Search

The article discusses a study conducted by hypothesizing that rate of return to a level of play similar to or greater than preinjury level after repair of combined superior labrum anterior-posterior (SLAP) and infraspinatus injuries will be lower than in previous reports of SLAP repair alone. It notes that only 35 percent of the patients were able to return to same or superior preinjury level of performance and that prognosis for an athlete with both SLAP and infraspinatus tear is more guarded.

Background: Complete repair of massive rotator cuff tears can be limited by tendon retraction and poor tissue quality. When a complete repair cannot be accomplished, a significant partial repair may be possible.Hypothesis: A partial repair will yield comparable outcomes to complete repair of massive rotator cuff tears in this specific patient population.Study Design: Cohort study; Level of evidence, 3.Methods: All consecutive arthroscopic rotator cuff repairs done at the authors’ institution over a 2-year period were identified. A retrospective chart review was performed. Inclusion criteria required that each patient have a massive rotator cuff tear (30 cm2 or greater). Patients were categorized as either partial or complete repair. The University of California, Los Angeles (UCLA) shoulder scores were used to measure patient outcomes at an average follow-up of 24 months (10-40 months).Results: Of 1128 consecutive arthroscopic rotator cuff repairs, 97 (9%) patients were noted intraoperatively to have massive tears measuring 30 cm2 or greater. Complete repair was achieved in 52 patients, whereas partial repair was possible in 45 patients. Eleven patients were lost to follow-up. The 41 remaining patients with only partial repair achieved a postoperative mean UCLA score of 29.49, and the 45 patients with complete repair achieved a mean UCLA score of 29.64, yielding significant improvement in both the partial repair group (P = .0001) and the complete repair group (P = .0001) compared with preoperative UCLA scores. However, no statistically significant differences in postoperative outcomes were noted when the 2 groups were compared with one another (P = .89).Conclusion: Partial repair of massive rotator cuff tears yielded outcomes comparable with complete repair of massive tears. [ABSTRACT FROM PUBLISHER]

Background: As women become more involved in athletic activity, injuries specific to this population also increase. No data exist regarding operative treatment of female patients with elbow instability secondary to ulnar collateral ligament insufficiency., Hypothesis: Women with symptomatically unstable elbows who failed nonoperative treatment will improve after surgical intervention., Study Design: Case series; Level of evidence, 4., Methods: Nineteen women were retrospectively evaluated using the Andrews and Carson Elbow Outcome Score. Patients were included if they underwent repair or reconstruction of the ulnar collateral ligament for symptomatic instability that precluded them from participation in their desired sport or activities, despite nonoperative treatment., Results: The mean age was 22.0 years (range, 15.1-37.2 years). The mean follow-up was 38.8 months (range, 12.4-68.6 months). Of the 19 patients, 14 were softball players, gymnasts, and tennis players. Only 1 was a pitcher. Eighteen women underwent repair by one of the following procedures: plication (n = 6), repair to bone using anchors (n = 11), or drill holes (n = 1). One patient underwent a palmaris graft reconstruction. The mean overall preoperative outcome score of 120 improved to 191 postoperatively (P < .0001). Seventeen of 18 athletes were able to return to their sport at a mean of 2.5 months postoperatively. One patient did not participate in athletics., Conclusion: This study demonstrated excellent overall results in 16 and good results in 3 female patients after medial elbow repair or reconstruction. Women appear to be able to consistently return to a high level of function after repair or reconstruction for medial elbow instability.

Objectives: The purpose of the study was to determine if and where there were counties with significantly better or poorer health than others in the region., Methods: Using Z scores for 6 mortality-related measures, this study identifies counties within the Delta states with the highest and lowest rates., Results: Although Delta counties account for only 33% of the counties in the eight target states, they represent the majority of counties with the highest mortality measures, and represent the minority of counties with positive health outcomes., Conclusions: These findings confirm the appropriateness of targeting interventions, and help pinpoint places where better health is being achieved despite high poverty and other risk factors, where important lessons can be drawn.