Shoulder Instability. Current Concepts and Controversies

Ibán, Miguel Ángel Ruiz

doi:10.2174/1874325001711010810

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…The management of antero-inferior traumatic shoulder instability is controversial [24] and has evolved greatly in the last 25 years [2]. The classical discussion between bone block procedures (such as the Latarjet procedure) and soft tissue procedures (such as the open Bankart repair) [29] was initially tilted in favour of the Bankart repair with the emergence of arthroscopic techniques [15].…”

Section: Introductionmentioning

confidence: 99%

Instability severity index score values below 7 do not predict recurrence after arthroscopic Bankart repair

Ibán

Gismero

Marco³

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Purpose To evaluate the eicacy of the Instability Severity Index Score (ISIS) in predicting an increased recurrence risk after an arthroscopic Bankart repair. Methods Retrospective review of a cohort of patients operated in three diferent centres. The inclusion criteria (recurrent anterior instability [dislocation or subluxation] with or without hyperlaxity, arthroscopic Bankart repair) and the exclusion criteria (concomitant rotator cuf lesion, acute irst-time dislocation, surgery after a previous anterior stabilization, surgery for an unstable shoulder without true dislocation or subluxation; multidirectional instability) were those used in the study that deined the ISIS score. The medical records and a telephone interview were used to identify the six variables that deine the ISIS and identify recurrences. Results One hundred and sixty-three shoulders met the inclusion and exclusion criteria. Of these, 140 subjects (22 females/118 males; mean age 35.5 ± 7.9) with 142 (89.0%) shoulders were available for follow-up after 5.3 (1.1) (range 3.1-7.4) years. There were 20 recurrences (14.1%). The mean (SD) preoperative ISIS was 1.8 (1.6) in the patients without recurrence and 1.8 (1.9) in the patients with recurrence (n.s.). In the 117 subjects with ISIS between 0 and 3 the recurrence rate was 12.8%; in the 25 with ISIS 4 to 6 the rate was 20% (n.s.). Conclusion For subjects with anterior shoulder instability in which an arthroscopic Bankart repair is being considered, the use of the ISIS, when the values obtained are ≤ 6 was not useful to predict an increased recurrence risk in the midterm in this retrospectively evaluated case series. The eicacy of the ISIS score in deining a group of subjects with a preoperative increased risk of recurrence after an arthroscopic Bankart instability repair is limited in lower risk populations (with ISIS scores ≤ 6). Level of evidence Retrospective case series, Level IV.

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Section: Introductionmentioning

confidence: 99%

Instability severity index score values below 7 do not predict recurrence after arthroscopic Bankart repair

Ibán

Gismero

Marco³

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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“…All these different joints have a role in normal function, during sporting activities, and in shoulder pathology [ 18 ]. Certain problems affect more selectively one of these joints and the glenohumeral joint is affected predominately in different traumatic, overuse or degenerative shoulder problems [ 4 , 11 , 16 , 20 ]. When there is a limitation of the shoulder range of motion (ROM), these joints can have different roles.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the inter and intraobserver reproducibility of the GRASP method: a goniometric method to measure the isolated glenohumeral range of motion in the shoulder joint

et al. 2021

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Purpose To evaluate the intra and interobserver reproducibility of a new goniometric method for evaluating the isolated passive range of motion of the glenohumeral joint in an outpatient setting. Methods This is a prospective observational study on healthy subjects. The Glenohumeral ROM Assessment with Scapular Pinch (GRASP) method is a new method for assessing the isolated range of motion (ROM) of the glenohumeral joint (GH) by a single examiner with a clinical goniometer. It measures the isolated glenohumeral passive abduction (GH-AB), passive external rotation (GH-ER) and internal rotation (GH-IR) with the arm at 45º of abduction. These three GH ROM parameters were measured in both shoulders of 30 healthy volunteers (15 males/15 females, mean age:41.6[SD = 10.3] years). The full shoulder passive abduction, passive external rotation and internal rotation 45º of abduction were measured by the same examiners with a goniometer for comparison. One examiner made two evaluations and a second examiner made a third one. The primary outcome was the intra- and interobserver reproducibility of the measurements assessed with intraclass correlation coefficients (ICC) and the Bland–Altman plot. Results The intra-observer ICC for isolated glenohumeral ROM were: 0.84 ± 0.07 for GH-ABD, 0.63 ± 0.09 for GH-ER, and 0.61 ± 0.14 for GH-IR. The inter-observer ICC for isolated glenohumeral ROM were: 0.86 ± 0.06 for GH-ABD, 0.68 ± 0.12 for GH-ER, and 0.62 ± 0.14 for GH-IR. These results were similar to those obtained for full shoulder ROM assessment with a goniometer. Conclusion The GRASP method is reproducible for quick assessment of isolated glenohumeral ROM. Level of evidence III

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“…Recurrent shoulder instability is a significant health problem that affects young and healthy adults [5]. Its optimal surgical management is disputed, but the repair of the anterior capsulolabral structures (the Bankart procedure) described in 1923 [2] is still considered a good alternative [19]. Nowadays, this procedure is most frequently performed with arthroscopic assistance [17] and the repair is done over anchors inserted into the anterior glenoid bone.…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic Bankart repair with all-suture anchors does not cause important glenoid bone osteolysis: a volumetric CT study of 143 anchors

Ibán

Rodriguez

Heredia

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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Purpose To evaluate with computed tomography (CT) the incidence of anchor-related osteolysis after implantation of two types of all-suture anchors for the management of labral lesions in shoulder instability. Methods Single-cohort, observational study with 12-month follow-up. Thirty-three participants (27 males/6 females; age 38.3 years [SD 11.3]) with anterior labral lesions in which 143 all-suture anchors (71 Iconix 1.4 mm and 72 Sutureix 1.7 mm) were implanted were evaluated with a CT performed a mean of 15.4 [3.85] months after surgery. The volume of the bone defects was measured in the CT. Every anchor was classiied into one of four groups: (1) no bone defect. (2) Partial bone defect (defects smaller than the drill used for anchor placement). (3) Tunnel enlargement (defects larger than the drill volume but smaller than twice that volume). (4) Cystic lesion (defects larger than twice the drill volume). Results No bone defect was identiied in 16 anchors (11.2%, [95% CI 6.5-17.5%]). A partial bone defect was found in 84 anchors (58.7% [50.2-66.9%]). Tunnel enlargement was found in 43 anchors (30.11% [22.6-37.6%]). No anchor caused cystic lesions (0% [0-2.5%]). The defect volume was a mean of 27.8 mm 3 (SD 18.4 mm 3 , minimum 0 mm 3 , maximum 94 mm 3 ). Neither the position in the glenoid nor the type of implant used had a signiicant efect in the type or size of the defects. Conclusion When using all-suture anchors in the glenoid during instability surgery, relevant bone osteolytic defects are rare at 1-year follow-up. Most anchor insertion tunnels will ill completely (11%) or partially (59%) with bone. Tunnel enlargement will develop in 30% of anchors. No cystic defects larger than 0.125 cm 3 were observed. There is a low risk that all-suture anchors cause signiicant osteolytic bone defects in the glenoid. These implants can be used safely. Level of evidence IV

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Shoulder Instability. Current Concepts and Controversies

Cited by 3 publications

References 22 publications

Instability severity index score values below 7 do not predict recurrence after arthroscopic Bankart repair

Instability severity index score values below 7 do not predict recurrence after arthroscopic Bankart repair

Evaluation of the inter and intraobserver reproducibility of the GRASP method: a goniometric method to measure the isolated glenohumeral range of motion in the shoulder joint

Arthroscopic Bankart repair with all-suture anchors does not cause important glenoid bone osteolysis: a volumetric CT study of 143 anchors

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