Hamidreza Aslani, MD; Hamid Farrokhi, MD; Hamed Vahedi, MD; Manoochehr Ghazaleh, MD
Abstract
Background: Rotator cuff tear is one of the most prevalent shoulder disorders in middle aged and old people and MRI is gold standard paraclinic diagnostic test. This research is aimed at assessing the accuracy of MRI reports in rotator cuff tears.Methods: A cross-sectional study was done from May 2005 ...
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Background: Rotator cuff tear is one of the most prevalent shoulder disorders in middle aged and old people and MRI is gold standard paraclinic diagnostic test. This research is aimed at assessing the accuracy of MRI reports in rotator cuff tears.Methods: A cross-sectional study was done from May 2005 to February 2006 in two hospitals in Tehran. Fifty consecutive patients who had been investigated with MRI and then undergone shoulder arthroscopy were assessed. The reports on MRI findings of the shoulder were compared with the arthroscopic findings. The sensitivity, specificity, positive and negative predictive values of MRI in reference to the arthroscopic findings were studied.Results: MRI in these 27 men and 23 women showed 97.4% sensitivity, 45.4% specificity, 86.3% positive predictive value, 83.3% negative predictive value and 84% accuracy. The values for the same parameters were respectively 83.9%, 78.9%, 86.7%, 75% and 82% for complete and 50%, 76.2%, 28.6%, 88.9% and 70% for partial rotator cuff tears.Conclusions: The MRI reports for rotator cuff disease, in our center, are reliable for complete tears, but not for partial tears.
Hamidreza Aslani, MD; Hamed Vahedi, MD
Abstract
Background: Rotator cuff tear is one of the most common causes of shoulder complaint in the older age group. Treatments differ depending on the severity of tear and patient’s condition. Surgery is one of the important treatment options which may be done arthroscopically or by open technique. In this ...
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Background: Rotator cuff tear is one of the most common causes of shoulder complaint in the older age group. Treatments differ depending on the severity of tear and patient’s condition. Surgery is one of the important treatment options which may be done arthroscopically or by open technique. In this study we would like to report a short-term result of arthroscopic repair of complete tears of rotator cuff.Methods: A cross-sectional study was done in 3 hospitals in Tehran, Iran. 183 patients were treated for their rotator cuff disease by arthroscopic technique from January 2003 to August 2006. 107 cases that had complete tears, and had at least one year follow-up were considered for the study. 89 patients (56 male, 33 female) attended the assessment sessions and were evaluated by UCLA (University of California, Los Angeles) Shoulder and Elbow scoring system. The scores were compared with the preoperative UCLA scores. Acromioplasty was performed in 83 patients.Results: With a mean age of 53.2 (32-71) years, the average UCLA score was 11.3 before surgery and 31.4 in follow-ups. There were 11 patients with excellent, 62 good, 11 fair and 5 poor scores. Nine of the 11 cases with excellent scores and 34 of the good scores were younger than 55 years of age. Out of the 16 fair or poor results, 13 were older than 60 years of age.Conclusions: A significant improvement in UCLA scores is possible after arthroscopic repair of complete rotator –cuff tear, in short term. The treatment results are better in younger patients.
Hamidreza Aslani, MD; Hamed Vahedi, MD
Abstract
Background: Ipsilateral fractures of tibia and femur or’ “floating knee”, commonly occur as a result of high energy trauma. It is, therefore, associated with high chance of knee injuries. This articles looks at the prevalence of intra-articular knee injury in “floating knee” when the fractures ...
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Background: Ipsilateral fractures of tibia and femur or’ “floating knee”, commonly occur as a result of high energy trauma. It is, therefore, associated with high chance of knee injuries. This articles looks at the prevalence of intra-articular knee injury in “floating knee” when the fractures are extra-articular, both in tibia and femur.Methods: During a 3.5 year period of time (March 2002-Oct 2005), 61, out of total of 76 cases of “floating knees” that had extra-articular femur and tibia fractures, had no history of prior knee problems, and the fractures of both segments had been internally fixed were studied. Each knee was examined for any possible ligamentous injury, following rigid fixation of the fractures, under the same anesthesia. The findings were documented and the patients were later followed for any new findings or complaints up to nine months after the incident.Results: The mean age in these 61 cases (57 males, 4 females) was 29.3 (18-46). Lachman and Pivot tests were positive in 5 and Posterior Drawer test in 3 cases. Valgus instability in 9 and varus instability in 6 other cases were detected. After the 9-months follow-up, knee pain was the chief complaint in 19 patients, while the MRI study which was done in 16 cases was positive for meniscal damage in 13 patients.Conclusions: Concomitant knee insults are fairly common in “floating knee” injuries. A thorough knee examination, following fixation of "floating knee” fractures, while the patient is still under anesthesia is essential. Further evaluation during the course of fracture treatment for any knee complaint is also recommended.
