Returning to golf after rotator cuff repair.

Background: The prevalence of rotator cuff repair is increasing; however, no study has assessed patients who have returned to golf activity after arthroscopic rotator cuff repair. Methods: The subjects of the survey were 633 patients who were at least two years postoperative after rotator cuff repair from January 2005 to December 2017. From August 2019 to October 2019, survey responses were collected via an online questionnaire or phone calls and a total of 197 patients were reviewed retrospectively to study about returning to golf after rotator cuff repair. The detailed survey included 12 questions specific to the patient's golf career, performance, time of return to play, and symptoms related to golf activity. Depending on the size of the rotator cuff tear, each question was statistically analyzed to determine whether there were differences in the time of return to golf, uncomfortable symptoms when golfing, and distance of the driving. Results: Of the 197 patients who underwent arthroscopic rotator cuff repair, there were 145 patients (73.6%) returned to golf. In the analysis results of 145 patients, the longer the golf career, the greater the chance of returning to golf. Sixty (30.5%) people returned to golf at 1 year after surgery. Twenty-one patients (10.7%) improved and 46 patients (23.4%) maintained their driving distance, whereas 78 patients (39.6%) had a worse driving distance after surgery. Ten patients (5.1%) improved and 97 patients (49.2%) maintained their golf score, but 38 patients (19.3%) had worse golf scores after surgery. Symptoms when playing golf were reported in the order of no symptoms (62.1%), a limited range of motion (13.1%), muscle weakness (11.1%), and anxious about their operated shoulder (10.3 %). Men were 6.9 times more likely to return to golf than women (odds ratio, 6.9; 95% confidence interval, 3.2-14.8). The younger the age and the shorter the time since surgery, the higher the golfing return rate. The rate of returning to golf was high in the group of patients with good tissue quality during surgery (odds ratio, 3.9; 95% confidence interval, 0.01-2.6). Conclusion: The golfing return rate after arthroscopic rotator cuff repair was higher than expected (73.6%) and most players returned at 1 year after surgery. Especially, in the case of young males, their golf scores were maintained or improved and they were able to return to golf earlier after surgery. Better tissue quality in the intraoperative torn tendon was associated with a greater chance of returning to golf.

The full-length mitochondrial genome of the Fernholm's hagfish, Myxine fernholmi (Myxini; Myxiniformes; Myxinidae).

The full-length mitochondrial genome of the Fernholm's hagfish, Myxine fernholmi (Myxini; Myxiniformes; Myxinidae) was analyzed by the primer walking method. Its mitogenome was 18,862 bp in total length and was composed of 13 protein-coding genes, two ribosomal RNA genes, and 22 transfer RNA genes. The gene content and order were congruent with those of typical vertebrates. In the phylogenetic tree, M. fernholmi showed the closest relationship to M. glutinosa in the same genus and subfamily and well separated from the other hagfish in the subfamily Eptatretinae.

The full-length mitochondrial genome of Cobitis nalbanti (Teleostei: Cypriniformes: Cobitidae).

The entire mitochondrial genome of Cobitis nalbanti (Teleostei: Cypriniformes: Cobitidae) was analyzed using the primer walking method. The mitogenome was 16,631 bp in length, comprising 13 protein-coding genes, 2 ribosomal RNA genes, and 22 transfer RNA genes. Its gene order was congruent with those of typical vertebrates. In the phylogenetic tree, C. nalbanti was clearly separated from C. lutheri, which supported the recent taxonomic revision.

Prospective evaluation of the effectiveness of a home-based program of isometric strengthening exercises: 12-month follow-up.

BACKGROUND: The aim of this prospective randomized clinical trial was to investigate the efficacy of a home-based program of isometric strengthening exercises for the treatment of the lateral epicondylitis (LE) of the distal humerus. We hypothesized that 1) use of isometric strengthening exercises would result in clinical benefits similar to those provided by medication and pain relief and 2) functional improvements after exercise would be time-dependent. METHODS: Patients were assigned to one of two groups: 1) an immediate physical therapy group (group I), or 2) a delayed physical therapy group (group D). Group I patients (n = 16) were instructed how to do the exercises at their first clinic visit and immediately carried out the exercise program. Group D patients (n = 15) learned and did the exercises after being on medications for 4 weeks. RESULTS: Outcomes at the 1-month clinic visit indicated that pain (measured using a visual analogue scale [VAS]) had been significantly reduced in group I compared to group D (p < 0.01). However, significant differences between groups were not found at 3-, 6-, and 12-month follow-up for either VAS scores or Mayo elbow performance scores. For modified Nirschl/Pettrone scores, a significant difference between groups was found only at the 1-month follow-up visit. By then, the number of participants who returned to all activities with no pain or occasional mild pain was six (37%) in Group I and two (13%) in Group D (p = 0.031). At the final follow-up visit, 88% of all participants performed physical activities without pain. CONCLUSIONS: Isometric strengthening exercises done early in the course of LE (within 4 weeks) provides a clinically significant improvement.

Perianchor radiolucency after knotless anchor repair for shoulder instability: correlation with clinical results of 69 cases.

BACKGROUND: Although there would seem to be a logical relationship between radiolucency around the suture anchor and clinical result in Bankart repair, the correlation has not been demonstrated so far. HYPOTHESIS: Knotless suture anchor is a viable alternative for arthroscopic Bankart repair, but postoperative radiologic findings of radiolucency around anchors are correlated with poor clinical results. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Sixty-nine consecutive patients with Bankart lesions were treated with arthroscopic reconstruction using knotless metal suture anchors. The mean follow-up was 40 months. Clinical and radiologic analysis was performed retrospectively. A new concept of perianchor radiolucency was introduced and, according to this radiologic finding, patients were divided into 2 subgroups: the perianchor radiolucency group and those who did not reveal perianchor radiolucency. The perianchor radiolucency group was further subdivided by shape and location. "Root type" was defined as a radiolucent halo at the root of the anchor, and perianchor radiolucency without any root halo was named "branch type." Location of perianchor radiolucency was described as above or below the equator of the glenoid. RESULTS: After operation, the mean Rowe score increased to 93.8 from 43.1, and computed tomography arthrogram showed a 97% healing rate. Reoperations were performed due to 1 case of redislocation and 2 cases of anchor arthropathy. All these reoperated cases revealed perianchor radiolucency before reoperation. Other than reoperated cases, 2 patients showed apprehension at final evaluation. The perianchor radiolucency group had a significantly lower Rowe scores than the group that showed no perianchor radiolucency. Some of the patients in the perianchor radiolucency group had peculiar radiologic findings frequently associated with complications. The radiologic findings that consisted of root-type perianchor radiolucency located below the equator of the glenoid was termed the "ominous sign." Osteophytes of the humeral head together with the ominous sign is considered a warning sign of forthcoming progression of anchor arthropathy, and the authors suggest early surgical intervention with these findings. CONCLUSION: After Bankart repair using knotless suture anchor, the ominous sign might be an important warning sign for possible forthcoming complications including redislocation, anchor arthropathy, and residual instability.

Comparison of the clinical outcomes of single- and double-row repairs in rotator cuff tears.

BACKGROUND: Although research has demonstrated the superiority of double-row rotator cuff repair over single-row methods from a biological and mechanical point of view, few studies have compared clinical outcome of the 2 methods, and no articles have been published describing the superiority of double-row methods in clinical aspects. HYPOTHESIS: Arthroscopic double-row repair of a rotator cuff tear has superior clinical outcome to single-row repair. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: The study included 78 patients operated on for full-thickness rotator cuff tears between May 2002 and May 2004. A single-row fixation method was used in the first consecutive 40 patients, and a double-row fixation method was used in the next consecutive 38 patients. The mean age at surgery was 56 years. At 2 years after surgery, final evaluation was done with American Shoulder and Elbow Surgeons and Constant scoring systems and the Shoulder Strength Index. The Shoulder Strength Index is a new evaluation method to estimate relative shoulder strength compared with the unaffected shoulder. RESULTS: At final follow-up, the average American Shoulder and Elbow Surgeons scores were 91.6 in the single-row group and 93.0 in the double-row group. The Constant score was 76.7 in the single-row group and 80.0 in the double-row group. Functional outcome was improved in both groups after surgery, but there was no significant difference between the 2 groups. When the patients were further divided by size of tear, there was still no difference between the repair techniques in the patients with small to medium (<3 cm) tears. However, in patients with large to massive tears (>3 cm), the American Shoulder and Elbow Surgeons and Constant scores and Shoulder Strength Index were all significantly better in the group that had double-row repair. CONCLUSION: Small to medium rotator cuff tears should be repaired with the single-row method, and large to massive tears should be repaired with the double-row method.

A vector for purification-free cloning of polymerase chain reaction products.

Conventional cloning requires the purification of restriction-enzyme-digested vectors prior to the ligation reaction. The purification often involves the separation of restriction fragments via electrophoresis, the cutting out of a piece of gel, and the gel extraction of the linearized vector. In addition to the loss of significant amounts of DNA, reduced cloning efficiency, time, and cost, these steps are also mutagenic to DNA and hazardous to humans. We developed a purification-free cloning vector pGT3 with a bright green fluorescent protein indicator that is suitable for TA cloning of polymerase chain reaction (PCR) products. PCR products were cloned into pGT3 efficiently without the gel purification steps.