• Title/Summary/Keyword: 견관절 탈구

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Arthroscopic Treatment of Metallic Suture Anchor Failures after Bankart Repair (Bankart 수술 후 발생한 금속 봉합 나사못 합병증의 관절경적 치료)

  • Shin, Sang-Jin;Jung, Jae-Hoon;Kim, Sung-Jae;Yoo, Jae-Doo
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.70-76
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    • 2006
  • Purpose: This study presents 5 patients who had metallic anchor protrusion on glenoid after Bankart repair in anterior shoulder instability and reviewed the cause, clinical feature and arthroscopic removal technique. Method and Materials: 5 male with average age of 22 years (range 19 to 25 years) were included. 4 patients had arthroscopic Bankart repair and 1 patient had open repair for anterior shoulder instability. They had protruded metallic suture anchors on glenoid and the protruded suture anchors were removed arthroscopically using larger suture anchor empty inserter. Results: 4 patients had painful clicking sound with motion of abduction and external rotation and 1 patient showed shoulder instability. The ROM showed normal except mild degrees loss of external rotation. The position of protruded metallic anchor was 2, 3 and 5 O'clock in three patients and 4 O'clock in 2 patients. In 2 patients, the metallic suture anchor was malpositioned about 5mm off on the medial side from the anterior glenoid edge. All had Outerbrige classification Grade II-III chondral damage on humeral head and 1 patient showed glenoid cartilage destruction. None had shoulder instability after 2 years of follow-up. Constant score was 65 preoperatively and 89 postoperatively. ASES score was 67 preoperatively and 88 postoperatively. Conclusion: Symptoms of protruded suture anchor are not combined with instability. Most of symptoms were revealed from the rehabilitation period and confused with postoperative pain. Prompt diagnosis and early arthroscopic removal or impaction of protruded metallic suture anchor is recommended because of serious glenohumeral cartilage destruction. This is easy and simple and reproducible method to remove protruded metallic suture anchor arthroscopically.

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Shoulder instability with congenital absence of bilateral long head of biceps tendon - A Case Report - (양측성 상완이두장건 결손과 견관절 불안정성 - 증례 보고 -)

  • Rah, Jung-Ho;Chung, Hoi-Jeong;Kim, Doo-Sup
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.3
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    • pp.188-191
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    • 2010
  • Absence of long head of biceps tendon is a very rare anomaly. We encountered a 19 year-old male patient who had right shoulder subluxation. On magnetic resonance imaging, shallow intertubercular groove on right humerus was observed, and absence of long head of biceps tendon was discovered. Arthroscopically, labral rupture and absence of long head of biceps tendon were also evident. Left shoulder had a similar symptom as right 5 months after the initial development of the symptom on the right shoulder. Both MRI and arthroscopy revealed absence of long head of biceps tendon and labral ruptre. Arthroscopic labral repair was performed for both shoulders, and, postoperatively, they were fixated with abduction brace. In this case, it is considered that the absence of long head of biceps tendon triggered the instability of shoulder found in our patient.

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Initial and Recurrent Anterior Dislocation in Shoulder (견관절 초기 전방 탈구와 재발성 전방 탈구)

  • Kim Young-Kyu;Lee Jae-Hoon;Kim Hyun-Min;Lee Choong-Hoon
    • Clinics in Shoulder and Elbow
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    • v.8 no.2
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    • pp.148-153
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    • 2005
  • Purpose: To assess the usefulness of early stabilization for initial shoulder dislocation which is indicated in some patients by comparing the arthroscopic findings and the outcomes of Bankart repair in the initial and recurrent dislocation. Materials and Methods: The study was performed on 16 cases of initial dislocation and 44 cases of recurrent dislocation. The follow-up period was 25 months in the initial dislocation group and 28 months in the recurrent group. Bankart lesion and the adjacent tissues were compared, and the results were evaluated by the Rowe rating scale. Results: Detached labrum and capsular ligament of the initial dislocation group were elastic and unretracted. While in the recurrent dislocation those were inelastic, and displaced and adhesive in many cases. The outcomes were mean 95 points in the initial group and 91 points in the recurrent group. In the initial group, apprehension was detected in only 1 case(6%). In the recurrent group, instability was detected in 4 cases(9%). Conclusion: Our data suggest that Bankart lesion in the initial dislocation can be repaired readily by surgery, the recovery is efficient, and the recurrence would be reduced. Thus, in active young sports lovers as well as athletes, early stabilization surgery for initial shoulder dislocation may be more helpful.

Comparison of Rotational Strength in Shoulders with Anterior Instability and Normal Shoulders Using Isokinetic Testing (등속성 검사를 통한 견관절 전방 불안정 환자와 정상인의 회전력 비교)

  • Lee, Dong-Ki;Kim, Tae-Kwon;Lee, Jin-Hyuck;Lee, Dae-Hee;Jung, Woong-Kyo
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.79-85
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    • 2012
  • Objective: It has been expected that patient with posttraumatic recurrent anterior shoulder dislocation might have limited daily life activity because of pain and apprehension of dislocation. But there have been only a small number of investigations regarding the rotator strength in this patient. The aim of this study is to find the characteristics about rotator strength of patient with posttraumatic recurrent anterior shoulder dislocation using an isokinetic testing. Method: We enrolled thirteen patients with posttraumatic recurrent anterior shoulder dislocation and fifteen sex, age-matched healthy nonathletic subjects in this controlled study. All participants were male and there were no significant differences between the two groups in age, height, weight, BMI. Isokinetic internal rotator and external rotator strength was evaluated with a Biodex Isokinetic Testing machine (Biodex Medical Systems, Shirley, NY, USA), tests were performed at 60 deg/sec and 180 deg/sec for both sides. Peak torque normalized to body weight, external rotator to internal rotator ratio, total work and fatigue were calculated for each angular velocity. The association between internal rotator and external rotator strength and shoulder instability was analyzed by comparisons with a control group. Results: Any notable differences could not be found between the two groups given all data from no symptomatic left shoulder. There were no significant differences between the two groups statistically in internal rotation strength of right shoulder. However, there has been a tendency that at all angular velocities, external rotator peak torque to body weight, total work and external rotator to internal rotator ratio were significantly lower in the anterior instability group than the control group at all angular velocities. There was no substantial difference between those groups with respect to the fatigue of external rotator and internal rotator in our study. Conclusion: The prominent characteristics of posttraumatic recurrent anterior shoulder dislocation are external rotator weakness and loss of balance with external rotator and internal rotator. Therefore selective training using this information rotator might be helpful in conservative treatment and rehabilitation.

Bankart Lesion and ALPSA Lesion in Anterior Instability of the Shoulder (견관절 전방 불안정성에서 Bankart 병변과 ALPSA 병변)

  • Kim, Young-Kyu;Ahn, Seung-Jun;Ko, Young-Hwan
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.186-193
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    • 2005
  • Purpose: To determine whether it is possible to differentiate between ALPSA(anterior labroligamentous periosteal sleeve avulsion) lesion and Bankart lesion using arthroscopic findings and to investigate the clinical significance of ALPSA lesion. Materials and Methods: This study was performed on 66 cases that underwent arthroscopic Bankart repair for the anterior instability of the shoulder. By the readings of MRI, there were 56 cases(85%) of Bankart lesion and ten cases(15%) of ALPSA lesion. Arthroscopic findings of Each cases were classified and their average follow-up period was 22 months. Results: It was observed that ALPSA lesions developed in younger age groups than Bankart lesions. Under the arthroscope, ALPSA lesions showed various forms, especially there were five cases of severe inferomedial displacements. Within Bankart lesion, 21 cases were observed to be severely displaced and from the arthroscopic findings, it was difficult to distinguish the difference of Bankart lesion cases displaced inferomedially from the neck of scapula without severe lateral displacements and ALPSA lesion. Regarding the recurrence, there were no redislocation but apprehension shows in two cases(20%) with severe inferomedial displacement in ALPSA group. In Bankart lesion, there were four recurrent cases(7.1%); one of redislocation; one case of subluxation; two of apprehension. Conclusion: It was difficult to differentiate Bankart lesion and ALPSA lesion with severe inferomedial displacement and severely displaced ALPSA lesion showed high rate of recurrence. Thus, complete detachment of ALPSA lesion should be performed more carefully to reduce the recurrence rate.

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Review in Remplissage on Anterior Shoulder Instability with Huge Hill-Sachs Lesion (전방 견관절 불안정성의 Hill-Sachs 병변의 치료에서 Remplissage의 Review)

  • Ko, Sang-Hun;Lee, Chae-Chil;Park, Han-Chang
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.134-139
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    • 2011
  • Purpose: We wanted to review the arthroscopic Remplissage technique and introduce our experiences with it for treating recurrent shoulder instability with a large Hill-Sachs lesion. Materials and Methods: The arthroscopic Remplissage technique with Bankart repair is performed in patients with no osteoarthritis, no fracture around the shoulder, a history of recurrence more than 10 times, a large Hill-Sachs lesion more than 30 to 40% of the humeral articular surface and glenoid bone loss less than 20%. Results and Conclusion: For recurrent shoulder instability with a large Hill-Sachs lesion, the Remplissage technique resulted in a good outcome for the shoulder stability, and good clinical and functional results.

Large Hill-Sachs Lesion Combined with a Rotator Cuff Tear in an Acute Traumatic Anterior Dislocation of the Shoulder in an Elderly Patient Treated with an Allogenic Iliac Tricortical Bone Graft (노인 환자의 급성 외상성 견관절 전방 탈구에서 회전근개 파열과 동반된 거대 Hill-Sachs 병변에 대해 간접 정복 및 지지대 목적의 동종 장골 삼중 피질골 이식을 통한 치료 1예)

  • Hyun, Yoonsuk;Lim, Jinkyu;Baek, Seung-Ha;Park, Jinho;Lee, Seung-Jin
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.188-192
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    • 2020
  • An indirect reduction through the bicipital groove and allogenic iliac tricortical bone graft was performed as a treatment for a large Hill-Sachs lesion with a rotator cuff tear in an acute traumatic shoulder joint dislocation in an elderly patient. Six months after surgery, the rotator cuff healing and bone union were confirmed. The patient also showed satisfactory clinical results with 95 points of the American Shoulder and Elbow Surgeons (ASES) shoulder score and active range of motion with 155° flexion, 120° abduction, and 70° external rotation and 30° internal rotation at 90° abduction. The surgical method can be considered for a large Hill-Sachs lesion with rotator cuff tear in an acute traumatic shoulder joint dislocation in elderly patients.