Shoulder instability after total shoulder arthroplasty: a case of arthroscopic repair.
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ABSTRACT:
SUBMITTER: Gee AO
PROVIDER: S-EPMC3903956 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:PurposeThis study evaluates outcomes of a consistent arthroscopic stabilization technique for recurrent posterior instability.Methods79 shoulders with symptomatic posterior instability treated with arthroscopic repair and evaluated at a follow-up of 36 months. The mean age was 25.4 years of which 66 males and 13 females, and in 75% the dominant shoulder was affected. A known traumatic injury had occurred in 80%, with 25% having a documented dislocation. Arthroscopic repair was performed through an anterosuperior 12 O'clock viewing portal. Suture anchor repairs were performed in 60 cases and plication to the intact labrum in 19. A shoulder immobilizer was used for 4 weeks, followed by progressive range of motion, weightlifting at 3 months and return to contact sports at 6 months. The 79 cases had complete pre-op and post-op shoulder outcome scores.ResultsSignificant improvement from preoperatively to final follow-up was seen for ASES scores, from 58 to 93. All patients returned to their previous level of athletic activity. Two patients reported postoperative instability; none required reoperation. There were no other postoperative complications.ConclusionsThis study represents a consecutive series of patients with recurrent posterior instability undergoing arthroscopic posterior stabilization. In this population arthroscopic posterior labral repair and capsular plication provided significant clinical improvement with low recurrence and revision rate.
| S-EPMC7479253 | biostudies-literature
Project description:Stiffness is a well-known complication after reverse shoulder arthroplasty. Although multiple factors may be involved, the main cause for stiffness is rarely identified. Imaging studies frequently are inconclusive in ruling out mechanical or biological causes. Periprosthetic infection should be always suspected, but the absence of major clinical signs and accurate diagnostic tests is frequent. A lack of objective criteria establishing a diagnosis and when to proceed with revision surgery is often present in such cases. Moreover, additional surgical procedures should be carefully evaluated, as they can represent a point of no return. Shoulder arthroscopy plays an increasingly important role in these cases, either as a diagnostic or therapeutic tool. There are no reports about arthroscopy on stiffness after reverse shoulder arthroplasty. In this Technical Note, we describe an arthroscopic technique aimed to identify potential causes of reverse shoulder arthroplasty stiffness. Subsequent circumferential release is described and discussed.
| S-EPMC7528875 | biostudies-literature
Project description: Not available
| S-EPMC11293315 | biostudies-literature
Project description:We present a technique for arthroscopic glenoid removal in a case of glenoid loosening after total shoulder arthroplasty (TSA). The presented technique is technically feasible and may be useful if 1-stage surgery with glenoid reimplantation is not indicated. To exclude low-grade infection, the presented technique allows for an intraoperative infection workup such as intraoperative cultures. However, glenoid loosening in TSA is a well-known problem and has been described before. The advantages of the presented technique include minimally invasive surgery, decreased pain, preservation of the subscapularis tendon, and assurance of exclusion of low-grade infection before reimplantation of a new glenoid implant. In this case a 73-year-old patient was treated with a TSA for severe osteoarthritis of the right shoulder in April 2014. Because of persistent anterior shoulder pain postoperatively, radiographic evaluation was performed and showed signs of glenoid loosening 6 months after surgery without any clinical signs of infection. To exclude low-grade infection, arthroscopy of the right shoulder was performed. Arthroscopy showed a totally loosened glenoid component leading to arthroscopic glenoid removal by use of a special forceps.
| S-EPMC4454821 | biostudies-other
Project description:Posterior shoulder instability, although relatively rare in the general population, is more commonly seen in athletes, especially those in contact sports. Although nonoperative treatment has been associated with satisfactory results in the setting of posterior shoulder instability, conservative management may ultimately fail and lead to recurrence particularly in young, male patients. Both arthroscopic and open repair techniques to address posterior instability have been described, with each showing positive patient-reported outcomes, low risk of recurrence, and considerably high return-to-sport rates. In particular, arthroscopic treatment includes the following: capsular plication and knotted and/or knotless suture anchor fixation. The purpose of this technique is to describe our preferred technique to treat recurrent posterior shoulder instability through arthroscopic labral repair using knotless suture anchor fixation.
| S-EPMC5799491 | biostudies-other
Project description:Humeral avulsion of the glenohumeral ligament (HAGL) is a rare cause of anterior shoulder instability. Recurrent instability and anterior shoulder pain could be caused by an unrepaired HAGL; therefore, making the diagnosis is crucial. Only a few articles describe arthroscopic HAGL repair. This uncommon technique uses lateral decubitus arthroscopy and standard Bankart instrumentation. Different methods used to facilitate visualization of the working space as well as anchor placements are described.
| S-EPMC7953040 | biostudies-literature
Project description:Capsulolabral augmentation is one of the most used arthroscopic techniques to address multidirectional instability of the shoulder. Given the thin and weak capsule seen in the affected patients, reconstruction in this subset of patients can be particularly challenging. This arthroscopic technique aims to reduce the capsular volume and deepen the glenoid socket through the creation of a particularly voluminous "bumper" along the glenoid bone. Increasing the depth of the glenoid facilitates a concavity-compression stabilizing effect and, therefore, shoulder stability, especially midrange stability. This technique aims to augment the bump of the standard capsulolabral reconstruction by using a resorbable surgical mesh derived from porcine skin.
| S-EPMC5382315 | biostudies-literature
Project description:Initial treatment of shoulder multidirectional instability (MDI) consists of nonoperative modalities of physical therapy and rehabilitation; if this fails, surgical treatment can become necessary. MDI of the shoulder can be challenging to manage in individuals who fail conservative management. Historically, surgical treatment for MDI has been open capsular plication; however, arthroscopic capsular plication has now become the standard of care, with outcomes similar to the open procedure. The purpose of this article and Video 1 is to describe our arthroscopic technique for pancapsular shift with labral repair.
| S-EPMC5621849 | biostudies-other
Project description:PurposeTo evaluate the outcomes of arthroscopic Bankart repair with remplissage (ABRR) compared with the arthroscopic Latarjet (AL) procedure for anterior shoulder instability in patients with a labral tear and a concomitant engaging Hill-Sachs lesion.MethodsA retrospective review of patients who underwent either ABRR or the AL procedure for a diagnosis of anterior shoulder instability with a concomitant engaging Hill-Sachs lesion between 2011 and 2019 was performed. Recurrent instability, the visual analog scale score, the Subjective Shoulder Value, the Western Ontario Shoulder Instability score, patient satisfaction, willingness to undergo surgery again, and return to work or sport were evaluated.ResultsOur study included 41 patients treated with ABRR and 26 treated with the AL procedure. At final follow-up, there was no difference between patients who underwent ABRR and those who underwent the AL procedure in the reported Western Ontario Shoulder Instability score (21.8% vs 28.2%, P = .33) or any of its components, the visual analog scale score (0.9 vs 1.4, P = .32), the Subjective Shoulder Value (78.4 vs 74.5, P = .6062), the rate of satisfaction (81.6% vs 85.6%, P = .54), or whether patients would undergo surgery again (81.6% vs 96.1%, P = .16). Overall, 5 patients in the ABRR group and 2 patients in the AL group had recurrent instability events (12.2% vs 7.8%, P = .70), with no significant difference in the rate of recurrent dislocation (12.2% vs 3.8%, P = .39).ConclusionsIn patients with anterior shoulder instability and a concomitant Hill-Sachs lesion, both ABRR and the AL procedure were shown to be reliable treatments, with a low rate of recurrent instability and excellent patient-reported outcomes in appropriately selected patients. However, our study could not determine whether there was critical glenoid bone loss in patients undergoing ABRR, and surgeons should still exercise caution in performing ABRR in patients with high-grade glenoid bone loss or in those with failed prior stabilizations.Level of evidenceLevel III, retrospective cohort study.
| S-EPMC9210364 | biostudies-literature
Project description:The arthroscopic Bankart repair is a safe and reliable procedure for the treatment of recurrent shoulder instability for the well-indicated patient. Many repair techniques have been described to restore both labral height and width and recreate a dynamic concavity-compression effect. The modified Mason-Allen knot was first described for rotator cuff tear repair and consists of a horizontal mattress knot with a simple vertical stitch on the same anchor. The purpose of this work is to present the use of the modified Masen-Allen knot for the repair of the capsular labral complex during an arthroscopic Bankart procedure.
| S-EPMC8355410 | biostudies-literature