“ Shoulder Arthroplasty in Young ”

Journal of Clinical Orthopaedics | Vol 6 | Issue 1 |  Jan-Jun 2021 | page: 74-80 | Nagraj Shetty

Author: Nagraj Shetty [1]

[1] Consultant Arthroscopy, Shoulder, Knee preservation Surgeon Lilavati hospital Nanavati Superspeciality hospital Hinduja Healthcare Surgical, Mumbai, India.

Address of Correspondence
Dr. Nagraj Shetty,
Orthopaedic Department, Nanavati Superspeciality Hospital, SV Road, Vile Parle west , Mumbai, India.


Background: Prosthetic shoulder replacement provides excellent pain relief and functional improvement for patients with shoulder arthritis. Total shoulder arthroplasty for osteoarthritis and reverse shoulder arthroplasty for cuff tear arthropathy remains the gold standard for the geriatric patient population. Poor long-term survivorship, implant failure (glenoid component loosening, and glenoid arthrosis), and functional deterioration requiring early revision surgery are major concerns of similar management in younger patients. Young patients prove as a major challenge to shoulder surgeons due to expected longer life expectancy, desire to pursue sports, and active lifestyle thereby placing excessive demands on their shoulder arthroplasty components. Alternative strategies for arthroplasty in young have been developed; however, there is presently no clear consensus, recommendations to guide clinicians toward management. This manuscript reviews the current concepts of shoulder arthroplasty in young patients.
Keywords: Shoulder, arthritis, arthroplasty, glenoid, total shoulder arthroplasty


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How to Cite this article: Shetty N. “ Shoulder Arthroplasty in Young ”. Journal of Clinical Orthopaedics Jan-Jun 2021;6(1):74-80.

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Partial Rotator Cuff Tears: a review of the literature

Journal of Clinical Orthopaedics | Vol 5 | Issue 2 |  July-Dec 2020 | page:30-34 | Stefania Kokkineli, Emmanouil Brilakis, Emmanouil Antonogiannakis

Author: Stefania Kokkineli [1], Emmanouil Brilakis [1], Emmanouil Antonogiannakis [1]

[1] Department of Orthopaedic, HYGEIA Hospital. MD. Erythrou Stavrou 4, Marousi 15123

Address of Correspondence
Dr. Stefania Kokkineli,
Department of Orthopaedic, HYGEIA Hospital. Athens, Greece
Address: Erythrou Stavrou 4, Marousi 15123. Greece


Partial- thickness rotator cuff tears are the most common cause of shoulder pain in adults and have been classified into subtypes according to location and depth. The frequency rate and tear size progression increase with age, tobacco use and medical comorbidities. Partial tears are divided into tears of acute, chronic or acute-on-chronic onset. Surgical treatment is indicated in symptomatic patients with persistent pain after failed conservative treatment of at least 3 months, mainly with tears that exceed 50% of the tendon thickness. Arthroscopic repair techniques include in situ and tear completion repair. Authors’ preferred technique for in situ repair is described followed by the postoperative rehabilitation protocol. The surgical techniques described have various advantages and disadvantages with regard to intra- operative complications, clinical outcomes, recovery time and re-tear rates which make it difficult to decide on which technique to use. The option is a matter of surgical indications, philosophy and skills.
Keywords: Partial-thickness rotator cuff tears, transtendon repair, in-situ repair, shoulder, arthroscopy


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2. Liu, C., T., Ge, H. an, Hu, R., Huang, J., B., Cheng, Y. C., Wang, M., et al. Arthroscopic knotless single-row repair preserving full footprint versus tear completion repair for partial articular-sided rotator cuff tear. J Orthop Surg. 2018;26(2):230949901877089. doi:10.1177/2309499018770897.
3. Salem, H., Carter, A., Tjoumakaris, F., Freedman, K., B. Double-Row Repair Technique for Bursal-Sided Partial-Thickness Rotator Cuff Tears. Arthrosc Tech. 2018;7(3):e199–e203. doi:10.1016/j.eats.2017.08.068.
4. Ellman H. Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res. 1990;(254):64–74.
5. Fukuda, H. THE MANAGEMENT OF PARTIAL-THICKNESS TEARS OF THE ROTATOR CUFF. JBJS Br. 2013;85-B(1):3–11. doi:10.1302/0301-620x.85b1.13846.
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8. Ardeljan A, Palmer J, Drawbert H, Ardeljan A, Vakharia RM, Roche MW. Partial thickness rotator cuff tears: Patient demographics and surgical trends within a large insurance database. J Orthop. 2019;17:158‐161. doi:10.1016/j.jor.2019.08.027.
9. Lee CS, Davis SM, Doremus B, Kouk S, Stetson WB. Interobserver Agreement in the Classification of Partial-Thickness Rotator Cuff Tears Using the Snyder Classification System. Orthop J Sports Med. 2016;4(9):2325967116667058. doi:10.1177/2325967116667058.
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11. Jordan, R., W., Bentick, K., Saithna, A. Transtendinous Repair of Partial Articular Sided Supraspinatus Tears is associated with Higher Rates of Stiffness and Significantly Inferior Early Functional Scores than Tear Completion and Repair: A Systematic Review. Orthop Traumatol Surg. 2018;104(6):829-837. doi:10.1016/j.otsr.2018.06.007.
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14. Habermeyer, P., Krieter, C., Tang, K., Lichtenberg, S., Magosch, P. A new arthroscopic classification of articular-sided supraspinatus footprint lesions: A prospective comparison with Snyder’s and Ellman’s classification. JSES. 2008;17(6):909–913. doi:10.1016/j.jse.2008.06.007.
15. Rahu, M., Kartus, J., T., Põldoja, E., Pedak, K., Kolts, I., Kask, K. Do Articular-Sided Partial-Thickness Rotator Cuff Tears After a First-Time Traumatic Anterior Shoulder Dislocation in Young Athletes Influence the Outcome of Surgical Stabilization? Orthop J Sports Med. 2018;6(6):232596711878131. doi:10.1177/2325967118781311.
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17. Yamamoto, N., Mineta, M., Kawakami, J., Sano, H., Itoi, E. Risk Factors for Tear Progression in Symptomatic Rotator Cuff Tears: A Prospective Study of 174 Shoulders. Am J Sports Med. 2017;45(11):2524–2531. doi:10.1177/0363546517709780.
18. Ranebo, M., C., Björnsson Hallgren, H., C., Adolfsson, L., E. Patients with a long-standing cuff tear in one shoulder have high rates of contralateral cuff tears: a study of patients with arthroscopically verified cuff tears 22 years ago. JSES. 2018;27(3):e68–e74. doi:10.1016/j.jse.2017.10.007.
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32. Heuberer, P., R., Smolen, D., Pauzenberger, L., Plachel, F., Salem, S., Laky, B., et al. Longitudinal Long-term Magnetic Resonance Imaging and Clinical Follow-up After Single-Row Arthroscopic Rotator Cuff Repair: Clinical Superiority of Structural Tendon Integrity. The Am J Sports Med.2017;45(6):1283–1288. doi:10.1177/0363546517689873..

How to Cite this article: Kokkineli S, Brilakis E, Antonogiannakis E. Partial Rotator Cuff Tears: a review of the literature. Journal of Clinical Orthopaedics July-Dec 2020;5(2):30-34.

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History and Future Direction of Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears

Vol 3 | Issue 2 |  July-Dec 2018 | Page 12-15 | Teruhisa Mihata.

Authors: Teruhisa Mihata [1,2,3].

[1] Department of Orthopedic Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
[2] Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, California, USA
[3] Katsuragi Hospital, Kishiwada, Osaka, Japan

Address of Correspondence
Dr. TeruhisaMihata,
Department of Orthopedic Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan


Lesions of the superior shoulder capsule had been a neglected entity before I reported my technique for superior capsule reconstruction (SCR).I had noticed that patients with irreparable rotator cuff tears always had irreparable defects of the superior shoulder capsule as well as the rotator cuff tendons, because the superior shoulder capsule is attached to the undersurface of these tendons. Therefore, I hypothesized that reconstruction of the superior shoulder capsule might be useful to prevent superior migration of the humeral head and subacromial impingement in irreparable rotator cuff tears. To prove my hypothesis, our group performed a cadaveric biomechanical study in 2005. This biomechanical study showed that SCR completely restored superior stability of the glenohumeral joint, whereas patch grafting to the supraspinatus tendon (conventional patch graft surgery) only partially restored superior translation to the intact level. Consequently, in 2007,we started arthroscopic SCR for patients with irreparable rotator cuff tears. From our 10 years of experience with SCR, we conclude that arthroscopic SCR restores superior glenohumeral stability and improves shoulder function in irreparable rotator cuff tears.
Keywords: Irreparable, Reconstruction, Rotator Cuff, Shoulder, Superior capsule


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How to Cite this article: Mihata T. History and Future Direction of Superior Capsule Reconstruction for Irreparable Rotator Cuff Tears. Journal of Clinical Orthopaedics July-Dec 2018; 3(2):12-15.

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