Aims. The
Analyzing shoulder kinematics is challenging as the shoulder is comprised of a complex group of multiple highly mobile joints. Unlike at the elbow or knee which has a primary flexion/extension axis, both primary shoulder joints (glenohumeral and scapulothoracic) have a large range of motion (ROM) in all three directions. As such, there are six degrees of freedom (DoF) in the shoulder joints (three translations and three rotations), and all these parameters need to be defined to fully describe shoulder motion. Despite the importance of
A fracture of the tuberosity is associated with 16% of anterior
Knowledge of the premorbid glenoid shape and the morphological changes the bone undergoes in patients with
Massive irreparable rotator cuff tears often lead to superior migration of the humeral head, which can markedly impair
We studied retrospectively a consecutive series of 547 shoulders in 529 patients undergoing operation for instability. In 41, the cause of instability was considered to be lateral avulsion of the capsule, including the inferior
The natural history of primary anterior dislocation
of the
Introduction. For anatomical reconstruction in shoulder arthroplasty, it is important to understand normal
Aims. Frozen shoulder is a common, painful condition that results in impairment of function. Corticosteroid injections are commonly used for frozen shoulder and can be given as
We report our experience with
Aims: Although the
Background. Rotator cuff atrophy evaluated with computed tomography scans has been associated with asymmetric glenoid wear and humeral head subluxation in
The aim of this study was to determine if the extent of the glenoid and humeral bone loss affects the rate of recurrent instability and the functional outcome following the Latarjet procedure. 161 patients underwent open Latarjet procedure during the period 2006–2015 (Mean age 30.0 years, 150t (93.2%) Male, 118 (73.3%) primary procedure). Functional outcome was measured using the Western Ontario Shoulder Instability Index (WOSI) and Quick Disabilities of the Arm, Shoulder and Hand (QuickDash) score at a mean of 4.7 years post-operatively. All patients underwent computed tomographic (CT) imaging pre-operatively. Using three-dimensional reconstruction, the glenoid bone loss, Hill-Sachs lesion and ‘Glenoid Track’ status was recorded. Radiographically-confirmed redislocation was rare (1.2%), but 18.5% (n=23/124) reported ongoing subjective shoulder instability. Fifty-two shoulders (32.3%) were classified as “Off-Track”. The median Quick DASH and WOSI scores were 2.27 (IQR 9.09; range 0–70.45) and 272.0 (IQR 546.5; range 0–2003), respectively. There were no significant differences observed between overall Quick DASH scores or WOSI scores for either On-Track or Off-Track groups (p=0.7 and 0.73, respectively). Subjective instability was not influenced by the degree of glenoid bone loss (p=0.82), the overall size of the Hill-Sachs lesion (p=0.80), or the presence of an ‘Off-Track’ lesion (p=0.84). Functional outcome and recurrent instability following the Latarjet procedure do not appear to be influenced by the extent of
The natural history of primary anterior
Introduction and Objective. Only few studies have investigated the outcome of exercises in patients with
Cementless surface replacement arthroplasty (CSRA) is an established treatment for
Purpose: Study experimental instability by ligament section leaving intact all the periarticular elements. Material and methods: Sixteen fresh cadaver shoulders were studied. Dissection was achieved via an axillary approach isolating the ligaments without muscle section. Instability was classified in five stages: 0) stable, 1) drawer and sulcus, 2) subluxation: the head crossed the glenoid border but remained in the plane of the glenoid, 3) reversible dislocation: the head was dislocated by returned spontaneously into place when the arm was left to hang along the body, 4) permanent dislocation. The ligaments were sectioned in the following order: 1) betrween 7h and 5h, 2) between 5h and 2h, 3) between 1h and 11h. Instability was tested with usual manœuvres: drawer, sulcus, hyperabduction test, provoked dislocation in elevation and maximal external rotation, downward pressure in the axis of the humerus. Results: Dissection of the ligaments produced class 1 instability in 0% of the shoulders, Section between 7h and 5h (anterior part of the inferior
Introduction The complex movement of scapula is significant for the support of the arm and the stability of the shoulder joint. Recent investigations showed an adaptation in scapula rhythm after total shoulder replacement with a big variability within subjects. The latter can change the loading pattern in the
Purpose: Arthroscopic treatment of calcified tendinopathy is classically performed in two times: exploration of the
This study compared the effect of a computer-assisted and a traditional surgical technique on the kinematics of the
Purpose:. The optimal degree of conformity between the glenoid and humeral components in cemented total shoulder arthroplasty (TSA) has not been established. Glenoid component stability is thought to be at risk due to the “rocking-horse” phenomenom, which, can lead to increased micromotion and loosening in response to humeral head edge loading. The goal of this biomechanical study is to investigate the influence of
Surgical treatment for traumatic, anterior glenohumeral instability requires repair of the anterior band of the inferior
Introduction and purpose: Neuropathy associated with syringomyelia is a relatively rare entity that predominantly affects the
Purpose. There is minimal information on outcome of
Aim: To study the morphology of the anterior cap-suloligamentous structures of the
We have compared the functional outcome after
Summary. Analysis of existing data of patients who had undergone debridement procedure for osteoarthritis (OA) of
Introduction. Augmented glenoid implants provide a new avenue to correct glenoid bone loss and can possibly reconcile current prosthetic failures and improve long-term performance. Biomechanical implant studies have suggested benefits from augmented glenoid components but limited evidence exists on optimal design of these augmented glenoid components. The aim of this study was to use integrated kinematic finite element analysis (FEA) model to evaluate the optimal augmented glenoid design based on biomechanical performance in extreme conditions for failure. Materials and Methods. Computer aided design software (CAD) models of two different commercially available augmented glenoid designs - wedge (Equinox®, Exactech, Inc.) and step (Steptech®, Depuy Synthes) were created per precise manufacturer's dimensions and sizes of the implants. Using FE modeling, these implants were virtually implanted to correct 20° of glenoid retroversion. Two
Background:. Currently, there are a variety of different reverse shoulder implant designs but few anatomic studies to support the optimal selection of prosthetic size. This study analyzed the
Background. A challenge to obtaining proper glenoid placement in total shoulder arthroplasty is eccentric posterior bone loss and associated glenoid retroversion. This bone loss can lead to poor stability and perforation of the glenoid during arthroplasty. The purpose of this study was to evaluate the three dimensional morphology of the glenoid with associated bone loss for a spectrum of osteoarthritis patients using 3-D computed tomography imaging and simulation software. Methods. This study included 29 patients with advanced
Our aim in this prospective study was to evaluate the outcome of total shoulder replacement in the treatment of young and middle-aged active patients with primary
Introduction: The Spaso technique for reduction of
Introduction. Resurfacing of the
Introduction. The treatment of
Aim. Biomechanical models of the shoulder have been used to measure forces and
Introduction. The reliability of currently available proximal humeral fracture classi?cation systems has been shown to be poor, giving rise to the question whether a more objective measure entails improved predictability of surgical outcome. This study aims to apply a novel software system to predict the functional range of motion of the
We report the use of the reverse shoulder prosthesis in the revision of a failed shoulder hemiarthroplasty in 19 shoulders in 18 patients (7 men, 11 women) with severe pain and loss of function. The primary procedure had been undertaken for
Fourteen cases of hemiarthroplasty for four-part fractures of the proximal humerus were reviewed. Pain relief was satisfactory, but function was limited, mainly due to loss of
Whereas a general trend in the management of obstetric brachial plexus injuries has been nerve reconstruction in patients without spontaneous recovery of biceps function by three to six months of age, many recent studies suggest this may be unnecessary. In this study, the severity of
This study was conducted to determine the effect of passive and active muscle loading on humeral head translation during
Purpose: We hypothesized that
Background. Acute anterior dislocation of the
Aim: To study the contribution of humeral avulsion of the
Examination was made of 486 skeletons of subjects over the age of 60 years to study patterns of degenerative change in the
Introduction. Reverse total shoulder arthroplasty (RTSA) is a commonly performed operation for a variety of pathologies. Despite excellent short-term outcomes, complications are commonly encountered. Recurrent instability occurs in up to 31% of cases, often due to components placed with too little tension. Acromial stress fractures can occur in up to 7% of cases, often due to components placed in too much tension. Despite these concerns, there is little evidence evaluating the intraoperative tension and
Background: The Inferior
Purpose: The glenoid status is a crucial aspect of planning for shoulder replacements. This study revisits the classification proposed by Walch et al and discusses its value to orthopedic surgeons in terms of reproducibility and reliability. Method: Three evaluators viewed one hundred-sixteen (116) shoulder CT-scans with primary
We hypothesised that a large acromial cover with
an upwardly tilted glenoid fossa would be associated with degenerative
rotator cuff tears (RCTs), and conversely, that a short acromion
with an inferiorly inclined glenoid would be associated with glenohumeral
osteoarthritis (OA). This hypothesis was tested using a new radiological parameter,
the critical shoulder angle (CSA), which combines the measurements
of inclination of the glenoid and the lateral extension of the acromion
(the acromion index). The CSA was measured on standardised radiographs of three groups:
1) a control group of 94 asymptomatic shoulders with normal rotator
cuffs and no OA; 2) a group of 102 shoulders with MRI-documented
full-thickness RCTs without OA; and 3) a group of 102 shoulders
with primary OA and no RCTs noted during total shoulder replacement.
The mean CSA was 33.1° (26.8° to 38.6°) in the control group, 38.0°
(29.5° to 43.5°) in the RCT group and 28.1° (18.6° to 35.8°) in
the OA group. Of patients with a CSA >
35°, 84% were in the RCT
group and of those with a CSA <
30°, 93% were in the OA group. We therefore concluded that primary