Evaluation of Rotator Cuff Repair with Concomitant Biceps Tenodesis

Introduction: Surgical rotator cuff repair (RCR) has proven to be an effective treatment for rotator cuff tears. Commonly, rotator cuff tears are associated with concomitant biceps pathology, which are often treated by biceps tenodesis (BT). We hypothesize that patient outcomes will be similar in those that have undergone RCR with concomitant BT and isolated RCR. Methods: This is a retrospective cohort study comparing patients who underwent arthroscopic RCR with arthroscopic or open BT to patients who underwent isolated RCR at a multisurgeon orthopaedic practice during the time period of November 2016 to December 2016. The outcome for comparison is the American Shoulder and Elbow Surgeons score (ASES). Patients with postoperative scores of at least 6 months after surgery were included. The data was collected from the Rothman Institute registry and OBERD. It was analyzed via independent t-test. Results: A total of 53 patients (37 = M; 16 = F) were in the isolated RCR group and 34 patients (27 = M; 7 = F) were in the RCR with BT group. The average age in the isolated RCR group was 58.6 years vs. 58.9 years in the RCR with BT group. There was no statistical difference between postoperative ASES scores (83.69 and 79.43, P = .40) and difference in preoperative and postoperative ASES scores (34.26 and 35.30, P = .85) in the isolated RCR and RCR with BT groups, respectively. Conclusion: There was no significant difference in postoperative ASES scores as well as difference in preoperative and postoperative ASES scores in patients undergoing isolated RCR and RCR with BT. This supports the hypothesis that patients undergoing RCR with BT will have similar outcomes to those undergoing isolated RCR

Evaluation of Arthroscopic Repair to Pan-Labral Lesions of the Glenoid: A Retrospective Review of Patient Outcomes Over a Ten-Year Period and Matched Cohort Analysis

Introduction: Most shoulder labral tears are partial and treated with surgery, but rarely they are “panlabral” around the entire shoulder. Due to infrequency panlabral tears aren’t well understood, and thus this study compares outcomes between panlabral and more common SLAP tears. We hypothesize no difference in outcomes based on surgeon experiences. Methods: This is a retrospective cohort study of shoulder labrum repairs at Rothman Institute from 2006-2016. All patients received arthroscopic repair and were categorized to compare panlabral to SLAP tears. The primary outcome is return-to-activity rate at six months post-surgery and secondary outcomes include post-operative range of motion, strength, and identifying the incidence of this rare injury. Chart abstraction into Excel and patient phone calls/emails for return-to-activity rates will be analyzed via Independent T-tests and Chi-squared tests. Results: The panlabral tear incidence was 3.9%. Currently the primary outcome (return-to-activity rate) lacks enough panlabral patients for analysis with 140 patients (60 SLAP, 3 panlabral, 77 other) of 739 total (350 SLAP, 29 panlabral, 360 other) answering phone calls/emails. Secondary outcome analysis indicated no difference in range of motion, strength, or complications between SLAP and panlabral repairs. Discussion: Compared to existing reports of 2.4% incidence, using one of (if not) the largest cohorts we suggest the true incidence of panlabral tears is higher at 3.9%. Though primary outcome analysis is ongoing, secondary outcomes demonstrate that, as hypothesized, panlabral repairs perform as well as SLAP repairs. This may represent the highest level of evidence support yet for current treatment of this rare injury

Does Prior Acromioplasty Increase the Incidence of Acromial Fracture Following Reverse Total Shoulder Arthroplasty? A Retrospective Matched Cohort Analysis

Introduction: Reverse total shoulder arthroplasty (RTSA) is an effective treatment option for multiple shoulder pathologies. Arthroscopic acromioplasty is a treatment for subacromial impingement. RTSA can place excess stress on the acromion. No studies have evaluated outcomes following RTSA among patients with prior acromioplasty. The purpose of this study was to report outcomes in patients following RTSA who have had a prior acromioplasty. The authors hypothesized patients with prior acromioplasty who undergo RTSA will have significant improvements in clinical outcomes with no increased risk of acromial fracture. Methods: Patients from a single institution who underwent RTSA with a history of acromioplasty from 2009 to 2017 with two-year follow up were identified. Clinical outcome scores were obtained using ASES, SST, VAS, and SANE surveys. X-rays and charts will be reviewed to determine if patients sustained anacromion fracture following RTSA. Patients will be matched to a cohort of patients who underwent RTSA without a prior acromioplasty.These groups will be compared to determine any differences in clinical outcome scores or number of postoperative acromial fractures. Results: 45 patients were included.Average outcomes scores were: ASES:70.7%, SST: 62.1%, VAS: 2.4, and a SANE: 60.6%. On average, active external rotation improved from 33.1° to 37.1° and forward elevation improved from 92.2° to 136.1°. Discussion: While data collection in the matched cohort remains ongoing to compare the outcomes of RTSA with prior acromioplasty to the outcomes of RTSA alone, initial data suggests history of acromioplasty does not negatively impact RTSA outcomes

Cerebral Blood Volume Changes During Radiotherapy May Predict Pseudoprogression versus Disease Progression for Patients with High Grade Glioma

https://openworks.mdanderson.org/sumexp21/1040/thumbnail.jp

Overview of AC microgrid controls with inverter-interfaced generations

Distributed generation (DG) is one of the key components of the emerging microgrid concept that enables renewable energy integration in a distribution network. In DG unit operation, inverters play a vital role in interfacing energy sources with the grid utility. An effective interfacing can successfully be accomplished by operating inverters with effective control techniques. This paper reviews and categorises different control methods (voltage and primary) for improving microgrid power quality, stability and power sharing approaches. In addition, the specific characteristics of microgrids are summarised to distinguish from distribution network control. Moreover, various control approaches including inner-loop controls and primary controls are compared according to their relative advantages and disadvantages. Finally, future research trends for microgrid control are discussed pointing out the research opportunities. This review paper will be a good basis for researchers working in microgrids and for industry to implement the ongoing research improvement in real systems