Introduction. The Bankart lesion is the most common form of labro-ligamentous injury in patients with traumatic dislocations of the shoulder. Various methods have been described each with its own advantages and disadvantages. We describe 5-year results of
Previously, we conducted a multi-center, double-blinded randomized controlled trial comparing
The aim of this study was to evaluate prospectively the outcome following
Currently there is no standard quantitative methodology for the description of Hill-Sachs defects (HSD), the size of which is important in planning surgical treatment for patients with anterior shoulder instability. The main purpose was to develop a simple imaging measurement to improve communication regarding HSDs. The secondary goal was to determine, using this new measurement, whether there was a significant difference in the size of HSDs in patients who underwent a Weber osteotomy (more invasive surgical intervention for those failing Bankart repair) compared with patients who underwent clinically successful
Recurrent anterior shoulder instability (RASI) is related to progressive bone loss on the glenoid and on the humeral head. Bone deficit magnitude is a well-recognized predictor of recurrence of instability after an arthroscopic Bankart surgery, but the best way to measure it is unknown. In this study, we want to determine which measurement method is the best predictor of recurrence of instability and function. For 10 years now, all patients undergoing surgery for RASI in 4 centers are included in a prospective study: the LUXE cohort. Patients with a pre-operative CT-scan and a minimum of 1-year follow-up were included. ISIS score was used to stratify patients. WOSI and Quick-Dash questionnaires were used to characterise function. Bone defects were assessed using the Clock method, the Glenoid Ratio, the Humeral Ratio, the Glenoid Track method and the angle of engagement in the axial plane. A total of 262 patients are now included in the LUXE study. One hundred and three patients met the inclusion criteria for analysis with a majority of male (79%) and a mean age is 28 years old. The median number of dislocations prior to surgery was 6. Seventy patients had an
Concepts in glenoid tracking and treatment strategies of glenoid bone loss are well established. Initial observations in our practice in Singapore showed few patients with major bone loss requiring glenoid reconstructions. This led us to investigate the incidence of and the extent of bone loss in our patients with shoulder instability. Our study revealed bony Bankart lesions were seen in 46% of our patients but glenoid bone loss measured only 6–10% of the glenoid surface. In the same study we found that arthroscopic labral repair with capsular plication and Mason-Ellen suturing (Hybrid technique) was sufficient to stabilise patients with bipolar bone defects and minor glenoid bone loss. This led us to develop the concept of minor bone loss and a new algorithm. Our algorithm and strategies to deal with major bone loss will also be discussed, and techniques & outcomes of
Background:. Individuals with large Hill-Sachs lesions may be prone to failure and reoccurrence following standard
Michael Robinson has been a Consultant Orthopaedic Surgeon and Senior Lecturer in the Department of Orthopaedics and Traumatology in Edinburgh, Scotland, United Kingdom for 10 years. His special interests include the treatment of proximal humeral and clavicle fractures, and shoulder instability. Primary traumatic anterior dislocations of the glenohumeral joint in young adults are common injuries, which are associated with persistent deficits of shoulder function and a high risk of recurrent instability. Although several risk factors have been implicated, a younger age at the time of the primary dislocation, and male gender, are the factors that have been most consistently associated with a higher risk of recurrence. Recent studies have suggested that primary arthroscopic repair of the anteroinferior detachment of the glenoid labrum (Bankart repair) may reduce the risk of subsequent recurrent instability and improve function, when compared with non-operative treatment. However, the unblinded or single-blind design of these studies fails to eliminate the potential for error due to observer or subject bias, and the therapeutic effects of the Bankart repair cannot be distinguished from those of the arthroscopic examination and washout alone. The latter may reduce the rate of subsequent instability, by promoting healing of the labral detachment, or by altering the patient's subsequent level of physical activity and compliance with rehabilitation protocols. A clinical trial conducted recently in our Institution assessed the efficacy of a primary arthroscopic stabilisation after a first-time dislcoation, whilst controlling for the therapeutic effects of the arthroscopic examination and washout alone. We aimed to specifically test the null hypothesis, that an
Recurrent shoulder instability in those with bony defects is a difficult surgical problem to resolve. Burkhart and De Beer described an unacceptably high recurrence rate for
Coracoid fractures during screw insertion and graft osteolysis are serious concerns with standard screw fixation techniques in Latarjet procedure. This study tends to evaluate the outcome of mini open Latarjet using Arthrex mini-plate for coracoids graft fixation. We did retrospective analysis of 30 patients with recurrent anterior shoulder instability after