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superior labrum

Eric J Cotter, Charles P Hannon, David Christian, Rachel M Frank, Bernard R Bach
CONTEXT: Shoulder pain and dysfunction are common, with patients presenting complaints to both primary and orthopaedic physicians. History and physical examination remain essential to creating a differential diagnosis, even as noninvasive imaging has improved. EVIDENCE ACQUISITION: Literature was obtained through keyword searches based on the pathology in question (eg, rotator cuff) and the keywords physical examination using PubMed from January 1, 1980, through September 20, 2017...
February 1, 2018: Sports Health
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
B Finke, W Petersen
OBJECTIVE: The aim of a tenotomy of the long biceps tendon is to remedy a painful pathology in the proximal region of the tendon. Tenodesis of the tendon can restore the motor and cosmetic function of the biceps brachii muscle. INDICATIONS: Partial rupture or tendopathy of the long biceps tendon, injuries of the anchor of the long biceps tendon (SLAP lesions; SLAP: superior labrum anterior posterior), lesions of the pulley system. CONTRAINDICATIONS: Infections or tumors, loss of the long head biceps tendon from the intertubercular groove...
February 2018: Operative Orthopädie und Traumatologie
Anne Le Bouthillier, Kawan S Rakhra, Etienne L Belzile, Ryan C B Foster, Paul E Beaulé
BACKGROUND: Clinically, understanding how the soft tissue envelope adapts to various forms of hip dysfunction could enhance both surgical and nonsurgical management. Very few studies have looked at soft tissue structures as preoperative discriminators between varying underlying etiologies of hip conditions. PURPOSE: To demonstrate that the magnetic resonance arthrography assessment of soft tissue structures of the hip will preoperatively differ in patients with different underlying hip joint diseases...
February 2018: Journal of Orthopaedic Trauma
Itay Perets, Edwin O Chaharbakhshi, David E Hartigan, Victor Ortiz-Declet, Brian Mu, Benjamin G Domb
PURPOSE: To evaluate a delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) index designed to predict focal acetabular articular cartilage damage in patients with femoroacetabular impingement (FAI). METHODS: The inclusion criteria were patients who underwent dGEMRIC and hip arthroscopy between April 2010 and August 2015 for FAI syndrome. The exclusion criteria were previous hip conditions, a Tönnis grade greater than 1, and a delay between magnetic resonance imaging and surgery greater than 180 days...
January 17, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Songkiat Thanacharoenpanich, Sarah Bixby, Michael A Breen, Young-Jo Kim
BACKGROUND: Traumatic posterior hip dislocations in children and adolescents requires emergent closed reduction. Postreduction imaging is necessary to assess the concentricity of reduction and structural injuries to the hip. There is no a consensus for which imaging is a modality of choice in such condition. The purposes of this study are to describe magnetic resonance imaging (MRI) findings of traumatic posterior hip dislocations and to compare the effectiveness of MRI with computerized tomography (CT) in detecting structural abnormalities of the hip that impact patient management...
January 19, 2018: Journal of Pediatric Orthopedics
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
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
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...
January 17, 2018: Current Reviews in Musculoskeletal Medicine
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
Soon Hyuck Lee, Woo Young Jang, Gi Won Choi, Young Keun Lee, Hae Woon Jung
PURPOSE: To investigate the arthroscopic pathoanatomy of the transverse acetabular ligament (TAL) and determine whether a TAL incision is necessary for the concentric reduction of developmental dysplasia of the hip (DDH) in infants and young children. METHODS: We retrospectively reviewed patients who underwent arthroscopic-assisted reduction for DDH between July 2008 and April 2016. The indications for this intervention included patients in whom closed reduction failed and those who did not require bone operations...
December 26, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
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
Sandra Boesmueller, Antal Nógrádi, Patrick Heimel, Christian Albrecht, Sylvia Nürnberger, Heinz Redl, Christian Fialka, Rainer Mittermayr
BACKGROUND: The postoperative course after arthroscopic superior labrum anterior to posterior (SLAP) repair using suture anchors is accompanied by a prolonged period of pain, which might be caused by constriction of nerve fibres. The purpose was to histologically investigate the distribution of neurofilament in the superior labrum and the long head of the biceps tendon (LHBT), i.e. the location of type II SLAP lesions. METHODS: Ten LHBTs including the superior labrum were dissected from fresh human specimen and immunohistochemically stained against neurofilament (NF)...
November 22, 2017: Journal of Orthopaedic Surgery and Research
Muhammet Baybars Ataoglu, Mehmet Cetinkaya, Mustafa Ozer, Tacettin Ayanoglu, Ulunay Kanatli
BACKGROUND: The purpose of this study was to assess the frequency of superior labrum anterior posterior (SLAP) lesions, long head of biceps tendon (LHBT) pathologies, and superior rotator cuff tears accompanying subscapularis tears. We hypothesised that LHBT lesions, superior rotator cuff tears, and especially SLAP lesions were very frequent with subscapularis tears. METHODS: The digital files of patients who underwent shoulder arthroscopy were reviewed retrospectively...
November 16, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
A Chopra, A J Grainger, B Dube, R Evans, R Hodgson, J Conroy, D Macdonald, Philip Robinson
OBJECTIVE: To compare the diagnostic accuracy of conventional 3T MRI against 1.5T MR arthrography (MRA) in patients with clinical femoroacetabular impingement (FAI). METHODS: Sixty-eight consecutive patients with clinical FAI underwent both 1.5T MRA and 3T MRI. Imaging was prospectively analysed by two musculoskeletal radiologists, blinded to patient outcomes and scored for internal derangement including labral and cartilage abnormality. Interobserver variation was assessed by kappa analysis...
October 6, 2017: European Radiology
Nathan D Orvets, Robert L Parisien, Emily J Curry, Justin S Chung, Josef K Eichinger, Akira M Murakami, Xinning Li
BACKGROUND: The delayed management of patients with shoulder instability may increase the prevalence and severity of concomitant intra-articular shoulder injuries resulting from persistent subluxations and dislocations. HYPOTHESIS: Patients with a longer delay from the initial dislocation event to undergoing magnetic resonance imaging (MRI) or magnetic resonance arthrography will demonstrate more subluxations or dislocations and a greater amount of intra-articular shoulder damage...
September 2017: Orthopaedic Journal of Sports Medicine
Bernardo Aguilera-Bohorquez, Eduardo Gil, John Fonseca, Miguel Fernandez, Miguel Sánchez
Arthroscopy is a surgical technique useful in the treatment of intra- and extra-articular hip pathologies, including femoroacetabular impingement (FAI). In the arthroscopic treatment of pincer-type FAI, tendon interposition of the reflected head of the rectus femoris frequently hinders acetabular edge resection in the anterior-superior region (acetabuloplasty) and labrum repositioning, even causing tendon injury during the surgical procedure. Many surgeons do not give importance to the reflected head of the rectus femoris, and during the procedure they try to avoid it, giving 30° of flexion to the hip...
August 2017: Arthroscopy Techniques
Kyoung-Hwan Koh, Su Cheol Kim, Jae Chul Yoo
BACKGROUND: The purpose of this study was to evaluate the angle between the long head of the biceps tendon (LHBT) and the glenoid during arthroscopic surgery and its correlation with biceps subluxation on magnetic resonance imaging (MRI). Furthermore, we evaluated the relationship of this angle with subscapularis tears and biceps pathologies. METHODS: MRI and arthroscopic images of 270 consecutive patients who had undergone arthroscopic surgery were retrospectively evaluated...
September 2017: Clinics in Orthopedic Surgery
Nirav H Amin, Alexander Volpi, Matthew Simons, Gavin Mills, Stephen Silver
Pathology to the proximal biceps tendon has the potential to be a major source of pain in the shoulder, secondary to complex superior labrum from anterior to posterior (SLAP) lesions, partial biceps tears, and subluxations. In order to restore function and improve the patient's quality of life, repair of these injuries is crucial. Tenodesis has long been the ideal treatment of persistent pain caused by pathology of the proximal biceps tendon. A biceps tenodesis helps prevent biceps pain and cramping during movement and avoids the cosmetic deformity associated with a biceps tenotomy...
September 2017: Journal of Orthopaedic Surgery
Joong-Bae Seo, Jae-Sung Yoo, Joon-Yeul Lee, Kyoo-Hong Han
The purpose of this study was to evaluate the influence of anatomical factors degenerative superior labrum anterior to posterior lesion in rotator cuff tear. The study included 421 middle-aged patients treated using arthroscopic surgery for rotator cuff tears. Patients were divided into two groups based on the superior labrum anterior-to-posterior (SLAP). Glenoid inclination, glenoid length, humeral head diameter, acromio-humeral distance (AHD) head-glenoid difference (HGD), head glenoid angle (HGA), size and retraction of rotator cuff tears were evaluated in both groups...
December 2017: Journal of Orthopaedics
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