Treatment of The Posterior Unstable Shoulder

Alepuz, Eduardo Sánchez; Pérez-Barquero, Jaime Alonso; Jorge, Nadia Jover; García, Francisco Lucas; Baixauli, Vicente Carratalá

doi:10.2174/1874325001711010826

Cited by 21 publications

(18 citation statements)

References 69 publications

(172 reference statements)

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“…The median UCLA score was increased from 8 (range, 4-22) preoperatively to 35 (range, 33-35) at the last follow-up (p < 0.01). Respectively, the mean Oxford instability score was increased from 5 (range, [3][4][5][6][7][8][9][10][11][12][13][14][15][16] preoperatively to 46 (range, 43-48) at the last follow-up (p < 0.01; ►Fig. 4).…”

Section: Resultsmentioning

confidence: 99%

All-Arthroscopic McLaughlin's Procedure in Patients with Reverse Hill–Sachs Lesion Caused by Locked Posterior Shoulder Dislocation

Brilakis

Malahias

Patramani

et al. 2019

Joints

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Purpose This study aims to investigate the clinical and functional outcomes of the all-arthroscopic McLaughlin procedure in a clinical series of patients suffering by neglected locked posterior shoulder dislocation. Methods A retrospective clinical study based on prospectively collected data was conducted in a single center regarding 10 patients with neglected locked posterior shoulder dislocation and concomitant reverse Hill–Sachs lesion, who were treated with the all-arthroscopic Mclaughlin procedure. The average humeral bone defect was 39 ± 7% according to the preoperative computed tomography evaluation. The mean time of follow-up was 77 ± 16 months (range, 63–104 months). Results No patient had suffered a new dislocation, whereas all of them were satisfied with the surgical outcome and returned to their previous activities of daily living. External rotation was restored to every patient studied from 0 degrees at the baseline. At the last follow-up, the median external rotation beside the body was 90 degrees (range, 50–90 degrees; p < 0.01) and the respective measurement at 90 degrees of abduction was 90 degrees (range, 80–90 degrees; p < 0.01). The active forward flexion was increased (p < 0.01), from 60 degrees (range, 30–180 degrees) at the baseline to 180 degrees (range, 160–180 degrees) at the last follow-up and the internal rotation was gained (p < 0.01) from the level of buttock (range, lateral thigh–T12) at the baseline to the T11 level (range, T7–L3) at the last follow-up. The median UCLA score was increased from 8 (range, 4–22) to 35 (range, 33–35; p < 0.01) and the Oxford instability score from 5 (range, 3–16) to 46 (range, 43–48; p < 0.01), respectively. Conclusion The arthroscopic McLaughlin procedure in substantial reverse Hills–Sachs lesion caused by locked posterior dislocation leads to excellent clinical and functional results in the long-term follow-up. Level of Evidence This is a therapeutic study, case series with no comparison group, Level IV.

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Section: Resultsmentioning

confidence: 99%

All-Arthroscopic McLaughlin's Procedure in Patients with Reverse Hill–Sachs Lesion Caused by Locked Posterior Shoulder Dislocation

Brilakis

Malahias

Patramani

et al. 2019

Joints

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“…At 4 weeks, unlimited progressive range of motion is initiated as well as isometric posterior rotator cuff strengthening. Progressively, after 1 week from the treatment, a passive and successively active mobility of the shoulder must be executed until complete mobility is achieved approximately after three months [27].…”

Section: Post-operative Care and Rehabilitationmentioning

confidence: 99%

“…Progressively, after 1 week from the treatment, a passive and successively active mobility of the shoulder must be executed until complete mobility is achieved approximately after three months [27].…”

Section: Clinical and Radiographic Assessmentmentioning

confidence: 99%

Surgical and Rehabilitative Treatment of Misdiagnosed Posterior Dislocation of the Shoulder: Case Series

Pavone

Caruso

Chisari

et al. 2018

JFMK

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Abstract:Background: Posterior gleno-humeral joint (GHJ) dislocation is a rare injury accounting for 2.7-3% of all shoulder dislocations. Early detection is the key for an effective treatment. Poor clinical outcomes or prosthetic solutions depend on the severity of the lesions at the time of trauma and worsening of the McLaughlin lesion during the months when the dislocation remains unrecognized or untreated. The aim of the study is to report our experience in treating, and clinically and radiographically evaluate the outcomes of, four neglected posterior GHJ dislocations. Methods: Four patients with inveterate posterior dislocation of the shoulder were evaluated. In three cases, the technique of McLaughlin was performed, and in one case, plication of the subscapularis tendon was performed. During the follow up, patients were clinically evaluated using the Constant shoulder score; an imaging investigation, using X-ray integrated with computed tomography(CT) and magnetic resonance imaging (MRI), was assessed. Results: Following the Constant criteria, treated shoulders reported an excellent outcome with an average score of 91. The mean score of untreated shoulders was 92.5. The humeral appearance that resulted was radiographically well-structured. Surgical treatment with McLaughlin lesion or transposition of the subscapularis were satisfactory from a subjective and objective point of view. To perform surgery soon as possible after the traumatic episode is considered a positive prognostic factor.

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“…4,5 A great number of techniques have been described to treat the RHSL; they are divided into anatomic, nonanatomic, and substitution techniques. 6,7 Historically, most of the current treatments for posterior shoulder instability were based on the humeral head defect size. However, consensus on a specific treatment is yet to be established.…”

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confidence: 99%

Arthroscopic Knotless Subscapularis Bridge Technique for Reverse Hill-Sachs Lesion With Posterior Shoulder Instability

Hachem

Bascones

D’O

et al. 2021

Arthroscopy Techniques

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Posterior shoulder dislocations are an uncommon cause of glenohumeral instability; they are frequently missed and are associated with humeral head defects and capsulolabral lesions. Despite surgical treatment often being mandatory, there is still no standardized treatment for anterior impaction fractures of the humeral head (reverse Hill-Sachs lesions). Arthroscopic surgery is typically indicated, with a tendency toward resorting to knotless techniques in recent years. We present a method for the treatment of posterior shoulder dislocations with engaging reverse Hill-Sachs lesions that achieves full defect coverage using an arthroscopic all-in-the-box knotless subscapularis bridge technique with 2 anchorsdwith one crossing the subscapularis tendon and the other embracing itdalong with posterior capsulolabral complex restoration. This promising technique is a potentially superior alternative for the treatment of these lesions that can also be used in the presence of concomitant partial subscapularis tears. Preoperative Evaluation and IndicationsPost-traumatic shoulder dislocations with recurrent episodes of atraumatic posterior subluxation caused by From the Shoulder Unit,

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Treatment of The Posterior Unstable Shoulder

Cited by 21 publications

References 69 publications

All-Arthroscopic McLaughlin's Procedure in Patients with Reverse Hill–Sachs Lesion Caused by Locked Posterior Shoulder Dislocation

All-Arthroscopic McLaughlin's Procedure in Patients with Reverse Hill–Sachs Lesion Caused by Locked Posterior Shoulder Dislocation

Surgical and Rehabilitative Treatment of Misdiagnosed Posterior Dislocation of the Shoulder: Case Series

Arthroscopic Knotless Subscapularis Bridge Technique for Reverse Hill-Sachs Lesion With Posterior Shoulder Instability

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