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Shoulder instability conservative treatment

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https://www.readbyqxmd.com/read/29590445/atlantoaxial-instability-in-a-patient-with-neck-pain-and-ankylosing-spondylitis
#1
Christian Lyons, Michael Ross, Ryan Elliott, Michael Tall
The purpose of this report is to describe the evaluation and treatment of a patient with neck pain and ankylosing spondylitis who had underlying atlantoaxial instability. The patient was a 31-yr-old man diagnosed with ankylosing spondylitis 1 yr prior who was referred to a physical therapist for the treatment of chronic, worsening low back and hip pain. He also had secondary complaints of neck, upper back, and shoulder pain. The patient worked as a military pilot. As part of the patient's physical examination, a Sharp-Purser test was performed, which was positive for excessive motion...
March 26, 2018: Military Medicine
https://www.readbyqxmd.com/read/29464283/-osteoarthritis-of-the-shoulder-pathogenesis-diagnostics-and-conservative-treatment-options
#2
REVIEW
J Mehl, A B Imhoff, K Beitzel
PATHOGENESIS: Osteoarthritis of the shoulder is characterized by a progressive degenerative process, which is based on chronic inflammation with intra-articular release of different cytokines and proteolytic enzymes. The main predisposing factors are a history of trauma or surgery, as well as chronic overuse or instability of the glenohumeral joint. Affected patients especially suffer from impaired joint function and pain, which are often associated with cognitive and psychosocial restrictions...
February 20, 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29430388/arthroscopic-labral-repair-in-the-setting-of-recurrent-posterior-shoulder-instability
#3
George Sanchez, Nicholas I Kennedy, Márcio B Ferrari, Sandeep Mannava, Salvatore J Frangiamore, Matthew T Provencher
Posterior shoulder instability, although relatively rare in the general population, is more commonly seen in athletes, especially those in contact sports. Although nonoperative treatment has been associated with satisfactory results in the setting of posterior shoulder instability, conservative management may ultimately fail and lead to recurrence particularly in young, male patients. Both arthroscopic and open repair techniques to address posterior instability have been described, with each showing positive patient-reported outcomes, low risk of recurrence, and considerably high return-to-sport rates...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354405/arthroscopic-pancapsular-shift-with-labral-repair-for-multidirectional-instability-of-the-shoulder
#4
Salvatore J Frangiamore, Sandeep Mannava, Jonathan A Godin, Jack Anavian, Erik M Fritz, Peter J Millett
Initial treatment of shoulder multidirectional instability (MDI) consists of nonoperative modalities of physical therapy and rehabilitation; if this fails, surgical treatment can become necessary. MDI of the shoulder can be challenging to manage in individuals who fail conservative management. Historically, surgical treatment for MDI has been open capsular plication; however, arthroscopic capsular plication has now become the standard of care, with outcomes similar to the open procedure. The purpose of this article and Video 1 is to describe our arthroscopic technique for pancapsular shift with labral repair...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29350239/-the-abc-guide-for-the-treatment-of-posterior-shoulder-instability
#5
REVIEW
P Moroder, V Danzinger, M Minkus, M Scheibel
BACKGROUND: Posterior glenohumeral instability (PGHI) is an often unrecognized or misdiagnosed type of shoulder instability due to its heterogenic clinical and radiological presentation. CLASSIFICATION: The ABC classification for PGHI is based on the different pathomechanisms and recommended treatment standards and is therefore a guide to finding the correct diagnosis and therapy for affected patients. There are different types of PGHI: A (first time), B (dynamic), C (static)...
February 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29335760/-current-aspects-and-new-techniques-in-dislocation-of-the-shoulder-joint
#6
REVIEW
J Abel, M A Zumstein, L Bolliger, M O Schär
With 12% of all injuries concerning the shoulder, acromioclavicular (AC) joint dislocations are a common injury especially in young and active patients. The Rockwood classification is widely accepted, which differentiates between six types depending on the degree of injury and the vertical dislocation. Because the classification does not adequately address the horizontal instability, its benefits are questionable and there is currently no consensus. For this reason, the classification and the therapy of these injuries are increasingly becoming the subject of scientific investigations...
February 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29124296/-diagnostics-and-treatment-of-posterior-shoulder-instability
#7
REVIEW
M Wellmann, M-F Pastor, T Smith
Posterior shoulder instability has a markedly lower incidence than anterior shoulder instability. It has a wide spectrum of clinical symptom manifestations and the overwhelming number of patients lack a traumatic primary dislocation. In addition to a detailed medical history, a specific clinical examination with the help of standardized provocation tests is essential for the diagnostics. For the detection of structural posterior capsule and labral lesions in cases of chronic courses, magnetic resonance imaging (MRI) should be used with an intra-articular contrast agent...
November 9, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28979596/treatment-of-the-posterior-unstable-shoulder
#8
Eduardo Sánchez Alepuz, Jaime Alonso Pérez-Barquero, Nadia Jover Jorge, Francisco Lucas García, Vicente Carratalá Baixauli
BACKGROUND: It is estimated that approximately 5% of glenohumeral instabilities are posterior. There are a number of controversies regarding therapeutic approaches for these patients. METHODS: We analyse the main surgery alternatives for the treatment of the posterior shoulder instability. We did a research of the publications related with posterior glenohumeral instability. RESULTS: There are conservative and surgical treatment options. Conservative treatment has positive results in most patients, with around 65 to 80% of cases showing recurrent posterior dislocation...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28979595/multidirectional-shoulder-instability-treatment
#9
Miguel Angel Ruiz Ibán, Jorge Díaz Heredia, Miguel García Navlet, Francisco Serrano, María Santos Oliete
BACKGROUND: The treatment of multidirectional instability of the shoulder is complex. The surgeon should have a clear understanding of the role of hiperlaxity, anatomical variations, muscle misbalance and possible traumatic incidents in each patient. METHODS: A review of the relevant literature was performed including indexed journals in English and Spanish. The review was focused in both surgical and conservative management of multidirectional shoulder instability...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28969823/editorial-commentary-leveraging-the-literature-what-can-a-half-century-s-worth-of-studies-tell-us-about-recurrent-instability-following-primary-shoulder-dislocation
#10
EDITORIAL
Mark P Cote
A benefit of systematic review (SR) research methods is that well-performed reviews allow authors and readers to identify weaknesses and variability in the orthopaedic literature. An SR on the topic of recurrence rates after conservative treatment of first-time shoulder dislocation provides an excellent example. The example reviews studies covering more than one-half century of time and employing varying methodological designs; the results include estimates of recurrence of shoulder dislocation ranging widely (from 4% to 94...
October 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28947382/the-effects-of-a-conservative-rehabilitation-program-for-multidirectional-instability-of-the-shoulder
#11
Lyn Watson, Simon Balster, Ross Lenssen, Greg Hoy, Tania Pizzari
BACKGROUND: Conservative management is commonly recommended as the first-line treatment for multidirectional instability (MDI) of the shoulder. Despite this, the evidence for efficacy of treatment is limited, and until recently, guidance for clinicians on conservative rehabilitation programs has been inadequate. This study evaluated the effectiveness of a physiotherapy-led exercise program for participants with MDI. METHODS: In a single-group study design, 43 participants (16 male, 27 female; mean age, 19...
January 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28888526/posterior-shoulder-instability-managed-by-arthroscopic-acromial-pediculated-bone-block-technique
#12
P Métais, J Grimberg, P Clavert, J-F Kouvalchouk, F Sirveaux, G Nourissat, J Garret, P Mansat, A Godenèche
In posterior shoulder instability (recurrent dislocation, involuntary posterior subluxation or voluntary subluxation that has become involuntary), surgery may be considered in case of failure of functional treatment if there are no psychological contraindications. Acromial bone-block with pediculated deltoid flap, as described by Kouvalchouk, is an alternative to iliac bone-block, enabling triple shoulder locking by the blocking effect, the retention hammock provided by the deltoid flap and posterior capsule repair...
September 6, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28868087/use-of-shoulder-pacemaker-for-treatment-of-functional-shoulder-instability-proof-of-concept
#13
Philipp Moroder, Marvin Minkus, Elisabeth Böhm, Victor Danzinger, Christian Gerhardt, Markus Scheibel
BACKGROUND: Functional shoulder instability (polar type III) is caused by underactivity of rotator cuff and periscapular muscles, which leads to subluxation or dislocation during shoulder movement. While surgical treatment has shown no benefits, aggravates pain, and frequently diminishes function even further, conservative treatment is often ineffective as well. OBJECTIVES: The aim was to investigate the effectiveness of a "shoulder pacemaker" device that stimulates underactive muscles in patients with functional instability during shoulder movement in order to re-establish glenohumeral stability...
2017: Obere Extremität
https://www.readbyqxmd.com/read/28861125/abc-classification-of-posterior-shoulder-instability
#14
REVIEW
Philipp Moroder, Markus Scheibel
Posterior glenohumeral instability (PGHI) is a commonly under- and misdiagnosed pathology owing to its variety of clinical presentations. In order to facilitate diagnosis and treatment, the simple yet comprehensive ABC classification for PGHI is based on the underlying pathomechanical principles and current standard of treatment. Three main groups of PGHI are distinguished based on the type of instability: A (first time), B (dynamic), C (static). Two subtypes further differentiate these groups in terms of their specific pathomechanism and provide a guideline in the choice of appropriate treatment: A (1, subluxation; 2, dislocation), B (1, functional; 2, structural), C (1, constitutional; 2, acquired)...
2017: Obere Extremität
https://www.readbyqxmd.com/read/28799049/-diagnostics-and-treatment-concepts-for-anteroinferior-shoulder-instability-current-trends
#15
F Martetschläger, M Tauber, P Habermeyer
Shoulder instability arises when static or dynamic stabilizers deviate from the natural equilibrium. The most common form of shoulder instability is in an anteroinferior direction, affects young athletes in contact sports and can lead to permanent impairment of shoulder function and early degeneration of the joint. Conservative as well as operative therapy options have been controversially discussed for years. This article describes the current state of diagnostics, current trends in therapy decisions and relevant therapy options for anterior shoulder instability...
October 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28777213/glenohumeral-instability-related-to-special-conditions-slap-tears-pan-labral-tears-and-multidirectional-instability
#16
Gregory S Van Blarcum, Steven J Svoboda
Glenohumeral instability is one of the more common conditions seen by sports medicine physicians, especially in young, active athletes. The associated anatomy of the glenohumeral joint (the shallow nature of the glenoid and the increased motion it allows) make the shoulder more prone to instability events as compared with other joints. Although traumatic dislocations or instability events associated with acute labral tears (ie, Bankart lesions) are well described in the literature, there exists other special shoulder conditions that are also associated with shoulder instability: superior labrum anterior/posterior (SLAP) tears, pan-labral tears, and multidirectional instability...
September 2017: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/28741077/-chronic-acromioclavicular-joint-injury-of-rockwood-v-type-with-concomitant-chronic-anterior-sternoclavicular-instability
#17
Sebastian Schmitt, Petra Magosch, Peter Habermeyer, Sven Lichtenberg
Bipolar dislocation of the clavicle is rare. In the literature, every reported bipolar dislocation of the clavicle is caused by a traumatic injury with loss of function of the affected shoulder. Currently, there is no recommendation to treat. A conservative treatment can be tried first to achieve adequate shoulder function. If this cannot be achieved, surgical treatment will be indicated. In the literature, many options for surgical treatment are described. This article presents a case of a chronic Rockwood V injury with chronic anterior sternoclavicular joint instability...
September 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28641736/a-comprehensive-rehabilitation-program-for-posterior-instability-of-the-shoulder
#18
Lyn Watson, Simon Balster, Sarah Ann Warby, Jackie Sadi, Greg Hoy, Tania Pizzari
Posterior shoulder instability is recognised as being less prevalent than anterior instability, however the diagnosis of this pathology is easily overlooked or missed and this may contribute to an underestimation of prevalence. Recently, there has been increasing recognition of this condition and consequently a greater requirement for knowledge of diagnostic procedures and treatment directions. Currently there is limited research into the conservative management of posterior instability, although it is recommended as first-line treatment prior to surgical review, particularly in those with an atraumatic instability mechanism...
April 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28630753/how-to-deal-with-a-glenoid-fracture
#19
Lars Henrik Frich, Morten Schultz Larsen
The glenoid fossa is involved in approximately 10% of all scapular fractures.Glenoid fossa incongruity is surprisingly well tolerated.Surgery is recommended when 20% or more of the anterior glenoid fossa is involved.Glenoid rim fractures often lead to chronic shoulder instability.Unstable glenoid neck fractures need surgical treatment and stable fractures can be treated conservatively.CT examination with 3D reformations of the glenoid fossa has improved insight into fracture morphology and fracture patterns and is very helpful for clinical decision makers...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28572850/the-treatment-of-multidirectional-instability-of-the-shoulder-with-a-rehabilitation-programme-part-2
#20
REVIEW
Lyn Watson, Sarah Warby, Simon Balster, Ross Lenssen, Tania Pizzari
BACKGROUND: The most commonly recommended initial treatment for multidirectional instability is a rehabilitation program. Although there is evidence to support the effect of conservative management on this condition, the published literature provides little information on the exercise parameters of such programs. METHODS: This paper is the second part of a two-part series that outlines a six-stage rehabilitation program for multidirectional instability with a focus on scapula control and exercise drills into functional positions...
January 2017: Shoulder & Elbow
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