Recent advances in the evaluation and treatment of shoulder instability: Anterior, posterior, and multidirectional

Abrams, Jeffrey S.; Savoie, Felix H.; Tauro, Joseph C.; Bradley, James P.

doi:10.1016/s0749-8063(02)80110-4

Cited by 18 publications

(33 citation statements)

References 24 publications

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“…Nowadays arthroscopic treatment has been the standard treatment method for recurrent anterior glenohumeral instabilities, but the clinical outcomes are comparable to those after traditional open stabilization [1,3,4,11,26,27]. The results of our patients with recuurent anterior shoulder disclocations, who were operated using this modified Boytchev procedure and followed up for more than 15 years, were strikingly excellent (data not published yet).…”

Section: Introductionmentioning

confidence: 74%

Stabilizing effect of the transferred conjoined tendon on shoulder stability

Jiang

Cui

Zhou

et al. 2006

Knee Surg Sports Traumatol Arthrosc

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The modified Boytchev procedure, i.e., rerouting of the coracoid process with its attached conjoined tendon (short head of biceps and coracobrachialis) deep to the subscapularis and reattachment to its anatomical location, has been advocated for recurrent anterior glenohumeral instability with controversial clinical outcomes. We aimed to investigate the dynamic contribution of the conjoined tendon in situ or transferred to the glenohumeral articulation in stable and unstable shoulders. Eight cadaveric shoulders were tested with the arm in 90 degrees abduction and 90 degrees external rotation. A constant 1.5 kg anterior translation force was applied to the proximal humerus, combined with 0, 1.5, 3.0 kg of load applied to the conjoined tendon sequentially. Anterior displacement of the humeral head relative to the scapula was recorded before and after an imitation Bankart lesion was created, and after treated with the modified Boytchev procedure for the Bankart lesion. Application of load to the conjoined tendon significantly reduced anterior displacement of the humeral head either with the capsule intact or with Bankart lesion simulated. The most significant decrease of the anterior displacement occurred when the conjoined tendon was transferred beneath the subscapularis. Our findings show that the conjoined tendon per se has a stabilizing effect on stable and unstable shoulders and therefore provide scientific support for the treatment of recurrent shoulder instability using the modified Boytchev procedure.

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Section: Introductionmentioning

confidence: 74%

Stabilizing effect of the transferred conjoined tendon on shoulder stability

Jiang

Cui

Zhou

et al. 2006

Knee Surg Sports Traumatol Arthrosc

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show abstract

“…Published recurrence rates after arthroscopic shoulder stabilization with suture anchors are 0-13%. 1,6,14,21,23,32,42,48 Although many recurrences have been linked to unrecognized/unaddressed osseous lesions, certain recurrences are for other reasons, such as capsular injury and inadequate number of suture anchors. 9,11 It is also possible that placing the capsulolabral soft tissue onto the glenoid articular surface with full release of the tissue from the anterior glenoid could result in compromised healing.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of glenoid capsulolabral complex insertional anatomy and restoration with single- and double-row capsulolabral repairs

Ahmad

Galano

Vorys

et al. 2009

Journal of Shoulder and Elbow Surgery

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“…Whereas preoperative diagnosis of shoulder instability in humans is more defined and well characterized, it remains a challenge for physicians. Human shoulder instability is typically classified into 1 of 3 types: anterior, posterior, or multidirectional 10–12 . Recurrent anterior instability accounts for the largest number of human shoulder instability cases, 10 whereas <5% are posterior shoulder instability and the prevalence of multidirectional shoulder instability remains unknown 11,12 .…”

Section: Discussionmentioning

confidence: 99%