Mini Lateral Shoulder Approach

Study Overview
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Brief Summary
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The incision is very useful and easy for the direct lateral shoulder joint exposure.

Detailed Description
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The skin incision is about 4 to 5 cm made by the distal acromial edge in sagittal plane, The dissection takes place slightly over the acromial edge proximally and over the origin of the acromial deltoid part (the middle part of deltoid origin) distally. After clearly revealing the region of the medial deltoid origin on the acromion, the acromionic deltoid origin is skinned only; of the edge of the acromion, and that maybe accrued by electric knife pen or periosteal elevator, without exposure the clavicular deltoid origin in the front and the deltoid origin on the spine of scapula in the back, the origin of the acromial deltoid is distanced laterally and distally, where the lateral edge, the lower surface of the acromion, under acromial bursa and the rotator cuff are exposed clearly. Throw this approach can be made acromioplasty and rotator cuff tears repair especially upper part of rotator cuff tear very easily. For wound closure the acromionic deltoid origin is reattached to the acromial edge by long period synthetic absorbable sutures as PDS and PDO, or non absorbable sutures as Polyester suture, under skin and skin sutures are made.

Official Title
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Mini Lateral Shoulder Approach

Conditions
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Shoulder Impingement Syndrome, Rotator Cuff Tendinopathy, Adhesive Capsulitis and Frozen Shoulder Syndrome

Intervention / Treatment
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* Procedure: Mini Lateral Shoulder Approach (MLSA)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients presented with Shoulder Impingement Syndrome refractory to conservative treatment and local steroid injection Patients presented with Adhesive Capsulitis and Frozen Shoulder Syndrome refractory to conservative treatment and local steroid injection Patients without femur head immigration on X-ray Patients with injury for one month to six months maximum Exclusion Criteria: Patients with femur head immigration on X-ray Patients with injury for more than six months Un controlled diabetes mellitus type 1 and 2 Patients with non controlled Vascular hypertension Significant renal disease, defined as a history of chronic renal failure requiring dialysis or kidney transplant. Myocardial infarction, other acute cardiac event requiring hospitalization, stroke, transient ischemic attack, or treatment for acute congestive heart failure within 4 months prior to randomization Patients with history of Carpal Tunnel release surgery failure

Ages Eligible for Study
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Minimum Age: 16 Years
Maximum Age: 73 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Issa1<br>Dr.A.Sayed Issa and his team | Procedure: Mini Lateral Shoulder Approach (MLSA)<br>* The skin incision is about 4 to 5 cm made by the distal acromial edge in sagittal plane, The dissection takes place slightly over the acromial edge proximally and over the origin of the acromial deltoid part (the middle part of deltoid origin) distally. After clearly revealing the region of the medial deltoid origin on the acromion, the acromionic deltoid origin is skinned only; of the edge of the acromion, and that maybe accrued by electric knife pen or periosteal elevator, without exposure the clavicular deltoid origin in the front and the deltoid origin on the spine of scapula in the back, the origin of the acromial deltoid is distanced laterally and distally, where the lateral edge, the lower surface of the acromion, under acromial bursa and the rotator cuff are exposed clearly.<br>* Other names: Second Sayed Issa's Approach;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Less surgical procedure time than traditional approaches | 25 minutes to 45 minutes, it's depends of rotator cuff tear if exist or not. | up to two years | 
| Less rehabilitation time than traditional approaches | 6 - 8 weeks | up to two years | 
| Passive physiotherapy immediately | next day of surgery | up to two years | 
| Active physiotherapy without rotator cuff tear | after two weeks of surgery | up to two years | 
| Mini cosmetic incision to the shoulder | 4 - 5 cm | up to two years | 
| Active physiotherapy with rotator cuff tear | after three weeks of surgery | up to two years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| very good patients satisfaction | after 8 weeks | up to two years | 
| Restore deltoid muscle strength | about 3 months after surgery | up to two years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Shoulder, Shoulder approach, Lateral Shoulder approach, Shoulder impingement syndrome, Rotator cuff tendinopathy, Adhesive capsulitis, Frozen shoulder syndrome