Hamid Reza Aslani; Amin karimi; Zohreh Zafarani
Abstract
Background: In massive irreparable shoulder rotator cuff tears in older patients, an alternative surgery is debredement of subacromial bursa, biceps tendon and tuberoplasty. This is a short-term report of such a treatment performed arthroscopically in a small group of patients. Methods: In a prospective ...
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Background: In massive irreparable shoulder rotator cuff tears in older patients, an alternative surgery is debredement of subacromial bursa, biceps tendon and tuberoplasty. This is a short-term report of such a treatment performed arthroscopically in a small group of patients. Methods: In a prospective study, in a 2 year interval, 8 patients with massive irreparable rotator cuff tear with mean age of 65 (60-75) underwent arthroscopic debridement of necrotic rotator cuff tendon remnants and tuberoplasty without coracoaromial ligament excision. The sign and symptoms of patients before and after surgery were evaluated with modified UCLA score. Results: With a mean follow-up of 12 months (6-18 months), the modified UCLA score improved from 9.2 to 27.5. In 7 patients, pain and range of motion improved to near normal and 6 cases obtained near normal function. Although the acromiohumeral distance decreased from 5 to 4 millimeters and slight increase in degenerative changes was observed, the functional outcome was good. Conclusion: This simple arthroscopic procedure is recommended in massive irreparable rotator cuff tear especially in elderly patients.
Hamid Reza Aslani, MD; Khalil Alizadeh, MD; Amin Karimi, MD; Mohammad Hossein Karimi, MD; Zohreh Zaferani, MD
Abstract
Background: Carpal tunnel syndrome is one of the most common compression neuropathies in the upper limb and requires surgery if conservative treatment fails. This article compares the result of regular open incision, midpalmar mini incision and endoscopic technique in carpal tunnel release.Methods: This ...
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Background: Carpal tunnel syndrome is one of the most common compression neuropathies in the upper limb and requires surgery if conservative treatment fails. This article compares the result of regular open incision, midpalmar mini incision and endoscopic technique in carpal tunnel release.Methods: This is a clinical trial study on 53 patients (5 males, 48 females) within one year, who were surgical candidates. The surgery was done by arthroscopy, with regular open incision or with mid palmar small incision. The clinical outcomes were evaluated one week, 4 weeks and 4 months post surgery.Results: Relief and satisfaction were better in the first month in the arthroscopic and mini-incision group. All 3 techniques had similar outcomes after 4 months. In 4-months follow-up, night pain relief, followed by parasthesia relief were the ones with the best improvement. Weakness was the symptom with the least improvement. Longer incision cases were associated with more delay to return to work.Conclusion: Carpal tunnel release with endoscopic and mini incision techniques have a better early satisfaction rates compared to regular open incision, but no difference is seen between the two groups after four months.
Hamid Reza Aslani, MD; Mehdi Abooei Mehrizi, MD; Amin Karimi, MD; Zohreh Zaferani, MD
Abstract
Background: Rotator cuff muscles are the milestone of shoulder function. Tear of the rotator cuff could result in shoulder pain and deterioration of the function. The purpose of this study was to evaluate the outcome of arthroscopically repaired large and massive rotator cuff tears in short term. Methods: ...
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Background: Rotator cuff muscles are the milestone of shoulder function. Tear of the rotator cuff could result in shoulder pain and deterioration of the function. The purpose of this study was to evaluate the outcome of arthroscopically repaired large and massive rotator cuff tears in short term. Methods: Fifity one consecutive patients (41 males, 10 females) with average age of 49 years old (38-62 y/o) who had arthroscopically repairable large or massive tears during a 3 year period in two hospitals in Tehran were included in the study. Ten of these patients were lost to follow-up and were excluded from the study. The remaining 41 were the focus of this study. Results: 28 patients had large tears and 13 had massive tears. Follow-up averaged 25 months (range, 12 to 48 months). Based on the University of California Los Angeles shoulder rating (UCLA), 88% of patients had good or excellent outcomes. Although 5 patients were considered failures based on the UCLA score, 98% of patients were satisfied with the result. Only 1 of these failures underwent a second operation for revision repair. There was no significant difference in final scores when comparing the massive tears with the entire group. The preoperative scores however for massive tears were lower than the large tears.Conclusion: Arthroscopic management of large and massive of rotator cuff tears results in good or excellent outcomes comparable to reported outcomes following open repair
Hamid Reza Aslani, MD; Mehdi Abooei Mehrizi, MD; Zohreh Zafarani, MD
Abstract
Background: Ganglion cyst is one of the common causes of wrist mass, presenting with weakness and pain in the wrist. Among the arrays of treatment options for this problem arthroscopic resection is probably the most recent treatment modality. We would like to review a short-term result of such a treatment ...
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Background: Ganglion cyst is one of the common causes of wrist mass, presenting with weakness and pain in the wrist. Among the arrays of treatment options for this problem arthroscopic resection is probably the most recent treatment modality. We would like to review a short-term result of such a treatment in a small group of patients.Methods: In a case series study, 13 patients (10 women, 3 men) with dorsal wrist ganglion treated with arthroscopic resection in a two-year period, were evaluated for post operative recurrence pain swelling or wrist motion limitation and grip strength. The mean age was 29.8 years old. The cases had an average of 12 months (7-19 months) follow-up.Results: In the all cases no intra-or post operative complication was encountered. The wrist range of motion, and grip strength showed improvement no scapholunate instability was seen. One recurrence after 6 months had occurred.Conclusion: Arthroscopic ganglionectomy is a swelling surgical alternative for dorsal wrist ganglion with less scar, and comparative results to open surgery.
Hamid Reza Aslani, MD; Manoochehr Ghazaleh, MD; Zohreh Zafarani, MD
Abstract
Background: The superior labral lesion causes shoulder pain, disability and severe dysfunction. These lesions can see separated or with rotator cuff tear. The pain and recurrent instability require surgical repairing. The purpose of this study was to evaluate the results of arthroscopy surgery of superior ...
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Background: The superior labral lesion causes shoulder pain, disability and severe dysfunction. These lesions can see separated or with rotator cuff tear. The pain and recurrent instability require surgical repairing. The purpose of this study was to evaluate the results of arthroscopy surgery of superior labral lesion of the shoulder.Methods: In a case series study, we evaluated 29 patients (23 men, 6 women, mean age=26 years, range: 19-36 years) at a mean 31 months (12 ـ 47 months) following arthroscopic surgery of superior labral lesion of the shoulder. The outcome of treatment was evaluated with the University of California-Los Angeles Shoulder Scale (UCLA). 13 patients were involved in athletic activities, 7 of which in “overhead” sports and one contact sport. 8 patients had type I, 17 type II, 3 type III, and 1 patient type IV of slap lesions. The treatment included debridment for type I, debridment and decortication of glenoid and anchor suture in type II, debridment and excision of labral tear in type 3 and, excision and anchor suture of labral tear in type IV.Results: Surgery of the superior labral lesion resulted in satisfactory UCLA score. 19 regained their preinjury level of shoulder function. The shoulder score and the return to activity were correlated with the type of sports activity. The patients participating in overhead sports had significantly lower shoulder scores and a lower percentage of return to their preinjury level of shoulder function compared with patients who were not engaged in overhead activity.Conclusion: arthroscopic surgery of superior labral is successful in the majority of patients but less satisfactory in those doing “overhead” sports. However, the result in patient who participates not involved in overhead sports.
