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Complications and Pitfalls-Recurrence

Recurrence is the most frequently reported complication after open and arthroscopic surgery for anterior instability. Recurrence may be secondary to new trauma or to atraumatic events.Patients with traumatic recurrence of their instability usually have better post-operative results after revision surgery than patients with atraumatic recurrence. The recurrence rate is related to the number of prior […]

Subscapularis Tears

Rupture of the subscapularis in association with primary anterior shoulder instability is more common after a prior open instability repair and should be suspected in those who have had prior anterior stabilization procedures in which the subscapularis was released for exposure.

Failure to recognize and treat a subscapularis tear in a proper and timely fashion […]

Humeral Bone Deficiency

Humeral head defects are commonly present in patients with shoulder instability. The defects are usually small and carry the eponym Hill-Sachs lesion when secondary to anterior instability and reverse Hill-Sachs lesions when secondary to posterior instability.

Although quite ubiquitous in recurrent anterior shoulder instability, the management of large Hill-Sachs defects remains controversial especially in […]

Relative Indications for Open Surgery

Despite advancements in surgical technique and implants, certain clinical scenarios are prone to failure by arthroscopic methods. These include HAGL lesions and capsular ruptures. Other relative indications for open surgery include failed prior arthroscopic or open repairs. In the setting of failed thermal capsulorrhaphy, the surgeon is often faced with residual casulolabral tissue that is […]


Surgical complications related to ASAD are similar to those of other shoulder procedures. They can be separated into complications related to inaccurate or incomplete diagnosis and those related to incorrect technique.

An incomplete diagnosis can occur from failure to recognize and address coexisting pathology such as a labral tear or partial rotator cuff tear. These […]

Catastrophic Cervical Spine Injuries-Congenital Spinal Anomalies

Anatomical variants and congenital anomalies predispose athletes to certain forms of spinal cord injury. For example, Klippel-Feil syndrome, which reduces the number of motion segments in the spine, may lead to progressive instability or degenerative stenosis. Multiple fusions in the cervical spine in this condition make it difficult to dissipate loads that are applied to […]

Tendon Injuries

Closed injuries to tendons of the hand and wrist are common in the athlete. These problems are often neglected and may not be seen by a physician until the end of the season, when the athlete notes a significant disability. Failure to initiate treatment in the acute stages may jeopardize the final result. Every effort […]

Dislocation of MCP joint

Dislocation of the MCP joint is a rare injury. When it does occur the border digits (the index and little fingers) are most commonly affected. Dorsal dislocation of the MCP joint occurs following forced hyperextension (bending backwards) of the fingers. The volar (palm) plate is ruptured and the head of the metacarpal can sometimes be […]

Ligamentous Injuries and Dislocations

Injury to the ligamentous structures surrounding the fingers and thumb is common during sports activities, especially those that involve ball handling or heavy physical contact. The key to the treatment of hand injuries is to make an accurate diagnosis through careful history and examination. Failure to recognize the importance of these injuries leads to poor […]

Partial Tears

In a cuff with smooth coverings of synovial and bursal tissue, the severity of a partial tear can be classified as follows:

1. Minimal superficial bursal or synovial irritation, or slight capsular fraying with a partial tear less than 1 cm (0.4 in) in size.

2. Actual fraying and failure of some rotator cuff fibers […]