TY - JOUR
T1 - Reliability of forced internal rotation and active internal rotation to assess lateral instability of the biceps pulley
AU - Arrigoni, Paolo
AU - Delle Rose, Giacomo
AU - D'Ambrosi, Riccardo
AU - Rotundo, Giorgio
AU - Campagna, Vincenzo
AU - Pirani, Piergiorgio
AU - Panascì, Manlio
AU - Petriccioli, Dario
AU - Bertone, Celeste
AU - Grasso, Andrea
AU - Latte, Carmine
AU - Costa, Alberto
AU - Viola, Gino
AU - De Giorgi, Silvana
AU - Panella, Antonello
AU - Padua, Roberto
AU - Beccarini, Alessandro
AU - Salcher, Barbara
AU - Olivieri, Matteo
AU - Mugnaini, Marco
AU - Pannone, Antonello
AU - Ceoldo, Chiara
AU - Longo, Umile Giuseppe
AU - Denaro, Vincenzo
AU - Cerciello, Simone
AU - Schiavone Panni, Alfredo
AU - Avanzi, Paolo
AU - Zorzi, Claudio
AU - Ragone, Vincenza
AU - Castagna, Alessandro
AU - Randelli, Pietro
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Purpose: the aim of this study was to investigate the relationship between positive painful forced internal rotation (FIR) and lateral pulley instability in the presence of a pre-diagnosed posterosuperior cuff tear. The same investigation was conducted for painful active internal rotation (AIR). Methods: a multicenter prospective study was conducted in a series of patients scheduled to undergo arthroscopic posterosuperior cuff repair. Pain was assessed using a visual analog scale (VAS) and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) was administered. The VAS score at rest, DASH score, and presence/absence of pain on FIR and AIR were recorded and their relationships with lesions of the lateral pulley, cuff tear patterns and shape of lesions were analyzed. Results: the study population consisted of 115 patients (mean age: 55.1 years) recruited from 12 centers. The dominant arm was affected in 72 cases (62.6%). The average anteroposterior extension of the lesion was 1.61 cm. The mean preoperative VAS and DASH scores were 6.1 and 41.8, respectively. FIR and AIR were positive in 94 (81.7%) and 85 (73.9%) cases, respectively. The lateral pulley was compromised in 50 cases (43.4%). Cuff tears were partial articular in 35 patients (30.4%), complete in 61 (53%), and partial bursal in 19 (16.5%). No statistical correlation between positive FIR or AIR and lateral pulley lesions was detected. Positive FIR and AIR were statistically associated with complete lesions. Negative FIR was associated with the presence of partial articular tears. Conclusions: painful FIR in the presence of a posterosuperior cuff tear does not indicate lateral pulley instability. When a cuff tear is suspected, positive FIR and AIR are suggestive of full-thickness tear patterns while a negative FIR suggests a partial articular lesion. Level of evidence: level I, validating cohort study with good reference standards.
AB - Purpose: the aim of this study was to investigate the relationship between positive painful forced internal rotation (FIR) and lateral pulley instability in the presence of a pre-diagnosed posterosuperior cuff tear. The same investigation was conducted for painful active internal rotation (AIR). Methods: a multicenter prospective study was conducted in a series of patients scheduled to undergo arthroscopic posterosuperior cuff repair. Pain was assessed using a visual analog scale (VAS) and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) was administered. The VAS score at rest, DASH score, and presence/absence of pain on FIR and AIR were recorded and their relationships with lesions of the lateral pulley, cuff tear patterns and shape of lesions were analyzed. Results: the study population consisted of 115 patients (mean age: 55.1 years) recruited from 12 centers. The dominant arm was affected in 72 cases (62.6%). The average anteroposterior extension of the lesion was 1.61 cm. The mean preoperative VAS and DASH scores were 6.1 and 41.8, respectively. FIR and AIR were positive in 94 (81.7%) and 85 (73.9%) cases, respectively. The lateral pulley was compromised in 50 cases (43.4%). Cuff tears were partial articular in 35 patients (30.4%), complete in 61 (53%), and partial bursal in 19 (16.5%). No statistical correlation between positive FIR or AIR and lateral pulley lesions was detected. Positive FIR and AIR were statistically associated with complete lesions. Negative FIR was associated with the presence of partial articular tears. Conclusions: painful FIR in the presence of a posterosuperior cuff tear does not indicate lateral pulley instability. When a cuff tear is suspected, positive FIR and AIR are suggestive of full-thickness tear patterns while a negative FIR suggests a partial articular lesion. Level of evidence: level I, validating cohort study with good reference standards.
KW - Biceps pulley
KW - Clinical test
KW - Diagnostic accuracy
KW - Internal rotation
KW - Shoulder arthroscopy
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U2 - 10.11138/jts/2015.3.1.020
DO - 10.11138/jts/2015.3.1.020
M3 - Article
AN - SCOPUS:84978958247
VL - 3
SP - 20
EP - 24
JO - Joints
JF - Joints
SN - 2282-4324
IS - 1
ER -