Aims. The aims of this study were to validate the minimal clinically important difference (MCID) and patient-acceptable symptom state (PASS) thresholds for Western Ontario Shoulder Instability Index (WOSI), Rowe score, American Shoulder and Elbow Surgeons (ASES), and visual analogue scale (VAS) scores following
Aims. The factors that predispose to recurrent instability and revision
stabilization procedures after
Purpose: Although
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
Recurrence represents the leading complication of arthroscopic anterior shoulder stabilization. Even with modern suture anchor techniques, a recurrence rate of between 5 to 20% persists; emphasizing that
In this study we evaluated whether the Instability
Severity Index Score (ISIS) and the Western Ontario Shoulder Instability
Index (WOSI) could detect those patients at risk of failure following
arthroscopic Bankart repair. Between April 2008 and June 2010, the
ISIS and WOSI were recorded pre-operatively in 110 patients (87
male, 79%) with a mean age of 25.1 years (16 to 61) who underwent
this procedure for recurrent anterior glenohumeral instability. . A telephone interview was performed two-years post-operatively
to determine whether patients had experienced a recurrent dislocation
and whether they had returned to pre-injury activity levels. In
all, six (5%) patients had an ISIS >
6 points (0 to 9). Of 100 (91%)
patients available two years post-operatively, six (6%) had a recurrent dislocation,
and 28 (28%) did not return to pre-injury activity. No patient who
dislocated had an ISIS >
6 (p = 1.0). There was no difference in
the mean pre-operative WOSI in those who had a re-dislocation and
those who did not (p = 0.99). The pre-operative WOSI was significantly
lower (p = 0.02) in those who did not return to pre-injury activity, whereas
the ISIS was not associated with return to pre-injury activity (p
= 0.13). . In conclusion, neither the pre-operative ISIS nor WOSI predicted
recurrent dislocation within two years of
Purpose: Arthroscopic stabilization for post-traumatic anterior glenohumeral instability is designed to minimize soft tissue dissection while achieving similar or improved outcomes relative to open techniques. This study’s purpose was to determine the rate of post-operative recurrent instability and evaluate health related quality of life (HRQL) and shoulder range of motion (ROM) following
The April 2023 Shoulder & Elbow Roundup. 360. looks at:
Aims. The aim of this study was to identify risk factors for recurrent instability of the shoulder and assess the ability to return to sport in patients with engaging Hill-Sachs lesions treated with
There is no simple method available to identify patients who will develop recurrent instability after an arthroscopic Bankart procedure and who would be better served by an open operation. We carried out a prospective case-control study of 131 consecutive unselected patients with recurrent anterior shoulder instability who underwent this procedure using suture anchors. At follow-up after a mean of 31.2 months (24 to 52) 19 (14.5%) had recurrent instability. The following risk factors were identified: patient age under 20 years at the time of surgery; involvement in competitive or contact sports or those involving forced overhead activity; shoulder hyperlaxity; a Hill-Sachs lesion present on an anteroposterior radiograph of the shoulder in external rotation and/or loss of the sclerotic inferior glenoid contour. These factors were integrated in a 10-point pre-operative instability severity index score and tested retrospectively on the same population. Patients with a score over 6 points had an unacceptable recurrence risk of 70% (p <
0.001). On this basis we believe that an
The aim of this study was to use motion analysis to study a surgeon’s learning curve for an
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
Aim: The aim of this study was to evaluate prospectively the mid-term outcome following
[Hong Kong Orthopaedic Association, Travelling Fellow]. Glenoid bone loss predisposes to further dislocation and failure of
Purpose: The aim of this study was to evaluate prospectively the outcome following
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
The laterjet procedure is an important option in both primary and revision surgeries, especially in anterior shoulder instabilities that progress with glenoid bone loss. 12 patients who had a history of unsuccessful
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