Rotational humeral osteotomy for recurrent anterior dislocation of the shoulder associated with a large Hill-Sachs lesion.

Weber, B. G.; Simpson, Lex A.; Hardegger, F

doi:10.2106/00004623-198466090-00019

Cited by 227 publications

(113 citation statements)

References 10 publications

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“…Multiple surgical techniques have been described to avoid redislocation of Satisfied the humeral head. Rotational humeral osteotomy in recurrent anterior dislocations of the shoulder was first described in 1984 by Weber [23] and Kronberg et al [9,10]. As an alternative treatment option, filling of the defect with humeral allograft has been proposed [5,18].…”

Section: Discussionmentioning

confidence: 99%

“…In bone defects of more than 45% of the humeral surface we believe that adequate stability will be hard to achieve with CHSRA and suggest treatment with a conventional hemiarthroplasty. In younger patients (<50 years) we would suggest humeral head preserving surgery techniques such as reorientation of the humeral head [9,23] or filling the defect with humeral allograft [18]. In our opinion, reconstruction of the rotator cuff, especially of the subscapularis tendon, is crucial to avoid redislocation and gain good clinical results.…”

Section: Discussionmentioning

confidence: 99%

“…Several surgical treatment options have been described to avoid redislocation of the humeral head. These include reorientation of the humeral head [9,23], filling the defect with humeral allograft [18] to restore joint congruency, and bone transfer techniques [4,7,11,24]. Shoulder replacement for fixed shoulder dislocation has been discussed extensively as new implants were developed in shoulder arthroplasty in recent years [1,14,17,19,21].…”

Section: Introductionmentioning

confidence: 99%

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Humeral head resurfacing for fixed anterior glenohumeral dislocation

Raiss

Aldinger

Kasten

et al. 2007

International Orthopaedics (SICOT)

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The purpose of this prospective study was to describe cementless humeral surface replacement arthroplasty (CHSRA) as a bone preserving treatment option for patients with fixed anterior glenohumeral dislocation. Ten patients with post-traumatic fixed anterior glenohumeral dislocation underwent CHSRA with a mean follow-up of 24 months. All patients were evaluated clinically using the Constant score and with radiographs in two planes. There were two reoperations: one patient developed glenoid erosion and was revised and in another case redislocation occurred. Clinical or radiographical signs of implant loosening were not found. The humeral head centred in the glenoid in nine out of ten cases radiographically. The Constant score increased from 20 points preoperatively to 61 points postoperatively (p<0.007). CHSRA is a viable treatment option for elderly patients with fixed anterior glenohumeral dislocation and bone defects of the humeral head. Good clinical results and a moderate complication rate were found in the short term.Résumé Le sujet de cette étude prospective était de montrer que le resurfaçage sans ciment au niveau de l'épaule est un option permettant la préservation du capital osseux pour des patients avec une luxation antérieure chronique de l'épaule. Dix patients avec une luxation gléno humérale antérieure fixée ont subi un resurfaçage sans ciment avec un suivi moyen de 24 mois. Tous les patients ont été évalués cliniquement à l'aide du score de Constant et des radiographies dans deux plans. Deux réinterventions ont été nécessaires. Un patient a développé une érosion glénoïdienne nécessitant un changement de prothèse et un patient a récidivé sa luxation. Il n'y avait pas de signe clinique ou radiographique de descellement des implants. La tête humérale était centrée dans la glène dans 9 cas sur 10. Le score de constant s'est accru de 20 points en préopératoire à 61 points en post opératoire (p<0.007). Le resurfaçage huméral sans ciment est donc une solution fiable pour les patients âgés avec une luxation antérieure chronique et une encoche au niveau de la tête humérale. De bons résultats clinique et un taux de complications modéré ont été retrouvés à court terme.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Humeral head resurfacing for fixed anterior glenohumeral dislocation

Raiss

Aldinger

Kasten

et al. 2007

International Orthopaedics (SICOT)

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“…If the lesion occupies a specific size and position on the humeral head, shoulder destabilisation occurs [25][26][27]. Sekiya et al showed in their biomechanical work that even Hill-Sachs lesions affecting 12.5 % of the humeral head lead to glenohumeral-joint destabilisation [23].…”

Section: Discussionmentioning

confidence: 99%

“…In particular, operations using tendon transpositions, as described by McLaughlin [20] or Hawkins [21] or humeral head derotation [22] often used in the past, are associated with a reduced range of motion. Therefore the aim of this feasibility study was to develop a minimally invasive procedure to restore the anatomical humeral head geometry as an innovative treatment option.…”

Section: Introductionmentioning

confidence: 99%

Balloon osteoplasty—a new technique for minimally invasive reduction and stabilisation of Hill–Sachs lesions of the humeral head: a cadaver study

Sandmann

Ahrens

Schaeffeler

et al. 2012

International Orthopaedics (SICOT)

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Purpose Traumatic shoulder dislocation may be complicated by concomitant bony injury of the glenoid rim or the humeral head. In Hill-Sachs lesions, reconstruction techniques vary widely and range from open reduction to tendon transposition or humeral head derotation. These operations are extensive and have questionable outcomes. With the expertise from vertebral compression fracture reduction by kyphoplasty, we examined in a cadaver feasibility study whether reduction of the Hill-Sachs lesion via hydraulic lift might be an anatomical and minimally invasive treatment option. We postulated that the use a of a balloon-assisted kyphoplasty reduction could achieve almost anatomical correction of the defect. Methods We created Hill-Sachs lesions in six humeral specimens and performed a computed tomography (CT) scan before and after reduction with the kyphoplasty system. The entry point at the greater tuberosity and balloon positioning was visualised by fluoroscopy. The size of the HillSachs lesion before and after reduction was measured using CT scans in the axial orientation. Results Using the balloon kyphoplasty system, we achieved a statistically significant reduction (80 % ) of the Hill-Sachs lesion. Conclusion In a preliminary cadaver study we show that using a balloon kyphoplasty system might be an alternative treatment option for Hill-Sachs lesions, with reduced collateral damage that can occur with other minimally invasive techniques. Future work is needed to evaluate the technique under arthroscopic conditions.

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