12/13/2023 0 Comments Rotating in hexelsAs someone who has never been able to afford bespoke shoes myself, I viewed the process as binary: you get fit, they make the last, and that last is what you get. Sam, thank you for your thoughtful reply. I would say that St C’s are actually quite market-leading in a lot of aspects of bringing some of the design flexibility and styling points from bespoke down to a RTW pricepoint. I believe Saint Crispin’s offer a similar service to what you’ve described though – might be worth having a look at. The time that goes into creating and perfecting a last would probably only start to see returns if customers buy multiple pairs over time, which I suspect most people would not do. Indeed, it would probably lead to more frustrated customers who assume that they will get a much more perfect fit than they actually end up with. I don’t think the approach you suggested would solve a substantial problem with fit, as it’s not uncommon for initial fittings to have issues that are traditionally solved by iteration. multiple fittings and refinements to the design. My understanding would be (and hopefully Jesper can correct if wrong) that most of the additional time, effort and therefore cost from bespoke goes into the iteration of the process and the time of the specialists involved -eg. NCT003362320 ( identifier).ĭelamination double-layer rotator cuff repair magnetic resonance tomography shoulder arthroscopy.George – this is an interesting point. Clinical short-term outcome was not different between the DL and SL repair groups. This randomized controlled trial showed significantly lower retear rates after DL repair as compared with SL repair in delaminated rotator cuff tears. The majority of patients were very satisfied or satisfied with their arthroscopic procedure (DL, 94.1% SL, 92.9%). No significant group differences were detected regarding postoperative Constant score, forward flexion, external rotation, American Shoulder and Elbow Surgeons score, Simple Shoulder Test, subjective shoulder value, and visual analog scale and between intact and retorn tendons. All functional and subjective scores improved significantly pre- to postoperatively in both groups ( P <. One patient in the control group with a retear underwent revision. The rate of magnetic resonance-verified intact repairs (Sugaya grades 1 + 2) was significantly higher in the DL group (70.6%) than in the SL group (44.8% P =. There were no significant group differences regarding baseline characteristics and pre- and postoperative fatty degeneration of the supraspinatus and atrophy of the supraspinatus and infraspinatus. Ninety percent of patients (n = 34, DL n = 29, SL) were followed-up. Complications were monitored throughout the study. Pre- and postoperative evaluations included the Constant score, range of motion, American Shoulder and Elbow Surgeons score, Simple Shoulder Test, subjective shoulder value, and postoperative satisfaction with the procedure. Tendon integrity according to Sugaya, fatty degeneration, and muscular atrophy were evaluated by magnetic resonance tomography. Exclusion criteria were subscapularis tendon rupture (Lafosse >1°), fatty muscular infiltration >2°, and nondelaminated tendons. Randomized controlled trial Level of evidence, 1.Ī total of 70 patients were 1:1 randomized to receive an arthroscopic DL reconstruction (study group: DL suture-bridge repair) or SL reconstruction (control group: SL suture-bridge repair) for posterosuperior tears of the rotator cuff between 2.0 and 3.5 cm of the footprint detachment. To investigate whether DL as compared with SL repair could decrease retear rates after arthroscopic reconstruction of posterosuperior rotator cuff tears. However, it is controversial whether double-layer (DL) repair is superior to single-layer (SL) repair in terms of retear rate and outcome. Sometimes the inferior layer may be neglected during rotator cuff repair. The rotator cuff is known to consist of 2 macroscopically visible layers that have different biomechanical properties.
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