摘要:

The purpose of this study was to assess patient outcome after a selective capsular repair approach for treatment of both anterior and multidirectional instability. Seventy patients with diagnoses of shoulder instability, 38 anterior and 32 multidirectional, were retrospectively evaluated at an average of 3.1 years (range, 2–6 years). All 70 underwent repair through an anterior approach. The mean age of the 45 male and 25 female patients was 26.3 years (range, 15–79 years) at the time of surgery. Half of the 70 patients had diagnoses of atraumatic/microtraumatic recurrent instability. A rotator interval defect was noted and closed in 44% of the patients. All patients were noted to have capsular redundancy at the time of surgery. Results of this study demonstrate improved patient function and return to sport compared with previously reported studies of treatment of shoulder instability. After surgery, three patients had recurrent instability. No patient had a restriction of motion more than 10° of external rotation compared with the contralateral arm. Ninety-four percent of the patients had increased function of their shoulder in the overhead position. The authors conclude that the care of patients with anterior or multidirectional instability can be achieved by using a selective capsular tightening approach based on each patient's specific pathologic condition. This capsular repair corrects instability of the glenohumeral joint, maintains symmetric range of motion, and allows the patient to return to overhead shoulder activity.

ISSN:1523-9896    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1523-9896    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

SummaryMany different surgical options are available for the treatment of lateral epicondylitis. One of the most simple involves a release that can be performed in the office or an outpatient surgery center. This procedure involves infiltration of local anesthesia at the point of origin of the extensor carpi radialis brevis. A number 11 knife blade is used to release the extensor carpi radialis brevis from the epicondyle. Soft dressings are applied, and the patient is allowed immediate range of motion. Normal activities usually are resumed approximately 3 weeks to 3 months after surgery. In a review of 21 elbow operations in 17 patients who underwent a percutaneous release, 20 of 21 elbows resumed normal function and had an Andrews-Carson rating of approximately 198/200. One patient had failed percutaneous release and required reoperation. For isolated lateral epicondylitis, a percutaneous release performed in the office is an effective treatment for recalcitrant lateral epicondylitis that has failed nonoperative management.

ISSN:1523-9896    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Soft tissue interposition with hemiarthroplasty recently has generated considerable interest as a treatment alternative in the younger patient with advanced arthritis of the glenohumeral joint. Despite early promising results, there have been concerns regarding the durability of currently used interposition materials in the shoulder. The authors hypothesized that resurfacing the glenoid with a lateral meniscal allograft would offer several advantages to the previously described techniques. These advantages include an established history of synovial healing in the knee, improved structural characteristics for durability, and a wedge shape that could compensate for pre-existing glenoid wear. A technique was developed to allow secure fixation of the meniscal allograft to the glenoid in combination with hemiarthroplasty replacement of the humeral head. The authors discuss the indications and contraindications for the procedure and describe the surgical technique.

ISSN:1523-9896    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Glenoid deficiency is a feature of different articular pathologic conditions of the shoulder joint, requiring replacement or revision arthroplasty. Small cavitary or segmental defects can be easily corrected without compromising the autologous bone stock necessary for stable glenoid implantation. However, for larger defects little information is available regarding the optimal reconstruction strategy. Different techniques have been proposed without clear guidelines to direct clinical decision making. This article discusses the importance of careful preoperative evaluation and planning for rational decision making and describes technical aspects of some reconstructive procedures preferred by the authors.

ISSN:1523-9896    

出版商:OVID    

年代:2001

数据来源: OVID