Calcific tendinitis of the rotator cuff: state of the art in diagnosis and treatment

Calcific tendinitis is a painful shoulder disorder characterised by either single or multiple deposits in the rotator cuff tendon. Although the disease subsides spontaneously in most cases, a subpopulation of patients continue to complain of pain and shoulder dysfunction and the deposits do not show any signs of resolution. Although several treatment options have been proposed, clinical results are controversial and often the indication for a given therapy remains a matter of clinician choice. Herein, we report on the current state of the art in the pathogenesis, diagnosis and treatment of calcific tendinitis of the rotator cuff

Reverse shoulder arthroplasty in patients aged sixty years old or younger: are we really doing the best?

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Infraspinatus strength assessment and ultrasound evaluation of posterior capsulotenodesis after arthroscopic Hill-Sachs remplissage in traumatic anterior glenohumeral instability: a retrospective controlled study protocol

Giovanni Merolla Co-investigator: Giuseppe Porcellini Investigation performed at the Biomechanics Laboratory "Marco Simoncelli", D. Cervesi Hospital, Cattolica - Italy PLAN OF CLINICAL INVESTIGATION (PCI): Version 1.0 of June 12, 2012 Approved by AV/IRST Ethical Committee (Comitato Etico Area Vasta Romagna) and authorized by AUSL RN ("Determina AUSL Rimini numero 326 del 29/03/2013: Remplissage U.O Chirurgia della Spalla - Valutazione clinica ed ultrasonografica dell'infraspinato dopo capsulo-tenodesi artroscopica (remplissage) nell'instabilit\ue0 anteriore traumatica di spalla con lesione di Bankart e difetto omerale di Hill-Sachs")

Complications of calcific tendinitis of the shoulder: a concise review

Abstract: Calcific tendinitis (CT) of the rotator cuff (RC) muscles in the shoulder is a disorder which remains asymptomatic in a majority of patients. Once manifested, it can present in different ways which can have negative effects both socially and professionally for the patient. The treatment modalities can be either conservative or surgical. There is poor literature evidence on the complications of this condition with little consensus on the treatment of choice. In this review, the literature was extensively searched in order to study and compile together the complications of CT of the shoulder and present it in a clear form to ease the understanding for all the professionals involved in the management of this disorder. Essentially there are five major complications of CT: pain, adhesive capsulitis, RC tears, greater tuberosity osteolysis and ossifying tendinitis. All the above complications have been explained right from their origin to the control measures required for the relief of the patient. Level of evidence: 5

Surgical treatment of chronic acromioclavicular dislocation with biologic graft vs synthetic ligament: A prospective randomized comparative study

Background: Acromioclavicular (AC) dislocation involves complete loss of articular contact; it is defined as chronic when it follows conservative management or unsuccessful surgical treatment. Materials and methods: The study compared the clinical and radiographic outcomes of AC joint stabilization performed in 40 patients with chronic dislocation using a biological allograft (group A) or a synthetic ligament (group B). Demographic data included: M/F: 25/15; mean age: 35 ± 3.2 years; previous surgery in 11 patients, including Weaver-Dunn (3), coracoacromial ligament repair (4), stabilization with K-wires (4). Dislocation was type III in 14 (35 %) and type IV in 26 (65 %) patients. Clinical assessment was with the Constant-Murley score (pre- and postoperative) and with the modified UCLA score. Enrollment started in January 2004 and was completed in March 2008. Patients were evaluated at 1 and 4 years. Postoperative X-rays were examined to assess joint stability in the coronal and axial planes, coracoclavicular ossification, and signs of AC joint osteoarthritis and distal clavicular osteolysis. Results: The "biological" group achieved significantly better clinical scores than the "synthetic" group at both 1 and 4 years. Poor subjective satisfaction and lower clinical scores were found in the 3 patients (1 from group A and 2 from group B) who experienced complete postoperative dislocation. No significant correlations were found with other radiographic parameters. Conclusions: The biological graft afforded better clinical and radiographic outcomes than the synthetic ligament in patients with chronic AC joint instability. Fixation to the clavicle constitutes the main weakness of both approaches and needs improving. © 2012 The Author(s)

Ossifying tendinitis of the rotator cuff after arthroscopic excision of calcium deposits: report of two cases and literature review

Ossifying tendinitis (OT) is a type of heterotopic ossification, characterized by deposition of hydroxyapatite crystals in a histologic pattern of mature lamellar bone. It is usually associated with surgical intervention or trauma and is more commonly seen in Achilles or distal biceps tendons, and also in the gluteus maximus tendon. To our knowledge, there is no description of OT as a complication of calcifying tendinitis of the rotator cuff. In this report, we describe two cases in which the patients developed an OT of the supraspinatus after arthroscopic removal of calcium deposits. The related literature is reviewed

Shoulder arthroplasty in osteoarthritis: current concepts in biomechanics and surgical technique

Shoulder arthroplasty is a technically demanding procedure to restore shoulder function in patients with severe osteoarthritis of the glenohumeral joint. The modern prosthetic system exploit the benefits of modularity and the availibility of additional sizes of the prosthetic components. In this paper we describe the biomechanics of shoulder arthroplasty and the technique for shoulder replacement including total shoulder arthroplasty (TSA) with all-polyethylene and metal-backed glenoid component, humeral head resurfacing and stemless humeral replacement

Clinical and radiographic mid-term outcomes after total shoulder replacement: a retrospective study protocol including 400 anatomical and reverse prosthetic implants

Objectives: To obtain outcomes data on anatomical and reverse total shoulder arthroplasty by analysis of clinical scores and standard radiographs. Subject selection and enrollment: 400 consecutive series of patients replaced with anatomical and reverse total shoulder arthroplasty (minimum 3 years follow-up). Study Design: retrospective monocenter. Preoperative assessment: Demographics, clinical scores (Constant-Murley) as available, shoulder X-ray (AP, outlet and axillary views) . Last follow-up: Postoperative radiographhs and clinical scores. Adverse events and complications to be reported as occurred since implantation. Statistical analysis: Data collected will be summarized and analyzed for statistical significance

Functional assesment of symptomatic snapping scapula after scapulothoracic arthroscopy: a prospective study protocol

Giovanni Merolla Co-investigator: Giuseppe Porcellini Investigation performed at Biomechanics Laboratory "Marco Simoncelli", D. Cervesi Hospital, Cattolica - Italy PLAN OF CLINICAL INVESTIGATION (PCI): Version 1.0 of December 10, 2012 Approved by AV/IRST Ethical Committee (Comitato Etico Area Vasta Romagna) Reg. Sperimentazioni 914 Prot. N\ub0: 1785/2013/I.5/46

Cross-cultural adaptation and validation of the Italian version of the Kerlan\u2013Jobe Orthopaedic Clinic Shoulder and Elbow score

Background: The Kerlan\u2013Jobe Orthopaedic Clinic (KJOC) Shoulder and Elbow score is a reliable and sensitive tool to measure the performance of overhead athletes. The purpose of this study was to carry out a cross-cultural adaptation and validation of the KJOC questionnaire in Italian and to assess its reliability, validity, and responsiveness. Materials and methods: Ninety professional athletes with a painful shoulder were included in this study and were assigned to the \u201cinjury group\u201d (n = 32) or the \u201coveruse group\u201d (n = 58); 65 were managed conservatively and 25 were treated by arthroscopic surgery. To assess the reliability of the KJOC score, patients were asked to fill in the questionnaire at baseline and after 2 weeks. To test the construct validity, KJOC scores were compared to those obtained with the Italian version of the Disabilities of the Arm, Shoulder, and Hand (DASH) scale, and with the DASH sports/performing arts module. To test KJOC score responsiveness, the follow-up KJOC scores of the participants treated conservatively were compared to those of the patients treated by arthroscopic surgery. Results: Statistical analysis demonstrated that the KJOC questionnaire is reliable in terms of the single items and the overall score (ICC 0.95\u20130.99); that it has high construct validity (rs =  120.697; p < 0.01); and that it is responsive to clinical differences in shoulder function (p < 0.0001). Conclusions: The Italian version of the KJOC Shoulder and Elbow score performed in a similar way to the English version and demonstrated good validity, reliability, and responsiveness after conservative and surgical treatment. Level of evidence: II