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Glenohumeral Instability

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1. Is the Instability Severity Index Score a Valid Tool for Predicting Failure After Primary Arthroscopic Stabilization for Anterior Glenohumeral Instability? (PubMed)

Is the Instability Severity Index Score a Valid Tool for Predicting Failure After Primary Arthroscopic Stabilization for Anterior Glenohumeral Instability? To assess the validity of the Instability Severity Index Score in predicting the rate of recurrence of dislocation in patients undergoing arthroscopic Bankart repair.The inclusion criteria were recurrent anterior traumatic glenohumeral instability and a minimum follow-up of 5 years. According to the preoperative Instability Severity Index (...) Severity Index Score is a validated tool with which to assess the recurrence rate of dislocation after arthroscopic surgery in patients with shoulder instability. Arthroscopic stabilization in patients with an Instability Severity Index Score ≤3 is associated with a significantly lower risk of recurrence of glenohumeral instability compared with that in patients with an Instability Severity Index Score >3 points.III, case-control study.Copyright © 2019 Arthroscopy Association of North America

2019 Arthroscopy

2. Comparison of 2 Exercise Rehabilitation Programs for Multidirectional Instability of the Glenohumeral Joint: A Randomized Controlled Trial

Comparison of 2 Exercise Rehabilitation Programs for Multidirectional Instability of the Glenohumeral Joint: A Randomized Controlled Trial The recommended initial treatment for multidirectional instability (MDI) of the shoulder is a rehabilitation program, yet there is very low-quality evidence to support this approach. Purpose/Hypothesis: The purpose was to compare the Watson MDI program and Rockwood Instability program among patients with nontraumatic, nonstructural MDI. The hypothesis (...) was that the Watson MDI program would produce clinically and statistically superior outcomes over the Rockwood Instability program.Randomized controlled trial; Level of evidence, 2.Forty-one participants with MDI were randomly allocated to the Watson MDI or Rockwood Instability program. Participants attended 12 weekly physiotherapy sessions for exercise prescription. Outcomes were assessed at baseline and 6, 12, and 24 weeks after randomization. Primary outcomes were the Melbourne Instability Shoulder Score (MISS

2017 EvidenceUpdates

3. Coracoacromial morphology: a contributor to recurrent traumatic anterior glenohumeral instability? (PubMed)

Coracoacromial morphology: a contributor to recurrent traumatic anterior glenohumeral instability? Although scapular morphology contributes to glenohumeral osteoarthritis and rotator cuff disease, its role in traumatic glenohumeral instability remains unknown. We hypothesized that coracoacromial and glenoid morphology would differ between healthy subjects and patients with recurrent traumatic anterior shoulder instability.Computed tomography scans of 31 cadaveric control scapulae and 54 (...) scapulae of patients with recurrent traumatic anterior shoulder instability and Hill-Sachs lesions were 3-dimensionally reconstructed. Statistical shape modeling identified the modes of variation between the scapulae of both groups. Corresponding measurements quantified these modes in relation to the glenoid center (linear offset measures), defined by the best-fit circle of the inferior glenoid, or the glenoid center plane (angles), which bisects the glenoid longitudinally. Distances were normalized

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2019 Journal of Shoulder and Elbow Surgery

4. Reverse shoulder arthroplasty in the treatment of glenohumeral instability. (PubMed)

Reverse shoulder arthroplasty in the treatment of glenohumeral instability. Glenohumeral instability is a rare indication for primary reverse total shoulder arthroplasty (RTSA), accounting for fewer than 1% of the indications in the literature. The aim of this study was to analyze the clinical and radiographic outcomes of RTSA for recurrent instability after failed operative repair or instability associated with major bone loss in elderly patients.A retrospective matched case-control study (...) in cases or controls, but subjective insecurity regarding stability was reported once in each group.RTSA seems to represent a valuable treatment option for glenohumeral instability in an elderly population with large bone loss or as a salvage procedure after failed operative glenohumeral stabilization. Postoperative instability was not observed in the case and control groups.Copyright © 2019 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

2019 Journal of Shoulder and Elbow Surgery

5. Indication for Computed Tomography Scan in Shoulder Instability: Sensitivity and Specificity of Standard Radiographs to Predict Bone Defects After Traumatic Anterior Glenohumeral Instability (PubMed)

Indication for Computed Tomography Scan in Shoulder Instability: Sensitivity and Specificity of Standard Radiographs to Predict Bone Defects After Traumatic Anterior Glenohumeral Instability Quantifying glenohumeral bone loss is key in preoperative surgical planning for a successful Bankart repair.Simple radiographs can accurately measure bone defects in cases of recurrent shoulder instability.Cohort study (diagnosis); Level of evidence, 2.A true anteroposterior (AP) view, alone (...) , and reliability. Therefore, CT scan should be considered in the treatment algorithm for accurate quantification of bone loss to prevent high rates of recurrent instability.

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2017 Orthopaedic journal of sports medicine

6. Age-Related Changes of Elastic Fibers in Shoulder Capsule of Patients with Glenohumeral Instability: A Pilot Study (PubMed)

Age-Related Changes of Elastic Fibers in Shoulder Capsule of Patients with Glenohumeral Instability: A Pilot Study Recurrent shoulder dislocations occur much more frequently in adolescents than in the older population but a clear explanation of this incidence does not exist. The aim of the present study was to define the age-related distribution of the elastic fibers (EFs) in the shoulder capsule's extracellular matrix as a factor influencing shoulder instability.Biopsy specimens were obtained (...) from the shoulder capsule of patients divided preoperatively into three groups: Group 1 consisted of 10 male patients undergoing surgery for unidirectional traumatic anterior instability (TUBS); Group 2 consisted of 10 male patients undergoing surgery for multidirectional instability (MDI); Group 3 represents the control, including 10 patients with no history of instability. In addition to the group as a whole, specific subgroups were analyzed separately on the basis of the age of subjects: > 22

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2018 BioMed research international

7. Evidence-Based Review of Clinical Diagnostic Tests and Predictive Clinical Tests That Evaluate Response to Conservative Rehabilitation for Posterior Glenohumeral Instability: A Systematic Review.

Evidence-Based Review of Clinical Diagnostic Tests and Predictive Clinical Tests That Evaluate Response to Conservative Rehabilitation for Posterior Glenohumeral Instability: A Systematic Review. Posterior glenohumeral instability is poorly understood and can be challenging to recognize and evaluate. Using evidence-based clinical and predictive tests can assist clinicians in appropriate assessment and management.To review evidence-based clinical diagnostic tests for posterior glenohumeral (...) instability and predictive tests that identify responders to conservative management.A comprehensive electronic bibliographic search was conducted using Embase, Ovid MEDLINE, PEDro, and CINAHL databases from their date of inception to February 2017.Studies were included for further review if they (1) reported on clinical diagnostic tests for posterior or posteroinferior instability of the glenohumeral joint, (2) assessed predictive clinical tests for posterior instability of the glenohumeral joint, and (3

2018 Sports health

8. An arthroscopic bone block procedure is effective in restoring stability, allowing return to sports in cases of glenohumeral instability with glenoid bone deficiency. (PubMed)

An arthroscopic bone block procedure is effective in restoring stability, allowing return to sports in cases of glenohumeral instability with glenoid bone deficiency. A group of patients affected by bone loss in the context of recurrent anterior shoulder instability were treated arthroscopically with a modified Eden-Hybinette technique since 2005. The last modification was made in 2013, consisting of fixation using a pair of specifically designed double round Endobuttons, which secure the bone (...) graft to the glenoid rim placed through a guide. This report describes patients operated on after this last modification. No reports have described the results of this technique, and the purpose of this study was to assess early clinical and radiological results of an arthroscopic bone block procedure with double round Endobutton fixation. We hypothesized that this technique would restore shoulder stability in patients with anteroinferior glenohumeral instability with glenoid bone deficit

2018 Knee Surgery, Sports Traumatology, Arthroscopy

9. Epidemiology of the Frequency, Etiology, Direction, and Severity (FEDS) system for classifying glenohumeral instability. (PubMed)

Epidemiology of the Frequency, Etiology, Direction, and Severity (FEDS) system for classifying glenohumeral instability. The purpose of this multicenter epidemiologic study was to determine the distribution of patients within the Frequency, Etiology, Direction, and Severity (FEDS) classification system to determine which categories are of clinical importance.Shoulder instability patients were identified using International Classification of Diseases, Ninth Revision coding data from 3 separate (...) institutions from 2005-2010. Data were collected retrospectively. Details of instability were recorded in accordance with the FEDS classification system. Each patient was assigned a classification within the FEDS system. After all patients were assigned to a group, each group was individually analyzed and compared with the other groups.There are a total of 36 possible combinations within the FEDS system. Only 16 categories were represented by at least 1% of our patient population. Six categories captured

2018 Journal of Shoulder and Elbow Surgery

10. Overhead Perturbation Training for Glenohumeral Joint Instability

Overhead Perturbation Training for Glenohumeral Joint Instability Overhead Perturbation Training for Glenohumeral Joint Instability - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Overhead Perturbation (...) Training for Glenohumeral Joint Instability (OPT) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03380494 Recruitment Status : Not yet recruiting First Posted : December 21, 2017 Last Update Posted : February 20, 2018 See

2017 Clinical Trials

11. Ibuprofen impairs capsulolabral healing in a rat model of anterior glenohumeral instability. (PubMed)

Ibuprofen impairs capsulolabral healing in a rat model of anterior glenohumeral instability. Failure of glenoid labrum and capsular healing after glenohumeral dislocation can lead to persistent shoulder instability. The purpose of this study was to determine the effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on the healing glenoid labrum and capsule after glenohumeral dislocation in a rat model.Sixty-six rats had surgically induced anterior-inferior labral tears and anterior (...) , the maximum load was significantly decreased in the injured limb of the 2-week NSAID group. At 4 weeks, the NSAID group had decreased stiffness compared with the 4-week control group.In a new rat model of glenohumeral instability, the postinjury administration of ibuprofen resulted in decreased capsulolabral healing. A matched pair analysis of injured to uninjured limbs supported the findings of impaired healing in the NSAID-treated animals. These findings demonstrate that the use of NSAIDs after

2017 Journal of Shoulder and Elbow Surgery

12. Epidemiology of glenohumeral dislocation and subsequent instability in an urban population. (PubMed)

Epidemiology of glenohumeral dislocation and subsequent instability in an urban population. Glenohumeral dislocation is the most commonly encountered adult joint instability. The epidemiology in the United Kingdom and worldwide is unclear and often limited to young, active groups that are not representative of general populations. Information regarding epidemiology and outcome from a first dislocation is useful for trauma service planning and patient counseling. We calculated the incidence (...) of shoulder instability after a first dislocation in our urban population and investigated predictors of recurrent instability.A prospectively collected trauma database was retrospectively examined to identify patients with a first-time dislocation. Demographics, subsequent dislocation, and instability details were collected from electronic patient records.In a 38-month study period, 329 first dislocations occurred in a population of 475,147 with mean follow-up 28.5 months (range, 10-50 months

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2017 Journal of Shoulder and Elbow Surgery

13. Conjoined Tendon Transfer for Traumatic Anterior Glenohumeral Instability in Patients With Large Bony Defects and Anterior Capsulolabral Deficiency. (PubMed)

Conjoined Tendon Transfer for Traumatic Anterior Glenohumeral Instability in Patients With Large Bony Defects and Anterior Capsulolabral Deficiency. To report outcomes of a conjoined tendon transfer procedure in a small case series of young active patients of various activity levels with recurrent traumatic anterior shoulder instability.A retrospective chart review identified 10 consecutive patients who underwent conjoined tendon transfer (8 open and 2 arthroscopic) for anterior glenohumeral (...) instability from January 2009 through December 2012. The indications were traumatic anterior shoulder instability with 25% or greater anterior glenoid bone loss, engaging Hill-Sachs lesion, or absent anterior-inferior labral tissue with anterior capsular tissue that did not readily hold sutures or a combination of these deficiencies. Patients did not undergo the procedure if they had healthy capsulolabral tissue and small bony defects or if they competed in high-level collision sports or were overhead

2017 Arthroscopy

14. Three-dimensional quantitative analysis of humeral head and glenoid bone defects with recurrent glenohumeral instability. (PubMed)

Three-dimensional quantitative analysis of humeral head and glenoid bone defects with recurrent glenohumeral instability. Although bone defects of the humeral head and glenoid could affect glenohumeral instability, bone loss has not been sufficiently evaluated. The purpose of this study was to quantify bone defects 3-dimensionally in cases with glenohumeral instability.Three-dimensional surface models of bilateral proximal humeri and glenoids were reconstructed from computed tomography scans (...) of 90 patients with symptomatic, unilateral, recurrent glenohumeral instability. The left-side models were mirrored, and intact bone areas were matched to those of the right-side models. The volume, length, width, and depth of identified bone defects were assessed. After the values were corrected by patient height, the characteristics of the bone defects were evaluated.Bone defects were present in 97.8% of the humeral heads and 96.7% of the glenoids, and women had significantly smaller bone defects

2017 Journal of Shoulder and Elbow Surgery

15. Dynamic Anterior Stabilization Using the Long Head of the Biceps for Anteroinferior Glenohumeral Instability (PubMed)

Dynamic Anterior Stabilization Using the Long Head of the Biceps for Anteroinferior Glenohumeral Instability Anteroinferior glenohumeral instability can be treated by variants of the Bankart repair, remplissage, and the Latarjet procedure, although all options remain associated with complications, including recurrence, stiffness, persistent pain, apprehension, and dislocation arthropathy. The authors therefore thought of a concept of dynamic anterior stabilization to treat anteroinferior (...) glenohumeral instability by transferring the long head of the biceps within a subscapularis split to the anterior glenoid margin, thereby creating a "sling effect" by using a conservative technique. A standard Bankart repair is then to re-establish the labral damper effect. The main benefit of the dynamic anterior stabilization procedure is that it grants the "sling effect," but is easier and safer than arthroscopic Latarjet. It does not require screws nor traction of the coracoid process, and should

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2017 Arthroscopy techniques

16. Acromial J-bone graft on the acromion for surgical treatment of glenohumeral instability: an anatomical study (PubMed)

Acromial J-bone graft on the acromion for surgical treatment of glenohumeral instability: an anatomical study Anterior glenohumeral instability is frequently associated with anteroinferior glenoid bone defects. One original technique has been described in the literature that incorporates a J-shaped graft from the iliac crest into the anterior glenoid rim. The main goal of the present study was to evaluate the feasibility of harvesting a J-shaped graft from the acromion that corresponds

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2017 Shoulder & elbow

17. Anatomic Humeral Head Reconstruction With Fresh Osteochondral Talus Allograft for Recurrent Glenohumeral Instability With Reverse Hill-Sachs Lesion (PubMed)

Anatomic Humeral Head Reconstruction With Fresh Osteochondral Talus Allograft for Recurrent Glenohumeral Instability With Reverse Hill-Sachs Lesion The treatment of recurrent glenohumeral instability, especially with a concomitant bony lesion, remains challenging. This is especially true in the case of posterior instability given its less common incidence. Moreover, the presence of an engaging reverse Hill-Sachs lesion in combination with posterior instability will result in the need for a more (...) Hill-Sachs lesion with recurrent glenohumeral instability through use of a fresh osteochondral talus allograft, as well as discuss the advantages and disadvantages of this allograft option.

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2017 Arthroscopy techniques

18. Prevention and management of post-instability glenohumeral arthropathy (PubMed)

Prevention and management of post-instability glenohumeral arthropathy Post-instability arthropathy may commonly develop in high-risk patients with a history of recurrent glenohumeral instability, both with and without surgical stabilization. Classically related to anterior shoulder instability, the incidence and rates of arthritic progression may vary widely. Radiographic arthritic changes may be present in up to two-thirds of patients after primary Bankart repair and 30% after Latarjet

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2017 World journal of orthopedics

19. The “Purse String” Procedure for Recurrent Anterior Glenohumeral Instability: A Simple Technique to Achieve Bankart Repair, Capsular Shift, and a Good Labral Bumper (PubMed)

The “Purse String” Procedure for Recurrent Anterior Glenohumeral Instability: A Simple Technique to Achieve Bankart Repair, Capsular Shift, and a Good Labral Bumper Failure of arthroscopic techniques in cases of recurrent anterior glenohumeral instability may result from inadequate treatment of capsular injury. The use of few anchors has been cited as a cause of failure in arthroscopic stabilization techniques. This applies to the use of the suture anchors as spot-welding points (...) in conventional techniques. It has been shown that horizontal mattress suture techniques restore better labral height and anatomy than simple suture techniques in the repair of acute Bankart lesions. Horizontal mattress repairs, like the one achieved with the "purse-string" technique, pushes the labrum toward the humeral side of the joint, thus providing a buttress to the glenohumeral joint. We present the purse-string technique, which involves the use of only 1 suture anchor located at the 4-o'clock position

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2017 Arthroscopy techniques

20. Arthroscopic Management of Posterior Instability due to “Floating” Posterior Inferior Glenohumeral Ligament Lesions (PubMed)

Arthroscopic Management of Posterior Instability due to “Floating” Posterior Inferior Glenohumeral Ligament Lesions The "floating" posterior inferior glenohumeral ligament (floating PIGHL) is an uncommon cause of posterior shoulder instability. This pathologic lesion, defined as detachment of both the origin of the PIGHL (posterior Bankart lesion) and insertion of the of the PIGHL from its humeral head insertion site, often results in significant and persistent shoulder instability symptoms

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2017 Arthroscopy techniques

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