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anterior glenohumeral instability.

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https://www.readbyqxmd.com/read/29443703/the-thrower-s-shoulder
#1
Jonathan D Gelber, Lonnie Soloff, Mark S Schickendantz
Overhead athletes subject their shoulders to extreme repetitive torque, compression, distraction, and translation stresses, resulting in adaptive changes of the soft tissues and osseous structures within and around the glenohumeral joint. These anatomic adaptations result in biomechanical enhancements, which improve performance. Understanding the difference between necessary and adaptive changes and pathologic findings is critical when making treatment decisions. Injuries to the shoulder of the overhead athlete can be generally classified into three groups: internal impingement, internal impingement with acquired secondary anterior instability, and primary anterior or multidirectional instability...
February 13, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29435624/arthroscopic-soft-tissue-reconstruction-in-anterior-shoulder-instability
#2
REVIEW
R M Frank, A A Romeo
Anterior glenohumeral instability remains a difficult problem in the athletic and working patient populations. Treatment strategies are variable and range from nonoperative approaches incorporating immobilization and rehabilitation to surgical management. Surgical decision-making can be challenging, especially with a high-level patient who wishes to return to high-demand activities. Operative options range from open soft tissue stabilization to arthroscopic soft tissue stabilization, with both open and arthroscopic options for bony reconstruction in the setting of clinically significant anterior glenoid bone loss...
February 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29387470/arthroscopic-remplissage-is-it-still-an-option
#3
Mohamed G Morsy
Posterolateral humeral head defects can be large and engage on the anterior glenoid, and they usually contribute to anterior shoulder instability in 40% to 90% of cases.The purpose of this study is to evaluate the results of the largest series of patients who underwent arthroscopic remplissage with Bankart repair for recurrent anterior shoulder instability due to associated Bankart lesions, with large and engaging (> 25% involvement) humeral Hill-Sachs defects (HSDs).A total of 51 patients underwent arthroscopic Bankart repair with remplissage technique for the treatment of recurrent anterior glenohumeral instability with large and medial HSDs...
December 2017: EFORT Open Reviews
https://www.readbyqxmd.com/read/29377721/glenoid-bone-loss-in-posterior-shoulder-instability-prevalence-and-outcomes-in-arthroscopic-treatment
#4
Adam Hines, Jay B Cook, James S Shaha, Kevin Krul, Steve H Shaha, John Johnson, Craig R Bottoni, Douglas J Rowles, John M Tokish
BACKGROUND: Glenoid bone loss is a well-accepted risk factor for failure after arthroscopic stabilization of anterior glenohumeral instability. Glenoid bone loss in posterior instability has been noted relative to its existence in posterior instability surgery. Its effect on outcomes after arthroscopic stabilization has not been specifically evaluated and reported. PURPOSE: The purpose was to evaluate the presence of posterior glenoid bone loss in a series of patients who had undergone arthroscopic isolated stabilization of the posterior labrum...
January 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29354478/arthroscopic-triple-labral-repair-in-an-adolescent
#5
Eric J Cotter, Rachel M Frank, Scott W Trenhaile
Traumatic glenohumeral dislocations often result in significant injury to the anterior-inferior labrum, most commonly leading to recurrent anterior instability. While in skeletally immature patients, shoulder trauma more commonly results in fracture versus a true dislocation, shoulder instability does occur and can be difficult to manage in the setting of open physes. In any event, the goal of treatment is to reduce the risk of recurrence and allow full participation in activities, including sports. Arthroscopic stabilization has been shown to be an effective treatment option for young patients, with good return to sport rates; however, the vast majority of literature on shoulder instability in the youth patient population focuses on anterior instability...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354424/the-purse-string-procedure-for-recurrent-anterior-glenohumeral-instability-a-simple-technique-to-achieve-bankart-repair-capsular-shift-and-a-good-labral-bumper
#6
Luis Gerardo Natera, Paolo Consigliere, Caroline Witney-Lagen, Juan Bruguera, Giuseppe Sforza, Ehud Atoun, Ofer Levy
Failure of arthroscopic techniques in cases of recurrent anterior glenohumeral instability may result from inadequate treatment of capsular injury. The use of few anchors has been cited as a cause of failure in arthroscopic stabilization techniques. This applies to the use of the suture anchors as spot-welding points in conventional techniques. It has been shown that horizontal mattress suture techniques restore better labral height and anatomy than simple suture techniques in the repair of acute Bankart lesions...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354417/arthroscopic-repair-of-humeral-avulsion-of-the-glenohumeral-ligament-lesion
#7
Erik M Fritz, Jonas Pogorzelski, Zaamin B Hussain, Jonathan A Godin, Peter J Millett
Humeral avulsion of the glenohumeral ligament (HAGL) is a lesion associated with anterior shoulder instability. Although uncommon, HAGL lesions are a significant contributor to shoulder pain and dysfunction and, if missed, can even be a cause of failed Bankart repair. HAGL lesions should generally be repaired surgically; however, given their low prevalence, there is no consensus on the optimal surgical approach. The purpose of this Technical Note is to describe our preferred surgical technique for the fixation of an HAGL lesion using an all-arthroscopic approach and a knotless suture anchor construct...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29349003/arthroscopic-anterior-shoulder-stabilization-with-incorporation-of-a-comminuted-bony-bankart-lesion
#8
Drew Lansdown, Eamon D Bernardoni, Eric J Cotter, Anthony A Romeo, Nikhil N Verma
Bony Bankart lesions are a common finding in patients with anterior glenohumeral dislocation. Although there are no defined guidelines, small bony Bankart fractures are typically treated arthroscopically with suture anchors. The 2 main techniques used are double- and single-row suture anchor stabilization, with debate over superiority. Biomechanical studies have shown improved reduction and stabilization with the double-row over the single-row suture anchor technique; however, this has not been reported for small or comminuted bony fragments...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29335759/bone-mediated-anteroinferior-glenohumeral-instability-current-concepts
#9
REVIEW
A Lädermann, E Böhm, E Tay, M Scheibel
Recurrent anterior shoulder instability is commonly associated with defects of the anterior glenoid rim. Substantial osseous defects significantly diminish the glenohumeral stability and require a bony augmentation, either by a coracoid transfer or free bone grafting procedure. Both reconstructive techniques have been applied for a long time and evaluated biomechanically and clinically. Although neither treatment option has been recognized as clearly superior, both comprise certain advantages and disadvantages...
January 15, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29320219/modified-latarjet-without-capsulolabral-repair-in-rugby-players-with-recurrent-anterior-glenohumeral-instability-and-significant-glenoid-bone-loss
#10
Maximiliano Ranalletta, Luciano A Rossi, Agustin Bertona, Ignacio Tanoira, Ignacio Alonso Hidalgo, Gastón D Maignon, Santiago L Bongiovanni
BACKGROUND: The optimal management of recurrent anterior shoulder instability with significant glenoid bone loss in high-demand collision athletes remains a challenge. PURPOSE: To analyze the time to return to sport, clinical outcomes, and recurrences following a modified Latarjet procedure without capsulolabral repair in rugby players with recurrent anterior shoulder instability and significant glenoid bone loss. STUDY DESIGN: Case series; Level of evidence, 4...
January 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29216740/new-concepts-of-radiologic-preoperative-evaluation-of-anterior-shoulder-instability-on-track-and-off-track-lesions
#11
Aishwarya Gulati, Riham Dessouky, Vibhor Wadhwa, Drew Sanders, Avneesh Chhabra
The shoulder is the most frequently dislocated joint in the body due to a larger range of motion and a small area of articulation between the humeral and glenoid surfaces. Traumatic shoulder dislocations, especially those associated with injury to the labroligamentous or bony stabilizers of the joint, lead to further reduction of articular surface contact with resultant glenohumeral instability and recurrent shoulder dislocations. Imaging plays an increasingly important role in the preoperative evaluation of patients with traumatic shoulder instability by evaluating glenohumeral bone loss (uni- or bipolar), assessing soft tissue injuries and identifying patients at risk of postoperative recurrence...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/29195899/ibuprofen-impairs-capsulolabral-healing-in-a-rat-model-of-anterior-glenohumeral-instability
#12
Jonathan D Packer, Arya G Varthi, David S Zhu, Frances G Javier, Jason D Young, Jennie V Garver, Havalee Henry, Steven M Tommasini, Theodore A Blaine
BACKGROUND: Failure of glenoid labrum and capsular healing after glenohumeral dislocation can lead to persistent shoulder instability. The purpose of this study was to determine the effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on the healing glenoid labrum and capsule after glenohumeral dislocation in a rat model. METHODS: Sixty-six rats had surgically induced anterior-inferior labral tears and anterior glenohumeral dislocation. Postoperatively, the animals were assigned to either normal (n = 32) or ibuprofen drinking water (n = 31)...
November 29, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29135565/pediatric-and-adolescent-anterior-shoulder-instability-clinical-management-of-first-time-dislocators
#13
Kenneth M Lin, Evan W James, Elad Spitzer, Peter D Fabricant
PURPOSE OF REVIEW: The purpose of this review is to discuss the epidemiology, pathoanatomy, diagnosis, and clinical management of pediatric and adolescent patients following a first-time shoulder dislocation. RECENT FINDINGS: Shoulder instability is becoming increasingly common as pediatric and adolescent patients engage in earlier organized sports competition. Recommended treatment following a first-time glenohumeral dislocation event in adolescents depends on several factors, but surgical stabilization is becoming more frequently performed...
November 11, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29119123/indication-for-computed-tomography-scan-in-shoulder-instability-sensitivity-and-specificity-of-standard-radiographs-to-predict-bone-defects-after-traumatic-anterior-glenohumeral-instability
#14
Audrey Delage Royle, Frédéric Balg, Martin J Bouliane, Fanny Canet-Silvestri, Laurianne Garant-Saine, David M Sheps, Peter Lapner, Dominique M Rouleau
Background: Quantifying glenohumeral bone loss is key in preoperative surgical planning for a successful Bankart repair. Hypothesis: Simple radiographs can accurately measure bone defects in cases of recurrent shoulder instability. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A true anteroposterior (AP) view, alone and in combination with an axillary view, was used to evaluate the diagnostic properties of radiographs compared with computed tomography (CT) scan, the current gold standard, to predict significant bone defects in 70 patients...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29114636/accuracy-of-coracoid-bone-graft-placement-open-versus-arthroscopic-latarjet
#15
Adriano Russo, Andrea Grasso, Annalisa Arrighi, Angela Pistorio, Luigi Molfetta
Purpose  The aim of this study was to compare the accuracy of the coracoid bone graft placement with the open Latarjet-Patte and arthroscopic Latarjet (arthro-Latarjet) procedures in the treatment of anterior instability of the shoulder. Methods  Forty-six patients affected by anterior shoulder instability were divided into two groups. In group A ( n  = 25), patients were operated by arthroscopic Latarjet (arthro-Latarjet) procedure and in group B ( n  = 21), patients were operated by open Latarjet-Patte procedure...
June 2017: Joints
https://www.readbyqxmd.com/read/29114337/arthroscopic-soft-tissue-procedures-for-anterior-shoulder-instability
#16
Mathew Brown, Andrew Wallace, Andrew Lachlan, Susan Alexander
Background: Arthroscopy has rapidly transformed the treatment of anterior shoulder instability over the past 30 years. Development of arthroscopic equipment has permitted the investigation and diagnosis of the unstable shoulder, and fixation methods have evolved to promote arthroscopy from an experimental procedure to one of first-line mainstream treatment. Methods: Key research papers were reviewed to identify the fundamental principles in patient diagnosis and appropriate selection for arthroscopic treatment...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29102569/the-glenoid-labral-articular-teardrop-lesion-a-chondrolabral-injury-with-distinct-magnetic-resonance-imaging-findings
#17
Evan S Lederman, Stephen Flores, Christopher Stevens, Damien Richardson, Pamela Lund
PURPOSE: Evaluation and description of a pathognomonic lesion identified on magnetic resonance imaging (MRI) of a chondrolabral injury of the glenohumeral joint. METHODS: Patients were prospectively identified at the time of MRI by a characteristic teardrop appearance of a pedicled displaced chondrolabral flap in the axillary recess on coronal imaging and retrospectively reviewed. RESULTS: In a sample of 36 patients, there were 30 males (83%), and the average age was 27 years (14-75 years)...
November 1, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29063152/bone-grafts-used-for-arthroscopic-glenoid-reconstruction-restore-the-native-glenoid-anatomy
#18
Benjamin Bockmann, Arne Johannes Venjakob, Rolf Gebing, Frank Reichwein, Marthe Hagenacker, Wolfgang Nebelung
PURPOSE: Recurrent anterior instability of the glenohumeral joint is a demanding condition, especially in cases of glenoid bone loss. Various treatment options have been described, such as arthroscopic grafting techniques and the Latarjet procedure. In this study, the degree to which an arthroscopically applied iliac crest graft restores the glenoid anatomy was evalutated. METHODS: Nine patients (three women and six men) with an average age of 31 ± 9 years (21-46 years) who were treated with an arthroscopic iliac crest graft technique were included in this study...
October 23, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29043566/clinical-evaluation-and-physical-exam-findings-in-patients-with-anterior-shoulder-instability
#19
REVIEW
Vincent A Lizzio, Fabien Meta, Mohsin Fidai, Eric C Makhni
PURPOSE OF REVIEW: The goal of this paper is to provide an overview in evaluating the patient with suspected or known anteroinferior glenohumeral instability. RECENT FINDINGS: There is a high rate of recurrent subluxations or dislocations in young patients with history of anterior shoulder dislocation, and recurrent instability will increase likelihood of further damage to the glenohumeral joint. Proper identification and treatment of anterior shoulder instability can dramatically reduce the rate of recurrent dislocation and prevent subsequent complications...
December 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29038953/current-concepts-in-rehabilitation-for-traumatic-anterior-shoulder-instability
#20
REVIEW
Richard Ma, Olubusola A Brimmo, Xinning Li, Lindsey Colbert
PURPOSE OF REVIEW: The objectives of this review are to evaluate the current evidence-based literature and concepts surrounding rehabilitation in patients with anterior shoulder instability injuries and surgical repair. RECENT FINDINGS: The current literature evidence for shoulder rehabilitation for anterior shoulder instability and labral repair is limited. As a result, there are variations among surgeons and physical therapists in rehabilitation protocols after anterior shoulder instability injuries and repair...
December 2017: Current Reviews in Musculoskeletal Medicine
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