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Operative Treatment for Adhesive Capsulitis

Manipulation Under Anesthesia

Manipulation under anesthesia (MUA) has been used to treat adhesive capsulitis for many years. This treatment has commonly been described to prospective patients as “stretching the tight capsule” or “breaking up adhesions” within the shoulder joint. Arthroscopic visualization of the glenohumeral joint after this procedure, however, reveals that a MUA does not […]

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 […]

Dynamic Stability Factors

Glenohumeral stability is mainly achieved through dynamic factors. Active contraction of the rotator cuff contributes to joint stabilization by coordinated muscular activity and by secondary tightening of the ligamentous constraints. This effect works in combination with the concavity-compression mechanism, in which muscle contraction causes compression of nearly congruent articular surfaces into one another.

The rotator […]

Biomechanics of Shoulder Stability-Static Stability Factor

The glenohumeral joint is inherently unstable, with the large humeral head articulating with the small and shallow glenoid. Static stability is provided by the orientation of the articular surfaces, the articular conformity of humerus and the glenoid, the glenoid labrum, the negative intra-articular pressure, the adhesion-cohesion of synovial joint fluid, and the glenohumeral joint capsule […]

Shoulder and Upper Arm

Shoulder motion

Shoulder motion is guided by the integrated motion of several joints such as the sternoclavicular, acromioclavicular, scapulothoracic, and glenohumeral joints. – The glenohumeral joint is the main shoulder joint, comprising the head (ball) of the humerus and the glenoid (socket) of the scapula (shoulder blade). The surrounding capsule is loosely applied and allows […]

Shoulder/Glenohumeral Arthritis

Basics Description Progressive loss of glenohumeral joint space with thinning of articular cartilage, formation of osteophytes, and progressive deformity Epidemiology Females are more likely than males to have primary glenohumeral osteoarthritis. Patients >60 years old are more likely to have it than are younger patients. Incidence ~0.4% in the general population Can reach 4.6% […]

Shoulder Anatomy and Examination

Basics Description Bones: Glenohumeral joint: The humeral head articulates with the glenoid fossa of the scapula. Stabilized by the glenohumeral ligaments capsule and rotator cuff muscles The labrum of the glenoid deepens the joint and enhances stability. AC joint: The acromion process of the scapula articulates with the distal clavicle. Suspends the arm and […]

A Patient’s Guide to Shoulder Dislocations

Introduction

A shoulder dislocation is a painful and disabling injury of the glenohumeral joint. Most dislocations are anterior (forward) but the shoulder can dislocate posteriorly (backwards). Inferior and posterolateral dislocations are possible but occur much less often. The specific type of dislocation is based on the position of the humeral head in relation to the […]

A Patient’s Guide to Shoulder Anatomy

Introduction

The shoulder is an elegant piece of machinery. It has the greatest range of motion of any joint in the body. However, this large range of motion can lead to joint problems.

Understanding how the different layers of the shoulder are built and connected can help you understand how the shoulder works, how it […]

A Patient’s Guide to Quadrilateral Space Syndrome

Introduction

Quadrilateral space syndrome (QSS) happens when the axillary nerve is compressed, or injured in the back of the shoulder. Sometimes the symptoms are caused by the compression of an artery in the same area.

Quadrilateral space syndrome usually happens from overuse, especially with overhead sports like throwing and swimming. The syndrome can also be […]