A new classification system for shoulder instability

Kuhn, John E.

doi:10.1136/bjsm.2009.071183

Cited by 83 publications

(44 citation statements)

References 36 publications

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“…As a result, diagnoses for certain forms of instability (e.g. multidirectional instability, bidirectional instability, subtle instability and voluntary instability) have multiple and sometimes discordant definitions 9,17,19,23. This lack of consensus has produced a pot-pouri of descriptive terms for this condition which confuses clinicians3 and the literature 23,30.…”

Section: Introductionmentioning

confidence: 99%

Development and reliability testing of the frequency, etiology, direction, and severity (FEDS) system for classifying glenohumeral instability

Kuhn

Helmer

Dunn

et al. 2011

Journal of Shoulder and Elbow Surgery

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Section: Introductionmentioning

confidence: 99%

Development and reliability testing of the frequency, etiology, direction, and severity (FEDS) system for classifying glenohumeral instability

Kuhn

Helmer

Dunn

et al. 2011

Journal of Shoulder and Elbow Surgery

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“…The reader is directed to the particular article cited and Tables 2-7 for clarification. 113 It is also not clear when manipulation is indicated for the spine and not the GHJ, or the GHJ, spine, scapula, and upper ribs; this is explicated in a minor way in the Tables 3 to 7; and again, the reader is directed to the individual articles cited.…”

Section: Limitationsmentioning

confidence: 99%

Manipulative Therapy for Shoulder Pain and Disorders: Expansion of a Systematic Review

Brantingham

Cassa

Bonnefin

et al. 2011

Journal of Manipulative and Physiological Therapeutics

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“…36 Most recently, the frequency, etiology, direction, and severity (FEDS) classification was designed to be a classification system that has content validity, is highly reliable and reproducible, and is less dependent on examiner opinion than other classfications. 15,16 Other classifications that are less commonly utilized to describe instability include the Kessel and Bayley, Schneeberger and Gerber, and Stanmore classifications. 13,33 …”

Section: Classificationmentioning

confidence: 99%

Current Concepts in the Diagnosis and Management of Traumatic, Anterior Glenohumeral Subluxations

Gil

DeFroda

Owens

2017

Orthopaedic Journal of Sports Medicine

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Traumatic anterior glenohumeral subluxations comprise the majority of glenohumeral instability events and are endemic in young athletes. Unlike the definitive complete dislocation event, subluxation events may often be more subtle in presentation and, therefore, may be overlooked by clinicians. Glenohumeral subluxation events are associated with a high rate of labral tears as well as humeral head defects. While less is known of the natural history of these injuries, young athletes are at risk for recurrent instability events if not properly diagnosed and treated. While reports of surgical treatment outcomes isolated to subluxation events are limited, arthroscopic and open Bankart repair have been shown to result in excellent outcomes. The purpose of this paper is to review the etiology and pathoanatomy of traumatic anterior glenohumeral subluxations as well as to review the appropriate evaluation and management of patients with this injury. Keywords: subluxation; glenohumeral subluxation; shoulder instability; instabilityThe glenohumeral joint has the greatest range of motion of any joint in the body, leaving it susceptible to instability, particularly during extremes in ranges of motion, such as those encountered among contact athletes.24 Glenohumeral instability comprises a spectrum of injuries that range from atraumatic subluxations to traumatic dislocations. Although glenohumeral subluxation accounts for the majority of shoulder instability events, studies that have investigated shoulder instability have focused primarily on glenohumeral dislocations. 21,26 Glenohumeral subluxation events are more difficult to investigate because of the challenge of precisely defining and diagnosing these events. 27In 1980, Protzman 29 clearly delineated glenohumeral subluxation as a unique type of shoulder instability that is present in shoulders that have not previously sustained a glenohumeral dislocation event. In 1983, Warren 37 reported on a series of patients with chronic recurrent glenohumeral subluxations who underwent a stabilization procedure. Radiographic evaluation of these patients revealed that 37% of patients had a Hill-Sachs lesion and 50% had a Bankart lesion. In 1983, Mizuno and Hirohata 21 also reported on a series of 55 patients with chronic recurrent anterior glenohumeral subluxations. They reported that radiographs demonstrated a Bankart lesion in 45 of these patients. In 1992, Burkhead and Rockwood 4 reported on a series of patients with traumatic glenohumeral subluxation, and 55% of these patients had radiographic evidence of an osseous Bankart lesion. In 2007, Owens et al 26 demonstrated that 85% of traumatic glenohumeral instability events are glenohumeral subluxations rather than dislocations. These were diagnosed by a history of a traumatic shoulder event combined with physical examination findings of a positive anterior apprehension sign and a symptomatic load shift. Despite long-term knowledge of glenohumeral subluxations and the subsequent studies that demonstrated a high rate of associated gl...

show abstract

A new classification system for shoulder instability

Cited by 83 publications

References 36 publications

Development and reliability testing of the frequency, etiology, direction, and severity (FEDS) system for classifying glenohumeral instability

Development and reliability testing of the frequency, etiology, direction, and severity (FEDS) system for classifying glenohumeral instability

Manipulative Therapy for Shoulder Pain and Disorders: Expansion of a Systematic Review

Current Concepts in the Diagnosis and Management of Traumatic, Anterior Glenohumeral Subluxations

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