Article: Transfer of teres minor with bone pedicle for irreparable posterior-superior rotator cuff tears.[show abstract] [hide abstract]
ABSTRACT: The objectives of this study are to evaluate the clinical and radiographic mid- to long-term outcomes of patients treated by teres minor with bone pedicle transfer for irreparable massive rotator cuff tear and to investigate the limitations of this procedure. Clinical outcomes were assessed by quantifying: the range of shoulder motion; a visual analog pain scale; the University of California, Los Angeles Shoulder Score (UCLA score); and the Disability of the Arm, Shoulder, and Hand (DASH) score. Radiographs were assessed for deterioration of the glenohumeral joint and upper migration of the humeral head. Eighteen patients with mean age of 66.9 years and mean follow-up of 74.4 months were included. The technique resulted in significant decrease in shoulder pain. The mean UCLA score improved from 10.3 points initially to 24.1 points at time of final follow-up. However, the postoperative results were classified as poor in 11 shoulders. The mean postoperative DASH score was 27.6 points. The mean active forward elevation significantly improved from 75.9° initially to 121.6° at time of final follow-up. In radiographic assessment, osteoarthritis of the glenohumeral joint progressed in 15 shoulders, and the upper migration of humeral head progressed in 14 shoulders. Aggravation of the glenohumeral joint and upper migration of the humeral head both progressed postoperatively at a high rate. Therefore, we conclude that this procedure should no longer be performed despite its relative simplicity.Journal of Orthopaedic Science 07/2012; 17(5):538-44. · 0.84 Impact Factor
Article: Arthroscopic debridement with continuous irrigation for septic arthritis of the shoulder joint[show abstract] [hide abstract]
ABSTRACT: PurposeThe purpose of this study was to investigate the outcome of arthroscopic debridement with continuous irrigation in patients with septic arthritis of the shoulder joint. MethodsTen patients (four men, six women) with septic arthritis of the shoulder joint were treated with a combination of arthroscopic debridement and continuous irrigation. All patients were followed for a minimum of 4years. The average age was 61.7years with a range of 25 to 86. The etiology of infection was determined to be a subacromial injection in six cases, EMG needle puncture in one, hematogenous in two, and unknown in one case. Causative bacteria, follow-up period, recurrence, shoulder pain, University of California, Los Angeles (UCLA) shoulder score, and radiographic findings were evaluated. Result Staphylococcus aureus was cultured in six cases, and Staphylococcus epidermidis, in four cases. The average follow-up period was 103.3months with a range of 48 to 199. The infection was eradicated completely with a single arthroscopic debridement with continuous irrigation in nine patients. One patient required a second operation. In all patients, severe pain before operation improved. The average UCLA shoulder score increased from 5.7 points prior to the operation to a post-operation score of 26.4 points. In standard radiographic findings, five cases had aggravated osteoarthritis in the affected joint. ConclusionThis study shows that arthroscopic debridement with continuous irrigation for septic arthritis of the shoulder joint improves shoulder pain, functional scores, and subjective outcome and prevents recurrence in many cases. KeywordsShoulder joint–Septic arthritis–Arthroscopic debridement–Continuous irrigation04/2012; 2(3):87-92.
Article: Alterations of high-mannose type N-glycosylation in human and mouse osteoarthritis cartilage.Atsushi Urita, Tomoya Matsuhashi, Tomohiro Onodera, Hiroaki Nakagawa, Megumi Hato, Maho Amano, Naoki Seito, Akio Minami, Shin-Ichiro Nishimura, Norimasa Iwasaki[show abstract] [hide abstract]
ABSTRACT: The process of N-glycosylation is involved in the pathogenesis of various diseases. However, little is known about the contribution of changes in N-glycans in osteoarthritis (OA). The aim of this study was to identify the alterations in N-glycans in human OA cartilage, to characterize the messenger RNA (mRNA) expression of N-glycan biosynthesis enzyme genes (N-glycogenes) in mouse articular chondrocytes during cartilage degradation, and to analyze the relationship between altered N-glycan patterns and mechanisms of cartilage degradation. Alterations in N-glycans were analyzed in human OA cartilage and degraded mouse cartilage by high-performance liquid chromatography and mass spectrometry. N-glycogene mRNA expression in mouse chondrocytes was measured using reverse transcription-polymerase chain reaction. To assess the relationship between the altered N-glycans and degradation of mouse cartilage, experiments involving either knockdown or overexpression of N-glycogenes were performed in mouse articular chondrocytes. Alterations in high-mannose type N-glycans were observed in both human OA cartilage and degraded mouse cartilage. The expression of β1,2N-acetylglucosaminyltransferase I (GlcNAc-TI) mRNA, which converts high-mannose type N-glycans, was significantly increased in degraded mouse cartilage. Mouse chondrocytes with suppressed GlcNAc-TI expression had reduced levels of matrix metalloproteinase 13 (MMP-13) and ADAMTS-5 (aggrecanase 2) mRNA following stimulation with interleukin-1α (IL-1α). In contrast, mouse chondrocytes overexpressing GlcNAc-TI had increased levels of MMP-13 and ADAMTS-5 mRNA following stimulation with IL-1α. These findings indicate that alterations in high-mannose type N-glycans and N-glycogenes in chondrocytes correlate with the release of MMP-13 and ADAMTS-5 during cartilage degradation. These findings suggest that N-glycans play a crucial role in the initiation and progression of OA.Arthritis & Rheumatism 08/2011; 63(11):3428-38. · 7.87 Impact Factor
Article: Midterm outcomes after humeral head replacement with rotator cuff repair in patients with syringomyelia shoulder neuroarthropathy: a report on three cases.Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 08/2011; 20(8):e8-15. · 1.93 Impact Factor
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ABSTRACT: We have carried out a replacement of the lunate in 12 patients with advanced Kienböck's disease, with excision of the lunate and insertion of an iliac bone flap wrapped into palmaris longus. The aims of this study were to determine the effect of this procedure for advanced Kienböck's disease. At a mean follow-up period of 45.3 months, the mean clinical score was excellent in all cases. Radiographically, progression of osteoarthritis (OA) in the radiocarpal joint was found in two patients. At follow-up, the X-ray findings indicated a reduced of osseous core in four patients. On the other hand, carpal height ratio showed no significant change at follow-up. Excision arthroplasty using a tendon ball with osseous core for advanced Kienböck's disease leads to OA progression in some cases. However, clinical results were excellent in all cases. Therefore, this current study provides effective therapeutic procedure for advanced Kienböck's disease.Hand Surgery 01/2011; 16(3):277-82.