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Mandeep S Virk, Richard L Manzo, Mark Cote, James K Ware, Augustus D Mazzocca, Carl W Nissen, Kevin P Shea, Robert A Arciero
BACKGROUND: The results of open and arthroscopic instability repairs have been shown to be equivalent in recent literature. PURPOSE: To compare the time to recurrence (TTR) of instability and disease-specific outcome measures in patients undergoing open and arthroscopic Bankart repair. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Patients with recurrent traumatic anterior shoulder instability and a Bankart lesion on diagnostic arthroscopy underwent either open Bankart repair (OB) or arthroscopic Bankart and suture capsulorrhaphy (ABSC) using suture anchors...
June 2016: Orthopaedic Journal of Sports Medicine
M Brett Raynor, Marilee P Horan, Joshua A Greenspoon, J Christoph Katthagen, Peter J Millett
BACKGROUND: Outcomes after arthroscopic pancapsular capsulorrhaphy (APC) with suture anchors for multidirectional instability (MDI) of the shoulder are not widely reported. PURPOSE: To compare intraoperative findings and midterm outcomes of APC with suture anchors for MDI between female and male athletes and between a classic, atraumatic onset versus clinical onset of MDI after a traumatic event. STUDY DESIGN: Cohort study; Level of evidence, 3...
August 19, 2016: American Journal of Sports Medicine
Josef K Eichinger, Joseph W Galvin, Jason A Grassbaugh, Stephen A Parada, Xinning Li
➤Subtle forms of glenoid dysplasia may be more common than previously thought and likely predispose some patients to symptomatic posterior shoulder instability. Severe glenoid dysplasia is a rare condition with characteristic radiographic findings involving the posteroinferior aspect of the glenoid that often remains asymptomatic.➤Instability symptoms related to glenoid dysplasia may develop over time with increased activities or trauma. Physical therapy focusing on rotator cuff strengthening and proprioceptive control should be the initial management...
June 1, 2016: Journal of Bone and Joint Surgery. American Volume
Brian R Waterman, Philip J Chandler, Edward Teague, Matthew T Provencher, John M Tokish, Mark P Pallis
PURPOSE: To describe the short-term clinical outcomes of glenoid bone block augmentation in a high-demand population, as well as to describe its clinical success and complications at greater than 2 years' follow-up in an at-risk military population. METHODS: All patients undergoing anterior capsulorrhaphy with coracoid process transfer or anterior bone block augmentation (Current Procedural Terminology code 23662 or 23460) for shoulder instability between 2006 and 2012 were isolated from the Military Health System Management Analysis and Reporting Tool...
September 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Neil L Duplantier, Patrick C McCulloch, Shane J Nho, Richard C Mather, Brian D Lewis, Joshua D Harris
PURPOSE: To determine patient- and surgery-specific characteristics of patients sustaining postarthroscopic hip dislocation or subluxation. METHODS: A systematic review of multiple medical databases was registered with PROSPERO and performed using Preferred Reporting Items for Systemic Reviews and Meta-Analysis guidelines. Level I to IV clinical outcome studies reporting the presence of hip dislocation or subluxation after hip arthroscopy were eligible. Length of follow-up was not an exclusion criterion...
July 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Carlos Suarez-Ahedo, S Pavan Vemula, Christine E Stake, Zachary A Finley, Timothy J Martin, Chengcheng Gui, Benjamin G Domb
The role of radiofrequency energy (RFE) devices has been minimally studied in hip arthroscopy. The purpose of this study was to determine the role of RFE devices in hip arthroscopy through a systematic review of the literature. We searched the PubMed database using the following Medical Subject Heading terms: hip arthroscopy, hip radiofrequency, thermal capsulorrhaphy, thermal chondroplasty and radiofrequency debridement. Two authors independently reviewed the literature and included articles based on predetermined inclusion criteria...
December 2015: Journal of Hip Preservation Surgery
Omer Mei-Dan, Tigran Garabekyan, Mark McConkey, Cecilia Pascual-Garrido
Symptomatic anterior instability of the hip is typically iatrogenic in nature and poses a challenging problem for the orthopaedist. With early recognition, capsular repair and plication are often effective in restoring stability. Cases involving multiple instability episodes or those with delayed presentation, however, may have patulous and deficient capsular tissue precluding successful capsulorrhaphy. Capsular reconstruction may play an important role in restoring stability in these difficult cases. We present an arthroscopic technique for iliofemoral ligament reconstruction, with Achilles tendon allograft, to address instability of the hip due to anterior capsular deficiency...
December 2015: Arthroscopy Techniques
Amar A Patel, Ali A Alhandi, Edward Milne, Christopher J Dy, Loren L Latta, E Anne Ouellette
PURPOSE: To assess ulnocarpal joint stability after treatment of a peripheral triangular fibrocartilage complex (TFCC) injury with all-inside arthroscopic suture repair (SR), extensor retinaculum capsulorrhaphy with the Herbert sling (HS), and a combination of both (SR+HS). METHODS: Twelve fresh-frozen, age-matched, upper-extremity specimens intact from the distal humerus were prepared. Nondestructive mechanical testing was performed to assess native ulnocarpal joint stability and load-displacement curves were recorded...
March 2016: Journal of Hand Surgery
Umile Giuseppe Longo, Giacomo Rizzello, Mattia Loppini, Joel Locher, Stefan Buchmann, Nicola Maffulli, Vincenzo Denaro
PURPOSE: To analyze outcomes of surgical and conservative treatment options for multidirectional instability (MDI). METHODS: A systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed. A comprehensive search of the PubMed, MEDLINE, CINAHL, Cochrane, EMBASE, and Google Scholar databases using various combinations of the keywords "shoulder," "multidirectional instability," "dislocation," "inferior instability," "capsulorrhaphy," "capsular plication," "capsular shift," "glenoid," "humeral head," "surgery," and "glenohumeral," over the years 1966 to 2014 was performed...
December 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
Ahmed Naeem Atiyya, Wael A M Nassar
PURPOSE: To evaluate the validity of performing a static anti-claw procedure (metacarpophalangeal joint volar capsulorrhaphy and A1 and A2 pulley release) at the time of ulnar nerve repair for acute or chronic lacerations to prevent development of claw hand deformity and disability or to correct them. METHODS: We present a case series of 14 patients for whom metacarpophalangeal joint capsulorrhaphy and pulley advancement were done at the time of ulnar nerve management...
September 2015: Journal of Hand Surgery
Mickaël Ropars, Armel Cretual, Rajiv Kaila, Isabelle Bonan, Anthony Hervé, Hervé Thomazeau
PURPOSE: There is a paucity of data detailing management of anterior capsular redundancy (ACR) when using the Latarjet procedure for unidirectional instability. This study aimed to describe the surgical management and to assess the clinical profile of patients presenting with anterior capsular redundancy [ACR(+)] with anterior shoulder instability. METHODS: Seventy-seven patients who had a Latarjet procedure were followed for a 55-month period. Per-operative ACR was assessed during surgery...
May 24, 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Sheila McRae, Jeff Leiter, Kanthalu Subramanian, Robert Litchfield, Peter MacDonald
PURPOSE: Electrothermal arthroscopic capsulorrhaphy (ETAC) was introduced as an adjunct to shoulder stabilization surgery to address capsular laxity in the treatment of traumatic anterior dislocation. No previous RCT has compared arthroscopic Bankart repair with ETAC of the medial glenohumeral ligament and anterior band of the inferior glenohumeral ligament versus undergoing arthroscopic Bankart repair alone. Our hypothesis was that there would be no difference in quality of life between these two groups...
February 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Tudisco C, Bisicchia S, Savarese E, Ippolito E
BACKGROUND: There is still debate about the best treatment option for highly recurrent anterior shoulder dislocation in patients with severe impairment of the anterior capsule and/or recurrence after either arthroscopic or open capsulorrhaphy. Materials and. METHODS: The clinical and radiological findings of 7 patients treated with an open capsulorrhaphy stabilized with an "8 plate" for a highly recurrent traumatic anterior shoulder dislocation with severe impairment of the anterior capsule and a large Bankart lesion were retrospectively reviewed...
2014: Open Orthopaedics Journal
Frederick A Matsen
PURPOSE: The purpose of this paper is to provide some essential and basic information concerning the ream and run technique for shoulder arthroplasty. METHODS: In a total shoulder arthroplasty, the humeral head prosthesis articulates with a polyethylene glenoid surface placed on the bone of the glenoid. Failure of the glenoid component is recognised as the principal cause of failure of total shoulder arthroplasty. By contrast, in the ream and run procedure, the humeral head prosthesis articulates directly with the glenoid, which has been conservatively reamed to provide a stabilising concavity and maximal glenohumeral contact area for load transfer...
February 2015: International Orthopaedics
Andrew S Neviaser, Michael T Benke, Robert J Neviaser
BACKGROUND: The purpose of this study was to analyze the outcome of open Bankart repair for failed stabilization surgery at a mean follow-up of >10 years. MATERIALS AND METHODS: Thirty patients underwent revision open Bankart repair by a single surgeon for failed prior stabilization surgery, with a standard technique and postoperative rehabilitation. All patients were referred by other surgeons. Evaluation was by an independent examiner, at a mean follow-up of 10...
June 2015: Journal of Shoulder and Elbow Surgery
Kasey Rolfes
OBJECTIVE: Shoulder instability is a common disorder of the shoulder that can result in debilitating pain and decreased function. Poorly treated cases of instability result in excessive mobility, possibly leading to labral tears and degenerative arthritis. The purpose of my systematic review was to compare the effectiveness of 2 popular arthroscopic techniques used to reduce shoulder instability: capsular plication and thermal capsulorrhaphy. DATA SOURCES: Articles were retrieved from PubMed, Cochrane Library, and Ovid/MEDLINE searches using the terms capsular plication, capsular shift, capsular shrinkage, shoulder capsulorrhaphy, and treatment of shoulder instability...
January 2015: Journal of Athletic Training
Grant H Garcia, Samuel A Taylor, Christopher J Dy, Alexander Christ, Ronak M Patel, Joshua S Dines
BACKGROUND: Evaluations of the medical literature suggest that many online sites provide poor-quality information. The purpose of our study was to investigate the value of online resources for patient education about shoulder instability. METHODS: Three search terms ("shoulder instability," "loose shoulder," and "shoulder dislocation") were entered into three Internet search engines. Three orthopaedic residents independently gauged the quality and accuracy of the information with use of a set of predetermined scoring criteria, in addition to noting whether or not four potential surgery options were mentioned...
October 15, 2014: Journal of Bone and Joint Surgery. American Volume
Peter N Chalmers, Randy Mascarenhas, Timothy Leroux, Eli T Sayegh, Nikhil N Verma, Brian J Cole, Anthony A Romeo
PURPOSE: Shoulder instability frequently recurs in young patients without operative treatment. Both open and arthroscopic approaches to shoulder stabilization with labral repair and capsulorrhaphy have been described and are routinely used. Multiple trials have been conducted to compare these approaches, with multiple meta-analyses performed to synthesize these trials; however, the results remain controversial. The purpose of this study was to critically evaluate the current meta-analyses to identify the current state of the art...
February 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
Timothy S Johnson, Christine M DiPompeo, Zahra C Ismaeli, Polly A Porter, Shannon L Nicholson, David C Johnson
Recurrent shoulder instability often leads to labral abnormality that requires surgical intervention that may require fixation with suture anchors. The proposed surgical technique allows the surgeon to achieve 2 points of fixation around the labrum and/or capsule with a single suture secured to the glenoid with a knotless anchor. Instead of cutting and discarding the residual suture limbs after anchor insertion, this technique uses the residual suture limbs of the knotless anchor for a second suture pass. This technique (1) creates a more cost- and time-efficient surgical procedure than using multiple single-loaded anchors or double-loaded anchors, (2) decreases the known risk of glenoid fracture from the stress riser at the implant tips of multi-anchor repairs by reducing the number of anchors required for stabilization, (3) decreases the surgical time compared with the use of double-loaded anchors through simpler suture management and less knot tying, (4) allows for the secure reapproximation of the labrum to the glenoid while offering a convenient option for capsulorrhaphy without the need to insert another anchor, and (5) yields more points of soft-tissue fixation with fewer anchors drilled into the glenoid...
June 2014: Arthroscopy Techniques
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