Vídeo acerca del trabajo realizado por los alumnos de Diplomatura en Fisioterapia de la Universidad Miguel Hernández, Arturo García Verdejo y Jorge D. García Martínez, en la asignatura de Biomecánica.
En el vídeo mostramos los hallazgos encontrados en nuestra pieza de estudio, así como los distintos elementos que participan en la biomecánica del complejo articular del hombro. Esperamos os sean de utilidad. http://youtu.be/Dz8BmRRlMX8
Propionibacterium is commonly recovered from deep cultures obtained at the time of revision shoulder arthroplasty - even if the shoulder shows none of the characteristic clinical evidence of infection. The purpose of this study was to explore the origin ofPropionibacterium in surgical wounds and to seek an optimized strategy for culturing this organism at the time of revision surgery.
Part I: In 23 of 30 volunteers, cultures taken from unprepared epidermis over the deltopectoral incisional area grew Propionibacterium. Cultures from males were more positive than those from females (p<.002)
Part II: In 41 patients having revision shoulder arthroplasty, only 1 of the 20 females had any positive culture while 12 males had positive dermal cultures and 12 had positive deep cultures - these two positive findings were significantly associated (p .0001).
Part III: In the 74 shoulders with a Propionibacterium score>0.1, 372 cultures (average 5 per shoulder) were obtained of which 203 were positive. Cultures of component explants and soft tissues were positive in over half of the cases; fluid cultures were positive in only 40%. Anaerobic Brucella media were positive in 70%; aerobic and broth media were each positive in 52%. If only the Brucella media had been used, 30% of the 203 positive cultures would have been missed. The average time for the cultures to turn positive was 8.0 days +/- 4.7 days (range 1-25 days).
The chance of recovering Propionibacterium that are present in a surgical wound is optimized (95%) if (a) four different non-fluid specimens are obtained, (b) specimens are cultured on aerobic, anaerobic and broth media, and (c) the cultures are observed for a minimum of 17 days.
Association of suprascapular neuropathy with rotator cuff tendon tears and fatty degeneration.
Although the knowledge regarding diagnosis and treatment of suprascapular neuropathy (SSN) has increased dramatically over the last decade, the possible associations between the presence of rotator cuff injury, SSN and fatty degeneration of the rotator cuff muscles are not fully understood. It has been hypothesized in literature that large, retracted rotator cuff tears may contribute to SSN; on top of that, rotator cuff injury may cause fatty degeneration in the involved muscles. This study investigated the relationships between quality of the rotator cuff tendons, SSN and fatty degeneration.
When tendon pathology progresses from its initial stage of tendinopathy to a final full thickness tear with retraction, there is also a gradual increase in fatty degeneration. The incidence of SSN was higher in cases presenting more severe tendon pathology – this was especially the case for the infraspinatus muscle. Nevertheless, no significant association was present between SSN and fatty degeneration > From Shi et al., J Shoulder Elbow Surg 2013 (Epub ahead of print). All rights reserved to the Journal of Shoulder and Elbow Surgery Board of Trustees.
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Alleviating Shoulder Pain in Adults: Rotator Cuff Surgery is a Cost-Effective Treatment Option
For rotator cuff injuries, understanding treatment options and costs and benefits can help patients choose the right course to save money and continue to be active in their work and personal lives.
Just like 4.5 million Americans each year, Wesley Linton and Michaela “Pinky” Puno visited their doctors with extreme shoulder pain. However, today they are able to keep doing what they love, work and support their families. Linton, a firefighter in Winston Salem, North Carolina, can rescue victims from fires, complete 50 push-ups with no pain and lift patients needing assistance. Puno, an amateur ballroom dancer, can continue improving her technique, practice two hours a day and dance competitively. Both patients are able to live full lives thanks to the rotator cuff surgery they had to ease their shoulder pain.
In their cases, Linton and Puno required surgery to repair their rotator cuffs. However, many patients do not require surgery to alleviate their shoulder pain. The American Academy of Orthopaedic Surgeons recently released Appropriate Use Criteria (AUC) to help guide orthopaedic surgeons as they determine when a patient requires surgery. The AUC covers five different common treatments for rotator cuff injuries and helps clinicians identify when each type of treatment is appropriate.
Dr Michael Maguire is a Shoulder Surgeon at the Gold Coast who performs arthroscopic rotator cuff repair. Dr Maguire is an Orthopaedic Surgeon with subspecialty upper limb fellowship training. His surgical practice is exclusively shoulder and upper limb surgery. Dr Maguire also performs elbow arthroscopy, wrist arthroscopy and endoscopic carpal tunnel release surgery. Arthroscopic rotator cuff repair has many advantages over "open" rotator cuff surgery including less post-operative pain and morbidity. Usually only 3 or 4 tiny puncture wounds measuring about one cm each are required, thus minimizing scarring. The advantages of keyhole surgery for rotator cuff repair make it an attractive option compared to traditional open surgery. Arthroscopic rotator cuff repair can often be performed as a day case obviating the need to stay over-night in hospital. http://youtu.be/sDil6xpvoQ0
