Instabilidade glenoumeral anterior: Revisão sistemática dos desfechos usados no Brasil

Abstract

A review involving the six major international orthopedic journals has been published recently. It described the tools used for the evaluation of outcomes in the surgical treatment of recurrent anterior dislocation of the shoulder. There are no studies that exhibit the main outcome tools for this disease in Brazil. The authors evaluated the outcomes of clinical studies involving anterior glenohumeral instability that were published in the last decade in the two leading Brazilian orthopedic journals, Revista Brasileira de Ortopedia and Acta Ortopédica Brasileira . A review of the literature was performed, including all clinical papers published between 2007 and 2016 describing at least one outcome measure before and after surgical intervention. The outcomes were range of motion, muscle strength, physical examination testing, patient satisfaction, return to sports, imaging, complications, and functional outcomes scores. Twelve studies evaluating the clinical outcomes of surgical treatment for anterior shoulder instability were published. Ten studies (83%) were case series (level of evidence IV), 1 (8%) was a case-control study (III), and 1 was a retrospective cohort (III). On average, the number of outcomes assessed was 3.7 ± 1.7. The Rowe score was used in 9 studies (75%), and 7 (58%) papers used the University of California Los Angeles (UCLA) scale. Ten studies (83%) reported complications related to surgical treatment. The complication most frequently reported was recurrent instability, found in 9 studies (75%). The national studies have preferentially used scales considered to be of low reliability, responsiveness, and internal consistency.

Acute Effects of Whole-Body Vibration on Muscle Strength in Subjects with Shoulder Instability

“…Muscle strength was measured using isokinetic dynamometrythe gold standard for assessing this variable and is already used in many studies on shoulder instability (34)(35)(36)(37). A Biodex III model isokinetic dynamometer (Biodex Medical Systems, Inc., Shirley, NY) was used.…”

“…Patients with shoulder instability have a neuromuscular imbalance in both shoulders and exercises that aim to improve neuromuscular qualities should be part of the treatment of this population. Physiotherapeutic treatment aims to restore functional stability, seeking a rebalance of strength between the rotator cuff, scapular and deltoid muscles, thus restoring dynamic joint protection through neuromuscular balance (32)(33)(34). Bearing in mind the needs of patients with shoulder instability and the positive effects that WBV has been achieving on muscle strength and joint instabilities, the aim of this study was to investigate the acute effects of WBV on the muscle strength of patients with shoulder instability.…”

Best implant choice for coracoid graft fixation during the Latarjet procedure depends on patients’ morphometric considerations

“…The glenohumeral joint is the least stable joint in the human body, and is prone to recurrent anterior instability. Anterior shoulder instability is disabling and has the highest incidence in young males, and the preferred treatment is surgical [1]. The two commonest surgical treatments for anterior shoulder instability are the arthroscopic Bankart repair and the Latarjet procedure [2].…”