To quantify the prevalence of Generalized Joint
Greater trochanteric pain syndrome (GTPS) is a common and disabling hip condition.
We have studied patients with Joint
Introduction:
Background.
Background.
This study was performed to assess the incidence of generalised ligament laxity in patients presented with recurrent shoulder dislocations. Prospective data was collected for 38 patients with recurrent shoulder dislocations and 43 patients with clavicle fractures as a control group between May 2007 and July 2009, including demographic details, mechanism of injury, number of dislocations and hyperlaxity. Clinical examination was used to assess the ligament laxity using the Beighton score. The mean age was 29 years with a range from 14-40 years. There were 36 males and 2 females. The left shoulder was involved in 21 patients; right in 13 patients and 4 patients had bilateral shoulder dislocations. The average number of dislocations was 3 with a range from 2-17, while the average number of subluxations was 4.5 with a range from 0-35. The average Beighton score for the patients with recurrent shoulder dislocations was 2.8 with a range from 0-8. 17 patients (45%) in this group had a Beighton score of 4 or more as compared to the control group that had only 12 patients (27%) There was a statistically significant difference between the 2 groups with a P value of < 0.05. 8 patients (21%) fulfilled the Brighton criteria for BJHS. The most common cause of recurrent shoulder dislocation was sports related injuries in 26 patients (68%). The most common sport was football in 14 patients (37%) followed by rugby in 10 (26%) patients. We looked at the incidence of generalised ligament laxity in patients with recurrent shoulder dislocations and found a statistically significant difference as compared with the control group. 21% of the patients fulfilled the Brighton criteria for BJHS but 45% had a Beighton score of 4 or more. Appropriate advice should be given to these patients with hyperlaxity and the timing of shoulder stabilisation should be carefully decided.
The mechanisms of how spinal arthrodesis (SA) affects patient function after total hip replacement (THA) remain unclear. The objectives of this study were to a) Determine how outcome post-THA compares between patients with- and without-SA, b) Characterize sagittal pelvic changes that occur when moving between different functional positions, and test for differences between patients with- and without-SA, and c) Assess whether differences in sagittal pelvic dynamics are associated with outcome post-THA. Forty-two patients with THA-SA (60 hips) were case-control matched for age, gender, BMI with 42 THA-only patients (60 hips). All presented for review where outcome, PROMs [including Oxford-Hip-Score(OHS)] and 4 radiographs of the pelvis and spino-pelvic complex in 3 positions (supine, standing, deep-seated) were obtained. Cup orientation and various spino-pelvic parameters [including pelvic tilt (PT) and Pelvic-Femoral-Angle (PFA)] were measured. The difference in PT between standing and seated allowed for patient classification based on spino-pelvic mobility into normal (±10–30°), stiff (<±10°) or hypermobile (>±30°).Introduction
Patients/Materials & Methods
Unidirectional instability with or without hyperlaxity can be adressed as such; mostly traumatic changes like Bankart or capsule lesions are seen and they can be treated with the standard arthroscopic suture techniques. Multidirectional instability (MDI) with or without hyperlaxity is quite rare. In the literature MDI is often mentioned, but most of the time it refers to multidirectional laxity with unidirectional instability. During arthroscopy often capsular redundancy is seen without obvious pathological changes. Several series have been described where arthroscopic capsulorraphy has shown to be reasonably succesfull Since the introduction of thermal shrinkage several series have been published, with poorer results compared to capsular shift: failure rates vary between 11 to 36%. The possible reason of this high failure rate is that 1) many patients with multi-directional laxity are included, 2) as well as the fact that after time the effect of the shrinkage disappears due to regeneration of the capsule. Posterior instability. In posterior subluxation, often posttraumatic, with hyperlaxity frequently as accompanying phenomenon, arthroscopic capsulorraphy has been rather successful. My personal series of 10 patients showed a failure rate of 50%. Shrinkage has been applied for this indication as well, with varying results. Since 1998 13 patients with posterior subluxations were treated in our hospital with shrinkage after the failure of extensive physical therapy. After 1 yr follow-up most of them were stable; after 18–24 months follow-up all showed recurrence of the posterior instability. The pain, often accompanying the subluxation, was however still absent at the latest follow-up. Multidirectional instability with or without hyperlaxity is a not well defined clinical entity; for this reason the results of several treatment modalities are often not comparable. Posterior instability, especially subluxations are often posttraumatic, with some accompanying hyperlaxity. In both pathological conditions arthroscopic capsulorraphy seems to be more effective than shrinkage
Introduction: The increasing use of Arthroscopic surgery for recurrent anterior shoulder dislocations (RASD) has questioned the indications and contraindications for this procedure. The ideal candidate for this kind of surgery is an overhead athlete, who participates in a noncontact sport, with traumatic unidirectional anterior instability with a well-defined Bankart lesion. Purpose of the paper: To demonstrate that complementing the Arthroscopic Bankart Repair (ABR) with an Arthroscopic Rotator Interval Closure (ARIC) the indication for Arthroscopic management of Anterior shoulder instability can be broaden for patients who has a less defined Bankart lesion and has additional multidirectional hyperlaxity. Patients and Methods: Between January 1, 1999 and December 31, 2002, 166 patients (175 shoulders) suffering from recurrent anterior dislocations were treated by ABR. In the first two years, only patients who had unidirectional instability with no
The aetiology of hallux valgus is well published and largely debated.
Purpose: This study was performed to assess the incidence of generalized ligament laxity in patients undergoing revision ACL reconstruction. Methods and Results: Prospective data was collected for 40 patients undergoing revision ACL reconstruction, between 2004 and 2009 under the care of a single orthopaedic consultant including demographic details, graft used during primary and revision ACL reconstruction and causes of graft failure. Clinical examination was used to assess the ligament laxity using the Beighton score. Laxity is scored on a 0–9 scale. Scores of 4 or above are indicative of generalized ligament laxity. Brighton criteria is used to diagnose Benign Joint
Purpose: This study was performed to assess the incidence of generalized ligament laxity in patients undergoing revision shoulder stabilization. Methods and Results: Prospective data was collected for 21 patients undergoing revision shoulder stabilization and 43 patients with clavicle fractures as a control group, between 2004 and 2009 under the care of orthopaedic surgeons at the Royal Infirmary of Edinburgh including demographic details, type of primary stabilization and causes of failure. Clinical examination was used to assess the ligament laxity using the Beighton score. Laxity is scored on a 0–9 scale. Scores of 4 or above are indicative of generalized ligament laxity. Brighton criteria is used to diagnose Benign Joint
Introduction: This study was performed to assess the incidence of generalized ligament laxity in patients presented with 1st time anterior shoulder dislocation. Patients and Methods: Prospective data was collected for patients presented with 1st time anterior shoulder dislocation and clavicle fracture as a control group between Aug 2008 and Feb 2009 under the care of a specialist shoulder surgeon. Data included demographic details, mechanism of injury and generalized ligament laxity using Beighton score. Laxity is scored on a 0–9 scale. Scores of 4 or above are indicative of generalized ligament laxity. Brighton criteria was used to diagnose Benign Joint
Purpose of the study: The purpose of the study was to present the clinical and arthroscan results obtained in a prospective series of 32 patients who underwent Bankart arthroscopy. We wanted to identify concrete applications. Material and methods: These 32 patients presented unidirectional anterior shoulder instability with a history of true dislocation. Unstable painful shoulders, multidirectional dislocations, and HAGL injuries were excluded as well as rotator cuff tears. An arthroscopic treatment was used in all cases, followed by the same rehabilitation protocol. All patients were reviewed at six months. External rotation (RE1 and RE2) and Gagey hyperabduction were noted as well as the Walch-Duplay, Rowe, and ISIS scores. Plain x-rays and an arthroscan were obtained preoperatively and postoperatively. Attention was focused on passage bone lesions, healing, and changes in volume of the inferior recessus after surgery. Results: Mean follow-up was 17.1 months (range 6.5–31.3), mean age 26.3 years (range 17–46), sex-ration predominantly male: 4.3/1.
Purpose: The purpose of this work was to determine whether the position of the coracoid block used for surgical stabilisation of the shoulder using the Patte procedure has an influence or not on persistent postoperative apprehension. Material and methods: Forty patients, mean age 26 years (19–37) operated on by the same surgeon (PV) were reviewed retrospectively at mean 40 months (24–60). Instability was expressed by dislocation (70%), subluxation (20%), or both (10%).