Labral repairs 2013 lf
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This document discusses labral repair techniques and tips. It begins by defining common types of labral tears such as Bankart tears and SLAP tears. It then discusses surgical techniques for anterior and posterior labral repairs including recommended portals and tools such as curved osteoraptors. Potential complications are also mentioned such as paralabral cysts and osteolysis from biodegradable implants.
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πρωτο εξάρθρημα
This document discusses the treatment of first-time shoulder dislocations. It finds that arthroscopic stabilization has lower recurrence rates compared to conservative treatment, especially for young athletes. Arthroscopy allows visualization and repair of common lesions like Bankart tears and Hill-Sachs defects. Studies show arthroscopic stabilization reduces recurrence to 16% versus 47% for conservative care. Arthroscopy provides excellent outcomes with minimal pain and quick return to previous activity levels. It is the recommended approach for young, active patients to prevent future dislocations and allow continued athletic participation.
Assessing bone loss in instability lf 2016
This document discusses various methods for assessing bone loss in the glenoid and humeral head in shoulder instability. It finds that while CT may be the most reliable method, there is no consensus on measurement techniques and what constitutes a clinically significant lesion. Methods like MRI and arthroscopy have not been sufficiently validated. Plain radiography is not accurate enough for pre-operative planning. The glenoid track and engagement formulas attempt to combine glenoid and humeral head measurements but also have limitations and have not been fully validated. Overall, the document concludes there is still uncertainty around accurately assessing and defining the critical amount of bone loss that increases recurrence risk in shoulder instability.
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Congenital vertical talus UG lecture
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This document discusses the operative management of grade III acromioclavicular joint (ACJ) injuries. It reviews the evidence for surgery versus non-surgical treatment, noting that early studies found non-surgical treatment had better outcomes. However, more recent studies using newer surgical techniques like the Ligament Augmentation and Reconstruction System (LARS) ligament and tightrope fixation have reported good to excellent results in 87.5-93.3% of surgical patients, compared to 58.8-0% of non-surgical patients. The document concludes that with advances in surgical techniques, surgery is now the better option for treating type III ACJ injuries.
ACJ revision surgery 2017
There is no “gold standard” technique for the surgical stabilization of Acromioclavicular joint (ACJ) disruptions and each of the described techniques has a failure rate. The management of failed ACJ stabilizations is a difficult problem and salvage procedures may often be constrained by the original procedure and the resultant anatomy. Reliable anatomical and biomechanically robust revision procedures for failed ACJ stabilization are therefore required. We describe a technique for revision stabilization of the ACJ that utilises a synthetic ligament in combination with augmentation from the coracoacromial ligament and biceps short head aponeurosis (‘biceps flip’ procedure).
SCJ instability athletes 2017
Sternoclavicular joint (SCJ) injuries are uncommon. A minority of patients with anterior dislocation progress to chronic instability associated with pain and a limitation of activities, and thus surgery should be considered. The technique is safe and effective for reconstructing chronic anterior SCJ dislocations. The all anterior approach for reconstruction of the SCJ reduces the risk to the structures posterior to the medial clavicle, manubrium sterni or first rib.
Recommended
πρωτο εξάρθρημα
This document discusses the treatment of first-time shoulder dislocations. It finds that arthroscopic stabilization has lower recurrence rates compared to conservative treatment, especially for young athletes. Arthroscopy allows visualization and repair of common lesions like Bankart tears and Hill-Sachs defects. Studies show arthroscopic stabilization reduces recurrence to 16% versus 47% for conservative care. Arthroscopy provides excellent outcomes with minimal pain and quick return to previous activity levels. It is the recommended approach for young, active patients to prevent future dislocations and allow continued athletic participation.
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This document discusses various methods for assessing bone loss in the glenoid and humeral head in shoulder instability. It finds that while CT may be the most reliable method, there is no consensus on measurement techniques and what constitutes a clinically significant lesion. Methods like MRI and arthroscopy have not been sufficiently validated. Plain radiography is not accurate enough for pre-operative planning. The glenoid track and engagement formulas attempt to combine glenoid and humeral head measurements but also have limitations and have not been fully validated. Overall, the document concludes there is still uncertainty around accurately assessing and defining the critical amount of bone loss that increases recurrence risk in shoulder instability.
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This document discusses essential elements for the functional/final stage of shoulder rehabilitation, including proprioceptive awareness, kinetic chain neuromuscular control, glenohumeral joint dynamic stability provided by compressive forces, and scapular mobility and stability. It emphasizes retraining muscle synergy between agonist and antagonist groups to control adverse humeral head translation at the glenoid. Clinical applications include using symptom modification to guide targeted muscle group rehabilitation in controlled vulnerable positions, and positioning the glenoid to support the humeral head in functional positions for each patient. The goal of late-stage rehabilitation is to achieve optimal biomechanical function and return to sport or work activities through integrated techniques built upon endurance and strength foundations while maintaining
InSpace balloon for massive rotator cuff tears 2017
This document summarizes the results and experience of a study comparing the InSpace Balloon procedure to rotator cuff repair for massive rotator cuff tears. The interim analysis of the first 20 subjects in the randomized controlled trial showed no difference in outcomes between the two procedures at 6 months follow-up. The study is ongoing and being conducted by principal investigators across the United States to further compare the efficacy of InSpace Balloon versus repair for massive rotator cuff tears.
Congenital vertical talus UG lecture
This document discusses congenital convex pes valgus (CVT), a rare rigid flatfoot condition present at birth. CVT is caused by genetic syndromes or abnormal muscle fibers/tendon contractures. Clinically, it presents as a rigid flatfoot with the talus medially displaced. Imaging can classify the deformity and assess reducibility. Nonoperative treatment with casting is rarely effective. The preferred surgical treatment is a single-stage correction using approaches like Cincinnati to release tissues and reduce/fix the talonavicular joint. Complications include recurrence, stiffness, and avascular necrosis of the talus. Later presentations may require more extensive fusions.
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This document discusses the operative management of grade III acromioclavicular joint (ACJ) injuries. It reviews the evidence for surgery versus non-surgical treatment, noting that early studies found non-surgical treatment had better outcomes. However, more recent studies using newer surgical techniques like the Ligament Augmentation and Reconstruction System (LARS) ligament and tightrope fixation have reported good to excellent results in 87.5-93.3% of surgical patients, compared to 58.8-0% of non-surgical patients. The document concludes that with advances in surgical techniques, surgery is now the better option for treating type III ACJ injuries.
ACJ revision surgery 2017
There is no “gold standard” technique for the surgical stabilization of Acromioclavicular joint (ACJ) disruptions and each of the described techniques has a failure rate. The management of failed ACJ stabilizations is a difficult problem and salvage procedures may often be constrained by the original procedure and the resultant anatomy. Reliable anatomical and biomechanically robust revision procedures for failed ACJ stabilization are therefore required. We describe a technique for revision stabilization of the ACJ that utilises a synthetic ligament in combination with augmentation from the coracoacromial ligament and biceps short head aponeurosis (‘biceps flip’ procedure).
SCJ instability athletes 2017
Sternoclavicular joint (SCJ) injuries are uncommon. A minority of patients with anterior dislocation progress to chronic instability associated with pain and a limitation of activities, and thus surgery should be considered. The technique is safe and effective for reconstructing chronic anterior SCJ dislocations. The all anterior approach for reconstruction of the SCJ reduces the risk to the structures posterior to the medial clavicle, manubrium sterni or first rib.
Rotator cuff the future 2015
The document discusses potential future directions for rotator cuff repair surgery. It describes 4 possibilities - 1) biological repairs that enhance healing using growth factors, 2) augmentation devices to reinforce repairs, 3) gene therapy and nano-surgery approaches for prevention and treatment, and 4) algorithms to better determine who needs surgery versus non-operative treatment based on age, genetics, and other factors. The future may include enhanced sutures that promote angiogenesis, balloon devices to support tissue, gene therapies administered through self-monitoring techniques, and remotely-controlled nano-instruments.
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Rotator cuff Repair in Rugby 2015 funk
1) Arthroscopic rotator cuff repair was performed on 11 elite rugby players with significant rotator cuff injuries.
2) The tears ranged in size from small (<1cm) to massive (>5cm), with a mean size of 1.8cm. Post-operative ultrasound scans showed the repairs to be intact in all 9 cases that were checked.
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This document discusses shoulder injuries in rugby players. It provides statistics showing that rugby has a high risk of shoulder injuries, which are often recurrent. Common shoulder injuries in rugby players include labral injuries, AC joint sprains, rotator cuff tears, and glenohumeral arthritis. Video analysis has shown that tackles are a major cause of shoulder injuries in rugby. The document outlines the forces involved in rugby tackles and compares them to car crash forces. It then discusses approaches to diagnosing and treating shoulder injuries in rugby players, including rehabilitation protocols and return to play timeframes following arthroscopic stabilization surgery.
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This document discusses shoulder instability, including traumatic and atraumatic causes. It presents three case studies to demonstrate different types of instability: 1) a rugby player with recurrent anterior dislocations requiring surgical repair for bony lesions; 2) a drama student with recurrent posterior subluxations and normal imaging, indicating a motor control issue; and 3) a gymnast with multidirectional instability and hyperlaxity who may benefit from capsular plication. The document outlines the Stanmore classification system for shoulder instability (Polar types I-III) and factors to consider in surgical versus rehabilitation management depending on the specific instability pattern.
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2) When comparing patients who experienced capsular rupture to those who did not, there were no significant differences in baseline characteristics or magnitudes of improvement between the groups.
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This document discusses different techniques for infrapectoral biceps tenodesis. It notes that tenodesis may not be functionally superior to tenotomy based on literature. However, tenodesis is preferred to avoid potential muscle cramps experienced by some patients after tenotomy. The document recommends an optimal technique of open subpectoral biceps tenodesis using direct visualization and fixation of the interosseous tendon with an interference screw for a strong construct allowing early mobilization without stress on the diaphysis. Post-operative rehabilitation is described as allowing elbow range of motion as comfort permits, with no strengthening for 6 weeks and no weight training for 3 months.
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This study reviewed outcomes of revision procedures for failed Latarjet surgery in 16 patients over 5 years. The most common direction of recurrent instability was anterior (11 cases). Common causes of failure included coracoid non-union (7 cases) and capsular laxity (8 cases). Revision procedures included Eden-Hybinette (5 cases), arthroscopic stabilization (8 cases), and remplissage (1 case). Complications occurred in 4 revisions. Most patients (12/16) and professionals (9/11) returned to their pre-injury level of sport following revision. Capsular laxity and posterior lesions were implicated in recurrent multi-directional and posterior instability cases.
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1. Shoulder Anatomy and Function Overview
2. Exercises for Healthy Shoulders
3. Good vs. Bad Pain
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5. Cutting Edge Treatments
6. Frozen Shoulder
- Causes and Treatment options
7. Unstable Shoulder
- Advances in Treatment
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Best Surgical Options Today
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This document discusses shoulder instability, including traumatic and atraumatic causes. It presents three case studies to demonstrate different types of instability: 1) a rugby player with recurrent anterior dislocations requiring surgical repair for bony lesions; 2) a drama student with recurrent posterior subluxations and normal imaging, indicating a motor control issue; and 3) a gymnast with multidirectional instability and hyperlaxity who may benefit from capsular plication. The document outlines the Stanmore classification system for shoulder instability (Polar types I-III) and factors to consider in surgical versus rehabilitation management depending on the specific instability pattern.
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Impingement syndromes
This document discusses various types of shoulder impingement syndromes. It begins with a brief history, noting that while Meyer first described the process in 1931, Neer classified and named shoulder impingement syndrome in 1972. It then describes current classifications, including primary and secondary subacromial impingement, coracohumeral impingement, glenoid (internal) impingement, ASI (AnteroSuperior Impingement), and PSGI (PosteroSuperior Glenoid Impingement). The bulk of the document focuses on describing these various impingement syndromes in more detail, including causes, presentations, treatments, and relevant anatomy. It provides an overview of imaging and clinical exams for
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This document discusses the rehabilitation approach for patients following shoulder instability surgery. It focuses on principles such as analgesia, quality range of motion, muscle control, timing, strength goals, and patient-specific rehabilitation. The approach emphasizes avoiding immobilization to prevent deconditioning while also protecting the surgical repair site. Exercises target the rotator cuff and scapular muscles as well as proprioception and the kinetic chain. The rehabilitation progresses from an initial protection phase using range of motion and proprioceptive exercises to a functional phase incorporating strengthening, sports-specific exercises, and plyometrics.
Hydrodilation for frozen shoulder Does capsular rupture matter
This document summarizes a study examining the outcomes of hydrodilatation for frozen shoulder and whether capsular rupture during the procedure matters. The study found:
1) Patients experienced significant improvements in pain, range of motion, Constant-Murley scores, and Oxford Shoulder scores following hydrodilatation.
2) When comparing patients who experienced capsular rupture to those who did not, there were no significant differences in baseline characteristics or magnitudes of improvement between the groups.
3) Hydrodilatation resulted in meaningful pain relief and functional improvement for frozen shoulder patients, and capsular rupture during the procedure did not influence outcomes.
Arthroscopic Lat Dorsi Transfer 2017
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Diagnosing Instability in Rugby Players
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Complications in ACL reconstruction 2014
The document discusses potential complications from ACL reconstruction surgery, noting that surgical technical errors during graft harvest, tunnel preparation, or fixation are most common causes of failure. Five possible causes of reconstruction failure are identified as graft discontinuity, inappropriate tunnel positioning, hardware failure, infection, or arthrofibrosis. Proper surgical technique and avoidance of tunnel malpositioning are emphasized to prevent complications.
Subpectoral biceps tenodesis walton
This document discusses different techniques for infrapectoral biceps tenodesis. It notes that tenodesis may not be functionally superior to tenotomy based on literature. However, tenodesis is preferred to avoid potential muscle cramps experienced by some patients after tenotomy. The document recommends an optimal technique of open subpectoral biceps tenodesis using direct visualization and fixation of the interosseous tendon with an interference screw for a strong construct allowing early mobilization without stress on the diaphysis. Post-operative rehabilitation is described as allowing elbow range of motion as comfort permits, with no strengthening for 6 weeks and no weight training for 3 months.
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Return to swimming after Shoulder Surgery or Injury
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Hydrodilation for frozen shoulder Does capsular rupture matter
Hydrodilation for frozen shoulder Does capsular rupture matter
More from Lennard Funk
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ACJ Osteolysis.pdf
This document summarizes a study evaluating the clinical outcomes of direct arthroscopic acromioclavicular (AC) joint excision for osteolysis. Osteolysis of the AC joint is caused by excessive overhead motions and is commonly seen in weightlifters and rugby players, causing pain and limited shoulder range of motion. The study retrospectively reviewed 16 patients who underwent direct arthroscopic AC joint excision over a 2 year period. Patients showed significant improvements in their Constant Shoulder Score and QuickDASH score between pre-op and post-op assessments at a mean follow-up of 21 months. Patients also reported high satisfaction ratings. The study concluded that direct arthroscopic AC joint excision is an effective treatment for osteolysis with significant
Chronic Pectoralis Major Injuries Len Funk 2020
This document discusses chronic injuries to the pectoralis major muscle and surgical techniques for repairing them. It provides details on indications for surgery, including factors that make for good and poor surgical candidates. Surgical techniques described include preparing and attaching an allograft tendon to the pec major footprint using suture anchors. Post-op rehabilitation is outlined in phases focusing initially on range of motion and later on strengthening. Ultrasound imaging is used post-operatively to monitor healing. Outcomes of surgeries performed are also mentioned.
Rotator Cuff Augment 2018.pdf
This document discusses rotator cuff augmentation, which involves adding graft material to reinforce rotator cuff repairs. There are several types of grafts, including autografts from the patient's own tissue, allografts from human donors, xenografts from animals, and synthetic grafts. The evidence for whether augmentation improves outcomes comes from a limited number of randomized controlled trials and observational studies of varying quality. While allograft augmentation seemed to produce better results than controls in some studies, the overall evidence is inconclusive due to the low quality and small size of available studies. More research is still needed to determine whether and when augmentation provides meaningful benefits over standard rotator cuff repair without grafting.
Rotator Cuff Update 2022 for Medbelle Len Funk.pptx
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.
Should We Repair Rotator Cuff Tears OPN 2017.pdf
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!
Anterior shoulder instability st4-6
This document discusses the evolution and current approaches to shoulder instability surgery. It begins with a brief history of instability surgery techniques from Hippocrates to modern arthroscopic and open surgical procedures. It then covers classification of instability, pathological lesions, management decisions, and surgical procedure principles. Key points discussed include the Stanmore classification system, types of soft tissue lesions like Bankart tears and bone defects like bony Bankart fractures and Hill-Sachs lesions. Decision factors for open versus arthroscopic surgery are outlined. Surgical techniques like Bankart repair, capsular plication, bone graft procedures for glenoid deficiency, and remplissage for large Hill-Sachs lesions are summarized.
ACJ revision surgery for failed reconstructions and excisions
This document discusses ACJ revision surgery. It provides information on the functional anatomy of the AC joint, causes of failed ACJ excision or reconstruction, and describes a technique for ACJ revision surgery. The technique involves removing scar tissue from previous procedures, taking micro samples, performing an anatomical reconstruction of the CC and AC ligaments using LARS ligaments and a biceps flip or CAL transfer, and performing a delto-trapezial reefing. Results from 23 revision cases over 7 years showed improved Constant scores, low rates of re-displacement and infection, and no need for further revision after a mean follow up of 37 months.
Pectoralis Major Injuries for BESS 2020
This document discusses pectoralis major injuries, including anatomy, diagnosis, treatment options, and outcomes. It provides an overview of the author's experience treating tears in athletes from various sports. Diagnosis involves clinical exam and imaging like ultrasound or MRI. Treatment can be non-operative with strength loss, or operative with surgical repair which often provides best results, especially for distal tears. Post-operative rehabilitation is outlined in phases focusing first on range of motion and later on strengthening. Reported outcomes include patients regaining 90% of strength on average and returning to sports within 6 months.
Anterior shoulder Instability in the young athlete 2020 bostaa
This document discusses anterior glenohumeral joint instability in younger athletes. It notes that recurrence rates after non-operative treatment are high, between 70-100% in most studies. Arthroscopic stabilization also has high recurrence rates, particularly in those under age 16. The Latarjet procedure has shown good outcomes in both adolescent and adult populations with low recurrence rates and high rates of return to previous sport levels. For a semi-pro rugby player with anterior instability, surgery may be considered given the presence of major structural lesions, inability to continue playing, and pressures to return mid-season. The Latarjet procedure would be a good surgical option in this younger athlete population.
Superior Capsular Reconstruction Outcomes Wrightington 2020
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.
Shoulder Instability Sports - Decision Making
Lennard Funk presented on the clinical and radiological assessment of shoulder instability in athletes. He discussed evaluating anterior and posterior instability through physical examination tests in different positions and assessing glenoid and humeral bone loss on imaging studies like MRI arthrograms. Funk also covered management strategies and decision making, which involves considering factors related to the patient, their profession, the type and extent of pathology, and the treating physician.
Scapula Pain
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.
The Incidence of Traumatic Posterior and Combined Labral Tears in Patients Un...
Posterior and combined labral tears are more common than previously thought, especially in young active populations. The study reviewed 442 patients undergoing shoulder stabilization surgery and found that posterior and combined tears accounted for 47% of cases, compared to only 53% being isolated anterior tears. Rates of posterior and combined tears were even higher in sporting populations (52%) compared to non-sporting populations (32%). Rugby players in particular had a high rate of posterior and combined tears (53%). The study concludes that posterior and combined shoulder instability is more prevalent than reported, especially in contact sports.
Pectoralis major allograft reconstruction
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%).
What the surgeon wants from radiologist
The document discusses shoulder injuries in sports. It provides guidance on what information is important to understand from MRI reports for rotator cuff tears, including the size and location of the tear and the extent of muscle atrophy. It emphasizes the importance of collaboration between surgeons and radiologists for accurate diagnoses. The treatment approach for sports injuries depends on factors like the patient's age, type of sport played, and time since injury.
Rotator cuff tear management 2019
Rotator cuff tears do not always require surgical repair. The decision depends on factors like the patient's age and activity level as well as the size and chronicity of the tear. Smaller tears in younger, more active patients may heal with non-operative treatment or repair, while larger, chronic tears in older individuals often do not heal after repair. When repair is not indicated for massive, irreparable tears, options include tendon transfers, superior capsular reconstruction, augmented repairs, and InSpace balloon spacers. Ultrasound is useful for initial evaluation and post-operative monitoring but MRI may better assess tear size and tissue quality factors that predict repair outcomes.
Perioperative pain management toni hundle the arm clinic 2019
Peri-operative pain management from Anaesthetist, Dr Toni Hundle for The Arm Clinic at HCA The Wilmslow Hospital 2019
Hydrodistension outcomes 2017
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.
More from Lennard Funk (20)
Rotator Cuff Update 2022 for Medbelle Len Funk.pptx
Rotator Cuff Update 2022 for Medbelle Len Funk.pptx
ACJ revision surgery for failed reconstructions and excisions
ACJ revision surgery for failed reconstructions and excisions
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
The Incidence of Traumatic Posterior and Combined Labral Tears in Patients Un...
The Incidence of Traumatic Posterior and Combined Labral Tears in Patients Un...
Perioperative pain management toni hundle the arm clinic 2019
Perioperative pain management toni hundle the arm clinic 2019
Labral repairs 2013 lf
- 1. 23/03/2013! Labral Repairs Tips & Tricks Lennard Funk Wrightington Hospital Salford University lenfunk@shoulderdoc.co.uk 1 12 12 3 9 3 9 6 6 2 Labral Tears - Names & Acronyms Bankart = Antero-inferior labral tear Bony Bankart = with bony component Perthes = Undisplaced Bankart ALPSA = Medially displaced Bankart GLAD = Bankart + ant. glenoid cartilage wear GLOM = Anterosuperior labral tear ( ovoid mass ) Reverse Bankart = Posterior labral tear Reverse Bony Bankart Reverse ALPSA Kim s Lesion = hidden posterior labral tear 3 1!
- 2. 23/03/2013! ALPSA 4 GLAD 5 Kim lesion Seung-Ho Kim. Arthroscopy. 2004! 6 2!
- 3. 23/03/2013! Posterior Repair - Portals 7 8 Single Cannula Technique 9 3!
- 4. 23/03/2013! Curved Osteoraptor 12 3 9 6 10 Paralabral Cyst 11 Osteolysis with Biodegradables Mitek Lupine (6m) 12 4!
- 5. 23/03/2013! Osteolysis Osteoraptor (8m) PEEK Curved (6m) 13 Summary 1. Beware Acronyms 2. Arm Positioner 3. Lateral portal for posterior repair 4. Single portal - virtual cannula 5. Curved Osteoraptor 6. Safe range 14 c.co.uk shoulderdo lenfunk@ 15 5!