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"Shoulder anatomy"

Ryan A Mlynarek, Simon Lee, Asheesh Bedi
The overhead pitching motion is a coordinated sequence of movements that subjects the shoulder to extreme forces. The ultimate goal of this complex, dynamic activity is to generate high ball velocity and accuracy. In doing so, repetitive throwing can cause adaptive and pathologic changes in the thrower's shoulder. This article reviews the relevant shoulder anatomy, the kinetic chain, and throwing mechanics, as well as common shoulder injuries and surgical options for the treating orthopedic surgeon.
February 2017: Hand Clinics
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
Adam M Pourcho, Sean W Colio, Mederic M Hall
Chronic and acute shoulder pain and dysfunction are common complaints among patients. Shoulder pain may be the result of abnormality involving the rotator cuff, subacromial-subdeltoid bursa, biceps tendon, glenoid labrum, glenohumeral joint, acromioclavicular joint, sternoclavicular joint, or glenohumeral joint capsule. Ultrasound-guided (USG) procedures of the shoulder are well established for interventional management. Ultrasound provides the advantages of excellent soft tissue resolution, injection accuracy, low cost, accessibility, portability, lack of ionizing radiation, and the ability to perform real-time image-guided procedures...
August 2016: Physical Medicine and Rehabilitation Clinics of North America
Anthony G Ho, Ashok L Gowda, J Michael Wiater
Management of the unstable shoulder after a failed stabilization procedure can be difficult and challenging. Detailed understanding of the native shoulder anatomy, including its static and dynamic restraints, is necessary for determining the patient's primary pathology. In addition, evaluation of the patient's history, physical exam, and imaging is important for identifying the cause for failure after the initial procedure. Common mistakes include under-appreciation of bony defects, failure to recognize capsular laxity, technical errors, and missed associated pathology...
September 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Larry D Field, Richard K N Ryu, Jeffrey S Abrams, Matthew Provencher
Arthroscopic shoulder stabilization offers several potential advantages compared with open surgery, including the opportunity to more accurately evaluate the glenohumeral joint at the time of diagnostic assessment; comprehensively address multiple pathologic lesions that may be identified; and avoid potential complications unique to open stabilization, such as postoperative subscapularis failure. A thorough understanding of normal shoulder anatomy and biomechanics, along with the pathoanatomy responsible for anterior, posterior, and multidirectional shoulder instability patterns, is very important in the management of patients who have shoulder instability...
2016: Instructional Course Lectures
Chan Hong Park, Sang Ho Lee
BACKGROUND: Cervical epidural steroid injection (CESI), given in conjunction with local anesthetics, is a common remedy for cervical radicular pain and is generally performed under c-arm fluoroscopic guidance, computed tomography (CT), or ultrasound. Interlaminar procedures, such as CESI, typically rely on anteroposterior and lateral (APL) views during needle placement. However, lateral views may be obscured by body habitus in certain individuals. Swimmer's view or contralateral oblique (CLO) view may be used to avoid this...
September 2016: Pain Practice: the Official Journal of World Institute of Pain
Bakir Kadum, Hamid Hassany, Mats Wadsten, Arkan Sayed-Noor, Göran Sjödén
PURPOSE: The aim of this study was to investigate the ability of a stemless shoulder prosthesis to restore shoulder anatomy in relation to premorbid anatomy. METHODS: This prospective study was performed between May 2007 and December 2013. The inclusion criteria were patients with primary osteoarthritis (OA) who had undergone stemless total anatomic shoulder arthroplasty. Radiographic measurements were done on anteroposterior X-ray views of the glenohumeral joint...
April 2016: International Orthopaedics
Benjamin Bockmann, Sonja Soschynski, Philipp Lechler, Steffen Ruchholtz, Florian Debus, Tim Schwarting, Michael Frink
PURPOSE: Profound knowledge of variations in shoulder anatomy is gaining relevance in daily clinical work. In our study, we examine age-dependent variations of glenohumeral parameters in healthy individuals. METHODS: In this analysis, 774 severely injured patients who received a whole-body computed tomography (CT) scan were included. Patients with shoulder fractures were excluded. The resulting scans were split into two groups: patients younger than 25 (group 1) and older than 60 years (group 2)...
January 2016: International Orthopaedics
Jorge H Villafañe, Kristin Valdes, Fabio Anselmi, Caterina Pirali, Stefano Negrini
STUDY DESIGN: A cohort study. INTRODUCTION: The causes of the pain can be difficult for clinicians to diagnose due to the complexity of the shoulder anatomy and the wide spectrum of shoulder conditions. PURPOSE OF THE STUDY: The aim of this study was to investigate the clinical usefulness of provocative diagnostic tests, in patients with partial-thickness tears of the supraspinatus (SST) tendon. METHODS: The partial-thickness tears SST tendon group consisted of 50 patients and 50 subjects with shoulder pain...
July 2015: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Soterios Gyftopoulos, Eric J Strauss
OBJECTIVE: The objectives of the article are to improve the radiologist's understanding of shoulder arthroscopy and see how it correlates with MRI. We review the basic principles of arthroscopy followed by a comparison of its strengths and weaknesses relative to MRI. This discussion is supplemented by a series of cases that show the relationship between arthroscopy and MRI in terms of the visualization of normal and abnormal anatomy in the diagnosis of common shoulder abnormalities. CONCLUSION: By understanding what our orthopedic colleagues are seeing (and not seeing) during arthroscopic shoulder surgery, we can better understand the strengths and weaknesses of MRI, which provides us the opportunity to improve our imaging interpretations and produce valuable management-guiding diagnostic reports...
June 2015: AJR. American Journal of Roentgenology
Thomas Youm, Richelle Takemoto, Brian Kyu-Hong Park
The shoulder joint has the greatest range of motion of any joint in the body. However, it relies on soft-tissue restraints, including the capsule, ligaments, and musculature, for stability. Therefore, this joint is at the highest risk for dislocation. Thorough knowledge of the shoulder's anatomy as well as classification of dislocations, anesthetic techniques, and reduction maneuvers is crucial for early management of acute shoulder dislocation. Given the lack of comparative studies on various reduction techniques, the choice of technique is based on physician preference...
December 2014: Journal of the American Academy of Orthopaedic Surgeons
Randy Mascarenhas, Jamie Rusen, Bryan M Saltzman, Jeff Leiter, Jaskarndip Chahal, Anthony A Romeo, Peter MacDonald
Recurrent shoulder instability and resultant glenoid and humeral head bone loss are not infrequently encountered in the population today, specifically in young, athletic patients. This review on the management of bone loss in recurrent glenohumeral instability discusses the relevant shoulder anatomy that provides stability to the shoulder joint, relevant history and physical examination findings pertinent to recurrent shoulder instability, and the proper radiological imaging choices in its workup. Operative treatments that can be used to treat both glenoid and humeral head bone loss are outlined...
2014: Advances in Orthopedics
Todd C Moen, Glen H Rudolph, Kyle Caswell, Christopher Espinoza, Wayne Z Burkhead, Sumant G Krishnan
Over the past 20 to 30 years, arthroscopic shoulder techniques have become increasingly popular. Although these techniques have several advantages over open surgery, surgical complications are no less prevalent or devastating than those associated with open techniques. Some of the complications associated with arthroscopic shoulder surgery include recurrent instability, soft-tissue injury, and neurapraxia. These complications can be minimized with thoughtful consideration of the surgical indications, careful patient selection and positioning, and a thorough knowledge of the shoulder anatomy...
July 2014: Journal of the American Academy of Orthopaedic Surgeons
J R Andrews, W G Carson
Our technique of diagnostic and surgical shoulder arthroscopy is presented, and normal variational arthroscopic anatomy of the shoulder is described. This report was based on the diagnostic findings of 118 patients (120 shoulders) who, over a 26-month period, presented with pain, popping, or instability of the shoulder and who underwent diagnostic or operative shoulder arthroscopy. The average duration of symptoms prior to surgery was 12 months. Arthroscopic examination revealed one or more abnormalities in 88% of the patients...
September 1, 1983: Orthopedics
Luis S Beltran, Jenny T Bencardino, Lynne S Steinbach
Magnetic resonance imaging (MRI) evaluation of the postoperative shoulder presents technical and diagnostic challenges related to imaging artifacts from hardware and micrometallic shavings, postsurgical scarring, and morphological alterations. Improved visualization of postoperative shoulder anatomy and pathology can be obtained with the use of metal artifact reduction techniques as well as MR arthrography. In this article we review the MR techniques that are designed to address these technical and diagnostic challenges, and we discuss the definitions and indications, normal MRI appearance, and complications of routine surgical procedures for treatment of injuries to the rotator cuff, labral ligamentous complex, and biceps tendon...
December 2014: Journal of Magnetic Resonance Imaging: JMRI
Maike Mueller, Gregory Hoy
Total shoulder arthroplasty is now capable of recreating near anatomic reproduction of native bony shoulder anatomy, but the function and longevity of anatomic shoulder replacement is dependent on a competent soft tissue envelope and adequate motoring of all musculo-tendinous units about the shoulder. Balancing the soft tissues requires understanding of the anatomy and pathology, as well as technical skills. The advent of reverse shoulder biomechanics has brought with it special requirements of understanding of the soft tissue elements still left in the shoulder despite major rotator cuff deficiency...
March 2014: Current Reviews in Musculoskeletal Medicine
Eric P Tannenbaum, Jon K Sekiya
Historically, posterior shoulder instability has been a challenging problem for contact athletes and orthopedic surgeons alike. A complete understanding of the normal shoulder anatomy and biomechanics and the pathoanatomy responsible for the instability is necessary for a successful clinical outcome. In addition, the surgeon must be familiar with the diagnostic imaging and physical examination maneuvers required for the correct diagnosis without missing any other concurrent abnormalities. This understanding will allow orthopedists to plan and execute the appropriate management, whether this may involve conservative or surgical intervention...
October 2013: Clinics in Sports Medicine
C Quental, J Folgado, J Ambrósio, J Monteiro
The reverse shoulder replacement, recommended for the treatment of several shoulder pathologies such as cuff tear arthropathy and fractures in elderly people, changes the biomechanics of the shoulder when compared to the normal anatomy. Although several musculoskeletal models of the upper limb have been presented to study the shoulder joint, only a few of them focus on the biomechanics of the reverse shoulder. This work presents a biomechanical model of the upper limb, including a reverse shoulder prosthesis, to evaluate the impact of the variation of the joint geometry and position on the biomechanical function of the shoulder...
November 2013: Journal of Biomechanical Engineering
E Wiedemann
Modern shoulder prostheses adapt to the size, inclination, posterior offset and retrotorsion of the shoulder anatomy. Typical implants are cup prostheses for surface replacement, stemless prostheses that anchor in metaphyseal bone, anatomical prostheses using stems of different lengths, and last but not least reverse prostheses. The main reasons for implantation of shoulder prostheses are primary osteoarthritis, posttraumatic and rheumatoid arthritis, avascular necrosis, arthritis of instability and cuff defect arthropathy...
July 2013: Der Orthopäde
Johannes F Plate, Patrick Haubruck, Jordan Walters, Sandeep Mannava, Beth P Smith, Thomas L Smith, Christopher J Tuohy
Professional and recreational athletes involved in contact sports and sports with repetitive overhead motion are at increased risk for rotator cuff tears. Shoulder anatomy, pathology, and biomechanics place unique stress on the rotator cuff tendons during sports activity. Athletes demand effective treatment to quickly return to elite competition. A PubMed search assessed treatment options providing expedited recovery time and return to competition. Twelve of 231 articles fit the objective criteria; 90.5% of professional contact athletes, 40% of professional overhead athletes, and 83...
2013: Journal of Surgical Orthopaedic Advances
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