Background: Failure of glenoid labrum and capsular healing after glenohumeral dislocation can lead to persistent shoulder instability. The purpose of this study was to determine the effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on the healing glenoid labrum and capsule after glenohumeral dislocation in a rat model.
Methods: Sixty-six rats had surgically induced anterior-inferior labral tears and anterior glenohumeral dislocation. Postoperatively, the animals were assigned to either normal (n = 32) or ibuprofen drinking water (n = 31). Animals were euthanized at 2 and 4 weeks postoperatively for biomechanical testing and histologic analysis.
Results: The maximum load increased from 2 to 4 weeks after injury in the NSAID groups but not in the control groups. At 2 weeks, the maximum load was lower in the NSAID group compared with the control group. In a matched comparison between injured and uninjured limbs, the maximum load was significantly decreased in the injured limb of the 2-week NSAID group. At 4 weeks, the NSAID group had decreased stiffness compared with the 4-week control group.
Conclusions: In a new rat model of glenohumeral instability, the postinjury administration of ibuprofen resulted in decreased capsulolabral healing. A matched pair analysis of injured to uninjured limbs supported the findings of impaired healing in the NSAID-treated animals. These findings demonstrate that the use of NSAIDs after glenohumeral dislocation may impair capsulolabral healing and should be limited or avoided to optimize glenohumeral stability.
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http://dx.doi.org/10.1016/j.jse.2017.09.027 | DOI Listing |
JBJS Case Connect
October 2024
North American Spine and Pain; Hainesport, New Jersey.
Case: We report a case of a 29-year-old woman who sustained a left lateral sternoclavicular joint (SCJ) dislocation. Imaging demonstrated a 30-mm gap between the sternum and medial clavicle. Given well-preserved shoulder range of motion and well-controlled pain, she was ultimately treated nonoperatively.
View Article and Find Full Text PDFArthrosc Sports Med Rehabil
December 2024
Department of Orthopaedics and Traumatology, Hacettepe University, Ankara, Turkey.
Purpose: To assess the modified 1 anterior portal Bankart repair and compare it to the 2-portal Bankart repair in terms of surgical time, functional scores, and recurrent dislocation.
Methods: Patients who underwent Bankart repair from 2014 to 2021 were identified and separated into 2 groups: a modified 1 anterior portal group and a 2 anterior portal group. The inclusion criteria were being >18 years old, having a recurrent anterior shoulder dislocation with a Bankart lesion, and having a minimum 2-year follow-up.
J Orthop Surg Res
January 2025
Department of Orthopaedic Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, 650-0047, Japan.
Background: Although the Neer and AO/OTA classifications have been widely accepted, observer reliability studies of these two classifications have questioned their reliability and reproducibility to date. We developed an entirely new classification, the Mitsuzawa classification, for dislocated and displaced proximal humeral fractures and tested all three classifications for their intra- and interobserver reliability.
Methods: Two experienced shoulder surgeons and two orthopedic residents independently evaluated the Xray (xR) values of 100 proximal humeral fractures (PHFs).
JBJS Case Connect
October 2024
Lexington Clinic, Lexington, Kentucky.
Case: A 75-year-old woman status post total shoulder arthroplasty and posterior rib resection 29 years previously experienced a low-energy intrathoracic scapular dislocation (ISD). Closed reduction under anesthesia was unsuccessful, and she required open surgical repair performed by a novel modification of Kibler's technique for medial scapular muscle repair.
Conclusion: This case is unique because increased range of motion after successful arthroplasty allowed her shoulder to flex forward enough to result in ISD.
Am J Sports Med
January 2025
Harvard Medical School, Boston, Massachusetts, USA.
Background: While risk factors for recurrent instability (RI) after arthroscopic Bankart repair (ABR) for anterior glenohumeral instability (aGHI) have been well established in adult populations, there is much less evidence in pediatric and adolescent patients, despite being the most affected epidemiologic subpopulation.
Purpose: To identify the clinical, demographic, radiologic, and operative risk factors for RI after ABR for aGHI in pediatric and adolescent patients.
Study Design: Systematic review; Level of evidence, 4.
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