There is an association between SLAP lesions and laxity of the shoulder. The relationship between rotator cuff disease and hypermobility has also been implied. The purpose of this case-control study was to assess the impact of rotator cuff and superior labral pathologies on degree of glenohumeral translation and range of motion of the shoulder in comparison with individuals with normal shoulders.

This study involved individuals with asymptomatic shoulders (control group), and individuals with Rotator Cuff (RC) and Superior Labral Anterior and Posterior (SLAP) pathologies who underwent a repair. Subjects were matched by age, gender and hand dominance side. To assess laxity, all subjects including the control group were examined under anesthesia. The degree of humeral head translation was recorded in three (anterior, posterior and inferior) directions. Range of motion was documented in five directions.

Forty-six females and forty-four males with RC pathology and twenty-seven men with SLAP pathology were compared with the age and gender matched control group. The number of women with SLAP pathology was not sufficient for analysis. Rotator cuff pathology reduced range of motion of the affected side in all directions including flexion, elevation in scapular plane, internal rotation at ninety degrees of abduction and external rotation at zero and ninety degrees of abduction (p=0.02 to p< 0.001) as compared to normal population. Men with SLAP pathology had reduced range of motion in all directions (p< 0.001) except external rotation at ninety degrees of abduction. There were no statistically significant differences in glenohumeral glides between the normal group and SLAP group. However, the affected side of the patients with RC pathology had less laxity than normal population in anterior and posterior directions.

Presence of rotator cuff and superior labral pathologies affect biomechanics and consequently range of motion and accessory movements of the glenohumeral joint. We were unable to confirm a positive relationship between laxity and SLAP and RC pathologies. Prolonged disuse of the shoulder in these pathologies might have played a role in our findings.

Purpose: The purpose of this historical prospective study was to compare the pre and post-operative range of motion (ROM) and quality of life outcomes 6 months post-operatively in patients with partial and full-thickness tears of the rotator cuff.

Methods: Data of 90 consecutive patients diagnosed with partial thickness tear (PTT) who had undergone decompression and or acromiploasty were compared with 90 patients (age and gender-matched) who had undergone repair of a full-thickness tear (FTT). The outcomes were objective pre and post-operative range of motion (ROM) in 5 directions and three patient-derived outcome measures; one disease-specific, the Western Ontario Rotator Cuff Index, and two shoulder specific measures: the American Shoulder & Elbow Surgeons standardized shoulder assessment form and, the Constant-Murley. A statistical paired t-test analysis was conducted between change (pre vs. 6 months) in ROM and QOL scores to examine the impact of severity on improvement between the 2 groups.

Results: Forty-three females and 47 males in each group (180 subjects in total) were included in the analysis. The mean age was 54.8 and 54.9 for the PTT and FTT groups respectively. The PTT group was significantly stiffer in pre-operative passive flexion (p=0.010), abduction (p=0.022) and active external rotation at 0 degree of abduction (p=0.040). The 6-month WORC, ASES, and relative Constant all showed significant improvement in quality of life in both groups (p< 0.0001). There was a statistically significant difference in passive external rotation at 0 degrees of abduction between groups with FTT group being stiffer than the PTT group (p=0.019) post-operatively. Change in ROM was not significantly different in all other directions.

Conclusions: The intent of this study was to compare the pre-operative and rate of improvement in two groups of patients suffering from different severity of pathology. The results indicate that quality of life improves significantly regardless of the extent of tear (partial thickness vs. full thickness). Patients with FTT may require a longer time to improve their range of motion in external rotation.

In osteogenesis imperfecta (OI) because of bone fragility, deformities in load bearing regions of the body such as femoral neck and proximal femur are expected. The purpose of this study was to determine the prevalence and clinical presentation of coxa vara in two hundred and ninety-two patients with different types of OI. More than half of the patients were OI type III (55%) and the highest prevalence of coxa vara was seen in OI type VI (44,5%). The children suffering from coxa vara had also a significant limitation of range of motion in their hips.

The charts and x-rays of one hundred and fifty-four girls and one hundred and thirty-eight boys with OI were reviewed. The patients were classified according to the Sillence classification modified by Glorieux: eighty-seven Type I, sixty-nine Type IV, sixty-two Type III, eighteen Type V, nine type VI, four types VII, and forty-three unclassified. The mean age was nine, four years (0, 3–23, 3).

Twenty-nine patients (9, 9%) had coxa vara (twenty-three left, twenty right). 55% of them were type III, 17% type IV, 13, 8% type VI and three, 4% each of types I, V, VII and unclassified OI. The prevalence of coxa vara was 1% in type I, 5,5% in type V, 7 % in type IV, 25% in type VII , 26% in type III and 44,5% in type VI (p< 0,001 for difference between types I, III and IV). Coxa vara was less frequent in patients with blue sclera (p=0,007). The mean neck-shaft angle was 99° (80°–110°) and the mean Hilgenreiner-epiphyseal angle was 68° (40°–90°). Twenty-five of coxa vara patients (thirty-six hips) had femoral rodding before diagnosis and six hips (all type III) had no history of rodding; however, 26 % of five hundred and thirty-one hips without coxa vara, had previous history of femoral rodding (p=0,004).

Abduction, extension and internal rotation were restricted in the hips with deformity. The abductors and extensors of the hips were weak in some that resulted in limping and Trendelenburg gait.

Special attention including clinical and radiological follow-up should be given to type III and VI patients particularly in the presence of previous femoral rodding.