Glenohumeral Instability

Matsen, Frederick A.; Lippitt, Steven B.; Bertlesen, Alexander; Rockwood, Charles A.; Wirth, Michael A.

doi:10.1016/b978-1-4160-3427-8.50022-2

Cited by 66 publications

(103 citation statements)

References 420 publications

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“…This mechanism stabilizes the shoulder at middle range of motion (ROM) when the capsulolabral structures are lax and at terminal ROM through muscle activity that limits motion and decreases strain on the glenohumeral ligaments [6,16,21,27]. The shoulder muscle activity balances translational (destabilizing) forces with compressive (stabilizing) forces to maintain glenohumeral joint stability throughout its arc of motion [20,22,23,25,31].…”

Section: Introductionmentioning

confidence: 99%

Rotator Cuff Tear and Glenohumeral Instability

Gomberawalla

Sekiya

2014

Clinical Orthopaedics &Amp; Related Research

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Background The rotator cuff plays a significant role in the static and dynamic stability of the glenohumeral joint. Rotator cuff tears may occur after shoulder dislocations, whether in younger athletes or older patients with agerelated tendon degeneration. Untreated tears may cause persistent pain, dysfunction, instability, and degenerative changes. A thorough understanding of when to look for rotator cuff tears after shoulder dislocations and how best to manage them may decrease patients' pain and improve function. Questions/purposes We systematically reviewed the available literature to better understand (1) when a rotator cuff tear should be suspected after a dislocation, (2) whether surgical or nonsurgical approaches result in better scores for pain and satisfaction in patients with rotator cuff tears resulting from shoulder dislocations, and (3) whether intraarticular lesions, rotator cuff tears, or both should be addressed when surgery is performed. Methods We systematically searched MEDLINE 1 , CI-NAHL, and EMBASE for studies published from 1950 to 2012. We included studies reporting outcomes after treatment in patients with rotator cuff tears and shoulder dislocations. We excluded case reports, studies without any treatment, and studies about patients treated with arthroplasty. Five Level III and six Level IV studies were ultimately selected for review. Results Patients with persistent pain or dysfunction after a shoulder dislocation often had a concomitant rotator cuff tear. Surgical repair resulted in improved pain relief and patient satisfaction compared to nonoperative management. Repair of the rotator cuff, along with concomitant capsulolabral lesions, helped restore shoulder stability. While these findings are based on Level III and IV evidence, better long-term studies with larger cohorts are needed to strengthen evidence-based recommendations. Conclusions Persistent pain and dysfunction after a shoulder dislocation should prompt evaluation of the rotator cuff, especially in contact or overhead athletes, patients older than 40 years, or those with nerve injury. Surgery should be considered in the appropriately active patient with a rotator cuff tear after dislocation. While the current literature suggests improved stability and function after surgical repair of the rotator cuff, higher-quality prospective studies are necessary to make definitive conclusions.

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Section: Introductionmentioning

confidence: 99%

Rotator Cuff Tear and Glenohumeral Instability

Gomberawalla

Sekiya

2014

Clinical Orthopaedics &Amp; Related Research

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“…This lesion is reported to be as high as 90% after a traumatic shoulder dislocation. Matsen described a Bankart lesion as a significant finding in a patient with anterior shoulder instability who suffered a traumatic dislocation requiring surgical correction (2).…”

Section: Introductionmentioning

confidence: 99%

Is clinical evaluation alone sufficient for the diagnosis of a Bankart lesion without the use of magnetic resonance imaging?

2016

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Background: Imaging modalities such as magnetic resonance arthrogram (MRA) offer great utility in diagnosing Bankart lesions but they are associated with a high degree of intra and interobserver variability. This study aims to evaluate the diagnostic accuracy of clinical evaluation and imaging modalities in Bankart lesions such as magnetic resonance imaging (MRI) and MRA of the shoulder. Conclusions: In our study, we report that clinical evaluation with focused history-taking and anterior apprehension, load and shift clinical examination can diagnose anterior shoulder instability as reliably as MR imaging. For patients with equivocal clinical findings, MR imaging can aid in the diagnosis.

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“…24) Normal state of rotator cuff tendons play a role as fulcrum to change the shear force by deltoid muscle to rotation force, enabling a shoulder elevation. 25,26) But if there is absent of rotator cuff, this mechanism is lost. Therefore the shear force by deltoid muscle elevates humeral head and precludes the shoulder elevation.…”

Section: Physiology and Mechanismmentioning

confidence: 99%

Reverse Total Shoulder Arthroplasty in the Massive Rotator Cuff Tear

Jeong¹,

Eun²

2014

Clin Shoulder Elbow

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In the patients of retracted massive rotator cuff tears, there are much of difficulty to functional recovery and pain relief. Nevertheless the development of treatment, there are still debates of the best treatments in the massive rotator cuff tears. Recenlty various of treatments are introduced; these are acromioplasty with debridement, biceps tenotomy, great tuberoplasty with biceps tenotomy, partial repair, mini-open rotator cuff repair, arthroscopic rotator cuff repair, soft tissue augmentation, tendon transfer, flap, hemiarthroplasty, and reverse total shoulder arthroplasty. That there is no difference of result for reverse total shoulder arthroplasty between patients who have massive rotator cuff tear without arthritis and patients who have cuff tear arthropathy. Reverse total shoulder arthroplasty is one of reliable and successful treatment options for massive rotator cuff tear. Especially it is more effective for patients who have a pseudoparalysis. (Clin Shoulder Elb 2014;17(3):145-150)

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Glenohumeral Instability

Cited by 66 publications

References 420 publications

Rotator Cuff Tear and Glenohumeral Instability

Rotator Cuff Tear and Glenohumeral Instability

Is clinical evaluation alone sufficient for the diagnosis of a Bankart lesion without the use of magnetic resonance imaging?

Reverse Total Shoulder Arthroplasty in the Massive Rotator Cuff Tear

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