Complications observed following labral or rotator cuff repair with use of poly-L-lactic acid implants.

Background: A variety of complications associated with the use of poly-L-lactic acid (PLLA) implants, including anchor failure, osteolysis, glenohumeral synovitis, and chondrolysis, have been reported in patients in whom these implants were utilized for labral applications. We report on a large series of patients with complications observed following utilization of PLLA implants to treat either labral or rotator cuff pathology.

Methods: Patients who had undergone arthroscopic debridement to address pain and loss of shoulder motion following index labral or rotator cuff repair with PLLA implants were identified retrospectively with use of our research database.

Coracoid impingement: diagnosis and treatment.

Coracoid impingement is a controversial, well-known diagnosis that results in anterior shoulder pain. Idiopathic, traumatic, and iatrogenic etiologies have been identified. Proper diagnosis requires a focused clinical examination of the anterior shoulder and adjacent structures.

Treatment of glenohumeral osteoarthritis.

This clinical practice guideline is based on a systematic review of published studies on the treatment of glenohumeral osteoarthritis in the adult patient population. Of the 16 recommendations addressed, nine are inconclusive. Two were reached by consensus-that physicians use perioperative mechanical and/or chemical venous thromboembolism prophylaxis for shoulder arthroplasty patients and that total shoulder arthroplasty not be performed in patients with glenohumeral osteoarthritis who have an irreparable rotator cuff tear.

Typical and atypical shoulder impingement syndrome: diagnosis, treatment, and pitfalls.

The cause of shoulder impingement syndrome usually is considered to be compression of the rotator cuff and subacromial bursa against the anterolateral aspect of the acromion. The typical symptom is anterolateral shoulder pain that worsens at night and with overhead activity. However, the pain may be caused by factors other than a hooked acromion.

Computed tomography analysis of the coracoid process and anatomic structures of the shoulder after arthroscopic coracoid decompression: a cadaveric study.

The purpose of this anatomic study is to define the morphologic changes of the coracoid and surrounding soft tissue after arthroscopic coracoid decompression. We obtained 5 fresh-frozen forequarter cadaveric specimens, 3 female and 2 male, with a mean age of 86.2 years.

Nonoperative management for in-season athletes with anterior shoulder instability.

Background: Acute or recurrent anterior shoulder instability is a frequent injury for in-season athletes. Treatment options for this injury include shoulder immobilization, rehabilitation, and shoulder stabilization surgery.

Purpose: To determine if in-season athletes can be returned to their sports quickly and effectively after nonoperative treatment for an anterior instability episode.

Poly-L-lactic acid tack synovitis after arthroscopic stabilization of the shoulder.

Background: Progress has been made in the design of bioabsorbable implants, with reduced complication rates and slower degradation times.

Purpose: To report on complications related to use of poly-L-lactic acid implants after arthroscopic shoulder stabilization procedures.

Study Design: Retrospective cohort study.

Anteromedial capsular redundancy and labral deficiency in shoulder instability.

Background: Redundancy of the anteromedial capsule of the shoulder may persist despite proper tensioning of the capsule and repair of a Bankart lesion during an anteroinferior capsular shift procedure.

Hypothesis: A barrel-stitch suture technique incorporated into a capsular shift procedure is effective in achieving satisfactory shoulder stability.

Study Design: Uncontrolled retrospective review.