PURPOSE: This study provides an insight on the extent of muscular variability at the suprascapular notch and elaborates on its anatomical interference in suprascapular nerve arthroscopic decompression procedures. METHODS: The suprascapular notch was dissected and its muscular topography was observed in 115 cadaveric specimens. High resolution imaging of the suprascapular notch was captured by a handheld digital microscope (Q-scope). The supraspinatus and subscapularis muscles were traced as they course at the suprascapular notch vicinity. The omohyoid muscle attachment onto the suprascapular ligament was measured. A scoping review and meta-analysis were done to investigate the observed rare muscular variants. RESULTS: In 3.48%, the suprascapular notch anterior surface was fully covered by the subscapularis muscle. The omohyoid muscle inserted onto the suprascapular ligament in 31.25% and extended up to 3/4th of the suprascapular ligament length in 2.61%. Two rare variant muscles were encountered: subclavius posticus muscle and a newly reported "coracoscapularis muscle". CONCLUSIONS: Four categories of muscles with topographical relationship to the suprascapular notch and its arthroscopic feasibility have been classified: (1) constant muscles not intervening with the suprascapular notch space - supraspinatus muscle; (2) constant muscles with variable positions that can intervene with the suprascapular notch space - subscapularis muscle; (3) constant muscles with variable positions that can intervene with the surgical approach - omohyoid muscle; (4) variable muscles intervening with the suprascapular notch space and surgical approach - subclavius posticus and coracoscapularis muscles. This study elucidates the necessity to assess/secure the omohyoid muscle attachment onto the suprascapular ligament in suprascapular nerve decompression ligamentectomy. LEVEL OF EVIDENCE: V Basic Science Research.

• MeSH
• Anatomic Variation * MeSH
• Arthroscopy * methods   MeSH
• Decompression, Surgical methods   MeSH
• Muscle, Skeletal * innervation   anatomy & histology   MeSH
• Middle Aged MeSH
• Humans MeSH
• Scapula innervation   anatomy & histology   MeSH
• Cadaver * MeSH
• Shoulder Joint innervation   surgery   anatomy & histology   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Feasibility Studies MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

PURPOSE OF THE STUDY: This study investigated the relationship between the position of the tip of the coracoid process (CP) relative to the glenoid with subscapularis (Ssc) tears. We hypothesized that the coracoid tip is more inferior, lateral and posterior in patients with Ssc tear. MATERIAL AND METHODS: This research enrolled 34 isolated Ssc tears and 44 controls. We introduced the axial central glenoid-coracoid angle (acGCA) and sagittal central glenoid-coracoid angle (scGCA) to evaluate the position of the tip of the CP relative to the glenoid center on MRI images. In both groups, acGCA, scGCA on MRI and critical shoulder angle (CSA), glenoid inclination (GI) on true anterior-posterior shoulder radiography were evaluated. RESULTS: When both groups were compared in terms of acGCA, the acGCA values of the Ssc tear group were significantly higher than the control group (p<0.001). The best cut-off value of acGCA for Ssc tears was 28.3°. acGCA values higher than 28.3° showed 93.3% sensitivity and 93.1% specificity for Ssc tears (likelihood ratio:13.53, AUC: 0.979, 95% CI of AUC: 0.950- 0.999). In terms of acGCA, the power analysis between Ssc tears group and control group was 99.9% between Ssc tears and the control group (effect size d=2.63). When both groups were compared in terms of scGCA, the scGCA values of the Ssc tear group were significantly higher than the control group (p<0.001). The best cut-off value of scGCA for Ssc tears was 41.4°. Scores of scGCA greater than 41.8° showed 80% sensitivity and 89.7% specificity for Ssc tears (likelihood ratio: 7.73, AUC: 0.899 95% CI of AUC: 0.837-0.958). In terms of scGCA, the power analysis between Ssc tear and control group was 99.8% (effect size d=1.23). When both groups were compared in terms of CSA and GI; CSA and GI values in the Ssc tear group were significantly higher (p<0.001 and p<0.012, respectively). CONCLUSIONS: AcGCA values higher than 28.3° indicate that the coracoid tip is located more laterally and posteriorly; scGCA values higher than 41.8° indicate that the coracoid tip is located more inferiorly and these two new indexes are showing that more laterally, posteriorly and inferiorly coracoid tip is related to subscapularis tears. KEY WORDS: coracoid process, subscapularis tear, coracoid morphology, scapula morphology.

• MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging * methods   MeSH
• Rotator Cuff Injuries * diagnostic imaging   MeSH
• Coracoid Process * injuries   diagnostic imaging   MeSH
• Shoulder Joint diagnostic imaging   MeSH
• Sensitivity and Specificity MeSH
• Case-Control Studies MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

PURPOSE OF THE STUDY: In this study, we aimed to evaluate acromiohumeral distance (AHD) and supraspinatus tendon (ST) thickness measurements and their relationship with pain and function in ST pathologies. MATERIAL AND METHODS: The study included 111 patients and 25 healthy controls (HC). Patients were divided into 3 groups according to their diagnosis: non-tear tendinopathy (NTT), partial thickness tear (PTT), and full thickness tear (FTT). The AHD and ST thickness of the participants were measured with ultrasound. The pain and functional status of the patients were evaluated with the Numeric Rating Scale (NRS), The QuickDASH shortened version of the DASH Outcome Measure - Disabilities of the Arm Shoulder and Hand (QDASH), and Simple Shoulder Test (SST). RESULTS: The AHD value was significantly higher in the NTT group (p=0.000). The AHD value was significantly lower in the FTT group (p=0.000). ST thickness value was significantly lower in the PTT group compared to the NTT group (p=0.000). There was a positive correlation between ST thickness and BMI (r=0.553,p<0.01). There was a negative correlation between ST thickness and SST and a positive correlation between ST thickness (r=-0.223,p<0.05) and QDASH (r=0.276,p<0.05). CONCLUSIONS: We found that AHD and SST thicknesses significantly differed in the NTT, PTT, FTT, and HC groups. This difference may be important for diagnosis. In addition, the effect of obesity on ST thickness and the relationship between ST thickness and functional scores may be considered. Weight control may be effective at this point. KEY WORDS: acromiohumeral distance, supraspinatus tendon thickness, ultrasound.

• MeSH
• Acromion diagnostic imaging   MeSH
• Shoulder Pain etiology   diagnostic imaging   physiopathology   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Pain Measurement methods   MeSH
• Rotator Cuff Injuries * diagnostic imaging   physiopathology   MeSH
• Rotator Cuff * diagnostic imaging   physiopathology   MeSH
• Case-Control Studies MeSH
• Tendinopathy diagnostic imaging   physiopathology   MeSH
• Ultrasonography * methods   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

• Keywords
• ChondroGrid,
• MeSH
• Injections, Intra-Articular methods   MeSH
• Clinical Studies as Topic MeSH
• Collagen * administration & dosage   pharmacology   therapeutic use   MeSH
• Humans MeSH
• Rotator Cuff * physiopathology   MeSH
• Tendinopathy * etiology   drug therapy   pathology   MeSH
• Treatment Outcome MeSH
• Check Tag
• Humans MeSH
• Geographicals
• Italy MeSH

Publikace se zaměřuje na masáž a fyzickou terapii nemocí muskuloskeletárního systému. Určeno odborné veřejnosti.; Monografie určená osobám provádějícím masáže obsahuje popis pohybového aparátu, cév, nervů a kůže s následným funkčním výkladem.

• MeSH
• Anatomy MeSH
• Massage MeSH
• Musculoskeletal Manipulations MeSH
• Musculoskeletal Diseases rehabilitation   MeSH
• Publication type
• Monograph MeSH

• Conspectus
• Fyzioterapie. Psychoterapie. Alternativní lékařství
• NML Fields
• rehabilitační a fyzikální medicína
• ortopedie

• MeSH
• Arthroscopy methods   rehabilitation   MeSH
• Humans MeSH
• Musculoskeletal Manipulations methods   MeSH
• Recovery of Function MeSH
• Postoperative Complications prevention & control   MeSH
• Postoperative Care MeSH
• Shoulder Joint surgery   physiopathology   MeSH
• Rotator Cuff physiopathology   MeSH
• Range of Motion, Articular physiology   MeSH
• Shoulder Impingement Syndrome * surgery   diagnosis   rehabilitation   MeSH
• Physical Therapy Modalities * MeSH
• Exercise Therapy MeSH
• Enhanced Recovery After Surgery MeSH
• Check Tag
• Humans MeSH

OBJECTIVES: To investigate the anatomical feasibility of the infraspinatus branch of the suprascapular nerve (IB-SSN) reconstruction by lower subscapular nerve (LSN) transfer. METHODS: The morphological study was performed on 18 adult human cadavers. The length of the distal stump of the IB-SSN, the length of the LSN available for reconstruction and diameter of both stumps were measured. The feasibility study of the LSN to IB-SSN transfer was performed. RESULTS: The mean length of the IB-SSN to the end of its first branch was 40.9 mm (±4.6). Its mean diameter was 2.3 mm (±0.3). The mean length of the LSN stump, which was mobilized from its original course and transferred to reach the distal stump of the IB-SSN was 66.5 mm (±11.8). Its mean diameter was 2.1 mm (±0.3). The mean ratio between LSN and IB-SSN diameters was 0.9 (±0.1). The nerve transfer was feasible in 17 out of 18 cases (94.4%). CONCLUSION: This study demonstrates that direct LSN to IB-SSN transfer is anatomically feasible in most cases in the adult population. It may be used in cases of complex scapular fractures resulting in severe suprascapular nerve injury.

• MeSH
• Adult MeSH
• Humans MeSH
• Nerve Transfer * methods   MeSH
• Brachial Plexus * surgery   MeSH
• Nerve Regeneration physiology   MeSH
• Rotator Cuff MeSH
• Feasibility Studies MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: LAMA2-related muscular dystrophy (LAMA2-RD) encompasses a group of recessive muscular dystrophies caused by mutations in the LAMA2 gene, which codes for the alpha-2 chain of laminin-211 (merosin). Diagnosis is straightforward in the classic congenital presentation with no ambulation and complete merosin deficiency in muscle biopsy, but is far more difficult in milder ambulant individuals with partial merosin deficiency. OBJECTIVE: To investigate the diagnostic utility of muscle imaging in LAMA2-RD using whole-body magnetic resonance imaging (WBMRI). RESULTS: 27 patients (2-62 years, 21-80% with acquisition of walking ability and 6 never ambulant) were included in an international collaborative study. All carried two pathogenic mutations, mostly private missense changes. An intronic variant (c.909 + 7A > G) was identified in all the Chilean cases. Three patients (two ambulant) showed intellectual disability, epilepsy, and brain structural abnormalities. WBMRI T1w sequences or T2 fat-saturated images (Dixon) revealed abnormal muscle fat replacement predominantly in subscapularis, lumbar paraspinals, gluteus minimus and medius, posterior thigh (adductor magnus, biceps femoris, hamstrings) and soleus. This involvement pattern was consistent for both ambulant and non-ambulant patients. The degree of replacement was predominantly correlated to the disease duration, rather than to the onset or the clinical severity. A "COL6-like sandwich sign" was observed in several muscles in ambulant adults, but different involvement of subscapularis, gluteus minimus, and medius changes allowed distinguishing LAMA2-RD from collagenopathies. The thigh muscles seem to be the best ones to assess disease progression. CONCLUSION: WBMRI in LAMA2-RD shows a homogeneous pattern of brain and muscle imaging, representing a supportive diagnostic tool.

• MeSH
• Whole Body Imaging MeSH
• Adult MeSH
• Muscle, Skeletal diagnostic imaging   pathology   MeSH
• Laminin genetics   MeSH
• Humans MeSH
• Magnetic Resonance Imaging * methods   MeSH
• Muscular Dystrophies * congenital   diagnostic imaging   genetics   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Publication type
• Journal Article MeSH

Vysokoškolská učebnice, která se zaměřuje na obecnou kineziologii.; Text se zabývá kineziologickými vztahy, popisem jejich problematiky a popisem nejdůležitějších svalových skupin, které hrají podstatnou roli při vzniku strukturálních poruch pohybového aparátu.

• MeSH
• Kinesiology, Applied MeSH
• Motor Disorders MeSH
• Motor Activity MeSH

• Conspectus
• Fyziologie člověka a srovnávací fyziologie
• Učební osnovy. Vyučovací předměty. Učebnice
• NML Fields
• fyziologie
• rehabilitační a fyzikální medicína
• NML Publication type
• učebnice vysokých škol

PURPOSE OF THE STUDY To present the technique, learning curve, complications, postoperative pain levels and cost-effectiveness analysis of 24 patients with symptomatic rotator cuff tear operated with Drillbone Tunneler - a novel transosseous suture-passing device designed for arthroscopic use. MATERIAL AND METHODS Between February and May 2021, 24 patients underwent arthroscopic transosseous rotator cuff repair. During the study, the time spent preparing the tunnels was recorded along with the occurrence of complications during the operation. Price calculation of the delivered transosseous cuff repair and an alternative procedure with suture anchors was made. During the postoperative period, the patients rated their pain (on the VAS scale) twice a day, in the morning and in the evening, for 4 weeks, based on which the average values per each week were calculated. RESULTS The average time it took to prepare the tunnels and pull through the sutures was 6.2 minutes. In one case it was impossible to pull the shuttle loop through and that is why during the surgery arthroscopic transosseous-equivalent repair using suture anchors was performed instead. Apart from this, no other complications occurred. The patients reported rapid reduction of postoperative pain during the second and third week after surgery. The cost price analysis proved an average saving of CZK 9.463 per procedure. DISCUSSION There is a growing body of evidence that arthroscopic transosseous rotator cuff repairs achieve equivalent clinical outcomes as suture anchor repairs or even better clinical outcomes. These techniques are safe and effective; there is an earlier reduction of postoperative pain. Healing is more biological due to better vascularity, larger footprint coverage and clinically optimal biomechanical strength. Moreover, these techniques significantly save costs and meet requirements of the upcoming era of value-based surgery. CONCLUSIONS In our cohort, a favourable learning curve and minimum occurrence of complications were established. The study confirmed the data published so far on early relief of postoperative pain. We also proved that significant saving of costs of the materials used was achieved. Key words: arthroscopic transosseous rotator cuff repair, suture anchor, postoperative pain, cost-benefit analysis, Drillbone Tunneler.

• MeSH
• Arthroscopy adverse effects   methods   MeSH
• Humans MeSH
• Pain, Postoperative surgery   MeSH
• Rotator Cuff Injuries * surgery   MeSH
• Rotator Cuff * surgery   MeSH
• Suture Techniques MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH