Role of shoulder gradient in the pathogenesis of rotator cuff tears

BACKGROUND Shoulder gradient has been associated with shoulder pathologies such as shoulder impingement syndrome.AIM To investigate if there is an association between shoulder gradient and incidence of rotator cuff tear(RCT).METHODS A total of 61 patients with a confirmed diagnosis of RCT were included in this retrospective study.The anteroposterior radiograph of the shoulder was used to measure shoulder gradient in adduction and neutral rotation positions.The pain level was assessed with the visual analog scale for pain.RESULTS The mean age of the patients was 55.7±12.3 years.The mean visual analog scale of the patients was 4.1±1.2.The mean shoulder gradient was 14.11 ±2.65 for the affected shoulder and 15.8 ±2.2 for the unaffected shoulders.This difference was not statistically significant(P=0.41).A difference of 1.15 ±1.82 was found between the injured and non-injured shoulder.No significant association was found between the gradient difference of the shoulder and demographic and clinical characteristics of the patients.CONCLUSION Shoulder gradient is not associated with the pathology of RCT.Yet,future studies with more standardization and a larger sample size are needed to investigate the role of shoulder gradient in RCT pathogenesis further.

Analysis of electrocautery smoke released from the tissues frequently cut in orthopedic surgeries

BACKGROUND Electrosurgical smoke could be different by the device of cutting or the type of tissue that is being cut.AIM To analyze the electrocautery smoke released from the tissues that are frequently cut in orthopedic surgeries.METHODS The released smoke from electrocautery of five different tissue types(meniscus,ligament,adipose,muscle,and synovium)of five patients who underwent total knee arthroplasty were collected and analyzed for volatile organic compounds(VOCs)and 27 candidate polycyclic aromatic hydrocarbons(n=25).Surgical smoke was produced with an electrocautery device for 4 min.RESULTS None of the 27 evaluated polycyclic aromatic hydrocarbons compounds were detectable in electrocautery smoke collected from the surgical cutting of the different tissues.The number and identity of detected VOCs were similar between the patients but not between tissue types.The number of detected VOCs was the highest in synovial tissue(n=21)and the lowest in the meniscus and adipose tissue(n=12).The number of toxic and/or carcinogenic VOCs were the most in the muscle and meniscus tissues(Toluene,Ethylbenzene,and Styrene).No toxic and/or carcinogenic VOCs were identified in the ligament and adipose tissue.CONCLUSION Meniscus and muscle tissue are associated with the highest number of toxic and/or carcinogenic VOCs.Therefore,we recommend that surgeons avoiding the electrocautery of these tissues.