The "purse string" technique for anterior glenohumeral instability: long-term results 7-13-year follow-up.

Purpose: The "Purse-String Technique" (PST) is an arthroscopic horizontal mattress suture technique for recurrent anterior shoulder instability that uses a single double-loaded suture anchor at the 4-o' clock position, achieving a Bankart labral repair and an infero-superior capsular shift. In this study, we describe the long-term results of the PST.

Methods: The study included 69 individuals (70 shoulders), with a mean age of 30 years, who had recurrent post-traumatic anteroinferior instability.

Acute versus delayed reverse total shoulder arthroplasty for proximal humeral fractures: a consecutive cohort study.

Background: The treatment of displaced proximal humeral fractures (PHFs) remains controversial. Open reduction-internal fixation (ORIF) can be challenging, especially in elderly patients with poor bone quality, whereas hemiarthroplasty has had unpredictable outcomes. Conservative treatment may result in severe fracture sequelae with poor outcomes, requiring late reverse total shoulder arthroplasty (RTSA) in many cases.

Minimally invasive fixation with modified palm tree technique for proximal humerus fractures: Outcomes in a series of 132 patients.

Introduction: Various surgical techniques and implants are available for surgical treatment of significantly displaced proximal humerus fractures. We describe a minimally invasive technique using 3 curved wires, inserted in a retrograde fashion into the humeral head. These are aimed to diverge within the humeral head to provide three separate 3-point fixations to achieve good stability.

Accelerated rehabilitation following reverse total shoulder arthroplasty.

Background: Postoperative rehabilitation is considered essential and indeed routine practice following rTSA. However, the optimal approach to postoperative rehabilitation is unknown, based on protocols for anatomic TSA, and published literature is sparse, as is the quantity and quality of research evidence. The aim of this study is to outline the accelerated rehabilitation protocol (with immediate activity and no immobilization at all) following reverse total shoulder arthroplasty (rTSA) and assess its safety and effectiveness compared to the more conservative rehabilitation protocols of immobilization in a sling for 6 weeks and for 3 weeks.

Software simulations of changing offsets and thus soft tissue tension when revising anatomic to reverse total shoulder arthroplasty in convertible platform systems.

Background: Revision shoulder arthroplasty may involve the need to remove a well-fixed humeral stem. To avoid this, convertible platform systems have been introduced. The biomechanics of reverse total shoulder arthroplasty (rTSA) differs from anatomic shoulder arthroplasty (aTSA).

Subacromial impingement syndrome: management challenges.

The painful shoulder is the most common condition seen in specialist shoulder clinics. It is often associated with lack of range of motion and reduced shoulder function. Lack of sleep and difficulties in performing basic daily life activities are common findings.

Do elderly patients gain as much benefit from arthroscopic rotator cuff repair as their younger peers?

Background: This study was conducted to ascertain whether patients aged older than 75 years achieve outcomes after arthroscopic rotator cuff repair comparable to younger patients.

Methods: Arthroscopic cuff repair was performed in 60 shoulders of 59 patients aged older than 75 years. A control group of 60 younger patients, matched for sex, tear size, and American Society of Anesthesiology Functional Classification grade were included.

The "Parachute" Technique: A Simple and Effective Single-Row Procedure to Achieve an Increased Contact Area Between the Cuff-Tendon and Its Footprint.

Many techniques of arthroscopic rotator cuff repair have been described. No significant differences in clinical outcomes or rerupture rates have been observed when comparing single-row with double-row methods. Not all single- and double-row repairs are the same.

The "Purse String" Procedure for Recurrent Anterior Glenohumeral Instability: A Simple Technique to Achieve Bankart Repair, Capsular Shift, and a Good Labral Bumper.

Failure of arthroscopic techniques in cases of recurrent anterior glenohumeral instability may result from inadequate treatment of capsular injury. The use of few anchors has been cited as a cause of failure in arthroscopic stabilization techniques. This applies to the use of the suture anchors as spot-welding points in conventional techniques.

Reverse shoulder arthroplasty with a cementless short metaphyseal humeral implant without a stem: clinical and radiologic outcomes in prospective 2- to 7-year follow-up study.

Background: Reverse shoulder prostheses are increasingly used in recent years for treatment of glenohumeral arthropathy with deficient rotator cuff. Bone preservation is becoming a major goal in shoulder replacement surgery. Metaphyseal humeral components without a stem were developed to minimize bone resection and preserve bone.

Acromioclavicular joint acceleration-deceleration injury as a cause of persistent shoulder pain: Outcome after arthroscopic resection.

Background: Shoulder pain in general and acromioclavicular joint (ACJ) pain specifically is common after acceleration-deceleration injury following road traffic accident (RTA). The outcome of surgical treatment in this condition is not described in the literature. The aim of the present study was to report the outcome of arthroscopic resection of the ACJ in these cases.

Medium to long-term outcome of thoracoscapular arthrodesis with screw fixation for facioscapulohumeral muscular dystrophy.

Background: Shoulder girdle muscle weakness is the most constant feature of facioscapulohumeral muscular dystrophy and leads to scapular winging. Mechanical fixation of the scapula to the thoracic wall provides a stable fulcrum on which the deltoid muscle can exert its action on the humerus. The aim of this study was to evaluate the medium to long-term outcome of thoracoscapular arthrodesis with screw fixation (the modified Howard-Copeland technique).

The "anchor shape" technique for long head of the biceps tenotomy to avoid the popeye deformity.

Surgical options for symptomatic pathologies of the long head of the biceps (LHB) include tenotomy and tenodesis. Tenotomy is surgically simple and quick, does not require immobilization, and avoids implant complications. However, it is associated with residual "Popeye" muscle deformity and biceps muscle cramps.

The 'hand squeeze' test for posterior 'muscle patterning instability' of the shoulder.

Muscular patterning can be a contributor of positional posterior shoulder instability. Failure to recognize this pattern may lead to unnecessary surgical treatment with high failure rate. We analyzed the results of a new simple clinical test (hand squeeze test).

Management of first-time dislocations of the shoulder in patients older than 40 years: the prevalence of iatrogenic fracture.

Objective: To evaluate the prevalence of iatrogenic humeral neck fracture after attempted closed reduction in patients older than 40 years who present with a first-time anterior dislocation.

Design: Retrospective cohort study, evidence-based medicine level IV.

Patients: Ninety-two patients older than 40 years (mean 66.

Arthroscopically assisted internal fixation of the symptomatic unstable os acromiale with absorbable screws.

Background: Symptomatic meso- type os acromiale is a common pathology with inconsistent outcomes of treatment with various surgical techniques. We report the outcome of a new technique for arthroscopic fusion of symptomatic os acromiale with absorbable screws.

Materials And Methods: The study included 8 shoulders in 8 patients with symptomatic meso- type os acromiale who were treated with the use of a new technique for arthroscopic fusion with absorbable screws.

Pattern and time phase of shoulder function and power recovery after arthroscopic rotator cuff repair.

Background: It has been our observation that early during rehabilitation after rotator cuff repair, patients may take a step back before improving. The purpose of this study is to investigate the pattern and time phase of changes in Constant score and strength recovery after arthroscopic rotator cuff repair.

Materials And Methods: Forty-five patients undergoing arthroscopic rotator cuff repair were prospectively enrolled in this study.

"Put your 'extended' finger on the bleeder": the use of direct pressure from the shaver blade to achieve hemostasis.

Maintaining good hemostasis is vital to ensure clear vision during arthroscopic surgery. This is most commonly achieved with electrocautery or radiofrequency devices. Another technique involves temporarily increasing the arthroscopic fluid inflow pressure to tamponade the bleeding.

Long-term result after traumatic anterior shoulder dislocation: what works best?

Traumatic anterior shoulder dislocation is a common pathology. To inform the patient, it is therefore important to know the natural history of anterior dislocation and the long-term result of conservative treatment versus the long-term results of operative treatment. In this review article, we compare the effectiveness of various anatomical and non-anatomical interventions and between open and arthroscopic surgery.

Arthroscopic management of the painful snapping scapula.

Purpose: The aim of this study was to evaluate the results of the arthroscopic management of the snapping scapula syndrome.

Type Of Study: Case series.

Methods: Thirteen patients underwent surgery for painful scapular snapping that had not responded to adequate conservative treatment.

Geometrical analysis of Copeland surface replacement shoulder arthroplasty in relation to normal anatomy.

This study examines the effect of humeral head surface replacement on the geometry of the arthritic glenohumeral joint and correlates changes to clinical outcome. Thirty-nine patients undergoing resurfacing arthroplasty were prospectively followed up clinically and radiologically for a mean of 38 months (range, 24 to 72 months). Measurements were taken from coronal radiographs by use of a validated technique.

The use of a differential fluorescent staining method to detect bacteriuria.

Background: This report describes a differential staining method which distinguishes gram-positive from gram-negative bacteria in fluorescence. Gram-positive bacteria appear yellow and gram-negative bacteria appear green.

Material And Methods: The method is based on two fluorochromes, one acting in the wavelength of red, i.

Copeland surface replacement arthroplasty of the shoulder in rheumatoid arthritis.

Background: Shoulder arthroplasty with a stemmed prosthesis is a recognized treatment for rheumatoid arthritis of the shoulder. The humeral component of the Copeland cementless surface replacement arthroplasty consists of a cup for surface replacement with a short central peg for primary fixation to the bone. We hypothesized that surface replacement may offer some advantages over stemmed prostheses.

The role of arthroscopy for the problem shoulder arthroplasty.

Between 1995 and 2000, 29 patients who had excessive pain or limitation of motion after a shoulder arthroplasty underwent arthroscopy. Preoperative diagnoses of impingement syndrome in 10 patients (treated by arthroscopic subacromial decompression), large rotator cuff tear in 1, loose bodies in 1, unstable cuff arthropathy in 1, and septic arthritis in another were confirmed at arthroscopy. Of the 15 patients without a preoperative diagnosis, 7 had postarthroplasty capsular fibrosis, with 6 undergoing arthroscopic capsular release.