Specialists

Featured on Channel NewsAsia

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 […]

Allograft Tissues

Allograft tissues have been employed to reconstruct a variety of joint surfaces, and the humerus is certainly no different. The use of smaller focal defects, however, is not extensively described in the literature with the exception of a few case series. In one study, Gerber et al.It employed a large segmental humeral head allograft to […]

Autologous Tissues

The use of autologous tissues about the knee has been commonplace for several years, and has included the transplantation of local tissue, transfer of remote tissue, and finally the genetic production of cloned tissue from knee cartilage cells .

A technique that has been used in the knee is transfer of autologous tissue from other […]

Cartilage

Key Points

Full-thickness articular cartilage defects have a limited capacity to heal. Thus, articular cartilage lesions and osteochondral defects in any joint present a challenging problem. Cartilage lesions are less likely to be seen in the glenohumeral joint than in the knee, therefore there has not been extensive research on shoulder cartilage repair. Making the […]

Impingement: Primary

Impingement of the tendinous portion of the rotator cuff as it passes under the coracoacromial arch is a classic cause of rotator cuff injury. The impingement syndrome, as originally described by Neer, encompasses a spectrum of pathologic changes involving the rotator cuff and associated bony changes within the coracoacromial arch, affecting primarily those 40 years […]

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 […]

Ulnar Nerve Neuritis

WHAT IS ULNAR NERVE NEURITIS?

Ulnar nerve neuritis begins with a little bit of tingling in the little and ring fingers especially when placing the elbow on arm rests in cars or on a chair.

WHAT ARE THE CAUSES?

Ulnar nerve neuritis is caused by compression or irritation of the ulnar nerve as it runs […]

Shoulder instability / shoulder dislocation

WHAT IS SHOULDER DISLOCATION?

A dislocated shoulder occurs when the humerus separates from the scapula at the glenohumeral joint.

HOW IS SHOULDER DISLOCATION DIAGNOSED?

Diagnosis includes physical examination where there is a significant pain, which can sometimes be felt past the shoulder, along the arm. The person is unable to move the arm from its […]

Physical Findings

A systematic evaluation includes observation for abnormal motion patterns and atrophy, palpation to localize painful areas, assessment of both active and passive range of motion, measurement of strength of the rotator cuff, deltoid and scapular stabilizer muscles, neurovascular examination, and finally provocative testing maneuvers for instability. It is important to examine the opposite shoulder for […]

Capsular Lesions

Traumatic intra-substance injury of the joint capsule is commonly associated with anterior dislocation. Depending on the magnitude of the anterior shear force, either plastic deformation or a complete tear of the joint capsule can occur.

The recognition of a concomitant posttraumatic capsular laxity or rupture and a Bankart lesion is essential in order to select […]