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Faculty of Medicine, University of Geneva, Switzerland
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Affidea Centre de Diagnostic Radiologique de Carouge CDRC, Geneva, Switzerland
Department of Surgical Sciences, Uppsala University, Sweden
Department of Neuroradiology, University Hospital Freiburg, Germany
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Medical Research Department, Artanim Foundation, Geneva, Switzerland
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biceps, 44 the capsulorrhaphy, 35 the repaired labrum or the remplissage. 45 Interestingly, less invasive approaches do not seem to improve results regarding stability compared with open ones; more recurrences have been noted after
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due to inadequate surgical exposure. 3 , 4 Anatomical considerations The two classically recognized approaches for shoulder arthroplasty are the deltopectoral approach and the transdeltoid approach. In both cases, the glenoid is exposed
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University Hospital Antwerp, Department of Orthopedic Surgery, Edegem, Belgium
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higher when the surgical repair is performed at later stages. 37 Early surgical repair is therefore preferred. Approach Surgical repair of the DBT can be performed through a single or double-incision approach. Both approaches have been extensively
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instability will additionally show a positive jerk and drawer tests, as well as recurrent subluxations and dislocations that can be reproduced by the patient or with provocative maneuvers. Several factors determine the approach in patients with recurrent
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beach-chair position. A deltopectoral approach is used with a 7–8 cm incision extending from coracoid process to axilla. Deltoid, pectoralis major muscles and cephalic vein are exposed and dissection is deepened between these two muscles. Then conjoint
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deltopectoral approach, Edwards et al reported the incidence of instability without subscapularis repair to be double compared to when subscapularis repair was obtained. 29 This information may not apply when a lateralised centre of rotation is used or when
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arthroplasty type and the approach to address glenoid wear, such as reaming, bone grafting, or augmented glenoids ( 19 ). The reliability of glenoid inclination 2D measurements is influenced by the viewing angle on plain radiographs, making it necessary to
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Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
Faculty of Medicine, University of Geneva, Switzerland
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matter of debate. Frozen shoulder is often described as ‘self-limiting’, 27 meaning that recovery will be achieved over time, regardless of treatment approach. Out of the 24 systematic reviews assessed, eight (33%) described frozen shoulder or
These authors contributed equally to this work
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Cell & Tissue Bank-Regenerative Medicine Centre, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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and robustness, we also appraised our evidence quality by using the GRADE approach, as recommended by the Cochrane method. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach is utilized to assess the certainty
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The rotator cable and rotator interval are among the most recent topics of interest in current shoulder literature. Most of the research has been published in the last two decades and our understanding about the importance of these anatomical structures has improved with biomechanical studies, which changed the pre- and intra-operative approaches of shoulder surgeons to rotator cuff tears in symptomatic patients.
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The rotator cable is a thick fibrous bundle that carries the applied forces to the rotator cuff like a ‘suspension bridge’. Tears including this weight-bearing bridge result in more symptoms. On the other hand, the rotator interval is more like a protective cover consisting of multiple layers of ligaments and the capsule rather than a single anatomical formation like the rotator cable.
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Advances in our knowledge about the rotator interval demonstrate that even basic anatomical structures often have greater importance than we may have understood. Misdiagnosis of these two important structures may lead to persistent symptoms.
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Furthermore, some distinct rotator cuff tear patterns can be associated with concomitant rotator interval injuries because of the anatomical proximity of these two anatomical regions. We summarize these two important structures from the aspect of anatomy, biomechanics, radiology and clinical importance in a review of the literature.
Cite this article: EFORT Open Rev 2019;4:56-62. DOI: 10.1302/2058-5241.4.170071.
