2Background: The objective of this study was the transcultural adaptation of the rotator cuff quality of life (RC-QOL) questionnaire and the determination of the reliability and validity of the questionnaire in the Persian-speaking population with rotator cuff disease. Methods: This study was conducted in Isfahan from April 2022 to February 2023. The participants consisted of 56 people with rotator cuff pathology. The process of adapting and translating the questionnaire was done with the methodology presented previously by Beaton et al. Content validity was first tested by a group of orthopedic and physical medicine and rehabilitation specialists and then through a pilot study consisting of 15 Persian-speaking patients with rotator cuff disease. Test-retest reliability was established with an intraclass correlation coefficient. Internal consistency was calculated using Cronbach's alpha. The measurement's error estimation was calculated with the standard error of the measurement. Reproducibility evaluation was measured with a 3-day interval between the completion of the test-retest questionnaire. Results: The age range of the participants was 34 to 68 years (55% men and 45% women). The mean (standard deviation) of the total score of the RC-QOL questionnaire was 44. 33(10. 81) and ranged from 17. 35 to 70. 88. Cronbach's alpha was 0. 971, which showed high internal consistency. The intraclass correlation coefficient was 0. 99, indicating high test-retest reliability. The mean values (standard deviations) of the DASH and SPADI questionnaires were equal to 77. 66(13. 69) and 66. 66(18. 25), respectively. The results of the study showed excellent and significant convergent validity of the RC-QOL questionnaire with both the DASH and SPADI questionnaires. The correlation value with the DASH and SPADI questionnaires was equal to 0. 907 and 0. 941, respectively. Conclusion: The Persian version of the RC-QOL questionnaire is a valid and reliable tool to evaluate the quality of life in patients diagnosed with rotator cuff injuries

Background: The clinical outcomes of rotator cuff repair (RCR) surgeries vary because each method has its own advantages and limitations. Objectives: This study aimed to compare the short-term outcomes of arthroscopic RCR (ARCR) and mini-open RCR (MRCR). Methods: In this study, we included 49 patients with a diagnosis of full rotator cuff tear who had undergone ARCR and MRCR at Poursina Hospital of Rasht and Akhtar Hospital of Tehran from 20 March 2017 to 20 March 2020. The patients were divided into ARCR (n = 24) and MRCR (n = 25) groups. The two surgical procedures were compared with each other before surgery and three and six months after surgery in terms of shoulder function based on UCLA, disability based on QUICKDASH, range of motion (ROM), and pain based on Visual Analogue Scale (VAS). Data were analyzed by chi-square, independent t-test, and repeated measures analysis of variance (ANOVA). Results: There were no differences between the groups in terms of demographic details. The mean duration of surgery was significantly higher in the ARCR group compared to MRCR group (125. 5 vs. 70. 42 minutes). The short-term outcomes in the two groups on three measurement occasions showed a significant improvement in shoulder function, disability, and ROM in both groups along with a reduction in pain severity (P < 0. 05),however, there was no signifi, cant difference between the two groups on any of the three occasions (P > 0. 05). Conclusions: Shoulder function, disability, ROM, and pain were not diff, erent between the two groups, but duration of surgery was less in MRCR group. Therefore, under the same conditions, MRCR is a better choice than ARCR due to its short duration of surgery.

Background and Aim rotator cuff injuries are one of the most common causes of shoulder pain. There are different therapeutic approaches for their treatment. The evidence of the positive effect of exercise therapy on this pathology is inconclusive. This study aims to evaluate the effect of a combined exercise program on improvement of shoulder pain and function in patients with rotator cuff injuries. Methods & Materials In this clinical trial, 24 patients (Mean age= 51. 5 years) with confirmed rotator cuff injuries in clinical examination and shoulder MRI received the 12-week exercise protocol at four phases. The 12-week exercise protocol included strengthening, stretching, proprioceptive neuromuscular facilitation, and dynamic stabilization exercises. Pain was measured by visual analog scale (VAS) and function was measured by two questionnaires,the disabilities of the arm, shoulder and hand (DASH) and western Ontario rotator cuff index (WORC). Range of motion (ROM) of shoulder joint was measured in five directions by a goniometer. All outcomes were evaluated before the intervention and 6, 12, 24 weeks after the intervention. Ethical Considerations This study was registered by Iranian Registry of Clinical Trials (Code: IRCT20100718004409N13). The written informed consent was obtained from all participants before the study. Results Of 24 patients, 14 (53. 8%) had supraspinatus tendinopathy, 6 (23%) had supraspinatus tear, 3 (12. 5%) were with both Supraspinatus and biceps tendinopathy, and one (4. 16%) with both subscapularis and supraspinatus tendinopathy. The VAS score decreased at all follow-up periods especially in the 24th week (8±, 0. 1 vs 3±, 0. 1) (P< 0. 001). Shoulder ROM and function based on WORC and DASH scores were also improved from pretest phase to 24 weeks after intervention which were statistically significant (P< 0. 001). Conclusion The 12-week exercise protocol is effective on reduction of shoulder pain and improvement of shoulder function and ROM in patients with shoulder rotator cuff tendinopathy and partial tear. It has a lasting effect of 6 months.

Background: rotator cuff tear is one of the most common causes of shoulder complaints in the elderly. Based on the severity and patient's condition, a variety of methods applies to manage the tear and surgery is an important method, which could be done by open or arthroscopic technique. The current study aimed to investigate and report short-term results of arthroscopic repair of complete rotator cuff tears.Methods: This was a cross-sectional study on 183 patients who underwent arthroscopic surgery to repair rotator cuff tear in three different hospitals of Tehran between January 2003 and August 2006. Of all patients, 107 cases included in our study, which had a complete rotator cuff tear, and at least one-year follow up record.89 patients (56 male and 33 female) attended assessment sessions and were evaluated by UCLA (University of California, Los Angeles) Shoulder and Elbow Scoring System, pre- and post-operatively, and acromioplasty was performed in 83 patients.Results: With a mean age of 53.2±15.8 (32-71) years, the average UCLA score was 11.3 before the surgery and 31.4 post-operatively. There were 11 patients with excellent scores, 62 good, 11 fair, and 5 poor scores.9 out of 11 cases with excellent score and 34 out of 62 with good score were younger than 55 years; however, 13 cases were older than 60 years amongst 16 fair or poor scores.Conclusions: Arthroscopic repair of complete rotator cuff tear would cause a significant improvement in a short-term period and results are better in younger patients, through the UCLA scoring system.

Objectives: In order to treat a rat model of rotator cuff rupture, this work concentrated on the expression of TNMD and RUNX2, followed by rotator cuff repair and secretome-hMSCs. Methods: A total of thirty 10-weeks-old male Sprague–Dawley rats were separated into five groups randomly, RC on week 0, lesion treated with a rotator cuff repair and saline (RC + NaCl group, n = 6) for 2 and 8 weeks, and lesion treated with a rotator cuff repair and secretome-hMSCs (RC + secretome-hMSC group, n = 6) for 2 and 8 weeks. The supraspinatus and infraspinatus muscle–tendon units were obtained for histological and biomechanical investigation at 0, 2 and 8 weeks following injury. Results: The findings showed that, in comparison with the RC + NaCl group, secretome-hMSCs significantly improved tendon repair by upregulating TNMD and RUNX2 expression and histology score. Conclusion: Combining Secretome-hypoxia MSCs with RC healing may help rats with rotator cuff tears. Level of evidence: IV

Background: rotator cuff muscles are the milestone of shoulder function. Tear of the rotator cuff could result in shoulder pain and deterioration of the function. The purpose of this study was to evaluate the outcome of arthroscopically repaired large and massive rotator cuff tears in short term.Methods: Fifity one consecutive patients (41 males, 10 females) with average age of 49 years old (38-62 y/o) who had arthroscopically repairable large or massive tears during a 3 year period in two hospitals in Tehran were included in the study. Ten of these patients were lost to follow-up and were excluded from the study. The remaining 41 were the focus of this study.Results: 28 patients had large tears and 13 had massive tears. Follow-up averaged 25 months (range, 12 to 48 months).Based on the University of California Los Angeles shoulder rating (UCLA), 88% of patients had good or excellent outcomes. Although 5 patients were considered failures based on the UCLA score, 98% of patients were satisfied with the result. Only 1 of these failures underwent a second operation for revision repair. There was no significant difference in final scores when comparing the massive tears with the entire group. The preoperative scores however for massive tears were lower than the large tears.Conclusion: Arthroscopic management of large and massive of rotator cuff tears results in good or excellent outcomes comparable to reported outcomes following open repair.