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      Ultrasound-guided biodegradable subacromial spacer implantation in a patient with massive irreparable rotator cuff tears

      case-report

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          Abstract

          The aim of this manuscript is to present a modification of the current arthroscopic implantation technique of a biodegradable subacromial spacer. This modified ultrasound-guided technique was intended to maximally reduce the invasiveness of the procedure. The ultrasound technique was used to measure the subacromial space for an optimal fit and to verify subacromial spacer placement in the sagittal and frontal planes. This finding is of particular importance for patients with contraindications to general or regional anesthesia. The follow-up (5 months) of subacromial spacer implantation using ultrasound in a patient with an irreparable rotator cuff tear showed correct spacer placement.

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          Most cited references17

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          A Clinical Method of Functional Assessment of the Shoulder

          A. H. G. Murley, C. R. Constant (1987)
          Article 0 comments Cited 324 times – based on 0 reviews     Review now
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            Influence of cuff muscle fatty degeneration on anatomic and functional outcomes after simple suture of full-thickness tears.

            Daniel Goutallier, Jean-Marie Postel, Pascal Gleyze … (2003)
            Two hundred twenty shoulders with a rotator cuff tear repaired by simple tendon-to-bone suture were analyzed to determine whether the severity of presurgical fatty degeneration had an influence on their anatomic and functional outcome. Fatty degeneration was evaluated for each muscle with the 5-stage grading system developed by Goutallier et al. A global fatty degeneration index (GFDI), the mean value of the 3 muscles, was calculated for each shoulder. Cuff integrity was evaluated by magnetic resonance imaging (116 cases) or computed arthrotomography scan (104 cases) at a mean 37 months' follow-up, and functional outcomes were evaluated with the Constant score. A recurrent tear was found in 79 cases (36%) and was more frequently encountered in posterosuperior tears. The likelihood of a recurrent tear was greater for tendons whose muscle showed fatty degeneration greater than grade 1. Fatty degeneration of the infraspinatus or subscapularis muscles had an influence on supraspinatus tendon outcome. A GFDI lower than 0.5 was necessary to yield less than 25% retears. The mean global Constant score was 75 at revision, significantly lower when a retear was present (70.5 versus 77.5). In the subgroup of watertight cuffs, it was lower when GFDI was higher. Fatty degeneration is an important prognostic factor in rotator cuff surgery.
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              Massive tears of the rotator cuff.

              Joshua Dines, Asheesh Bedi, David M Dines … (2010)
              Repair of massive rotator cuff tears is technically difficult but often feasible. Technical and biological challenges to a successful repair include inelastic poor-quality tendon tissue, scarring, muscle atrophy, and fatty infiltration. Fatty infiltration of the involved rotator cuff muscles has been identified as an important negative prognostic factor for the outcome after repair of massive rotator cuff tears. Tendon transfer is a good option for young patients and manual laborers with an irreparable massive rotator cuff tear. Arthroplasty can be considered for the treatment of symptomatic massive rotator cuff tears in patients who have glenohumeral arthritis.
              Article 0 comments Cited 82 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Wideochir Inne Tech Maloinwazyjne
                Journal ID (iso-abbrev): Wideochir Inne Tech Maloinwazyjne
                Journal ID (publisher-id): WIITM
                Title: Videosurgery and other Miniinvasive Techniques
                Publisher: Termedia Publishing House
                ISSN (Print): 1895-4588
                ISSN (Electronic): 2299-0054
                Publication date (Electronic): 08 August 2018
                Publication date (Print): January 2019
                Volume: 14
                Issue: 1
                Pages: 145-148
                Affiliations
                [1 ]Department of Orthopedic Surgery, Surgery Clinic, Medicover Hospital, Warsaw, Poland
                [2 ]Department of Oncology and Nursing Oncology, Institute of Nursing and Obstetrics, Faculty of Medicine and Health Science, Jan Kochanowski University, Kielce, Poland
                [3 ]First Chair and Clinic of General and Vascular Surgery, Second Faculty of Medicine with the English Division, Medical University of Warsaw, Warsaw, Poland
                [4 ]National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
                Author notes
                Address for correspondence Tomasz Poboży MD, PhD, Department of Orthopedic Surgery, Surgery Clinic, Medicover Hospital, Al. Rzeczypospolitej 5, 02-972 Warsaw, Poland. phone: +48 600 980 648. e-mail: pobozytomasz@ 123456gmail.com
                Article
                Publisher ID: 33453
                DOI: 10.5114/wiitm.2018.77555
                PMC ID: 6372862
                SO-VID: c6ff8756-c789-409c-88f6-2fa9cf775767
                Copyright © Copyright: © 2018 Fundacja Videochirurgii
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

                History
                Date received : 14 February 2018
                Date accepted : 15 June 2018
                Categories
                Subject: Case Report

                Keywords: ultrasonography,glenohumeral joint,rotator cuff tears,biodegradable subacromial spacer,ultrasound-guided implantation
                Data availability:
                Keywords: ultrasonography, glenohumeral joint, rotator cuff tears, biodegradable subacromial spacer, ultrasound-guided implantation

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