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Arthroscopic Bankart Repair Is a Function Selection Patient Indication
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH Number 390, pp. 31–41 © 2001 Lippincott Williams & Wilkins, Inc. Arthroscopic Bankart Repair Experience With an Absorbable, Transfixing Implant 03/25/2020 on BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3XGJiJSDa6kLdjliRzOOsR+bI3gZWJ99pv/KNUfPjA6Y= by https://journals.lww.com/clinorthop from Downloaded Stephen Fealy, MD; Mark C. Drakos, BA; Downloaded Answorth A. Allen, MD; and Russell F. Warren, MD from https://journals.lww.com/clinorthop by 3 BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo4XMi0hCywCX1AWnYQp/IlQrHD3XGJiJSDa6kLdjliRzOOsR+bI3gZWJ99pv/KNUfPjA6Y= The use of arthroscopic means to address shoul- scribed in 1938. The essential lesion of shoul- der instability has provided a technically advan- der instability, as described by Bankart, is tageous way to approach Bankart lesions while thought by many to represent the most com- posing complex questions regarding the specific mon disorder underlying possible causes for indications for such an intervention. A successful shoulder instability.2,19,31 It represents a de- outcome with arthroscopic Bankart repair is a tachment of the labrum and its osseous inser- function of proper surgical indication and pa- tient selection. Several authors have evaluated tion from the anteroinferior glenoid. Reestab- the causes of failure and reasons for success with lishing the structural integrity of the soft tissue the Suretac device. The development of a bioab- to glenoid interface is the paramount objective sorbable repair device at the authors’ institution of the Bankart repair and has an essential role was precipitated by a desire to address and re- in surgery for shoulder stability. Although the pair Bankart lesions arthroscopically while traditional open Bankart repair remains the avoiding the frequent complications associated gold standard in treatment options, continued with the metal staple and the transglenoid suture development of arthroscopic techniques and technique. -
Coracoid Graft Union: a Quantitative Assessment by Computed Tomography in Primary and Revision Latarjet Procedure
ARTICLE IN PRESS J Shoulder Elbow Surg (2018) ■■, ■■–■■ www.elsevier.com/locate/ymse ORIGINAL ARTICLE Coracoid graft union: a quantitative assessment by computed tomography in primary and revision Latarjet procedure Mohammad Samim, MD, MRCSa, Kirstin M. Small,MDb,*, Laurence D. Higgins, MD, MBAc aDepartment of Radiology, NYU Langone Medical Center, New York, NY, USA bDepartment of Radiology, Brigham and Women’s Hospital, Boston, MA, USA cBoston Shoulder Institute, Boston, MA, USA Background: The goal of the Latarjet procedure is restoration of shoulder stability enabled by accurate graft positioning and union. This study aimed to establish a reproducible method of quantitatively assess- ing coracoid graft osseous union percentage (OUP) using computed tomography (CT) scans and to determine the effect of other factors on the OUP. Materials and methods: Postoperative CT scans of 41 consecutive patients treated with the open Latarjet procedure (37% primary, 63% revision) for anterior glenohumeral instability were analyzed for the OUP, position of the graft, and screw type and angle. Two musculoskeletal radiologists independently exam- ined the images 2 times, and intraobserver and interobserver reliability was calculated using intraclass correlation coefficient (ICC). Results: Mean OUP was 66% (range, 0%-94%) using quantitate methods, with good intraobserver re- liability (ICC = 0.795) and interobserver reliability (ICC = 0.797). Nonunion and significant graft resorption was found in 2 patients. No significant difference was found in the mean OUP in the primary (63%) vs. revision Latarjet procedure (67%). Grafts were flush in 39%, medial in 36%, and lateral in 8%. The medial and neutral graft position was associated with slightly higher OUP (72% and 69%) compared with lateral (65%). -
Open Latarjet: Tried, Tested and True
Review Article Page 1 of 14 Open Latarjet: tried, tested and true Owen Mattern1, Allan Young1, Gilles Walch2 1Sydney Shoulder Research Institute, Sydney, Australia; 2Centre Orthopédique Santy, Lyon, France Contributions: (I) Conception and design: G Walch, A Young; (II) Administrative support: A Young; (III) Provision of study materials or patients: None; (IV) Collection and assembly of data: None; (V) Data analysis and interpretation: None; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Allan Young. Sydney Shoulder Research Institute, Suite 201, 156 Pacific Highway, St Leonards, Sydney, New South Wales 2065, Australia. Email: [email protected]. Abstract: The open Latarjet procedure has proven to be an effective procedure in the treatment of anterior shoulder instability, particularly in patients with glenoid bone loss and/or an engaging Hill-Sachs lesion. The transfer of the coracoid bone block to the anterior glenoid provides stability via the “triple blocking effect”. We describe our indications and surgical technique for the open Latarjet procedure. Keywords: Latarjet; coracoid transfer; anterior shoulder instability Received: 04 June 2017; Accepted: 18 September 2017; Published: 08 November 2017. doi: 10.21037/aoj.2017.10.01 View this article at: http://dx.doi.org/10.21037/aoj.2017.10.01 Introduction Latarjet included a lower recurrence and dislocation rate, whilst loss of external rotation was less with Latarjet of Traumatic anterior shoulder instability is a common injury 11.5° compared to 20.9° with Bankart repair (11). for the contact athlete, with high rates of recurrence in some athletic populations (1-4). Anatomical Bankart repair procedures have been successful, however high recurrence Principles rates have been shown in certain patient groups (5,6). -
Anatomic Anterolateral Ligament Reconstruction of the Knee Leads to Overconstraint at Any Fixation Angle
AJSM PreView, published on July 12, 2016 as doi:10.1177/0363546516652607 Winner of the 2016 Excellence In Research Award Anatomic Anterolateral Ligament Reconstruction of the Knee Leads to Overconstraint at Any Fixation Angle Jason M. Schon,* BS, Gilbert Moatshe,*yz MD, Alex W. Brady,* MSc, Raphael Serra Cruz,*§ MD, Jorge Chahla,* MD, Grant J. Dornan,* MSc, || # Travis Lee Turnbull,* PhD, Lars Engebretsen,y MD, PhD, and Robert F. LaPrade,*{ MD, PhD Investigation performed at the Department of Biomedical Engineering of the Steadman Philippon Research Institute, Vail, Colorado, USA Background: Anterior cruciate ligament (ACL) tears are one of the most common injuries among athletes. However, the ability to fully restore rotational stability with ACL reconstruction (ACLR) remains a challenge, as evidenced by the persistence of rotational instability in up to 25% of patients after surgery. Advocacy for reconstruction of the anterolateral ligament (ALL) is rapidly increasing because some biomechanical studies have reported that the ALL is a significant contributor to internal rotational stability of the knee. Hypothesis/Purpose: The purpose of this study was to assess the effect of ALL reconstruction (ALLR) graft fixation angle on knee joint kinematics in the clinically relevant setting of a concomitant ACLR and to determine the optimal ALLR graft fixation angle. It was hypothesized that all fixation angles would significantly reduce rotational laxity compared with the sectioned ALL state. Study Design: Controlled laboratory study. Methods: Ten nonpaired fresh-frozen human cadaveric knees underwent a full kinematic assessment in each of the following states: (1) intact; (2) anatomic single-bundle (SB) ACLR with intact ALL; (3) anatomic SB ACLR with sectioned ALL; (4) anatomic SB ACLR with 7 anatomic ALLR states using graft fixation angles of 0°, 15°, 30°, 45°, 60°, 75°, and 90°; and (5) sectioned ACL and ALL. -
The Anterolateral Ligament of the Knee: What the Radiologist Needs to Know
26 The Anterolateral Ligament of the Knee: What the Radiologist Needs to Know Pieter Van Dyck, MD, PhD1 ElineDeSmet,MD1 Valérie Lambrecht, MD2 Christiaan H. W. Heusdens, MD3 Francis Van Glabbeek, MD, PhD3 Filip M. Vanhoenacker, MD, PhD1,2,4 Jan L. Gielen, MD, PhD1 Paul M. Parizel, MD, PhD1 1 Department of Radiology, Antwerp University Hospital and Address for correspondence Pieter Van Dyck, MD, PhD, Department University of Antwerp, Edegem, Belgium of Radiology, Antwerp University Hospital and University of Antwerp 2 Department of Radiology, Ghent University Hospital, Ghent, Belgium Wilrijkstaat 10, 2650 Edegem, Belgium 3 Department of Orthopaedics, Antwerp University Hospital and (e-mail: [email protected]). University of Antwerp, Edegem, Belgium 4 Department of Radiology, AZ Sint-Maarten, Duffel, Belgium Semin Musculoskelet Radiol 2016;20:26–32. Abstract The anterolateral ligament (ALL) was recently identified as a distinct component of the anterolateral capsule of the human knee joint with consistent origin and insertion sites. Biomechanical studies revealed that the current association between the pivot shift and Keywords an injured anterior cruciate ligament (ACL) should be loosened and that the rotational ► anterolateral component of the pivot shift is significantly affected by the ALL. This may change the ligament clinical approach toward ACL-injured patients presenting with anterolateral rotatory ► anterior cruciate instability (ALRI), the most common instability pattern after ACL rupture. Radiologists ligament rupture should be aware of the importance of the ALL to ACL injuries. They should not overlook ► anterolateral rotatory pathology of the anterolateral knee structures, including the ALL, when reviewing MR instability images of the ACL-deficient knee. -
Multidirectional Shoulder Instability with Bone Loss and Prior Failed
Technical Note Multidirectional Shoulder Instability With Bone Loss and Prior Failed Latarjet Procedure: Treatment With Fresh Distal Tibial Allograft and Modified T-Plasty Open Capsular Shift Liam A. Peebles, B.A., Zachary S. Aman, B.A., Fletcher R. Preuss, B.S., Brian T. Samuelsen, M.D., M.B.A., Tyler J. Zajac, M.S., A.T.C., O.T.C., Mitchell I. Kennedy, B.S., and Matthew T. Provencher, M.D., C.A.PT., M.C., U.S.N.R. Abstract: Recurrent multidirectional shoulder instability (MDI) is a challenging clinical problem, particularly in the setting of connective tissue diseases, and there is a distinct lack of literature discussing strategies for operative management of this unique patient group. These patients frequently present with significant glenoid bone loss, patulous and abnormal capsulolabral structures, and a history of multiple failed arthroscopic or open instability procedures. Although the precise treatment algorithm requires tailoring to the individual patient, we have shown successful outcomes in correcting recurrent MDI in the setting of underlying connective tissue disorders by means of a modified T-plasty capsular shift and rotator interval closure in conjunction with distal tibial allograft bony augmentation. The purpose of this Technical Note was to describe a technique that combines a fresh distal tibial allograft for glenoid bony augmentation with a modified T-plasty capsular shift and rotator interval closure for the management of recurrent shoulder MDI in patients presenting with Ehlers-Danlos syndrome or other connective tissue disorders after failed Latarjet stabilization. ecurrent multidirectional shoulder instability Conversely, MDI without hyperlaxity is more likely to R(MDI) is a difficult clinical problem and becomes present with anterior and/or posterior capsulolabral even more challenging in the face of connective tissue pathology1,2 in addition to bony lesions. -
The Open Eden-Hybinette Procedure for Recurrent Anterior Shoulder Instability with Glenoid Bone Loss Joseph W
The Open Eden-Hybinette Procedure for Recurrent Anterior Shoulder Instability With Glenoid Bone Loss Joseph W. Galvin, DO,* Zachary R. Zimmer, MD,* Alexander M. Prete, BS,* and Jon J.P. Warner, MD* In the setting of significant glenoid bone loss, soft tissue stabilization procedures for recur- rent anterior shoulder instability have high failure rates. The open or arthroscopic Eden- Hybinette procedure with tricortical iliac crest autograft has been shown to provide good results with low rates of recurrent instability. Indications for this technique include severe glenoid bone loss (>40%), recurrent instability following a Latarjet or distal tibial allograft procedure, or patients with abnormal coracoid morphology. In this technique article, we review the indications, contraindications, surgical technique, postoperative care, out- comes, and complications of the open Eden-Hybinette procedure. Oper Tech Sports Med 27:95-101 © 2019 Elsevier Inc. All rights reserved. KEYWORDS Eden-Hybinette, recurrent anterior instability Introduction through advanced imaging with MRI and 3-dimensional recon- struction computed tomography (CT) scans has likely led to nterior shoulder instability is a common problem in young increased utilization of bone augmentation techniques such as A active individuals with an incidence in the United States the Latarjet procedure, distal tibial allograft (DTA), and distal 1,2 (US) general population of 0.08 per 1000 person-years. Cer- clavicular autograft.13-17 The Latarjet and DTA procedures have tain at-risk populations involved in contact and collision activi- showntobeeffectiveandprovidegoodoutcomeswithlow ties, such as American football players and military athletes, rates of recurrent instability in primary and revision instability have anterior instability at an order of magnitude greater of scenarios,18-20 with the Latarjet showing long-term durability. -
Clinical Guidelines
CLINICAL GUIDELINES Joint Services Guidelines Version 1.0.2019 Clinical guidelines for medical necessity review of comprehensive musculoskeletal management services. © 2019 eviCore healthcare. All rights reserved. Regence: Comprehensive Musculoskeletal Management Guidelines V1.0.2019 Large Joint Services CMM-311: Knee Replacement/Arthroplasty 3 CMM-312: Knee Surgery-Arthroscopic and Open Procedures 14 CMM-313: Hip Replacement/Arthroplasty 35 CMM-314: Hip Surgery-Arthroscopic and Open Procedures 46 CMM-315: Shoulder Surgery-Arthroscopic and Open Procedures 47 CMM-318: Shoulder Arthroplasty/ Replacement/ Resurfacing/ Revision/ Arthrodesis 62 ______________________________________________________________________________________________________ © 2019 eviCore healthcare. All Rights Reserved. Page 2 of 69 400 Buckwalter Place Boulevard, Bluffton, SC 29910 (800) 918-8924 www.eviCore.com Regence: Comprehensive Musculoskeletal Management Guidelines V1.0.2019 CMM-311: Knee Replacement/Arthroplasty CMM-311.1: Definition 4 CMM-311.2: General Guidelines 5 CMM-311.3: Indications and Non-Indications 5 CMM-311.4 Experimental, Investigational, or Unproven 9 CMM-311.5: Procedure (CPT®) Codes 10 CMM-311.6: References 10 ______________________________________________________________________________________________________ © 2019 eviCore healthcare. All Rights Reserved. Page 3 of 69 400 Buckwalter Place Boulevard, Bluffton, SC 29910 (800) 918-8924 www.eviCore.com Regence: Comprehensive Musculoskeletal Management Guidelines V1.0.2019 CMM-311.1: Definition -
Health Technology Assessment Program
Health Technology Assessment Program Selected Technologies 2018 - Revised List of contents 1. Director’s selection letter - Revised 2. Topic selection background information - Revised 3. Literature update searches performed since 2017 topic selection – Addition [This page left intentionally blank.] WA – Health Technology Assessment June 14, 2018 Technologies selected Primary criteria ranking Technology Safety Efficacy Cost 1 Wearable cardiac defibrillators (WCD) Med Med/ High High Policy Context/Reason for Selection: Wearable defibrillators are externally worn devices that can monitor heart function and provide electrical shock (defibrillation) if a life-threatening cardiac arrhythmia is detected. Wearable defibrillators may offer a temporary alternative treatment to more invasive treatments or hospitalization. The topic is proposed based on concerns related to the safety, efficacy and value for wearable defibrillators. Peripheral nerve ablation (PNA) for the treatment of limb 2 pain High High Med/ High Policy context/reason for selection: Ablation, or the severing of nerves transmitting pain signals from joints or other origins, is a potential treatment for discomfort caused by osteoarthritis and other conditions. This procedure can be used for upper and lower limb pain including, pain in the shoulder or knee. Nerve ablation for osteoarthritis and other limb and joint pain appears to be an emerging medical intervention with recent publications evaluating the treatment. Initial topic scoping resulted in the addition of upper limb ablation to the topic. The topic is proposed based on concerns related to the safety, efficacy and value of the intervention for treatment. 3 Renal denervation (RDN) High High Med/ High Policy Context/Reason for Selection: Renal denervation (RDN) is a treatment for chronic high blood pressure (hypertension) that does not respond adequately to drug or other treatment. -
H3 Schedule of Procedures H3 Insurance Schedule of Procedures
H3 Schedule of Procedures H3 Insurance Schedule of Procedures This schedule is based on the CCSD schedule of procedures. H3 Schedule of Procedures Version 2020 All codes listed detail the maximum amount we will pay towards the fee a specialist and anaesthetist will charge for the operation/procedure. H3 Insurance is a trading name of Insure I Limited which is authorised and regulated by the Financial Conduct Authority. Insure I Ltd is registered in Northern Ireland, Registered number NI072940. H3 Insurance Registered address is Channel Wharf, 21 Old Channel Road, Belfast, BT3 9DE. T: 028 9046 9990 www.h3insurance.com H3 Schedule of Procedures Index Guidance Notes .................................................................................................................. 1 Abdomen – excluding urinary / reproductive organs......................................................... 3 Bones, joints & connective tissue / tendon muscle ......................................................... 13 Brain, cranium & other intracranial organs ...................................................................... 29 Breasts .............................................................................................................................. 32 Consultations, simple investigations & general procedures ............................................ 35 Ear, nose & throat… .......................................................................................................... 38 Endoscopic GIT procedures ............................................................................................. -
The Biomechanics of the Latarjet Reconstruction: Is It All About the Sling? Nobuyuki Yamamoto, MD,* and Scott P
The Biomechanics of the Latarjet Reconstruction: Is It All About the Sling? Nobuyuki Yamamoto, MD,* and Scott P. Steinmann, MD† It has been clinically believed that the stabilizing mechanism of the Latarjet procedure is the sling effect. Biomechanical studies have demonstrated that there are 3 stabilizing mecha- nisms of the Latarjet procedure, the main one being the sling effect produced by the sub- scapularis and conjoint tendons. The other 2 mechanisms are the suturing of the capsular flap at the end-range arm position and reconstruction of the glenoid concavity at the mid- range arm position. All 3 stabilizing mechanisms function at both the mid- and end-range arm positions. After the Latarjet procedure, the shoulder even with a large glenoid defect can have stability increased by 14% compared to the normal shoulder. The acceptable clini- cal outcomes of the Latarjet procedure are supported by these 3 stabilizing mechanisms. Oper Tech Sports Med 27:49-54 © 2019 Elsevier Inc. All rights reserved. KEYWORDS biomechanics, Latarjet reconstruction, sling, subscapularis Why Good Clinical Results Can in which the essential lesion, the Bankart lesion is not repaired? To date, “sling effect of the subscapularis muscle” Be Obtained Without the Bankart has been clinically believed as the main stabilizing mechanism Repair? of this procedure. This was speculation among surgeons. Its he Latarjet procedure has gained popularity with recent precise stabilizing mechanism had not been studied. T reports1,2 showing that postoperative arthritis can be avoided by appropriate positioning of the coracoid bone graft. Excellent clinical results even for shoulders with a large Biomechanical Experiments glenoid defect have been reported. -
Epidemiology of Paediatric Shoulder Dislocation: a Nationwide Study in Italy from 2001 to 2014
International Journal of Environmental Research and Public Health Article Epidemiology of Paediatric Shoulder Dislocation: A Nationwide Study in Italy from 2001 to 2014 Umile Giuseppe Longo 1,* , Giuseppe Salvatore 1, Joel Locher 1, Laura Ruzzini 2, Vincenzo Candela 1, Alessandra Berton 1, Giovanna Stelitano 1, Emiliano Schena 3 and Vincenzo Denaro 1 1 Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Rome, Italy; [email protected] (G.S.); [email protected] (J.L.); [email protected] (V.C.); [email protected] (A.B.); [email protected] (G.S.); [email protected] (V.D.) 2 Department of Orthopedics, Children’s Hospital Bambino Gesù, Via Torre di Palidoro, Palidoro, 00165 Rome, Italy; [email protected] 3 Unit of Measurements and Biomedical Instrumentation, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, Italy; [email protected] * Correspondence: [email protected]; Tel.: +39-06-225411613; Fax: +39-06-225411638 Received: 10 March 2020; Accepted: 17 April 2020; Published: 20 April 2020 Abstract: Limited knowledge is accessible concerning the tendencies of hospitalization for skeletally immature patients with episodes of shoulder dislocation. Our research aim was to evaluate annual hospitalizations for shoulder dislocation in paediatric patients in Italy from 2001 to 2014, on the basis of the official data source as hospitalization reports. The second purpose was to investigate geographical diversification in hospitalization for shoulder dislocation in regions of Italy. The last aim was to make statistical predictions of the number of shoulder dislocation hospitalization volumes and rates in skeletally immature patients based on data from 2001 to 2014.