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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 […]

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 […]

Techniques-Glenoid Bone Deficiency

Although osteoarticular pathology rarely is a cause of anterior instability, it is essential that it be ruled out prior to proceeding with any soft-tissue stabilization procedure or in the revision setting. A small subset of patients may be predisposed to instability due to developmental glenoid dysplasia, or pathologic flattening or hypoconcavity of the glenoid as […]

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 […]

Skeletal Lesions

The limited constraint provided by the glenoid is further decreased by bony lesions of the anterior or posterior glenoid rim. These lesions may result from an osseous (anterior or posterior) Bankart lesion, a displaced glenoid fracture, or wear and erosion of the glenoid rim as a result of multiple recurrent dislocations. Burkhart and De Beer […]