Functional results and return to sports on recurrent anterior glenohumeral instability. Influence of the COVID-19 pandemic; Comparative retrospective study and short-term results.

AIMS: Our objective is to compare the functional results in patients that underwent surgery for recurrent anterior shoulder instability (RAGHI) during the COVID-19 pandemic with remotely-based rehabilitation, to those who had surgery before the pandemic and had in-person rehabilitation therapy. METHODS: A retrospective case series of 68 patients were included and divided into two groups: In person-group and Home-based group. Western Ontario Shoulder Instability Index (WOSI) and Subjective Shoulder Value (SSV) scores were used to evaluate objective and subjective clinical parameters. Time and level of return to sports was studied by the Subjective Patient Outcome for Return to Sports (SPORTS) score. RESULTS: The mean SSV score was 82% (40-100) on the In-Person group compared with 87% (65-100) for the Home-Based group. Results for WOSI score were similar, with an average of 210.42 (90%) for In-Person and 261.45 (88%) for the Home-Based group (p 0.12). Return to sports was carried out in an average of 6.6 (4-16) months for In-Person group, compared to 6.5 (5-8) months for Home-Based. CONCLUSION: Follow-up and rehabilitation methods for patients who underwent surgery for RAGHI, during COVID-19 lockdown, were not significantly (p 0.12) affected on functional and athletic return in comparison to traditional methods according to WOSI scale. LEVEL OF EVIDENCE: IV Retrospective series of cases.

Treatment Protocol for Rotator Cuff Calcific Tendinitis Using a Single-Crystal Piezoelectric Focused Shock Wave Source.

Focused shock waves have emerged as a highly effective noninvasive therapeutic option for the treatment of calcific tendinitis of the shoulder. There are three types of focused shock wave generators: electrohydraulic, electromagnetic, and piezoelectric. According to our literature search, there are no reports of results with the use of single-crystal piezoelectric generators in calcific tendinitis of the shoulder. In a consecutive retrospective series of 23 patients with Gärtner type I and II calcifications of the rotator cuff, we performed three applications of high-energy piezoelectric focused waves (4,000 pulses per session with a frequency of 6 Hz). At the final follow-up (average of 14 months), 82.6% of the cases showed complete resorption of the calcification in radiographic controls. In 8.7% of the cases, partial disappearance of the calcification was achieved, and in the remaining 8.7% there were no significant changes. Single-crystal piezoelectric generators have a success rate comparable to those already reported with electrohydraulic and electromagnetic devices.

Síndrome de fricción femoroacetabular: tratamiento artroscópico. Resultados a mediano plazo, complicaciones y fallas / Femoroacetabular friction syndrome: arthroscopic treatment. Middle-term results, complications and failures

El éxito de la artroscopía de cadera en el tratamiento del síndrome de fricción femoroacetabular (SFFA) ha sido reportado por múltiples autores. Sus indicaciones se han ido extendiendo, provocando un incremento sustancial en el número de complicaciones. El propósito de este estudio fue evaluar retrospectivamente los resultados clínicos-radiológicos de la artroscopía de cadera en pacientes adultos con diagnóstico de SFFA, haciendo énfasis en las complicaciones y en las causas de falla.Se analizaron pacientes con un seguimiento mínimo de tres años. Se clasificó la severidad del desgaste articular y daño condral con la escala de Tönnis y Outerbridge, respectivamente.Se utilizaron los scores de Harris Hip (HHS) y de Resultados de Cadera (HOS, por sus siglas en inglés). La evaluación subjetiva fue medida a través de la Escala Visual Análoga del dolor (EVA). La serie quedó conformada por ciento catorce pacientes: cincuenta y seis (49%) de sexo masculino y cincuenta y ocho de sexo femenino con una edad promedio de 42.5 (17 ­ 59). El score de Harris registró un incremento significativo luego de la cirugía (71.06 ± 5.68 versus 87.11 ± 5.89; p<0.05). El score subjetivo de EVA demostró un descenso estadísticamente significativo (6.55 ± 1.27 versus 1.84 ± 1.42; p<0.05). El HOS evidenció valores de 91 y 87.8% con respecto a las actividades de la vida diaria y al deporte. Hubo ocho complicaciones menores (7.01%) y tres conversiones a artroplastia (2.63%).La artroscopía de cadera constituye una herramienta efectiva como técnica de preservación articular, con índices de satisfacción cercanos al 90%. Nivel de Evidencia: IV

Hip arthroscopy success for treatment of Femoro-Acetabular Impingement (FAI) has been well reported over the past decade.The indications of this procedure have increased over the past years, as well as complications. The purpose of this study was to assess of clinical-radiological outcomes of hip arthroscopy in adults over 50 years old with FAI, and their complications. We evaluated patients with a minimum of 3-years follow up. The presence of Pincer and/or CAM deformity was registered by analyzing anteroposterior and lateral x-rays. Articular and chondral damage severity was assessed with Tönnis and Outerbridge classifications, respectively. Objective analysis was performed using Harris Hip Score (HHS) and Hip Outcome Score (HOS). Subjective evaluation was made using Visual Analogue Pain Scale (VAS). Our study included one hundred fourteen patients: fifty-six (49%) was male and fifty-eight (51%) females with a mean of 42.5 years. We observed significant increase in HHS after surgery (71.06 ± 5.68 versus 87.11 ± 5.89; p<0.05). VAS demonstrated a statistically significant decrease (6.55 ± 1.27 versus 1.84 ± 1.42; p<0.05). HOS score yielded values of 91% for daily living activities and 87.8% for sports. We observed three patients that required conversion to total hip arthroplasty (2.64%).Hip Arthroscopy is a highly effective tool as joint preservation technique, being able to achieve rates up to 90%, both for daily living activities and sports, after surgery. Level of Evidence: IV