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  1. 1

    Superior Capsular Reconstruction with Fascia Lata Allograft for Irreparable Supraspinatus Tendon Tears

    Publication
    by Gracitelli,Mauro Emilio Conforto
    Other Authors: Beraldo,Rodrigo Alves; Malavolta,Eduardo Angeli; Assunção,Jorge Henrique; Oliveira,Danilo Ricardo Okiishi de; Ferreira Neto,Arnaldo Amado
    Origin: Oasisbr
    Abstract Superior capsular reconstruction is a recently described procedure for the treatment of irreparable supraspinatus tendon tears. Graft options that have been previously described include autogenous fascia lata and decellularized dermal graft. No studies were published with the use of fascia lata allograft. The purpose of this technical note is to describe the surgical technique of superior capsular reconstruction using fascia lata allograft. The procedure is performed by arthroscopic visualization, with the patient positioned in the lateral decubitus position. The authors describe a technique based on the use of a double-pulley knot in the glenoid and greater tuberosity, facilitating the procedure and allowing the graft to be brought into the subacromial space in the definitive position, with the appropriate tension. The allografts are available from this institution's tissue bank, cryopreserved and submitted to microbiological and histopathological evaluation. Superior capsular reconstruction is a promising surgery. The technique described in the present technical note shows a viable arthroscopic alternative, with a smaller number of anchors when compared with other techniques.
    2019 article Brazil open access
  2. 2

    Reverse shoulder arthroplasty: Functional results in rotator cuff arthropathy

    Publication
    by Nascimento,Alexandre T.
    Other Authors: Claudio,Gustavo K.; Rocha,Pedro B.
    Origin: Oasisbr
    Abstract Objective To evaluate the functional results of patients submitted to reverse shoulder arthroplasty for the treatment of rotator cuff arthropathy refractory to conservative treatment. Methods A retrospective study of 20 patients (21 shoulders), 17 women (81%) and 3 men (19%), underwent a reverse shoulder arthroplasty between October 2012 and September 2017, for a rotator cuff arthropathy treatment, operated by a single surgeon in a single center. The patients were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) score, the Short-Form (36) Health Survey (SF-36), the visual analogue scale (VAS) of pain rating, and the University of California - Los Angeles (UCLA) score. The mean age at surgery was of 66 years old (range: 55 to 83 years old). The duration of symptoms before surgery was of ∼ 2.5 years (range: 12 months to 6 years). The mean follow-up was of 42.4 months (range: 19 to 56.7 months). Results The mean postoperative scores were 18.2 points in DASH; 2 points in EVA, of which 16 (77%) corresponded to mild pain, 4 (18%) to moderate pain, and 1 (5%) to severe pain; 29 points in UCLA, of which 6 patients presented a regular result (28%), 10 patients a good result (48%), and 5 patients an excellent result (24%); and 63 points in the SF-36. The complications were four cases of notching, one case of acromial fracture due to stress, and one case of postoperative infection. Conclusions Reverse arthroplasty of the shoulder presents good functional results in the evaluated scores, providing a significant improvement in the quality of life of the patients.
    2020 article Brazil open access