Complex Posterior Glenohumeral Instability Case Management

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2022 May 23

PMID 35602811

Authors

Rony H Melhem

Eliane K Doumith

Marc Soubeyrand

Affiliations

Soon will be listed here.

Abstract

A 21-year-old male patient suffering from insidious shoulder instability from neurogenic and structural attenuation of shoulder stabilizer, due to old minor cerebrovascular accident, presented with a two-year history of repetitive shoulder dislocation, operated by fixing the biceps tendon to its insertion on the superior labrum, correction of the glenoid version and reattaching the subscapular tendon along with a new technique for stabilization of the shoulder replicating the coracohumeral ligament with a ligament advanced reinforcement system (LARS) transplant. Following structured physical therapy, our patient returned to normal daily activities at 15 months.

References

Moroder P, Danzinger V, Minkus M, Scheibel M . [The ABC guide for the treatment of posterior shoulder instability]. Orthopade. 2018; 47(2):139-147. DOI: 10.1007/s00132-017-3513-4. View

Blasier R, Soslowsky L, Malicky D, Palmer M . Posterior glenohumeral subluxation: active and passive stabilization in a biomechanical model. J Bone Joint Surg Am. 1997; 79(3):433-40. View

Sanchez Alepuz E, Perez-Barquero J, Jorge N, Garcia F, Carratala Baixauli V . Treatment of The Posterior Unstable Shoulder. Open Orthop J. 2017; 11:826-847. PMC: 5611705. DOI: 10.2174/1874325001711010826. View

Meuffels D, Schuit H, van Biezen F, Reijman M, Verhaar J . The posterior bone block procedure in posterior shoulder instability: a long-term follow-up study. J Bone Joint Surg Br. 2010; 92(5):651-5. DOI: 10.1302/0301-620X.92B5.23529. View

von Eisenhart-Rothe R, Mayr H, Hinterwimmer S, Graichen H . Simultaneous 3D assessment of glenohumeral shape, humeral head centering, and scapular positioning in atraumatic shoulder instability: a magnetic resonance-based in vivo analysis. Am J Sports Med. 2009; 38(2):375-82. DOI: 10.1177/0363546509347105. View

Jaggi A, Lambert S . Rehabilitation for shoulder instability. Br J Sports Med. 2010; 44(5):333-40. DOI: 10.1136/bjsm.2009.059311. View

Barden J, Balyk R, Raso V, Moreau M, Bagnall K . Atypical shoulder muscle activation in multidirectional instability. Clin Neurophysiol. 2005; 116(8):1846-57. DOI: 10.1016/j.clinph.2005.04.019. View

Glousman R, Jobe F, Tibone J, Moynes D, Antonelli D, Perry J . Dynamic electromyographic analysis of the throwing shoulder with glenohumeral instability. J Bone Joint Surg Am. 1988; 70(2):220-6. View

DeLong J, Bradley J . Posterior shoulder instability in the athletic population: Variations in assessment, clinical outcomes, and return to sport. World J Orthop. 2015; 6(11):927-34. PMC: 4686439. DOI: 10.5312/wjo.v6.i11.927. View

10.

Konrad G, Jolly J, Labriola J, McMahon P, Debski R . Thoracohumeral muscle activity alters glenohumeral joint biomechanics during active abduction. J Orthop Res. 2006; 24(4):748-56. DOI: 10.1002/jor.20062. View

11.

Hawkins R, Koppert G, Johnston G . Recurrent posterior instability (subluxation) of the shoulder. J Bone Joint Surg Am. 1984; 66(2):169-74. View

12.

Kronberg M, Nemeth G, Brostrom L . Muscle activity and coordination in the normal shoulder. An electromyographic study. Clin Orthop Relat Res. 1990; (257):76-85. View

13.

Fuchs B, Jost B, Gerber C . Posterior-inferior capsular shift for the treatment of recurrent, voluntary posterior subluxation of the shoulder. J Bone Joint Surg Am. 2000; 82(1):16-25. DOI: 10.2106/00004623-200001000-00003. View

14.

Moroder P, Ernstbrunner L, Pomwenger W, Oberhauser F, Hitzl W, Tauber M . Anterior Shoulder Instability Is Associated With an Underlying Deficiency of the Bony Glenoid Concavity. Arthroscopy. 2015; 31(7):1223-31. DOI: 10.1016/j.arthro.2015.02.009. View