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https://www.readbyqxmd.com/read/28970978/anterior-capsular-reconstruction-for-irreparable-subscapularis-tears
#1
Jonas Pogorzelski, Zaamin B Hussain, George F Lebus, Erik M Fritz, Peter J Millett
Chronic anterior shoulder instability due to structural failure of the subscapularis muscle and the anterior capsule is a rare and challenging diagnosis for surgeons to manage because poor-quality capsular, labral, and rotator cuff tissue often limits effective treatment options. If primary repair is not possible because of retraction and poor tissue quality, reconstruction with an allograft or autograft may be the only joint-preserving option. The purpose of this article is to describe a surgical technique for anterior capsular reconstruction using a human acellular dermal allograft for the treatment of irreparable subscapularis tears...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28965317/radiographic-evaluation-of-patients-with-anterior-shoulder-instability
#2
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...
September 30, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28948058/reverse-total-shoulder-arthroplasty-as-treatment-for-rotator-cuff-tear-arthropathy-and-shoulder-dislocations-in-an-elderly-male-with-parkinson-s-disease
#3
John G Skedros, James S Smith, Tanner D Langston, Micheal G Adondakis
We report the case of a 70-year-old male with Parkinson's disease (PD) and recurrent traumatic left shoulder dislocations. This case is rare because (1) he had a massive irreparable rotator cuff tear and end-stage arthritis (i.e., rotator cuff-tear arthropathy) of the same shoulder and (2) his shoulder was ultimately reconstructed with a reverse total shoulder arthroplasty (RTSA). His first dislocation occurred after a fall. Recurrent shoulder dislocations occurred despite successful closed reduction and physical therapy...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28873347/outcomes-of-capsulolabral-reconstruction-for-posterior-shoulder-instability
#4
K Andrieu, J Barth, M Saffarini, P Clavert, A Godenèche, P Mansat
BACKGROUND: Surgical treatment of isolated posterior shoulder instability-a rare and often misdiagnosed condition-is controversial because of poor outcomes. Failure of physical therapy in symptomatic young athletes requires capsulolabral reconstruction or bone block procedures. The goal of this study was to report the outcomes of patients who have undergone surgical capsulolabral reconstruction and to look for risk factors that contribute to failure of this procedure. MATERIAL AND METHOD: We analyzed the outcomes of 101 patients who underwent capsulolabral reconstruction: 83 included retrospectively, 18 included prospectively...
September 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28873346/painful-posterior-shoulder-instability-anticipating-and-preventing-failure-a-study-in-25-patients
#5
Jerome Garret, Geoffroy Nourissat, Marie Béatrice Hardy, Diego Antonucci, Philippe Clavert, Pierre Mansat, Arnaud Godenèche
BACKGROUND: Painful posterior shoulder instability (PPSI) is the least common of the three clinical patterns of posterior shoulder instability. PPSI is defined as pain combined with anatomical evidence of posterior instability but no instability events. MATERIAL AND METHOD: We studied a multicentre cohort of 25 patients with PPSI; 23 were identified retrospectively and had a follow-up of at least 2 years and 2 patients were included prospectively. Most patients engaged in sports...
September 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28839500/arthroscopic-acetabular-labral-reconstruction-with-fascia-lata-allograft-clinical-outcomes-at-minimum-one-year-follow-up
#6
Ritesh Rathi, Jacek Mazek
BACKGROUND: The integrity of the acetabular labrum is crucial to normal biomechanics of the hip joint. Disruption of the labral seal could be detrimental to the overall nutrition of the cartilage, leading to its premature degeneration. PURPOSE: The aim of this study is to determine the clinical effectiveness of arthroscopic hip labral reconstruction using fascia lata allograft. The hypothesis is that labral reconstruction would provide good clinical outcomes. METHODS: We retrospectively reviewed all 10 patients who underwent labral reconstruction with fascia lata allograft from January 2013 to October 2015...
2017: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/28717888/acetabular-labral-reconstruction-using-the-indirect-head-of-the-rectus-femoris-tendon-significantly-improves-patient-reported-outcomes
#7
Eyal Amar, Thomas G Sampson, Zachary T Sharfman, Alyssa Caplan, Noa Rippel, Ran Atzmon, Michael Drexler, Ehud Rath
PURPOSE AND HYPOTHESIS: The aim of this study was to evaluate outcomes after acetabular labral reconstruction using the indirect head of the rectus femoris tendon. The study hypothesis stated that arthroscopic acetabular labral reconstruction may improve patient reported outcomes in patients with labral tears that were not amenable to repair. METHODS: Between 2009 and 2015, the senior author performed 31 acetabular labral reconstructions using the indirect head of the rectus femoris tendon...
July 17, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28706819/circumferential-labral-reconstruction-using-the-knotless-pull-through-technique-surgical-technique
#8
Itay Perets, David E Hartigan, Edwin O Chaharbakhshi, John P Walsh, Mary R Close, Benjamin G Domb
Arthroscopic labral reconstruction is an alternative procedure for an irreparable hip labrum in the nonarthritic hip population. Although labral reconstruction is a relatively new procedure, data in the literature show favorable outcomes. Patients have shown beneficial outcomes from labral reconstructive surgery as well as when compared with labral repair and debridement patients. However, one of the challenges in performing labral reconstruction has been correctly measuring the graft to perfectly fit the area of labral deficiency...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706807/labral-gracilis-tendon-allograft-reconstruction-and-cartilage-regeneration-scaffold-for-an-uncontained-acetabular-cartilage-defect-of-the-hip
#9
Laurel E MacInnis, Ahmed Al Hussain, Catherine Coady, Ivan H Wong
Hip cartilage injuries are very common, with rates as high as 50% having been reported in some series; abnormal femoral acetabular contact can result in a full-thickness cartilage defect or labral lesion. The prevalence of labral lesions can be as high as 55%. This Technical Note describes an arthroscopic technique to reconstruct an uncontained, full-thickness, focal cartilage defect of the acetabulum, with reconstruction of the missing labrum using a gracilis allograft and use of a biological liquid scaffold for cartilage reconstruction...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28636468/do-ligamentum-teres-tears-portend-inferior-outcomes-in-patients-with-borderline-dysplasia-undergoing-hip-arthroscopic-surgery-a-match-controlled-study-with-a-minimum-2-year-follow-up
#10
Edwin O Chaharbakhshi, Itay Perets, Lyall Ashberg, Brian Mu, Christopher Lenkeit, Benjamin G Domb
BACKGROUND: Arthroscopic surgery in borderline dysplastic hips remains controversial, but the role of the ligamentum teres (LT) has not been studied in this setting. HYPOTHESIS: Borderline dysplastic patients with LT tears have worse short-term outcomes than those without LT tears. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Data were prospectively collected on patients who underwent arthroscopic surgery between February 2008 and April 2014...
September 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28630729/acetabular-rim-length-an-anatomical-study-to-determine-reasonable-graft-sizes-for-labral-reconstruction
#11
Michael R Karns, Sunny H Patel, Jensen Kolaczko, Raymond W Liu, Richard C Mather, Brian J White, Shane J Nho, Michael J Salata
The purpose of this article is to determine normative values for the length of the acetabular rim and detect differences between gender, age, ethnicity, height and leg length. Six measurements were taken on the acetabular rim of 143 cadaveric skeleton specimens (286 acetabula) using a coordinate-measuring device: circumferential (excluding acetabular notch), anterior inferior iliac spine (AIIS)-anterior, AIIS-posterior, 12-3 o'clock, 12-9 o'clock and 11-5 o'clock. Museum specimen height data and leg length data from a previous study were recorded for 109 of 143 specimens...
January 2017: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/28630724/labral-reconstruction-with-tendon-allograft-histological-findings-show-revascularization-at-8-weeks-from-implantation
#12
Esther Moya Gómez, Carlomagno Cardenas, Emmanuelle Astarita, Vittorio Bellotti, Francesc Tresserra, Luis Gerardo Natera, Manel Ribas
This description shows the histological findings of a peroneus brevis tendon allograft used for labral reconstruction, implanted 8 weeks before being retrieved due to a postoperative complication unrelated to the graft. As far as we have knowledge this is the first description about revascularization of an allograft used for hip labral reconstruction. The histological report of the removed peroneus brevis tendon allograft shows evidence of vascular ingrowth represented by small vessels with a thin muscular wall in all layers of the graft and cellular migration mainly represented by mature fibroblasts...
January 2017: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/28630722/hip-arthroscopy-protocol-expert-opinions-on-post-operative-weight-bearing-and-return-to-sports-guidelines
#13
Ehud Rath, Zachary T Sharfman, Matan Paret, Eyal Amar, Michael Drexler, Nicolas Bonin
The objectives of this study are to survey the weight-bearing limitation practices and delay for returning to running and impact sports of high volume hip arthroscopy orthopedic surgeons. The study was designed in the form of expert survey questionnaire. Evidence-based data are scares regarding hip arthroscopy post-operative weight-bearing protocols. An international cross-sectional anonymous Internet survey of 26 high-volume hip arthroscopy specialized surgeons was conducted to report their weight-bearing limitations and rehabilitation protocols after various arthroscopic hip procedures...
January 2017: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/28580252/arthroscopic-hip-labral-augmentation-technique-with-iliotibial-band-graft
#14
Renato Locks, Jorge Chahla, Jonathan M Frank, Jack Anavian, Jonathan A Godin, Marc J Philippon
The importance of the acetabular labrum has been well documented for the function and overall health of the hip joint. Several biomechanical studies have shown the sealing effect of the acetabular labrum. In the past decade, labral repair procedures have gained increased attention, with the literature suggesting that the outcomes after hip arthroscopy are directly related to labral preservation. However, a primary labral repair can be challenging in cases of hypoplastic, ossified, or complex and irreparable labral tears in which there is insufficient tissue to perform a primary repair...
April 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28571722/arthroscopic-reconstruction-of-segmental-defects-of-the-hip-labrum-results-in-22-patients-with-mean-2-year-follow-up
#15
Sivashankar Chandrasekaran, Nader Darwish, Mary R Close, Parth Lodhia, Carlos Suarez-Ahedo, Benjamin G Domb
PURPOSE: To report mean 2-year patient-reported outcomes (PROs) and the incidence of revision hip arthroscopy or conversion to total hip arthroplasty (THA) in patients who had undergone arthroscopic reconstruction of the hip labrum for segmental defects. METHODS: Data were prospectively collected and retrospectively reviewed on all patients who had undergone hip arthroscopy from April 2008 to April 2013. All patients who underwent arthroscopic labral reconstruction with either a semitendinosus allograft or a gracilis autograft with mean 2-year follow-up were part of the inclusion criteria...
September 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28409104/multidirectional-shoulder-instability-arthroscopic-labral-augmentation
#16
Enrico Gervasi, Enrico Sebastiani, Alessandro Spicuzza
Capsulolabral augmentation is one of the most used arthroscopic techniques to address multidirectional instability of the shoulder. Given the thin and weak capsule seen in the affected patients, reconstruction in this subset of patients can be particularly challenging. This arthroscopic technique aims to reduce the capsular volume and deepen the glenoid socket through the creation of a particularly voluminous "bumper" along the glenoid bone. Increasing the depth of the glenoid facilitates a concavity-compression stabilizing effect and, therefore, shoulder stability, especially midrange stability...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28408155/arthroscopic-capsular-plication-and-labral-seal-restoration-in-borderline-hip-dysplasia-2-year-clinical-outcomes-in-55-cases
#17
Sivashankar Chandrasekaran, Nader Darwish, Timothy J Martin, Carlos Suarez-Ahedo, Parth Lodhia, Benjamin G Domb
PURPOSE: To report clinical outcomes in patients with borderline dysplasia undergoing an arthroscopic technique of labral seal restoration with minimal acetabular rim resection and capsular plication. METHODS: Patients younger than 40 years with a lateral center-edge angle of 18° greater and 25° or less and 2-year follow-up after undergoing an arthroscopic technique of labral seal restoration with minimal rim resection (≤2 mm) and capsular plication (3-5 sutures placed in an oblique orientation to create an imbrication and inferior shift) were included...
April 10, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28371596/biomechanical-assessment-of-hip-capsular-repair-and-reconstruction-procedures-using-a-6-degrees-of-freedom-robotic-system
#18
Marc J Philippon, Christiano A C Trindade, Mary T Goldsmith, Matthew T Rasmussen, Adriana J Saroki, Sverre Løken, Robert F LaPrade
BACKGROUND: Although acetabular labral repair has been biomechanically validated to improve stability, capsular management of the hip remains a topic of growing interest and controversy. PURPOSE: To biomechanically evaluate the effects of several arthroscopically relevant conditions of the capsule through a robotic, sequential sectioning study. STUDY DESIGN: Controlled laboratory study. METHODS: Ten human cadaveric unilateral hip specimens (mean age, 51...
July 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28195988/decision-making-for-labral-treatment-in-the-hip-repair-versus-d%C3%A3-bridement-versus-reconstruction
#19
COMPARATIVE STUDY
Benjamin G Domb, David E Hartigan, Itay Perets
The role and function of the acetabular labrum have been studied extensively in the past decade. Recent studies have proposed that, in addition to causing pain and mechanical symptoms, labral tears may accelerate arthritis. Labral preservation is believed to be important because of the role the labrum plays in maintaining a healthy joint. Treatment of the acetabular labrum is becoming one of the fastest growing fields in orthopaedics; therefore, the treatment decision-making process must be refined. Currently, three commonly practiced labral treatments are available: repair, débridement, and reconstruction...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28149713/arthroscopic-iliac-crest-bone-block-for-reconstruction-of-the-glenoid-a-fixation-technique-using-an-adjustable-length-loop-cortical-suspensory-fixation-device
#20
Socrates Kalogrianitis, Vasileios Tsouparopoulos
Recurrent anterior shoulder instability with significant bone loss represents a surgical challenge. Anterior bone block procedures including variations of the Latarjet coracoid transfer have been used in this setting. Bone graft resorption with prominence of the metalwork is a serious concern, whereas the relative contribution of the dynamic sling effect of a Latarjet procedure is still controversial. We describe an arthroscopic technique for anatomic reconstruction of anterior glenoid bone defects using autologous iliac crest graft...
December 2016: Arthroscopy Techniques
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