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Rotator Cuff

The rotator cuff is a group of four muscles and their tendons that stabilize the shoulder joint and enable a wide range of arm movements.
Injuries to the rotator cuff, such as tears or tendinitis, can cause pain, weakness, and reduced mobility in the shoulder.
Understanding the anatomy and function of the rotator cuff is crucial for effective diagnosis and treatment of shoulder disorders.
Ongoing research aims to optimize surgical and non-surgical interventions to promote rotator cuff healing and prevent further injury.
Advancing this area of study is critical for improving patient outcomes and enhancing the quality of life for individuals affected by rotator cuff pathologies.

Most cited protocols related to «Rotator Cuff»

Prospective Cohort Study of New-onset PMR

The study was a prospective cohort study that included a cohort of patients with new-onset PMR and a comparison cohort of non-PMR patients with various conditions mimicking PMR. Study subjects were recruited from 21 community-based and academic rheumatology clinics in 10 European countries and the USA. Inclusion criteria for PMR patients were age 50 years or older, new-onset bilateral shoulder pain and no corticosteroid treatment (for any condition) within 12 weeks before study entry, fulfilling all the inclusion and exclusion criteria defined by our previous report and in accordance with the judgement of the participating investigator that the patient had PMR.18 (link) Every effort was made to choose patients across the spectrum of disease severity. Corticosteroid treatment for PMR patients was initiated according to a predefined treatment protocol starting with 15 mg a day oral prednisone for weeks 1 and 2, 12.5 mg a day for weeks 3 and 4, 10 mg a day for weeks 6–11, 10 mg/7.5 mg every other day for weeks 12–15, 7.5 mg a day for weeks 16–25 and tapering according to treatment response from week 26 onwards. The gold standard for the pre-steroid diagnosis of PMR was established as above at presentation and when the diagnosis was maintained without an alternative diagnosis at week 26 of follow-up.
The non-PMR comparison cohort included conditions representative of the types that need to be distinguished from PMR, in both primary and secondary care. Inclusion criteria for the non-PMR comparison cohort were age 50 years or older, new-onset bilateral shoulder pain and a diagnosis of either inflammatory or non-inflammatory conditions, including new-onset RA, connective tissue diseases, various shoulder conditions (eg, bilateral rotator cuff syndrome and/or adhesive capsulitis, rotator cuff tear, glenohumeral osteoarthritis), fibromyalgia, generalised osteoarthritis and others. Patients known to have the condition for more than 12 weeks before the baseline evaluation (except fibromyalgia and chronic pain) were not eligible for inclusion. PMR patients with clinical suspicion of giant cell arteritis were included as part of the comparison cohort because these patients required different corticosteroid doses. Patients in the comparison cohort were included on the basis of clinician diagnosis and not on formal criteria. No guidelines were provided for treatment of the conditions in the comparison cohort.
Ethics board approval was obtained at all participating institutions before initiation of the study, and all participants gave written informed consent before enrollment.

Dasgupta B., Cimmino M.A., Maradit-Kremers H., Schmidt W.A., Schirmer M., Salvarani C., Bachta A., Dejaco C., Duftner C., Jensen H.S., Duhaut P., Poór G., Kaposi N.P., Mandl P., Balint P.V., Schmidt Z., Iagnocco A., Nannini C., Cantini F., Macchioni P., Pipitone N., Amo M.D., Espígol-Frigolé G., Cid M.C., Martínez-Taboada V.M., Nordborg E., Direskeneli H., Aydin S.Z., Ahmed K., Hazleman B., Silverman B., Pease C., Wakefield R.J., Luqmani R., Abril A., Michet C.J., Marcus R., Gonter N.J., Maz M., Carter R.E., Crowson C.S, & Matteson E.L. (2012). 2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Annals of the Rheumatic Diseases, 71(4), 484-492.

Publication 2012

Adhesive Capsulitis Adrenal Cortex Hormones Chronic Pain Connective Tissue Diseases Degenerative Arthritides Diagnosis Europeans Fibromyalgia Giant Cell Arteritis Gold Inflammation Patients Prednisone Rotator Cuff Secondary Care Shoulder Shoulder Pain Steroids Syndrome Treatment Protocols

Shoulder Questionnaire Comparison: WORC, OSS, SPADI

The Western Ontario Rotator Cuff (WORC) index is a self-report questionnaire developed to measure health related quality of life in patients with rotator cuff disease [3 (link)]. WORC consists of 21 items in 5 domains: physical symptoms (6 items), sports and recreation (4 items), work (4 items), lifestyle (4 items) and emotions (3 items). Each question is scored on a 100 mm VAS scale and summed to a total score of maximally 2100, with a higher score indicating a reduced quality of life. A percentage score ranging from 0 (worst possible) to 100 (best possible) is used as advocated by its developers.
Oxford Shoulder Score (OSS) is a self-report questionnaire developed for patients having shoulder disease other than instability, and consists of 12 questions about pain and disability [19 (link)]. Respondents report their pain or difficulty in completing a task by circling a number from 1 to 5 with verbal anchors following each number. All items are summed up to a total score ranging from 12 to 60. To allow scores to be easily compared, the OSS total sum score was converted to range from 0 to 100. In the original publication of OSS, all respondents were asked to consider their shoulder for the last 4 weeks when completing the questionnaire. In order to compare the questionnaires, this was revised in the present study to yield the most recent week, to parallel the other questionnaires in the study.
Shoulder Pain and Disability Index (SPADI) is a self-report questionnaire for patients with shoulder pain and consists of 13 questions divided in two domains: pain (5 items) and disability (8 items) [20 (link)]. The questions are scored on VAS scales from 0 (best) to 11(worst) and summed up to a domain score. Each domain score is equally weighted, then added, for a total percentage score ranging from 0 to 100. A higher score indicates a worse shoulder pain and function.

Ekeberg O.M., Bautz-Holter E., Tveitå E.K., Keller A., Juel N.G, & Brox J.I. (2008). Agreement, reliability and validity in 3 shoulder questionnaires in patients with rotator cuff disease. BMC Musculoskeletal Disorders, 9, 68.

Publication 2008

argipressin, Asu(1,6)- Disabled Persons Emotions Pain Patients Physical Examination Rotator Cuff Shoulder Shoulder Pain

Evaluating Upper Extremity Disorders in Japan

A series of 73 patients with upper extremity disorders was seen on an outpatient basis in five orthopedic surgery departments in Japan.9 (link) Exclusion criteria were age below 18 years, and relevant comorbidity (e.g., connective tissue disease). One patient with comorbidity of systemic lupus erythematosus (SLE) was excluded. The study was conducted on a total of 72 patients (17 men, 55 women) with carpal tunnel syndrome (38 patients), rotator cuff disease (10 patients), cubital tunnel syndrome (7 patients), thoracic outlet syndrome (4 patients), or others (13 patients). The mean age was 54.1 years (SD 14.9 years, range 20–81 years). After informed consent was obtained from the patients to participate in this study, they answered the DASH-JSSH questionnaire, the official Japanese version of the 36-Item Short-Form Health Survey (SF-36; version 1.2),21 (link),22 (link) and the Visual Analog Scale (VAS) [0–10 scale] for pain. The data collected from the 72 patients were used as a baseline value. Among the 72 patients, the 38 who had no treatment such as medication and rehabilitation during the consecutive visits were readministered the DASH-JSSH questionnaire and VAS for pain 1 or 2 weeks later. The 17 patients with carpal tunnel syndrome who received carpal tunnel release by three hand surgeons answered the DASH-JSSH questionnaire and VAS for pain twice preoperatively and postoperatively (3 months after surgery). The protocol of this study was reviewed and approved by the institutional review board prior to implementation.

Imaeda T., Toh S., Wada T., Uchiyama S., Okinaga S., Kusunose K, & Sawaizumi T. (2006). Validation of the Japanese Society for Surgery of the Hand Version of the Quick Disability of the Arm, Shoulder, and Hand (QuickDASH-JSSH) questionnaire. Journal of Orthopaedic Science, 11(3), 248-253.

Publication 2006

Carpal Tunnel Syndrome Connective Tissue Diseases Cubital Tunnel Syndrome Ethics Committees, Research Japanese Lupus Erythematosus, Systemic Operative Surgical Procedures Orthopedic Surgical Procedures Outpatients Pain Patients Pharmaceutical Preparations Rehabilitation Rotator Cuff Surgeons Thoracic Outlet Syndrome Upper Extremity Vision Visual Analog Pain Scale Woman Wrist Joint

Assessing Upper Extremity Disorders

A series of 73 patients with upper extremity disorders were seen on an outpatient basis in five orthopedic surgery departments in Japan. Exclusion criteria were age below 18 years and relevant co-morbidity (e.g., connective tissue disease). One patient with a co-morbidity of systemic lupus erythematosus (SLE) was excluded. The study was thus conducted on 72 patients (17 men, 55 women) who were suffering from carpal tunnel syndrome (38 patients), rotator cuff disease (10 patients), cubital tunnel syndrome (7 patients), thoracic outlet syndrome (4 patients), or other problems (13 patients). The mean age was 54.1 years (SD 14.9 years, range 20–81 years). After informed consent was obtained from the patients to participate in this study, they answered the questionnaire. The DASH-JSSH questionnaire, the official Japanese version of the 36-item short-form health survey (SF-36, version 1.2)21 (link),22 (link) and the Visual Analog Scale (VAS) (0–10 scale) for pain. The data collected from the 72 patients were used as a baseline value. Among the 72 patients, the 38 who had no therapy during the consecutive outpatient visits were readministered the DASH-JSSH questionnaire and VAS for pain 1 or 2 weeks later. The 17 patients with carpal tunnel syndrome who underwent carpal tunnel release by three hand surgeons answered the DASH-JSSH questionnaire and the VAS for pain twice preoperatively and postoperatively (3 months after surgery). The protocol of this study was reviewed and approved by the institutional review board prior to this implementation.

Imaeda T., Toh S., Nakao Y., Nishida J., Hirata H., Ijichi M., Kohri C, & Nagano A. (2005). Validation of the Japanese Society for Surgery of the Hand version of the Disability of the Arm, Shoulder, and Hand questionnaire. Journal of Orthopaedic Science, 10(4), 353-359.

Publication 2005

Carpal Tunnel Syndrome Connective Tissue Diseases Cubital Tunnel Syndrome Ethics Committees, Research Japanese Lupus Erythematosus, Systemic Operative Surgical Procedures Orthopedic Surgical Procedures Outpatients Pain Patients Rotator Cuff Surgeons Therapeutics Thoracic Outlet Syndrome Upper Extremity Vision Visual Analog Pain Scale Woman Wrist Joint

Rotator Cuff and Scapula Stabilizer Strengthening Protocol

The programme was based on the latest scientific literature23 (link)
28 (link)
29 (link) and clinical experience and focused on strengthening eccentric exercises for the rotator cuff and strengthening concentric/eccentric exercises for the scapula stabilisers. The programme consisted of six different exercises: two eccentric exercises for the rotator cuff (supraspinatus, infraspinatus, and teres minor), three concentric/eccentric exercises for the scapula stabilisers (middle and lower trapezius, rhomboideus, and serratus anterior), and a posterior shoulder stretch. Each strengthening exercise was repeated 15 times in three sets twice daily for eight weeks. The posterior shoulder stretch was performed for 30-60 seconds and repeated three times twice daily. From week eight to week 12, the exercises were repeated once a day. The exercises were individually adjusted and progressed with increased external load by using weights and elastic rubber band at the physiotherapist visits once every other week during the whole rehabilitation period. When necessary, the physiotherapist performed manual treatment by stretching the posterior glenohumeral capsule and pectoralis minor during the visits. The pain monitoring model30 (link) was used to find the individual resistance for each patient. The patients were not allowed to exceed 5 on this 0-10 scale when they performed the exercises; however, they were recommended to feel some pain during loading. After completion of an exercise session, increased pain had to revert to levels before exercise before the next session; otherwise, the external load was decreased. Great emphasis was placed on teaching good posture (thoracic spine extension and retracted shoulders) and to maintain this position during the exercises. After completion of the specific exercise programme (after 12 weeks), we recommended participants to maintain the daily home exercises for another two months. A more detailed description of the exercise programme can be found in the appendix on bmj.com.

Holmgren T., Björnsson Hallgren H., Öberg B., Adolfsson L, & Johansson K. (2012). Effect of specific exercise strategy on need for surgery in patients with subacromial impingement syndrome: randomised controlled study. The BMJ, 344, e787.

Publication 2012

Capsule Feelings Infraspinatus Neoplasm Metastasis Pain Patients Pectoralis Minor Muscle Physical Therapist Rehabilitation Rotator Cuff Rubber Scapula Shoulder Supraspinatus Teres Minor Trapezius Muscle Vertebral Column

Most recents protocols related to «Rotator Cuff»

Structural Outcomes of Rotator Cuff Repair and Healing Tendon Formation

Protocol full text hidden due to copyright restrictions

Open the protocol to access the free full text link

Publication 2023

Ethics Committees, Research Operative Surgical Procedures Patients Rotator Cuff Supraspinatus Surgeons Tears

Biomechanical Specimen Preparation for Shoulder Research

After having been thawed overnight at room temperature, specimens were dissected free of skin, subcutaneous tissue, and muscles. Rotator cuff muscles, capsule, and the coracoacromial ligament were carefully preserved. Under fluoroscopy control (Mini C-Arm, GE Medical Systems Inc.) a 2.0 mm K-wire was drilled parallel to the glenoid surface from posterior to anterior at the middle of the superior–inferior diameter. A second 2.0 mm k-wire was drilled from inferior to superior parallel to the glenoid. The scapulae were trimmed using an oscillating saw and potted in a custom rectangular box with the glenoid surface being aligned parallel to the floor. After being shortened, the humerus was centered and potted in a poly-vinyl chloride pipe (PVC; diameter, 3.8 cm; length, 7 cm) using bone cement, leaving only 2 cm of the proximal humeral shaft exposed, in order to minimize diaphyseal bending moments [17 , 18 (link)].

Muench L.N., Murphey M., Oei B., Kia C., Obopilwe E., Cote M.P., Mazzocca A.D, & Berthold D.P. (2023). Elliptical and spherical heads show similar obligate glenohumeral translation during axial rotation in total shoulder arthroplasty. BMC Musculoskeletal Disorders, 24, 171.

Publication 2023

Bone Cements Capsule Diaphyses Fluoroscopy Humerus Kirschner Wires Ligaments, Coracoacromial Marijuana Abuse Muscle Tissue Poly A Rotator Cuff Scapula Skin Subcutaneous Tissue Vinyl Chloride

Biomechanical Shoulder Testing Rig Protocol

The specimens were mounted to a validated shoulder testing rig as previously described, which allowed for positioning of the glenohumeral joint in 6 degrees of freedom (Fig. 1A) [18 (link)–22 (link)]. With the glenoid surface being in a horizontal position parallel to the floor, the scapula was fixed to a vertical linear bearing translator and lever arm system on top of an X-Y table, allowing for glenohumeral translation in the anteroposterior and superoinferior direction. The rotation of the humerus was defined as neutral with the bicipital groove being aligned with the anterior margin of the acromion according to Selecky et al. [17 , 23 (link)]. The rotator cuff muscles were loaded based on physiological cross-sectional area ratios with multiple lines of pull as previously described [24 (link), 25 (link)]. Specifically, two lines of pull were used for the supraspinatus, three for the subscapularis, two for the infraspinatus, and one for the teres minor (Fig. 1B) [18 (link), 25 (link)]. Each line of pull was loaded with 5 N, resulting in a total load of 40 N [18 (link), 25 (link)].
Fig. 1

(A) Displaying a right shoulder specimen mounted to the shoulder testing rig. The scapula is fixed to a vertical linear bearing translator and lever arm system on top of an X-Y table, allowing for glenohumeral translation in the anteroposterior and superoinferior direction. During testing, an axial compression load of 40 N is constantly applied via the lever arm of the X-Y table to center the joint. As the humerus is fixed in the testing rig, the oppositely directed force of 30 N is consequently applied to the X-Y table (glenoid) in the posterior direction during external rotation (green arrow) and in the anterior direction (red arrow) during internal rotation. The force is applied via a friction-less cable, which is attached to a servohydraulic testing system or 30 N hanging weight, depending on the direction of force. (B) The rotator cuff muscles are loaded based on physiological cross-sectional area ratios with multiple lines of pull. Specifically, two lines of pull are used for the supraspinatus (orange), three for the subscapularis (blue), two for the infraspinatus (red), and one for the teres minor (yellow). Each line of pull is loaded with 5 N, resulting in a total load of 40 N

Publication 2023

Acromion Friction Humerus Infraspinatus Joints Muscle Tissue physiology Rotator Cuff Scapula Shoulder Shoulder Joint Subscapularis Supraspinatus Teres Minor

Revision Arthroscopic Labral Repair Outcomes

The study protocol was approved by our institutional review board, and informed consent was obtained from all participants. Of the 44 patients who underwent revision arthroscopic labral repair for failed primary arthroscopic Bankart repair between April 2013 and January 2020 at our institution, we enrolled patients who underwent surgery in which only all-suture anchors were used. Included in the study were patients (1) who had undergone arthroscopic Bankart repair with suture anchors as the primary operation; (2) with anterior glenoid bone loss of <15% at the time of revision surgery^{30 (link)}; (3) with residual instability and frank redislocation history, observed even after a sufficient rehabilitation period after primary arthroscopic Bankart repair; (4) who underwent revision surgery with a simple-suture technique with a single type of all-suture anchor; and (5) who had at least 2 years of clinical follow-up data. Patients were excluded for the following reasons: (1) only superior labral anterior-posterior (SLAP) or posterior labral lesions had been repaired (ie, no Bankart repair) in the primary operation; (2) concomitant procedures, including biceps tenodesis, panlabral repair, or rotator cuff repair, were performed during the primary Bankart repair; (3) patients had large bony Bankart lesions requiring bone healing by proper fixation of the fragment; (4) remplissage had been performed to engage Hill-Sachs lesions during the revision surgery; (5) patients had a history of unresolved brachial plexus injuries or uncontrolled seizures; or (6) shoulder instability was predominantly multidirectional with generalized ligament hyperlaxity.^{15 (link)}

Lee J.H, & Shin S.J. (2023). Revision Arthroscopic Labral Repair Using All-Suture Anchors in Patients With Subcritical Glenoid Bone Loss After Failed Bankart Repair: Clinical Outcomes at 2-Year Follow-up. Orthopaedic Journal of Sports Medicine, 11(3), 23259671231151418.

Publication 2023

Arthroscopes Bankart Fractures Bones Ethics Committees, Research Hill-Sachs Lesion Injuries Ligaments Osteopenia Patients Plexus, Brachial Rehabilitation Repeat Surgery Rotator Cuff Seizures Shoulder Suture Anchors Suture Techniques Tenodesis

Rehabilitation of Rotator Cuff Injuries

The data included in this study were obtained from literature in the Science Citation Index Expanded (SCIE) of the Web of Science (WOS) Core Collection (WOSCC) database from inception to 31 December 2021. An entire online search was accomplished on 14 July 2022. The keywords searched were established according to the medical subject heading (Mesh) terms in PubMed. The search strategy was as follows: TS = (Rehabilitation OR Physiotherapy OR “Physical therapy^*” OR Physiotherapy (Techniques) OR Physiotherapies (Techniques) OR “Techniques, Physical Therapy” OR “Group Physiotherapy” OR Therapy, Physical) AND TS = (“Cuff Injury” OR “Rotator cuff” OR “Tear, Rotator Cuff” OR “Tears, Rotator Cuff”) AND TS = (Shoulder). Only peer-reviewed articles and reviews related to the rehabilitation of RCI that were written in English were included in this study. The flowchart of literature selection is shown in Figure 1.

Hu Y., Wu L., He L., Luo X., Hu L., Wang Y, & Zhao X. (2023). Bibliometric and visualized analysis of scientific publications on rehabilitation of rotator cuff injury based on web of science. Frontiers in Public Health, 11, 1064576.

Publication 2023

Group Physiotherapy Injuries Laceration Physical Examination Rehabilitation Rotator Cuff Shoulder Tears Therapeutics Therapy, Physical

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More about "Rotator Cuff"

The rotator cuff is a critical anatomical structure in the shoulder joint, consisting of a group of four muscles and their tendons that work together to stabilize the shoulder and enable a wide range of arm movements.
Injuries to the rotator cuff, such as tears or tendinitis, can lead to significant pain, weakness, and reduced mobility in the shoulder, making it a common and debilitating condition.
Understanding the complex anatomy and function of the rotator cuff is essential for effective diagnosis and treatment of shoulder disorders.
Ongoing research in this field aims to optimize both surgical and non-surgical interventions to promote rotator cuff healing and prevent further injury.
This includes the development of advanced imaging techniques, like MRI using a Signa HDx system, and the use of specialized tools and protocols, such as those involving Collagenase II and α-MEM media, to study and manipulate rotator cuff tissues.
Improving patient outcomes and enhancing the quality of life for individuals affected by rotator cuff pathologies is a critical goal of this research.
By leveraging the latest technologies and techniques, scientists and clinicians can better understand the underlying mechanisms of rotator cuff injuries and develop more effective treatment strategies.
This may involve the use of antibiotics, antimycotic mixtures, and other specialized reagents and instruments, like the Leica-LM microtome, to support tissue culture and analysis.
Ultimately, the continued advancement of rotator cuff research, facilitated by the optimization of experimental protocols and the integration of cutting-edge AI-driven tools like PubCompare.ai, is crucial for improving the lives of those affected by this debilitating condition.
By staying up-to-date with the latest developments in the field and incorporating the most effective products and procedures, researchers and healthcare providers can work together to deliver better outcomes for patients struggling with rotator cuff injuries and disorders.