Week 1: Quiz 3 Flashcards
What are the norms for ROM in the shoulder?
PART A: Flexion ROM: 0-180˚
PART B:Abduction ROM: 0-180˚
PART C: Extension ROM : 0-60˚
PART D:Internal Rotation ROM : 0-45˚ isolated, 70˚ composite
PART E:External Rotation ROM: 0-90˚
Epidemiological factors for RTC repair and rehab
Part A- what is the important indicator?
Size of the tear
Epidemiological factors for RTC repair and rehab
Part A: Top three (best predictor for outcomes)
- Size of the tear
- Quality of tissue
- FIbro-fatty inlfiltration of muscle
Epidemiological factors for RTC repair and rehab
Part C: what size tear has better prognosis?
smaller, the better
Epidemiological factors for RTC repair and rehab
Quality of tissue:
Part D: List two factors affecting quality
- Age
- Smoking
- Activity level
Epidemiological factors for RTC repair and rehab
Part E: name 2 others factors besides the top three (if he asks for a Part E)
(there are 7)
- Type of surgical approach (open vs mini-open vs arthroscopic)
- Status of deltoid
- Open detaches deltoid, mini-open splits deltoid
- Ability to mobilize tissue
- Type of fixation (bony vs soft tissue)
- Safe ROM achieved at surgery
- Secondary surgical procedures (comorbidities)
- Degree of post-op immobilization (wedge vs. sling)
What are the stages of fibro-fatty infiltration?
- Stage 0: normal muscle
- Stage 1: muscle containing some fatty streaks
- Stage 2: manifest fatty infiltration but less fat than muscle
- Stage 3: same amount of fat as muscle
- Stage 4: more fat than muscle
Is fibro-fatty infiltration reversible or irreversible?
Irreversable
What is the staging system for fibro fatty infiltration called?
Goutallier staging system
PART A: What are the different types of RTC fixations (3 most common)?
and briefly describe each?
- Single Row Suture Anchors
- Sutures in tendon connecting to anchors in the bone
- Double Row Suture Anchors
- Anchors through the tendon and anchors in the bone; sutures to connect the double set of anchors
- Transosseous Sutures
- Anchors driven diagonally from the superior facet of the greater tuberosity through to the lateral side of the humeral head
- Sutures run through the “bone tunnel”
PART B: What is the gold standard for RTC fixations?
(name and brief description)
Double Row Suture Bridge Technique
- Suture bridging is a criss cross of the sutures instead of straight
What is the ultimate goal of RTC fixations?
(include quantitative information in your answer)
Footprint restoration (percentage of original footprint)
- Single Row: 47%
- Transosseous: 71%
- Double Row: 100%
Why do patients with re-tears still not feel as bad as they did before the surgery?
(2 things)
- Surgeon cleans out all the “bad stuff” in the sub-acromial space during repair
- Partial integrity of a tear is better than a full thickness tear
What are the different types of surgical approaches for RTC repairs?
(include relevant summaries)
- Open
- Anterior deltoid is completely detached (BAD) from the anterior acromion
- Mini-open
- Deltoid is split
- Arthroscopy
Difference between adhesive capsulitis and selective hypomobility
PART A: what part of the capsule does adhesive capsulitis or selective hypomobility involve?
Adhesive capsulitis is global; selective hypomobility is isolated