Giuseppe Sforza

Giuseppe Sforza
Shoulder and Elbow Centre · Orthopaedic

About

70
Publications
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895
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Publications

Publications (70)
Article
Full-text available
Purpose The “Purse-String Technique” (PST) is an arthroscopic horizontal mattress suture technique for recurrent anterior shoulder instability that uses a single double-loaded suture anchor at the 4-o’ clock position, achieving a Bankart labral repair and an infero-superior capsular shift. In this study, we describe the long-term results of the PST...
Article
This systematic review of the literature aims to analyse current knowledge to inform choice between hemiarthroplasty (HA) and reverse total shoulder arthroplasty (rTSA) for managing proximal humerus fractures (PHF) in elderly patients; the aim is to understand if rTSA can be considered the gold standard for treating PHF in the elderly when surgical...
Article
Introduction: Glenoid bone loss is a commonly encountered problem in complex primary and revision shoulder arthroplasty. Addressing glenoid bone loss is critical to avoid complications like early loosening, impingement, notching and instability. A large number of techniques like bone grafting using autograft or allograft, eccentric reaming, augmen...
Article
Background Reverse Total Shoulder Arthroplasty (rTSA) improves shoulder elevation in patients treated for cuff tear arthropathy (CTA) or irreparable massive cuff tears. Patient satisfaction can be limited by reduced active external rotation (AER). Rotator cuff muscles that externally rotate the shoulder are Infraspinatus and Teres Minor (TM). Aim...
Article
Background The treatment of displaced proximal humerus fractures (PHF) remains controversial. Internal fixation (ORIF) can be challenging, especially in elderly patients with poor bone quality, whereas hemiarthroplasty has had unpredictable outcomes. Conservative treatment, may result in severe fracture sequelae with poor outcome, requiring late re...
Article
Full-text available
Background Revision shoulder arthroplasty may involve the need to remove a well-fixed humeral stem. To avoid this, convertible platform systems have been introduced. The biomechanics of reverse total shoulder arthroplasty (rTSA) differs from anatomic shoulder arthroplasty (aTSA). The different humeral osteotomy and soft tissue tension may jeopardiz...
Article
AimTo assess the clinical and radiological results of a metaphyseal reverse total shoulder arthroplasty (rTSA) without diaphyseal stem, in rheumatoid arthritis (RA) patients.Methods Forty-five shoulders in 36 consecutive RA patients (2005–2015) underwent rTSA with a bone impaction technique. Patients were assessed clinically and radiographically pr...
Article
Full-text available
Introduction Various surgical techniques and implants are available for surgical treatment of significantly displaced proximal humerus fractures. We describe a minimally invasive technique using 3 curved wires, inserted in a retrograde fashion into the humeral head. These are aimed to diverge within the humeral head to provide three separate 3-poin...
Article
Introduction Postoperative rehabilitation is considered essential and indeed routine practice following rTSA. However, the optimal approach to postoperative rehabilitation is unknown, based on protocols for anatomic TSA, published literature is sparse, as is the quantity and quality of research evidence. Objective To outline the accelerated rehabi...
Article
Background This study was conducted to ascertain whether patients aged older than 75 years achieve outcomes after arthroscopic rotator cuff repair comparable to younger patients. Methods Arthroscopic cuff repair was performed in 60 shoulders of 59 patients aged older than 75 years. A control group of 60 younger patients, matched for sex, tear size...
Article
Full-text available
The painful shoulder is the most common condition seen in specialist shoulder clinics. It is often associated with lack of range of motion and reduced shoulder function. Lack of sleep and difficulties in performing basic daily life activities are common findings. Subacromial Impingement Syndrome (SAIS) has been considered as the most common cause o...
Article
Full-text available
Many techniques of arthroscopic rotator cuff repair have been described. No significant differences in clinical outcomes or rerupture rates have been observed when comparing single-row with double-row methods. Not all single- and double-row repairs are the same. The details of the technique used are crucial. It has been shown that the suture-tendon...
Article
Full-text available
Failure of arthroscopic techniques in cases of recurrent anterior glenohumeral instability may result from inadequate treatment of capsular injury. The use of few anchors has been cited as a cause of failure in arthroscopic stabilization techniques. This applies to the use of the suture anchors as spot-welding points in conventional techniques. It...
Article
Introduction: Reverse shoulder arthroplasty changes the anatomy of the shoulder and lengthens the humero-acromial distance. The long-term effects to the deltoid function and, thereby, to the clinical outcome remain unclear. Objectives: To examine the long term results to the deltoid function and clinical outcome. Methods: The study comprised 48 rev...
Chapter
Subacromial impingement syndrome is one of the most frequent causes of shoulder pain. Patients are commonly referred to the shoulder specialist for severe pain and limited function of the shoulder joint. The shoulder is a complex joint that needs to be balanced to work properly. Mechanical forces have to be counteracted by muscle action and capsula...
Article
Background: Reverse shoulder prostheses are increasingly used in recent years for treatment of glenohumeral arthropathy with deficient rotator cuff. Bone preservation is becoming a major goal in shoulder replacement surgery. Metaphyseal humeral components without a stem were developed to minimize bone resection and preserve bone. This study evalua...
Article
Full-text available
Aim: Os acromiale is a rare shoulder condition, which may be symptomatic. The rate of rotator cuff disease in the presence of os acromiale is unknown. The aim of this study was to investigate the prevalence of os acromiale in patients with massive rotator cuff tears and in those with cuff tear arthropathy. Material and Methods: Prospective data col...
Article
Full-text available
Shoulder pain in general and acromioclavicular joint (ACJ) pain specifically is common after acceleration-deceleration injury following road traffic accident (RTA). The outcome of surgical treatment in this condition is not described in the literature. The aim of the present study was to report the outcome of arthroscopic resection of the ACJ in th...
Article
Shoulder girdle muscle weakness is the most constant feature of facioscapulohumeral muscular dystrophy and leads to scapular winging. Mechanical fixation of the scapula to the thoracic wall provides a stable fulcrum on which the deltoid muscle can exert its action on the humerus. The aim of this study was to evaluate the medium to long-term outcome...
Article
Full-text available
Surgical options for symptomatic pathologies of the long head of the biceps (LHB) include tenotomy and tenodesis. Tenotomy is surgically simple and quick, does not require immobilization, and avoids implant complications. However, it is associated with residual "Popeye" muscle deformity and biceps muscle cramps. Tenodesis avoids Popeye deformity, b...
Article
Full-text available
Muscular patterning can be a contributor of positional posterior shoulder instability. Failure to recognize this pattern may lead to unnecessary surgical treatment with high failure rate. We analyzed the results of a new simple clinical test (hand squeeze test). The test is regarded positive, if during squeezing with the contralateral hand and elev...
Article
Objective: To evaluate the prevalence of iatrogenic humeral neck fracture after attempted closed reduction in patients older than 40 years who present with a first-time anterior dislocation. Design: Retrospective cohort study, evidence-based medicine level IV. Patients: Ninety-two patients older than 40 years (mean 66.6 years of age) with a first-...
Article
Full-text available
A new technical tip for the improvement of the arthroscopic treatment of symptomatic calcifying tendinitis is described. Arthroscopic excision of calcifying tendonitis may result with multiple minute calcific debris in the subacromial bursa, causing severe post operative pain due to chemical irritation of the bursa. We suggest the use of a bladeles...
Article
Symptomatic meso-type os acromiale is a common pathology with inconsistent outcomes of treatment with various surgical techniques. We report the outcome of a new technique for arthroscopic fusion of symptomatic os acromiale with absorbable screws. Materials and methods: The study included 8 shoulders in 8 patients with symptomatic meso-type os acr...
Article
It has been our observation that early during rehabilitation after rotator cuff repair, patients may take a step back before improving. The purpose of this study is to investigate the pattern and time phase of changes in Constant score and strength recovery after arthroscopic rotator cuff repair. Forty-five patients undergoing arthroscopic rotator...
Article
Maintaining good hemostasis is vital to ensure clear vision during arthroscopic surgery. This is most commonly achieved with electrocautery or radiofrequency devices. Another technique involves temporarily increasing the arthroscopic fluid inflow pressure to tamponade the bleeding. Unfortunately, both of these methods are not without risks or limit...
Article
Traumatic anterior shoulder dislocation is a common pathology. To inform the patient, it is therefore important to know the natural history of anterior dislocation and the long-term result of conservative treatment versus the long-term results of operative treatment. In this review article, we compare the effectiveness of various anatomical and non...
Article
Surface replacement arthroplasty of the shoulder is a well accepted and frequently performed procedure. There are reports of good long-term results to support this. As with all surgical procedures, however, the results depend on a thorough understanding of the surgical technique. This article discusses the most common pitfalls and suggests solution...
Article
The aim of this study was to evaluate the results of the arthroscopic management of the snapping scapula syndrome. Case series. Thirteen patients underwent surgery for painful scapular snapping that had not responded to adequate conservative treatment. They had no evidence of anatomic abnormalities on plain radiographs. All patients underwent burse...
Article
This study examines the effect of humeral head surface replacement on the geometry of the arthritic glenohumeral joint and correlates changes to clinical outcome. Thirty-nine patients undergoing resurfacing arthroplasty were prospectively followed up clinically and radiologically for a mean of 38 months (range, 24 to 72 months). Measurements were t...
Article
Shoulder arthroplasty with a stemmed prosthesis is a recognized treatment for rheumatoid arthritis of the shoulder. The humeral component of the Copeland cementless surface replacement arthroplasty consists of a cup for surface replacement with a short central peg for primary fixation to the bone. We hypothesized that surface replacement may offer...
Article
This report describes a differential staining method which distinguishes gram-positive from gram-negative bacteria in fluorescence. Gram-positive bacteria appear yellow and gram-negative bacteria appear green. The method is based on two fluorochromes, one acting in the wavelength of red, i.e. the acridine orange, and another acting in the wavelengt...
Article
In this report we evaluated the geographical incidence of Lyme disease in Abruzzo, a region of Central Italy. 201 subjects at risk (forestry workers and soldiers) were tested for the presence of IgM and IgG antibodies to B. burgdorferi. Seroprevalence was found to be 11,9% using ELISA and 9,4% using Western Blot. The data indicate that Lyme disease...
Article
The aim of this study was to evaluate a differential staining method to distinguish gram-positive from gram-negative bacteria in fluorescence. The method is based on two fluorochromes, one acting in the wavelength of red, i.e. the acridine orange, and another acting in the wavelength of green, i.e. the fluorescein. With this method, gram-positive b...
Article
Full-text available
Between 1995 and 2000, 29 patients who had excessive pain or limitation of motion after a shoulder arthroplasty underwent arthroscopy. Preoperative diagnoses of impingement syndrome in 10 patients (treated by arthroscopic subacromial decompression), large rotator cuff tear in 1, loose bodies in 1, unstable cuff arthropathy in 1, and septic arthriti...
Article
Full-text available
Arthroscopic acromioplasty and distal clavicle resection has now become an accepted method of treatment for acromioclavicular (AC) joint arthritis. Complications following arthroscopic acromioplasty are relatively uncommon and include instrument breakage, hematoma, traction neuropathy, infection, acromial fracture, reflex sympathetic dystrophy, and...
Article
Full-text available
We present the short- and medium-term clinical results of thermal shrinkage in selected groups of patients with multidirectional or capsular stretch-type instability. We treated 56 patients (61 shoulders) by laser-assisted capsular shrinkage (LACS) and 34 patients (38 shoulders) by radiofrequency (RF) capsular shrinkage. The two groups were followe...
Article
Full-text available
We present the short- and medium-term clinical results of thermal shrinkage in selected groups of patients with multidirectional or capsular stretch-type instability. We treated 56 patients (61 shoulders) by laser-assisted capsular shrinkage (LACS) and 34 patients (38 shoulders) by radiofrequency (RF) capsular shrinkage. The two groups were followe...
Article
This study reports the diagnostic activity for the serological diagnosis of Lyme Disease (LD) in the patients of Abruzzo, a central region of Italy. During the period from August 1994 to July 1999, serological examinations for anti-Borrelia burgdorferi antibodies were performed on 1089 samples from 769 patients with symptomatology consistent with L...
Article
Purpose. Zygomycotic infections of traumatic wounds are rare in immunocompetent subjects. When these infections occur, they seldom involve Absidia corymbifera which, despite being ubiquitous in nature, is not usually harmful to man. Firm guidelines are still lacking for the treatment of these cases, as no current therapeutic option offers clear-cut...
Article
This study consists of 27 shoulders in 24 patients whose atraumatic shoulder instability was treated with the imbrication procedure described by Rockwood. Follow-up after 2 years or more showed the following results: 37% excellent, 30% good, 15% fair and 18% poor (Rowe score). No statistically significant differences in the results were observed be...
Article
Lyme disease is a multisystem disorder caused by the tick-transmitted spirochete Borrelia burgdorferi. It is widespread in the boreal emisphere, especially in the USA, Europe and some Asian areas. In Italy, it has been reported to occur as endemic in some northern regions, whereas only sporadic cases have been so far reported in the remaining regio...
Article
In the etiology of arthritis appearing in the first years of life is important to consider Borrelia burgdorferi infection, an ubiquitous zoonosis with a multisystemic pathology. The disease may be characterised by striking clinical and laboratory variations conditioned by the patient's immune response. The authors report the first case of Lyme dise...

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