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https://www.readbyqxmd.com/read/29135565/pediatric-and-adolescent-anterior-shoulder-instability-clinical-management-of-first-time-dislocators
#1
Kenneth M Lin, Evan W James, Elad Spitzer, Peter D Fabricant
PURPOSE OF REVIEW: The purpose of this review is to discuss the epidemiology, pathoanatomy, diagnosis, and clinical management of pediatric and adolescent patients following a first-time shoulder dislocation. RECENT FINDINGS: Shoulder instability is becoming increasingly common as pediatric and adolescent patients engage in earlier organized sports competition. Recommended treatment following a first-time glenohumeral dislocation event in adolescents depends on several factors, but surgical stabilization is becoming more frequently performed...
November 11, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29127438/-bony-bankart-lesions-and-glenoid-defects-from-refixation-techniques-to-bony-augmentation
#2
REVIEW
V Rausch, M Königshausen, J Geßmann, T A Schildhauer, D Seybold
Rim defects of the anterior glenoid cavity are a main reason for residual shoulder instability after traumatic dislocation of the shoulder. These defects can be the result of a glenoid rim fracture or chronic glenoid erosion after repeated shoulder dislocations. Treatment concepts for these entities are entirely different. While in the acute fracture situation glenoid rim fractures can be treated operatively or non-operatively, augmentation of the anterior glenoid for stabilization of the shoulder should be considered if the defect exceeds 15-25% of the anterior glenoid...
November 10, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29119123/indication-for-computed-tomography-scan-in-shoulder-instability-sensitivity-and-specificity-of-standard-radiographs-to-predict-bone-defects-after-traumatic-anterior-glenohumeral-instability
#3
Audrey Delage Royle, Frédéric Balg, Martin J Bouliane, Fanny Canet-Silvestri, Laurianne Garant-Saine, David M Sheps, Peter Lapner, Dominique M Rouleau
Background: Quantifying glenohumeral bone loss is key in preoperative surgical planning for a successful Bankart repair. Hypothesis: Simple radiographs can accurately measure bone defects in cases of recurrent shoulder instability. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: A true anteroposterior (AP) view, alone and in combination with an axillary view, was used to evaluate the diagnostic properties of radiographs compared with computed tomography (CT) scan, the current gold standard, to predict significant bone defects in 70 patients...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29117482/zero-echo-time-imaging-of-the-shoulder-enhanced-osseous-detail-by-using-mr-imaging
#4
Ryan E Breighner, Yoshimi Endo, Gabrielle P Konin, Lawrence V Gulotta, Matthew F Koff, Hollis G Potter
Purpose To determine the intermodality agreement of morphologic grading and clinically relevant quantitative measurements between computed tomography (CT) and zero echo time (ZTE) magnetic resonance (MR) imaging of the shoulder. The primary objective was to demonstrate the clinical applicability of ZTE in osseous shoulder imaging. Materials and Methods Thirty-four patients undergoing standard-of-care (SOC) MR imaging with concomitant CT were enrolled in this institutional review board-approved study. ZTE images were acquired after SOC MR imaging...
November 8, 2017: Radiology
https://www.readbyqxmd.com/read/29102020/editorial-commentary-when-a-tie-is-still-a-win-systematic-reviews-showing-no-difference-between-treatments-may-not-be-generalizable-to-individual%C3%A2-patients
#5
EDITORIAL
Merrick J Wetzler
When a systematic review finds no difference between treatment options for a particular disorder, this could mean more than you think. Individual patients requiring shoulder Bankart repair are unique with respect to their demands and expectations and pathology. Surgeons should combine published principles with understanding of their own skills and their specific patient to optimize a treatment outcome.
November 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29101541/rotator-cuff-muscular-integrity-after-arthroscopic-revision-of-a-bankart-repair
#6
Johannes Buckup, Frederic Welsch, Reinhard Hoffmann, Philip P Roessler, Karl F Schüttler, Thomas Stein
INTRODUCTION: Recurrent shoulder instability after arthroscopic Bankart repair is still a common complication. For primary Bankart repair studies have shown that the rotator cuff can recover completely. The ability of muscles to regenerate after arthroscopic revision Bankart repair (ARBR) has not been studied. Does the ARBR using a three-portal method allows complete muscle integrity compared with an uninjured imaging control group (ICG)? MATERIALS AND METHODS: Twenty-two (1 female, 21 males) physically active patients (mean age at follow-up 28...
November 3, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29100080/validity-of-radial-magnetic-resonance-imaging-to-determine-the-extent-of-bankart-lesions
#7
Akiko Ogura, Toru Morihara, Hiroyoshi Fujiwara, Yuji Arai, Yoshikazu Kida, Hirotoshi Ito, Ryuhei Furukawa, Yukichi Kabuto, Tsuyoshi Sukenari, Toshikazu Kubo
PURPOSE: The objectives were to compare conventional oblique coronal and axial images with radial images to determine the capacities of these modalities for visualizing sites in the glenoid labrum. MATERIALS AND METHODS: The glenoid labra of 45 patients without a labrum injury and 30 patients with Bankart lesions were examined by magnetic resonance imaging using three different sections. RESULTS: The radial images permitted a greater range of assessment of the morphology of the glenoid labrum than the conventional images...
October 20, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/29076041/return-to-sports-after-shoulder-stabilization-surgery-for-anterior-shoulder-instability
#8
REVIEW
Michael J Elsenbeck, Jonathan F Dickens
PURPOSE OF REVIEW: Young athletes continue to experience traumatic shoulder instability and are often plagued by recurrent instability, limiting their return to sport. The purpose of this paper was to review return to sport in athletes after shoulder stabilization surgery for anterior shoulder instability. RECENT FINDINGS: Athletes managed nonoperatively demonstrate unacceptably high rates of recurrent instability and are less likely to successfully return to sport...
December 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28994025/applying-the-glenoid-track-concept-in-the-management-of-patients-with-anterior-shoulder-instability
#9
REVIEW
Amit M Momaya, John M Tokish
PURPOSE OF REVIEW: The purpose of this paper is to evaluate the recent evolution in the treatment of anterior shoulder instability and the dynamic interaction between the glenoid and Hill-Sachs lesion. RECENT FINDINGS: Through the glenoid track concept, glenoid- and humeral-sided bone loss are evolving away from being approached as separate entities. Recent cadaveric studies have validated the glenoid track concept. Moreover, a recent clinical study has demonstrated a much higher rate of failure after arthroscopic Bankart repair for shoulders that were off track...
December 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28989939/recovery-of-shoulder-rotational-muscle-strength-after-arthroscopic-bankart-repair
#10
Masatoshi Amako, Hiroshi Arino, Yoshifumi Tsuda, Toyokazu Tsuchihara, Koichi Nemoto
BACKGROUND: Shoulder rotational muscles act as dynamic stabilizers of the glenohumeral joint, and the recovery of muscle strength plays an important role in stabilizing the joint during postoperative rehabilitation. However, temporal changes in muscle strength after arthroscopic Bankart repair have not been clarified. PURPOSE: To better understand the temporal recovery of shoulder rotational muscle strength after arthroscopic Bankart repair. STUDY DESIGN: Case series; Level of evidence, 4...
September 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28988351/management-of-complex-anterior-shoulder-instability-a-case-based-approach
#11
REVIEW
Nathan Olszewski, Michael Gustin, Emily J Curry, Xinning Li
PURPOSE OF THE REVIEW: The goal of this review is to provide a guide on surgical decision-making options for complex anterior shoulder instability using a case-based approach. RECENT FINDINGS: Arthroscopic Bankart repair is well documented for having successful outcomes in patients with isolated labral tear involvement with minimal bone loss. Latarjet is a generally accepted procedure in patients with 20-30% glenoid bone loss. When bone loss exceeds that which cannot be managed through Latarjet, a range of options exist and are highly dependent upon the extent of osseous deficiency on both the glenoid and humeral sides, surgeon experience, and patient-specific factors...
December 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28979604/management-of-humeral-defects-in-anterior-shoulder-instability
#12
Maria Valencia Mora, Miguel Ángel Ruiz-Ibán, Jorge Diaz Heredia, Raquel Ruiz Diaz, Ricardo Cuéllar
BACKGROUND: A Hill Sachs lesion is a posterior-superior bony defect of the humeral head caused by a compression of the hard glenoid rim against the soft cancellous bone in the context of an anterior instability episode. The presence of these humeral defects increases with the number of dislocations and larger lesions are associated with a greater chance of development of recurrent instability and recurrence after surgery. Also its location and pattern, in particular the so-called engaging Hill-Sachs, are associated with poor prognosis...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28979603/controversies-in-the-surgical-management-of-shoulder-instability-associated-soft-tissue-procedures
#13
Santos Moros Marco, José Luis Ávila Lafuente, Miguel Angel Ruiz Ibán, Jorge Diaz Heredia
BACKGROUND: The glenohumeral joint is a ball-and-socket joint that is inherently unstable and thus, susceptible to dislocation. The traditional and most common anatomic finding is the Bankart lesion (anterior-inferior capsule labral complex avulsion), but there is a wide variety of anatomic alterations that can cause shoulder instability or may be present as a concomitant injury or in combination, including bone loss (glenoid or humeral head), complex capsule-labral tears, rotator cuff tears, Kim´s lesions (injuries to the posterior-inferior labrum) and rotator interval pathology...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28979597/controversies-in-the-surgical-management-of-shoulder-instability-open-vs-arthroscopic-procedures
#14
Alejandro Huerta, Gustavo Rincón, Lluis Peidro, Andreu Combalia, Sergi Sastre
BACKGROUND: Traumatic anterior instability of the shoulder is a common condition associated with a high recurrence rate in young adults. Operative treatment reduces the risk of recurrence. Several studies have compared arthroscopic and open shoulder instability repair. The purpose of this paper is to perform a review of the literature where both techniques are compared in the repair of the anterior shoulder instability without bone loss. METHODS: Prior to arthroscopy, recurrent dislocations were managed by open repair...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28979596/treatment-of-the-posterior-unstable-shoulder
#15
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/28971317/arthroscopic-bankart-repair-for-the-management-of-anterior-shoulder-instability-indications-and-outcomes
#16
REVIEW
Steven DeFroda, Steven Bokshan, Evan Stern, Kayleigh Sullivan, Brett D Owens
PURPOSE OF REVIEW: Arthroscopic Bankart repair is commonly utilized for shoulder stabilization in patients with anterior shoulder instability with minimum glenoid bone loss. The purpose of this review is to provide the indications, surgical technique, complications, and recent outcomes in arthroscopic Bankart repair for shoulder instability. RECENT FINDINGS: Improvements in arthroscopic techniques have led to better patient outcomes, as well as an improved understanding of the pathoanatomy of instability...
December 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28969813/editorial-commentary-postoperative-outcomes-are-we-asking-the-right-questions-shoulder-arthroscopy-patient-quality-of-life-correlates-with-joint-specific-outcome-and-is-predicated-on-patient-expectation
#17
EDITORIAL
Jonas Pogorzelski, Peter J Millett
Patient-reported outcomes are, by definition, subjective, and there is consensus that individual patient expectations have a significant effect on the postoperative outcome after shoulder arthroscopy. Most of the outcomes in orthopaedic surgery are measured either in terms of functional scores assessing only one joint or as disease or condition-specific outcomes. As such, there exists a growing interest developing better tools to measure quality-of-life outcome scores as an assessment of overall patient health and satisfaction...
October 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28969811/editorial-commentary-off-track-hill-sachs-lesions-in-adolescents-with-multiple-anterior-dislocations-the-case-for-stabilizing-adolescent-first-time-dislocators
#18
EDITORIAL
Stephen S Burkhart
Recurrent anterior dislocations in adolescents reveal a high rate of off-track Hill-Sachs lesions, much higher than in adults. This new information makes a strong case in favor of arthroscopic Bankart repair for adolescents with a first-time anterior dislocation of the shoulder.
October 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28965317/radiographic-evaluation-of-patients-with-anterior-shoulder-instability
#19
REVIEW
Andrew J Kompel, Xinning Li, Ali Guermazi, Akira M Murakami
PURPOSE OF REVIEW: Injuries to the labrum, joint capsule (in particular the inferior glenohumeral ligament), cartilage, and glenoid periosteum are associated with anterior shoulder instability. The goal of this review is to provide common radiographic images and findings in patients with anterior shoulder instability. Furthermore, we will demonstrate the best methods for measuring anterior glenoid bone loss. RECENT FINDINGS: Magnetic resonance (MR) imaging is highly relied upon for evaluating anterior shoulder instability and can diagnose soft tissue injuries with high sensitivity...
December 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28963282/the-potential-clinical-benefits-of-medicines-optimisation-through-comprehensive-geriatric-assessment-carried-out-by-secondary-care-geriatricians-in-a-general-practice-care-setting-in-north-staffordshire-uk-a-feasibility-study
#20
Simon Christian Lea, Keira Louise Watts, Nathan Ashley Davis, Barnabas Panayiotou, Michael John Bankart, Amit Arora, Ruth Chambers
OBJECTIVES: To evaluate the feasibility and potential clinical benefits of medicines optimisation through comprehensive geriatric assessment (CGA) of frail patients with multiple conditions, by secondary care geriatricians in a general practice care setting. METHODS: Seven general practitioner (GP) practices in one region of Stoke-on-Trent volunteered to take part. GPs selected patients (n=186) who were local permanent residents, at least 65 years old and on eight or more medications per day...
September 28, 2017: BMJ Open
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