pain resulting in varying degree of disability to perform activities of daily living. A methodical history taking and focussed clinical examination helps in establishing the clinical diagnosis. A number of tests are mentioned in the literature to test the integrity of rotator cuff. This narrative review will focus upon methodology of each test, and their diagnostic accuracy.\u0000Keywords: Rotator cuff tear; Impingement; Clinical tests; Diagnosis.\u0000\u0000","PeriodicalId":331352,"journal":{"name":"Asian Journal of Arthroscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132266494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-10DOI: 10.13107/aja.2021.v06i01.016
Anshu Shekhar, Nilesh Kamat, S. Tapasvi
Rotator Cuff (RC) tear is a common cause of disability and pain for which middle aged and elderly individuals seek orthopaedic consultation. A unique feature of RC tear treatment is that it encompasses an entire spectrum, which ranges from humble conservative methods to complicated tendon transfers. There is a now a fair amount of agreement about which treatment modality must be offered to whom, based on tear type, tendon retraction, tissue quality and patient profile. What must be borne in mind however, is that no bridges be burnt when choosing a treatment method. This would keep the door open for a salvage or revision procedure to help the patient. This issue of the Asian Journal of Arthroscopy is a symposium dedicated to management strategies for Rotator cuff tears. The importance of clinical examination in a patient with shoulder pain and weakness cannot be overemphasized. It is the cornerstone of formulating an individualized treatment plan. Vivek Pandey has discussed the methodology for all the relevant tests to accurately diagnose a rotator cuff tear, along with their pearls and pitfalls. One of the most important reasons why arthroscopic shoulder surgery in general and rotator cuff surgery is particular has evolved, is the remarkable progress in imaging, especially Magnetic Resonance scans. Anupama Patil has written a detailed descriptive review in this subject. An understanding of the nuances of imaging will help the clinician to clinically co-relate her findings. A sound clinician is one has a grasp of theoretical concepts developed and validated over the years. The ability to a classify rotator cuff tear based on imaging findings and co-relating clinically in the foundation on which every treatment decision is made. Ram Chidambaram has written an exhaustive review detailing all classification systems for rotator cuff tear. Jaap Willems has presented an algorithm for such decision making based primarily on age and tear morphology. The non-operativ
{"title":"Rotator Cuff Tears: An Everlasting Enigma","authors":"Anshu Shekhar, Nilesh Kamat, S. Tapasvi","doi":"10.13107/aja.2021.v06i01.016","DOIUrl":"https://doi.org/10.13107/aja.2021.v06i01.016","url":null,"abstract":"Rotator Cuff (RC) tear is a common cause of disability and pain for which middle aged and elderly individuals seek orthopaedic consultation. A unique feature of RC tear treatment is that it encompasses an entire spectrum, which ranges from humble conservative methods to complicated tendon transfers. There is a now a fair amount of agreement about which treatment modality must be offered to whom, based on tear type, tendon retraction, tissue quality and patient profile. What must be borne in mind however, is that no bridges be burnt when choosing a treatment method. This would keep the door open for a salvage or revision procedure to help the patient. This issue of the Asian Journal of Arthroscopy is a symposium dedicated to management strategies for Rotator cuff tears.\u0000\u0000 \u0000\u0000The importance of clinical examination in a patient with shoulder pain and weakness cannot be overemphasized. It is the cornerstone of formulating an individualized treatment plan. Vivek Pandey has discussed the methodology for all the relevant tests to accurately diagnose a rotator cuff tear, along with their pearls and pitfalls. One of the most important reasons why arthroscopic shoulder surgery in general and rotator cuff surgery is particular has evolved, is the remarkable progress in imaging, especially Magnetic Resonance scans. Anupama Patil has written a detailed descriptive review in this subject. An understanding of the nuances of imaging will help the clinician to clinically co-relate her findings. A sound clinician is one has a grasp of theoretical concepts developed and validated over the years. The ability to a classify rotator cuff tear based on imaging findings and co-relating clinically in the foundation on which every treatment decision is made. Ram Chidambaram has written an exhaustive review detailing all classification systems for rotator cuff tear. Jaap Willems has presented an algorithm for such decision making based primarily on age and tear morphology.\u0000\u0000 \u0000\u0000The non-operativ","PeriodicalId":331352,"journal":{"name":"Asian Journal of Arthroscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133545666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-10DOI: 10.13107/aja.2021.v06i01.024
Andrew Arjun Sayampanathan, M. Tan, D. Lie
Rotator cuff tears are known to result in significant societal burden. This review synthesises the evidence regarding the role and outcomes of conservatively managed rotator cuff tears. 17 prospective randomised controlled trials (RCTs) (Level 1 and 2 studies) were included in this systematic review. Modalities which were studied were classified into physical rehabilitative modalities, electrophysiological rehabilitative modalities, biological therapies, and pharmacologic therapies. Outcomes which were evaluated in the included RCTs comprised of clinical outcomes, functional outcomes, pain scores, quality of life scores, imaging based outcomes, and patient satisfaction scores. As the modalities and outcomes studied were varied, no quantitative analysis could be performed based on the primary data available. Nevertheless, most studies do suggest that conservative treatment remains beneficial for the management of rotator cuff tears. Based on these findings, an algorithm which proposes conservative therapy as the central mode of management for rotator cuff tear patients has been described. More high-quality studies are required in this area of study to allow for a quantitative review (meta-analysis and meta-regression) of the various non-surgical treatment modalities of rotator cuff tears. Keywords: Rotator Cuff Tears; Conservative; Non-operative; Management; Randomised controlled trials; Review.
{"title":"Role And Outcomes of Conservative Treatment in Management of Rotator Cuff Tears: A Systematic Review of Randomised Controlled Trials","authors":"Andrew Arjun Sayampanathan, M. Tan, D. Lie","doi":"10.13107/aja.2021.v06i01.024","DOIUrl":"https://doi.org/10.13107/aja.2021.v06i01.024","url":null,"abstract":"Rotator cuff tears are known to result in significant societal burden. This review synthesises the evidence regarding the role and outcomes of conservatively managed rotator cuff tears. 17 prospective randomised controlled trials (RCTs) (Level 1 and 2 studies) were included in this systematic review. Modalities which were studied were classified into physical rehabilitative modalities, electrophysiological rehabilitative modalities, biological therapies, and pharmacologic therapies. Outcomes which were evaluated in the included RCTs comprised of clinical outcomes, functional outcomes, pain scores, quality of life scores, imaging based outcomes, and patient satisfaction scores. As the modalities and outcomes studied were varied, no quantitative analysis could be performed based on the primary data available. Nevertheless, most studies do suggest that conservative treatment remains beneficial for the management of rotator cuff tears. Based on these findings, an algorithm which proposes conservative therapy as the central mode of management for rotator cuff tear patients has been described. More high-quality studies are required in this area of study to allow for a quantitative review (meta-analysis and meta-regression) of the various non-surgical treatment\u0000modalities of rotator cuff tears.\u0000Keywords: Rotator Cuff Tears; Conservative; Non-operative; Management; Randomised controlled trials; Review.","PeriodicalId":331352,"journal":{"name":"Asian Journal of Arthroscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124885414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-10DOI: 10.13107/aja.2021.v06i01.022
R. Chidambaram, R. Mukhopadhyay
Rotator cuff pathology is one of the most common conditions affecting the shoulder joint. Several classification systems have been used to describe rotator cuff tears in orthopedic literature. However, no comprehensive classification inclusive of all types and characteristics currently exists. Rotator cuff tears are classified based on various parameters. These include: 1. Tear depth 2. Tear Size/Extent 3. Tear Retraction 4. Tendon Quality 5. Tear Progression 6. Arthroscopic Classification. This review article aims to establish an algorithm based on the various existing classification systems so as to arrive at the best surgical or non-surgical solution as well as prognosticate the patient regarding the outcome. Special consideration needs to be made for massive tears which are irreparable. Keywords: Rotator cuff tears; Rotator cuff tear classification; Massive irreparable rotator cuff tears; Partial rotator cuff tears; Subscapularis tears; Geometric Classification; Arthroscopic Classification; Rotator cuff retraction; Rotator cuff tendon quality; Prognosis for Rotator Cuff tears.
{"title":"Classification Systems in Rotator Cuff Tears","authors":"R. Chidambaram, R. Mukhopadhyay","doi":"10.13107/aja.2021.v06i01.022","DOIUrl":"https://doi.org/10.13107/aja.2021.v06i01.022","url":null,"abstract":"Rotator cuff pathology is one of the most common conditions affecting the shoulder joint. Several classification systems have been used to describe rotator cuff tears in orthopedic literature. However, no comprehensive classification inclusive of all types and characteristics currently exists. Rotator cuff tears are classified based on various parameters. These include: 1. Tear depth 2. Tear Size/Extent 3. Tear Retraction 4. Tendon Quality 5. Tear Progression 6. Arthroscopic Classification. This review article aims to establish an algorithm based on the various existing classification systems so as to arrive at the best surgical or non-surgical solution as well as prognosticate the patient regarding the outcome. Special consideration needs to be made for massive tears which are irreparable.\u0000Keywords: Rotator cuff tears; Rotator cuff tear classification; Massive irreparable rotator cuff tears; Partial rotator cuff tears; Subscapularis tears; Geometric Classification; Arthroscopic Classification; Rotator cuff retraction; Rotator cuff tendon quality; Prognosis for Rotator Cuff tears.","PeriodicalId":331352,"journal":{"name":"Asian Journal of Arthroscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120917821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-10DOI: 10.13107/aja.2021.v06i01.017
V. Vijayamohan, Shyam Gopal V, Mohan P. Chandran, A. Antony
Rehabilitation following anterior cruciate ligament surgery continues to evolve, with the current emphasis being on immediate weight bearing and range of motion, and progressive muscular strengthening, proprioception, dynamic stability, and neuromuscular control drills. In this study we evaluate the functional outcome of Immediate full weight bearing mobilization following arthroscopic ACL (Anterior Cruciate Ligament) reconstruction with quadrupled hamstring graft using endobutton and bioscrew. With the advancement of fixation techniques immediate weight bearing mobilization after arthroscopic ACL reconstruction can give better functional outcome and improved patient satisfaction. Although further large volume multicentric research is needed for establishing a standardized rehabilitation protocol following arthroscopic ACL reconstruction, immediate weight bearing doesn’t cause any complications and has better outcome as per our study. Keywords: Arthroscopic reconstruction; ACL; Immediate weight bearing.
{"title":"Functional Outcome in Arthroscopic ACL Reconstruction with Immediate Full Weight Bearing Mobilization- Retrospective Study","authors":"V. Vijayamohan, Shyam Gopal V, Mohan P. Chandran, A. Antony","doi":"10.13107/aja.2021.v06i01.017","DOIUrl":"https://doi.org/10.13107/aja.2021.v06i01.017","url":null,"abstract":"Rehabilitation following anterior cruciate ligament surgery continues to evolve, with the current emphasis being on immediate weight bearing\u0000and range of motion, and progressive muscular strengthening, proprioception, dynamic stability, and neuromuscular control drills.\u0000In this study we evaluate the functional outcome of Immediate full weight bearing mobilization following arthroscopic ACL (Anterior Cruciate\u0000Ligament) reconstruction with quadrupled hamstring graft using endobutton and bioscrew.\u0000With the advancement of fixation techniques immediate weight bearing mobilization after arthroscopic ACL reconstruction can give better\u0000functional outcome and improved patient satisfaction. Although further large volume multicentric research is needed for establishing a\u0000standardized rehabilitation protocol following arthroscopic ACL reconstruction, immediate weight bearing doesn’t cause any complications\u0000and has better outcome as per our study.\u0000Keywords: Arthroscopic reconstruction; ACL; Immediate weight bearing.","PeriodicalId":331352,"journal":{"name":"Asian Journal of Arthroscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130393011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-10DOI: 10.13107/aja.2021.v06i01.023
W. Willems
Rotator cuff tears are a frequent phenomenon with an increasing incidence when the patient gets older. A considerable number of tears remain asymptomatic during a lifetime. However, still, a substantial number of asymptomatic tears become symptomatic. There is, at present evolving evidence that surgical treatment of small to medium-sized tears does better than conservative treatment, even after a long term follow-up. A treatment algorithm is suggested to help the clinician in decision making, where tear size and age are important factors in the prognosis of surgical treatment. Keywords: Rotator cuff; Ruptures; Natural historyf tears; Partial rotator cuff tears; Subscapularis tears; Geometric Classification; Arthroscopic Classification; Rotator cuff retraction; Rotator cuff tendon quality; Prognosis for Rotator Cuff tears.
{"title":"Natural History of Rotator Cuff Tears","authors":"W. Willems","doi":"10.13107/aja.2021.v06i01.023","DOIUrl":"https://doi.org/10.13107/aja.2021.v06i01.023","url":null,"abstract":"Rotator cuff tears are a frequent phenomenon with an increasing incidence when the patient gets older. A considerable number of tears remain asymptomatic during a lifetime. However, still, a substantial number of asymptomatic tears become symptomatic. There is, at present evolving evidence that surgical treatment of small to medium-sized tears does better than conservative treatment, even after a long term follow-up. A treatment algorithm is suggested to help the clinician in decision making, where tear size and age are important factors in the prognosis of surgical treatment.\u0000Keywords: Rotator cuff; Ruptures; Natural historyf tears; Partial rotator cuff tears; Subscapularis tears; Geometric Classification; Arthroscopic Classification; Rotator cuff retraction; Rotator cuff tendon quality; Prognosis for Rotator Cuff tears.","PeriodicalId":331352,"journal":{"name":"Asian Journal of Arthroscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116805458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-10DOI: 10.13107/aja.2021.v06i01.020
A. Patil, Joban Babhulkar,, Pranav Mahadeokar
The rotator cuff is instrumental in movements of the shoulder, while at the same time producing balanced compressive forces to stabilise the glenohumeral joint (dynamic stabiliser) Cuff tears are usually diagnosed clinically but before a decision regarding surgery is taken, some form of cross-sectional imaging, USG and/or MRI, is a must. This descriptive review is an attempt to highlight key concepts from the existing literature, along with our experience to image these injuries and assist the clinicians to formulate protocols in the day to day management of rotator cuff pathologies. Keywords: Rotator cuff injuries; Cuff tears ; Cuff arthropathy; Post operative imaging.
{"title":"Spectrum of Imaging Findings In Rotator Cuff Tears – A Descriptive Review","authors":"A. Patil, Joban Babhulkar,, Pranav Mahadeokar","doi":"10.13107/aja.2021.v06i01.020","DOIUrl":"https://doi.org/10.13107/aja.2021.v06i01.020","url":null,"abstract":"The rotator cuff is instrumental in movements of the shoulder, while at the same time producing balanced compressive forces to stabilise the glenohumeral joint (dynamic stabiliser) Cuff tears are usually diagnosed clinically but before a decision regarding surgery is taken, some form of cross-sectional imaging, USG and/or MRI, is a must. This descriptive review is an attempt to highlight key concepts from the existing literature, along with our experience to image these injuries and assist the clinicians to formulate protocols in the day to day management of\u0000rotator cuff pathologies.\u0000Keywords: Rotator cuff injuries; Cuff tears ; Cuff arthropathy; Post operative imaging.\u0000\u0000","PeriodicalId":331352,"journal":{"name":"Asian Journal of Arthroscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133102780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-10DOI: 10.13107/aja.2021.v06i01.018
Sharat Balemane, Kaushik S. Eswaran, N. Shetty
Background: The etiopathogenesis of rotator cuff tears remains debatable. Among the many causes, abnormal scapular morphology has been found to accelerate the degenerative process of rotator cuff tears. The morphology and lateral extension of the acromion process were assessed indetail by Nyffeler et al. and the Acromion Index (AI) was introduced, which measures the lateral extension of the acromion. It was theorized that a large lateral extension of the acromion increased the chances of the supraspinatus tendon to degenerate because of impingement between the acromion and the deltoid muscle. The AI was compared between patients with rotator cuff tears and patients with an intact rotator cuff. Methods: 21 Indian patients presenting to the orthopaedics OPD, Yenepoya Medical College, with rotator cuff tears were taken up for this study between August 2020 and February 2021. Another 21 patients with intact rotator cuff and other shoulder diseases such as frozen shoulder were included in this study. Patients with rotator cuff tears were included in group A, and patients with intact rotator cuff were included in group B. Both groups had the AI measured on radiographs, and their values were compared. Results: The mean Acromial Index (AI) in the rotator cuff tear group was 0.74 and in the intact rotator cuff group it was 0.59, which was statistically significant. There was no statistical difference in AI between male and female patients. The mean age of the patients in the rotator cuff group was 50.8 years, and in non rotator cuff tear group, it was 50.2 years. Conclusion: Acromial Index is a useful predictive tool for detecting rotator cuff tears in the Indian population. Further studies are required to assess its usefulness in predicting the progression of a rotator cuff tear. Keywords: Rotator cuff tear; Acromial Index; Shoulder.
{"title":"Acromial Index in Indian Population and it’s Significance on Rotator Cuff Tears","authors":"Sharat Balemane, Kaushik S. Eswaran, N. Shetty","doi":"10.13107/aja.2021.v06i01.018","DOIUrl":"https://doi.org/10.13107/aja.2021.v06i01.018","url":null,"abstract":"Background: The etiopathogenesis of rotator cuff tears remains debatable. Among the many causes, abnormal scapular morphology has been found to accelerate the degenerative process of rotator cuff tears. The morphology and lateral extension of the acromion process were assessed indetail by Nyffeler et al. and the Acromion Index (AI) was introduced, which measures the lateral extension of the acromion. It was theorized that a large lateral extension of the acromion increased the chances of the supraspinatus tendon to degenerate because of impingement between the acromion and the deltoid muscle. The AI was compared between patients with rotator cuff tears and patients with an intact rotator cuff.\u0000Methods: 21 Indian patients presenting to the orthopaedics OPD, Yenepoya Medical College, with rotator cuff tears were taken up for this study between August 2020 and February 2021. Another 21 patients with intact rotator cuff and other shoulder diseases such as frozen shoulder were included in this study. Patients with rotator cuff tears were included in group A, and patients with intact rotator cuff were included in group B. Both groups had the AI measured on radiographs, and their values were compared.\u0000Results: The mean Acromial Index (AI) in the rotator cuff tear group was 0.74 and in the intact rotator cuff group it was 0.59, which was statistically significant. There was no statistical difference in AI between male and female patients. The mean age of the patients in the rotator cuff group was 50.8 years, and in non rotator cuff tear group, it was 50.2 years.\u0000Conclusion: Acromial Index is a useful predictive tool for detecting rotator cuff tears in the Indian population. Further studies are required to assess its usefulness in predicting the progression of a rotator cuff tear.\u0000Keywords: Rotator cuff tear; Acromial Index; Shoulder.","PeriodicalId":331352,"journal":{"name":"Asian Journal of Arthroscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131933044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-10DOI: 10.13107/aja.2021.v06i01.025
Sachin Kumar, R. Gogna, D. Morris, A. Tambe
Symptomatic rotator cuff tears cause pain and impaired function. Arthroscopic rotator cuff repair is an established treatment when nonoperative management fails. However, debate exists regarding the requirement of concurrent subacromial decompression. This review aims to answer pertinent questions and outline relevant literature in the role of arthroscopic subacromial decompression in rotator cuff repair. Keywords: Decompression, Cuff, Arthroscopic, Repair.
{"title":"Should We be Routinely Performing Arthroscopic Subacromial Decompression During Rotator Cuff Repair (RCR)?","authors":"Sachin Kumar, R. Gogna, D. Morris, A. Tambe","doi":"10.13107/aja.2021.v06i01.025","DOIUrl":"https://doi.org/10.13107/aja.2021.v06i01.025","url":null,"abstract":"Symptomatic rotator cuff tears cause pain and impaired function. Arthroscopic rotator cuff repair is an established treatment when nonoperative management fails. However, debate exists regarding the requirement of concurrent subacromial decompression. This review aims to answer pertinent questions and outline relevant literature in the role of arthroscopic subacromial decompression in rotator cuff repair.\u0000Keywords: Decompression, Cuff, Arthroscopic, Repair.","PeriodicalId":331352,"journal":{"name":"Asian Journal of Arthroscopy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122483233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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