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.
2. www.wrightington.com
My brief (10-15min):
Clinical assessment of complex anterior and
posterior instability. - with Video
Radiological assessment of glenoid
and humeral bone loss.
Management strategies
and decision making
!2
3. www.wrightington.com !3
1 Sports Injuries
of the Shoulder
Lennard Funk
Mike Walton
Adam C. Watts
Mike Hayton
Chye Yew Ng
Editors
1239 783030 230289
ISBN 978-3-030-23028-9
SportsInjuriesoftheShoulder
This book provides a practical guide detailing the aetiology,
diagnosis, relevant pathology, management principles, and out-
comes of a variety of injuries to the shoulder including rotator
cuff disorders, glenoid bone loss, and pectoralis major ruptures
in both elite and non-elite athletes. Each chapter features clinical
pearls and a question and answer section to emphasize key points.
Sports Injuries of the Shoulder is an essential book for those
seeking an up-to-date resource. It is aimed at sports doctors and
musculoskeletal doctors; senior orthopedic trainees with an
interest in upper limb and those preparing for the FRCSOrth
exam and similar international exams, as well as surgeons with
a particular interest in shoulder conditions.
Lennard Funk · Mike Walton · Adam C. Watts · Mike Hayton
Chye Yew Ng Editors
Sports Injuries of the Shoulder
Funk·Walton·Watts
Hayton·YewNgEds.
16. www.wrightington.com
What is a significant Hill-Sachs
Lesion?
1. 4cm long
2. 20% humeral head surface
3. 40% humeral head surface
4. Engaging at Arthroscopy
17. www.wrightington.com
Balance Stability Angle - Matsen
Effective Glenoid Arc = the area of the glenoid’s
articular surface available for humeral head
compression
Balance Stability Angle = the angle between the centre
of the glenoid and the end of the effective glenoid arc
in any direction (18 degrees anterior)
!17
19. www.wrightington.com
Glenoid:
Best fit circle (Huysmans)
!19
Humerus:
Hill-Sachs on coronal
GT = 0.84xD-d HS
D
d
1.If HS > GT, the HS is ‘off track’, or engaging.
2.If HS < GT, the HS is ‘on track’, or non-engaging.
Simplified: Not validatedTokish et al. 2015
20. www.wrightington.com
Two year period of 57 Bankart repairs
On-track (49) - recurrence 4%
Off-track (8) - recurrence 75%
PPV for Glenoid Track = 75%
PPV for Glenoid loss >20% = 43%
!20
26. www.wrightington.com
My brief:
Clinical assessment of complex anterior and posterior
instability. - with Video
History; Exam (positions)
Radiological assessment of glenoid and humeral bone loss.
MRA vs CTA: Radials
Assessing Bone Loss
Management strategies and decision making
1. Patient
2. Profession
3. Pathology
4. Physician
!26