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Glenohumeral joint instability

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https://www.readbyqxmd.com/read/30091179/feasibility-and-safety-of-arthroscopic-medial-glenohumeral-ligament-and-subscapularis-tendon-repair-with-knotless-anchors-a-cadaveric-study-in-dogs
#1
Alexandra Penelas, Andreas Gutbrod, Karolin Kühn, Antonio Pozzi
OBJECTIVE: To test the feasibility and safety of an arthroscopic imbrication of the medial glenohumeral ligament (MGHL) and the subscapularis tendon with knotless anchors in dogs. STUDY DESIGN: Cadaveric study. SAMPLE POPULATION: Ten limbs. METHODS: Cranial and caudal arms of the MGHL were imbricated with a 2.9- or a 2.4-mm knotless anchor. A horizontal mattress suture secured with a 3.5-mm knotless anchor was used to imbricate the subscapularis tendon...
August 9, 2018: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/30090835/comparison-of-a-distal-tibial-allograft-and-scapular-spinal-autograft-for-posterior-shoulder-instability-with-glenoid-bone-loss
#2
Christopher Nacca, Joseph A Gil, Steven F DeFroda, Rohit Badida, Brett D Owens
Background: Posterior glenoid bone deficiency can occur with recurrent glenohumeral instability. Glenoid reconstruction with a distal tibial allograft (DTA) has been reported to successfully restore contact pressures that occur during posterior glenohumeral translation. However, there are concerns regarding the risk of allograft resorption, availability, and costs. Extracapsular reconstruction using a scapular spinal autograft (SSA) has been reported as an alternative technique secondary to its anatomic location relative to the posterior shoulder and preferable autograft properties...
July 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/30059443/traumatic-anterior-instability-treatment-options-for-initial-instability
#3
Jeffrey R Dugas, Matthew W Crozier
Because of the lack of bony restraints and minimal articular contact, the glenohumeral joint can attain significant range of motion; however, this results in the propensity for instability. The most generic form of instability, traumatic anterior instability, reliably produces a series of pathoanatomic findings. While reliable, these findings contribute to the complexities of caring for patients after an initial instability event. Numerous studies have examined this issue and determined that careful consideration of patient factors can guide successful treatment, whether it be surgical or nonsurgical, after initial instability...
September 2018: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/30025379/scapular-muscles-weakness-in-subjects-with-traumatic-anterior-glenohumeral-instability
#4
Walter Ansanello Netto, Gisele Garcia Zanca, Michele Forgiarini Saccol, Salomão Chade Assan Zatiti, Stela Márcia Mattiello
OBJECTIVE: To investigate possible alterations on scapular muscle strength in subjects with traumatic anterior glenohumeral instability. DESIGN: Cross-sectional study. SETTING: Laboratory setting. PARTICIPANTS: Fifty-two subjects of both sexes: 26 healthy and 26 with traumatic anterior glenohumeral instability. MAIN OUTCOME MEASURES: Subjects performed maximal isometric and concentric isokinetic contractions of shoulder protraction and retraction in scapular and sagittal planes, at slow (12...
July 11, 2018: Physical Therapy in Sport
https://www.readbyqxmd.com/read/29985051/the-incidence-of-glenohumeral-bone-and-cartilage-lesions-at-the-time-of-anterior-shoulder-stabilization-surgery-a-comparison-of-patients-undergoing-primary-and-revision-surgery
#5
Kyle R Duchman, Carolyn M Hettrich, Natalie A Glass, Robert W Westermann, Brian R Wolf, Keith Baumgarten, Julie Bishop, Jonathan Bravman, Robert Brophy, James Carpenter, Grant Jones, John Kuhn, C Benjamin Ma, Robert Marx, Eric McCarty, Bruce Miller, Matthew Smith, McCarty Eric, Bruce Miller, Matthew Smith, Rick Wright, Alan Zhang
BACKGROUND: Intra-articular glenohumeral joint changes frequently occur after shoulder instability events. PURPOSE: (1) To compare demographic characteristics, baseline patient-reported outcomes, and intraoperative findings for patients undergoing primary or revision shoulder stabilization surgery and (2) to determine the incidence of glenohumeral bone and cartilage lesions in this population while identifying factors independently associated with these lesions...
August 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29881921/anatomic-analysis-of-the-whole-articular-capsule-of-the-shoulder-joint-with-reference-to-the-capsular-attachment-and-thickness
#6
Daisuke Momma, Akimoto Nimura, Satoru Muro, Hitomi Fujishiro, Takashi Miyamoto, Tadanao Funakoshi, Tomoyuki Mochizuki, Norimasa Iwasaki, Keiichi Akita
BACKGROUND: Although conventional Bankart repair has been the accepted procedure for traumatic anterior glenohumeral instability, the humeral avulsion of the glenohumeral ligament or an elongation of the capsule remains challenging to decide the appropriate treatment. The anatomical knowledge regarding the whole capsule of glenohumeral joint is necessary to accurately treat for the capsular disorders. The aims of the current study were to investigate the anatomical features of capsular attachment and thickness in a whole capsule of glenohumeral joint...
June 7, 2018: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/29851867/what-are-the-effects-of-capsular-plication-on-translational-laxity-of-the-glenohumeral-joint-a-study-in-cadaveric-shoulders
#7
Stephanie W Mayer, Andrew P Kraszewski, Anne Skelton, Andreas Kontaxis, Russell Warren
BACKGROUND: Surgical treatment for shoulder instability generally involves labral repair with a capsular plication or imbrication. Good results are reported in both open and arthroscopic procedures, but there is no consensus on the amount or location of capsular plication that is needed to achieve stability and anatomic anterior, posterior, and inferior translation of the joint. QUESTIONS/PURPOSES: (1) What are the separate and combined effects of increasing plication magnitude and sequential additive plications in the anterior, posterior, and inferior locations of the joint capsule on glenohumeral joint translation in the anterior, posterior, and inferior directions? (2) What plication location and magnitude restores anterior, posterior, and inferior translation to a baseline level? METHODS: Fourteen cadaveric shoulders were dissected down to the glenohumeral capsule and underwent instrumented biomechanical testing...
July 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29781910/superior-baseplate-inclination-is-associated-with-instability-after-reverse-total-shoulder-arthroplasty
#8
Robert Z Tashjian, Brook I Martin, Cassandra A Ricketts, Heath B Henninger, Erin K Granger, Peter N Chalmers
BACKGROUND: Instability is the most common complication after reverse total shoulder arthroplasty (rTSA). In the native glenohumeral joint, in addition to full dislocations, more subtle forms of instability exist. However, the incidence of more subtle forms of instability, the factors associated with instability, and the effect of instability on validated outcome scores after rTSA remain poorly understood. QUESTIONS/PURPOSES: (1) After rTSA, what is the risk of instability, including more subtle forms of subjective instability? (2) What are the factors associated with instability? (3) Are more subtle forms of instability associated with lower American Shoulder and Elbow Surgeons (ASES) functional outcome scores than those patients without instability? METHODS: A total of 168 rTSAs were performed during the study period...
August 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29770343/does-the-beighton-score-correlate-with-specific-measures-of-shoulder-joint-laxity
#9
Noah A Whitehead, Khalid D Mohammed, Mark L Fulcher
Background: Evaluation of shoulder joint laxity is an important component of the shoulder examination, especially in the setting of shoulder instability. Measures of generalized joint laxity, particularly the Beighton score, are often recorded and used to help make management decisions in these cases. However, no evidence is available to show that the Beighton score corresponds to specific measures of shoulder joint laxity. Purpose: To assess the correlation between the Beighton score and validated measures of shoulder joint laxity...
May 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29697499/management-of-articular-cartilage-defects-in-the-glenohumeral-joint
#10
Adam J Seidl, Matthew J Kraeutler
Articular cartilage defects are not often encountered in the glenohumeral joint. These lesions are typically found in patients with shoulder trauma, recurrent instability, or previous surgical treatment. Diagnosis can be difficult; these defects are often found incidentally during arthroscopic or open surgical management of other pathology. Initial management of isolated glenohumeral chondral defects is nonsurgical and includes physical therapy and/or corticosteroid injections. If nonsurgical treatment is unsuccessful, patients may undergo surgery...
June 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29659379/bony-reconstruction-of-the-anterior-glenoid-rim
#11
Laurent B Willemot, Bassem T Elhassan, Olivier Verborgt
Recurrent anterior shoulder instability is associated with glenohumeral bone loss. Glenoid deficiency compromises the concavity-compression mechanism. Medial Hill-Sachs lesions can result in an off-track humeral position. Anterior glenoid reconstruction or augmentation prevents recurrence by addressing the pathomechanics. In Bristow and Latarjet procedures, the coracoid process is harvested for conjoint tendon transfer, capsular reinforcement, and glenoid rim restoration. Complications and the nonanatomic nature of the procedure have spurred research on graft sources...
May 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29629579/anatomical-total-shoulder-arthroplasty-in-young-patients-with-osteoarthritis
#12
COMPARATIVE STUDY
M O Gauci, N Bonnevialle, G Moineau, M Baba, G Walch, P Boileau
Aims: Controversy about the use of an anatomical total shoulder arthroplasty (aTSA) in young arthritic patients relates to which is the ideal form of fixation for the glenoid component: cemented or cementless. This study aimed to evaluate implant survival of aTSA when used in patients aged < 60 years with primary glenohumeral osteoarthritis (OA), and to compare the survival of cemented all-polyethylene and cementless metal-backed glenoid components. Materials and Methods: A total of 69 consecutive aTSAs were performed in 67 patients aged < 60 years with primary glenohumeral OA...
April 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29589497/risk-factors-for-recurrent-instability-or-revision-surgery-following-arthroscopic-bankart-repair
#13
S A Mahure, B Mollon, B M Capogna, J D Zuckerman, Y W Kwon, A S Rokito
Aims: The factors that predispose to recurrent instability and revision stabilization procedures after arthroscopic Bankart repair for anterior glenohumeral instability remain unclear. We sought to determine the rate and risk factors associated with ongoing instability in patients undergoing arthroscopic Bankart repair for instability of the shoulder. Materials and Methods: We used the Statewide Planning and Research Cooperative System (SPARCS) database to identify patients with a diagnosis of anterior instability of the shoulder undergoing arthroscopic Bankart repair between 2003 and 2011...
March 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29567036/fibrocartilaginous-metaplasia-identified-in-the-long-head-of-the-biceps-brachii
#14
Carlo Bottegoni, Luca Farinelli, Alberto Aquili, Sandra Manzotti, Marco Baldini, Antonio Gigante
BACKGROUND: In the glenohumeral joint, the long head of biceps brachii (LHBB) is exposed to tension and compression loading. The short head of biceps brachii (SHBB) works only in tension. It is known that tendon under compression might develop fibrocartilaginous metaplasia that improves the resistance to compression but reduces the resistance to tension. This study evaluated the presence of cartilage in LHBB and SHBB samples, supporting its possible role in tendon tear. METHODS: Between 2014 and 2016, 13 samples of LHBB and SHBB were collected during surgery for shoulder instability, glenohumeral arthritis, and massive rotator cuff tears...
July 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29537865/critical-glenoid-bone-loss-in-posterior-shoulder-instability
#15
Christopher Nacca, Joseph A Gil, Rohit Badida, Joseph J Crisco, Brett D Owens
BACKGROUND: There is currently no consensus regarding the amount of posterior glenoid bone loss that is considered critical. Critical bone loss is defined as the amount of bone loss that occurs in which an isolated labral repair will not sufficiently restore stability. PURPOSE: The purpose is to identify the critical size of the posterior defect. STUDY DESIGN: Controlled laboratory study. METHODS: Eleven cadaveric shoulders were tested...
April 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29487784/pectoralis-major-muscle-transfer-with-the-sternal-head-and-hamstring-autograft-for-scapular-winging
#16
Antonio Cusano, Nicholas Pagani, Xinning Li
Medial scapular winging is often due to dysfunction of the serratus anterior muscle as a result of injury to the long thoracic nerve. Impairment of the serratus anterior muscle may cause uncoordinated scapulohumeral rhythm during shoulder elevation and subsequent subscapular or shoulder pain, subacromial impingement, and glenohumeral joint instability. Although long thoracic nerve injury typically resolves in 12 to 18 months after a physical therapy regimen, surgical intervention is indicated in patients who fail conservative management...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29464283/-osteoarthritis-of-the-shoulder-pathogenesis-diagnostics-and-conservative-treatment-options
#17
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...
May 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29443703/the-thrower-s-shoulder
#18
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...
March 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29430393/arthroscopic-posterior-glenoid-fracture-fixation-using-knotless-suture-anchors
#19
Jonathan A Baxter, James Tyler, Nivander Bhamber, Magnus Arnander, Eyiyemi Pearse, Duncan Tennent
Shoulder instability after a posterior glenoid rim fracture is rare and potentially difficult pathology to treat. Operative techniques often involve a large dissection to view the fragments resulting in local soft tissue injury. Internal fixation is often achieved with interfragmentary screws; however, this may not be possible with small or multifragmentary fracture patterns. We describe an arthroscopic technique for posterior glenoid rim fracture fixation using knotless suture anchors. These anchors can be inserted without cannulas allowing easier access to the posterior glenoid...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29356622/evidence-based-review-of-clinical-diagnostic-tests-and-predictive-clinical-tests-that-evaluate-response-to-conservative-rehabilitation-for-posterior-glenohumeral-instability-a-systematic-review
#20
REVIEW
Jasdeep Dhir, Myles Willis, Lyn Watson, Lyndsay Somerville, Jackie Sadi
CONTEXT: Posterior glenohumeral instability is poorly understood and can be challenging to recognize and evaluate. Using evidence-based clinical and predictive tests can assist clinicians in appropriate assessment and management. OBJECTIVE: To review evidence-based clinical diagnostic tests for posterior glenohumeral instability and predictive tests that identify responders to conservative management. DATA SOURCES: A comprehensive electronic bibliographic search was conducted using Embase, Ovid MEDLINE, PEDro, and CINAHL databases from their date of inception to February 2017...
March 2018: Sports Health
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