Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Transient postoperative inferior subluxation of the shoulder after surgical stabilization of recurrent anterior dislocation in a patient with myasthenia gravis: a case report

  • Samuel Baek (Department of Orthopaedic Surgery, Seoul Red Cross Hospital) ;
  • Geum-Ho Lee (Department of Orthopaedic Surgery, Seoul Red Cross Hospital) ;
  • Myung Ho Shin (Department of Orthopaedic Surgery, CM Hospital) ;
  • Tae Min Kim (Department of Orthopaedic Surgery, Seoul Prime Hospital) ;
  • Kyung-Soo Oh (Department of Orthopaedic Surgery, Konkuk University School of Medicine) ;
  • Seok Won Chung (Department of Orthopaedic Surgery, Konkuk University School of Medicine)
  • Received : 2022.01.19
  • Accepted : 2022.03.18
  • Published : 2023.09.01
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Abstract

The authors present a case of transient postoperative inferior subluxation of the shoulder after arthroscopic surgical stabilization for recurrent anterior dislocation. The patient was a 61-year-old woman with myasthenia gravis (MG). The first anterior shoulder dislocation occurred because of a fall to the ground. Despite a successful closed reduction, two more dislocations occurred in 3 weeks. Magnetic resonance imaging revealed an anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion, an engaging Hill-Sachs lesion, and large tears of the supraspinatus and infraspinatus tendons. The patient underwent arthroscopic rotator cuff repair and ALPSA repair with a remplissage procedure. Intraoperatively, no tendency for instability was found; however, a widened glenohumeral joint space and inferior subluxation of the humeral head without functional compromise was observed on the day after surgery and disappeared spontaneously on radiographs 2 weeks later. To the authors' knowledge, this is the first report documenting the occurrence of transient postoperative inferior subluxation of the shoulder in a patient with MG.

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References

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