Rotational osteotomy of the humerus for posterior instability of the shoulder.

Surin, Vladimir; Blåder, S; Markhede, Göran; Sundholm, Krister

doi:10.2106/00004623-199072020-00004

Cited by 80 publications

(14 citation statements)

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“…Other procedures include implantation of bone allograft or humeral osteotomy when the retroversion may be suspected to predispose the instability. Rotational osteotomies have shown fair results, and one paper demonstrated a 50% return to a pre-injury level of activity[ 46 ].…”

Section: Shoulder Joint Complex In Posterior Shoulder Dislocationmentioning

confidence: 99%

Biomechanics of posterior shoulder instability - current knowledge and literature review

Bäcker

Galle

Maniglio

et al. 2018

WJO

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Posterior instability of the shoulder is a rare condition and represents about 10% of shoulder instability. It has become more frequently recognized in the last year, even though it is more difficult to diagnose than anterior shoulder instability. As this form of shoulder pathology is somewhat rare, biomechanical knowledge is limited. The purpose of our study was to perform an extensive literature search, including PubMed and Medline, and to give an overview of the current knowledge on the biomechanics of posterior shoulder instability. The PubMed/Medline databases were utilized, and all articles related to posterior shoulder instability and biomechanics were included to form a comprehensive compilation of current knowledge. A total of 93 articles were deemed relevant according to our inclusion and exclusion criteria. As expected with any newly acknowledged pathology, biomechanical studies on posterior shoulder instability remain limited in the literature. Current biomechanical models are performed in a static manner, which limits their translation for explaining a dynamic pathology. Newer models should incorporate dynamic stabilization of both the rotator cuff and scapulothoracic joint. There is a current lack of knowledge with regards to the pathomechanism of posterior shoulder instability, with no consensus on appropriate treatment regimens. Further investigation is therefore required at both basic science and clinical levels.

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Section: Shoulder Joint Complex In Posterior Shoulder Dislocationmentioning

confidence: 99%

Biomechanics of posterior shoulder instability - current knowledge and literature review

Bäcker

Galle

Maniglio

et al. 2018

WJO

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“…25,96,97 In MDI, the anteroposterior radiograph may show inferior subluxation of the humerus in the glenoid. 102 Open soft tissue procedures for posterior and MDI include capsular shifts, subscapularis tendon transfer, posterior capsular plication and infraspinatus advancement, reverse Putti-Platt plication, reverse Bankart repair, Boyd-Sisk procedure, and biceps tendon transposition. MRI and MRA offer additional information to visualize the posterior FIGURE 11.…”

Section: Glenoid Hypoplasia Increased Retroversion and Glenoid Insumentioning

confidence: 99%

Management of the Failed Posterior/Multidirectional Instability Patient

Forsythe

Ghodadra

Romeo

et al. 2010

Sports Medicine and Arthroscopy Review

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Although the results of operative treatment of posterior and multidirectional instability (P-MDI) of the shoulder have improved, they are not as reliable as those treated for anterior instability of the shoulder. This may be attributed to the complexities in the classification, etiology, and physical examination of a patient with suspected posterior and multidirectional instability. Failure to address the primary and concurrent lesion adequately and the development of pain and/or stiffness are contributing factors to the failure of P-MDI procedures. Other pitfalls include errors in history and physical examination, failure to recognize concomitant pathology, and problems with the surgical technique or implant failure. Patulous capsular tissues and glenoid version also play in role management of failed P-MDI patients. With an improved understanding of pertinent clinical complaints and physical examination findings and the advent of arthroscopic techniques and improved implants, successful strategies for the nonoperative and operative management of the patient after a failed posterior or multidirectional instability surgery may be elucidated. This article highlights the common presentation, physical findings, and radiographic workup in a patient that presents after a failed P-MDI repair and offers strategies for revision surgical repair.

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“…Depending on the size, the reverse Hill-Sachs lesion is a risk factor for re-dislocation and therefore a surgical treatment is normally recommended [ 15 ]. For the treatment of the bone defect in the region of the humeral head, a variety of surgical procedures are described in the literature: filling the defect by tendon transposition of the subscapularis muscle [ 5 ], medial transposition of the lesser tuberosity [ 16 ] or allograft [ 17 ]; rotational osteotomy [ 18 ]; and hemi- or total arthroplasty [ 19 , 20 ] are options.…”

Section: Introductionmentioning

confidence: 99%

Posterior shoulder dislocation with associated reverse Hill-Sachs lesion: treatment options and functional outcome after a 5-year follow up

Guehring

Lambert

Stoeckle

et al. 2017

BMC Musculoskelet Disord

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BackgroundThe current study describes several surgical techniques for the treatment of the reverse Hill - Sachs lesion after posterior shoulder dislocation; we also aimed to present long term results followed for a minimum of five years.MethodsThis study is a prospective case series of 17 patients who were treated in our clinic between 2008 and 2011. Patients with a defect size smaller than 25% of the articular surface were treated conservatively. An endoprosthesis of the glenohumeral joint was implanted in patients with a defect size bigger than 40%. All remaining patients were treated by a variety of operative techniques, depending on the quality of the bone and size of the defect.ResultsTwelve of seventeen patients had a defect size of the humeral articular surface between 25% and 40% with a mean age of 39 years. Depending on the defect size these patients were treated with retrograde chondral elevation, antegrade cylindrical graft or a graft of the iliac bone crest with an open approach. All the procedures showed fair results, e.g. the open approach with a graft of the iliac bone crest (2010: Dash 3.89, Constant 90.33, Rowe 86.67; 2015: Dash 2.22, Constant 92.00, Rowe 93.33).ConclusionThe open approach is not a disadvantage for the functional outcome. The treatment algorithm should involve the superficial size of the defect as well as the depth of the defect and the time interval between the dislocation and the surgical treatment.Trial registration 223/2012BO2, 02 August 2010.

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Rotational osteotomy of the humerus for posterior instability of the shoulder.

Cited by 80 publications

References 0 publications

Biomechanics of posterior shoulder instability - current knowledge and literature review

Biomechanics of posterior shoulder instability - current knowledge and literature review

Management of the Failed Posterior/Multidirectional Instability Patient

Posterior shoulder dislocation with associated reverse Hill-Sachs lesion: treatment options and functional outcome after a 5-year follow up

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