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Posterior capsuloplasty reverse bankart

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Posterior capsuloplasty reverse bankart

  1. 1. www.shoulder.gr
  2. 2. Posterior dislocation Much less common than anterior (3-5 %) May be difficult to diagnose and may often be missed on up to 50% standard AP view Electric shock Seizures Trauma (alchoholics)
  3. 3. Mechanism of Injury • Axial loading of the adducted, internally rotated arm • Involuntary recurrent posterior subluxation may be associated w/ high forces generated during follow thru phase of various sports activities • Voluntary dislocation Internal rotation – Adduction – Flexion
  4. 4. Decision Making If the primary abnormality is found to be structural (eg. Bankart lesion, bony lesion or capsular injury) then surgery is often required early and the rehab follows accordingly
  5. 5. Posterior instability Surgery It depends on the injuries It is essential to identify the pathology and treat accordingly
  6. 6. Posterior instability Surgery Common Lesions Reverse Bankart Reverse Bony Bankart Reverse Hill Sachs Hyperlax posterior capsule
  7. 7. associated lesions Reverse Bankart lesion PosteriorAnterior
  8. 8. Reverse Hill-Sachs deformity AnteriorPosterior
  9. 9. Arthroscopic repair  Lower morbidity  Easily assess the entire joint and treat associated pathology SLAP lesion, Rotator Interval lesions and anterior labral injuries  Easier revision
  10. 10. Arthroscopic repair of posterior instability • Arthroscopic repair of posterior dislocation although rare is not so difficult • The only think needed is just to
  11. 11. EXAMINATION UNDER ANESTHESIA You must have a feel of the joint
  12. 12. ARTHROSCOPIC MANAGEMENT PosteriorAnterior
  13. 13. ARTHROSCOPIC MANAGEMENT Anchor placement
  14. 14. ARTHROSCOPIC MANAGEMENT Knot tying
  15. 15. ARTHROSCOPIC MANAGEMENT Knot tying
  16. 16. ARTHROSCOPIC MANAGEMENT
  17. 17. ARTHROSCOPIC MANAGEMENT
  18. 18. 3 months post-op
  19. 19. 3 months post-op
  20. 20. 3 months post-op
  21. 21. 3 months post-op
  22. 22. 3 months post-op
  23. 23. Thank you! For your attention

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