However, none of the previous studies have measured the position of the head relative to the glenoid in relation to the changes of intra-articular pressure.
We have observed that small variations in the alignment of the X-ray beam or in the position of the patient can result in substantial changes in the axis of the scapula.
Others have reported successful treatment with an appropriate rehabilitation program focusing on the rotator cuff muscles of patients with posterior shoulder instability.
Little attention was paid to the variations in the morphology and attachments at different regions of the glenoid rim.
Anterior acromioplasty has become the standard operation for patients whose chronic shoulder impingement resists conservative management.
There is unanimity of opinion that the best form of treatment is prevision.
There was a slight tendency with reference to the entire study group to overestimate the size of the small tears and to underestimate the size of the large or massive tear.
Recently, arthroscopic subacromial decompression has been advocated as an effective alternative to the open procedure.
Although the type of glenoid labral lesion could not be significantly correlated with the type of injury, there was a trend for posterior fray lesions to be caused by a repetitive type mechanism.
With respect to whether the injury occurred from a throwing or compressive type mechanism, 15 of 16 patients with posterior fray lesions reported their mechanism of injury occurred from an overhead or throwing type mechanism.
He reported his results in terms of labral location, with 55% of patients with superior lesions and 75% of patients with anterior-inferior lesions unable to return to their preinjury level of activity at two years follow-up.
They concluded that limited joint volume is of major important in maintaining glenohumeral joint stability.
They noted a low incidence of degenerative arthritis associated with recurrent posterior instability.
According to Jobe, the most sensitive means of eliciting occult anterior glenohumeral instability is the patient who has pain rather than apprehension during the classic apprehension test maneuver, which is relieved by the relocation test.
In vitro studies of fixation strength at the bone prosthesis interface by Fukuda indicated that the metal backed prosthesis exhibited superior fixation when compared with non-metal-backed designs.
This may be explained by the healing potential of the damaged capsule; but to the best of our knowledge this has not been evaluated in any reports in the literature.
結果の持つ価値や意味を考察する表現(レシピ②)
There are two possible explanations for this phenomenon.
The findings of this study have significant clinical implications.
The same trend also may be true in total shoulder replacement.
The relatively small surface area available for fixation and need for immediate secure fixation made it imperative to use cement.
Comparisons of findings in these unstable and normal shoulders may elicit differences that could improve conditioning and rehabilitation programs for patients who have an unstable shoulder.
Why tears develop in some people and not in others is best explained by the variations in shape and slope of the acromion.
It is thought to be related to subacromial impingement in two ways.
The tendency for the younger subjects to have more outward rotation but less inward rotation than the older subjects does seem noteworthy.
The results have led to changes in design and operative approach.
More than one factor in failure was present in almost every case.
Although special soft-tissue surgical technique and individualized post operative care are mandatory for optimum results, we think that an unconstrained implant of this type will permit better function and endure longer in the shoulder joint than an implant with a fixed fulcrum.
The necessity of an intact rotator cuff to provide a stable fulcrum in an unconstrained total shoulder replacement is demonstrated both clinically and radiologically.
Restoration of range of motion that allows independent performance of recreational activities and activities of daily living depend upon the patient's general health, the status of the rotator cuff, and surgical technique.
Improvement in the range of motion can be anticipated after total shoulder replacement, particularly in patient who have osteoarthritis.
The advantages of this method include the avoidance of intraoperative fragmentation while providing stable fixation.
This suggested that the apprehension relocation test may be associated with an undersurface cuff lesion and posterior superior labral tear, the "Kissing lesion."
Our study did not measure translations or absolute ranges of motion and these data should not be interpreted as negating the role of negative intraarticular pressure.
In addition, this paper should not be interpreted as a condemnation of the "classic" Bankart reconstruction because excellent results have been reported in the clinical literature.
Our results indicate that a smoking cesseation intervention program during the first six weeks after acute fracutre surgery decreased the risk of postoperative complications.
結果から疑問点・問題点,今後の展望を指摘する表現(レシピ③)
This finding prompts the question, what factors other than IAP contribute to inferior stability of the shoulder?
The questions naturally arises as to whether distal clavicle excision affects shoulder function.
There appeared to be two outstanding problems in this procedure: (1)...and (2)
We questioned how a patient with anterior instability but no capsular laxity could regain a full range of motion and normal function after an operation that shortens the capsule.
We have had too little experience with this technique to judge its merit.
The weakness of this study is the small number of cases with retrospective review.
Further investigation on EMG, muscle force and length of the deltoid and supraspinatus are needed to complete this discussion.
Further investigation is needed to completely elucidate these topics.
Additional, clinical studies are necessary to validate these experimental findings.
Well-disigned longitudinal clinical trials are needed to confirm the lthe findings of the present investigation in terms of quality of life after surgical treatment of intra-aritcular distal radial fractures.
The combination of air and dye renders interpretation difficult.
However, considering the anatomic and functional differences between the knee joint and shoulder joint, more specific and precise studies concerning shoulder stability were required.
A number of important consideration emerged, but foremost among these were the following recognition and beliefs: (1).........
Clearly, the outcome of arthroscopic treatment of a labral tear depends on the ability of the examiner to identify associated instability and, if present, treat it appropriately.
There is little doubt that the operation itself induced the hamstring rigidity which caused the contracture; but whether it acted as a catalyst leading to progression of the disease is unclear.
The surgeon should keep in mind the possibility of a postoperative loss of external rotation and follow an active rehabilitation protocol to obtain successful results.
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