Glenohumeral joint instability

» Posterior glenohumeral instability is relatively uncommon compared with anterior instability, but is becoming an increasingly recognized and surgically managed shoulder pathology.» Soft-tissue stabilization alone may not be sufficient in patients who present with substantial bone loss to the posterior glenoid and/or the anterior humeral head.» For posterior glenoid defects, posterior glenoid osteoarticular augmentation can be used, and posterior glenoid opening wedge osteotomy can be considered in cases of posterior instability with pathologic retroversion...

The purpose of this review is to provide a comprehensive resource for shoulder proprioception assessment and its integration into clinical decision making as well as targeted rehabilitation protocols. Data for this review were acquired from peer-reviewed articles from computerized online databases, namely PubMed and Medline, published between 1906 and 2021. The development of digital/smart phone goniometers can improve shoulder joint range of motion (ROM) measurements and demonstrate comparable measurement accuracy to the universal standard goniometer...

PURPOSE: The purpose of this study is to compare the accuracy of 3D magnetic resonance imaging (MRI) with that of 3D CT in evaluating glenoid bone loss (GBL). METHODS: This review aligned with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed, the Cochrane Library, Embase, and Web of Science were obtained from data inception to Aug 28, 2023. The search term "glenoid bone loss" was extracted and analyzed via stringent inclusion and exclusion criteria...

PURPOSE: The anterior stability of reverse total shoulder arthroplasty is affected by multiple factors. However, the effect of glenosphere inclination on stability has rarely been investigated, which is what this study aims to look into. METHODS: Reverse shoulder arthroplasty was performed on 15 cadaveric human shoulders. The anterior dislocation forces and range of motion in internal rotation in the glenohumeral joint (primary measured parameters) were tested in a shoulder simulator in different arm positions and implant configurations, as well as with a custom-made 10° inferiorly inclined glenosphere...

PURPOSE OF REVIEW: Anterior shoulder instability is associated with concomitant injury to several stabilizing structures of the shoulder, including glenoid bone loss. While instability is most common in young athletes and patients with predisposing conditions of hyperlaxity, recurrent shoulder instability can occur throughout various age ranges and may lead to longer term effects including pain and shoulder arthritis. Glenoid bone loss exceeding certain thresholds is generally treated by glenoid reconstruction via bone block augmentation to adequately stabilize the glenohumeral joint...

PURPOSE: A variety of instabilities are grouped under multidirectional instability (MDI) of the shoulder. This makes understanding its diagnostic process, presentation and treatment difficult due to lack of evidence-based consensus. This review aims to propose a novel classification for subtypes of MDI. METHODS: A systematic search was performed on PubMed Medline and Embase. A combination of the following 'MeSH' and 'non-MesH' search terms were used: (1) Glenohumeral joint[tiab] OR Glenohumeral[tiab] OR Shoulder[tiab] OR Shoulder joint[tiab] OR Shoulder[MeSH] OR Shoulder joint[MeSH], (2) Multidirectional[tiab], (3) Instability[tiab] OR Joint instability[MeSH]...

The anterior subtype of shoulder dislocations constitutes the vast majority that either reduces instantly or is reduced at the point of care with no serious complexities. The posterior ones are infrequent and inferior and superior dislocations are even more rare. Rupture of the deltoid is considered to be linked with superior dislocation; regardless, very few articles are available pertaining to the mechanism of onset and the management of a superior shoulder dislocation. In the line of traumatic shoulder dislocations, we present a one-year-old neglected case of a 23-year-old male who sustained an open injury over the right outstretched upper arm, abducted at an angle of approximately 45° due to a fall from a height of approximately 18 feet...

BACKGROUND: The rationale for the Latarjet procedure was described as the "triple blocking" effect. Satisfactory surgical outcomes have been reported after surgery. However, it has been reported that the "triple blocking" effect increases joint stability, but it does not fully restore it. Moreover, the procedure is nonanatomic and concerns remain regarding the effects. The study of scapulohumeral rhythm, which is a clinical parameter used for the functional evaluation of shoulder kinematics, can offer new perspectives on the rationale for the procedure...

Background: Concomitant glenohumeral pathologies may be present in patients with acromioclavicular joint (ACJ) dislocations. This study aims to record and compare the prevalence and treatment of CGP in cases with acute and chronic ACJ dislocations. Methods: This retrospective cross-sectional binational, bicentric study included patients that underwent arthroscopically assisted stabilization for acute (group A) and chronic (group C) ACJ dislocations. Intraoperatively, CGPs and eventual treatments (debridement and reconstructive measures) were recorded...

Glenohumeral biomechanics after rotator cuff (RC) tears have not been fully elucidated. This study aimed to investigate the muscle compensatory mechanism in weight-bearing shoulders with RC tears and asses the induced pathomechanics (i.e., glenohumeral translation, joint instability, center of force (CoF), joint reaction force). An experimental, glenohumeral simulator with muscle-mimicking cable system was used to simulate 30° scaption motion. Eight fresh-frozen shoulders were prepared and mounted in the simulator...

OBJECTIVE: We aimed to develop a consensus-based rehabilitation guideline specifically designed to reduce apprehension following arthroscopic Bankart repair after traumatic anterior shoulder dislocation. DESIGN: Delphi-based consensus. METHOD: A comprehensive list of interventions for potential inclusion in a postoperative rehabilitation guideline was developed. American and European physiotherapists and orthopedic surgeons were invited to participate in a Delphi panel, engaging in three survey rounds. The health professionals were surveyed about their level of agreement on both initially listed and newly suggested interventions...

OBJECTIVES: Bankart lesion is one of the most common lesions of the glenohumeral joint. Several double-row suture methods were reported for Bankart repair, which could provide more stability, yet more motion limitation and complications. Therefore, we introduced a new double-row Bankart repair technique, key point double-row suture which used one anchor in the medial line. The purpose of this article is to investigate the clinical outcomes of this new method and to compare it with single-row suture...

PURPOSE: The purpose of this study was to compare outcomes of patients that underwent rotator cuff repair (RCR) with concomitant biceps tenodesis to those that underwent an isolated RCR. METHODS: Exclusion criteria included prior ipsilateral shoulder surgery, irreparable rotator cuff tears, rotator cuff arthropathy, calcific tendinitis, adhesive capsulitis requiring a capsular release or advanced osteoarthritis of the glenohumeral joint. Patients were indicated for biceps tenodesis if they had any degree of tendon tearing, moderate to severe tenosynovitis, instability, or a significant degenerative SLAP tear...

BACKGROUND: Shoulder instability is a complex impairment and identifying biomarkers which differentiate subgroups is challenging. There is limited fundamental movement and muscle activity data for identifying different mechanisms for shoulder instability in children and adolescents which may inform subgrouping and treatment allocation. HYPOTHESIS: Children and adolescents with shoulder instability (irrespective of etiology) have differences in their movement and muscle activity profiles compared to age- and sex-matched controls (two-tailed)...

Improving the modalities for advanced glenohumeral joint imaging has been an important area to address in the field of orthopaedic surgery. The current gold standard for imaging glenoid and humeral bone loss in patients with shoulder instability, 3D computed tomography (3D-CT), provides high-quality 3D images of bones, but comes with a cost of extra time, additional imaging, due to the need of an additional MRI, and exposure to radiation. 3D magnetic resonance imaging (3D-MRI) is a promising solution that can produce high contrast images depicting both bony structures and soft tissues...

In unstable shoulders, excessive anteroinferior position of the humeral head relative to the glenoid can lead to a dislocation. Measuring humeral head position could therefore be valuable in quantifying shoulder laxity. The aim of this study was to measure (1) position of the humeral head relative to the glenoid and (2) joint space thickness during passive motion in unstable shoulders caused by traumatic anterior dislocations and in contralateral uninjured shoulders. A prospective cross-sectional CT-study was performed in patients with unilateral anterior shoulder instability...

PURPOSE: The inferior glenohumeral ligament (IGHL) is composed of three parts: the anterior branch or band (AB), the axillary pouch and the posterior band (PB). The latter has rarely been studied. We aim to describe the PB of the IGHL and its dynamic behaviour in different arm positions. METHODS: Twelve fresh cadaveric shoulders were used and the two bands (AB and PB) of the IGHL were dissected and isolated, taking away all muscle, ligaments and capsule. Characteristics of the bands were studied in five positions: maximum external rotation (ER1), abduction (ABD), internal rotation (IR), ABD external rotation (ER2) and anterior elevation-adduction-IR (Hawkins-Kennedy test position)...

A proportion of patients with anterior glenohumeral instability present with bipolar bone loss comprising large Hill-Sachs lesions and substantial glenoid defect. These are surgically difficult cases to treat. We describe a novel surgical procedure of bulk size-matched osteochondral allograft reconstruction for massive Hill-Sachs lesions combined with the Latarjet procedure for these challenging cases.

AIM: Reverse shoulder arthroplasty (RSA) is a well recognized treatment for many shoulder conditions, including rotator cuff arthropathy, primary glenohumeral joint arthritis, rheumatoid arthritis and can be utilized in both trauma and revision settings. Over the past 10 years its popularity in New Zealand has been increasing, with a 6-7% annual growth during this period. The proposed advantages of a stemless (sRSA) design are to preserve humeral bone stock, limit periprosthetic fractures and can be indicated in patients with abnormal diaphyseal humeral anatomy...

Teres minor denervation (TMD) has gained increasing attention in recent years, particularly with the advent of magnetic resonance imaging (MRI). The potential association between TMD and shoulder instability or rotator cuff tear remains a subject of interest in the orthopedic community. In this retrospective and cross-sectional study, authors aim to investigate the potential association between TMD and shoulder instability or rotator cuff tears. Authors retrospectively analyzed MRI findings from 105 patients with TMD, focusing on rotator cuff pathologies, posterior labrocapsular complex (PLCC) tears, and posteroinferior glenohumeral joint capsule alterations...