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labrum repair

Jennifer L Pierce, Nicholas C Nacey, Stephen Jones, Davis Rierson, Brian Etier, Stephen Brockmeier, Mark W Anderson
Imaging interpretation of the postoperative shoulder is a challenging and difficult task for both the radiologist and the orthopedic surgeon. The increasing number of shoulder rotator cuff, labrum, and biceps tendon repairs performed in the United States also makes this task a frequent occurrence. Whether treatment is surgical or conservative, imaging plays a crucial role in patient care. Many imaging findings can be used to predict prognosis and functional outcomes, ultimately affecting treatment. In addition, evolving surgical techniques alter the normal anatomy and imaging appearance of the shoulder such that accepted findings proved to be pathologic in the preoperative setting cannot be as readily described as pathologic after surgery...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Robert A Duerr, John J Christoforetti
Posterior glenohumeral capsular rupture is a rare cause of posterior glenohumeral instability. With advances in imaging and arthroscopic techniques, diagnosis and treatment of posterior glenohumeral instability are becoming more common in practice. We present a technique for arthroscopic repair of a posterior glenohumeral capsular rupture with concomitant anterior and posterior labrum detachment. Arthroscopic fixation was facilitated by use of a 70° arthroscope through an anterior viewing portal to allow accurate placement of the posterior portal in preparation for knot tying...
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
Nata Parnes, Maryellen Blevins, Brian Carr, Paul Carey
Inferior labrum anterior to posterior lesions as an isolated injury or as part of an extensive traumatic labral tear are uncommon and may present as multidirectional instability of the shoulder. These lesions are hard to visualize radiographically and many times are diagnosed only during surgery. Arthroscopic repair of these lesions requires advanced arthroscopic skills and is required for restoration of glenohumeral stability. We report a combined double-pulley simple knot technique that anatomically reconstructs the inferior labrum while overcoming the typical technical challenges, providing a large footprint for healing along the inferior glenoid rim and minimizing the amount of suture material in direct contact with the articular cartilage and the risk of knot migration...
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
Matthew T Provencher
Although superior labrum anterior posterior (SLAP) repairs have a relatively high success rate, emerging evidence suggests that this is not always the case. The authors of "Subsequent Shoulder Surgery Following Isolated Arthroscopic SLAP Repair" reveal that 1 in 10 people needed additional surgery within 3 years after SLAP repair-mainly for disorders of the rotator cuff, biceps, and distal clavicle. This underscores the fact that SLAP tears rarely occur in isolation and that the initial diagnosis and management may require more than just SLAP work...
October 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Joshua D Harris
The importance of the acetabular labrum has been increasingly recognized, playing a critical role in both normal anatomy and abnormal pathology of the hip joint. The labrum increases acetabular surface area and volume, providing a stable and durable articulation. The fibrocartilaginous composition affords a tissue capable of a lifetime of normal function in the absence of significant osseous pathology. In the setting of femoroacetabular impingement (FAI) or dysplasia, bony biomechanics may cause labral injury, which may translate to patient symptoms...
August 31, 2016: Current Reviews in Musculoskeletal Medicine
Michael E Steinhaus, Eric C Makhni, Adam C Lieber, Cynthia A Kahlenberg, Lawrence V Gulotta, Anthony A Romeo, Nikhil N Verma
BACKGROUND: Outcomes assessments after superior labrum anterior and posterior (SLAP) tear/repair are highly varied, making it difficult to draw comparisons across the literature. This study examined the inconsistency in outcomes reporting in the SLAP tear literature. We hypothesize that there is significant variability in outcomes reporting and that although most studies may report return to play, time to return reporting will be highly variable. METHODS: The PubMed, Medline, Scopus, and Embase databases were systematically reviewed for studies from January 2000 to December 2014 reporting outcomes after SLAP tear/repair...
November 2016: Journal of Shoulder and Elbow Surgery
M Beirer, G H Sandmann, A B Imhoff, S Buchmann
OBJECTIVE: To restore the physiologic anterior and posterior capsular volume to achieve an anatomic central contact point of the glenohumeral articulation and treatment of concomitant glenohumeral injuries due to posterosuperior impingement (PSI). INDICATIONS: Plateauing of clinical improvement despite adequate nonsurgical treatment (for at least 6-12 months). CONTRAINDICATIONS: General contraindications for elective arthroscopic surgery...
July 28, 2016: Operative Orthopädie und Traumatologie
Benjamin F Ricciardi, Stephanie W Mayer, Kara G Fields, Catherine Wentzel, Bryan T Kelly, Ernest L Sink
BACKGROUND: Symptomatic labral tears are common in patients with acetabular dysplasia; however, optimal treatment of the labrum remains controversial. PURPOSE: To present patient characteristics and early functional outcomes associated with combined arthroscopic labral refixation and Bernese periacetabular osteotomy (PAO) for symptomatic acetabular dysplasia with a displaced labral tear from the acetabular rim. STUDY DESIGN: Cohort study; Level of evidence, 3...
July 14, 2016: American Journal of Sports Medicine
Paul E Caldwell, Sara E Pearson, Mark S D'Angelo
Operative management of symptomatic labral tears of the shoulder has traditionally been the preferred treatment. Arthroscopic techniques and equipment continue to be refined and subsequent new recommendations for treatment are being developed. Contemporary techniques for arthroscopic knotless repair offer possible advantages over traditional arthroscopically tied knots. Although knotless repair of labral tears is well recognized, advancements continue to progress toward stronger fixation with reduced risks of cutting through the labrum and chondral abrasion...
April 2016: Arthroscopy Techniques
Andrew B Wolff, Jamie Grossman
The options for labral treatment are debridement, repair, and reconstruction. Debridement of labral tissue is indicated when there is peripheral tearing of the labrum that does not compromise the functionality of the labrum at its base or if the labrum is not playing an important role in the patient's pathology. Labral repair is performed when the base of the labrum is unstable at its attachment at the acetabular rim and the tissue is of otherwise good quality. Labral reconstruction is an option for labral tissue compromised beyond repair, segmental labral defect, or previous failed repair...
July 2016: Clinics in Sports Medicine
Marcus Robert Chia, Cameron Hatrick
Arthroscopic repair of lesions of the superior labrum and biceps anchor has been shown to provide good to excellent results. We describe a simplified arthroscopic surgical technique using a single knotless anchor with a mattress suture configuration. This technique provides an effective and reproducible method to reattach and re-create the normal appearance of the superior labrum and biceps anchor in a time-efficient manner without the need for knot tying.
December 2015: Arthroscopy Techniques
Jourdan M Cancienne, Stephen F Brockmeier, Brian C Werner
BACKGROUND: Although the general health consequences of tobacco use have been well defined, the effects of perioperative tobacco use on arthroscopic shoulder procedures remain largely unknown. The purpose of this study is to use a national database to investigate the relationship between tobacco use and rates of superior labrum anterior and posterior (SLAP) repair failure and postoperative infection after primary SLAP repair compared with matched controls. METHODS: A national private-payer insurance database was queried for patients who underwent arthroscopic primary SLAP from 2005-2012...
June 1, 2016: Journal of Shoulder and Elbow Surgery
Josef K Eichinger, Joseph W Galvin, Jason A Grassbaugh, Stephen A Parada, Xinning Li
➤Subtle forms of glenoid dysplasia may be more common than previously thought and likely predispose some patients to symptomatic posterior shoulder instability. Severe glenoid dysplasia is a rare condition with characteristic radiographic findings involving the posteroinferior aspect of the glenoid that often remains asymptomatic.➤Instability symptoms related to glenoid dysplasia may develop over time with increased activities or trauma. Physical therapy focusing on rotator cuff strengthening and proprioceptive control should be the initial management...
June 1, 2016: Journal of Bone and Joint Surgery. American Volume
Claire Marie C Durban, Je Kyun Kim, Sae Hoon Kim, Joo Han Oh
BACKGROUND: The aims of this study were to investigate the clinical characteristics of patients with combined anterior instability and superior labrum from anterior to posterior (SLAP) lesions, and to analyze the effect of concomitant SLAP repair on surgical outcomes. METHODS: We retrospectively reviewed patients who underwent arthroscopic stabilization for anterior shoulder instability between January 2004 and March 2013. A total of 120 patients were available for at least 1-year follow-up...
June 2016: Clinics in Orthopedic Surgery
Stefano Zaffagnini, Cecilia Signorelli, Tommaso Bonanzinga, Nicola Lopomo, Federico Raggi, Tommaso Roberti Di Sarsina, Alberto Grassi, Giulio Maria Marcheggiani Muccioli, Maurilio Marcacci
PURPOSE: To quantitatively describe the kinematic behaviour of the hip joint with particular interest in the contribution of the periarticular soft tissues to the stability. To quantitatively assess the sealing function of the acetabular labrum of an intact labrum, the effect of a labral-chondral separation and different surgical approaches. The biomechanics of the joint during specific clinical examinations was also assessed. METHODS: All the kinematics tests, manually performed, have been acquired using a navigation systems...
May 14, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Hiroshi Hashiguchi, Satoshi Iwashita, Atsushi Ohkubo, Shinro Takai
INTRODUCTION: A spinoglenoid cyst with suprascapular nerve disorders is highly associated with superior labrum anterior posterior (SLAP) lesion. Conservative or surgical treatment is applied to relieve pain and neurological symptoms. The purpose of this study was to evaluate clinical outcomes of patients treated by arthroscopic surgery for SLAP lesion with a spinoglenoid cyst. METHODS: The subjects of this study were six patients with SLAP lesion with a spinoglenoid cyst who underwent arthroscopic surgery...
2016: SICOT-J
Duncan Tennent, Eyiyemi Pearse
We describe a percutaneous technique for repair of type II SLAP lesions. Through the Neviaser portal, a spinal needle is used to pass a FiberStick suture (Arthrex, Naples, FL) through the labrum to create 2 mattress sutures that are secured with PushLock anchors (Arthrex). This technique is simple, reproducible, and knotless and requires no cannulas. At the end of the procedure, minimal suture material remains in the joint.
February 2016: Arthroscopy Techniques
Nata Parnes, Paul Carey, Monica Morman, Brian Carr
Posterior shoulder instability is more prevalent than traditionally believed. Surgical repairs of posterior shoulder instability have overall good success rates. However, in elite overhead and throwing athletes, a low rate of return to the preinjury level of play after repair remains a challenge. The 2 goals of posterior shoulder stabilization surgery are secure fixation of the labrum to the glenoid and retensioning of the posterior capsulolabral complex. Recent studies have shown significant advantages of arthroscopic anatomic repair over open nonanatomic techniques...
February 2016: Arthroscopy Techniques
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