Specialists

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Principles of Instability Surgery

The goal of treatment in both open and arthroscopic instability surgery is twofold: to restore the labrum to its anatomic attachment site and to re-establish the appropriate tension to the inferior capsuloligamentous complex of the joint. Cadaveric studies have shown that both the labrum and the capsule must be injured for a dislocation to occur.

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Operative Treatment

For patients who fail nonoperative treatment, the procedure of choice is arthroscopic subacromial decompression (ASAD). The advantages of the arthroscopic approach include minimally invasive surgery without detachment of the deltoid.

This leads to a more comfortable postoperative recovery and the capability to accelerate rehabilitation. Arthroscopy also allows complete evaluation of the glenohumeral joint and the […]

Managment-Operative Management

Surgical decision making is first dependent on whether a cyst is causing suprascapular nerve compression. If a ganglion cyst is present, then the cyst is a result of intra-articular pathology; in athletes, this frequently is because of a labral tear. The natural history of ganglion cysts about the shoulder is not known; however, it commonly […]

Evaluation-imaging

Imaging techniques to help in the evaluation of suprascapular nerve injury include the standard radiographic shoulder series, including an AP radiograph in which the beam is directed caudally by 15 to 30 degrees. The suprascapular notch also may be seen on the Stryker notch view.

Although plain radiographs usually are nondiagnositic, they can be useful […]

Glenoid Labrum Tears

Glenoid labrum tears The glenoid labrum is a fibrocartilage rim surrounding the articular surface of the glenoid cavity (the socket of the shoulder joint). The labrum contributes to stability by increasing the depth of the glenoid socket. The loss of the glenoid labrum decreases the depth of the socket by 50% in either direction. A […]

Hip Joint Labral Tears

SYMPTOMS

There is gradual onset of diffuse exercise-induced pain in the groin. Occasionally the patient experiences, and may be able to demonstrate, clicking from the groin in rotational movement. The hip joint is usually stiff and more painful in the morning than in the afternoon and rotational movements are most difficult. In severe cases […]

Prescription Sports

RUNNING ON A HARD SURFACE

Running is one of the most popular sports in the world. This not only covers marathons and track and field running – running is also part of the training in virtually all other sports, including soccer, rugby, handball and triathlon. Running is a very efficient method for maintaining or improving […]

Shoulder Impingement Syndrome

Basics Description Shoulder pain with overhead activities is a common musculoskeletal complaint. Impingement syndrome: Inflammatory condition of the soft tissues of the subacromial space Most common cause of presentation for shoulder complaints to a physician’s office (>50% of all shoulder complaints) Represents a continuum, progressing from acute bursitis, to chronic bursitis, to partial-thickness tears […]

Hip Anatomy and Examination

Basics Description Bones: Pelvis and femur bone The acetabulum is the socket Muscles: Flexors: Iliopsoas, sartorius, rectus femoris Extensors: Gluteus maximus, hamstring muscles Abductors: Gluteus medius, gluteus minimus Adductors: Gracilis, pectineus, adductor longus, adductor brevis, adductor magnus Nerves: Femoral: Hip flexors Obturator: Adductors Superior gluteal: Abductors Ligaments: Sacroiliac: Sacrum to ilium Sacrotuberous: Sacrum to […]

Arthroscopy

Basics Description Arthroscopy should be performed after a complete history and physical examination and after appropriate imaging studies have been obtained. Most procedures can be performed on an outpatient basis. Knee: Indications: Meniscal repair or debridement Meniscal cyst Treatment of osteochondral lesions ACL or PCL tear debridement or reconstruction Synovial biopsy or synovectomy Determination […]