In disclosure of general conflict of interests not related to the submission of this paper, consider the following: for Peter MacDonald, research support from a company or supplier (Conmed Linvatec) as a PI; medical/orthopaedic publications editorial/governing boards (Journal of Shoulder and Elbow Surgery, Clinical Journal of Sports Medicine); for Anthony A. Romeo, royalties from a company or supplier (Arthrex, Inc.), speakers bureau/paid presentations for a company or supplier (Arthrex, Inc.), paid consultant for a company or supplier (Arthrex, Inc.), research support from a company or supplier as a PI (Arthrex, Inc.; DJO Surgical; Smith & Nephew; Ossur), other financial or material support from a company or supplier (Arthrex, Inc.; DJO Surgical), royalties, financial, or material support from publishers (Saunders/Mosby-Elsevier), medical/orthopaedic publications editorial/governing board (Journal of Shoulder and Elbow Surgery; SLACK Incorporated; Orthopedics Today; Orthopedics; Sports Health; Techniques in Shoulder and Elbow Surgery; Operative Techniques in Sports Medicine; Orthopaedic Journal of Sports Medicine); board member/committee appointments for a society (American Orthopaedic Society for Sports Medicine; American Shoulder and Elbow Surgeons; Arthroscopy Association of North America). 1% (30/3871) L 1 # Suture anchors are then placed on the anterior glenoid neck to facilitate repair of the labrum with imbrication of the inferior aspect of the glenohumeral capsule into the labral repair (Figure 6). endstream endobj 103 0 obj <>stream 3, pp. 150 N(newton) , 10 20 . Ann Surg Elmslie 100 364 1934 10.1097/00000658-193408000-00012, Foot Ankle Gould 1 84 1980 10.1177/107110078000100206, J Bone Joint Surg Am Karlsson 70 581 1988 10.2106/00004623-198870040-00015, J Bone Joint Surg Br Ahlgren 71 300 1989 10.1302/0301-620X.71B2.2647757, J Bone Joint Surg Am Anderson 67 930 1985 10.2106/00004623-198567060-00016, Foot Ankle Int Brodsky 26 816 2005 10.1177/107110070502601005, Foot Ankle Hamilton 14 1 1993 10.1177/107110079301400101, Knee Surg Sports Traumatol Arthrosc Schmidt 13 231 2005 10.1007/s00167-004-0562-0, Mann's surgery of the foot and ankle e-book: expert consult--online Coughlin 2013, Foot Ankle Int Ferkel 28 24 2007 10.3113/FAI.2007.0005, Clin Sports Med Kibler 15 799 1996 10.1016/S0278-5919(20)30088-0, Am J Sports Med Taga 21 120 1993 10.1177/036354659302100120, Clin Orthop Relat Res Ferkel 391 89 2001 10.1097/00003086-200110000-00010, Arthroscopy Imade 25 215 2009 10.1016/j.arthro.2007.08.027, Campbell's operative orthopaedics (ebook) Canale 2012, Am J Sports Med Maffulli 41 858 2013 10.1177/0363546512474967, Am J Sports Med Wainright 40 2099 2012 10.1177/0363546512454840, J Am Acad Orthop Surg Colville 6 368 1998 10.5435/00124635-199811000-00005, Foot Ankle Int Kuhn 27 77 2006 10.1177/107110070602700201, J Korean Orthop Assoc Chung 49 13 2014 10.4055/jkoa.2014.49.1.13, Foot Ankle Int Jeong 35 1137 2014 10.1177/1071100714543645, Foot Ankle Int Behrens 34 587 2013 10.1177/1071100713477622, J Foot Ankle Surg Trichine 57 226 2018 10.1053/j.jfas.2017.06.010, Foot Ankle Int Messer 21 996 2000 10.1177/107110070002101203, Foot Ankle Int Yeo 37 1037 2016 10.1177/1071100716666508, JBJS Rev Yasui 4 2016 10.2106/JBJS.RVW.15.00074, Foot Ankle Surg Guelfi 24 11 2018 10.1016/j.fas.2016.05.315, Knee Surg Sports Traumatol Arthrosc Lee 24 1096 2016 10.1007/s00167-014-3159-2, Foot Ankle Surg Buerer 19 36 2013 10.1016/j.fas.2012.10.005, J Foot Ankle Surg Cho 52 9 2013 10.1053/j.jfas.2012.10.004, Am J Sports Med Bell 34 975 2006 10.1177/0363546505282616, Am J Sports Med Choi 36 2167 2008 10.1177/0363546508319050, Arthroscopy Hua 26 524 2010 10.1016/j.arthro.2010.02.002, Foot Ankle Spec Lee 4 284 2011 10.1177/1938640011416355, Am J Sports Med Li 37 488 2009 10.1177/0363546508327541, Am J Sports Med Nery 39 2381 2011 10.1177/0363546511416069, Am J Sports Med Hennrikus 24 400 1996 10.1177/036354659602400402, Am J Sports Med Viens 42 405 2014 10.1177/0363546513510141, Foot Ankle Int DiGiovanni 27 854 2006 10.1177/107110070602701019, J Bone Joint Surg Am Bosien 37-A 1237 1955 10.2106/00004623-195537060-00011, Br J Sports Med Van Dijk 36 83 2002 10.1136/bjsm.36.2.83, Foot Ankle Int Komenda 20 708 1999 10.1177/107110079902001106, = Journal of Korean Foot and Ankle Society, [] 60 , [] Subungual Schwannoma Mimicking Glomus Tumor on Ultrasonography: A Case Report, [] Bilateral Anterior Interosseous Nerve Syndrome: A Case Report, [] Outcomes of Unstable Extraarticular Metacarpal Fractures Treated with Low Profile Titanium Plate System. We obtained the normal range of Korean adults, and used as a standard value for judgment of mechanical instability. 2016 Jan;37(1):64-9. doi: 10.1177/1071100715603372. Illinois Bone & Joint Institute, LLC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. A. Sidles, D. T. Harryman II, and F. A. Matsen III, Effect of a chondral-labral defect on glenoid concavity and glenohumeral stability: a cadaveric model, Journal of Bone and Joint Surgery A, vol. L. Lafosse and S. Boyle, Arthroscopic Latarjet procedure, Journal of Shoulder and Elbow Surgery, vol. In 6 men with defects consisting of 40% articular surface involvement, all patients returned to their previous occupation by 4 months after operation. 8.3 , 24, 18 , 3, 117 (Table 2). There were no failures, stretch-outs, re-dos, or complications. [65]. The current study included patients who complained of unilateral ankle joint instability. 159176, 2000. Recurrent shoulder instability and resultant glenoid and humeral head bone loss are not infrequently encountered in the population today, specifically in young, athletic patients. A. M. Halder, S. G. Kuhl, M. E. Zobitz, D. Larson, and K. N. An, Effects of the glenoid labrum and glenohumeral abduction on stability of the shoulder joint through concavity-compression: an in vitro study, Journal of Bone and Joint Surgery, vol. Wittig U, Hohenberger G, Ornig M, Schuh R, Leithner A, Holweg P. EFORT Open Rev. 9, pp. . 68, no. (false negative) , . Since the glenohumeral joint is least stable in the anterior/posterior direction, and the majority of dislocations occur when the humeral head translates anteriorly on glenoid, most glenoid defects occur at an area from the 3 oclock position extending inferiorly to the 6 oclock position [10]. (walking boots) . 9, pp. (false negative) , . Cummins CA, Messer T, Schafer M: Prevalence and Characteristics of Suprascapular Nerve Injury in Major League Baseball Players. 7376, 1995. 918, 1987. Messer T, Cummins C, Kelikian A: Modified Brostrom Procedure Using Implantable Suture Anchors for Chronic Lateral Ankle Instability. 10331041, 2007. 5). Unable to load your collection due to an error, Unable to load your delegates due to an error. In addition, glenohumeral ligaments are slack in the midranges of motion [9]. 2010;26(4):524-8. [57], 19 of 47 shoulders showed arthritic change at a follow-up of 72 months with 11 of these patients having preoperative evidence of arthrosis. Methods All published randomized clinical trials comparing MBG and other operations were found by searching the Cochrane Library, EMBASE, and PubMed J Bone Joint Surg, 82-A: 415-424, 2000. The purpose of this review is to provide a brief overview of the anatomy of the glenohumeral joint relevant to its stability (and instability) and to illustrate the pertinent history and physical examination findings in patients with bone loss and recurrent shoulder instability. Outcomes of the Chrisman-Snook and modified-Brostrm procedures He is board-certified in orthopedic surgery and is one of less than 5% of orthopedic surgeons with an additional board certification in sports medicine. 32, no. Dr. Cummins has been involved at the leadership level at Good Shepherd Hospital having previously served as the orthopaedic section chairman and the surgery department chairman. Intramedullary screw fixation. Nonetheless, all of these methods appear effective in restoring and maintaining stability. Much of her cargo was offloaded before she was successfully refloated. . A technical note, Journal of Bone and Joint Surgery A, vol. , (usefulness) . Talar tilt angle on varus stress radiograph showed 57% of sensitivity, 97% of specificity, 89% of positive and 86% of negative prediction value. 20, 30, 40 , 10 60(120) . Finally, numerous outcome studies are discussed in the evaluation of the efficacy of these relevant surgical procedures. 279289, 2006. 18491855, 2004. 88% In the setting of chronic anterior instability it has been suggested that increasing the amount of retroversion by 1015 degrees may increase stability. Cummins CA, Sasso L, Anderson D: Impingement Syndrome: Temporal Outcomes of Non-Operative Treatment. At fifteen-year prospective follow-up, 3.4% of patients had one or more recurrences of instability. Autogenous bone grafting procedures of the glenoid, mainly with iliac crest, are gaining increasing popularity secondary to suggestions that they may offer a more anatomical reconstruction of the glenoid and thus restoration of the natural articular arc [52]. Risks and benefits of each procedure must be thoroughly explained to the operative candidate, with special attention paid to the increased risk that revision surgery holds due to potentially altered anatomy and scar tissue. 8, 2009. 19(3): 239-248, 2003. Am J Sports Med. A. Martinez, A. Calvo, J. Domingo, J. Cuenca, A. Herrera, and M. Malillos, Allograft reconstruction of segmental defects of the humeral head associated with posterior dislocations of the shoulder, Injury, vol. , , . This procedure was nonanatomic and largely relied on the glenohumeral restraint offered by the sling effect of the coracobrachialis with the arm in abduction and external rotation. The convenient all-in-one system includes 2 BioComposite SutureTak anchors, all the necessary drill guides, the Micro SutureLasso retrievers to help facilitate percutaneous shuttling of the #1 FiberWire Of the 28 operations performed, there were 26 excellent results, one good result, and one fair result. 9, pp. 446452, 2009. 169174, 2004. I. K. Y. This is achieved with a standard deltopectoral approach to identify the lesion and using an oscillating saw to convert the impacted defect into a wedge of exposed metaphyseal cancellous bone. Foot Ankle Int. 2022 Jul 19;33:87-94. doi: 10.1016/j.jor.2022.07.006. A. (peroneal tendon sheath) . 9, pp. The Latarjet procedure, on the other hand, requires removal of a much larger portion of the coracoid (2-3cm) with transfer along its long axis to the anteroinferior glenoid neck [48] (Figures 7 and 8). M. D. Lazarus, J. The ATFL and the CFL insertions were elevated off the distal fibula. Following preparation of the glenoid neck and labrum for Bankart repair, visualization of the bony defect is done through the anterosuperior portal. M. J. Dipaola, L. M. Jazrawi, A. S. Rokito et al., Management of humeral and glenoid bone loss associated with glenohumeral instability: results with anatomical bone grafting, Bulletin of the NYU Hospital for Joint Diseases, vol. The lack of musculature and the redundant capsule in the inferior aspect of the glenohumeral joint are the main contributors to the anterior/inferior instability of the shoulder joint. Cortical screws can be inserted perpendicularly to support the correction. A standard deltopectoral approach is used and the subscapularis tendon is identified at its insertion on the lesser tuberosity. 243, pp. ( ), (mobilization). J Bone Joint Surg Am Karlsson 70 581 1988 10.2106/00004623-198870040-00015 ; 6. v.22 no.3 Although there are not sufficient outcome data to conclude which of these two techniques is superior, the former provides a soft tissue interposition between the humeral head articular surface and the bony graft, while the latter allows the humeral articular surface to sit on exposed nonarticular bone graft which may increase the risk of arthrosis. Hawkins and colleagues [37] later published on the addition of a lesser tuberosity transfer to increase the stability of the repair in larger defects (40% articular surface) [33, 36]. 5, pp. Webmodified Brostrom-Gould procedure is the preferred anatomical surgical procedure for the treatment of lateral ankle instability. Purpose: This study was performed to evaluate the diagnostic usefulness of ankle stress radiograph for evaluation of chronic lateral ankle instability. Beran et al. In regard to the arthroscopic remplissage procedure, Purchase et al. Criteria 3, pp. All athletes in the series returned to previous levels of function, including 14 professionals. Stability should be tested intraoperatively to ensure correction of the instability prior to completing the operation. A. Romeo, W. N. Levine, B. R. Bach, and M. T. Provencher, Glenoid bone deficiency in recurrent anterior shoulder instability: diagnosis and management, Journal of the American Academy of Orthopaedic Surgeons, vol. Clinical outcomes studies reporting general results of these techniques are highlighted. 22, no. Furthermore, with evidence supporting better outcomes of primary total shoulder arthroplasty over isolated hemiarthroplasty for glenohumeral osteoarthritis [45, 46], a thorough evaluation of glenoid sided pathology including articular cartilage degeneration and bone loss is imperative. The procedure: Eliminates chronic pain and swelling; . View Dr. Cummins's Patient Resources and Rehab Protocols, Certificate of Added Qualification, Sports Medicine, American Orthopaedic Society of Sports Medicine. M. Khazzam, S. M. Kane, and M. J. Smith, Open shoulder stabilization procedure using bone block technique for treatment of chronic glenohumeral instability associated with bony glenoid deficiency, The American Journal of Orthopedics, vol. S. B. Lippitt, J. E. Vanderhooft, S. L. Harris, J. doi: 10.1177/1071100717726303. Telos , 9,12). 2~14 mm). Foot Ankle Int. J Orthop Surg (Hong Kong), 2007,15:306-10. 1, pp. The RI contains the coracohumeral ligament, the superior glenohumeral ligament, and the joint capsule. Before commencing with the operative procedure, a detailed physical exam must be performed making sure to document the exact degree of range of motion that causes dislocation, specifically external rotation. HW]o6}M,?@fm. 197202, 2012. ( ), [] 245 77, no. Repair of concomitant lateral ankle ligament instability and peroneus brevis splits through a posteriorly modified Brostrom Gould. ( ) Scheibel et al. Six industrial fuel aboard grounded one-half mile offshore from the Brigantine Wildlife Refuge. 2735, 1993. 7.6mm , 29, 13 , 3, 117 (Table 3). All the professional dancers obtained excellent results. WebThe Arthrex Brostrom Repair System allows surgeons to perform a modified Brostrm-Gould procedure through a single, 1.5 cm incision. . 17921797, 2009. 249254, 2009. 2, pp. 2638, 1948. 7, pp. WebModified Embedded-Atom Interatomic Potential Parameters of the Ti-Cr Binary and Ti-Cr-N Ternary Systems, SB Ding and Y Li and YY Luo and ZM Wu and XQ Wang, C Ma and N Skoglund and M Carlborg and M Brostrom, FUEL, 302, 121072 (2021). Bermuda, May 1999. J. C. Adams, Recurrent dislocation of the shoulder., The Journal of Bone and Joint Surgery, vol. Cummins CA, Appleyard RC, Strickland S, Haen P, Chen S, Murrell, G: Rotator Cuff Repair: An Ex Vivo Analysis of Suture Anchor Repair Techniques on Initial Load to Failure. Please enable it to take advantage of the complete set of features! Before A. Romeo et al., Normalization of glenohumeral articular contact pressures after Latarjet or iliac crest bone-grafting, Journal of Bone and Joint Surgery A, vol. 6, pp. Factors to assess with regard to the specific shoulder pathology include the chronicity of instability, the functional limitation resulting from the instability, quantification and qualification of glenoid and humeral-sided bone loss, and an evaluation of the articular cartilage in the glenohumeral joint. 1). All-arthroscopic reconstruction of the anterior talofibular ligament is comparable to open reconstruction: a systematic review. WebOur CO 2 emissions are on a constant rise, reaching a monthly average of 419 ppm in 2021, a record high in the last 2 million years. 814820, 2014. Modified Brostrom procedure. 94102, 1996. , (peroneal strength exercise), (Achilles stretching exercise), (proprioception) 34 (Fig. Little has been published in the literature with regard to indications and outcomes of this technique, but it has been suggested that disimpaction grafting is the best indicated for defects that are less than 3 to 4 weeks old and involve <40% of the articular surface. 95% , 8.3 , 7.6 mm (Table 1). Initially described by Weber, the procedure combines a standard deltopectoral and separate posterior approach. Dr. Cummins seeks to develop a dialogue with his patients to help them fully understand the diagnostic process, their own unique problem, their treatment choices, and the recovery process. Of patients who underwent the modified Brostrom procedure under the diagnosis of chronic lateral ankle instability, 40 patients (40 ankles) who could be followed during a minimum period of 2 years were enrolled in the current study. A. CORR Insights: Do Mid-term Outcomes of Lateral Ankle Stabilization Procedures Differ Between Military and Civilian Populations. Most will have recurrent instability and multiple atraumatic subluxation/dislocation events warranting further investigation into osseous deficiency in the unstable shoulder. ? A total of 50 patients were followed up for more than 2 years after undergoing the modified Brostr This is from the OP report: Right ankle lateral ligament reconstruction, modified Brostrom type. Treatment decisions can be made based on these measurements. In addition, the role of the long head of biceps tendon as a depressor of the humeral head is confirmed by the presence of superior migration of the humeral head following rupture of the tendon [11, 12]. 1992 May;13(4):224-5. doi: 10.1177/107110079201300411. The majority of the stability of the glenohumeral joint is achieved by the surrounding musculature and the extracapsular ligaments. Based on the limited strength of the representing studies, one technique could not be recommended over another. The stability of the glenohumeral joint varies throughout the arc of motion and the contact between the articular surfaces reaches a maximum of 30% at a given range. 7. The interval between the subscapularis and supraspinatus muscles is known at the rotator interval (RI). The Modified Shuttle Walking Test (MSWT) was modified from the 20-MST to provide a standardized progressive test for obtaining a symptom-limited maximum performance in individuals with chronic airway obstruction (CAO). 23, no. 27401 W. Highway 22 Messer TM, Cummins CA, Ahn J, Kelikian AS. 22872291, 2012. While nonoperative treatment options are available, surgical treatment is often the gold-standard of the therapeutic options for both glenoid and humeral head bone loss when significant bony defects exist [3]. 2017; 38 :12071214. In the setting of chronic anterior instability, transfer of the infraspinatus tendon with or without the greater tuberosity has been used to successfully fill defects smaller than 40% of the articular surface. (120) , 1.96 95% . , 2011, pp.35 - 40 31, no. See below weight-bearing and impact restrictions to be considered. The average loss of external rotation was less than 5 degrees without noticeable diminution of power or function in most patients. 10) , 3) . He has served as an instructor for the Arthroscopy Association of North America, and has also consulted for various orthopedic companies, teaching basic and cutting-edge arthroscopic techniques to orthopedic surgeons across the country. and transmitted securely. Once range of motion is documented, a standard deltopectoral approach is utilized to expose the proximal humerus and an oscillating saw is then used to complete a transverse osteotomy through the surgical neck. Primary Repair, Reconstruction, and Suture Tape Augmentation All Provide Excellent Outcomes for Lateral Ligament Instability: A Systematic Review. Weboften a planned secondary procedure, required to allow the TMT joints to return to motion ~20% of patients following arthrodesis. In symptomatic recurrent glenohumeral instability, advanced imaging techniques are strongly recommended before proceeding to surgery in order to quantify glenohumeral bone loss, including defect size and location [2]. 317328, 2009. The sural nerve should not be in any danger with proper placement of the incision. . 381388, 1998. The subscapularis cotensions the inferior glenohumeral ligament complex (IGHLC) [9] which restricts the shoulder joint from reaching the endpoint of ligament function. 1519, 2003. 44, no. Any residual instability or glenoid articular wear needs to be addressed through either glenoid-sided bone grafting, total shoulder arthroplasty, or soft tissue imbrication [33]. A. Auffarth, J. Schauer, N. Matis, B. Kofler, W. Hitzl, and H. Resch, The J-bone graft for anatomical glenoid reconstruction in recurrent posttraumatic anterior shoulder dislocation, American Journal of Sports Medicine, vol. (anterior talofibular ligament) . The recovery is extensive and first starts with crutches followed by walking boot. On the other hand, disadvantages include potentially inadequate fixation of the implant to the humeral head, a mismatch between the implant and defect geometry that may require further reaming and resurfacing of unaffected humeral cartilage, and an inability to accurately align the surface of the prosthesis with the adjacent articular surface [25, 44]. When a lesser tuberosity transfer is indicated, an osteotomy is made at its base just medial to the bicipital groove and the tuberosity is transferred into the defect and secured in place using 2 cancellous screws with the subscapularis tendon sutured overtop to the medial edge of the articular surface. Arthroscopic techniques can be used when bone loss is less than 15%, but attempts should be made to incorporate any bony fragments into the repair. Intraoperative photographs demonstrating the Latarjet procedure through subscapularis split. 128, no. 80, no. 68, no. Rupture of these Modified Brostrm procedure . M. D. Kazel, J. K. Sekiya, J. 3, pp. The posterior deltoid is identified and split to reveal the infraspinatus tendon which is dissected off its attachment on the greater tuberosity. Other radiographic views that may be helpful include an anteroposterior radiograph with the arm in internal rotation [19], an apical oblique view with the beam angled towards the glenoid face as described by Garth and colleagues [20], and a Stryker notch view obtained with the patients arm on top of the head and the beam centered over the coracoid process directed 10 degrees cephalad. Arthrodesis of the medial tarsometatarsal joints. 16, no. , , 46 . Cummins CA, Murrell G: Mode of Failure forRotator Cuff Repair: Intra-Operative Findings at Revision Surgery. H. Rahme, L. Wikblad, J. Nowak, and S. Larsson, Long-term clinical and radiologic results after Eden-Hybbinette operation for anterior instability of the shoulder, Journal of Shoulder and Elbow Surgery, vol. In regard to arthropathy diagnosed using an AP projection of the shoulder, 34.2% of patients had mild arthropathy, 4.4% had moderate arthropathy, and 1.8% of patients had severe arthropathy. [72] also reported on the results of osteoarticular allograft for the management of humeral head defects following recurrent shoulder instability. Consequently, decarbonizing the global economy via the 2% (60/3871) 4. S.-H. Kim, J.-C. Park, J.-S. Park, and I. Oh, Painful jerk test: a predictor of success in nonoperative treatment of posteroinferior instability of the shoulder, The American Journal of Sports Medicine, vol. The peroneal tendon sheath was opened to inspect the tendons and protect them, and Other studies with long-term follow-up (1420 years) have demonstrated moderate to severe arthropathy rates following a coracoid transfer ranging from 19% to 28.6% [48, 62]. 78, no. 1, no. government site. A systematic review of largely heterogeneous studies on arthroscopic remplissage for shoulder instability reported apparent success of the procedure from 8 articles with a total of 207 patients, reporting a mean redislocation rate of % (range, 015%) and a mean recurrent instability rate of % (range, 015%) [70]. 791794, 2002. We analyzed the sensitivity, specificity, positive and negative prediction value of ankle stress radiograph. Foot Ankle Int. O. J. Gagey and N. Gagey, The hyperabduction test, Journal of Bone and Joint Surgery B, vol. 18, no. J. R. Lynch, J. M. Clinton, C. B. Dewing, W. J. Warme, and F. A. Matsen III, Treatment of osseous defects associated with anterior shoulder instability, Journal of Shoulder and Elbow Surgery, vol. For slightly larger defects measuring 2540% of the articular surface, the greater tuberosity can be osteotomized and secured into the defect with two fully threaded cancellous screws after appropriate debridement of bony surfaces [33, 34]. 95% , 8.3 , 7.6 mm (Table 1). 7.6mm , 29, 13 , 3, 117 (Table 3). 11, pp. Armitage et al. 13271334, 2009. However, it was our perception that this local tissue repair may fail eventually, particularly in patients that are overweight, hyperflexible, or are involved in strenuous work or athletic activity. 1242.e11242.e5, 2007. 584590, 1952. J Shoulder Elbow Surg, 18: 172-177, 2009. CT scan which demonstrates a large Hill-Sachs lesion. Purchase, E. M. Wolf, E. R. Hobgood, M. E. Pollock, and C. C. Smalley, Hill-Sachs remplissage: an arthroscopic solution for the engaging Hill-Sachs lesion, Arthroscopy, vol. 897908, 1980. Recurrent glenohumeral instability is a difficult orthopaedic problem that requires specific history and physical examination to delineate whether bony deficiency may be the root of the problem. , . The procedure involves the creation of a cortical window in the mid greater tuberosity just lateral to the bicipital groove and proximal to the location of the axillary nerve. The management of chronic lateral ankle instability is traditionally conservative treatment in the acute phase. 3% (77/2622) 4. All six of these studies were level IV evidence (case series) with 5 being retrospective [53, 5760] and one being prospective [55]. While previously described in the literature for glenohumeral osteoarthritis, avascular necrosis, and rheumatoid arthritis [42], several authors [43, 44] have since published on the use of these implants in the setting of chronic instability. Patient factors to consider include the presence of any significant medical comorbidities or neurological lesions, an assessment of overall functional demands, and the degree of expected patient compliance. Multiplanar reformatting and three-dimensional reconstructions with digital subtraction techniques allow for a thorough assessment of location and size of bone loss on both the glenoid and humeral sides. Twenty-eight ankles in twenty-seven patients (average age 28) underwent the Gould modification of the Brostrom repair for symptomatic lateral ankle instability. Cummins CA, Schneider DS: Peripheral Nerve Injuries in Baseball Players. 392414, 2014. 107109, 1969. A. C. Atalar, K. Bilsel, I. Eren, D. Celik, H. Cil, and M. Demirhan, Modified Latarjet procedure for patients with glenoid bone defect accompanied with anterior shoulder instability, Acta Orthopaedica et Traumatologica Turcica, vol. Cummins CA, Murrell GAC: Mode of Failure for Rotator Cuff Repair with Suture Anchors Identified at Revision Surgery. The authors thus advised reconstruction of glenohumeral defects of this size. , (Fig. J. J. P. Warner, T. J. Gill, J. D. O'Hollerhan, N. Pathare, and P. J. Millett, Anatomical glenoid reconstruction for recurrent anterior glenohumeral instability with glenoid deficiency using an autogenous tricortical iliac crest bone graft, The American Journal of Sports Medicine, vol. A. Martinez, E. Navarro, D. Iglesias, J. Domingo, A. Calvo, and I. Carbonel, Long-term follow-up of allograft reconstruction of segmental defects of the humeral head associated with posterior dislocation of the shoulder, Injury, vol. Cummins CA: Lateral Epicondylitis: In Vivo Assessment of Arthroscopic Debridement and Correlation With Patient Outcomes. A best-fit circle is used to approximate normal inferior glenoid surface area and observed bone loss can be calculated from this measurement [10, 23] (Figure 1). M. Kronberg and L. A. Brostrom, Rotation osteotomy of the proximal humerus to stabilise the shoulder: five years' experience, Journal of Bone and Joint Surgery B, vol. Based on this, we cannot advocate for or against this technique at the present time. For patients with significant anteroinferior glenoid bone loss (>25%), various coracoid transfer procedures have been described. Accordingly, decreasing the retroversion by 1015 degrees in the setting of posterior instability may further stabilize the glenohumeral joint [33, 37]. The tendon of the long head of biceps is intra-articular and contributes to superior/inferior and anterior/posterior stability of the shoulder joint. Some techniques advocate placing the bone block after repair of the labrum and capsule (extracapsular), while others suggest placing the bone block within the capsule and subsequently repairing the remaining labrum and capsule to the extent that tissue quality allows. 35, no. 3 , 24, 18 , 3, 117 (Table 2). The modified Brostr6m procedure offers several advan- tages. 1, pp. ; Two particularly important subsets of patients to identify are those patients with a history of seizures or voluntary dislocations in which traditional operative intervention carries a high risk of failure. Chronic pain. Assessment for a sulcus sign (inferior instability) [17] and a posterior jerk test (posterior instability) [18] are also important. (sensitivity), (specificity), (positive prediction value), (negative prediction value) . G. C. Singer, P. M. Kirkland, and R. J. H. Emery, Coracoid transposition for recurrent anterior instability of the shoulder. Suite 125 Kronberg and Brostrom [75] reported their five-year results of 20 derotation osteotomies performed for recurrent instability. ; 19, no. = Journal of Korean orthopaedic sports medicine WebThe modified Brostrom procedure is the most common surgical procedure used for ankle reconstruction, primarily to repair the anterior talofibular ligament. In regard to the effect of glenoid reconstruction on the long-term risk of glenohumeral osteoarthritis, only two of the six studies in the review by Beran et al. PDF KISTI DDS . Foot Ankle Int. This site needs JavaScript to work properly. We would love to hear from you! The Latarjet coracoid transfer can also serve as reinforcement to anteroinferior capsular deficiency. A thorough preoperative workup consisting of appropriate history, physical exam, and imaging must be completed prior to a discussion of surgical options. I elevated at the fibula up to the periosteum. I made an incision at the tip of the fibula. Podium and Poster Presentation. 57%, 97%, 89%, 86% , 69%, 97%, 91%, 90% . 10) , 3) . American Academy of Orthopaedic Surgery, Annual Meeting, 2004, San Francisco. Bookshelf 69%, 97%, 91%, 90% (Table 4). American Volume, vol. Clipboard, Search History, and several other advanced features are temporarily unavailable. Quantification of the extent of bone loss has been suggested to guide operative treatment (Figure 3). Cummins CA, Anderson K, Nuber G, Bowen M, Roth SI: Anatomy of the Spinoglenoid Ligament. It should be noted that there was no observed increase in motion loss in patients undergoing a Latarjet reconstruction as opposed to the more anatomic bone grafting reconstruction in the included studies [56]. 57%, 97%, 89%, 86% . Podium and Poster Presentation. 10, pp. #Modified $Brostr{\ddot{o}}m$ procedure. 207213, 2003. FOIA 19, no. J. J. P. Warner, M. K. Bowen, X. Deng, J. Modified-Brostrom procedure. 0% (12/4150) 4. Only 1 player redislocated, and 93% of patients were happy or very happy with the results. 150 N(newton) , 10 20 . The long-term follow-up of allograft reconstruction of humeral head segmental defects from posterior shoulder dislocation was evaluated by Martinez et al. official website and that any information you provide is encrypted AOSSM Annual Meeting, Keystone, Colorado, June 28-July 1, 2001; Poster Presentation. (anterior talofibular ligament) . M. C. Beran, C. T. Donaldson, and J. Y. Bishop, Treatment of chronic glenoid defects in the setting of recurrent anterior shoulder instability: a systematic review, Journal of Shoulder and Elbow Surgery, vol. 2012 CGC Healy, 41, no. It comes with a talus Federal government websites often end in .gov or .mil. ( ), ( ) (Fig. . (multiple single leg calf raises) .13), PDF KISTI DDS . , (ankle neutral position), (slightly eversion position) . 122125, 1989. American Academy of Orthopaedic Surgery, Annual Meeting, Orlando, Florida, March 16, 2000; Podium Presentation. 1, pp. = Journal of Korean Foot and Ankle Society The humeral shaft is rotated externally to 510 degrees more than the position of instability measured on physical exam and the osteotomy is then secured using a rigid fixation implant such as a blade plate. Allograft reconstruction with a tendon graft from the fibula to the 5th metatarsal base. 8, no. Goals of treatment in this situation rely on addressing both the soft tissue and bony pathology that are causative of the recurrent instability. 4, pp. ( ) The tendon of the long head of the biceps brachii along with the supraspinatus contributes to the prevention of superior translation of the humerus from the glenoid cavity of the scapula. 7, pp. C. Gerber and S. M. Lambert, Allograft reconstruction of segmental defects of the humeral head for the treatment of chronic locked posterior dislocation of the shoulder, Journal of Bone and Joint Surgery A, vol. 7, pp. Once the size of the defect is evaluated, its surface is prepared using a burr set on reverse. 66, no. , , Ahovuo 1) . It is limited however by interpreter skill and difficulty in discerning size and orientation of the lesion. Various imaging modalities are paramount to allow for quantification of bone loss and surgical planning, and numerous techniques exist for reconstruction of both humeral and glenoid sided defects. [] 66 , [tarsal coalition], [neuromuscular disease], [neurologic disease], [functional instability]), , , , (direct suturing technique), (splint) , 12 . Furthermore, by utilizing rigid anatomic fixation, early rehabilitation is permitted minimizing the risk of stiffness and deconditioning of the surrounding shoulder musculature [25, 27]. 85, no. P. Grondin and J. Leith, Combined large Hill-Sachs and bony Bankart lesions treated by Latarjet and partial humeral head resurfacing: a report of 2 cases, Canadian Journal of Surgery, vol. 4 mm) . 5, no. Mid-America Orthopaedic Association, Seventeenth Annual Meeting, Bermuda, May 1999; Podium Presentation. , . 2). procedure. 1, pp. Operative treatments that can be used to treat both glenoid and humeral head bone loss are outlined. There is a paucity of literature with long-term follow-up related to the surgical reconstruction of humeral head defects in patients with recurrent shoulder instability. (validity) , . Operative management of recurrent shoulder instability in the setting of bone loss exists as the treatment of choice to minimize risk of future dislocation and best restore function. . The mean Rowe across these four studies was 90.5 (excellent). P. A. Davidson, L. J. Lemak, and J. W. Uribe, Anatomic humeral head resurfacing. 150 N Telos , . A. L. Chen, S. A. H. Saito, E. Itoi, H. Minagawa, N. Yamamoto, Y. Tuoheti, and N. Seki, Location of the Hill-Sachs lesion in shoulders with recurrent anterior dislocation, Archives of Orthopaedic and Trauma Surgery, vol. Brostrom(Modified Brostrom) (Protraction) (Effective is an Epidural for Back Pain) (Hypomania) (Rib Removal) (Ashman Phenomenon) (Tendon Graft) They reported no cases of recurrent instability, infection, nonunion, or neurological sequelae. . First described by Weber in 1969 [34], this procedure attempts to prevent an engaging Hill-Sachs lesion from contacting the glenoid and contributing to recurrent instability by allowing external rotation to be maintained through the osteotomy site. M. Scheibel, C. Nikulka, A. Dick, R. J. Schroeder, A. Gerber Popp, and N. P. Haas, Autogenous bone grafting for chronic anteroinferior glenoid defects via a complete subscapularis tenotomy approach, Archives of Orthopaedic and Trauma Surgery, vol. 8, pp. It is important to note that pain may the chief presenting complaint, as the patient may not be aware that their symptoms may be secondary to recurrent subluxation of the shoulder [14]. Mean VAS scores decreased significantly, from to . 5, no. 13171325, 2008. , (lateral branch of superficial peroneal nerve) (sural nerve) . 60(120) . A 20-year follow-up study, Journal of Bone and Joint Surgery B, vol. 638647, 2008. All patients had failed instability repairs and had humeral head defects greater than 25% of the articular surface. 83, no. Another emerging modality to image for Hill-Sachs lesions is ultrasound [28], which is readily available and avoids excessive radiation. , , Ahovuo 1) . Follow-up averaged 64.3 months (range 30-132 months). 23, no. WebBackgroundThis study assessed the average time to return to training and official game participation after modified Brostrm operation (MBO) in elite athletes.MethodsSixty athletes diagnosed with lateral ankle instability underwent MBO from October 2011 to December 2013. http://www.arthrosurface.com/literature-data/brochures/. Brostrom ( ) 42(38) . The purpose of this procedure is to stabilize the ankle, improve the ankle's mechanics and restore full function. Foot Ankle Int, 1999,20:246-52. Results: On ankle stress radiograph, normal range of talar tilt angle and anterior talar translation was below $8.3^{\circ}$, below 7.6mm. 212, 2010. R. J. Hawkins, C. S. Neer II, R. M. Pianta, and F. X. Mendoza, Locked posterior dislocation of the shoulder, Journal of Bone and Joint Surgery A, vol. Orthopedic Surgeon with Fellowship Training in Shoulder Surgery and Sports Medicine, 2022 Illinois Bone & Joint Institute. WebPurpose. 9, pp. Cummins CA, Messer TM, Schafer M: Infraspinatus Muscle Atrophy in Major League Baseball Player. 653684, 2013. Partial resurfacing of large humeral head impression fractures with a cobalt-chrome articular component is an emerging technique in younger patients which may decrease the risks seen with other osseous procedures. 17, no. [] 66 , : helpdesk@kisti.re.kr : 080-969-4114, . PMC 3, pp. R. Lugo, P. Kung, and C. B. Ma, Shoulder biomechanics, European Journal of Radiology, vol. Arthroscopic techniques may be used for osseous defects that measure less than 25% of the glenoid. Active and passive shoulder range of motion and strength of the rotator cuff muscles should be assessed. WebBrostrom repair with the InternalBrace procedure provides additional fixation of the repaired ligament backdown to bone during the healing process, allowing early mobility during recovery and a quicker return to activity.1 The InternalBrace 2.0 surgical technique provides surgical versatility with added size and material options. 47, no. 396402, 2007. P. W. Weng, H. C. Shen, H. H. Lee, S. S. Wu, and C. H. Lee, Open reconstruction of large bony glenoid erosion with allogeneic bone graft for recurrent anterior shoulder dislocation, The American Journal of Sports Medicine, vol. ( ) . 2, pp. 10.1177/0363546518820529. 95% 8.3 , 7.6 mm . 16771684, 1996. Attempts should be made to avoid deconditioning of the shoulder musculature at all costs. Acta Chir Scand Brostrom 132 551 1966 ; 4. The rotator cuff muscles provide support to the posterior, superior, and anterior aspect of the glenohumeral joint. Arthroscopic tibiotalar arthrodesis. International Symposium on Limb Salvage. The graft is prepared to fit the glenoid defect with a saw and provisionally secured into the defect with k-wires. 170175, 2004. Arthroscopy. WebMurine respirovirus, formerly Sendai virus (SeV) and previously also known as murine parainfluenza virus type 1 or hemagglutinating virus of Japan (HVJ), is an enveloped,150-200 nm in diameter, a negative sense, single-stranded RNA virus of the family Paramyxoviridae. . Although the majority of evidence comes from the use of oxygen in patients with chronic obstructive pulmonary disease, the scope of the guidance includes patients with a variety of long Lafosse et al. A. Hannafin, S. P. Arnoczky, and R. F. Warren, Articular contact patterns of the normal glenohumeral joint, Journal of Shoulder and Elbow Surgery, vol. Neurovascular status of the limb should be documented with special attention paid to axillary nerve function, while inspection should focus on any signs of deformity and muscle atrophy/wasting. Arthroscopy. The remaining two studies reported overall Constant scores of 94 [59] and 94.4 [58]. A thorough assessment of the glenoid and final testing of stability needs to be performed prior to completing the operation. [25] have conducted a succinct review of the outcomes to date following the current spectrum of procedures which includes humeroplasty, remplissage, osteoarticular allograft, rotational osteotomies, and partial resurfacing. Both Strauss [21] and Danzig and colleagues [22] commented that the Stryker notch view is the most effective in demonstrating this lesion. Bethesda, MD 20894, Web Policies Arthroscopic view of the shoulder demonstrating the remplissage procedure. A. J. Bois, R. E. Walker, P. Kodali, and A. Miniaci, Imaging instability in the athlete: the right modality for the right diagnosis, Clinics in Sports Medicine, vol. In addition, between different bone block reconstruction techniques, there is no clear delineation of outcomes between allograft and iliac crest bone graft. . ( ) 14731478, 2005. The coracoid graft demonstrated osseous union in all patients at a mean months (range, 1274) with no further instability or degenerative arthritis. . P . 11, pp. [35] reported a recurrence rate of 7% and no loss of shoulder motion following this procedure. 798.e1798.e4, 2006. WebThe present prospective, randomized study was conducted to compare the clinical outcomes of the modified Brostrom procedure using single and double suture anchors for chronic lateral ankle instability. Cummins CA, Strickland S, Appleyard RC, Szomor ZL, Grant C, Murrell GAC: Rotator Cuff Repair: An Ex Vivo Mechanical Study Comparing Trans-Osseous Sutures, Suture Anchors and Bio-Absorbable Screws. WebMesser TM, Cummins CA, Ahn J, Kelikian AS: Outcome of the Modified Brostrom Procedure for Chronic Lateral Ankle Instability Using Suture Anchors. Egge T. Reconstruction of the lateral ligamentous structures of the ankle with a modified Watson-Jones procedure. [64] retrospectively reviewed 28 shoulders in 26 soccer players affected by chronic anterior instability. e7e13, 2013. 255262, 1996. Telos (SE 2000, Telos GmbH, Marburg, Germany) , 2 3 . 150 N(newton) , 10 20 . [61] have looked at the onset of glenohumeral arthropathy 15 years following 118 cases of coracoid transfer for recurrent shoulder instability. Crystal Lake, IL 60014. Drs. 34, no. 3-4%. , . Am J Sports Med. 328332, 1980. ? Epub 2015 Sep 4. 2022 Jan 11;7(1):3-12. doi: 10.1530/EOR-21-0075. , , (direct repair) , (supination) . 6974, 2001. Am J Sports Med, 27: 810-812, 1999. After an appropriate preoperative workup that includes a CT scan to delineate humeral head bony architecture and the characteristics of the lesion, a sized matched fresh-frozen humeral or femoral head is obtained and used to graft into the identified defect. A. J. HELFET, Coracoid transplantation for recurring dislocation of the shoulder, The Journal of Bone and Joint Surgery B, vol. These values are clinically relevant, however, when weighing the option of surgical intervention. (sensitivity), (specificity), (positive prediction value), (negative prediction value) . 417425, 2010. The authors declare that there is no relevant conflict of interests regarding the publication of this paper. An experimental study, The American Journal of Sports Medicine, vol. Hunt, and J. D. Zuckerman, Humeral head impression fractures and head-splitting fractures, in Shoulder Fractures: The Practical Guide to Management, J. D. Zuckerman and K. J. Koval, Eds., pp. University of Florida, Gainesville, Florida, Northwestern University Feinberg School of Medicine, Chicago Illinois - Orthopaedic Surgery, University of New South Wales, Kogarah/Sydney, Australia - Shoulder Surgery and Sports Medicine. (anterior talofibular ligament) . H. Sugaya, J. Moriishi, M. Dohi, Y. Kon, and A. Tsuchiya, Glenoid rim morphology in recurrent anterior glenohumeral instability, Journal of Bone and Joint Surgery A, vol. 400, pp. Nonoperative treatment of shoulder instability in the setting of glenoid or humeral bone loss is generally reserved for patients with significant medical comorbidities in which surgery carries unacceptably high risk, those who have low functional demands, and those who demonstrate poor compliance to postoperative rehabilitation protocols. Copyright 2014 Randy Mascarenhas et al. . 15, no. 33, no. Excellent outcomes were obtained on Rowe scores, Constant scores, and Western Ontario Shoulder Instability Index at final follow-up. The University of Pennsylvania Orthopaedic Journal. 878884, 2003. M. B. Strauss, The shoulder- roentgenographical evaluation of recurrent anterior instability, in Fractures, C. A. Rockwood Jr. and D. P. Green, Eds., p. 646, JB Lippincott, Philadelphia, Pa, USA, 1975. 366368. 6, pp. The tendon is mobilized and sutured into the defect over the lateral humeral cortex. Mid- America Orthopaedic Association, Seventeenth Annual Meeting. 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