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Chad M Fortun, Ivan Wong, Joseph P Burns
Failed arthroscopic soft-tissue stabilization and anterior glenoid bone loss have been shown to have high failure rates after standard arthroscopic stabilization techniques. For patients with recurrent glenohumeral instability, the Bristow-Latarjet procedure is currently the standard of care. It is predominantly performed through an open deltopectoral approach but has recently been described arthroscopically. Although providing excellent clinical outcomes, the Bristow-Latarjet procedure violates the subscapularis muscle, has a steep learning curve with a high complication rate, and permanently changes the anterior shoulder anatomy, making any future revision surgery more challenging...
August 2016: Arthroscopy Techniques
Justin A Ly, Erin M Coleman, Eric J Kropf
The treatment of anterior shoulder instability is well described with various techniques, including arthroscopic double-row repair, an alternative to open stabilization procedures in high-risk groups. The surgical management of posterior instability in high-risk and athletic populations is a less-explored entity. We describe our technique for an all arthroscopic double-row suture anchor repair of a large posterior bony Bankart lesion. We prefer this technique over percutaneous cannulated screw fixation because the double-row suture technique allows for incorporation of capsular plication with bony fixation in an effort to better restore normal anatomy for capsulolabral complex...
August 2016: Arthroscopy Techniques
Mukesh Kumar, Jai Thilak
INTRODUCTION: The glenoid labrum is frequently torn in traumatic glenohumeral dislocation; arthroscopic repair is the standard method of treatment. The complications associated with this repair are pulling out of metal suture anchors, chondrolysis and joint infection. The infection of joint after arthroscopy is less than 1%. Staphylococcus is most common organism and rarely followed by Pseudomonas aeruginosa. We report a case of infected shoulder with chondrolysis of the joint and pulled out metal suture anchor lying inside the joint after Bankart's repair...
April 2016: Journal of Orthopaedic Case Reports
Brian Waterman, Brett D Owens, John M Tokish
CONTEXT: Given its young, predominately male demographics and intense physical demands, the US military remains an ideal cohort for the study of anterior shoulder instability. EVIDENCE ACQUISITION: A literature search of PubMed, MEDLINE, and the Cochrane Database was performed to identify all peer-reviewed publications from 1950 to 2016 from US military orthopaedic surgeons focusing on the management of anterior shoulder instability. STUDY DESIGN: Clinical review...
September 30, 2016: Sports Health
Jo Gibson, Jim Kerss, Chris Morgan, Peter Brownson
BACKGROUND: Advances in arthroscopic surgery have resulted in biomechanically stronger repairs that might allow for accelerated rehabilitation protocols and hence faster return to play. Evidence for such regimes in the shoulder, particularly in elite athletes, is lacking. METHODS: This prospective single surgeon (PB) series included 34 professional footballers undergoing an accelerated rehabilitation programme following arthroscopic soft tissue stabilization subsequent to traumatic anterior shoulder dislocation...
October 2016: Shoulder & Elbow
Christian Deml, Peter Kaiser, Wouter F van Leeuwen, Magdalena Zitterl, Simon A Euler
BACKGROUND: The J-shaped bone graft procedure is one of the recommended methods to reconstruct significant glenoid rim defects. PURPOSE: To evaluate long-term (minimum 10-year) clinical outcomes and show further details of the remodeling effects on the articular cavity of the glenoid after J-shaped bone grafting. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: A total of 14 patients treated with a J-shaped bone graft procedure were observed clinically...
September 15, 2016: American Journal of Sports Medicine
Yoshiaki Itoigawa, Alexander W Hooke, John W Sperling, Scott P Steinmann, Kristin D Zhao, Nobuyuki Yamamoto, Eiji Itoi, Kai-Nan An
BACKGROUND: It is not clear whether the anterior capsule should be repaired to the coracoid process or to the native glenoid during the modified Latarjet procedure. We investigated joint stability and range of motion of the shoulder after the modified Latarjet procedure with both of these methods of capsular repair. METHODS: Eighteen fresh-frozen cadaveric shoulders were used. After a Bankart lesion and 6-mm glenoid defect were created, the coracoid process was transferred to the glenoid and fixed with screws...
September 7, 2016: Journal of Bone and Joint Surgery. American Volume
S Schröter, M Krämer, B Welke, C Hurschler, R Russo, M Herbst, U Stöckle, A Ateschrang, M Maiotti
BACKGROUND: Anterior shoulder dislocation is common. The treatment of recurrence with glenoid bone defect is still considered controversial. A new arthroscopic subscapularis augmentation has recently been described that functions to decrease the anterior translation of the humeral head. The purpose of the presented study was to examine the biomechanical effect on glenohumeral joint motion and stability. METHODS: Eight fresh frozen cadaver shoulders were studied by use of a force guided industrial robot fitted with a six-component force-moment sensor to which the humerus was attached...
October 2016: Clinical Biomechanics
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
Philipp Moroder, Franziska Haniel, Michael Quirchmayr, Eva Schulz, Manfred Eppel, Nicholas Matis, Alexander Auffarth, Herbert Resch
BACKGROUND: Current glenoid defect measurement techniques only quantify bone loss in terms of defect diameter or surface. However, the glenoid depth plays an important role in shoulder stabilization by means of concavity compression. CASE PRESENTATION: We present a case of a professional wrestler who suffered from anterior shoulder instability after sustaining a bony Bankart lesion without loss of glenoid surface area but flattening of the concavity due to medialization of the fragment...
2016: BMC Musculoskeletal Disorders
Przemysław Lubiatowski, Jan Długosz, Marta Ślęzak, Piotr Ogrodowicz, Jakub Stefaniak, Joanna Walecka, Leszek Romanowski
PURPOSE: The evaluation of glenohumeral joint volume in both unstable (with/without laxity) and stable shoulders (subacromial impingement) and volume reduction potential of arthroscopic techniques: (labral anchor repair vs. capsular shift). METHODS: Material was based on 133 patients: anterior shoulder instability without laxity (group I, n = 49), with laxity (group II, n = 22) and subacromial impingement (control group, n = 62) operated in 2010-2011...
August 19, 2016: International Orthopaedics
Hassanin Alkaduhimi, Just A van der Linde, Nienke W Willigenburg, Nuno Rui Paulino Pereira, Derek F P van Deurzen, Michel P J van den Bekerom
BACKGROUND: The purpose of this review was to determine the redislocation risk for collision athletes after an arthroscopic Bankart repair and to compare the redislocation rate between collision athletes and noncollision athletes after an arthroscopic Bankart repair. METHODS: A PubMed and Embase query was performed, screening all relevant literature of arthroscopic Bankart procedures mentioning redislocation rates in collision athletes. Studies with a follow-up <2 years or lacking information on redislocation rates in collision athletes were excluded...
September 2016: Journal of Shoulder and Elbow Surgery
Shadpour Demehri, Nima Hafezi-Nejad, Elliot K Fishman
The inherently unstable anatomy of glenohumeral (GH) joint predisposes it to shoulder dislocation. Shoulder dislocation can occur either due to acute trauma or due to chronic microtraumas in the setting of underlying morphological abnormality. A plain radiograph is the initial imaging modality for diagnosis and management of shoulder dislocation and its associated osseous abnormalities such as Hill-Sachs deformity or osseous Bankart lesion. However, advanced imaging techniques such as multidetector CT (MDCT) with three-dimensional (3D) volume rendering and MRI can be helpful in further characterization of osseous abnormalities and detection of associated soft tissue injuries, respectively...
August 13, 2016: Emergency Radiology
Rajeev Mannem, Melissa DuBois, Matthew Koeberl, Damian Kosempa, Scott Erickson
Shoulder dislocations are frequently seen in the general population and can be a cause of instability. Instability can lead to debilitating symptoms and morbidity as a result of progressive damage to the shoulder. Anterior shoulder dislocations are the most frequent type of dislocations and have been studied extensively with MRI. The soft tissue Bankart lesion is the most well-known entity associated with anterior instability; however, additional structural lesions arising from traumatic events have been described in recent literature which also predispose to anterior shoulder instability...
October 2016: Skeletal Radiology
Davide Blonna, Enrico Bellato, Francesco Caranzano, Marco Assom, Roberto Rossi, Filippo Castoldi
BACKGROUND: The arthroscopic Bankart repair and open Bristow-Latarjet procedure are the 2 most commonly used techniques to treat recurrent shoulder instability. PURPOSE: To compare in a case control-matched manner the 2 techniques, with particular emphasis on return to sport after surgery. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A study was conducted in 2 hospitals matching 60 patients with posttraumatic recurrent anterior shoulder instability with a minimum follow-up of 2 years (30 patients treated with arthroscopic Bankart procedure and 30 treated with open Bristow-Latarjet procedure)...
August 8, 2016: American Journal of Sports Medicine
Maurice Balke, Sven Shafizadeh, Bertil Bouillon, Marc Banerjee
INTRODUCTION: The aim of this study was to evaluate the current state of treatment in traumatic anterior shoulder dislocation in Germany and to detect changes over the last 12 years. METHODS: Seven hundred ninety-six trauma and/or orthopaedic departments were found in the German hospital directory 2012. The websites of each department were searched for the email address of the responsible shoulder surgeon (if applicable) or the head of the department. Seven hundred forty-six email addresses were found, and emails with the request to participate in an online survey were sent in January 2013...
August 8, 2016: Archives of Orthopaedic and Trauma Surgery
Mohit N Gilotra, Matthew W Christian, Richard M Lovering
The patient was a 21-year-old collegiate running back who was tackled during a football game and sustained a posterior glenohumeral dislocation. He was referred to an orthopaedist and presented 3 weeks after the injury, and, following examination, further imaging was ordered by the orthopaedist due to rotator cuff weakness. Magnetic resonance imaging showed a complete tear of the supraspinatus and infraspinatus, as well as a posterior Bankart lesion, a subscapularis tear, and a dislocation of the biceps long head tendon into the reverse Hill-Sachs lesion...
August 2016: Journal of Orthopaedic and Sports Physical Therapy
Paul J Roubal, Jeffrey D Placzek
The patient was a 61-year-old woman who underwent long-lever manipulation under anesthesia (MUA) for adhesive capsulitis. Two weeks following MUA, the constellation of clinical findings raised concern for possible adverse outcomes. Radiographs were obtained, as well as subsequent magnetic resonance imaging and computed tomography scans. Images revealed anterior shoulder dislocation with Bankart and Hill-Sachs lesions, and an anterior rotator cuff tear. J Orthop Sports Phys Ther 2016;46(8):707. doi:10.2519/jospt...
August 2016: Journal of Orthopaedic and Sports Physical Therapy
Vishal Saxena, Kevin D'Aquilla, Shannon Marcoon, Guruprasad Krishnamoorthy, Joshua A Gordon, James L Carey, Ari Borthakur, J Bruce Kneeland, John D Kelly, Ravinder Reddy, Brian J Sennett
BACKGROUND: Patients who suffer anterior shoulder dislocations are at higher risk of developing glenohumeral arthropathy, but little is known about the initial cartilage damage after a primary shoulder dislocation. T1ρ is a magnetic resonance imaging (MRI) technique that allows quantification of cartilage proteoglycan content and can detect physiologic changes in articular cartilage. PURPOSE: This study aimed to establish baseline T1ρ MRI values for glenoid and humeral head cartilage, determine whether T1ρ MRI can detect glenohumeral cartilage damage after traumatic primary shoulder dislocation, and assess for patterns in cartilage damage in anterior shoulder dislocation...
July 27, 2016: American Journal of Sports Medicine
P García Parra, M Anaya Rojas, B Jiménez Bravo, M O González Oria, M Lisbona Muñoz, J J Gil Álvarez, P Cano Luis
INTRODUCTION: Only a few clinical exploratory manoeuvres are truly discriminatory and useful in shoulder disease. The aim of this study is to correlate the physical examination results of the shoulder with the true diagnosis found by arthroscopy. METHODS: A retrospective case series of 150 patients with the most common surgical conditions of the shoulder. Data were collected on the suspicion of each pathology, the physical examination of the patient, and the actual discovery of the disease during arthroscopic surgery...
September 2016: Revista Española de Cirugía Ortopédica y Traumatología
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