Open Bankart Repair for the Treatment of Anterior Shoulder Instability without Substantial Osseous Glenoid Defects

Moroder, Philipp; Odorizzi, Marco; Pizzinini, Severino; Demetz, Ernst; Resch, Herbert; Moroder, Peter

doi:10.2106/jbjs.n.01214

Cited by 47 publications

(34 citation statements)

References 26 publications

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“…With regard to the heterogeneity of our study population, the “age- and gender-adjusted CS” was used [ 19 ]. The shoulder-related level of exertion in terms of work and sports was measured with the shoulder activity level (SAL; [ 20 ]). Current pain intensity was determined using a 10-part visual analogue scale (VAS 0–10).…”

Section: Methodsmentioning

confidence: 99%

Anterior shoulder dislocation and concomitant fracture of the greater tuberosity

et al. 2018

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BackgroundRecurrence rates after primary traumatic shoulder dislocation are distinctly high. We hypothesized that concomitant isolated fractures of the greater tuberosity are associated with low rates of persistent instability but decreased range of motion.MethodsBetween 2007 and 2013, 66 consecutive shoulders in 64 patients were treated for primary shoulder dislocation combined with an isolated fracture of the greater tuberosity with either a nonsurgical (48 shoulders, 72.7%) or surgical (18 shoulders, 27.3%) treatment approach. In all, 55 cases (83.3%) were available for clinical follow-up examination after an average of 59.0 ± 20.7 months (range: 25–96 months) and of these, 48 (72.7%) patients consented to radiological evaluation to determine healing and position of the greater tuberosity.ResultsThe mean range of motion of the affected shoulder was significantly decreased by 9° of elevation (p = 0.016), 11° of abduction (p = 0.048), 9° of external rotation in 0° of abduction (p = 0.005), and 10° of external rotation in 90° of abduction (p = 0.001), compared with the unaffected shoulder. The mean WOSI score was 373 ± 486 points, the mean Constant and Murley score was 75.1 ± 19.4 points, and the mean Rowe score was 83 ± 20 points. Three cases (5.5%) of re-dislocation were reported among the cohort, all of them were due to a relevant trauma. Radiological evaluation revealed anatomically healed fragments in 31 shoulders (65%), dislocation of the fragment in ten shoulders (21%), impaction into the humeral head in four shoulders (8%), and absorption in three shoulders (6%).ConclusionA concomitant isolated fracture of the greater tuberosity leads to low recurrence rates along with a significant decrease in range of motion after primary traumatic anterior shoulder dislocation.

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Section: Methodsmentioning

confidence: 99%

Anterior shoulder dislocation and concomitant fracture of the greater tuberosity

et al. 2018

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“…Before clinical examination, all cases completed a questionnaire on general medical history, pathology-specific medical history, and shoulder-specific activity level. 34 Standardized clinical scores including the Western Ontario Shoulder Instability Index, 26 Rowe Score, 39 as well as the Subjective Shoulder Value 12 were obtained. Furthermore, the pain level was rated on a numeric pain rating scale 13 at rest and in motion.…”

Section: Clinical Assessmentmentioning

confidence: 99%

Characteristics of functional shoulder instability

Moroder

Danzinger

Maziak

et al. 2020

Journal of Shoulder and Elbow Surgery

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Background: Pathologic activation pattern of muscles can cause shoulder instability. We propose to call this pathology functional shoulder instability (FSI). The purpose of this prospective study was to provide an in-detail description of the characteristics of FSI. Methods: In the year 2017, a total of 36 consecutive cases of FSI presenting to our outpatient clinic were prospectively collected. Diagnostic investigation included a pathology-specific questionnaire, standardized clinical scores, clinical examination, psychological evaluation, video and dynamic fluoroscopy documentation of the instability mechanism, as well as magnetic resonance imaging (MRI). In a final reviewing process, the material from all collected cases was evaluated and, according to the observed pattern, different subtypes of FSI were determined and compared. Results: Based on the pathomechanism, positional FSI (78%) was distinguished from nonpositional FSI (22%). Controllable positional FSI was observed in 6% of all cases and noncontrollable positional FSI in 72%, whereas controllable and noncontrollable nonpositional FSI were each detected in 11% of the cases. The different subtypes of FSI showed significant differences in all clinical scores (Western Ontario Shoulder Instability Index: P ¼ .002, Rowe Score: P ¼ .001, Subjective Shoulder Value: P ¼ .001) and regarding functional impairment (shoulder stability: P < .001, daily activities: P ¼ .001, sports activities: P < .001). Seventy-eight percent had posterior, 17% anterior, and 6% multidirectional instability. Although several patients showed constitutional glenoid shape alterations or soft tissue hyperlaxity, only few patients with acquired minor structural defects were observed. Conclusion: FSI can be classified into 4 subtypes based on pathomechanism and volitional control. Depending on the subtype, patients show different degrees of functional impairment. The majority of patients suffer from unidirectional posterior FSI. Level of evidence: Level IV; Case Series; Prognosis Study Ó 2019 The Author(s). This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/). Keywords: Shoulder instability; functional shoulder instability; voluntary shoulder instability; positional shoulder instability; noncontrollable shoulder instability; multidirectional shoulder instability; posterior shoulder instability; anterior shoulder instability This study was performed at

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“…At time of initial presentation at the outpatient clinic, a standardized written questionnaire was completed to record patient‐specific information, such as (i) age at the time of surgery, (ii) gender, (iii) height and weight indicating the BMI, (iv) dominant as well as affected shoulder, (v) current as well as previous professions and sport activities (SAL score), (vi) smoking habit (pack‐years), and (vii) systematic metabolic diseases (e.g., diabetes mellitus and thyroid dysfunction).…”

Section: Methodsmentioning

confidence: 99%

“…This cumulative rating scale consists of two items asking about (i) work‐ and (ii) sports‐related shoulder activity. The sum of the items (0–2 points each) is transformed into a score between 0 and 4 points, whereby 0 represents no shoulder‐specific activity and 4 extreme shoulder‐specific activity …”

Section: Methodsmentioning

confidence: 99%

Risk Factors for Rotator Cuff Disease: An Experimental Study on Intact Human Subscapularis Tendons

Plachel

Moroder

Gehwolf

et al. 2019

Journal Orthopaedic Research

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Although several studies revealed a multifactorial pathogenesis of degenerative rotator cuff disorders, the impact and interaction of extrinsic variables is still poorly understood. Thus, this study aimed at uncovering the effect of patient‐ and pathology‐specific risk factors that may contribute to degeneration of the rotator cuff tendons. Between 2015 and 2018, 54 patients who underwent arthroscopic shoulder surgery at three specialized shoulder clinics were prospectively included. Using tendon samples harvested from the macroscopically intact subscapularis (SSC) tendon, targeted messenger RNA expression profile analysis was performed in the first cohort (n = 38). Furthermore, histological analyses were conducted on tendon tissue samples obtained from a second cohort (n = 16). Overall, both study cohorts were comparable concerning patient demographics. Results were then analyzed with respect to specific extrinsic factors, such as patient age, body mass index, current as well as previous professions and sport activities, smoking habit, and systemic metabolic diseases. While patient age, sports‐activity level, and preexisting rotator cuff lesions were considered to contribute most strongly to tendinopathogenesis, no further coherences were found. With regards to gene expression analysis, change in expression correlated most strongly with patient age and severity of the rotator cuff pathology. Further, chronic disorders increased overall gene expression variation. Taken together, our study provides further evidence that tendon degeneration is the consequence of a multifactorial process and pathological changes of the supraspinatus tendon affect the quality of SSC tendon and most likely vice versa. Therefore, the rotator cuff tendons need to be considered as a unit when managing rotator cuff pathologies. © 2019 The Authors. Journal of Orthopaedic Research® published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society J Orthop Res 38:182–191, 2020

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Open Bankart Repair for the Treatment of Anterior Shoulder Instability without Substantial Osseous Glenoid Defects

Abstract: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 47 publications

References 26 publications

Anterior shoulder dislocation and concomitant fracture of the greater tuberosity

Anterior shoulder dislocation and concomitant fracture of the greater tuberosity

Characteristics of functional shoulder instability

Risk Factors for Rotator Cuff Disease: An Experimental Study on Intact Human Subscapularis Tendons

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