Soft Tissue-based Surgical Techniques for Treatment of Posterior Shoulder Instability

Overview

Journal Obere Extrem

Date 2017 Sep 2

PMID 28861126

Citations 5

Authors

Alessandro Castagna

Marco Conti

Raffaele Garofalo

Affiliations

Soon will be listed here.

Abstract

Posterior shoulder instability is a rare clinical condition that encompasses different degrees of severity including various possible pathologies involving the labrum, capsule, bony lesions, and even locked posterior dislocation. When focusing on soft tissue involvement, the diagnosis of posterior instability may be difficult to make because frequently patients report vague symptoms not associated with a clear history of traumatic shoulder dislocation. Pathological soft tissue conditions associated with posterior instability in most cases are related to posterior labral tear and/or posterior capsular detensioning/tear. The diagnosis can be facilitated by physical examination using specific clinical tests (i. e., jerk test, Kim test, and reinterpreted O'Brien test) together with appropriate imaging studies (i. e., magnetic resonance arthrography). Arthroscopy may help in a complete evaluation of the joint and allows for the treatment of soft tissue lesions in posterior instability. Caution is warranted in the case of concomitant posterior glenoid chondral defect as a potential cause of poor outcome after soft tissue repair in posterior instability.

Citing Articles

Arthroscopic medial tenodesis of subscapularis tendon (AMTS) in static posterior shoulder dislocation (C1): a surgical technique.

Romano A, Cuozzo F, de Giovanni R, Torsiello E, Ascione F, Casillo P JSES Rev Rep Tech. 2024; 4(4):733-736.

PMID: 39474194 PMC: 11514085. DOI: 10.1016/j.xrrt.2024.06.006.

The O'Brien test demonstrates a higher diagnostic value in identifying posteroinferior labral tears than superior labral anterior to posterior (SLAP) tears.

Alexander Buijze G, Mariaux S, van Spanning S, Verweij L, van Rijn S, Lafosse L JSES Int. 2023; 7(1):67-71.

PMID: 36820434 PMC: 9937831. DOI: 10.1016/j.jseint.2022.10.006.

Posterior Shoulder Dislocation with Engaging Reverse Hill-Sachs Lesion: A Retrospective Study of Ten Patients Treated with Arthroscopy or Open Reduction and Stabilization.

Ippolito G, Zitiello M, De Marinis G, DAngelo F, Surace M, Ronga M J Clin Med. 2021; 10(7).

PMID: 33915791 PMC: 8037443. DOI: 10.3390/jcm10071410.

Arthroscopic "Bone Block Cerclage" Technique for Posterior Shoulder Instability.

Hachem A, Rondanelli S R, Costa DO G, Verdalet I, Rius X Arthrosc Tech. 2020; 9(8):e1171-e1180.

PMID: 32874898 PMC: 7451436. DOI: 10.1016/j.eats.2020.04.017.

Arthroscopic Management of Locked Posterior Shoulder Dislocations.

Byram 3rd G, Field A, Field L Arthrosc Tech. 2018; 7(9):e945-e949.

PMID: 30258776 PMC: 6153398. DOI: 10.1016/j.eats.2018.05.008.

References

Antoniou J, Duckworth D, Harryman 2nd D . Capsulolabral augmentation for the the management of posteroinferior instability of the shoulder. J Bone Joint Surg Am. 2000; 82(9):1220-30. DOI: 10.2106/00004623-200009000-00002. View

Kim S, Ha K, Yoo J, Noh K . Kim's lesion: an incomplete and concealed avulsion of the posteroinferior labrum in posterior or multidirectional posteroinferior instability of the shoulder. Arthroscopy. 2004; 20(7):712-20. DOI: 10.1016/j.arthro.2004.06.012. View

Finkelstein J, Waddell J, ODriscoll S, Vincent G . Acute posterior fracture dislocations of the shoulder treated with the Neer modification of the McLaughlin procedure. J Orthop Trauma. 1995; 9(3):190-3. View

Fronek J, Warren R, Bowen M . Posterior subluxation of the glenohumeral joint. J Bone Joint Surg Am. 1989; 71(2):205-16. View

Duey R, Burkhart S . Arthroscopic treatment of a reverse hill-sachs lesion. Arthrosc Tech. 2013; 2(2):e155-9. PMC: 3716231. DOI: 10.1016/j.eats.2013.01.007. View

Castagna A, Snyder S, Conti M, Borroni M, Massazza G, Garofalo R . Posterior humeral avulsion of the glenohumeral ligament: a clinical review of 9 cases. Arthroscopy. 2007; 23(8):809-15. DOI: 10.1016/j.arthro.2007.02.006. View

Owen J, Boulter T, Walton M, Funk L, Mackenzie T . Reinterpretation of O'Brien test in posterior labral tears of the shoulder. Int J Shoulder Surg. 2015; 9(1):6-8. PMC: 4325388. DOI: 10.4103/0973-6042.150216. View

Provencher M, Frank R, LeClere L, Metzger P, Ryu J, Bernhardson A . The Hill-Sachs lesion: diagnosis, classification, and management. J Am Acad Orthop Surg. 2012; 20(4):242-52. DOI: 10.5435/JAAOS-20-04-242. View

Provencher M, Mologne T, Hongo M, Zhao K, Tasto J, An K . Arthroscopic versus open rotator interval closure: biomechanical evaluation of stability and motion. Arthroscopy. 2007; 23(6):583-92. DOI: 10.1016/j.arthro.2007.01.010. View

10.

Hatzis N, Kaar T, Wirth M, Rockwood Jr C . The often overlooked posterior dislocation of the shoulder. Tex Med. 2002; 97(11):62-7. View

11.

Jost B, Koch P, Gerber C . Anatomy and functional aspects of the rotator interval. J Shoulder Elbow Surg. 2000; 9(4):336-41. DOI: 10.1067/mse.2000.106746. View

12.

Hawkins R, Neer 2nd C, Pianta R, Mendoza F . Locked posterior dislocation of the shoulder. J Bone Joint Surg Am. 1987; 69(1):9-18. View

13.

Gartsman G, Roddey T, Hammerman S . Arthroscopic treatment of bidirectional glenohumeral instability: two- to five-year follow-up. J Shoulder Elbow Surg. 2001; 10(1):28-36. DOI: 10.1067/mse.2001.109324. View

14.

Bey M, Hunter S, Kilambi N, Butler D, Lindenfeld T . Structural and mechanical properties of the glenohumeral joint posterior capsule. J Shoulder Elbow Surg. 2005; 14(2):201-6. DOI: 10.1016/j.jse.2004.06.016. View

15.

Bateman D, Black E, Lazarus M, Abboud J . Outcomes Following Arthroscopic Repair of Posterior Labral Tears in Patients Older Than 35 Years. Orthopedics. 2016; 40(2):e305-e311. DOI: 10.3928/01477447-20161128-06. View

16.

Lavender C, Hanzlik S, Pearson S, Caldwell 3rd P . Arthroscopic Reverse Remplissage for Posterior Instability. Arthrosc Tech. 2016; 5(1):e43-7. PMC: 4809750. DOI: 10.1016/j.eats.2015.09.005. View

17.

Cvetanovich G, Hamamoto J, Campbell K, McCarthy M, Higgins J, Verma N . The Use of Accessory Portals in Bankart Repair With Posterior Extension in the Lateral Decubitus Position. Arthrosc Tech. 2017; 5(5):e1121-e1128. PMC: 5310186. DOI: 10.1016/j.eats.2016.06.003. View

18.

Savoie 3rd F, Holt M, Field L, Ramsey J . Arthroscopic management of posterior instability: evolution of technique and results. Arthroscopy. 2008; 24(4):389-96. DOI: 10.1016/j.arthro.2007.11.004. View

19.

McIntyre L, Caspari R, Savoie 3rd F . The arthroscopic treatment of posterior shoulder instability: two-year results of a multiple suture technique. Arthroscopy. 1997; 13(4):426-32. DOI: 10.1016/s0749-8063(97)90119-5. View

20.

Lenart B, Sherman S, Mall N, Gochanour E, Twigg S, Nicholson G . Arthroscopic repair for posterior shoulder instability. Arthroscopy. 2012; 28(10):1337-43. DOI: 10.1016/j.arthro.2012.03.011. View