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  • Author: Przemysław Lubiatowski x
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Anna Wawrzyniak Rehasport Clinic, Poznań, Poland

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Przemysław Lubiatowski Rehasport Clinic, Poznań, Poland
Sport Traumatology and Biomechanics Unit Department of Traumatology, Orthopaedics and Hand Surgery, Poznań University of Medical Science, Poznań, Poland

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Purpose

  • The purpose of this study was to collect and evaluate clinical and radiological evidence on shoulder neuroarthropathy (NA) in syringomyelia (SM) that may support the management and treatment of patients with this condition.

Materials and methods

  • This systematic review is based on the analysis of reports available in PubMed, Embase, Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials using the following keywords: syringomyelia, neuroarthropathy, Charcot joint and shoulder degeneration. Thirty-nine publications were found presenting case reports or case series meeting our criteria. Pooled data included a group of 65 patients and 71 shoulders with NA secondary to SM.

Results

  • The most commonly reported symptoms were range of motion (ROM) limitation, weakness, swelling, pain and dissociated sensory loss. NA is usually monolateral and concerns only the shoulder. The average active shoulder ROM was flexion −59.2° (s.d. 37.9), internal rotation −29.8° (s.d. 22.6) and external rotation −21.1° (s.d. 23.6). Most of the patients (75%) presented with complete or nearly complete proximal humerus degeneration, while the degree of glenoid preservation varied. Fifty-two neuroarthropathic shoulders were treated conservatively with physiotherapy, anti-inflammatory medication and splinting. Eighteen patients were treated by surgical intervention.

Conclusion

  • Shoulder NA due to SM is a devastating and progressive condition, and its course is often unpredictable. Patients with unexplained shoulder degeneration should be evaluated for SM, especially if there are additional neurological symptoms. Conservative treatment usually reduces shoulder pain without improving ROM. For select patients, shoulder arthroplasty may be a better option for restoring function.

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Przemysław Lubiatowski Sport Trauma and Biomechanics Unit, University of Medical Sciences, Poznań, Poland
Rehasport Clinic, Poznań, Poland
Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences, Poznań, Poland

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Joanna Wałecka Sport Trauma and Biomechanics Unit, University of Medical Sciences, Poznań, Poland
Rehasport Clinic, Poznań, Poland
Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences, Poznań, Poland

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Marcin Dzianach Rehasport Clinic, Poznań, Poland

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Jakub Stefaniak Sport Trauma and Biomechanics Unit, University of Medical Sciences, Poznań, Poland
Rehasport Clinic, Poznań, Poland
Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences, Poznań, Poland

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Leszek Romanowski Department of Traumatology, Orthopaedics and Hand Surgery, University of Medical Sciences, Poznań, Poland

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  • A synovial plica (fold) is normal anatomic finding, and occurs in 86–100% of cases; however, symptomatic plica is much less common (7.2–8.7% of all elbow arthroscopies).

  • Synovial plica syndrome is a painful elbow condition related to symptomatic synovial plica.

  • Synovial plica syndrome is diagnosed by clinical examination (lateral elbow pain) commonly accompanied by local tenderness, pain at terminal extension and/or painful snapping.

  • Synovial plica syndrome may be mimicked by other elbow conditions, commonly tennis elbow, loose bodies, and degenerative arthritis.

  • Magnetic resonance imaging or ultrasound scan may support diagnosis in correlation with clinical findings, but symptomatic plica may also be diagnosed as unexpected during elbow arthroscopy.

  • The arthroscopic resection is effective and safe if conservative treatment fails.

Cite this article: EFORT Open Rev 2020;5:549-557. DOI: 10.1302/2058-5241.5.200027

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Jakub Stefaniak Department of Traumatology, Orthopaedics and Hand Surgery, Poznan University of Medical Sciences, Poznan, Poland
Sport Traumatology and Biomechanics Unit, Rehasport Clinic, Poznan University of Medical Sciences, Poznan, Poland

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Przemyslaw Lubiatowski Sport Traumatology and Biomechanics Unit, Rehasport Clinic, Poznan University of Medical Sciences, Poznan, Poland

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Anna Maria Kubicka Institute of Zoology, Poznan University of Life Sciences, Poznan, Poland

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Anna Wawrzyniak Sport Traumatology and Biomechanics Unit, Rehasport Clinic, Poznan University of Medical Sciences, Poznan, Poland

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Joanna Wałecka Sport Traumatology and Biomechanics Unit, Rehasport Clinic, Poznan University of Medical Sciences, Poznan, Poland

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Leszek Romanowski Department of Traumatology, Orthopaedics and Hand Surgery, Poznan University of Medical Sciences, Poznan, Poland

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  • The coexistence of glenoid and humeral head bone defects may increase the risk of recurrence of instability after soft tissue repair.

  • Revealed factors in medical history such as male gender, younger age of dislocation, an increasing number of dislocations, contact sports, and manual work or epilepsy may increase the recurrence rate of instability.

  • In physical examination, positive bony apprehension test, catching and crepitations in shoulder movement may suggest osseous deficiency.

  • Anteroposterior and axial views allow for the detection of particular bony lesions in patients with recurrent anterior shoulder instability.

  • Computed Tomography (CT) with multiplanar reconstruction (MPR) and various types of 3D rendering in 2D (quasi-3D-CT) and 3D (true-3D-CT) space allows not only detection of glenoid and humeral bone defects but most of all their quantification and relations (engaging/not-engaging and on-track/off-track) in the context of bipolar lesion.

  • Magnetic resonance imaging (MRI) is increasingly developing and can provide an equally accurate measurement tool for bone assessment, avoiding radiation exposure for the patient.

Cite this article: EFORT Open Rev 2020;5:815-827. DOI: 10.1302/2058-5241.5.200049

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Hubert Laprus St Luke’s Hospital, Bielsko-Biala, Poland
Dworska Hospital, Kraków, Poland
Hospital in Proszowice, Poland

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Bartłomiej Juszczak University Children’s Hospital in Kraków, Poland

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Roman Brzóska St Luke’s Hospital, Bielsko-Biala, Poland

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Adrian Błasiak St Luke’s Hospital, Bielsko-Biala, Poland

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Ion-Andrei Popescu Romanian Shoulder Institute -ORTOPEDICUM, Bucharest, Romania

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Przemysław Lubiatowski Rehasport Clinic, Poznań, Poland

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  • Rotator cuff tears (RCT) and instability are the most common surgically treated shoulder pathologies.

  • The concept of augmentation using the long head of the biceps tendon (LHBT) autograft was created to improve the results of surgical treatment of these pathologies, especially in cases of chronic and massive injuries.

  • The popularity of using the LHBT for augmentation is evidenced by the significant number of publications on this topic published in the last 3 years; however, only one systematic review has been published regarding only LHBT augmentation for massive RCTs.

  • Several studies comparing partial repair with partial repair and additional LHBT augmentation for RCT showed superior clinical outcomes and lower re-tear rates when LHBT augmentation was performed.

  • There is a rising popularity of using LHBT as an autograft to perform superior capsule reconstruction (SCR) in case of irreparable rotator cuff tears.

  • In recent years, shoulder stabilization by arthroscopic Bankart repair with biceps augmentation has been promoted with very promising short-term results.

  • The evidence provided by studies appears to be sufficient to recommend the use of LHBT for augmentation whenever necessary; however, larger studies with long-term follow-up are needed.

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