Reliability of forced internal rotation and active internal rotation to assess lateral instability of the biceps pulley

PURPOSE: the aim of this study was to investigate the relationship between positive painful forced internal rotation (FIR) and lateral pulley instability in the presence of a pre-diagnosed posterosuperior cuff tear. The same investigation was conducted for painful active internal rotation (AIR). METHODS: a multicenter prospective study was conducted in a series of patients scheduled to undergo arthroscopic posterosuperior cuff repair. Pain was assessed using a visual analog scale (VAS) and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) was administered. The VAS score at rest, DASH score, and presence/absence of pain on FIR and AIR were recorded and their relationships with lesions of the lateral pulley, cuff tear patterns and shape of lesions were analyzed. RESULTS: the study population consisted of 115 patients (mean age: 55.1 years) recruited from 12 centers. The dominant arm was affected in 72 cases (62.6%). The average anteroposterior extension of the lesion was 1.61 cm. The mean preoperative VAS and DASH scores were 6.1 and 41.8, respectively. FIR and AIR were positive in 94 (81.7%) and 85 (73.9%) cases, respectively. The lateral pulley was compromised in 50 cases (43.4%). Cuff tears were partial articular in 35 patients (30.4%), complete in 61 (53%), and partial bursal in 19 (16.5%). No statistical correlation between positive FIR or AIR and lateral pulley lesions was detected. Positive FIR and AIR were statistically associated with complete lesions. Negative FIR was associated with the presence of partial articular tears. CONCLUSIONS: painful FIR in the presence of a postero-superior cuff tear does not indicate lateral pulley instability. When a cuff tear is suspected, positive FIR and AIR are suggestive of full-thickness tear patterns while a negative FIR suggests a partial articular lesion. LEVEL OF EVIDENCE: level I, validating cohort study with good reference standards

Development and Validation of a Scalable Fast Load Shedding Technique for Industrial Power Systems

The work aims to improve the existing fast load shedding algorithm for industrial power system to increase performance, reliability, and scalability for future expansions. The paper illustrates the development of a scalable algorithm to compute the shedding matrix, and the test performed on a model of the electric grid of an offshore platform. From this model it is possible to study the impact on the transients of various parameters, such as spinning reserve and delay time. Subsequently, the code is converted into Structured Text and implemented on an ABB PLC. The scalability of the load shedding algorithm is thus verified, confirming its performance with respect to the computation of the shedding matrix and the usefulness of the dynamic simulations during the design phase of the plant

Recurrent superior labral anterior to posterior tears after surgery: detection and grading with CT arthrography

This paper emphasizes the clinical usefulness of multidetector CT arthrography for evaluating recurrent SLAP tear

Reproducible noninvasive method for evaluation of glenoid bone loss by multiplanar reconstruction curved computed tomographic imaging using a cadaveric model

A new method to study the glenoid bone loss is proposed on the basis of a cadaveric CT stud