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A new tear pattern of the rotator cuff and its treatment: Fosbury flop tears.

Lädermann A, Denard PJ, Kolo FC - Int J Shoulder Surg (2015 Jan-Mar)

Bottom Line: A prospective radiologic and clinical study collected all patients with a magnetic resonance imaging arthrogram that underwent an arthroscopic rotator cuff repair over a 1 year period.Characteristic radiographic findings included a thicker tendon than normal, the presence of a stump and accumulation of liquid in the superior-medial part of the subacromial bursa, and adhesions between the supraspinatus tendon and the wall of the subacromial bursa.Level IV.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Meyrin, Switzerland ; Faculty of Medicine, University of Geneva, Switzerland.

ABSTRACT

Purpose: The purpose of this report is to describe a new full-thickness tear pattern of the posterosuperior rotator cuff with reversal healing. We describe the specific radiologic signs associated with this tear pattern and the arthroscopic rotator cuff repair technique.

Materials and methods: A prospective radiologic and clinical study collected all patients with a magnetic resonance imaging arthrogram that underwent an arthroscopic rotator cuff repair over a 1 year period.

Results: Among 97 patients, five demonstrated a tear of the posterosuperior rotator cuff with reversal healing. Characteristic radiographic findings included a thicker tendon than normal, the presence of a stump and accumulation of liquid in the superior-medial part of the subacromial bursa, and adhesions between the supraspinatus tendon and the wall of the subacromial bursa.

Conclusion: Avulsion of the posterosuperior rotator cuff with reversal healing on its bursal-side is a less common condition. This type of lesion and distinct radiographic signs that can be recognized to facilitate anatomic repair of the rotator cuff.

Level of evidence: Level IV.

No MeSH data available.


Related in: MedlinePlus

Arthroscopic view of a right shoulder viewed from lateral portal demonstrates a complete single row repair of the posterosuperior rotator cuff following mobilization of a Fosbury flop tear
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Figure 2: Arthroscopic view of a right shoulder viewed from lateral portal demonstrates a complete single row repair of the posterosuperior rotator cuff following mobilization of a Fosbury flop tear

Mentions: The operations were performed by a single surgeon who used a consistent operative technique. The patient was placed in a beach chair position with the arm in horizontal traction. A diagnostic arthroscopy was performed with an arthroscopic pump maintaining pressure at 50 mm Hg. The biceps was tenotomized or tenodesed according to previously described factors.[10] The subscapularis tendon was inspected, and the lesion classified according to Lafosse et al.,[11] and if torn, repaired to the lesser tuberosity bone bed with a single-row suture technique following a three-sided release. Attention was then turned to the posterosuperior rotator cuff (supraspinatus and infraspinatus tendons). Rotator cuff tear size was assessed after subacromial bursectomy but before rotator cuff debridement; tears were classified as small, medium, large, or massive based on the anterior-to-posterior dimension.[12] The appearances of the tears were unusual with thick tendons and images looking like ulcerations on the bursal-side [Figure 1]. After a progressive dissection, medial adhesions of the bursal layer were found. Excavation of the rotator cuff permitted return of the bursal layer from 180° (video illustration). Mobilization of the rotator cuff margins allowed repair [Figure 2]. To the lateral bone bed. The decision to use single-row or fixation depended on the tissue quality and tension on the repair.[13] All subjects took part in a standardized rehabilitation protocol.[14]


A new tear pattern of the rotator cuff and its treatment: Fosbury flop tears.

Lädermann A, Denard PJ, Kolo FC - Int J Shoulder Surg (2015 Jan-Mar)

Arthroscopic view of a right shoulder viewed from lateral portal demonstrates a complete single row repair of the posterosuperior rotator cuff following mobilization of a Fosbury flop tear
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325389&req=5

Figure 2: Arthroscopic view of a right shoulder viewed from lateral portal demonstrates a complete single row repair of the posterosuperior rotator cuff following mobilization of a Fosbury flop tear
Mentions: The operations were performed by a single surgeon who used a consistent operative technique. The patient was placed in a beach chair position with the arm in horizontal traction. A diagnostic arthroscopy was performed with an arthroscopic pump maintaining pressure at 50 mm Hg. The biceps was tenotomized or tenodesed according to previously described factors.[10] The subscapularis tendon was inspected, and the lesion classified according to Lafosse et al.,[11] and if torn, repaired to the lesser tuberosity bone bed with a single-row suture technique following a three-sided release. Attention was then turned to the posterosuperior rotator cuff (supraspinatus and infraspinatus tendons). Rotator cuff tear size was assessed after subacromial bursectomy but before rotator cuff debridement; tears were classified as small, medium, large, or massive based on the anterior-to-posterior dimension.[12] The appearances of the tears were unusual with thick tendons and images looking like ulcerations on the bursal-side [Figure 1]. After a progressive dissection, medial adhesions of the bursal layer were found. Excavation of the rotator cuff permitted return of the bursal layer from 180° (video illustration). Mobilization of the rotator cuff margins allowed repair [Figure 2]. To the lateral bone bed. The decision to use single-row or fixation depended on the tissue quality and tension on the repair.[13] All subjects took part in a standardized rehabilitation protocol.[14]

Bottom Line: A prospective radiologic and clinical study collected all patients with a magnetic resonance imaging arthrogram that underwent an arthroscopic rotator cuff repair over a 1 year period.Characteristic radiographic findings included a thicker tendon than normal, the presence of a stump and accumulation of liquid in the superior-medial part of the subacromial bursa, and adhesions between the supraspinatus tendon and the wall of the subacromial bursa.Level IV.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Meyrin, Switzerland ; Faculty of Medicine, University of Geneva, Switzerland.

ABSTRACT

Purpose: The purpose of this report is to describe a new full-thickness tear pattern of the posterosuperior rotator cuff with reversal healing. We describe the specific radiologic signs associated with this tear pattern and the arthroscopic rotator cuff repair technique.

Materials and methods: A prospective radiologic and clinical study collected all patients with a magnetic resonance imaging arthrogram that underwent an arthroscopic rotator cuff repair over a 1 year period.

Results: Among 97 patients, five demonstrated a tear of the posterosuperior rotator cuff with reversal healing. Characteristic radiographic findings included a thicker tendon than normal, the presence of a stump and accumulation of liquid in the superior-medial part of the subacromial bursa, and adhesions between the supraspinatus tendon and the wall of the subacromial bursa.

Conclusion: Avulsion of the posterosuperior rotator cuff with reversal healing on its bursal-side is a less common condition. This type of lesion and distinct radiographic signs that can be recognized to facilitate anatomic repair of the rotator cuff.

Level of evidence: Level IV.

No MeSH data available.


Related in: MedlinePlus