All athletes in the series returned to previous levels of function, including 14 professionals. The tendon is mobilized and sutured into the defect over the lateral humeral cortex. 128, no. Care should also be taken to ask questions regarding rotator cuff function in older patients that present with shoulder instability as their chief complaint. This technique is performed through a standard deltopectoral incision with the labrum dissected off the glenoid neck to allow osseous preparation down to a bleeding bone surface with a rasp. 4, pp. 17, no. Cummins CA, Murrell GAC: Mode of Failure for Rotator Cuff Repair with Suture Anchors Identified at Revision Surgery. (120) , 1.96 95% . 38, no. In the study by Auffarth et al. 11, pp. In the setting of chronic anterior instability, transfer of the infraspinatus tendon with or without the greater tuberosity has been used to successfully fill defects smaller than 40% of the articular surface. 10.1177/0363546518820529. 2022 Jan 11;7(1):3-12. doi: 10.1530/EOR-21-0075. 7.6mm , 29, 13 , 3, 117 (Table 3). A systematic review of largely heterogeneous studies on arthroscopic remplissage for shoulder instability reported apparent success of the procedure from 8 articles with a total of 207 patients, reporting a mean redislocation rate of % (range, 015%) and a mean recurrent instability rate of % (range, 015%) [70]. Cummins CA, Schneider DS: Peripheral Nerve Injuries in Baseball Players. , , , . #Ankle These values are clinically relevant, however, when weighing the option of surgical intervention. Do you want to share your patient story for Dr. Cummins? # #Chronic lateral ankle instability A modified Latarjet procedure with a coracoid bone block was successful in achieving increased patient satisfaction and return to former activity levels in 35 patients (mean age 35 years, range 2058) in a study by Atalar et al. . Arthroscopy. [32] have reported the results of a humeroplasty technique in four patients with associated capsulolabral repair or Latarjet transfer. [3] suggests that although the principle of identifying and treating glenoid and humeral bone defects in patients with traumatic anterior glenohumeral instability is acknowledged, there is a relative paucity of studies to allow definitive conclusions on the exact bone loss percentages which will increase the risk of redislocation. Arthroscopy. This surgical procedure (Modified Brostrom) for ankle sprains or ruptured ligaments addresses ankle instability. ( ), ( ) (Fig. University of Florida, Gainesville, Florida, Northwestern University Feinberg School of Medicine, Chicago Illinois - Orthopaedic Surgery, University of New South Wales, Kogarah/Sydney, Australia - Shoulder Surgery and Sports Medicine. 317328, 2009. 23, no. # . R. Lugo, P. Kung, and C. B. Ma, Shoulder biomechanics, European Journal of Radiology, vol. The Latarjet coracoid transfer can also serve as reinforcement to anteroinferior capsular deficiency. 1, pp. 80, no. MeSH 205212, 2006. W. P. Garth Jr., C. E. Slappey, and C. W. Ochs, Roentgenographic demonstration of instability of the shoulder: the apical oblique projection. PDF KISTI DDS . 1, pp. 32: 116-120, 2004. Using preoperative and intraoperative measurements, an implant of appropriate size is selected to match the patients particular anatomic defect and secured into place. 19(3): 239-248, 2003. This procedure was nonanatomic and largely relied on the glenohumeral restraint offered by the sling effect of the coracobrachialis with the arm in abduction and external rotation. It has also been demonstrated that the long head of biceps contributes to anterior and posterior stability during internal and external rotation of the humeral head, respectively [13]. B. G. Weber, Operative treatment for recurrent dislocation of the shoulder. 245250, 2010. [25] have conducted a succinct review of the outcomes to date following the current spectrum of procedures which includes humeroplasty, remplissage, osteoarticular allograft, rotational osteotomies, and partial resurfacing. 159176, 2000. 8.3 , 24, 18 , 3, 117 (Table 2). 27401 W. Highway 22 HHS Vulnerability Disclosure, Help Orthopaedic Reserch Society, Annual Meeting, Dallas, Feb 2002, Podium Presentation. M. D. Lazarus, J. Review of clinical outcomes and case presentations, In addi- tion, it does not sacrifice the peroneal tendon, which is an integral part in the adequate rehabilitation of the ankle. 22, no. 83, no. 319322, 2008. 85, no. The peroneal tendon sheath was opened to inspect the tendons and protect them, and A. J. HELFET, Coracoid transplantation for recurring dislocation of the shoulder, The Journal of Bone and Joint Surgery B, vol. 2009 Mar;37(3):488-94. doi: 10.1177/0363546508327541. Description: This protocol applies to patients following the Gould modified Bostrm repair of the Anterior Talo-fibular Ligament (ATFL) and Calcaneal Fibular Ligament (CFL). 6, pp. 4, pp. The rotator cuff muscles provide support to the posterior, superior, and anterior aspect of the glenohumeral joint. In regard to functional outcomes, four of the six studies used the Rowe score (0100) [53, 55, 57, 60]. Cummins CA, Anderson K, Bowen M, Nuber G, and Roth SI: Anatomy and Histological Characteristics of the Spinoglenoid Ligament. : , , . 14) (chondral fracture) (soft tissue impingement) Brostrm . At fifteen-year prospective follow-up, 3.4% of patients had one or more recurrences of instability. See below weight-bearing and impact restrictions to be considered. Re and colleagues [32] published on a variation of this technique using an anterior cruciate ligament (ACL) drill guide to localize the lesion, elevated it with retrograde bone tamping, and filled the defect with cancellous bone graft [25]. , , . doi: 10.1177/1071100717726303. Autogenous bone grafting procedures of the glenoid, mainly with iliac crest, are gaining increasing popularity secondary to suggestions that they may offer a more anatomical reconstruction of the glenoid and thus restoration of the natural articular arc [52]. M. J. Dipaola, L. M. Jazrawi, A. S. Rokito et al., Management of humeral and glenoid bone loss associated with glenohumeral instability: results with anatomical bone grafting, Bulletin of the NYU Hospital for Joint Diseases, vol. PMC , (proprioception) , , , , , /, , , , , , , , , , , , /, , , , , , , , ISBN, ISSN, , , (), (), (). (validity) , . L. A. Danzig, G. Greenway, and D. Resnick, The Hill-Sachs lesion. 26: 195-215, 2008. January 4. 6, pp. 1, pp. Arthroscopic techniques can be used when bone loss is less than 15%, but attempts should be made to incorporate any bony fragments into the repair. The study by Burkhart et al. 34, no. If nonoperative treatment is selected, specific attention should be paid to a supervised rehabilitation program that emphasizes graduated range of motion exercises dependant on the amount of bone loss present. Drill holes are made in a transosseous fashion through the lesser tuberosity and into the defect after appropriate debridement to bleeding cancellous bone, and the tendon is then transferred and secured in place into the defect using nonabsorbable suture. An official website of the United States government. Dr. Cummins seeks to develop a dialogue with his patients to help them fully understand the diagnostic process, their own unique problem, their treatment choices, and the recovery process. Orthopedic Surgeon with Fellowship Training in Shoulder Surgery and Sports Medicine, 2022 Illinois Bone & Joint Institute. 9, pp. 63, no. J. R. Lynch, J. M. Clinton, C. B. Dewing, W. J. Warme, and F. A. Matsen III, Treatment of osseous defects associated with anterior shoulder instability, Journal of Shoulder and Elbow Surgery, vol. (DOI: 10.1016/j.fuel.2021.121072) abstract. Telos (SE 2000, Telos GmbH, Marburg, Germany) , 2 3 . 212, 2010. Unable to load your collection due to an error, Unable to load your delegates due to an error. The following authors do not have any existing potential conflict of interests: Randy Mascarenhas, Jamie Rusen, Bryan M. Saltzman, Jeff Leiter, and Jaskarndip Chahal. The affected shoulder in question should be compared to the contralateral side for the duration of the physical exam. 37, no. 400, pp. Glenoid augmentation with distal tibial osteochondral allograft. It comes with a talus Open capsulolabral repair may be performed in the same circumstances and may be easier to perform in revision instability cases. A. L. Chen, S. A. v.22 no.3 (validity) , . All patients had failed instability repairs and had humeral head defects greater than 25% of the articular surface. , , (direct repair) , (supination) . The mean Rowe across these four studies was 90.5 (excellent). Messer T, Cummins C, Kelikian A: Modified Brostrom Procedure Using Implantable Suture Anchors for Chronic Lateral Ankle Instability. Mean reductions in external rotation in adduction, external rotation in abduction, and internal rotation were reported as 5.6 (40 to +30), 11.3 (50 to +7), and 0.9 (4 to 0) vertebral levels, respectively. , , . Although there are not sufficient outcome data to conclude which of these two techniques is superior, the former provides a soft tissue interposition between the humeral head articular surface and the bony graft, while the latter allows the humeral articular surface to sit on exposed nonarticular bone graft which may increase the risk of arthrosis. Excellent outcomes were obtained on Rowe scores, Constant scores, and Western Ontario Shoulder Instability Index at final follow-up. Attempts should be made to avoid deconditioning of the shoulder musculature at all costs. . WebThe present prospective, randomized study was conducted to compare the clinical outcomes of the modified Brostrom procedure using single and double suture anchors for chronic lateral ankle instability. 2, no. This site needs JavaScript to work properly. Telos , . Much of the recent progress is due to improvements in materials chemistry, MEA A. Martinez, E. Navarro, D. Iglesias, J. Domingo, A. Calvo, and I. Carbonel, Long-term follow-up of allograft reconstruction of segmental defects of the humeral head associated with posterior dislocation of the shoulder, Injury, vol. L. Lafosse and S. Boyle, Arthroscopic Latarjet procedure, Journal of Shoulder and Elbow Surgery, vol. , (the Difference between Omeprazole and Esomeprazole), (In Dentistry, what is a Lip Bumper), LEEP(What Should I Know About Pregnancy After a LEEP Procedure), (the Difference between Urticaria and Hives), Trendelenburg(the Trendelenburg Test), (Different Types of Homeopathic Therapies), (Difference Between Kwashiorkor and Marasmus), (Best Treatments for Arthritic Knee Pain), (Difference Between Arthritis and Rheumatism), (Different Types of Hernia Repair), MRIMRA(the Difference between an MRI and MRA), (What Types of Anti-Glare Lighting), (Common Types of Preservatives in Eye Drops), (Effective is an Epidural for Back Pain), (Should I See a Dermatologist for a Rash), (Different Monosomy Disorders), (Choose the Best Antifungal for Ringworm), (Treatments for Autonomic Nervous System Dysfunction). Arthroscopic os trigonum excision. All techniques are associated with the long-term development of arthrosis. He has served as an instructor for the Arthroscopy Association of North America, and has also consulted for various orthopedic companies, teaching basic and cutting-edge arthroscopic techniques to orthopedic surgeons across the country. 8, pp. J Shoulder Elbow Surg, 18: 172-177, 2009. Hovelius et al. eCollection 2022 Sep-Oct. Vopat ML, Lee B, Mok AC, Hassan M, Morris B, Tarakemeh A, Zackula R, Mullen S, Schroeppel P, Vopat BG. . 1, pp. Am J Sports Med. All the professional dancers obtained excellent results. WebMesser TM, Cummins CA, Ahn J, Kelikian AS: Outcome of the Modified Brostrom Procedure for Chronic Lateral Ankle Instability Using Suture Anchors. Gender Differences in Outcome After Modified Brostrm Procedure for Chronic Lateral Ankle Instability. Little has been published in the literature with regard to indications and outcomes of this technique, but it has been suggested that disimpaction grafting is the best indicated for defects that are less than 3 to 4 weeks old and involve <40% of the articular surface. . Careers. 34 (9): 1486-1491. B. G. Weber, L. A. Simpson, and F. Hardegger, Rotational humeral osteotomy for recurrent anterior dislocation of the shoulder associated with a large Hill-Sachs lesion, Journal of Bone and Joint Surgery A, vol. , (proprioception) , , . This allows for the sling effect provided by the coracobrachialis but also attempts to reconstruct the osseous anatomy of the glenoid. Kronberg and Brostrom [75] reported their five-year results of 20 derotation osteotomies performed for recurrent instability. 10) , 3) . WebActa Chir Scand Brostrom 128 483 1964 ; 3. . The glenoid labrum deepens the shoulder cavity by up to 50% which increases concavity compression and, ultimately, joint stability. ( ) 2, pp. ( ) (peroneal tendon sheath) . A deficient RI decreases stability in the inferior directions [9]. P. W. Weng, H. C. Shen, H. H. Lee, S. S. Wu, and C. H. Lee, Open reconstruction of large bony glenoid erosion with allogeneic bone graft for recurrent anterior shoulder dislocation, The American Journal of Sports Medicine, vol. M. T. Provencher, N. Ghodadra, L. LeClere, D. J. Solomon, and A. Anatomical reconstruction for chronic lateral ankle instability in the high-demand athlete: functional outcomes after the modified Brostrm repair using suture anchors. . J. C. Adams, Recurrent dislocation of the shoulder., The Journal of Bone and Joint Surgery, vol. 1624, 2008. Since the glenohumeral joint is least stable in the anterior/posterior direction, and the majority of dislocations occur when the humeral head translates anteriorly on glenoid, most glenoid defects occur at an area from the 3 oclock position extending inferiorly to the 6 oclock position [10]. , . 68, no. Arthroscopic techniques may be used for osseous defects that measure less than 25% of the glenoid. Please enable it to take advantage of the complete set of features! Telos , . ; 9, pp. Rotational osteotomy of the proximal humerus is also an option that has been described to deal with large humeral head defects in younger patients to delay the need for prosthetic replacement. A. M. Halder, S. G. Kuhl, M. E. Zobitz, D. Larson, and K. N. An, Effects of the glenoid labrum and glenohumeral abduction on stability of the shoulder joint through concavity-compression: an in vitro study, Journal of Bone and Joint Surgery, vol. No information regarding functional outcomes using shoulder-joint specific outcome measures was reported. , . 95% , 8.3 , 7.6 mm (Table 1). H. Rahme, L. Wikblad, J. Nowak, and S. Larsson, Long-term clinical and radiologic results after Eden-Hybbinette operation for anterior instability of the shoulder, Journal of Shoulder and Elbow Surgery, vol. Dr. Cummins leading-edge techniques, combined with proven methods, provide his patients with the best orthopedic care possible. E. M. Wolf and A. Arianjam, Hill-Sachs remplissage, an arthroscopic solution for the engaging Hill-Sachs lesion: 2- to 10-year follow-up and incidence of recurrence, Journal of Shoulder and Elbow Surgery, vol. For defects measuring 2025% of the articular surface, an infraspinatus tendon transfer can be utilized in isolation. WebOur CO 2 emissions are on a constant rise, reaching a monthly average of 419 ppm in 2021, a record high in the last 2 million years. I elevated at the fibula up to the periosteum. 1, pp. 69%, 97%, 91%, 90% (Table 4). S. M. Howell and B. J. Galinat, The glenoid labral socket. The purpose of this procedure is to stabilize the ankle, improve the ankle's mechanics and restore full function. 169174, 2004. [60] demonstrated that, of the ten patients in their series, two patients had grade I arthritis and one had grade II arthritis via the Samilson/Prieto classification. J Bone Joint Surg Am Karlsson 70 581 1988 10.2106/00004623-198870040-00015 ; 6. Patients may have redislocated following previous arthroscopic shoulder stabilization procedures as well and this is important to note. Clipboard, Search History, and several other advanced features are temporarily unavailable. . M. Khazzam, S. M. Kane, and M. J. Smith, Open shoulder stabilization procedure using bone block technique for treatment of chronic glenohumeral instability associated with bony glenoid deficiency, The American Journal of Orthopedics, vol. In addition, the role of the long head of biceps tendon as a depressor of the humeral head is confirmed by the presence of superior migration of the humeral head following rupture of the tendon [11, 12]. 653684, 2013. The lack of musculature and the redundant capsule in the inferior aspect of the glenohumeral joint are the main contributors to the anterior/inferior instability of the shoulder joint. L. Hovelius, B. Sandstrm, and M. Saeb, One hundred eighteen Bristow-Latarjet repairs for recurrent anterior dislocation of the shoulder prospectively followed for fifteen years: study II-the evolution of dislocation arthropathy, Journal of Shoulder and Elbow Surgery, vol. When a lesser tuberosity transfer is indicated, an osteotomy is made at its base just medial to the bicipital groove and the tuberosity is transferred into the defect and secured in place using 2 cancellous screws with the subscapularis tendon sutured overtop to the medial edge of the articular surface. [56] were evaluated for arthritis changes. This benefit is offset by the immense difficulty of the procedure, even in experienced hands [51]. Cummins CA, Appleyard RC, Strickland S, Haen P, Chen S, Murrell, G: Rotator Cuff Repair: An Ex Vivo Analysis of Suture Anchor Repair Techniques on Initial Load to Failure. Re et al. 8600 Rockville Pike 2). Foot Ankle. 5). M. Kronberg and L. A. Brostrom, Rotation osteotomy of the proximal humerus to stabilise the shoulder: five years' experience, Journal of Bone and Joint Surgery B, vol. 13, no. 78, no. 14781489, 2010. Methods All published randomized clinical trials comparing MBG and other operations were found by searching the Cochrane Library, EMBASE, and PubMed WebType of Procedure: outpatient Length of Procedure: 1 hour Anesthesia: general w/ popliteal or sciatic nerve block common method is called a modified Brostrom procedure. Since 2001, Dr. Cummins has functioned as a team physician for Barrington High School and previously was a team physician for Lake Zurich High School, from 2002-2016. Xiao L, Zheng B, Zhou Y, Hu D, Li J, Zheng X, Hou H, Wang H. J Clin Med. = Journal of Korean orthopaedic sports medicine, [] 4 , [] , [] Brostrom . 18, no. [72] also reported on the results of osteoarticular allograft for the management of humeral head defects following recurrent shoulder instability. The Brostrom-Gould procedure has been considered as a gold standard operative technique for chronic lateral ankle instability. 13171325, 2008. 1, no. In regard to the arthroscopic remplissage procedure, Purchase et al. International Symposium on Limb Salvage. This prevents the glenoid margin from falling into the defect. , , . A. Hannafin, S. P. Arnoczky, and R. F. Warren, Articular contact patterns of the normal glenohumeral joint, Journal of Shoulder and Elbow Surgery, vol. The mean age of the patients was 31.6 years; 10.5% were female and the combined mean follow-up was 55.6 months. A. Romeo, W. N. Levine, B. R. Bach, and M. T. Provencher, Glenoid bone deficiency in recurrent anterior shoulder instability: diagnosis and management, Journal of the American Academy of Orthopaedic Surgeons, vol. , 2018, pp.83 - 90 Hunt, and J. D. Zuckerman, Humeral head impression fractures and head-splitting fractures, in Shoulder Fractures: The Practical Guide to Management, J. D. Zuckerman and K. J. Koval, Eds., pp. 197202, 2012. S.-H. Kim, J.-C. Park, J.-S. Park, and I. Oh, Painful jerk test: a predictor of success in nonoperative treatment of posteroinferior instability of the shoulder, The American Journal of Sports Medicine, vol. Repair of concomitant lateral ankle ligament instability and peroneus brevis splits through a posteriorly modified Brostrom Gould. Cummins CA, Murrell G: Mode of Failure forRotator Cuff Repair: Intra-Operative Findings at Revision Surgery. Foot Ankle Int, 21(12): Cummins CA, Sabrina S, Appleyard R, Szomor Z, Marshall J, Murrell G: Rotator Cuff Repair with Bio- Absorbable Screws: An In Vivo and Ex Vivo Investigation. The coracoid graft demonstrated osseous union in all patients at a mean months (range, 1274) with no further instability or degenerative arthritis. , , 46 . 8, pp. 10) , 3) . 1, pp. 8, pp. 10621069, 2001. The long-term follow-up of allograft reconstruction of humeral head segmental defects from posterior shoulder dislocation was evaluated by Martinez et al. He works to develop a partnership with his patients, which begins with listening and gathering information, not only about the orthopedic injury but also how the physical problem is affecting the patients life. 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