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Shoulder subluxation

Boris Sowa, Martin Bochenek, Steffen Braun, Felix Zeifang, Jan Philippe Kretzer, Thomas Bruckner, Gilles Walch, Patric Raiss
BACKGROUND: Glenoid replacement in cases of severe glenoid retroversion (RV) or eccentric wear is challenging. The aim of this study was to evaluate different treatment methods under standardized conditions to assist surgeons in the decision-making process. METHODS: Three treatment options for severe glenoid RV (15°) were compared: (1) no RV correction; (2) complete RV correction; (3) no RV correction and implantation of a posterior augmented glenoid (PAG). A highly standardized implantation protocol using artificial glenoid bones (five per group) was chosen, and a physiologic shoulder movement was applied in a biomechanical setting...
March 7, 2018: Archives of Orthopaedic and Trauma Surgery
Nathan D Orvets, Aaron M Chamberlain, Brendan M Patterson, Peter N Chalmers, Michelle Gosselin, Dane Salazar, Alexander W Aleem, Jay D Keener
BACKGROUND: This study describes the short-term functional and radiographic outcomes after total shoulder arthroplasty (TSA) in shoulders with a B2 glenoid deformity addressed with corrective reaming. METHODS: We conducted a retrospective series of consecutive patients who underwent TSA with a Walch B2 glenoid quantified by computed tomography scan. All glenoid deformities were addressed using partially corrective glenoid reaming. Radiographic and functional outcome measures, including scores on the visual analog scale for pain, American Shoulder and Elbow Standardized Shoulder Assessment, and Simple Shoulder Test were collected...
February 28, 2018: Journal of Shoulder and Elbow Surgery
Minxun Lu, Li Min, Cong Xiao, Yongjiang Li, Yi Luo, Yong Zhou, Wenli Zhang, Chongqi Tu
Introduction: Currently, it is challenging to treat giant cell tumor (GCT) of distal radius. For Campanacci grade III or recurrent GCTs, en bloc resection has been accepted as a better treatment option. Although numerous methods are available for reconstruction, all of them have some limitations in joint function and complications. In this study, our aims were to treat the GCT of distal radius with uncemented three-dimensional (3D)-printed prosthesis and to present and evaluate the surgical techniques and short-term outcomes...
2018: Cancer Management and Research
Jared A Wolfe, Daniel L Christensen, Timothy C Mauntel, Brett D Owens, Lance E LeClere, Jonathan F Dickens
Introduction: Shoulder instability is one of the most common pathologies seen by the orthopedic sports medicine surgeon. With a uniquely young, high-demand patient population in the U.S. Military, the incidence of shoulder instability is remarkably more common than the civilian population. As such, military orthopedic surgeons and sports medicine and shoulder specialists have developed a unique understanding and experience of shoulder instability. The historical advances of shoulder instability in the military have been instrumental in understanding the epidemiology, evaluation, pathology, treatment of first-time shoulder subluxations and dislocations, operative and non-operative treatment options, arthroscopic and open stabilization methods, management of the in-season athlete, treatment of combined and circumferential labral pathology, and associated pathology...
February 6, 2018: Military Medicine
Maximiliano Ranalletta, Luciano A Rossi, Agustin Bertona, Ignacio Tanoira, Gastón D Maignon, Santiago L Bongiovanni
PURPOSE: To analyze time to return to sport, functional outcomes, and recurrences of the modified Latarjet procedure without capsulolabral repair in athletes with recurrent anterior shoulder instability after a failed previous operative stabilization. METHODS: We included athletes with recurrent anterior shoulder instability with a previous failed operative stabilization treated with the modified Latarjet procedure without capsulolabral repair with a minimum of 2-year follow-up...
February 3, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
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
Moheb S Moneim, Christina Salas, Andrea B Lese, Norfleet B Thompson, Deana M Mercer
The purpose of this study was to describe long-term outcomes of partial trapeziectomy with capsular interposition (PTCI) arthroplasty for patients with osteoarthritis of the basal joint of the thumb. A total of 27 patients (20 women, 7 men; 32 thumbs) with a mean age of 61 years (range, 47-74 years) agreed to return for follow-up and were included in the study. Mean postoperative follow-up was 64.3 months (range, 28-112 months). Evaluation included tests for grip and pinch strength; range of motion of the metacarpophalangeal joint; measurement of the first web space; completion of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire; visual analog scale (VAS) measurements; and radiographic examination of the hand...
January 25, 2018: Orthopedics
Nicholas I Kennedy, Jonathan A Godin, Marcio B Ferrari, George Sanchez, Mark E Cinque, Zaamin B Hussain, Matthew T Provencher
Bicep tendon pathology often arises from chronic overuse injuries, acute trauma, or degenerative changes in the glenohumeral joint. These injuries can cause significant shoulder pain, and can greatly limit range of motion and, in turn, activities of daily living. The diagnosis of biceps pathologies can be challenging, because patients often present with nonspecific symptoms. Some bicep tendon pathologies may be treated nonoperatively; however, biceps tendon subluxation and the presence of rotator cuff or SLAP lesions require surgical management...
August 2017: Arthroscopy Techniques
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)...
January 19, 2018: Der Orthopäde
Jason P Rogers, Adam Kwapisz, John M Tokish
A subscapularis complete tear presents its own challenges in management. The glenohumeral biomechanics and force couple are reliant on a competent and functioning subscapularis muscle. An irreparable subscapularis makes those same challenges even more difficult to address. Traditionally, this problem has been addressed with tendon transfers, including pectoralis major or latissimus dorsi. These techniques can alter the ideal biomechanics of the shoulder and have high rates or failure. Iliotibial autograft or tibialis anterior have also been wrought with high failure rates...
December 2017: Arthroscopy Techniques
Nicolas Bonnevialle, Charles Edouard Thélu, Yves Bouju, Jérôme Vogels, Charles Agout, Pauline Duriez, Vadim Azoulay
BACKGROUND: The arthroscopic Latarjet with double-button fixation is a guided procedure recently proposed to treat anterior shoulder instability with glenoid bone loss. The goal of this study was to report intraoperative and early postoperative complications and to analyze the learning curve. METHODS: This was a prospective, nonrandomized study that included 88 patients. Intraoperative or postoperative complications as well as adverse events and operative time were recorded...
January 12, 2018: Journal of Shoulder and Elbow Surgery
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...
March 2018: American Journal of Sports Medicine
Jong-Beom Park, Sung Shik Kang, Jin S Yeom
RATIONALE: Traumatic C1-2 dislocation associated with contiguous or noncontiguous cervical spine injury is rare. Moreover, there have been no reports describing traumatic C1-2 dislocation associated with multiple contiguous and noncontiguous cervical injuries. PATIENT CONCERNS: The authors present a case of a 20-year-old male with painful limitation of motion of the neck. This complex cervical injury occurred due to hyperextension of the head in a rotated position...
December 2017: Medicine (Baltimore)
Thomas Berendes, Nina Mathijssen, Hennie Verburg, Gerald Kraan
INTRODUCTION: A Bankart procedure is a surgical technique for the repair of recurrent shoulder joint dislocations. This study reports the long-term results of the 'open'-modified Bankart procedure. METHODS: We performed a retrospective cohort study in which patients are studied who had open-modified Bankart surgery for instability problems in the absence of a substantial osseous glenoid defect after a traumatic shoulder dislocation, 16-26 years ago, in a large regional hospital...
January 3, 2018: Archives of Orthopaedic and Trauma Surgery
Kyle E Walker, Xavier C Simcock, Bong Jae Jun, Joseph P Iannotti, Eric T Ricchetti
BACKGROUND: Walch defined the pathologic characteristics of glenohumeral osteoarthritis on the basis of patterns of glenoid morphology and humeral head subluxation. However, it is unclear how pathologic changes evolve over time. The purpose of this study was to determine whether there are common patterns of pathologic progression based on the Walch classification in primary glenohumeral osteoarthritis and if glenoid bone-loss patterns correlate with rotator cuff fatty infiltration. METHODS: A retrospective chart review identified 65 shoulders with glenohumeral osteoarthritis for which at least 2 computed tomography (CT) scans had been performed at least 24 months apart...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
Peter Domos, Enricomaria Lunini, Gilles Walch
The Latarjet procedure is a well-known, safe and reliable technique to treat primary or recurrent anterior dislocations or subluxations, with or without hyperlaxity, with or without glenoid bone loss. Both the open and the arthroscopic methods produce excellent clinical results, with a low rate of recurrent instability. There have been concerns of a higher surgical complication rate associated with this procedure, however, large reviews reported an overall complication rate in the open Latarjet procedure of 15%...
January 2018: Shoulder & Elbow
Ricardo Grieshaber-Bouyer, Christian Gerber
CASE: A 53-year-old man presented with osteoarthritis (Walch biconcave [B2] glenoid retroversion, 22°; glenohumeral subluxation index, 65%) and a partial rupture of the supraspinatus tendon in the left shoulder. Following anatomic total joint replacement, he developed disabling recurrent posterior subluxation despite a stable prosthesis and a correctly centered glenoid head, as observed with postoperative radiography and computed tomography. In order to avoid bone loss and the complications associated with revision arthroplasty, we performed arthroscopic reefing of the posterior capsule as an experimental minimally invasive treatment...
July 2017: JBJS Case Connector
Ioannis D Papanastassiou, Olga D Savvidou, George D Chloros, Panayiotis D Megaloikonomos, Vasileios A Kontogeorgakos, Panayiotis J Papagelopoulos
BACKGROUND: The necessity of stabilizing the residual ulnar stump after distal ulna tumor resection remains controversial. The authors retrospectively compared the outcome of patients who underwent wide resection of distal ulna giant cell tumors (GCTs) and reconstruction with tenodesis of the extensor carpi ulnaris (ECU) or without reconstruction. METHODS: Between 2007 and 2015, 9 patients (6 females, 3 males; mean age, 36.8 years; range, 24-65 years) who underwent distal ulna resection for GCT of bone were retrospectively reviewed...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
Takayuki Kawasaki, Yoshinori Hasegawa, Takefumi Kaketa, Yuki Shiota, Yoshinori Gonda, Shogo Sobue, Hideo Kobayashi, Jun Yamakawa, Yoshiaki Itoigawa, Kazuo Kaneko
BACKGROUND: Although surgical shoulder stabilization by coracoid transfer is effective for collision athletes and has a low reinjury rate, no reports have described the midterm results of this procedure in specific patient cohorts of sufficient number or provided subjective assessments of these patients. PURPOSE: To evaluate midterm results after treatment of shoulder instability with the Bristow procedure in a large cohort of rugby players. STUDY DESIGN: Case series; Level of evidence, 4...
March 2018: American Journal of Sports Medicine
María Valencia Mora, Miguel Ángel Ruiz Ibán, Jorge Diaz Heredia, Juan Carlos Gutiérrez-Gómez, Raquel Ruiz Diaz, Mikel Aramberri, Carlos Cobiella
Background: The clinical evaluation of the patient with shoulder instability can be challenging. The pathological spectrum ranges from the straightforward "recurrent anterior dislocation" patient to the overhead athlete with a painful shoulder but not clear instability episodes. Advances in shoulder arthroscopy and imaging have helped in understanding the anatomy and physiopathology of the symptoms. The aim of this general article is to summarize the main examination manoeuvres that could be included in an overall approach to a patient with a suspicion of instability...
2017: Open Orthopaedics Journal
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