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bankart and hill sachs

Shadpour Demehri, Nima Hafezi-Nejad, Elliot K Fishman
The inherently unstable anatomy of glenohumeral (GH) joint predisposes it to shoulder dislocation. Shoulder dislocation can occur either due to acute trauma or due to chronic microtraumas in the setting of underlying morphological abnormality. A plain radiograph is the initial imaging modality for diagnosis and management of shoulder dislocation and its associated osseous abnormalities such as Hill-Sachs deformity or osseous Bankart lesion. However, advanced imaging techniques such as multidetector CT (MDCT) with three-dimensional (3D) volume rendering and MRI can be helpful in further characterization of osseous abnormalities and detection of associated soft tissue injuries, respectively...
August 13, 2016: Emergency Radiology
Mohit N Gilotra, Matthew W Christian, Richard M Lovering
The patient was a 21-year-old collegiate running back who was tackled during a football game and sustained a posterior glenohumeral dislocation. He was referred to an orthopaedist and presented 3 weeks after the injury, and, following examination, further imaging was ordered by the orthopaedist due to rotator cuff weakness. Magnetic resonance imaging showed a complete tear of the supraspinatus and infraspinatus, as well as a posterior Bankart lesion, a subscapularis tear, and a dislocation of the biceps long head tendon into the reverse Hill-Sachs lesion...
August 2016: Journal of Orthopaedic and Sports Physical Therapy
Paul J Roubal, Jeffrey D Placzek
The patient was a 61-year-old woman who underwent long-lever manipulation under anesthesia (MUA) for adhesive capsulitis. Two weeks following MUA, the constellation of clinical findings raised concern for possible adverse outcomes. Radiographs were obtained, as well as subsequent magnetic resonance imaging and computed tomography scans. Images revealed anterior shoulder dislocation with Bankart and Hill-Sachs lesions, and an anterior rotator cuff tear. J Orthop Sports Phys Ther 2016;46(8):707. doi:10.2519/jospt...
August 2016: Journal of Orthopaedic and Sports Physical Therapy
Vishal Saxena, Kevin D'Aquilla, Shannon Marcoon, Guruprasad Krishnamoorthy, Joshua A Gordon, James L Carey, Ari Borthakur, J Bruce Kneeland, John D Kelly, Ravinder Reddy, Brian J Sennett
BACKGROUND: Patients who suffer anterior shoulder dislocations are at higher risk of developing glenohumeral arthropathy, but little is known about the initial cartilage damage after a primary shoulder dislocation. T1ρ is a magnetic resonance imaging (MRI) technique that allows quantification of cartilage proteoglycan content and can detect physiologic changes in articular cartilage. PURPOSE: This study aimed to establish baseline T1ρ MRI values for glenoid and humeral head cartilage, determine whether T1ρ MRI can detect glenohumeral cartilage damage after traumatic primary shoulder dislocation, and assess for patterns in cartilage damage in anterior shoulder dislocation...
July 27, 2016: American Journal of Sports Medicine
Robert U Hartzler, Christopher N H Bui, Woong K Jeong, Masaki Akeda, Alex Peterson, Michelle McGarry, Patrick J Denard, Stephen S Burkhart, Thay Q Lee
PURPOSE: To validate the glenoid track concept in a cadaveric bipolar bone loss model and to test whether "on-track" and "off-track" lesions can be stabilized with Bankart repair (BR) with or without Hill-Sachs remplissage (HSR). METHODS: Eight fresh-frozen cadaveric shoulders were tested in a custom apparatus with passive axial rotation and then progressive translational loading (10 to 40 N) at mid-range (60°) and end-range external rotation (90°). Injury conditions included glenoid bone loss of 15% with on-track (15%) and off-track (30%) Hill-Sachs lesions...
July 15, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
J Pogorzelski, K Beitzel, A B Imhoff, S Braun
OBJECTIVE: Shoulder stabilization. INDICATIONS: Symptomatic recurrent anterior shoulder instability combined with glenoid bone loss of approximately 20-35 % of the glenoid surface, engaging Hill-Sachs lesion and/or previously failed arthroscopic Bankart repair. In patients with a high risk of redislocation (contact sports) or irreparable soft tissue injury the Latarjet procedure can be considered as a first-line treatment. CONTRAINDICATIONS: Contraindicated if arthroscopic Bankart repair is possible...
July 12, 2016: Operative Orthopädie und Traumatologie
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
Joel Locher, Frauke Wilken, Knut Beitzel, Stefan Buchmann, Umile Giuseppe Longo, Vincenzo Denaro, Andreas B Imhoff
PURPOSE: To evaluate the effect of "off-track" Hill-Sachs lesions, according to the glenoid track concept, as a risk factor for recurrent instability and need for revision surgery after arthroscopic Bankart repair. METHODS: We retrospectively reviewed 254 patients with anteroinferior glenohumeral instability who were managed with an arthroscopic stabilization procedure between 2006 and 2013. Preoperative magnetic resonance imaging and/or computed tomography scans were available for 100 of these patients to calculate the glenoid track and the presence of "on-track" or off-track Hill-Sachs lesions...
May 7, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Grant H Garcia, Samuel A Taylor, Peter D Fabricant, Joshua S Dines
Despite an abundance of peer-reviewed literature, there is wide surgical practice variability for symptomatic shoulder instability. In this study, we identified consensus trends among specialists in glenohumeral instability. A survey was distributed to 417 members of the American Shoulder and Elbow Surgeons (ASES). Surveys consisted of 3 sections: surgeon demographics, presentation of 5 case scenarios, and instability management. Consensus responses were defined as more than 50% of participants giving a single response with more than 2 answer choices or more than 67% of participants giving a single response when 2 answer choices were available...
March 2016: American Journal of Orthopedics
M Olds, K Donaldson, R Ellis, P Kersten
BACKGROUND: Skeletal maturity and age-related changes in the composition of the glenoid labrum and joint capsule may influence rates of recurrent instability in children. We systematically review risk factors which predispose children to recurrent shoulder instability. METHODS: The systematic review-concerned studies published before May 2015. Statistical analysis was undertaken to compare rates of recurrence for each extracted risk factor. Pooled ORs were analysed using random effects meta-analysis...
September 2016: British Journal of Sports Medicine
Elisabeth C Robinson, Vijay B Thangamani, Michael A Kuhn, Glen Ross
BACKGROUND: Shoulder instability in the older patient traditionally has received less attention in the literature than in the younger patient population. However, when traumatic dislocation does occur, these patients often still have frequent pain, disability, and even continued instability. PURPOSE: To characterize the pathoanatomy of traumatic anterior shoulder instability in the older patient population and to discuss the correlating symptoms that ultimately led to operative treatment...
May 2015: Orthopaedic Journal of Sports Medicine
Nobuyuki Yamamoto, Eiji Itoi
Shoulder surgeons need to be aware of the critical size of the glenoid or humeral osseous defects seen in patients with anterior shoulder instability, since the considerable size of osseous defect is reported to cause postoperative instability. Biomechanical studies have identified the size of the osseous defect which affects stability. Since engagement always occurs between a Hill-Sachs lesion and the glenoid rim, when considering the critical size of the Hill-Sachs lesion, we have to simultaneously consider the size of the glenoid osseous defect...
December 2015: Clinics in Orthopedic Surgery
Marco Maiotti, Raffaele Russo, Antonio Zanini, Steffen Schröter, Carlo Massoni, Diana Bianchedi
BACKGROUND: This study presents the preliminary results of a new arthroscopic technique consisting of the association of 2 procedures, capsulolabral repair and subscapularis augmentation tenodesis, in the treatment of traumatic anterior shoulder instability with both glenoid bone loss and a Hill-Sachs lesion. METHODS: Eighty-nine patients engaged in sports were enrolled in this retrospective case-series study with 2 to 5 years' follow-up. All patients underwent a computed tomography scan to assess the percentage of glenoid bone loss by the Pico method...
June 2016: Journal of Shoulder and Elbow Surgery
Brian J Rebolledo, Benedict U Nwachukwu, Gabrielle P Konin, Struan H Coleman, Hollis G Potter, Russell F Warren
BACKGROUND: Lesions associated with posterior humeral avulsion of the glenohumeral ligament (HAGL) can lead to persistent symptoms related to posterior shoulder instability and can be commonly missed or delayed in diagnosis. PURPOSE: To identify and characterize the MRI findings in patients with a posterior HAGL lesion. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: This retrospective case series included 27 patients (28 shoulders) identified by search through the senior authors' databases, with cross-reference to their institutional radiologic communication system for MRI review...
December 2015: American Journal of Sports Medicine
Shigeto Nakagawa, Ritsuro Ozaki, Yasuhiro Take, Ryo Iuchi, Tatsuo Mae
BACKGROUND: While the combination of a glenoid defect and a Hill-Sachs lesion in a shoulder with anterior instability has recently been termed a bipolar lesion, their relationship is unclear. PURPOSE: To investigate the relationship of the glenoid defect and Hill-Sachs lesion and the factors that influence the occurrence of these lesions as well as the recurrence of instability. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: The prevalence and size of both lesions were evaluated retrospectively by computed tomography scanning in 153 shoulders before arthroscopic Bankart repair...
November 2015: American Journal of Sports Medicine
Karol Szyluk, Andrzej Jasiński, Wojciech Widuchowski, Michał Mielnik, Bogdan Koczy
BACKGROUND: Shoulder instability is an important clinical problem. Arthroscopic surgery is an established treatment modality in shoulder instability, but it continues to be associated with a high rate of recurrences and complications. The purpose of the study was to analyze late outcomes of arthroscopic repair of Bankart lesions in patients with post-traumatic anterior shoulder instability and non-engaging Hill-Sachs lesion, with special focus on the incidence and causes of recurrences and complications...
2015: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
David J Saliken, Troy D Bornes, Martin J Bouliane, David M Sheps, Lauren A Beaupre
BACKGROUND: Glenohumeral instability is a common problem following traumatic anterior shoulder dislocation. Two major risk factors of recurrent instability are glenoid and Hill-Sachs bone loss. Higher failure rates of arthroscopic Bankart repairs are associated with larger degrees of bone loss; therefore it is important to accurately and reliably quantify glenohumeral bone loss pre-operatively. This may be done with radiography, CT, or MRI; however no gold standard modality or method has been determined...
2015: BMC Musculoskeletal Disorders
Nam Su Cho, Jae Hyun Yoo, Hyung Suk Juh, Yong Girl Rhee
PURPOSE: The purpose of this study was to compare the clinical results of isolated arthroscopic Bankart repair and those of arthroscopic Bankart repair with posterior capsulodesis for anterior shoulder instability with engaging Hill-Sachs lesions. METHODS: Thirty-five shoulders that underwent isolated arthroscopic Bankart repair (Bankart group) and 37 shoulders that underwent arthroscopic Bankart repair with posterior capsulodesis (remplissage group) for anterior shoulder instability with engaging Hill-Sachs lesions were evaluated retrospectively...
July 14, 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Piyush Walia, Anthony Miniaci, Morgan H Jones, Stephen D Fening
PURPOSE: To quantify the effect of different size combinations of Hill-Sachs defects and bony Bankart defects on shoulder instability across a broad range of motion. METHODS: A computer-based finite element approach was used to model an intact glenohumeral joint. Defects were created for the glenoid with respect to its width (12.5%, 25%, 37.5%, and 50%). The defect sizes chosen for the humeral head were 6%, 19%, 31%, and 44% of the diameter. Simulations were analyzed using quasi-static analysis with displacement control under 50 N of medial compression...
November 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
Grant H Garcia, Min Jung Park, Clare Zhang, John D Kelly, G Russell Huffman
BACKGROUND: There is little comparative long-term clinical data comparing Bankart repair alone to the addition of remplissage. QUESTIONS/PURPOSES: Our purpose was to compare results of patients with significant humeral head lesions and who underwent either isolated arthroscopic Bankart repair or remplissage. METHODS: This is a retrospective cohort study of 14 isolated arthroscopic Bankart and 10 remplissage repairs all with large engaging Hill-Sachs (HS) lesions...
July 2015: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
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