Download acrobat pdf file 7mb icmje author disclosure forms. Perthes lesion is variant of bankart lesion, presenting as an anterior glenohumeral injury that occurs when the scapular periosteum remains intact but is stripped. Humeral avulsion of glenohumeral ligament lesions this lesion very difficult to visualize arthroscopically. Arthroscopic repair of a posterior bony bankart lesion. The choice between these procedures depends mainly on surgeon preference or training rather than published evidence.
Reverse bankart lesion radiology reference article. The anterior front labrum can peel off the glenoid. Pdf arthroscopic repair of combined bankart and slap. Anterior shoulder instability has classically been treated with open or arthroscopic softtissue bankart repair, with failure rates between 3. If a lesion of 20% to 30% the width of the glenoid is present, arthroscopic repair of the bony bankart lesion is preferable to repair of the softtissue lesion alone. Operative techniques and clinical results article pdf available in clinics in orthopedic surgery 21. Arthroscopic suture anchor fixation of bony bankart lesions. This procedure included the injection of a contrast dye directly into the shoulder joint, followed by an m. If you do not see its contents the file may be temporarily unavailable at the journal. Reverse bankart lesion is defined as the detachment of posteroinferior labrum with avulsion of posterior capsular periosteum. We present our technique for arthroscopic repair of the relatively.
Bankart lesion is the anterior glenohumeral instability most common associated injury. Posterior humeral avulsion of the glenohumeral ligament. Anterior stabilization bankart postoperative protocol dr kolowich, dr lock, dr rill, dr moutzouros phase i. Transfer of the coracoid process in recurrent anterior instability of. The arthroscopic method offers a less invasive technique of bankart repair for traumatic anterior shoulder instability. We would like to report the 2 year clinical outcomes of bioabsorbable suture anchors used in traumatic anterior dislocations of the shoulder. Results of arthroscopic bankart repair with hillsachs remplissage for anterior shoulder instability article pdf available in international orthopaedics 4112 may 2017 with 7 reads. Bankart and slap repair post operative pt protocol revised. This leads to laxity of posterior band of the inferior glenohumeral ligament with posterior displacement of the humeral head as is the case with a bankart lesion, the trauma may be severe enough to involve the bony glenoid, resulting in an accompanying small flake. A 30yearold man presents with recurrent anterior shoulder instability. The purpose of this study was to evaluate the outcome of arthroscopic capsulotenodesis of the posterior capsule and infraspinatus tendon.
This challenge is enhanced when the lesion is chronic and fibrous malunion of the fragment makes mobilization difficult. Evaluation of a treatment algorithm for acute traumatic. Long term results of arthroscopic bankart repair for. Bankart repair bankart lesion lesion of the anterior part of the glenoid labrum of the shoulder. Tears at glenohumeral ligaments can be intra substance or at humeral insertion, this location may be the cause of instability. Microbiological recommendations for the diagnosis and followup of infective endocarditis. To aid stability of the joint, the glenoid has a soft tissue bumper around its edge the labrum which acts as a bumper preventing dislocation of the head from the glenoid pathology. The osseous bankart lesion is an avulsion of the humeral labral complex with an anterior rim fracture. Untreated chronic shoulder dislocation eventually leads to functional disability and pain. A hillsachs lesion of the humeral head after a shoulder dislocation is clinically insignificant in most cases.
Contact between the glenoid and the humeral head in abduction, external rotation, and horizontal extension. Treatment of a posterior hillsachs lesion in the right shoulder with a doublepulley remplissage. The physiologic groove in the humerus or cysts and erosions at the attachment site of the infraspinatus tendon can simulate a hillsachs, but usually this is not. Study of bipolar bone defects in unstable shoulder. The shoulder joint is made up of the glenoid and humeral head. The open latarjet procedure is more reliable in terms of. The incidence of anterior glenoid rim fractures has been reported to be up to 22% after first time anterior shoulder dislocation and up to 73% after recurrent dislocations 27. These factors make it unlikely that a bankart tear heals. A bankart lesion is an injury of the anterior glenoid labrum of the shoulder due to anterior shoulder dislocation.
Using medline pubmed, cochrane and embase databases we performed a search of all published articles. Leitlinien unfallchirurgie neu entwickelte leitlinie awmf. This injury is caused by the labrum has a poor blood supply and joint fluid within the tear interferes with healing. Large bony bankart lesion 25% of the articular surface smaller lesion can be excised and repair the labral ligament complex. Purpose of this study is to conduct a metaanalysis comparing the results of open and arthroscopic bankart repair using suture anchors in recurrent traumatic anterior shoulder instability. Schulterinstabilitaten deutsches gelenkzentrum heidelberg. Viewing from the posterior portal, the surgeon identifies a large hillsachs lesion. Arthroscopic bankart repair and open latarjet bone block procedure are widely considered mainstays for surgical treatment of recurrent anterior shoulder instability.
We compared patients with recurrent posttraumatic anterior shoulder instability treated with arthroscopic. Journal of orthopaedic surgery and research risk factors for shoulder redislocation after arthroscopic bankart repair hideaki shibata masafumi gotoh 0 yasuhiro mitsui 0 yoshihiro kai hidehiro nakamura tomonoshin kanazawa takahiro okawa 0 fujio higuchi 0 masahiro shirahama naoto shiba 0 department of orthopaedic. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic bankart repairs. Here we will look at the common causes, associated injuries, symptoms and treatment options, both surgical and non surgical, for a bankart lesion labrum tear. Learn from lesion experts like frontiers and jose a. This lesion has been referred to as the medialized bankart lesion. Arthroscopic doublepulley remplissage using a 2portal. Media in category bankart lesion the following 5 files are in this category, out of 5 total. However, a sizable defect will engage with the anterior rim of the glenoid and cause instability even after anterior glenoid reconstruction.
They also found a slightly higher reoperation rate for the bankart procedure 12% versus 8%, p 0. Langzeitergebnisse nach offener bankartneeroperation. Complete this form if you are a member onz a visiting force including its civilian component or a crew member of any craft transporting such people. Arthroscopic repair of chronic bony bankart lesion using a. Arthroscopic repair of combined bankart and slap lesions. It may result either from a traumatic glenohumeral dislocation or a direct trauma to the adducted arm.
We hypothesized that open reduction and simultaneous bankart lesion repair in chronic anterior shoulder dislocation obviates the need for joint fixation and leads to better results than. Pdf fractures of the anteroinferior glenoid rim, termed bony bankart lesions, have been reported to occur in up to 22 % of first time anterior. Bankart and slap repair post operative pt protocol please contact the uwmc shoulder and elbow team with any questions. Treatment of chronic anterior shoulder dislocation by open. Perthes lesion a perthes lesion is a labroligamentous avulsion like a bankart, but with a medially stripped intact periosteum. When this happens, a pocket at the front of the glenoid forms that allows the humeral head to dislocate into it. Traumatic unidirectional bankart lesion surgical repair. A hill sachs lesion occurs when the lesion to the labrum presents simultaneously. Additionally, the labrum may slip off the face of the glenoid and no longer contributes to shoulder stability. The humeral head is ball shaped but the glenoid is more dish shaped than cup shaped. The significance of the alpsa lesion to the arthroscopist is that the labrum and attached ligaments, rather than floating free, heal in an abnormal position and eventually resynovialize, and may be difficult to identify as abnormal at the time of. Open reduction with different fixation methods have been introduced for most chronic shoulder dislocation.
Intraoperative findings and outcome of latarjet procedure. Data from 79 shoulders in 74 patients were collected over 4 years 2004 2008. The contribution of the hillsachs lesion to glenohumeral instability depends on. Achieved staged rom limits but do not significantly exceed them. Any information contained in this pdf file is automatically generated from. Traumatische vordere schultererstluxation aga gesellschaft fur. Bankart lesions are named after english orthopedic surgeon arthur sydney blundell bankart, 18791951, who first described the injury and the surgical repair process. Combined allarthroscopic hillsachs remplissage, latarjet. Continue sling x 4 weeks after surgery while sleeping and walking no lifting of anything heavier than a cup of coffee 8 ounces directions for physical therapist. Posterior bony defects of the glenoid rim, particularly those associated with instability, are often a frustrating challenge for arthroscopists because of the defects inaccessibility from standard portals.
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