Arthroscopic Rotator Interval Closure

Plausinis, Derek; Bravman, Jonathan T.; Heywood, C; Kummer, Frederick J.; Kwon, Young W.; Jazrawi, Laith M.

doi:10.1177/0363546506289881

Cited by 48 publications

(6 citation statements)

References 18 publications

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“…Plausinis et al . 5 demonstrated that arthroscopic RI closure with 1-2 sutures significantly reduced A-P glenohumeral translation by 17% at neutral rotation (with respect to forearm) and at 0º abduction. Authors did not observe significant reduction in posterior translation.…”

Section: Biomechanical Studies Of Ri Closure and Its Effects On Ghjmentioning

confidence: 96%

Rotator interval closure: inconsistent techniques and its association with anterior instability. A literature review

2019

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The Rotator interval (RI) is an anatomic space in the anterosuperior part of the glenohumeral joint. An incompetent or lax RI has been implicated in various conditions of shoulder instability and therefore RI has been frequently touted as an area that is important in preserving stability of the shoulder. Biomechanical studies have shown that repair of RI ligamentous and capsular structures decreases glenohumeral joint laxity in various directions. Clinical studies have reported successful outcomes after repair or plication of these structures in patients undergoing shoulder stabilization procedures. Although varieties of methods have been described for its closure, the optimal surgical technique is unclear with various inconsistencies in incorporation of the closure tissue. This in particular makes the analysis of the RI closure very difficult. The purposes of this study is to review the structures of the RI and their contribution to shoulder instability, to discuss the biomechanical and clinical effects of plication of RI structures in particular to anterior glenohumeral instability, to delineate the differences between an arthroscopic and open RI closure. Additionally, we have proposed a new classification system describing various techniques used during RI closure.

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Section: Biomechanical Studies Of Ri Closure and Its Effects On Ghjmentioning

confidence: 96%

Rotator interval closure: inconsistent techniques and its association with anterior instability. A literature review

2019

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“…Interval closure is controversial [ 65 , 66 , 71 ]. We perform this procedure when there is a sign of a 2 cm groove or when, after repairing an instability, a groove sign > 1 cm with the arm externally rotated persists [ 57 , 67 ].…”

Section: Interval Closurementioning

confidence: 99%

“…The closure of the rotator interval has been proposed as a technique to reduce recurrence rates. Recent biomechanical studies have not shown that the arthroscopic rotator interval closure is beneficial for the treatment of posterior glenohumeral instability [ 26 , 71 ].…”

Section: Complicationsmentioning

confidence: 99%

Treatment of The Posterior Unstable Shoulder

Alepuz¹,

Pérez-Barquero²,

Jorge³

et al. 2017

TOORTHJ

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Background:It is estimated that approximately 5% of glenohumeral instabilities are posterior. There are a number of controversies regarding therapeutic approaches for these patients.Methods:We analyse the main surgery alternatives for the treatment of the posterior shoulder instability. We did a research of the publications related with posterior glenohumeral instability.Results:There are conservative and surgical treatment options. Conservative treatment has positive results in most patients, with around 65 to 80% of cases showing recurrent posterior dislocation.There are multiple surgical techniques, both open and arthroscopic, for the treatment of posterior glenohumeral instability. There are procedures that aim to repair bone defects and others that aim to repair soft tissues and capsulolabral injuries. The treatment should be planned according to each case on an individual basis according to the patient characteristics and the injury type.Surgical treatment is indicated in patients with functional limitations arising from instability and/or pain that have not improved with rehabilitation treatment.The indications for arthroscopic treatment are recurrent posterior subluxation caused by injury of the labrum or the capsulolabral complex; recurrent posterior subluxation caused by capsuloligamentous laxity or capsular redundancy; and multidirectional instability with posterior instability as a primary component. Arthroscopic assessment will help identify potential injuries associated with posterior instability such as bone lesions or defects and lesions or defects of soft tissues.The main indications for open surgery would be in cases of Hill Sachs lesions or broad reverse Bankart lesions not accessible by arthroscopy.We indicated non-anatomical techniques (McLaughlin or its modifications) for reverse Hill-Sachs lesions with impairment of the articular surface between 20% and 50%. Disimpaction of the fracture and placement of bone graft (allograft or autograft) is a suitable treatment for acute lesions that do not exceed 50% of the articular surface and with articular cartilage in good condition. Reconstruction with allograft may be useful in lesions affecting up to 50% of the humeral surface and should be considered when there is a situation of non-viable cartilage at the fracture site. For defects greater than 50% of the articular surface or in the case of dislocations over 6 months in duration where there is poor bone quality, some authors advocate substitution techniques as a treatment of choice. The main techniques for treating glenoid bone defects are posterior bone block and posterior opening osteotomy of the glenoid.Conclusions:The treatment of the posterior glenohumeral instability has to be individualized based on the patient´s injuries, medical history, clinical exam and goals. The most important complications in the treatment of posterior glenohumeral instability are recurrent instability, avascular necrosis and osteoarthritis.

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“… 48 , 50 , 58 Specifically, some suggest that injuries to the RI are associated with increased glenohumeral translation and that surgical imbrication of the RI may augment the repair construct during multidirectional and posterior stabilization. 12 , 17 , 24 , 31 , 43 , 54 , 71 , 78 …”

mentioning

confidence: 99%

“…One concern with performing RI plication, particularly in cases in which the procedure is unnecessary, is the potential for postoperative loss of external rotation. 54 , 57 , 71 , 78 Historically, RI plication was performed via open surgical approaches; however, all-arthroscopic techniques for RI plication have more recently been described. 10 , 12 , 16 , 32 , 35 , 44 , 66 , 69 Of note, open and arthroscopic RI closure are different surgical procedures and plicate different tissues, each in a different biomechanical vector.…”

mentioning

confidence: 99%

The Rotator Interval of the Shoulder

Frank

Taylor

Verma

et al. 2015

Orthopaedic Journal of Sports Medicine

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Biomechanical studies have shown that repair or plication of rotator interval (RI) ligamentous and capsular structures decreases glenohumeral joint laxity in various directions. Clinical outcomes studies have reported successful outcomes after repair or plication of these structures in patients undergoing shoulder stabilization procedures. Recent studies describing arthroscopic techniques to address these structures have intensified the debate over the potential benefit of these procedures as well as highlighted the differences between open and arthroscopic RI procedures. The purposes of this study were to review the structures of the RI and their contribution to shoulder instability, to discuss the biomechanical and clinical effects of repair or plication of rotator interval structures, and to describe the various surgical techniques used for these procedures and outcomes.

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Arthroscopic Rotator Interval Closure

Abstract: This study suggests that the initial effect of arthroscopic rotator interval closure on anterior translation of the shoulder will be similar whether 1 or 2 sutures are used. In vivo studies are necessary to determine if the effect of these 2 methods would be the same over time.

Cited by 48 publications

References 18 publications

Rotator interval closure: inconsistent techniques and its association with anterior instability. A literature review

Rotator interval closure: inconsistent techniques and its association with anterior instability. A literature review

Treatment of The Posterior Unstable Shoulder

The Rotator Interval of the Shoulder

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