Submit Search
Upload
Arthroscopic lat dorsi transfer
•
0 likes
•
1,209 views
Lennard Funk
Follow
Arthroscopic lat dorsi transfer www.shoulderdoc.co.uk
Read less
Read more
Health & Medicine
Report
Share
Report
Share
1 of 43
Download now
Download to read offline
Recommended
Habitual dislocation of patella - surgical technique
Habitual dislocation patella
Habitual dislocation patella
vinod naneria
MPFL Rec onstruction for Patellar Instability - By Dr Shekhar Srivastav . Surgical Technique - Diagnostic Arthroscopy - Look for any Osteochondral fragment (Loose body) - Look for any Chondral damage - Patellar tracking though Supero-lateral portal Post-op Protocol Ambulation with stick and Knee Brace- 3 wks ROM exer – Next day upto 300 and progress Review every 2 wks,6 wks,3 mnths,6 mnths and yearly thereafter Post-op assessment (Crosby-Insall criteria) Excellent- No pain,normal activity Good- Occasional pain,discomfort Fair/Poor- Pain,loss of flexion,recurrent dislocation/subluxation Worse- Pain increased,displacement more frequent Caution Must avoid overtightening- Medial instability Medial patellar arthritis Patellar fractures Preexisting Chondromalacia Details @ http://www.delhiarthroscopy.com/
Mpfl tech - MPFL Reconstruction for Patellar Instability
Mpfl tech - MPFL Reconstruction for Patellar Instability
DelhiArthroscopy
Management of recurrent dislocation of patella by reconstructing2
Management of recurrent dislocation of patella by reconstructing2
Jitesh Jain
Patello femoral instability
Patello femoral instability
Hiren Divecha
Habitual dislocation of patella
Habitual dislocation of patella
Habitual dislocation of patella
sushilonlines
Intraoperative acetabular fracture and pelvic discontinuity in thr
Intraoperative acetabular fracture and pelvic discontinuity in thr
Intraoperative acetabular fracture and pelvic discontinuity in thr
jatinder12345
detailed journal club presentation on topic Dynamic medial patellofemoral ligament reconstruction in recurrent patellar instability
Dynamic medial patellofemoral ligament reconstruction in recurrent patellar i...
Dynamic medial patellofemoral ligament reconstruction in recurrent patellar i...
Love2jaipal
periprosthetic fracture
Periprosthetic fracture
Periprosthetic fracture
jatinder12345
Recommended
Habitual dislocation of patella - surgical technique
Habitual dislocation patella
Habitual dislocation patella
vinod naneria
MPFL Rec onstruction for Patellar Instability - By Dr Shekhar Srivastav . Surgical Technique - Diagnostic Arthroscopy - Look for any Osteochondral fragment (Loose body) - Look for any Chondral damage - Patellar tracking though Supero-lateral portal Post-op Protocol Ambulation with stick and Knee Brace- 3 wks ROM exer – Next day upto 300 and progress Review every 2 wks,6 wks,3 mnths,6 mnths and yearly thereafter Post-op assessment (Crosby-Insall criteria) Excellent- No pain,normal activity Good- Occasional pain,discomfort Fair/Poor- Pain,loss of flexion,recurrent dislocation/subluxation Worse- Pain increased,displacement more frequent Caution Must avoid overtightening- Medial instability Medial patellar arthritis Patellar fractures Preexisting Chondromalacia Details @ http://www.delhiarthroscopy.com/
Mpfl tech - MPFL Reconstruction for Patellar Instability
Mpfl tech - MPFL Reconstruction for Patellar Instability
DelhiArthroscopy
Management of recurrent dislocation of patella by reconstructing2
Management of recurrent dislocation of patella by reconstructing2
Jitesh Jain
Patello femoral instability
Patello femoral instability
Hiren Divecha
Habitual dislocation of patella
Habitual dislocation of patella
Habitual dislocation of patella
sushilonlines
Intraoperative acetabular fracture and pelvic discontinuity in thr
Intraoperative acetabular fracture and pelvic discontinuity in thr
Intraoperative acetabular fracture and pelvic discontinuity in thr
jatinder12345
detailed journal club presentation on topic Dynamic medial patellofemoral ligament reconstruction in recurrent patellar instability
Dynamic medial patellofemoral ligament reconstruction in recurrent patellar i...
Dynamic medial patellofemoral ligament reconstruction in recurrent patellar i...
Love2jaipal
periprosthetic fracture
Periprosthetic fracture
Periprosthetic fracture
jatinder12345
Fractures after Knee replacement can be challenging. An algorithmic approach would help manage them better. The presentation defines correct approach towards the same.
Periprosthetic Fractures around Knee
Periprosthetic Fractures around Knee
Vaibhav Bagaria
useful
Instability in TKR
Instability in TKR
Rishi Poudel
Description of the process, patient selection, rehab
Arthroscopy assisted mpfl reconstruction
Arthroscopy assisted mpfl reconstruction
Dr.Sabyasachi Bardhan DNB (Ortho), MNAMS
Medial patellofemoral ligament reconstruction ---- an update on techniques used. This lecture was taken by me at Trinity Arthroscopy Course, Chandigarh.
Medial Patellofemoral Ligament (MPFL) reconstruction 2014
Medial Patellofemoral Ligament (MPFL) reconstruction 2014
Dhananjaya Sabat
Total Knee Replacement
Total Knee Replacement
Jodi Richards
Periprosthetic fractures around the knee
Periprosthetic fractures around the knee
Periprosthetic fractures around the knee
Ahmed Azmy
HOW TO SELECT AND WHAT TYPE OF IMPLANTS TO SELECT IN REVISION TOTAL KNEE REPLACEMENT SURGERIES.
Implant Selection In Revision T.K.R
Implant Selection In Revision T.K.R
Murtuza Rassiwala
Introduction: The radiological work-up of patients with patellofemoral disorders continues to be debated. The interchangeability of the tibial tubercle-trochlear groove (TT-TG) distance between computed tomography (CT) and magnetic resonance imaging (MRI) has recently been questioned. In addition, a new measurement-the tibial tubercle-posterior cruciate ligament (TT-PCL) distance-has shown that not all patients with a pathological TT-TG distance (>20 mm) have lateralization of the tibial tubercle. Another factor to consider when looking at the position of the tibial tubercle is the knee joint rotation, defined as the angle between the femoral dorsal condylar line and the tibial dorsal condylar line. Aim: To determine, with a larger population, if the TT-TG measurements can be used interchangeably between CT and MRI and to confirm the correlation between the TT-PCL and TT-TG distances in determining tibial tubercle lateralization. Study Design: Cohort study (diagnosis); Level of evidence, 2. Patients with patellofemoral disorders and MRI and CT scans of the same knee (n = 141) were identified. The TT-PCL, the knee joint rotation, and TT-TG were measured independently by 2 fellowship-trained orthopaedic surgeons. Thirty measurements were repeated on a separate occasion to allow for an assessment of the intrarater reliability. The intraclass correlation coefficient (ICC) was used to assess reliability of the measurements. Results: The mean TT-TG was 4.16 mm less on MRI (P < .05), with the mean TT-TG ± SD being 17.72 ± 5.15 mm on CT (range, 6.97-31.33 mm) and 13.56 ± 6.07 mm on MRI (range, 2-30.04 mm). The ICC for each rater comparing the 2 imaging modalities was only fair (0.54 and 0.48). The mean TT-PCL measurement was 20.32 ± 3.45 mm (range, 10.11-32.01 mm) with excellent interobserver and intraobserver reliability (>0.75). Based on the TT-TG and TT-PCL measurements, 4 groups of patients can be established. When knee joint rotation is compared among groups, an increased TT-TG may result from true lateralization of the tibial tubercle, an increased knee joint rotation, or both. Conclusions: Based on a statistically significant mean difference (4.11 mm) and only a fair ICC (0.54 and 0.48) for raters comparing the 2 modalities, the measurements for the TT-TG cannot be used interchangeably between CT and MRI. Therefore, currently accepted values for TT-TG based on CT scans should not be applied to an MRI scan. The TT-PCL measurement is a measure of true lateralization of the tibial tubercle, while the TT-TG is an amalgamated measure of true lateralization and knee joint rotation.
The Radiological Work Up of Patients With Patellofemoral Pathology: ISAKOS 2015
The Radiological Work Up of Patients With Patellofemoral Pathology: ISAKOS 2015
Adnan Saithna - Orthopedic Surgeon, Scottsdale, Arizona
Anke fx fixation - Derek Park
Anke fx fixation - Derek Park
Derek Park
fracture classification and principals of management
Periprosthetic fractures of knee
Periprosthetic fractures of knee
Rukmangada Naidu
Periprosthetic fractures after hip replacement need skill full management. Key is to diagnose them appropriately and instate an early management.
Periprosthetic Fractures of Hip - basics & tips & tricks!
Periprosthetic Fractures of Hip - basics & tips & tricks!
Vaibhav Bagaria
ORTHOPAEDICS
Recurrent Dislocation of patella -PAWAN
Recurrent Dislocation of patella -PAWAN
Pawan Yadav
recent advances in all the majority of joints including spine
Recent advances in joint arthroplasty
Recent advances in joint arthroplasty
Central Institute of Orthopaedics, Safdarjang Hospital and VMMC, New Delhi
Lecture 11 parekh pilon
Lecture 11 parekh pilon
Selene G. Parekh, MD, MBA
basic steps in TKA
Steps total knee replacement
Steps total knee replacement
AdityaApte11
Lecture 41 parekh er f&a
Lecture 41 parekh er f&a
Selene G. Parekh, MD, MBA
The Principe of high tibial osteotomy is to reduce the stresses of the internal compartment of the knee by valgizing the tibia.The total knee arthroplasty on this tibia with a “malunion” presents technical difficulties related to the initial approach, the presence of osteosynthesis material, the presence of malunion and the change of bone density. The objectives of this study are to determine the clinical and radiographic results of patients undergoing Total Knee Arthroplasty (TKA) after High Tibial Osteotomy (HTO). This is a retrospective descriptive study including patients undergoing Total Knee Arthroplasty (TKA) after an High Tibial Osteotomy (HTO) at the Hospital of Mont de Marsan (France) from 2008 to 2017 with a minimum follow-up of 12 months. Thirty knees (27 patients) were recruited. The sex ratio was 1.72. The average age was 70.33 years (54years-88years). The average time between High Tibial Osteotomy (HTO) and Total Knee Arthroplasty (TKA) was 10.83 years (1 year-26 years). The medial opening was 63.33% and lateral closure for the rest. Clinical improvement was observed, with an average gain of 24.97 points for pain, 1 point for stability, 1 point for knee mobility and 5 points for walking distance. The clinical result was perfect in 13.33%, excellent in 42% and medium in 36.67% of cases. The alignment was obtained in 76.67% of cases (p = 0.0039). The posterior tibial slope, epiphyseal varus, patellar height were corrected in 80% of cases respectivly (p = 0.000011, p = 0.44, p = 0.15). Residual pain was observed in 26.66%, joint stiff ness in 16.66%, skin healing disorder in 16% and infection in 6.66% of cases. Total knee arthroplasty made it possible to recover the failure of an high tibial osteotomy.
International Journal of Orthopedics: Research & Therapy
International Journal of Orthopedics: Research & Therapy
SciRes Literature LLC. | Open Access Journals
Lecture 40 parekh malunited ankle fracture
Lecture 40 parekh malunited ankle fracture
Selene G. Parekh, MD, MBA
principles of Knee replacement, talking about the problems with sizing in TKR
The problems of over or undersizing of tkr
The problems of over or undersizing of tkr
Ahmed Qutub
Patella Fractures
Patella fractures seminar mukul 11.06.2018
Patella fractures seminar mukul 11.06.2018
MukulJain81
Lecture 23 24 parekh peroneal pathology
Lecture 23 24 parekh peroneal pathology
Selene G. Parekh, MD, MBA
Basics of patellofemoral instability for postgraduates. Gives brief introduction about patellofemoral joint anatomy, causes, examintaion and treatment for patellofemoral instability
Patellar Instability
Patellar Instability
Bijay Mehta
More Related Content
What's hot
Fractures after Knee replacement can be challenging. An algorithmic approach would help manage them better. The presentation defines correct approach towards the same.
Periprosthetic Fractures around Knee
Periprosthetic Fractures around Knee
Vaibhav Bagaria
useful
Instability in TKR
Instability in TKR
Rishi Poudel
Description of the process, patient selection, rehab
Arthroscopy assisted mpfl reconstruction
Arthroscopy assisted mpfl reconstruction
Dr.Sabyasachi Bardhan DNB (Ortho), MNAMS
Medial patellofemoral ligament reconstruction ---- an update on techniques used. This lecture was taken by me at Trinity Arthroscopy Course, Chandigarh.
Medial Patellofemoral Ligament (MPFL) reconstruction 2014
Medial Patellofemoral Ligament (MPFL) reconstruction 2014
Dhananjaya Sabat
Total Knee Replacement
Total Knee Replacement
Jodi Richards
Periprosthetic fractures around the knee
Periprosthetic fractures around the knee
Periprosthetic fractures around the knee
Ahmed Azmy
HOW TO SELECT AND WHAT TYPE OF IMPLANTS TO SELECT IN REVISION TOTAL KNEE REPLACEMENT SURGERIES.
Implant Selection In Revision T.K.R
Implant Selection In Revision T.K.R
Murtuza Rassiwala
Introduction: The radiological work-up of patients with patellofemoral disorders continues to be debated. The interchangeability of the tibial tubercle-trochlear groove (TT-TG) distance between computed tomography (CT) and magnetic resonance imaging (MRI) has recently been questioned. In addition, a new measurement-the tibial tubercle-posterior cruciate ligament (TT-PCL) distance-has shown that not all patients with a pathological TT-TG distance (>20 mm) have lateralization of the tibial tubercle. Another factor to consider when looking at the position of the tibial tubercle is the knee joint rotation, defined as the angle between the femoral dorsal condylar line and the tibial dorsal condylar line. Aim: To determine, with a larger population, if the TT-TG measurements can be used interchangeably between CT and MRI and to confirm the correlation between the TT-PCL and TT-TG distances in determining tibial tubercle lateralization. Study Design: Cohort study (diagnosis); Level of evidence, 2. Patients with patellofemoral disorders and MRI and CT scans of the same knee (n = 141) were identified. The TT-PCL, the knee joint rotation, and TT-TG were measured independently by 2 fellowship-trained orthopaedic surgeons. Thirty measurements were repeated on a separate occasion to allow for an assessment of the intrarater reliability. The intraclass correlation coefficient (ICC) was used to assess reliability of the measurements. Results: The mean TT-TG was 4.16 mm less on MRI (P < .05), with the mean TT-TG ± SD being 17.72 ± 5.15 mm on CT (range, 6.97-31.33 mm) and 13.56 ± 6.07 mm on MRI (range, 2-30.04 mm). The ICC for each rater comparing the 2 imaging modalities was only fair (0.54 and 0.48). The mean TT-PCL measurement was 20.32 ± 3.45 mm (range, 10.11-32.01 mm) with excellent interobserver and intraobserver reliability (>0.75). Based on the TT-TG and TT-PCL measurements, 4 groups of patients can be established. When knee joint rotation is compared among groups, an increased TT-TG may result from true lateralization of the tibial tubercle, an increased knee joint rotation, or both. Conclusions: Based on a statistically significant mean difference (4.11 mm) and only a fair ICC (0.54 and 0.48) for raters comparing the 2 modalities, the measurements for the TT-TG cannot be used interchangeably between CT and MRI. Therefore, currently accepted values for TT-TG based on CT scans should not be applied to an MRI scan. The TT-PCL measurement is a measure of true lateralization of the tibial tubercle, while the TT-TG is an amalgamated measure of true lateralization and knee joint rotation.
The Radiological Work Up of Patients With Patellofemoral Pathology: ISAKOS 2015
The Radiological Work Up of Patients With Patellofemoral Pathology: ISAKOS 2015
Adnan Saithna - Orthopedic Surgeon, Scottsdale, Arizona
Anke fx fixation - Derek Park
Anke fx fixation - Derek Park
Derek Park
fracture classification and principals of management
Periprosthetic fractures of knee
Periprosthetic fractures of knee
Rukmangada Naidu
Periprosthetic fractures after hip replacement need skill full management. Key is to diagnose them appropriately and instate an early management.
Periprosthetic Fractures of Hip - basics & tips & tricks!
Periprosthetic Fractures of Hip - basics & tips & tricks!
Vaibhav Bagaria
ORTHOPAEDICS
Recurrent Dislocation of patella -PAWAN
Recurrent Dislocation of patella -PAWAN
Pawan Yadav
recent advances in all the majority of joints including spine
Recent advances in joint arthroplasty
Recent advances in joint arthroplasty
Central Institute of Orthopaedics, Safdarjang Hospital and VMMC, New Delhi
Lecture 11 parekh pilon
Lecture 11 parekh pilon
Selene G. Parekh, MD, MBA
basic steps in TKA
Steps total knee replacement
Steps total knee replacement
AdityaApte11
Lecture 41 parekh er f&a
Lecture 41 parekh er f&a
Selene G. Parekh, MD, MBA
The Principe of high tibial osteotomy is to reduce the stresses of the internal compartment of the knee by valgizing the tibia.The total knee arthroplasty on this tibia with a “malunion” presents technical difficulties related to the initial approach, the presence of osteosynthesis material, the presence of malunion and the change of bone density. The objectives of this study are to determine the clinical and radiographic results of patients undergoing Total Knee Arthroplasty (TKA) after High Tibial Osteotomy (HTO). This is a retrospective descriptive study including patients undergoing Total Knee Arthroplasty (TKA) after an High Tibial Osteotomy (HTO) at the Hospital of Mont de Marsan (France) from 2008 to 2017 with a minimum follow-up of 12 months. Thirty knees (27 patients) were recruited. The sex ratio was 1.72. The average age was 70.33 years (54years-88years). The average time between High Tibial Osteotomy (HTO) and Total Knee Arthroplasty (TKA) was 10.83 years (1 year-26 years). The medial opening was 63.33% and lateral closure for the rest. Clinical improvement was observed, with an average gain of 24.97 points for pain, 1 point for stability, 1 point for knee mobility and 5 points for walking distance. The clinical result was perfect in 13.33%, excellent in 42% and medium in 36.67% of cases. The alignment was obtained in 76.67% of cases (p = 0.0039). The posterior tibial slope, epiphyseal varus, patellar height were corrected in 80% of cases respectivly (p = 0.000011, p = 0.44, p = 0.15). Residual pain was observed in 26.66%, joint stiff ness in 16.66%, skin healing disorder in 16% and infection in 6.66% of cases. Total knee arthroplasty made it possible to recover the failure of an high tibial osteotomy.
International Journal of Orthopedics: Research & Therapy
International Journal of Orthopedics: Research & Therapy
SciRes Literature LLC. | Open Access Journals
Lecture 40 parekh malunited ankle fracture
Lecture 40 parekh malunited ankle fracture
Selene G. Parekh, MD, MBA
principles of Knee replacement, talking about the problems with sizing in TKR
The problems of over or undersizing of tkr
The problems of over or undersizing of tkr
Ahmed Qutub
Patella Fractures
Patella fractures seminar mukul 11.06.2018
Patella fractures seminar mukul 11.06.2018
MukulJain81
What's hot
(20)
Periprosthetic Fractures around Knee
Periprosthetic Fractures around Knee
Instability in TKR
Instability in TKR
Arthroscopy assisted mpfl reconstruction
Arthroscopy assisted mpfl reconstruction
Medial Patellofemoral Ligament (MPFL) reconstruction 2014
Medial Patellofemoral Ligament (MPFL) reconstruction 2014
Total Knee Replacement
Total Knee Replacement
Periprosthetic fractures around the knee
Periprosthetic fractures around the knee
Implant Selection In Revision T.K.R
Implant Selection In Revision T.K.R
The Radiological Work Up of Patients With Patellofemoral Pathology: ISAKOS 2015
The Radiological Work Up of Patients With Patellofemoral Pathology: ISAKOS 2015
Anke fx fixation - Derek Park
Anke fx fixation - Derek Park
Periprosthetic fractures of knee
Periprosthetic fractures of knee
Periprosthetic Fractures of Hip - basics & tips & tricks!
Periprosthetic Fractures of Hip - basics & tips & tricks!
Recurrent Dislocation of patella -PAWAN
Recurrent Dislocation of patella -PAWAN
Recent advances in joint arthroplasty
Recent advances in joint arthroplasty
Lecture 11 parekh pilon
Lecture 11 parekh pilon
Steps total knee replacement
Steps total knee replacement
Lecture 41 parekh er f&a
Lecture 41 parekh er f&a
International Journal of Orthopedics: Research & Therapy
International Journal of Orthopedics: Research & Therapy
Lecture 40 parekh malunited ankle fracture
Lecture 40 parekh malunited ankle fracture
The problems of over or undersizing of tkr
The problems of over or undersizing of tkr
Patella fractures seminar mukul 11.06.2018
Patella fractures seminar mukul 11.06.2018
Similar to Arthroscopic lat dorsi transfer
Lecture 23 24 parekh peroneal pathology
Lecture 23 24 parekh peroneal pathology
Selene G. Parekh, MD, MBA
Basics of patellofemoral instability for postgraduates. Gives brief introduction about patellofemoral joint anatomy, causes, examintaion and treatment for patellofemoral instability
Patellar Instability
Patellar Instability
Bijay Mehta
Foot and ankle trauma
Foot and ankle trauma - Derek Park
Foot and ankle trauma - Derek Park
Derek Park
orthopaedics and trauma
G18 malunions
G18 malunions
Claudiu Cucu
Tendon transfers around the shoulder
Tendon transfers around the shoulder
Tendon transfers around the shoulder
Puneet Monga
Orthopedic
PCL injuriessss,mechanism,diagnosis and treatment.pptx
PCL injuriessss,mechanism,diagnosis and treatment.pptx
VigneshBabuViky
Lecture 27 parekh pttd3 and 4
Lecture 27 parekh pttd3 and 4
Selene G. Parekh, MD, MBA
Basics of total knee replacement
Tkr
Tkr
Md Ashiqur Rahman
RUKAMANEE YADAV, NCCT OR CECT PELVIS BONE, CECT PELVIS BONE, INDICATIONS OF PELVIS BONE
NCCT OR CECT PELVIS BONE.pptx, INDICATIONS OF PELVIS BONE
NCCT OR CECT PELVIS BONE.pptx, INDICATIONS OF PELVIS BONE
RukamaneeYadav
journal reading
Journal bukit
Journal bukit
Bangkit Primayudha
Knee injuries for MBBS (undergraduate students). This presentation deals with injuries to the bones and ligaments around the knee as well as gives a brief overview on the dislocations of the knee and patella.
Injuries around the knee
Injuries around the knee
Siddhartha Sinha
The mounting scientific, published research has proven the effectiveness and efficacy of extra-osseous talotarsal stabilization with HyProCure. This is a life-changing procedure. Over 20,000 procedures have been performed with not one significant complication (fracture, bone infection, amputation). Learn more at www.GraMedica.com.
Extra-Osseous TaloTarsal Stabilization - HyProCure: The Scientific Evidence i...
Extra-Osseous TaloTarsal Stabilization - HyProCure: The Scientific Evidence i...
GraMedica
In the elderly osteoporotic fractures although the principles are the same but some special considerations in management of the soft tissues and the bony injuries are considered.
Proximal tibial fracture
Proximal tibial fracture
Smarajit Patnaik
Acl tear
Acl tear
Acl tear
M A Roshan Zameer
Acl tear
Acl tear
Acl tear
M A Roshan Zameer
Knee replacement in a recurvatum deformity is one of the most challenging scenarios. This uncommon surgery is based on a few simple principles which are explained in this ppt. Hyperextension can be a part of neurological disorder, primary ligament laxity, mal-alignment around the joint, post traumatic conditions etc. a careful dissection and minimal bone cuts are essential points in this surgery. Contrary to regular principle we end up stuffing the joint to balance the posterior capsular hammock. Hope this ppt helps you with your surgery planning.
KNEE REPLACEMENT IN RECURVATUM KNEE.pptx
KNEE REPLACEMENT IN RECURVATUM KNEE.pptx
Vignesh Karthik
pcl
Pcl pp
Pcl pp
Dhruv Taneja
PRISM
AJM Sheet: pes cavus
AJM Sheet: pes cavus
Podiatry Town
Nursing during Total knee replacement(TKR)
Total knee replacement nursing management
Total knee replacement nursing management
HIRANGER
orthopaedics , sports injury
Ligamentous injury around knee joint
Ligamentous injury around knee joint
Akash kumar maddheshiya
Similar to Arthroscopic lat dorsi transfer
(20)
Lecture 23 24 parekh peroneal pathology
Lecture 23 24 parekh peroneal pathology
Patellar Instability
Patellar Instability
Foot and ankle trauma - Derek Park
Foot and ankle trauma - Derek Park
G18 malunions
G18 malunions
Tendon transfers around the shoulder
Tendon transfers around the shoulder
PCL injuriessss,mechanism,diagnosis and treatment.pptx
PCL injuriessss,mechanism,diagnosis and treatment.pptx
Lecture 27 parekh pttd3 and 4
Lecture 27 parekh pttd3 and 4
Tkr
Tkr
NCCT OR CECT PELVIS BONE.pptx, INDICATIONS OF PELVIS BONE
NCCT OR CECT PELVIS BONE.pptx, INDICATIONS OF PELVIS BONE
Journal bukit
Journal bukit
Injuries around the knee
Injuries around the knee
Extra-Osseous TaloTarsal Stabilization - HyProCure: The Scientific Evidence i...
Extra-Osseous TaloTarsal Stabilization - HyProCure: The Scientific Evidence i...
Proximal tibial fracture
Proximal tibial fracture
Acl tear
Acl tear
Acl tear
Acl tear
KNEE REPLACEMENT IN RECURVATUM KNEE.pptx
KNEE REPLACEMENT IN RECURVATUM KNEE.pptx
Pcl pp
Pcl pp
AJM Sheet: pes cavus
AJM Sheet: pes cavus
Total knee replacement nursing management
Total knee replacement nursing management
Ligamentous injury around knee joint
Ligamentous injury around knee joint
More from Lennard Funk
Management of Acromio-clavicular joint dislocations updated for 2022
ACJ Disloc Management 2022.pdf
ACJ Disloc Management 2022.pdf
Lennard Funk
Clavicle fractures in cyclists with emphasis on the professional athlete
Clavicle Fractures Pro Cyclists 2021.pdf
Clavicle Fractures Pro Cyclists 2021.pdf
Lennard Funk
ACromioclavicular joint Osteolysis lateral clavicle
ACJ Osteolysis.pdf
ACJ Osteolysis.pdf
Lennard Funk
Experience management and outcomes of managing chronic pec major injuries
Chronic Pectoralis Major Injuries Len Funk 2020
Chronic Pectoralis Major Injuries Len Funk 2020
Lennard Funk
Rotator cuff augmentation for roatator cuff repair
Rotator Cuff Augment 2018.pdf
Rotator Cuff Augment 2018.pdf
Lennard Funk
the common questions patients will ask once they have had a scan and a tear has been reported, particularly if they have had no injury of trauma, they ask what caused my tear. If I have a tear what can you do to fix it, it’s got to be fixed. How can I get better if it is not fixed. I have already had physiotherapy and that didn’t fix it so how will more physiotherapy. Some patients who are not keen on surgery, do I really need to have an operation. I have not had an injury. there are multiple options thrown into the mix here which we need to consider for an individual patient. The below illustration shows a very rough decision making tool that I would use in determining surgical or treatment options for particular patients. A younger patient who has both pain and weakness with a massive cuff tear, if it is partially repairable a biological augment would be suitable. If their predominant weakness is external rotation i.e. a positive Hornblower sign but good elevation, a lat dorsi tendon transfer. For an older patient who has a predominant weakness but no significant pain, deltoid rehabilitation programme is indicated. If they do have pain, a suprascapular nerve procedure such as an ablation would be beneficial. For those that have significant pain and weakness with failed non-operative options, a reverse shoulder replacement would be the best option. The balloon as we said, has a very limited place and this is for the older patient with slight loss of function and pain with higher demands. For those that have more significant pain and elevation weakness, a superior capsular reconstruction would be my preferred option.
Rotator Cuff Update 2022 for Medbelle Len Funk.pptx
Rotator Cuff Update 2022 for Medbelle Len Funk.pptx
Lennard Funk
Lennard Funk & Puneet Monga Prepared for Orthopaedic Product News, 2017 Rotator cuff disease is very common. There is as much enthusiastic discussion and debate on its management as there was 80 years ago when Codman (1937) first described the pathology and surgical management. There is great variation amongst surgeons as to the management of rotator cuff tears biased by experience and their understanding of the literature, skills levels and regional variations. There has been a lot of research done on the pathology, non-operative and operative treatments over the last two decades. Also, over the last decade there have been massive strides in the development of new surgical techniques and technologies. However, despite these advances there is as much discussion and debate!
Should We Repair Rotator Cuff Tears OPN 2017.pdf
Should We Repair Rotator Cuff Tears OPN 2017.pdf
Lennard Funk
Management of anterior shoulder instability for surgical trainees
Anterior shoulder instability st4-6
Anterior shoulder instability st4-6
Lennard Funk
Acromioclavicular joint surgery
ACJ revision surgery for failed reconstructions and excisions
ACJ revision surgery for failed reconstructions and excisions
Lennard Funk
Pec major ruptures - acute and chronic - experience, diagnosis, treatment and outcomes
Pectoralis Major Injuries for BESS 2020
Pectoralis Major Injuries for BESS 2020
Lennard Funk
Decision making for treatment of Anterior shoulder Instability in the young contact athlete
Anterior shoulder Instability in the young athlete 2020 bostaa
Anterior shoulder Instability in the young athlete 2020 bostaa
Lennard Funk
Hariharan Mohan, Jagwant Singh, Michael Walton, Lennard Funk, Puneet Monga Cautious optimism following SCR may be offered to this challenging subset of patients with symptomatic irreparable rotator cuff tears. It is likely that the relatively low re-operation rates can be further improved by considering the negative prognostic factors in defining indications for surgery. Further studies with longer term followup are recommended.
Superior Capsular Reconstruction Outcomes Wrightington 2020
Superior Capsular Reconstruction Outcomes Wrightington 2020
Lennard Funk
Clinical and radiological assessment and decision making in the sporting shoulder.
Shoulder Instability Sports - Decision Making
Shoulder Instability Sports - Decision Making
Lennard Funk
Isolated scapula pain is uncommon, but very difficult to diagnose and manage. In this presentation I run through the known causes and an approach to the diagnosis, in order to guide best treatment.
Scapula Pain
Scapula Pain
Lennard Funk
Presentation at ISAKOS, 2019 There were 442 primary arthroscopic labral repair procedures performed over the three-year period. The total cohort had a mean age of 25.91±9.09 years (range, 14-67 years) and consisted of 89.6% males. There was no significant difference in mean age or gender between the isolated anterior, posterior or combined groups (p=0.383 and p=0.541, respectively). • Of the 442 patients who underwent a shoulder labral repair, isolated anterior labral pathology occurred in 52.9% (n=234), with posterior and combined labral tears accounting for 16.3% (n=72) and 30.8%, respectively (n=136) (Table 3). • Patients were stratified as either sporting or non-sporting; 74.9% of patients were categorised as sporting (n=331) and had a mean age of 24.91±5.69 years, which was significantly lower than the mean age of 35.40±11.94 years in the non-sporting population (p<0.001). In the non-sporting population 68.5% (n=76) of patients had isolated anterior labral tears with 12.6% (n=14) posterior and 18.9% (n=21) combined. In the sporting population isolated anterior labral tears accounted for 47.7% (n=158), posterior 17.5% (n=58) and combined labral tears 34.7% (n=115). The sporting population had a significantly greater proportion of posterior and combined labral tears with the non-sporting population a significantly greater proportion of anterior labral tears (p=0.013). • Rugby players had the greatest incidence of shoulder instability within the sporting cohort accounting for 231 cases. Of the 231 cases, 47.2% were isolated anterior labral tears, 12.6% isolated posterior and 40.3% combined lesions. Posterior and combined shoulder labral tears are more prevalent than previously reported in the civilian population. The rates are higher in young, sporting populations and especially in contact sports such as rugby.
The Incidence of Traumatic Posterior and Combined Labral Tears in Patients Un...
The Incidence of Traumatic Posterior and Combined Labral Tears in Patients Un...
Lennard Funk
Presentation at ISAKOS, 2019 We performed a total of 142 pectoralis major repairs over a ten year period, of which 19 required allograft reconstruction. Of these 19 patients, 11 were available for response. All 11 patients were male with a mean age of 38.3 years (21 to 48 years). The mean time between injury and surgery was 12.2 months (4 to 30 months). Ten patients (91%) were unable to perform their previous level of work pre-operatively, with all patients returning to pre-injury occupation levels post-operatively. The main complaint prior to surgery was pain on pushing and moving the affected arm across the body, which improved in nine patients (82%), with no improvement reported in two patients. Strength improved significantly post-operatively, with only three patients reporting no improvement (paired t-test p=0.01). Six patients reported an improvement in cosmesis (50%).
Pectoralis major allograft reconstruction
Pectoralis major allograft reconstruction
Lennard Funk
Presented at the Upper Limb MSK Imaging Course In Liverpool, 20 May 2019
What the surgeon wants from radiologist
What the surgeon wants from radiologist
Lennard Funk
Rotator cuff tear management 2019
Rotator cuff tear management 2019
Rotator cuff tear management 2019
Lennard Funk
Peri-operative pain management from Anaesthetist, Dr Toni Hundle for The Arm Clinic at HCA The Wilmslow Hospital 2019
Perioperative pain management toni hundle the arm clinic 2019
Perioperative pain management toni hundle the arm clinic 2019
Lennard Funk
Hydrodistention is a treatment for frozen shoulder (FS) that is gaining popularity again. However, no large, long-term outcome data has been published yet. Our aims were to evaluate hydrodistension for the treatment of primary frozen shoulder (FS) in a large cohort of patients with long follow-up period. We present a case series of eighty-nine patients (36 males and 53 females) with a mean age of 52 years (33-73). Eleven (12.4%) had disease associations. We excluded post-operative secondary stiff shoulders. The mean volume injected was 33.7ml (16-66). 36/89 (40%) had capsular rupture. Six (6.7%) had adverse effects. The mean follow-up was 104.5 weeks (8-238). Mean improvement in forward flexion was 165.4, abduction 111.6, external rotation was hand above head with elbow back (and internal rotation in extension to T12. Mean improvement in quickDASH score was 17.1 (p<0.001) and Constant Score was 70.0 (p<0.001). Mean improvement in VAS was 7.3 (p<0.001). No patients had night pain (p<0.001). Eighty-eight (99%) returned to their previous occupation. Seventy-six (85%) returned to their previous level of sport. Gender, previous intra-articular steroid injection, volume of the injectate, type of steroid used, capsular rupture and underlying aetiology had no impact on outcome.
Hydrodistension outcomes 2017
Hydrodistension outcomes 2017
Lennard Funk
More from Lennard Funk
(20)
ACJ Disloc Management 2022.pdf
ACJ Disloc Management 2022.pdf
Clavicle Fractures Pro Cyclists 2021.pdf
Clavicle Fractures Pro Cyclists 2021.pdf
ACJ Osteolysis.pdf
ACJ Osteolysis.pdf
Chronic Pectoralis Major Injuries Len Funk 2020
Chronic Pectoralis Major Injuries Len Funk 2020
Rotator Cuff Augment 2018.pdf
Rotator Cuff Augment 2018.pdf
Rotator Cuff Update 2022 for Medbelle Len Funk.pptx
Rotator Cuff Update 2022 for Medbelle Len Funk.pptx
Should We Repair Rotator Cuff Tears OPN 2017.pdf
Should We Repair Rotator Cuff Tears OPN 2017.pdf
Anterior shoulder instability st4-6
Anterior shoulder instability st4-6
ACJ revision surgery for failed reconstructions and excisions
ACJ revision surgery for failed reconstructions and excisions
Pectoralis Major Injuries for BESS 2020
Pectoralis Major Injuries for BESS 2020
Anterior shoulder Instability in the young athlete 2020 bostaa
Anterior shoulder Instability in the young athlete 2020 bostaa
Superior Capsular Reconstruction Outcomes Wrightington 2020
Superior Capsular Reconstruction Outcomes Wrightington 2020
Shoulder Instability Sports - Decision Making
Shoulder Instability Sports - Decision Making
Scapula Pain
Scapula Pain
The Incidence of Traumatic Posterior and Combined Labral Tears in Patients Un...
The Incidence of Traumatic Posterior and Combined Labral Tears in Patients Un...
Pectoralis major allograft reconstruction
Pectoralis major allograft reconstruction
What the surgeon wants from radiologist
What the surgeon wants from radiologist
Rotator cuff tear management 2019
Rotator cuff tear management 2019
Perioperative pain management toni hundle the arm clinic 2019
Perioperative pain management toni hundle the arm clinic 2019
Hydrodistension outcomes 2017
Hydrodistension outcomes 2017
Recently uploaded
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi College Call Girls Virugambakkam No💰Advance Booking Details Are here: just visit website: https://www.loversbabe.com/ #Call Girl In Chennai, #Chennaicallgirls #CallgirlserviceChennai, #CallgirlsinChennai #locantoChennaicallgirls #Chennaicallgirls #Chennaicallgirlsimages #Chennaicallgirlskothrud #Chennaicallgirlslocanto #Chennaicallgirlsmobno #Chennaicallgirlsmobileno #Chennaicallgirlsmobilenumber #Chennaicallgirlspics #ChennaicallgirlsChennaiescorts #Chennaicallgirlsrates #Chennaicallgirlsservice #Chennaicallgirlsservices #Chennaicallgirlsskokka Click On WhatsApp Chat +91-7427069034 Chennai Escorts Make You Feel Like Royalty Chennai Escorts catering to high profile clients are available #S07 24-7 to meet their clients' needs and are also available for dinner dates, business conferences, foreign travel trips and clubbing activities. Their customers are contacted directly through in order to prevent risky situations from developing.is home to some of India's most beautiful women. These girls come highly educated with great backgrounds; furthermore they are extremely beautiful and will make you feel like royalty if hired for hours or days! Siya Khan | FOR BOOKING CALL Our All Services :- 1 )★ (Oral to consummation) bjnonCovered 2 )★ Special Massage 3 )★ O-Level (Oral sex) 4 )★ Blow Job; 5 )★ COB (Come On Body) 6 )★. Extraball (Have sex ordinarily) 7 )★ A-Level (5 star escort) 8 )★ Strip-bother 9 )★ BBBJ (Bareback Blowjob) 10 )★ Spending time in my rooms 11 )★ BJ (Blowjob Without a Condom) 12 )★ COF (Come On Face) 13 )★ Completionx
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
rajnisinghkjn
Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangalore Karnataka Booking Details Are here: just visit website: https://girlsinbangalore.com #Call Girl In Bangalore, #Bangalorecallgirls #CallgirlserviceBangalore, #CallgirlsinBangalore 12-May-2024( Mj) Click On WhatsApp Chat +91-9179660964 Bangalore Escorts Make You Feel Like Royalty Bangalore Escorts catering to high profile clients are available 24-7 to meet their clients' needs and are also available for dinner dates, business conferences, foreign travel trips and clubbing activities. Their customers are contacted directly through in order to prevent risky situations from developing.is home to some of India's most beautiful women. These girls come highly educated with great backgrounds; furthermore they are extremely beautiful and will make you feel like royalty if hired for hours or days! Siya Khan | FOR BOOKING CALL Our All Services :- 1 )★ (Oral to consummation) bjnonCovered 2 )★ Special Massage 3 )★ O-Level (Oral sex) 4 )★ Blow Job; 5 )★ COB (Come On Body) 6 )★. Extraball (Have sex ordinarily) 7 )★ A-Level (5 star escort) 8 )★ Strip-bother 9 )★ BBBJ (Bareback Blowjob) 10 )★ Spending time in my rooms 11 )★ BJ (Blowjob Without a Condom) 12 )★ COF (Come On Face) 13 )★ Completion
Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...
Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...
Sheetaleventcompany
Dehradun Call Girl Service ❤️🍑 8854095900 👄🫦Independent Escort Service Dehradun WhatsApp Chat: ☎️ +91-8854095900 Call Girls Dehradun offer you everything from intimate moments to wild nights - be it intimate or wild. Their girls are always prepared to meet all your needs and desires so you're assured a memorable experience with them. Beautiful Babes are sure to turn heads wherever they go, captivating men with their seductive personalities and captivating looks - not to mention their sensually alluring bodies that are sure to satisfy all your naughty fantasies, from blowjobs to anal massages; not forgetting BDSM and orgies as well. Show them some appreciation when the time is right. Call Girl Dehradun that their clients can be very demanding. To maintain their reputation and gain more clients, these sexy call girls always work tirelessly to provide exceptional service that ensures each customer's happiness - so much so that many men seek them out to have an unforgettable experience with Passionate about providing erotic pleasure for their clients - fulfilling all sexy fantasies while offering role play services such as BDSM. ★OUR BEST SERVICES: - FOR BOOKING ★ A-Level (5-star escort) ★ Strip-tease ★ BBBJ (Bareback Blowjob) ★ Spending time in my rooms ★ BJ (Blowjob Without a Condom) ★. Extra ball (Have ride many times) ☛ ☛ ☛ ✔✔ secure✔✔ 100% safe WHATSAPP CALL ME💥✨✨⭐⭐⚡💦💦💨🔥💫💫 Their services range from erotic encounters and movie dates to in-call and out-call services, making this option available 24/7. Available for services including NSA, threesomes and foursomes sessions as well as massage services and casual foreplay - they even provide real girlfriend experience. Find one online or visit local women's clubs, hotels or restaurants. Hiring a Dehradun call girl for an evening or day out can be the perfect addition to your social gathering or office event, or you could arrange for her to visit your home or hotel room. Not only are these women gorgeous, they're intelligent as well, with great senses of humor - sure to please and leave you wanting more. If you want a cheap escort in Dehradun, look for someone who is either a student or works part time so that she will always be available when you need her. In addition to this, look for housewives as this ensures they have stable lives that can keep you satisfied for extended periods. These beautiful ladies will capture your attention at first sight with stunning eyes and full, seductive lips; not to mention a seductive personality that makes you want to spend more time with them; moreover they are discreet enough to meet up anywhere nearby! Hiring a call girl in Dehradun can be done through either the internet or calling her directly, with services like massage or sex sessions offered to request from specific agencies within a few hours of making contact. Furthermore, text the girl directly for price quotes!
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Sheetaleventcompany
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery ★ CALL US High Class Luxury and Premium Escorts ServiCe We Provide Well Educated, Royal Class Female, High-Class Escorts Offering a Top High-Class Escorts Service In the & Several Nearby All Places Of . ★ Get The High Profile, Bollywood Queens , Well Educated , Good Looking , Full Cooperative Model Services. You Can See Me at My Comfortable Hotels or I Can Visit You In hotel Our Service Available IN All SERVICE, 3/4/5 STAR HOTEL , In Call /Out Call Services.24 hrs ,$P13 ★ To Enjoy With Hot and Sexy Girls . ★ We Are Providing :- • Models • Vip Models • Russian Models • Foreigner Models • TV Actress and Celebrities • Receptionist • Air Hostess • Call Center Working Girls/Women • Hi-Tech Co. Girls/Women • Housewife • Collage Going Girls. • Travelling Escorts. • Ramp-Models • Foreigner And Many More.. Incall & Outcall Available… • INDEPENDENT GIRLS / HOUSE WIFES ★ I Guarantee You To Have An Unforgettable Experience With Me.A Curvy Body, long Hair and Silky Smooth Skin. She Is an Independent Escorts Model Will Give You More Pleasure & Full Satisfaction. Call Now Seema:- 8250092165
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Jyoti singh
5-year survival of GCP after radical procedures significantly depended on: 1) PT “early-invasive cancer”; 2) PT N0--N12; 3) Cell Ratio Factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) GC cell dynamics; 9) GC characteristics; 10) tumor localization; 11) anthropometric data; 12) surgery type. Optimal diagnosis and treatment strategies for GC are: 1) screening and early detection of GC; 2) availability of sufficient quantity of experienced abdominal surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunotherapy for GCP with unfavorable prognosis.
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Oleg Kshivets
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available WhatsApp Chat : +91-8854095900 Get More Information About Mussoorie Escorts Service Mussoorie Escorts offer their services to their clients at any time of day or night - including sex, travel and tours. Contact them via telephone or the internet. Hire an escort as your movie partner, date or party companion - they're sure to exceed all your expectations. Girls available 24/7 make for great companions who offer sensual body massages and drinks/food service during your time together. Find one who fits with your personality or budget - these girls have you covered.
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Janvi Singh
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service Available 9630942363 Ahmedabad Escort Service Ahmedabad Call Girls Ahmedabad Escorts Service Ahmedabad Call Girl Russian 9630942363 Russian Ahmedabad Escort Service Vip Ahmedabad Escort Service Ahmedabad Call Girls Housewife Model College Girls Aunty Bhabhi Ahmedabad 9630942363 Genuine Ahmedabad Call Girl Escort Service
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
GENUINE ESCORT AGENCY
Kolkata Call Girls Shobhabazar 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Service Available Call Mrs Leela Ji +91-8005736733 We offer all types of girls of your choice with space. Our escorts are fully cooperative and understand your needs. All types of call girls like Housewives, College girls,#J11 Russian girls, Muslim girls, Afghani girls, Bengali girls, Working girls, south Indian girls, Punjabi girls, etc. In-Call: — You Can Reach At Our Place in Kolkata Our place Which Is Very Clean Hygienic 100% safe Accommodation. Out-Call: — Service for Out Call You have To Come Pick The Girl From My Place We Also Provide Door-Step Services Hygienic: — Full Ac Neat And Clean Rooms Available In Hotel 24 * 7 Hrs In Kolkata C010524HD Our Services and Rates: – One Shot — 2500/in call (time ½ hour), 5000/out call Two shot with one girl — 5000/in call (time 1 hour), 6000/out call Body to body massage with sex- 3000/in call (time 1 hour) full night for one person– 8000/in call, 10000/out call (shot limit 4 shot) We are available 24*7 all days of the year Call us — 8005736733 !! Thank you for Visiting.
Kolkata Call Girls Shobhabazar 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Gir...
Kolkata Call Girls Shobhabazar 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Gir...
Namrata Singh
❤️Chandigarh Escorts Service☎️9809698092☎️ Call Girl service in Chandigarh☎️ Chandigarh Call Girls Service ☎️ Call Girls In Chandigarh BEST Call Girls in CHANDIGARH Escort Service provide Cute Nice sweet and Sexy Models in beautiful CHANDIGARH city cash in hand to hand call girl in CHANDIGARH and CHANDIGARH escorts. HOT & SEXY MODELS // COLLEGE GIRLS IN CHANDIGARH AVAILABLE FOR COMPLETE ENJOYMENT WITH HIGH PROFILE INDIAN MODEL AVAILABLE HOTEL & HOME ★ SAFE AND SECURE HIGH CLASS SERVICE AFFORDABLE RATE ★ 100% SATISFACTION,UNLIMITED ENJOYMENT. ★ All Meetings are confidential and no information is provided to any one at any cost. ★ EXCLUSIVE Profiles Are Safe and Consensual with Most Limits Respected ★ Service Available In: - HOME & 24x7 :: 3 * 5 *7 *Star Hotel Service .In Call & Out call Services : ★ A-Level (5 star escort) ★ Strip-tease ★ BBBJ (Bareback Blowjob)Receive advanced sexual techniques in different mode make their life more pleasurable. ★ Spending time in hotel rooms ★ BJ (Blowjob Without a Condom) ★ Completion (Oral to completion) ★ Covered (Covered blowjob Without a Condom)Chandigarh Call Girls
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Sheetaleventcompany
❤️Amritsar Escorts Service☎️9815674956☎️ Call Girl service in Amritsar☎️ Amritsar Call Girls Service ☎️ Call Girls In Amritsar ❤️Amritsar Escort Service☎️9815674956☎️ Call Girl service in Amritsar☎️ Amritsar Call Girls Service ☎️ Call Girls In Amritsar BEST Call Girls in Amritsar Escort Service provide Cute Nice sweet and Sexy Models in beautiful Amritsar city cash in hand to hand call girl in Amritsar and Amritsar escorts. HOT & SEXY MODELS // COLLEGE GIRLS IN Amritsar AVAILABLE FOR COMPLETE ENJOYMENT WITH HIGH PROFILE INDIAN MODEL AVAILABLE HOTEL & HOME ★ SAFE AND SECURE HIGH CLASS SERVICE AFFORDABLE RATE ★ 100% SATISFACTION,UNLIMITED ENJOYMENT. ★ All Meetings are confidential and no information is provided to any one at any cost. ★ EXCLUSIVE Profiles Are Safe and Consensual with Most Limits Respected ★ Service Available In: - HOME & 24x7 :: 3 * 5 *7 *Star Hotel Service .In Call & Out call Services : ★ A-Level (5 star escort) ★ Strip-tease ★ BBBJ (Bareback Blowjob)Receive advanced sexual techniques in different mode make their life more pleasurable. ★ Spending time in hotel rooms ★ BJ (Blowjob Without a Condom) ★ Completion (Oral to completion) ★ Covered (Covered blowjob Without a Condom)Amritsar Call Girls
❤️Amritsar Escorts Service☎️9815674956☎️ Call Girl service in Amritsar☎️ Amri...
❤️Amritsar Escorts Service☎️9815674956☎️ Call Girl service in Amritsar☎️ Amri...
Sheetaleventcompany
Dehradun Call Girl Service ❤️🍑 8854095900 👄🫦Independent Escort Service Dehradun WhatsApp Chat: ☎️ +91-8854095900 Call Girls Dehradun offer you everything from intimate moments to wild nights - be it intimate or wild. Their girls are always prepared to meet all your needs and desires so you're assured a memorable experience with them. Beautiful Babes are sure to turn heads wherever they go, captivating men with their seductive personalities and captivating looks - not to mention their sensually alluring bodies that are sure to satisfy all your naughty fantasies, from blowjobs to anal massages; not forgetting BDSM and orgies as well. Show them some appreciation when the time is right. Call Girl Dehradun that their clients can be very demanding. To maintain their reputation and gain more clients, these sexy call girls always work tirelessly to provide exceptional service that ensures each customer's happiness - so much so that many men seek them out to have an unforgettable experience with Passionate about providing erotic pleasure for their clients - fulfilling all sexy fantasies while offering role play services such as BDSM. ★OUR BEST SERVICES: - FOR BOOKING ★ A-Level (5-star escort) ★ Strip-tease ★ BBBJ (Bareback Blowjob) ★ Spending time in my rooms ★ BJ (Blowjob Without a Condom) ★. Extra ball (Have ride many times) ☛ ☛ ☛ ✔✔ secure✔✔ 100% safe WHATSAPP CALL ME💥✨✨⭐⭐⚡💦💦💨🔥💫💫 Their services range from erotic encounters and movie dates to in-call and out-call services, making this option available 24/7. Available for services including NSA, threesomes and foursomes sessions as well as massage services and casual foreplay - they even provide real girlfriend experience. Find one online or visit local women's clubs, hotels or restaurants. Hiring a Dehradun call girl for an evening or day out can be the perfect addition to your social gathering or office event, or you could arrange for her to visit your home or hotel room. Not only are these women gorgeous, they're intelligent as well, with great senses of humor - sure to please and leave you wanting more. If you want a cheap escort in Dehradun, look for someone who is either a student or works part time so that she will always be available when you need her. In addition to this, look for housewives as this ensures they have stable lives that can keep you satisfied for extended periods. These beautiful ladies will capture your attention at first sight with stunning eyes and full, seductive lips; not to mention a seductive personality that makes you want to spend more time with them; moreover they are discreet enough to meet up anywhere nearby! Hiring a call girl in Dehradun can be done through either the internet or calling her directly, with services like massage or sex sessions offered to request from specific agencies within a few hours of making contact. Furthermore, text the girl directly for price quotes!
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Sheetaleventcompany
❤️Chandigarh Escorts Service☎️9809698092☎️ Call Girl service in Chandigarh☎️ Chandigarh Call Girls Service ☎️ Call Girls In Chandigarh BEST Call Girls in CHANDIGARH Escort Service provide Cute Nice sweet and Sexy Models in beautiful CHANDIGARH city cash in hand to hand call girl in CHANDIGARH and CHANDIGARH escorts. HOT & SEXY MODELS // COLLEGE GIRLS IN CHANDIGARH AVAILABLE FOR COMPLETE ENJOYMENT WITH HIGH PROFILE INDIAN MODEL AVAILABLE HOTEL & HOME ★ SAFE AND SECURE HIGH CLASS SERVICE AFFORDABLE RATE ★ 100% SATISFACTION,UNLIMITED ENJOYMENT. ★ All Meetings are confidential and no information is provided to any one at any cost. ★ EXCLUSIVE Profiles Are Safe and Consensual with Most Limits Respected ★ Service Available In: - HOME & 24x7 :: 3 * 5 *7 *Star Hotel Service .In Call & Out call Services : ★ A-Level (5 star escort) ★ Strip-tease ★ BBBJ (Bareback Blowjob)Receive advanced sexual techniques in different mode make their life more pleasurable. ★ Spending time in hotel rooms ★ BJ (Blowjob Without a Condom) ★ Completion (Oral to completion) ★ Covered (Covered blowjob Without a Condom)Chandigarh Call Girls
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Sheetaleventcompany
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service In Indore No💰Advance Cash On Delivery Service "Call Girls Indore VIP Call Girls Service Indore.. Booking Open Now We Are Providing Safe & Secure High Class girl women sucking men Services Affordable Rate 100% Satisfaction, Unlimited Enjoyment. Any Time for Model/ women seeking men in royal call girl High class luxury and premium call girl agency. ✔️High class luxury and premium escorts agency We Provide Well Educated, Royal Class Female, High-class Escorts agency offering a top high class escort service in the royal Escorts ✔️ Get High Profile queens , Well Educated , Good Looking , Full Cooperative Model Services. you can see me at my comfortable Hotels or I can visit you in hotel Our Service Available IN All Services 3/5/7 Star Hotels, In call /Out call Service 24/7.. ✔️ All Meetings We Provide Hottest Female With Me Are Safe And Consensual With Most Limits Respected Complete Satisfaction Guaranteed...Service Available In:- 24/7 3 * 5 *7 *Star Hotel Service In. In Call Out call service Avilable also. ✔️ I guarantee you to have an unforgettable experience with me A curvy body, long hair and silky smooth skin. She is an independent royal Escorts/Women Seeking Men model will give you more pleasure & Full satisfaction. ✔️ I am very sensual and flirtatious with charming personality! I love to laugh and my bright smile is ever Present. ,Hotel & Home Services CALL PLZZ ✔️Available Near All 3* 4* 5* 7* Hotels Of I Want Only Hotel Name , Guest Name , Room No. Only For Confirmation.✔️ Nandani... agency...⭐⭐⭐⭐⭐ VIP...Service ✣ ✤ ✥ ✦ TIME WASTERS AND BARGAINERS ARE PLEASE EXCUSE, WE RESPECT YOUR SAFETY AND PRIVACY AND EXPECT TH WHATSAPP: 9235973566 CALL ME" 9235973566
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Sheetaleventcompany
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos and Number ★ CALL US High Class Luxury and Premium Escorts ServiCe We Provide Well Educated, Royal Class Female, High-Class Escorts Offering a Top High-Class Escorts Service In the & Several Nearby All Places Of . ★ Get The High Profile, Bollywood Queens , Well Educated , Good Looking , Full Cooperative Model Services. You Can See Me at My Comfortable Hotels or I Can Visit You In hotel Our Service Available IN All SERVICE, 3/4/5 STAR HOTEL , In Call /Out Call Services.24 hrs ,$P13 ★ To Enjoy With Hot and Sexy Girls . ★ We Are Providing :- • Models • Vip Models • Russian Models • Foreigner Models • TV Actress and Celebrities • Receptionist • Air Hostess • Call Center Working Girls/Women • Hi-Tech Co. Girls/Women • Housewife • Collage Going Girls. • Travelling Escorts. • Ramp-Models • Foreigner And Many More.. Incall & Outcall Available… • INDEPENDENT GIRLS / HOUSE WIFES ★ I Guarantee You To Have An Unforgettable Experience With Me.A Curvy Body, long Hair and Silky Smooth Skin. She Is an Independent Escorts Model Will Give You More Pleasure & Full Satisfaction. Call Now Seema:- 9332606886
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
call girls hydrabad
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Available Call Mrs Leela Ji +91-8630512678 We offer all types of girls of your choice with space. Our escorts are fully cooperative and understand your needs. All types of call girls like Housewives, College girls,#J11 Russian girls, Muslim girls, Afghani girls, Bengali girls, Working girls, south Indian girls, Punjabi girls, etc. In-Call: — You Can Reach At Our Place in Lucknow Our place Which Is Very Clean Hygienic 100% safe Accommodation. Out-Call: — Service for Out Call You have To Come Pick The Girl From My Place We Also Provide Door-Step Services Hygienic: — Full Ac Neat And Clean Rooms Available In Hotel 24 * 7 Hrs In Lucknow Our Services and Rates: – One Shot — 2500/in call (time ½ hour), 5000/out call Two shot with one girl — 5000/in call (time 1 hour), 6000/out call Body to body massage with sex- 3000/in call (time 1 hour) full night for one person– 8000/in call, 10000/out call (shot limit 4 shot) We are available 24*7 all days of the year Call us — 8630512678 !! Thank you for Visiting.
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
soniyagrag336
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No💰Advance Cash On Delivery Service Chandigarh Call Girls Service punjab ❤️🍑 📲Lucky 8868886958📲 💚👄🫦 Independent Escort Service Chandigarh Call Now :- 8868886958 Lucky Call Girl In Chandigarh | Chandigarh Call Girl | Call girl service in Chandigarh | Call Girls In Chandigarh | Chandigarh Call Girls Their services range from erotic encounters and movie dates to in-call and out-call services, making this option available 24/7. Available for services including NSA, threesomes and foursomes sessions as well as massage services and casual foreplay - they even provide real girlfriend experience. Find one online or visit local women's clubs, hotels or restaurants. Hiring a Chandigarh call girl for an evening or day out can be the perfect addition to your social gathering or office event, or you could arrange for her to visit your home or hotel room. Not only are these women gorgeous, they're intelligent as well, with great senses of humor - sure to please and leave you wanting more. If you want a cheap escort in Chandigarh, look for someone who is either a student or works part time so that she will always be available when you need her. In addition to this, look for housewives as this ensures they have stable lives that can keep you satisfied for extended periods. These beautiful ladies will capture your attention at first sight with stunning eyes and full, seductive lips; not to mention a seductive personality that makes you want to spend more time with them; moreover they are discreet enough to meet up anywhere nearby! Hiring a call girl in Chandigarh can be done through either the internet or calling her directly, with services like massage or sex sessions offered to request from specific agencies within a few hours of making contact. Furthermore, text the girl directly for price quotes!
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
Sheetaleventcompany
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP Escorts Service Available 24*7 Book Call Mrs Janvi Ji +91-6378878445 We offer all types of girls of your choice with space. Our escorts are fully cooperative and understand your needs. All types of call girls like Housewives, College girls,#J11 Russian girls, Muslim girls, Afghani girls, Bengali girls, Working girls, south Indian girls, Punjabi girls, etc. In-Call: — You Can Reach At Our Place in Bangalore Our place Which Is Very Clean Hygienic 100% safe Accommodation. Out-Call: — Service for Out Call You have To Come Pick The Girl From My Place We Also Provide Door-Step Services Hygienic: — Full Ac Neat And Clean Rooms Available In Hotel 24 * 7 Hrs In Bangalore Our Services and Rates: – One Shot — 2500/in call (time ½ hour), 5000/out call Two shot with one girl — 5000/in call (time 1 hour), 6000/out call Body to body massage with sex- 3000/in call (time 1 hour) full night for one person– 8000/in call, 10000/out call (shot limit 4 shot) We are available 24*7 all days of the year Call us — 6378878445 !! Thank you for Visiting.
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
dishamehta3332
Call Girls in Lucknow Just Call 👉👉8875999948 Top Class Call Girl Service Available WhatsApp Chat : +91-8875999948 Get More Information About Lucknow Escorts Service Lucknow Escorts offer their services to their clients at any time of day or night - including sex, travel and tours. Contact them via telephone or the internet. Hire an escort as your movie partner, date or party companion - they're sure to exceed all your expectations. Girls available 24/7 make for great companions who offer sensual body massages and drinks/food service during your time together. Find one who fits with your personality or budget - these girls have you covered.
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Janvi Singh
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advance Cash On Delivery Service. Call Girl Service In Goa 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advance Cash On Delivery Service Call Girl Near Me Booking Details Are here: just visit website: https://hotbabe24.com #Call Girl In Goa, #Goacallgirls #CallgirlserviceGoa, #CallgirlsinGoa Website on rent : mailto:indiancallgirl4rent@gmail.com "Call Girls Goa VIP Call Girls Service Goa.. Booking Open Now We Are Providing Safe & Secure High Class girl women sucking men Services Affordable Rate 100% Satisfaction, Unlimited Enjoyment. Any Time for Model/ women seeking men in royal call girl High class luxury and premium call girl agency. ✔️High class luxury and premium escorts agency We Provide Well Educated, Royal Class Female, High-class Escorts agency offering a top high class escort service in the royal Escorts ✔️ Get High Profile queens , Well Educated , Good Looking , Full Cooperative Model Services. you can see me at my comfortable Hotels or I can visit you in hotel Our Service Available IN All Services 3/5/7 Star Hotels, In call /Out call Service 24/7.. ✔️ All Meetings We Provide Hottest Female With Me Are Safe And Consensual With Most Limits Respected Complete Satisfaction Guaranteed...Service Available In:- 24/7 3 * 5 *7 *Star Hotel Service In. In Call Out call service Avilable also. ✔️ I guarantee you to have an unforgettable experience with me A curvy body, long hair and silky smooth skin. She is an independent royal Escorts/Women Seeking Men model will give you more pleasure & Full satisfaction. ✔️ I am very sensual and flirtatious with charming personality! I love to laugh and my bright smile is ever Present. ,Hotel & Home Services CALL PLZZ ✔️Available Near All 3* 4* 5* 7* Hotels Of I Want Only Hotel Name , Guest Name , Room No. Only For Confirmation.✔️ Nandani... agency...⭐⭐⭐⭐⭐ VIP...Service ✣ ✤ ✥ ✦ TIME WASTERS AND BARGAINERS ARE PLEASE EXCUSE, WE RESPECT YOUR SAFETY AND PRIVACY AND EXPECT TH WHATSAPP: 9xx000xx09 CALL ME" 9xx000xx09
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Sheetaleventcompany
Delve into valuable content elucidating the anatomy and physiology of the respiratory system, in line with the PCI syllabus for pharmacy and PharmD students.
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
Swetaba Besh
Recently uploaded
(20)
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...
Cheap Rate Call Girls Bangalore {9179660964} ❤️VVIP BEBO Call Girls in Bangal...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
Kolkata Call Girls Shobhabazar 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Gir...
Kolkata Call Girls Shobhabazar 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Gir...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
❤️Amritsar Escorts Service☎️9815674956☎️ Call Girl service in Amritsar☎️ Amri...
❤️Amritsar Escorts Service☎️9815674956☎️ Call Girl service in Amritsar☎️ Amri...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
Call girls Service Phullen / 9332606886 Genuine Call girls with real Photos a...
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
Call Girls in Lucknow Just Call 👉👉8630512678 Top Class Call Girl Service Avai...
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
Goa Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Goa No💰Advanc...
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
ANATOMY AND PHYSIOLOGY OF RESPIRATORY SYSTEM.pptx
Arthroscopic lat dorsi transfer
1.
LennardFunk CharlieTalbot JuliaWalton
2.
Indicationfortendontransfer • MRCT withWeakness •
Functionalstrengthloss+/-pain
3.
Clinically • Pain • Weakness •
Functionloss ▫ IncludingADLs
4.
Pre-requisitesofTransfer • Intactdeltoid • IntactSubscapularis-maintainforce-couple •
Goodbone-fixation • Compliantpatient(youngactive)
5.
Pre-Habilitation • shouldertherapist • OptimiseDeltoid&function •
Activitymodifications • Re-assessbeforesurgery
6.
Biomechanics ▫ GerberJSES2008 ▫ 3differentinsertionsites ▫
Ant/post/inf GT ▫ PosteriormostmechanicallyadvantageoustoER
7.
Principlesofthetechnique • Open: • HarvestTendon •
Mobilisetendon • Arthroscopy: • Preparesurfaces • Developtrack • Transfertendon • Fixation
8.
Position
9.
10.
11.
12.
Portals viewing Anchor insertion Working Suture Retrieval
13.
14.
PosteriorRelease
15.
HumerusPrep
16.
Sutureretrieval
17.
TendonRetrieval
18.
TendonRetrieval
19.
TendonFixation
20.
FinalFixation
21.
PostSurgery ERbrace-comfortonly painmanagement limitNSAIDs coldcompression Woundcare Earlyrehab.
22.
Stage1PostSurgery (approx0-3weeks) • Painmanagement • Woundmonitoring •
ClosedactiveassistedROMwithinsafezones • Notforgettingthekineticchain
23.
Stage1Exerciseideas Shoulderdoc
24.
Stage1Exerciseideas -earlykineticchain ShoulderdocShoulderdoc
25.
Stage1Avoid… • Horizontaladduction/internalrotation • Earlyresistedexternalrotation •
Pain!
26.
Stage2(approx3-6Weeks) • Reduceslingsupport–weanfromERwedge • ContinuetoincreaseactiveassistedROMclosedchain (Proprioceptivevalue)
Qualityofmovement • Facilitatinghandoverelbow • BegingentleisometricERinneutral Thelatdorsi’snewrole Shoulderdoc
27.
Exerciseideas • Shoulderdoc
28.
Stage3(approx6-12Weeks) • ContinuewithactiveROMreinforcinghandoverelbow • Tips… •
Breakthemovementdown • Startwitheccentricallyloweringarmtoaid re-education (Donaldsonetal2011)
29.
Stage3(approx6-12Weeks) • CommenceopenchainROMleadingtoresistance work • Continuetointegratekineticchainandgeneral conditioningasable Goalspecificrehab.
30.
Stage3Exercise
31.
Stage3ExerciseIdeas
32.
Stage4(3Months+) • Progressfunction- load/endurance •
unconstrainedROM • Fitness&conditioning • Returntowork
33.
Stage4(3Months+)
34.
Results RCTnotappropriate/feasible Evidencecohorts/largecaseseries
35.
Results-Arthroscopic FrenchMULTICENTERPROSPECTIVESTUDY • J.Grimberg,J.Kany,Ph.Valenti,J.Garret,LD. Duranthon,VKChang • (Paris,SaintJean,Lyon,Hawaï) •
SECECmeeting,Lyon2011
36.
RESULTS • 49Patients(27DrJK,11DrPhV,11DrJG) • Meanageatsurgery:59,4(31-73) •
23primarysurgeries,26secondarysurgeries(1to 6previoussurgicalprocedures) • Meanfollowup:21,2months(12-42) • Nolosttofollow-up.
37.
CLINICALRESULTS • CONSTANTSCORE
38.
CLINICALRESULTS • 39/49=79,5%satisfiedorverysatisfied • Complications:2hematomas,oneuninfectedfattissue necrosis
39.
MRI:oneyearpostop • 44patients:89,8%ofpatientscontrolled • 41intacttendons:93%ofcontrolledpatients •
3tendon-bonesecondarypulloutprobablylinkedto boneweakness
40.
MRI LDmuscle LDtendon Deltoidmuscle
41.
PREDICTINGFACTORS • NOINFLUENCEONCLINICALRESULTS • Age>or<65 •
Sex • Manual/Light/Sedentarywork • Preopactiveanteflexion>or<90° • Zoneoftendonfixation:superiororposterior • PEJORATIVEFACTORS • Worker’scompensation • Preoperativesurgery
42.
Summary • SetREALISTICExpectations • pre-opspecialistrehab. •
PatientMUSTbecommitted • CommunicationVITAL • goodgraftfixation • Open/arthroscopic(?)
43.
lenfunk@shoulderdoc.co.uk
Download now