The incidence of reverse shoulder arthroplasty (RSA) has increased since the Food and Drug Administration approved its use in the United States in 2004. With the current RSA implants available for surgeon use within the United States of America, each design, regardless of humeral inlay vs. onlay, distalizes the shoulder's center of rotation. This new center of rotation purposely increases tension to the deltoid, which is the main working muscle in RSA, but also retensions the adjacent tendons. Some patients after RSA experience continued anterior shoulder discomfort that limits their active range of motion and overall patient satisfaction. It has been isolated with physical examination that there is tenderness to palpation at the coracoid process and throughout the conjoint tendon. We have completed conjoint tendon lengthening procedures on this subset of patients with excellent clinical results. This article describes the technique for patients who underwent conjoint tendon lengthening after RSA for recalcitrant anterior shoulder pain.
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http://dx.doi.org/10.1016/j.xrrt.2021.12.005 | DOI Listing |
JSES Rev Rep Tech
February 2025
Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA.
The utilization of free bone grafts to reconstruct large anterior glenoid defects has increased. Distal tibia allograft is commonly used due to its lack of donor site morbidity, ability to restore large bony defects, and near anatomic osteoarticular restoration. However, the intact coracoid and conjoint tendon often impair adequate visualization and access to perform an anatomic reconstruction during open free bone graft reconstruction and often requires violation of the subscapularis tendon to gain exposure.
View Article and Find Full Text PDFHernia
January 2025
Centro de Patología Herniaria Argentina, Cerviño 4449, 1425, Buenos Aires, Argentina.
Purpose: This article critically examines long-standing groin pain (LSGP) in physically active adults related to sports overload by analyzing terminology, pathophysiology, and treatment.
Method: This review is based on data from over 10,000 patients managed through a multidisciplinary algorithm. (LSGP) has been variably labeled, using terms that have led to inconsistencies in understanding its origin and management.
BMC Musculoskelet Disord
January 2025
Gold Coast University Hospital, 1 Hospital Boulevard, Gold Coast, Southport, QLD, 4215, Australia.
Background: Long term studies have shown the Latarjet procedure to be successful in preventing re-dislocation in primary and recurrent anterior inferior shoulder instability. It provides stability through the sling effect of the conjoint tendon and the bone block. It is unclear whether augmentation with capsular repair provides an added benefit or leads to restricted range of external rotation.
View Article and Find Full Text PDFDiagnostics (Basel)
December 2024
Department of Orthopedic Surgery, Nara medical university, Nara 6348521, Japan.
With the remarkable advances in diagnostic ultrasound equipment, there is a growing need for ultrasound diagnosis of muscle and soft tissue injuries in sports injuries. Among these, hamstring strains are often difficult to treat and require early and accurate diagnosis. Injuries to the proximal part of the hamstring often take a long time to heal.
View Article and Find Full Text PDFJ Shoulder Elbow Surg
January 2025
Department of Orthopaedic Surgery & Sports Medicine, University of Florida, Gainesville, FL, USA.
Background: The Latarjet procedure is considered the gold standard for treating patients with anterior shoulder instability in the presence of critical glenoid bone loss. Proponents of the Latarjet contend that its efficacy is in-part attributable to the "sling effect" of the conjoint tendon; however, recent studies have demonstrated similar restoration of anterior stability in patients undergoing free bone block (FBB) procedures. The purpose of this systematic review was to evaluate the biomechanical and clinical evidence for the sling effect.
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