Arthroscopic Repair of Anterior-Inferior Glenohumeral Instability Using a Portal at the 5:30-o’Clock Position

Imhoff, Andreas B.; Ansah, Patrick; Tischer, Thomas; Reiter, C; Bärtl, Christoph; Hench, Maximilian; Spang, Jeffrey T.; Vogt, Stephan

doi:10.1177/0363546510370199

Cited by 104 publications

(56 citation statements)

References 42 publications

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“…Several studies have noted that patient age at the time of first dislocation greatly influences the subsequent number of dislocations and have suggested that an increased number of dislocations creates more-severe labral tears. 15 20) Younger age and longer time from initial injury to surgery contribute to the propagation of the injuries, which in turn worsens the present instability. 4 5) However, recent investigations have reported that a history of high-energy trauma to the involved shoulder may also account for extensive lesions and severe instability even after a single dislocation.…”

Section: Discussionmentioning

confidence: 99%

“… 12 13) As such, other authors believe that reattachment of the concomitant SLAP lesion depends on the age and functional demands of the patient, noting that biceps tenodesis or tenotomy had varied results. Most studies claim that there is no significant difference in the range of motion (ROM), functional scores, and recurrence rates when compared to patients who underwent Bankart repair alone; 8 14 15 16) however, a number of authors have noted several limitations of ROM, especially in external rotation, among those who underwent the combined procedure. 8 17) …”

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confidence: 99%

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Anterior Shoulder Instability with Concomitant Superior Labrum from Anterior to Posterior (SLAP) Lesion Compared to Anterior Instability without SLAP Lesion

Durban

Kim

et al. 2016

Clin Orthop Surg

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BackgroundThe aims of this study were to investigate the clinical characteristics of patients with combined anterior instability and superior labrum from anterior to posterior (SLAP) lesions, and to analyze the effect of concomitant SLAP repair on surgical outcomes.MethodsWe retrospectively reviewed patients who underwent arthroscopic stabilization for anterior shoulder instability between January 2004 and March 2013. A total of 120 patients were available for at least 1-year follow-up. Forty-four patients with reparable concomitant detached SLAP lesions (group I) underwent combined SLAP and anterior stabilization, and 76 patients without SLAP lesions (group II) underwent anterior stabilization alone. Patient characteristics, preoperative and postoperative pain scores, Rowe scores, and shoulder ranges of motion were compared between the 2 groups.ResultsPatients in group I had higher incidences of high-energy trauma (p = 0.03), worse preoperative pain visual analogue scale (VAS) (p = 0.02), and Rowe scores (p = 0.04). The postoperative pain VAS and Rowe scores improved equally in both groups without significant differences. Limitation in postoperative range of motion was similar between the groups (all p-value > 0.05).ConclusionsAnterior instability with SLAP lesion may not be related to frequent episodes of dislocation but rather to a high-energy trauma. SLAP fixation with anterior stabilization procedures did not lead to poor functional outcomes if appropriate surgical techniques were followed.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Anterior Shoulder Instability with Concomitant Superior Labrum from Anterior to Posterior (SLAP) Lesion Compared to Anterior Instability without SLAP Lesion

Durban

Kim

et al. 2016

Clin Orthop Surg

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“…However, recent studies have shown recurrent rates of 4%–19% [[1]–[5]]. Several factors, including a young age at the time of surgery, male sex, shoulder instability on both sides, joint hyperlaxity, participation in collision sports, early return to contact sports, the size of the humeral defect (Hill-Sachs lesion), and bone defects have been associated with the recurrent instability [[6]–[10]]. In addition, a recent study showed that 55% of the re-dislocations after ABR occurred within the first year, and thereafter, the recurrence rate decreased for up to 5 years [[11]].…”

Section: Introductionmentioning

confidence: 99%

Risk factors for shoulder re-dislocation after arthroscopic Bankart repair

et al. 2014

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BackgroundRecent studies have shown effective clinical results after arthroscopic Bankart repair (ABR) but have shown several risk factors for re-dislocation after surgery. We evaluated whether patients are at a risk for re-dislocation during the first year after ABR, examined the recurrence rate after ABR, and sought to identify new risk factors.MethodsWe performed ABR using bioabsorbable suture anchors in 102 consecutive shoulders (100 patients) with traumatic anterior shoulder instability. Average patient age and follow-up period was 25.7 (range, 14–40) years and 67.5 (range, 24.5–120) months, respectively. We evaluated re-dislocation after ABR using patient telephone interviews (follow-up rate, 100%) and correlated re-dislocation with several risk factors.ResultsRe-dislocation after ABR occurred in nine shoulders (8.8%), of which seven sustained re-injuries within the first year with the arm elevated at 90° and externally rotated at 90°. Of the remaining 93 shoulders without re-dislocation, 8 had re-injury under the same conditions within the first year. Thus, re-injury within the first year was a risk for re-dislocation after ABR (P < 0.001, chi-squared test). Using multivariate analysis, large Hill-Sachs lesions (odds ratio, 6.77, 95% CI, 1.24–53.6) and <4 suture anchors (odds ratio, 9.86, 95% CI, 2.00–76.4) were significant risk factors for re-dislocation after ABR.ConclusionsThe recurrence rate after ABR is not associated with the time elapsed and that repair strategies should augment the large humeral bone defect and use >3 anchors during ABR.

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“…Bu yüzden saat 5 ve 5:30 portali tanımlanmıştır. [24] Anterior ve posterior Bankart lezyonuna eşlik eden SLAP lezyonu bulunması halinde patoloji "üçlü labral lezyon" olarak tanımlanır ve labral lezyonların %2,4'ünü oluşturmaktadır. [25] Açık Latarjet prosedürü Latarjet prosedürü, anterior instabilitede üç farklı mekanizma ile işlev görmektedir: (1) Abduksiyon ve eksternal rotasyonda konjuant tendon, eklem kapsülü ve supskapularis üzerine askı mekanizması etkisi gösterir, (2) Glenoid antero-posterior çapı artar, (3) Kapsülün korakoakromial ligamanın güdüğüne onarımı stabilizan etki gösterir.…”

Section: Bankart Ve Slap Lezyonuunclassified

Anterior instabilite: Yineleyen çıkık ve revizyon cerrahisi

Eren¹

2013

TOTBID

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Türk Ortopedi ve Travmatoloji Birliği Derneği anlaşılabilmiştir. İnstabilite tanımı hiperlaksite, subluksasyon ve dislokasyonu içeren bir spektrumdur. Bu çerçevede patoanatomi, etiyoloji ve instabilitenin yönünü içeren bir sınıflama yapılmıştır. İlk olarak Travmatik-Unidireksiyonel-Bankart-Cerrahi (TUBS) ve Atravmatik-Multidireksiyonel-Bilateral-Rehabilitasyon-İnferior Kapsüler Kaydırma-Rotator İnterval Kapatma (AMBRII) olarak iki gruba ayrılırken, atletler üzerinde yapılan çalışmalar ile Edinsel-İnstabilite-Aşırı Yüklenme-Cerrahi (AIOS) grubu da eklenmiştir. ANTERİOR İNSTABİLİTE Geçtiğimiz on yıl içerisinde, özellikle atletlerde yapılan çalışmalar ile instabilite kavramı daha iyi

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Arthroscopic Repair of Anterior-Inferior Glenohumeral Instability Using a Portal at the 5:30-o’Clock Position

Cited by 104 publications

References 42 publications

Anterior Shoulder Instability with Concomitant Superior Labrum from Anterior to Posterior (SLAP) Lesion Compared to Anterior Instability without SLAP Lesion

Anterior Shoulder Instability with Concomitant Superior Labrum from Anterior to Posterior (SLAP) Lesion Compared to Anterior Instability without SLAP Lesion

Risk factors for shoulder re-dislocation after arthroscopic Bankart repair

Anterior instabilite: Yineleyen çıkık ve revizyon cerrahisi

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