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Glenohumeral joint instability

John P Begly, Michael J Alaia
Anterior instability of the glenohumeral joint is a common and functionally limiting shoulder condition, particularly in young and active patients. In this population, non-operative management has been increasingly demonstrated to be associated with recurrent instability and increased long-term morbidity. Surgical treatment options include both arthroscopic and open techniques. In appropriately indicated patients, surgical treatment of first-time anterior shoulder instability is a cost-effective and successful treatment option...
March 2019: Bulletin of the Hospital for Joint Diseases
Kevin Clesham, Fintan J Shannon
INTRODUCTION: Shoulder instability following traumatic glenohumeral dislocation is a common injury sustained by athletes particularly in contact and collision sports. Overhead contact sports such as gaelic football and hurling pose a unique hazard to the glenohumeral joint, increasing the risk of dislocation. AIMS: To assess return to sport, level of play, recurrence and functional outcomes in gaelic football and hurling athletes in comparison with players of other sports...
February 15, 2019: Irish Journal of Medical Science
David H Hawkes, Omid A Khaiyat, Anthony J Howard, Graham J Kemp, Simon P Frostick
The shoulder relies heavily on coordinated muscle activity for normal function owing to its limited osseous constraint. However, previous studies have failed to examine the sophisticated interrelationship between all muscles. It is essential for these normal relationships to be defined as a basis for understanding pathology. Therefore, the primary aim of the study was to investigate shoulder inter-muscular coordination during different planes of shoulder elevation. Twenty healthy subjects were included. Electromyography was recorded from 14 shoulder girdle muscles as subjects performed shoulder flexion, scapula plane elevation, abduction and extension...
2019: PloS One
Jose Carlos Garcia, Felipe Machado do Amaral, Renan Juhasz Belchior, Lucas Queiroz de Carvalho, Gregory George Markarian, Edna Feasson de Souza Montero
Background: Coracoid process transfer for the treatment of recurrent glenohumeral dislocations is a safe and reliable procedure; however, there is no consensus as to which is the best method, the Bristow or Latarjet procedure. Purpose: To analyze the results of coracoid process transfer for the treatment of recurrent glenohumeral dislocations and to compare the results of this transfer between the Bristow and Latarjet techniques. Study Design: Systematic review; Level of evidence, 4...
January 2019: Orthopaedic Journal of Sports Medicine
Andrew S Bernhardson, Colin P Murphy, Zachary S Aman, Robert F LaPrade, Matthew T Provencher
BACKGROUND: Anterior and posterior shoulder instabilities are entirely different entities. The presenting complaints and symptoms vastly differ between patients with these 2 conditions, and a clear understanding of these differences can help guide effective treatment. PURPOSE: To compare a matched cohort of patients with anterior and posterior instability to clearly outline the differences in the initial presenting history and overall outcomes after arthroscopic stabilization...
January 30, 2019: American Journal of Sports Medicine
Giovanni Di Giacomo, Luigi Piscitelli, Mattia Pugliese
Shoulder stability depends on several factors, either anatomical or functional. Anatomical factors can be further subclassified under soft tissue (shoulder capsule, glenoid rim, glenohumeral ligaments etc) and bony structures (glenoid cavity and humeral head).Normal glenohumeral stability is maintained through factors mostly pertaining to the scapular side: glenoid version, depth and inclination, along with scapular dynamic positioning, can potentially cause decreased stability depending on the direction of said variables in the different planes...
December 2018: EFORT Open Reviews
Steven Magister, Andrew Bridgforth, Seth Yarboro
Introduction: Axillary artery injury is a rare and potentially devastating sequelae of glenohumeral dislocation. While neurovascular exam is critical in all presentations, the presence of "soft" and/or "hard" signs should prompt a more thorough examination and possible employment of advanced imaging techniques. Case Report: We present a case of a 51-year-old male with an axillary artery injury associated with an anterior glenohumeral dislocation...
July 2018: Journal of Orthopaedic Case Reports
Shigeto Nakagawa, Ryo Iuchi, Hiroto Hanai, Takehito Hirose, Tatsuo Mae
BACKGROUND: Recurrence of glenohumeral joint instability after primary traumatic anterior instability is not rare, and bipolar bone loss is one of the most critical factors for recurrent instability, but the development process of bipolar bone defects is still unclear. PURPOSE: To investigate the development process of bipolar bone defects from primary to recurrent instability among shoulders with traumatic anterior instability evaluated at least twice by computed tomography (CT)...
January 23, 2019: American Journal of Sports Medicine
En-Chang Zhou, Hao Yin, Ping Tang, Yu-Yan Zhang, Bang-Guo Li
OBJECTIVE: To study the influence of the number and position of anchor nails on the Bankart repair by the finite element analysis. METHODS: The 3D CT data of shoulder joints including normal adult volunteers were imported into Mimics 10.0 and Geomagic 2012 software to reconstruct the related tissues, and then meshed in Hypermesh 13.0 software to give material attributes. The position and number of MPC constraints were adjusted in Abaqus 6.14 to establish finite element model of shoulder joint under 6 working conditions including A model(normal control model), B model (Bankart damage control model), C model (1 anchor), D model (2 anchors), E model (3 anchors), F model (4 anchors)...
December 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Jessica L Hughes, Peter Kruk, Tracey P Bastrom, Eric W Edmonds
BACKGROUND: Managing recurrent shoulder instability in an athlete of any age is challenging. The pediatric literature regarding recurrence of instability is difficult to interpret because of the variable treatment protocols and varying ages. The adult literature suggests that bone loss on the humerus, glenoid or both, as detected by CT, has high rates of recurrence following surgical intervention. OBJECTIVE: The purpose of this study was to evaluate risk factors for recurrence following arthroscopic capsulorrhaphy in adolescent athletes using preoperative MR arthrograms...
December 18, 2018: Pediatric Radiology
Huw Lloyd Morgan Williams, Jonathan Peter Evans, Nicholas Duncan Furness, Christopher David Smith
BACKGROUND: The surgical treatment of recurrent shoulder instability has evolved in recent years to include a variety of soft tissue and bone block procedures, undertaken with either an open or arthroscopic approach. Although the utilization of such techniques has rapidly expanded, the associated risk of complications remains poorly defined. This information is vital for clinical decision making and patient counseling. PURPOSE: To quantify the complication rate associated with all types of surgery for anterior glenohumeral joint dislocation...
December 10, 2018: American Journal of Sports Medicine
Patrick Williamson, Amin Mohamadi, Arun J Ramappa, Joseph P DeAngelis, Ara Nazarian
BACKGROUND: Numerous biomechanical studies have addressed normal shoulder function and the factors that affect it. While these investigations include a mix of in-vivo clinical reports, ex-vivo cadaveric studies, and computer-based simulations, each has its own strengths and limitations. A robust methodology is essential in cadaveric work but does not always come easily. Precise quantitative measurements are difficult in in-vivo studies, and simulation studies require validation steps...
November 14, 2018: Journal of Biomechanics
Przemysław Lubiatowski, Piotr Ogrodowicz, Marcin Wojtaszek, Leszek Romanowski
HYPOTHESIS AND BACKGROUND: Proprioception is an important element of shoulder dynamic stability. It has been shown to be affected in cases of capsular or labral injuries of the glenohumeral joint. Therefore, this study was conducted to investigate bilateral shoulder proprioception by active reproduction of joint position both in patients with post-traumatic recurrent unilateral shoulder instability and in normal healthy volunteers. METHODS: We compared 41 patients, comprising 11 female and 30 male patients with an average age of 25...
November 28, 2018: Journal of Shoulder and Elbow Surgery
Redouane Kadi, Annemieke Milants, Maryam Shahabpour
The shoulder joint is functionally and structurally complex and is composed of bone, hyaline cartilage, labrum, ligaments, capsule, tendons and muscles. It links the trunk to the upper limb and plays an important biomechanical role in daily activities. Indications for imaging of the shoulder have considerably increased in the last few years. The article focuses mainly on Magnetic Resonance Imaging (MRI) as well as MR and CT arthrography, diagnostic procedures of choice for assessment of internal derangement of the shoulder...
December 16, 2017: Journal of the Belgian Society of Radiology
Haley Glazebrook, Blair Miller, Ivan Wong
Background: Anterior shoulder instability is the most common sequela of shoulder dislocation and can result in repeated dislocations or subluxation of the glenohumeral joint. Anterior shoulder instability can be treated conservatively or surgically with several procedures. Purpose: To date, arthroscopic Bankart is the most common surgical procedure for the treatment of anterior shoulder instability. No previous studies have compared all anterior shoulder surgical procedures...
November 2018: Orthopaedic Journal of Sports Medicine
Tingting Liu, Jianpeng Ma, Hetao Cao, Dongmei Hou, Lin Xu
BACKGROUND: Physical examinations may reveal the instability of a glenohumeral joint but cannot diagnose the bony Bankart lesions. Soft tissue Bankart lesion cannot be visualized on traditional radiogram. Magnetic resonance images have high cost and availability issues. The purpose of the study was to access the diagnostic performance of the Computed Tomography (CT) in the assessment of patients with shoulder instability and to diagnose the Bankart and bony Bankart lesions. METHODS: A total of 145 patients with shoulder instability were included in the study...
November 23, 2018: BMC Medical Imaging
Jeffrey D Trojan, Steven F DeFroda, Mary K Mulcahey
Shoulder instability is a common condition encountered by sports medicine and shoulder surgeons. Management can be challenging, both with regards to the underlying pathology and the high expectations associated with the very active patient population that this condition typically affects. High-performance athletes who are used to performing at activity levels which typically challenge the normal physiologic limits of the glenohumeral joint may be particularly difficult to treat. As physicians increasingly evaluate patient reported outcomes (PROs), a growing body of literature has emerged related to patient expectations for a variety of orthopaedic conditions, including shoulder instability...
November 14, 2018: Physician and Sportsmedicine
Meghan E Vidt, Anthony C Santago, Anthony P Marsh, Eric J Hegedus, Christopher J Tuohy, Gary G Poehling, Michael T Freehill, Michael E Miller, Katherine R Saul
BACKGROUND: Rotator cuff tears in older individuals may result in decreased muscle forces and changes to force distribution across the glenohumeral joint. Reduced muscle forces may impact functional task performance, altering glenohumeral joint contact forces, potentially contributing to instability or joint damage risk. Our objective was to evaluate the influence of rotator cuff muscle force distribution on glenohumeral joint contact force during functional pull and axilla wash tasks using individualized computational models...
December 2018: Clinical Biomechanics
Peter S Vezeridis, Chad R Ishmael, Kristofer J Jones, Frank A Petrigliano
Dislocation arthropathy describes the development of progressive degenerative changes of the glenohumeral joint in the setting of instability. Although the specific etiology remains unclear, the trauma of a single dislocation, repetitive injury associated with recurrent dislocations, changes in shoulder biomechanics, and complications associated with instability surgery have all been implicated in its development. Pain and restricted range of motion are the most common patient complaints. Conservative management, consisting of pain control, activity modification, and physical therapy, is the first-line treatment after the development of arthropathy...
October 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
Mark J Lemos
It has been reported and verified that anterior glenoid bone loss can lead to increased instability of the glenohumeral joint. Many authors have tried to quantify glenoid bone loss in recurrent instability of the glenohumeral joint. Techniques have included radiographic, magnetic resonance imaging, computed tomography (CT), 3-dimensional CT, and arthroscopic visualization. A 3-dimensional CT scan using the perfect circle technique, the Pico technique, has become a technique of choice for many authors. However, some have applied this technique using only the uninvolved shoulder...
September 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
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