The Effect of the Soft Tissue Structures Injury on the Development of Shoulder Joint Arthrosis
ARTICLE PDF (Українська)

Keywords

omarthrosis; shoulder joint; rotator cuff; articular cartilage.

How to Cite

Strafun, S., Bohdan, S., Serhiienko, R., & Lieskov , V. (2020). The Effect of the Soft Tissue Structures Injury on the Development of Shoulder Joint Arthrosis. Visnyk Ortopedii Travmatologii Protezuvannia, (3(106), 41-52. https://doi.org/10.37647/0132-2486-2020-106-3-41-52

Abstract

Summary. Injury of the soft tissue structures of the shoulder joint (rotator cuff, scapula labrum, etc.) is a common cause of omarthrosis. Objective: to investigate the changes in the articular cartilage of the shoulder head and the scapula glenoid in case of the soft tissue structures of the shoulder joint injury. Materials and Methods. We studied the long-term results of conservative and surgical treatment of 330 patients with soft tissue injuries of the shoulder joint, who were treated in the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine” (Kyiv) from 2009 to 2019. The age of patients ranged from 27 to 68 years (mean age 42.7±19.5 years); 225 were males (68.2%) and 105 females (31.8%). Surgical treatment was performed in 160 patients (48.5%); 170 patients (51.5%) underwent conservative treatment. For evaluation of the influence of the shoulder soft tissue structures injury on the articular cartilage, the degree of the articular cartilage damage was determined by R. Outerbridge and the obtained data were compared with the period from the onset of the disease to surgery. Conclusions: 1. The largest number of secondary omarthroses develops after ruptures of the rotator cuff tendons, both in conservative and surgical groups. Thus, a rupture of rotator cuff tendons is the most arthrosogenic factor among all soft tissue pathology of a shoulder joint. 2. Another arthrosogenic factor for the shoulder joint is rupture of the glenoid labrum in the anterior-inferior part in case of anterior shoulder dislocation and rupture of the posterior glenoid labrum without posterior dislocation (unrealized posterior instability), probably due to high energy trauma and trophic disorders of humeral head after dislocation. 3. A weak but significant dependence was found of the effect of the time from the beginning of the disease to surgery in various Pulley lesions on the degree of damage to the articular cartilage according to R. Outerbridge (r=0.4; p<0.05). Thus, early diagnosis and surgical treatment of Pulley lesions is a major prevention of omarthrosis. 4. A weak but significant dependence of the influence of the period from the onset of the disease to surgery was revealed in patients with isolated injury of the supraspinatus tendon (r=0.38; p<0.05). Early diagnosis and surgical treatment of rotator cuff tendon injuries is the main prevention of omarthrosis.

https://doi.org/10.37647/0132-2486-2020-106-3-41-52
ARTICLE PDF (Українська)

References

Boyle MJ, Youn SM, Frampton CM, Ball CM. Functional outcomes of reverse shoulder arthroplasty compared with hemiarthroplasty for acute proximal humeral fractures. J Shoulder Elbow Surg. 2013;(22):32-7. DOI: 10.1016/j.jse.2012.03.006.

Crosby LA, Neviaser RJ. Proximal Humerus Fractures Evaluation and Management. Springer: International Publishing Switzerland; 2015. 164 р.

Dini AA, Snyder SJ. Rotator cuff repair – The SCOI row method. Мedicina fluminensis. 2015;51(1):114-26.

Karl JW, Olson PR, Rosenwasser MP. The Epidemiology of Upper Extremity Fractures in the United States, 2009. J. Orthop. Trauma. 2015;(16):25-8. DOI: 10.1097 / BOT.0000000000000312.

Kelly JD. Elite Techniques in Shoulder Arthroscopy. Philadelphia: Springer; 2016. 334 р.

Lasanianos NG, Kanakaris NK, Giannoudis PV. Trauma and Orthopaedic Classifications. Berlin: Springer; 2015. 547 р.

McMahon PJ. Rotator Cuff Injuries A Clinical Casebook. Pittsburgh: Springer; 2017. 363 р.

Perren SM. Fracture healing: fracture healing understood as the result of a fascinating cascade of physical and biological interactions. Part I. An Attempt to Integrate Observations from 30 Years AO Research. Acta Chir Orthop Traumatol Cech. 2014;(81):355-64. PMID: 25748657.

Rockwood ChA, Masten FA. The Shoulder. 4th ed. Philadelphia: Sounders Elsevier; 2009. 1583 p.

Лапач СН, Губенко АВ, Бабич ПН. Статистические методы в медико-биологических исследованиях с использованием Excel. Киев: Морион; 2000. 320 с.

Lapach SN, Gubenko AV, Babich PN. Statistical methods in biomedical research using Excel. Kiev: Morion; 2000. 320 s. [in Russian].

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.