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https://www.readbyqxmd.com/read/29754193/mr-arthrogram-of-the-postoperative-glenoid-labrum-normal-postoperative-appearance-versus-recurrent-tears
#1
Christin A Tiegs-Heiden, Nicholas G Rhodes, Mark S Collins, Quintin A Fender, Benjamin M Howe
OBJECTIVE: The purpose of this study is to describe the MR arthrogram appearance of the postoperative glenoid labrum and to describe the features consistent with recurrent tear. MATERIALS AND METHODS: We identified 30 patients who had undergone glenoid labral repair, had a subsequent MR arthrogram of his or her shoulder, and went on to repeat shoulder arthroscopy. Each MR arthrogram was reviewed blindly, and the glenoid labrum was described as normal, irregular, or torn...
May 13, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29595538/labral-augmentation-with-native-tissue-preservation-with-a-7-5-year-follow-up-a-case-report
#2
Jonathan A Godin, Lorenzo Fagotti, Karen K Briggs, Marc J Philippon
CASE: Arthroscopic labral repair has resulted in excellent functional outcomes. However, extensive labral damage or diminutive size of the labrum may preclude a repair. In these cases, labral augmentation serves as an operative treatment option. We report the case of a labral augmentation with 7.5 years of follow-up, including intraoperative reexamination, which highlights the ability of an iliotibial band autograft to incorporate with the native labrum. CONCLUSION: When indicated in an appropriate patient, labral augmentation with an iliotibial band autograft is an established technique that can result in an excellent outcome...
January 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/29537865/critical-glenoid-bone-loss-in-posterior-shoulder-instability
#3
Christopher Nacca, Joseph A Gil, Rohit Badida, Joseph J Crisco, Brett D Owens
BACKGROUND: There is currently no consensus regarding the amount of posterior glenoid bone loss that is considered critical. Critical bone loss is defined as the amount of bone loss that occurs in which an isolated labral repair will not sufficiently restore stability. PURPOSE: The purpose is to identify the critical size of the posterior defect. STUDY DESIGN: Controlled laboratory study. METHODS: Eleven cadaveric shoulders were tested...
March 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29430391/modifications-to-the-hip-arthroscopy-technique-when-performing-combined-hip-arthroscopy-and-periacetabular-osteotomy
#4
Andrea M Spiker, Kate R Gumersell, Ernest L Sink, Bryan T Kelly
In the realm of hip preservation, hip arthroscopy is often used to address intra-articular impingement pathology, whereas periacetabular osteotomy (PAO) is used to address dysplasia and instability. Indications to combine these 2 procedures include hip dysplasia and symptomatic instability with a concomitant symptomatic labral tear or the other symptomatic intra-articular pathology (i.e., loose body, chondral flap). The arthroscopic portion of the procedure allows repair of the injured labrum and close inspection of the hip joint, and the PAO addresses undercoverage and/or inappropriate version of the acetabulum...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29423255/labral-cuff-refixation-in-the-hip-rationale-and-operative-technique-for-preserving-the-chondrolabral-interface-for-labral-repair-a-case-series
#5
Patrick Finton Carton, David Filan
Arthroscopic labral 'takedown' and refixation is utilized to permit adequate visualization and resection of the acetabular rim deformity, in patients with pincer or mixed femoroacetabular impingement. Deficiencies exist in present techniques, which include disruption of vital anatomical support and vascular structures to the labrum and chondrolabral junction, drill or anchor articular penetration risk, bunching, elevation and instability of the labrum. A new operative technique is described which preserves the important chondrolabral interface, accurately restoring the 'flap seal' of the acetabular labrum while minimizing vascular disruption and reducing the risk of drill and anchor penetration...
January 2018: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/29420773/trends-in-surgical-management-of-anterior-shoulder-instability-increased-utilization-of-bone-augmentation-techniques%C3%A2
#6
Joseph W Galvin, Josef K Eichinger, Eric J Cotter, Alyssa R Greenhouse, Stephen A Parada, Brian R Waterman
Purpose: The purpose of this study is to evaluate the trends in surgical management for anterior shoulder instability in the U.S. Military. Methods: A retrospective analysis of military service members undergoing arthroscopic or open shoulder stabilization from 2012 to 2015 within the U.S. Military Health System was conducted. Demographic and surgical variables were extracted from the medical record. Chi-square and linear regression analysis were performed to identify temporal trends by surgical procedures and concomitant surgery...
February 6, 2018: Military Medicine
https://www.readbyqxmd.com/read/29416984/single-working-portal-technique-for-knotless-arthroscopic-bankart-repair
#7
Dennis Zhaowen Ng, Bernard Puang Huh Lau, Bryan Hsi Ming Tan, V Prem Kumar
Arthroscopic Bankart repair is widely accepted as the method of choice in restoring the labrum to the glenoid rim. It has been shown to have comparable outcomes with open stabilization. This usually involves the use of 2 portals anteriorly: one anterosuperior accessory portal and another anteroinferior working portal. The aim of this Technical Note is to present a simple and reproducible technique for Bankart repair using a single working portal anteriorly without an accessory portal.
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29416969/-in-round-labral-repair-after-acetabular-recession-using-intermittent-traction
#8
Nathan W Skelley, William K Conaway, Scott D Martin
The prevalence of hip arthroscopy has increased exponentially with the advent of arthroscopic labral repair techniques for femoroacetabular impingement. The goal of arthroscopic labral repair is to re-create the anatomic suction seal of the labrum against the femoral head. This important anatomic relationship has been demonstrated in several biomechanical studies. Performing the acetabular recession and evaluating the congruity of labral repairs during surgery is difficult with the application of traction distracting the femoral head from the chondrolabral junction...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29399443/the-floating-labrum-bankart-lesion-repair-with-anterior-capsular-extension-using-2-anterior-working-portals
#9
Allison J Rao, Nikhil N Verma, Scott W Trenhaile
Surgical repair of a Bankart lesion requires thorough recognition of the capsulolabral attachment and adequate visualization for suture anchor repair. The glenoid labrum usually detaches from its capsule and bony attachment anteriorly and inferiorly; however, the labral and capsule detachment can sometimes extend beyond this zone of injury. Identification and repair may require additional viewing and working portals to allow for ease of suture passage and anchor placement. This technique guide describes a case scenario of a Bankart lesion with anterior extension of the capsular tear, repaired with use of 2 anterior working portals...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29377721/glenoid-bone-loss-in-posterior-shoulder-instability-prevalence-and-outcomes-in-arthroscopic-treatment
#10
Adam Hines, Jay B Cook, James S Shaha, Kevin Krul, Steve H Shaha, John Johnson, Craig R Bottoni, Douglas J Rowles, John M Tokish
BACKGROUND: Glenoid bone loss is a well-accepted risk factor for failure after arthroscopic stabilization of anterior glenohumeral instability. Glenoid bone loss in posterior instability has been noted relative to its existence in posterior instability surgery. Its effect on outcomes after arthroscopic stabilization has not been specifically evaluated and reported. PURPOSE: The purpose was to evaluate the presence of posterior glenoid bone loss in a series of patients who had undergone arthroscopic isolated stabilization of the posterior labrum...
April 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29366559/hip-chondrolabral-mechanics-during-activities-of-daily-living-role-of-the-labrum-and-interstitial-fluid-pressurization
#11
Jocelyn N Todd, Travis G Maak, Gerard A Ateshian, Steve A Maas, Jeffrey A Weiss
Osteoarthritis of the hip can result from mechanical factors, which can be studied using finite element (FE) analysis. FE studies of the hip often assume there is no significant loss of fluid pressurization in the articular cartilage during simulated activities and approximate the material as incompressible and elastic. This study examined the conditions under which interstitial fluid load support remains sustained during physiological motions, as well as the role of the labrum in maintaining fluid load support and the effect of its presence on the solid phase of the surrounding cartilage...
March 1, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29354478/arthroscopic-triple-labral-repair-in-an-adolescent
#12
Eric J Cotter, Rachel M Frank, Scott W Trenhaile
Traumatic glenohumeral dislocations often result in significant injury to the anterior-inferior labrum, most commonly leading to recurrent anterior instability. While in skeletally immature patients, shoulder trauma more commonly results in fracture versus a true dislocation, shoulder instability does occur and can be difficult to manage in the setting of open physes. In any event, the goal of treatment is to reduce the risk of recurrence and allow full participation in activities, including sports. Arthroscopic stabilization has been shown to be an effective treatment option for young patients, with good return to sport rates; however, the vast majority of literature on shoulder instability in the youth patient population focuses on anterior instability...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354424/the-purse-string-procedure-for-recurrent-anterior-glenohumeral-instability-a-simple-technique-to-achieve-bankart-repair-capsular-shift-and-a-good-labral-bumper
#13
Luis Gerardo Natera, Paolo Consigliere, Caroline Witney-Lagen, Juan Bruguera, Giuseppe Sforza, Ehud Atoun, Ofer Levy
Failure of arthroscopic techniques in cases of recurrent anterior glenohumeral instability may result from inadequate treatment of capsular injury. The use of few anchors has been cited as a cause of failure in arthroscopic stabilization techniques. This applies to the use of the suture anchors as spot-welding points in conventional techniques. It has been shown that horizontal mattress suture techniques restore better labral height and anatomy than simple suture techniques in the repair of acute Bankart lesions...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354411/shoulder-arthroscopy-in-the-beach-chair-position
#14
John D Higgins, Rachel M Frank, Jason T Hamamoto, Matthew T Provencher, Anthony A Romeo, Nikhil N Verma
Arthroscopic shoulder surgery can be performed in both the beach chair and lateral decubitus positions. The beach chair position is a reliable, safe, and effective position to perform nearly all types of shoulder arthroscopic procedures. The advantages of the beach chair position include the ease of setup, limited brachial plexus stress, increased glenohumeral and subacromial visualization, anesthesia flexibility, and the ability to easily convert to an open procedure. This position is most commonly used for rotator cuff repair, subacromial decompression, and superior labrum anterior-to-posterior repair procedures...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354408/arthroscopic-repair-of-a-circumferential-360%C3%A2-labral-tear
#15
Allison J Rao, Gregory L Cvetanovich, William A Zuke, Quentin Low, Brian Forsythe
Injuries to the glenoid labrum can result in shoulder instability and pain. These lesions may occur anywhere around the glenoid labrum, and thus, the arthroscopist must be prepared to approach all aspects of the glenoid from multiple angles. The pan-labral or circumferential (360°) tear of the glenoid labrum presents a unique challenge to even the experienced arthroscopist. The extent of the lesion requires the use of accessory portals and percutaneous techniques to establish adequate visualization and to facilitate the proper trajectory for anchor placement...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29351746/concomitant-glenohumeral-injuries-in-neer-type-ii-distal-clavicle-fractures
#16
Tobias Helfen, Georg Siebenbürger, Florian Haasters, Wolfgang Böcker, Ben Ockert
BACKGROUND: To identify the prevalence of concomitant glenohumeral injuries in surgically treated Neer type II distal clavicle fractures and relate its clinical importance. METHODS: Between 11/2011 and 11/2015 41 patients, suffering from a displaced and unstable distal clavicle fracture were included. 20 patients (group 1) received surgical treatment by means of plate osteosynthesis in combination with an arthroscopically assisted coraco-clavicular ligament augmentation...
January 19, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29349010/arthroscopic-repair-of-hip-labrum-with-suture-anchors
#17
Kartik Shenoy, Amos Z Dai, Siddharth A Mahure, Daniel J Kaplan, Brian Capogna, Thomas Youm
The acetabular labrum and the transverse acetabular ligament form a continuous ring of tissue on the periphery of the acetabulum that provides a seal for the hip joint and increases the surface area to spread load distribution during weight-bearing. When a labral tear is suspected, the treatment algorithm always begins with conservative management, including physical therapy and nonsteroidal anti-inflammatory drugs. When conservative management fails, patients become candidates for arthroscopic labral repair...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29344768/diagnosis-and-treatment-of-injuries-to-the-biceps-and-superior-labral-complex-in-overhead-athletes
#18
REVIEW
Jacob G Calcei, Venkat Boddapati, David W Altchek, Christopher L Camp, Joshua S Dines
PURPOSE OF REVIEW: This review discusses the diagnostic and treatment challenges presented by injuries to the biceps and superior labral complex. RECENT FINDINGS: A focused patient history, numerous physical examination maneuvers, and appropriate advanced imaging studies must be utilized to reach an accurate diagnosis. Nonoperative management, even in overhead athletes, has demonstrated relatively good outcomes, while operative outcomes have yielded mixed results...
March 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29337716/management-of-biceps-tendon-pathology-from-the-glenoid-to-the-radial-tuberosity
#19
Rachel M Frank, Eric J Cotter, Eric J Strauss, Laith M Jazrawi, Anthony A Romeo
Management of proximal and distal biceps tendon pathology is evolving. The long head of the biceps tendon, if inflamed, may be a pain-producing structure. In appropriately indicated patients, a symptomatic long head of the biceps tendon can be surgically managed via tenotomy, tenodesis, and/or superior labrum anterior to posterior repair. In some patients, primary superior labrum anterior to posterior pathology can be managed via biceps tenodesis. Determining which procedure is most appropriate and which technique and implant are preferred for a given patient with biceps tendon pathology is controversial...
February 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29230427/biomechanical-comparison-of-single-versus-double-row-capsulolabral-repair-for-shoulder-instability-a-review
#20
REVIEW
Matthew John Yousif, James Bicos
Background: The glenohumeral joint is the most commonly dislocated joint in the body. Failure rates of capsulolabral repair have been reported to be approximately 8%. Recent focus has been on restoration of the capsulolabral complex by a double-row capsulolabral repair technique in an effort to decrease redislocation rates after arthroscopic capsulolabral repair. Purpose: To present a review of the biomechanical literature comparing single- versus double-row capsulolabral repairs and discuss the previous case series of double-row fixation...
December 2017: Orthopaedic Journal of Sports Medicine
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