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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/29132328/posterior-shoulder-dislocation-with-associated-reverse-hill-sachs-lesion-treatment-options-and-functional-outcome-after-a-5-year-follow-up
#2
Markus Guehring, Simon Lambert, Ulrich Stoeckle, Patrick Ziegler
BACKGROUND: The current study describes several surgical techniques for the treatment of the reverse Hill - Sachs lesion after posterior shoulder dislocation; we also aimed to present long term results followed for a minimum of five years. METHODS: This study is a prospective case series of 17 patients who were treated in our clinic between 2008 and 2011. Patients with a defect size smaller than 25% of the articular surface were treated conservatively. An endoprosthesis of the glenohumeral joint was implanted in patients with a defect size bigger than 40%...
November 13, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29125820/rafting-technique-without-bone-grafting-in-reverse-hill-sachs-lesions
#3
Meriç Çırpar, Birhan Oktaş, Bülent Dağlar
In this article, we report a case of bilateral posterior shoulder instability, having reverse Hill-Sachs lesions of 25 to 50% of the articular surface on the right side, and of 50% on the left side. The defects were anatomically reconstructed after tuberculum minus osteotomy by elevation of the articular surface and buttressing with raft screws without graft usage. Early rehabilitation with pendulum shoulder exercises was started at third postoperative day. At postoperative sixth week, patient had full range of motion without instability and pain...
December 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/29124296/-diagnostics-and-treatment-of-posterior-shoulder-instability
#4
REVIEW
M Wellmann, M-F Pastor, T Smith
Posterior shoulder instability has a markedly lower incidence than anterior shoulder instability. It has a wide spectrum of clinical symptom manifestations and the overwhelming number of patients lack a traumatic primary dislocation. In addition to a detailed medical history, a specific clinical examination with the help of standardized provocation tests is essential for the diagnostics. For the detection of structural posterior capsule and labral lesions in cases of chronic courses, magnetic resonance imaging (MRI) should be used with an intra-articular contrast agent...
November 9, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29117482/zero-echo-time-imaging-of-the-shoulder-enhanced-osseous-detail-by-using-mr-imaging
#5
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/29114335/imaging-of-the-unstable-shoulder
#6
Paolo Baudi, Manuela Rebuzzi, Giovanni Matino, Fabio Catani
Background: Unstable shoulder can occur in different clinical scenarios with a broad spectrum of symptoms and presentations: first-time (or recurrent) traumatic acute shoulder anterior dislocation or chronic anterior instability after repeated dislocations.Imaging in unstable shoulder is fundamental for choosing the right treatment preventing recurrence.The goal of imaging depends on clinical scenario and patient characteristics. Method: Careful selection and evaluation of the imaging procedures is therefore essential to identify, characterize and quantify the lesions...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29101634/understanding-the-hill-sachs-lesion-in-its-role-in-patients-with-recurrent-anterior-shoulder-instability
#7
REVIEW
Jake A Fox, Anthony Sanchez, Tyler J Zajac, Matthew T Provencher
PURPOSE OF REVIEW: The purpose of this study is to provide an update to the orthopedic field in regard to treatment of the Hill-Sachs lesion and anterior shoulder instability. The review highlights the most current knowledge of epidemiology, clinical evaluation, and surgical methods used to treat Hill-Sachs lesions. It also details the relevant clinical and surgical findings that have been made throughout the literature in the past couple of years. RECENT FINDINGS: The most recent literature covering the Hill-Sachs lesion has focused on the relatively new and unexplored topic of the importance of concomitant injuries while treating a humeral head defect...
December 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29058754/partial-resurfacing-for-humeral-head-defects-associated-with-recurrent-shoulder-instability
#8
Matthew C Bessette, Nicholas C Frisch, Pradeep Kodali, Morgan H Jones, Anthony Miniaci
Recurrent traumatic shoulder instability is a complex clinical entity that commonly affects young, active patients. Humeral head defects are frequently associated with this condition, but specific treatment to stabilize the shoulder is rarely needed. Management options for defects of the humeral head that do necessitate treatment carry various risks and disadvantages, including the need for bone or soft tissue healing, complications related to hardware, and loss of motion. Partial prosthetic resurfacing has been reported as a treatment option...
October 20, 2017: Orthopedics
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/28988351/management-of-complex-anterior-shoulder-instability-a-case-based-approach
#10
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/28983224/arthroscopic-treatment-of-osseous-instability-of-the-shoulder
#11
REVIEW
David A Porter, Michael Birns, Sarah J Hobart, Marc Kowalsky, Gregory J Galano
BACKGROUND: Bony deficiency of the anteroinferior glenoid rim as a result of a dislocation can lead to recurrent glenohumeral instability. These lesions, traditionally treated by open techniques, are increasingly being treated arthroscopically as our understanding of the pathophysiology and anatomy of the glenohumeral joint becomes clearer. Different techniques for arthroscopic management have been described and continue to evolve. While the success of the repair is surgeon dependent, the recent advances in arthroscopic shoulder surgery have contributed to the growing acceptance of arthroscopic reconstruction of glenoid bone defects to restore stability...
October 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
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/28979598/evaluation-and-management-of-failed-shoulder-instability-surgery
#13
António Cartucho, Nuno Moura, Marco Sarmento
BACKGROUND: Failed shoulder instability surgery is mostly considered to be the recurrence of shoulder dislocation but subluxation, painful or non-reliable shoulder are also reasons for patient dissatisfaction and should be considered in the notion. METHODS: The authors performed a revision of the literature and online contents on evaluation and management of failed shoulder instability surgery. RESULTS: When we look at the reasons for failure of shoulder instability surgery we point the finger at poor patient selection, technical error and an additional traumatic event...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28979596/treatment-of-the-posterior-unstable-shoulder
#14
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/28970982/concomitant-reverse-hill-sachs-lesion-and-posterior-humeral-avulsion-of-the-glenohumeral-ligament-treatment-with-fresh-talus-osteochondral-allograft-and-arthroscopic-posterior-humeral-avulsion-of-the-glenohumeral-ligament-and-labrum-repair
#15
Justin J Mitchell, Alexander R Vap, George Sanchez, Daniel J Liechti, Jorge Chahla, Gilbert Moatshe, Márcio B Ferrari, Matthew T Provencher
Chronic posterior glenohumeral joint instability can be a challenging clinical entity for patients and surgeons alike. In the setting of a posterior dislocation, a large anterior humeral impaction injury (reverse Hill-Sachs [HS]) may occur, leading to engagement of the humerus with the posterior glenoid bone, especially during internal rotation of the joint. A reverse HS is especially debilitating because of the significant portion of affected humeral head cartilage, and is made worse in the setting of ligamentous disruption such as a posterior humeral avulsion of the glenohumeral ligament (HAGL) lesions...
August 2017: Arthroscopy Techniques
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
#16
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
#17
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/28952782/does-the-arthroscopic-latarjet-procedure-effectively-correct-off-track-hill-sachs-lesions
#18
Johannes E Plath, Daniel J H Henderson, Julien Coquay, Klaus Dück, David Haeni, Laurent Lafosse
BACKGROUND: The glenoid track concept describes the dynamic interaction of bipolar bone loss in anterior glenohumeral instability. Initial studies have successfully demonstrated this concept's application in clinical populations. In clinical practice, the Latarjet procedure is commonly the preferred treatment in addressing "off-track" Hill-Sachs lesions. The effectiveness of this procedure in restoring such lesions to an "on-track" state, however, has not yet been evaluated or described in the literature...
September 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28942024/eponymous-terms-in-anterior-shoulder-stabilization-surgery
#19
REVIEW
M P Somford, J A Van der Linde, J I Wiegerinck, D Hoornenborg, M P J Van den Bekerom, D F P Van Deurzen
Shoulder dislocation and its treatment are probably as old as time. Surgical treatment has gained acceptance recently, especially in recurrent cases. Within roughly the last 100years, numerous treatment strategies have been developed and questions elucidated regarding the entity of shoulder instability. Shoulder instability holds many eponymous terms. By means of literature and historical research, we present the biographical background of some common eponymous terms and the original publication on which those terms are based...
September 20, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28932486/-on-track-and-off-track-shoulder-lesions
#20
REVIEW
E Itoi
Shoulder stability depends on the position of the arm as well as activities of the muscles around the shoulder. The capsulo-ligamentous structures are the main stabilisers with the arm at the end-range of movement, whereas negative intra-articular pressure and concavity-compression effect are the main stabilisers with the arm in the mid-range of movement.There are two types of glenoid bone loss: fragment type and erosion type. A bone loss of the humeral head, known as a Hill-Sachs lesion (HSL), is a compression fracture of the humeral head caused by the anterior rim of the glenoid when the humeral head is dislocated anteriorly in front of the glenoid...
August 2017: EFORT open reviews
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