medigraphic.com
ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2005, Number 4

<< Back Next >>

Acta Ortop Mex 2005; 19 (4)

Recurrent glenohumeral instability. Functional results of surgical treatment by means of anatomical capsuloplasty and closure of rotator interval

Andia-Córdova R, Morales-De SR, Salcedo-Oviedo E

Language: Spanish
References: 29
Page: 152-160
PDF size: 160.57 Kb.


ABSTRACT

Objective. To determine functional outcomes of patients with recurrent glenohumeral instability treated by anatomical reconstruction including reparation of capsule, labrum and rotator interval injuries when present and anatomical capsular imbrication with total volume reduction of the capsule in presence of hyperlaxity of the capsule. Design retrospective, descriptive, transversal. Materials and methods. Were evaluated 31 patients treated surgically with the mentioned technique by the Thoracic Extremity Service at “Hospital de Traumatologia y Ortopedia Lomas Verdes” from January 2001 to December 2004. Were included patients of both genders, involving patients older than 15 years of age and younger than 55 years with diagnosis of recurrent glenohumeral dislocation without previous surgical treatment. The clinical files of the patients were examinated in order to document findings before, during and after the surgical procedure. Afterwards patients were assessed and evaluated by two standardized instruments: the American Shoulder and Elbow Surgery (ASES) scale and the European Shoulder and Elbow Society scale evaluating independently: function, strength, stability and mobility. Results. According to the ASES scale results were excellent in 18 cases (58%), good in 8 (26%), regular in 3 (10%) and poor in 2 (6%). According to the Walsh-Duplay scale the results were excellent in 16 (52%), good in 9 (30%), regular in 3 (9%) and poor in 3 (9%). Conclusions. An anatomical reconstruction of the anomalies found during this procedure, which mostly are Bankart, rotator interval injuries and capsular hyperlaxity, restores the shoulder stability, regardless its etiology.


REFERENCES

  1. Bigliani L, Newton PM, Steinmann SP, et al: Glenoid rim lesions associated with recurrent anterior dislocation of the shoulder. Am J Sports Med 1998; 26(1): 41-45.

  2. Harryman D 2nd, Sidles J, Clark JM, et al: Translation of the humeral head on the glenoid with passive glenohumeral motion. J Bone Joint Surg Am 1990; 72(9): 1334-1343.

  3. O’Brien S, Neves M, Arnowsky S, et al: The anatomy and histology of the inferior glenohumeral ligament complex of the shoulder. Am J Sports Med 1990; 18(5): 449-56.

  4. Schwartz R, O¨Brien S, Warren RF: Capsular restraints to the abducted shoulder: A biomechanical study. 1988; 12: 727.

  5. Turkel S, Panio M, Marshall JL, et al: Stabilizing mechanisms preventing anterior dislocation of the glenohumeral joint. J Bone Joint Surg Am 1981; 63(8): 1208-17.

  6. Speer KP: Anatomy and pathomechanics of shoulder instability. Clin Sports Med 1995; 14(4): 751-760.

  7. Brian JC, Scott AR, Stephen J, O´Brien, David Altchek: Anatomy and histology of the rotator interval capsule of the shoulder. Clin Orthop 2001; 390: 129-137.

  8. Harryman DA 2nd, Sidles J, Matsen FT 3rd: The role of the rotator interval capsule in passive motion and stability of the shoulder. J Bone Joint Surg Am 1992; 74(1): 53-66.

  9. Warner JJ, Deng XH, Warren RF: Static capsuloligamentous restraints to superior inferior translation of the glenohumeral joint. Am J Sports Med 1992; 20(6): 675-685.

  10. Zarins B, McMahon MS, Rowe CR: Diagnosis and treatment of traumatic anterior instability of the shoulder. Clin Orthop 1993; (291): 75-84.

  11. Lippitt SB, Steven MD, Frederick Matsen MD: Mechanisms of glenohumeral joint stability. Clin Orthop Relat Res 1993; (291): 20-28.

  12. González Pérez Claudia E: Manual de Normas y Procedimientos. Técnico Médicos. IMSS. HTOLV. Módulo de Extremidad Torácica.

  13. Taylor DC, Arciero RA: Pathologic changes associated with shoulder dislocations. Am J Sports Med 1997; 25(3): 306-311.

  14. Ortiz CJ, Tesis: Evaluación postquirúrgica de la luxación recidivante anterior del hombro tratada con técnica de Magnuson Stack Modificada. HTOLV. IMSS. 1992.

  15. Hawkins RJ, Angelo RL: Glenohumeral osteoarthrosis. A late complication of the Putti-Platt repair. J Bone Joint Surg 1990; 72(8): 1193-1197.

  16. Karadimas J, Rentis, Varovchas G: Repair of recurrent anterior dislocation of the shoulder using transfer of the subscapularis tendon. J Bone Joint Surg Am. 1980; 62(7): 147-149.

  17. Lusardi DA, Wirth MA, Rockwood CA Jr: Loss of external rotation following anterior capsulorrhaphy of the shoulder J Bone Joint Surg Am. 1993; 75(8): 1185-1192.

  18. Altchek DW, Warren RF, et al: T- plasty modification of the Bankart procedure for multidirectional instability of the anterior and inferior types. J Bone Joint Surg Am 1991; 73(1): 105-12.

  19. EIAttrache N, Jobe F: Anterior capsulolabral reconstruction in the treatment of traumatic glenohumeral instability. J Shoulder Elbow Surg 1994; 3: 54.

  20. Jobe FW, Giangarra CE, Kvitne RS, Glousman RE: Anterior capsulolabral reconstruction of the shoulder in athletes in overhand sports. Am J Sports Med 1991; 19(5): 428-34.

  21. Neer CS, Foster CR: Inferior capsular shift for involuntary inferior and multidirectional instability of the shoulder. J Bone Joint Sur 1980; 62(6): 897-908.

  22. Larry O, Warren RF, Stephen J, O´Brien, David W: Altchek, Isolated Closure of Rotator Interval Defects for Shoulder Instability. Am J Sports Med 1995; 23: 5.

  23. Michael J Skybar, Russell F Warren, David W Altchek: “The Upper Extremity in Sports Medicine” in Instability of the Shoulder. Mosby Company Chapter 7 pp, 181-212, 1990.

  24. O’Brien SJ, Pagnani MJ, Panariello RA, Flynn HM, Fealy S: “The Athletes Shoulder” in Anterior Instability of the Shoulder Mosby Company, Mexico, Chapter 18 pp. 177-201. 1997.

  25. King GJ, Richards RR, Zuckerman JD, et al: A standardized method for assessment of elbow function. Research Committee, American Shoulder and Elbow Surgeons. J Shoulder Elbow Surg 1999; 8(4): 351-354.

  26. Walch G: La luxation récidivante antérieure de I‘épaule. Journées de printemps de la SOFCOT, Estoril Mai 1990, Rev Chir Orthop 1991; (suppl 1): 77-148.

  27. Speer KP, Deng X, Borrero S, et al: Biomechanical evaluation of a simulated Bankart lesion. J Bone Joint Surg Am 1994; 76(12): 1819-1826.

  28. Bigliani LU, Pollock RG, Soslowsky LJ, et al: Tensile properties of the inferior glenohumeral ligament. J Orthop Res 1992; 10(2): 187-197.

  29. Cooper RA, Brems JJ: The inferior capsular-shift procedure for multidirectional instability of the shoulder. J Bone Joint Surg Am 1992; 74(10): 1516-1521.




2020     |     www.medigraphic.com