1,366 results match your criteria Anterior Glenohumeral Instability


Biomechanical Analysis of Anterior Stability After 15% Glenoid Bone Loss: Comparison of Bankart Repair, Dynamic Anterior Stabilization, Dynamic Anterior Stabilization with Bankart repair, and Latarjet.

J Shoulder Elbow Surg 2022 May 18. Epub 2022 May 18.

Hospital for Special Surgery, New York, NY, USA.

Background: Dynamic anterior shoulder stabilization (DAS) with Bankart repair is a recently described stabilization technique thought to be more robust than an isolated Bankart repair while avoiding many coracoid transfer related complications and technical demands. DAS involves transfer of the long head biceps through a subscapularis split to the anterior glenoid to create a sling effect. We hypothesize that DAS with Bankart repair will restore anterior stability in a human-cadaveric model with subcritical (15%) glenoid bone loss. Read More

View Article and Full-Text PDF

Evaluation of the Davos self-assisted technique for reduction of anterior glenohumeral dislocations: a comparative study with the traction/countertraction technique.

JSES Int 2022 May 17;6(3):391-395. Epub 2022 Jan 17.

Department of Orthopedics and Traumatology, São João University Hospital Center, Porto, Portugal.

Background: Few studies have compared conventional and self-assisted shoulder reduction maneuvers. The goal of this study was to evaluate the results of self-assisted Davos vs. traction/countertraction (T/Ct) techniques in the treatment of acute anterior shoulder dislocations. Read More

View Article and Full-Text PDF

Pathology and surgical outcomes of unstable painful shoulders.

JSES Int 2022 May 5;6(3):349-354. Epub 2022 Feb 5.

Tokyo Sports and Orthopaedic Clinic, Toshima, Tokyo, Japan.

Background: Boileau et al have reported on the unstable, painful shoulder (UPS), which was defined as painful shoulders without any recognized anteroinferior subluxations or dislocations that were associated with roll-over lesions (ie, instability lesions) on imaging or at arthroscopy. However, they included various pathologies, probably due to the ambiguity in their definitions of UPS. We redefined UPS as follows: (1) shoulder pain during daily or sports activities, (2) traumatic onset, (3) no complaint of shoulder instability, and (4) soft-tissue or bony lesions, such as Bankart or humeral avulsion of glenohumeral ligament lesion, confirmed by arthroscopy. Read More

View Article and Full-Text PDF

Satisfactory Functional Results and Complication Rates After Anterior Glenoid Bone Block Reconstruction in Recurrent Shoulder Dislocation: A Mean 4-Year Follow-up Comparative Study.

J ISAKOS 2022 May 10. Epub 2022 May 10.

Orthopedic Surgery Department, Faculty of Medicine, Zagazig University, Egypt. Electronic address:

Background: Anterior recurrent instability of the glenohumeral joint is a common clinical problem among the young population. Glenoid reconstruction with bone graft has become the treatment of choice, particularly in significant deficiency (˃ 20%). This study aims to assess the functional results of glenoid reconstruction using Latarjet and iliac bone graft in management of glenoid insufficiency associated with recurrent anterior dislocation of the glenohumeral joint. Read More

View Article and Full-Text PDF

Transient postoperative inferior subluxation of the shoulder after surgical stabilization of recurrent anterior dislocation in a patient with myasthenia gravis: a case report.

Clin Shoulder Elb 2022 May 11. Epub 2022 May 11.

Department of Orthopaedic Surgery, Konkuk University School of Medicine, Seoul, Korea.

The authors present a case of transient postoperative inferior subluxation of the shoulder after arthroscopic surgical stabilization for recurrent anterior dislocation. The patient was a 61-year-old woman with myasthenia gravis (MG). The first anterior shoulder dislocation occurred because of a fall to the ground. Read More

View Article and Full-Text PDF

The Painful Anterior Apprehension Test - an Indication of Occult Shoulder Instability.

Malays Orthop J 2022 Mar;16(1):97-102

Department of Orthopaedic Surgery, National University Health System, Singapore.

Introduction: To evaluate the clinical relevance of the painful anterior apprehension test in shoulder instability.

Materials And Methods: We performed a retrospective study of 155 patients that underwent arthroscopic anterior Bankart repair between 2014-2016. Exclusion criteria were previous ipsilateral shoulder surgery, bony Bankart lesions, glenohumeral osteoarthritis and concomitant surgery involving rotator cuff tears, biceps tendon pathology and superior labrum from anterior to posterior (SLAP) lesions. Read More

View Article and Full-Text PDF

Arthroscopic Bankart and Remplissage for Anteroinferior Instability With Subcritical Bone Loss Has a Low Recurrence Rate.

Arthrosc Sports Med Rehabil 2022 Apr 1;4(2):e695-e703. Epub 2022 Feb 1.

Department of Orthopaedics, Sancheti Institute for Orthopaedics and Rehabilitation, Shivajinagar, Maharashtra, India.

Objective: To demonstrate whether arthroscopic remplissage can achieve good outcomes without significantly impairing shoulder function.

Methods: Consecutive patients with recurrent anterior glenohumeral dislocation, glenoid bone loss <20%, and engaging Hill-Sachs lesion who were operated with arthroscopic Bankart repair and remplissage between 2013 and 2016 were identified. Patients were evaluated clinically for shoulder instability, range of motion, and scored as per Oxford Shoulder Instability Score and University of California at Los Angeles score. Read More

View Article and Full-Text PDF

Arthroscopic Remplissage Using Knotless, All-Suture Anchors.

Arthrosc Tech 2022 Apr 19;11(4):e615-e621. Epub 2022 Mar 19.

Mayo Clinic Arizona Department of Orthopedic Surgery, Phoenix, Arizona, U.S.A.

Glenohumeral bone loss is a significant risk factor for recurrent instability after shoulder dislocation. The Hill-Sachs lesion is an osseous defect of the posterior humeral head that is commonly recognized after anterior shoulder dislocation. Several procedures exist to address humeral-sided bone loss, including soft tissue filling procedures, osteoarticular allografts, bone plugs, rotation osteotomies, and humeral head replacements. Read More

View Article and Full-Text PDF

Arthroscopic bone block metal-free fixation for anterior shoulder instability. Short-term functional and radiological outcomes.

Rev Esp Cir Ortop Traumatol 2022 Apr 26. Epub 2022 Apr 26.

Departamento de Cirugía Ortopédica y Traumatología, Hospital Universitario de Bellvitge (L'Hospitalet de Llobregat, Barcelona, España). Profesor titular de cirugía ortopédica y traumatología. Universidad de Barcelona, España.

Introduction: Anterior glenohumeral bone loss reconstruction reduces failure rates after soft tissue surgery in patients with large glenoid bone defects. Multiple bone block techniques have been described, most with metal hardware fixation. The objective of this study is to evaluate the safety, as well as the short term functional and radiological results of an arthroscopic bone block metal-free fixation or Bone Block Cerclage (BBC). Read More

View Article and Full-Text PDF

Arthroscopic Latarjet for primary shoulder instability with off-track lesions or revision surgery yields satisfactory clinical results, and reliable return to sport and work at minimum 3-year follow-up. A single surgeon's experience on 95 cases.

Arthroscopy 2022 Apr 22. Epub 2022 Apr 22.

Department of Orthopaedic and Trauma Surgery, "Magna Graecia" University, "Mater Domini" University Hospital, Catanzaro, Italy.

Purpose: The study aims to retrospectively evaluate clinical and radiological outcomes and return to sport and to work of patients after arthroscopic Latarjet stabilization for primary instability or revision surgery; factors influencing and determining results, and potential predictors for clinical outcomes were also evaluated.

Methods: This is a retrospective study including patients aged greater than 18 years old who underwent arthroscopic Latarjet stabilization for recurrent anterior glenohumeral instability with off-track lesions, or for cases of recurrence after previous surgery, from 2011 to 2017. Patients were assessed preoperatively and at a minimum 3 years of follow-up using the Rowe score, the University of California at Los Angeles Shoulder Score and Simple Shoulder Test (SST) score; the range of motion, satisfaction rate, return to work and sport, perception of discomfort during sporting and daily activities, and complications and recurrence after surgery were also evaluated. Read More

View Article and Full-Text PDF

Cartilage decisively shapes the glenoid concavity and contributes significantly to shoulder stability.

Knee Surg Sports Traumatol Arthrosc 2022 Apr 17. Epub 2022 Apr 17.

Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany.

Purpose: Glenohumeral joint injuries frequently result in shoulder instability. However, the biomechanical effect of cartilage loss on shoulder stability remains unknown. The aim of the current study was to investigate biomechanically the effect of two severity stages of cartilage loss in different dislocation directions on shoulder stability. Read More

View Article and Full-Text PDF

Arthroscopic Bankart repair with additional footprint fixation using the double-row technique at the 4 o'clock position anatomically restored the capsulolabral complex and showed good clinical results.

Knee Surg Sports Traumatol Arthrosc 2022 Apr 15. Epub 2022 Apr 15.

Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan.

Purpose: To investigate the clinical outcome and magnetic resonance imaging (MRI) findings after arthroscopic Bankart repair with additional double anchor footprint fixation (DAFF) at the 4 o'clock position, where the native footprint is widest anatomically, for recurrent anterior shoulder instability.

Methods: Forty-two patients (mean age 27.0 years) with recurrent anterior shoulder instability and without severe glenoid bone defects underwent arthroscopic Bankart repair with additional DAFF at the 4 o'clock position. Read More

View Article and Full-Text PDF

Factors That Influence the Return to Sport After Arthroscopic Bankart Repair for Glenohumeral Instability.

Open Access J Sports Med 2022 2;13:35-40. Epub 2022 Apr 2.

Hospital Italiano de Buenos Aires, Investigation Performed at the Shoulder Unit Department of Orthopedic Surgery, Buenos Aires, Argentina.

Numerous studies have reported high rates of return to sports following arthroscopic Bankart repair (ABR) However, there is enormous controversy regarding the optimal management of these patients in the postoperative period. Controversy issues include rehabilitation, criteria for returning to sports, and the specific management of each athlete according to the sport they practice. Even though there are several rehabilitation protocols published in the literature, wide variability exists concerning the key elements of rehabilitation after an ABR. Read More

View Article and Full-Text PDF

Morphology of Glenoid Cartilage Defects in Anteroinferior Glenohumeral Instability.

Orthop J Sports Med 2022 Apr 4;10(4):23259671221086615. Epub 2022 Apr 4.

Department of Orthopaedic Surgery, University of Utah, Salt Lake City, Utah, USA.

Background: Glenoid cartilage defects may contribute to anterior shoulder instability recurrence and progression to osteoarthritis, but their morphology remains unknown.

Purpose/hypothesis: The purpose was to determine the shape, size, and location of glenoid cartilage defects and the prevalence and risk factors for cartilage defects in the setting of anterior glenohumeral instability. It was hypothesized that glenoid cartilage defects would be common, would be associated with recurrence of dislocation, and would share similar morphology with glenoid osseous defects. Read More

View Article and Full-Text PDF

Biomechanical Comparison Between Various Screw Fixation Angles for Latarjet Procedure: A Cadaveric Biomechanical Study.

J Shoulder Elbow Surg 2022 Apr 6. Epub 2022 Apr 6.

Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, Republic of China; Skeleton Materials and Bio-compatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan, Republic of China. Electronic address:

Background: The Latarjet procedure is a reliable treatment for the management of anterior glenohumeral instability with glenoid bone loss. However, the biomechanical properties of different fixation angles between screw and glenoid surface (α angle) have rarely been studied. The aim of the study was to investigate and compare the fixation stability, failure load and failure mechanism between different α angles for Latarjet procedures, which were performed on cadaver specimens. Read More

View Article and Full-Text PDF

Editorial Commentary: Buttoning Up After Recurrent Anterior Shoulder Instability: The Eden-Hybinette Procedure Is an Effective Salvage After Failed Latarjet.

Authors:
Brian Waterman

Arthroscopy 2022 04;38(4):1134-1136

Operative management of anterior glenohumeral dislocation can confer significant improvements in subjective shoulder function, pain, and overall stability. Although the coracoid-based Latarjet procedure has long been considered the ultimate treatment for complex anterior shoulder instability with glenoid or bipolar bone loss, few authors have considered the unimaginable question: what do you do when a patient fails Latarjet? A modified arthroscopic technique of the Eden-Hybinette procedure allows for revision anterior glenoid augmentation of critical glenoid bone loss with autologous tricortical iliac crest, while suture button fixation may obviate hardware complications previously seen with bicortical screw fixation. Although distal tibial allograft provides excellent congruity, viable articular cartilage, and no harvest site morbidity, financial costs and graft availability must also be considered. Read More

View Article and Full-Text PDF

Bankart Repair With Transferred Long Head of the Biceps Provides Better Biomechanical Effect Than Conjoined Tendon Transfer in Anterior Shoulder Instability With 20% Glenoid Defect.

Arthroscopy 2022 Mar 29. Epub 2022 Mar 29.

Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. Electronic address:

Purpose: To examine the biomechanical differences between labral repair with transferred conjoined tendon and transferred long head of the biceps tendon (LHBT) for anterior shoulder instability with 20% bone loss.

Methods: Twelve cadaveric shoulders were tested in sequent 5 conditions: intact, 20% glenoid defect, Bankart repair, Bankart repair with transferred conjoined tendon (dynamic conjoined tendon sling, DCS), and with transferred LHBT (dynamic LHBT sling, DLS) at 60° of glenohumeral abduction and 60° of external rotation. The physiological glenohumeral joint load was created by forces applied to the rotator cuff, conjoined tendon, and LHBT. Read More

View Article and Full-Text PDF

Anchoring Apparatus of Long Head of the Biceps Tendon: Ultrasonographic Anatomy and Pathologic Conditions.

Diagnostics (Basel) 2022 Mar 8;12(3). Epub 2022 Mar 8.

Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China.

The long head of the biceps tendon (LHBT) has been recognized as an important generator of anterior shoulder pain, causing a significant reduction in the shoulder flexion range. Various tendinous and ligamentous structures form the anchoring apparatus of the LHBT along its course to maintain its appropriate location during shoulder movements, including the coracohumeral ligament (CHL), superior glenohumeral ligament (SGHL), subscapularis (SSC) tendon and supraspinatus (SSP) tendon as well as the less recognized tendons of pectoralis major (PM), latissimus dorsi (LD) and teres major (TM). Lesions of this stabilizing apparatus may lead to an instability of the LHBT, resulting in pain at the anterior shoulder. Read More

View Article and Full-Text PDF

Accuracy of shoulder joint injections with ultrasound guidance: Confirmed by magnetic resonance arthrography.

World J Orthop 2022 Mar 18;13(3):259-266. Epub 2022 Mar 18.

Department of Orthopaedic Surgery, Daini Osaka Police Hospital, Osaka 543-8922, Japan.

Background: Intra-articular glenohumeral joint injections are essential procedures for treating various shoulder disorders. Fluoroscopy-guided injections have been extensively used; however, they pose a risk of radiation exposure and are expensive and time-consuming. Recently, it has been suggested that ultrasound-guided injections are accurate and cost effective procedures. Read More

View Article and Full-Text PDF

Primary Open Latarjet Procedure Results in Functional Differences but No Structural Changes in Subscapularis Muscle Quality vs the Healthy Contralateral Shoulder at Long-term Follow-up.

Am J Sports Med 2022 May 22;50(6):1495-1502. Epub 2022 Mar 22.

Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.

Background: There are concerns that the Latarjet procedure results in loss of glenohumeral rotation and strength and in subscapularis dysfunction. The long-term effects of this procedure on subscapularis quality, glenohumeral rotation, and strength are unknown.

Purpose/hypothesis: To analyze the long-term effect of the primary open Latarjet procedure using a muscle-splitting approach on internal and external rotation and strength, as well as subscapularis muscle quality as compared with the healthy contralateral side. Read More

View Article and Full-Text PDF

An algorithm for successfully managing anterior shoulder instability.

JAAPA 2022 Apr;35(4):17-28

Stephanie C. Petterson is clinical research director at the Orthopaedic Foundation in Stamford, Conn. At the time this article was written, Gerald Agyapong was a student in the PA program at Sacred Heart University in Fairfield, Conn. He now practices in orthopedics at New York Presbyterian-Queens Hospital in Flushing, N.Y. Jasmine E. Brite is a research assistant at Plancher Orthopaedics and Sports Medicine in New York, N.Y. Jaya Shanmugam is a fellow at the Orthopaedic Foundation and Plancher Orthopaedics. Karen K. Briggs is a research associate at the Orthopaedic Foundation. Kevin D. Plancher is a clinical professor in the Department of Orthopaedic Surgery at Montefiore Medical Center/Albert Einstein College of Medicine in New York, N.Y.; adjunct clinical assistant professor in the Department of Orthopaedic Surgery at Weill Cornell Medical College in New York, N.Y.; founder of the Orthopaedic Foundation; and practices at Plancher Orthopaedics and Sports Medicine. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Abstract: The most common form of shoulder instability involves the anterior glenohumeral joint. Often it is associated with labral and bony injuries with subsequent recurrent instability. To determine optimal management, clinicians should perform a detailed history and physical examination, including appropriate diagnostic imaging to assess for concomitant humeral and glenoid bony deficiencies and other soft-tissue pathologies. Read More

View Article and Full-Text PDF

Combined Double-Pulley Remplissage and Bankart Repair.

Arthrosc Tech 2022 Mar 18;11(3):e419-e425. Epub 2022 Feb 18.

Advanced Orthopaedics and Sports Medicine, San Francisco, California, U.S.A.

The use of arthroscopic Bankart repair to treat anterior shoulder instability has become increasingly widespread. However, high rates of recurrent instability within the presence of glenohumeral bony defects, specifically Hill-Sachs lesions, have well documented a key concern regarding the arthroscopic Bankart repair process. Our technique describes the pairing of a remplissage to fill the Hill-Sachs lesion with the Bankart repair, preventing loss in shoulder stiffness and stability. Read More

View Article and Full-Text PDF

Editorial Commentary: Recurrent Anterior Shoulder Instability With Glenoid Bone Loss Requires Restoring the Bone.

Authors:
James Shaha

Arthroscopy 2022 03;38(3):682-683

Phoenix, Arizona.

The success of treating anterior glenohumeral instability relies on multiple factors, including glenoid bone loss. Subcritical bone loss (<13.5%) has proven again and again to be a critical consideration when treating this problem. Read More

View Article and Full-Text PDF

Bone Fragment Resorption and Clinical Outcomes of Traumatic Bony Bankart Lesion Treated With Arthroscopic Repair Versus Open Latarjet.

Am J Sports Med 2022 Apr 4;50(5):1336-1343. Epub 2022 Mar 4.

Steadman Philippon Research Institute, Vail, Colorado, USA.

Background: Bony Bankart lesions can perpetuate chronic anterior glenohumeral instability. When surgical treatment is pursued, several factors need to be considered to obtain optimal outcomes.

Purpose: To (1) quantitatively describe patterns of bone fragment resorption and associated risk factors for developing glenoid bone loss (GBL) and (2) to compare clinical and radiological results of attritional bone loss treated with either the arthroscopic Bankart or the open Latarjet procedure. Read More

View Article and Full-Text PDF

The Latarjet-Patte Procedure Past, Present, and Future.

Bull Hosp Jt Dis (2013) 2022 Mar;80(1):80-87

The Latarjet-Patte procedure has a long and storied history that predates shoulder arthroscopy, but its popularity has increased over the past two decades as a treatment for anterior glenohumeral instability with bone loss. Transfer of the coracoid process and conjoint tendon to the anteroinferior glenoid creates a triple-blocking effect that is both static and dynamic, lending it biomechanical superiority over alternative bone block techniques. Patients undergoing the Latarjet-Patte procedure have low rates of recurrent instability compared to arthroscopic soft-tissue stabilization procedures, particularly in the setting of glenoid- and humeral-sided bone loss. Read More

View Article and Full-Text PDF

Patient Factors Associated With Increased Risk for Complications After the Latarjet Procedure.

Orthop J Sports Med 2022 Feb 18;10(2):23259671211062573. Epub 2022 Feb 18.

Idaho Sports Medicine Institute, Boise, Idaho, USA.

Background: The open Latarjet has become the most common method of addressing significant glenoid bone loss in patients with recurrent glenohumeral instability.

Purpose: To describe national trends in Latarjet procedures and risk factors for complications associated with this procedure.

Study Design: Cohort study; Level of evidence, 3. Read More

View Article and Full-Text PDF
February 2022

The safety and efficacy of 2 anterior-inferior portals for arthroscopic repair of anterior humeral avulsion of the glenohumeral ligament: cadaveric comparison.

J Shoulder Elbow Surg 2022 Feb 12. Epub 2022 Feb 12.

Andrews Research & Education Foundation, Gulf Breeze, FL, USA.

Background: Humeral avulsion of the glenohumeral ligament (HAGL) lesions are associated with shoulder instability. Arthroscopic repair of anterior HAGL lesions typically requires the placement of an anterior-inferior (5-o'clock) portal, with different variations of this portal described. The purpose of this study was to determine the efficacy of described anterior-inferior shoulder arthroscopy portals for arthroscopic anterior HAGL repair, as well as evaluate the safety of these portals with respect to the surrounding neurovascular structures. Read More

View Article and Full-Text PDF
February 2022

Modified Dynamic Anterior Stabilization (DAS) and Hill-Sachs Remplissage for the Treatment of Recurrent Anterior Shoulder Dislocation.

Arthrosc Tech 2022 Feb 13;11(2):e147-e152. Epub 2022 Jan 13.

Romanian Shoulder Institute, ORTOPEDICUM- Orthopaedic Surgery & Sports Clinic, Bucharest, Romania.

The optimal treatment for recurrent glenohumeral instability is a subject under debate. The recently described arthroscopic technique for dynamic anterior stabilization (DAS) fills the treatment indication gap between reconstructive bony procedures and soft tissue stabilization. However, indications for DAS are considered limited or not appropriate for patients with recurrent shoulder dislocations caused by severe bone defects. Read More

View Article and Full-Text PDF
February 2022

Shoulder Stabilization Versus Immobilization for First-Time Anterior Shoulder Dislocation: A Systematic Review and Meta-analysis of Level 1 Randomized Controlled Trials.

Am J Sports Med 2022 Feb 11:3635465211065403. Epub 2022 Feb 11.

University of Colorado School of Medicine, Department of Orthopaedics, University of Colorado, Aurora, Colorado, USA.

Background: Multiple studies have compared redislocation rates after stabilization and immobilization for patients experiencing a traumatic, first-time anterior shoulder dislocation (ASD).

Purpose: To systematically review the literature to compare rates of recurrent instability and subsequent instability surgery in patients undergoing treatment for a first-time ASD with surgical stabilization versus shoulder immobilization.

Study Design: Systematic review and meta-analysis; Level of evidence, 1. Read More

View Article and Full-Text PDF
February 2022