Lesion de bankart y hill sachs pdf files

Open capsular repair without bone block likely failures. The rate of hillsachs lesions in recurrent anterior shoulder instability has been reported to be as high as 93% and increased attention has been given to the size and location of humeral bone loss. Recent studies have shown effective clinical results after arthroscopic bankart repair abr but have shown several risk factors for redislocation after surgery. Itoi e, hatakeyama y, urayama m, pradhan rl, kido t, sato k. Links 12 kodali p, jones mh, polster j, miniaci a, fening sd. Contact athletes with bone defects bankart or hillsachs have a 90% recurrence rate with soft tissue only procedures and require open surgery with bony augmentation. Remplissagewhen and how to fill in the defect idowu. The hillsachs lesion is freshened with a bur placed in the posterior portal and afterwards, a posterior cannula is placed through the deltoid without penetration of the infraspinatus tendon or capsule. Pseudo hill sachs lesion is seen as flattening in posterolateral head of humerus below the level of the coracoid it is a normal variant in anatomy. Accuracy of measurement of hillsachs lesions with computed tomography.

From engaging nonengaging to ontrack offtrack epos. Long term results of arthroscopic bankart repair for. Shoulder xrays, including outlet, axillary lateral, and anteroposterior views,3 may reveal a bony bankart lesion. Open latarjet surgery is a good option for failed arthroscopic bankart repair. Evolving concept of bipolar bone loss and the hillsachs lesion. The hillsachs lesion defect was measured and showed an average bone loss of 17. Is clinical evaluation alone sufficient for the diagnosis. Recurrence rates now seem comparable to those reported for open bankart procedures although higher than for boneblock procedures, especially in case of bone defect of the humeral head humeral notch or hillsachs lesion or anteroinferior glenoid cavity edge. Pdf on mar 31, 2019, mohsen a mashour and others published arthroscopic remplissage. Assessment of bone loss in anterior shoulder instability. The distal two centimeters of the coracoid process, with the entire conjoined tendon, was transferred through the incised subscapularis and attached to the glenoid fossa with a lag screw.

No attempt was made to grade the severity of bony pathology. Magnetic resonance images have high cost and availability issues. The arthroscopic method offers a less invasive technique of bankart repair for traumatic anterior shoulder instability. Hillsachs lesion measurement with tridimensional models. Use inferior capsular flap to repair bankart lesion. The purpose of the study was to access the diagnostic performance of the computed tomography ct in the assessment of. Following placement of two transtendon suture anchors in. The relationship between hill sachs and recurrent anterior shoulder dislocation article in acta orthopaedica belgica 732. An animated description of two conditions that can occur with a shoulder dislocation and contribute to further shoulder instability. Fifty patients had a hillsachs lesion in ap or axillary radiographs, and two had no signs of a hillsachs lesion. Contact between the glenoid and the humeral head in abduction, external rotation, and horizontal extension.

Habituele anterieure schouderinstabiliteit als gevolg van een. Between november 2004 and september 2007, 15 patients with unilateral chronic anterior shoulder dislocation were referred to our clinic. Fifty patients had a hillsachs lesion and 32 patients had glenoid bone lesions on plain radiographs. Data from 79 shoulders in 74 patients were collected over 4 years 2004 2008. Revision open bankart surgery after arthroscopic repair for traumatic anterior shoulder. Accordingly, we simply evaluated bony hillsachs lesions. Evaluation of postoperative results from videoarthroscopic. However, nakagawa et al 18 have reported that the size of the hillsachs lesion does not influence postoperative recurrence of instability, as there were no significant differences among the 3 groups with regard to all parameters of hillsachs lesion size length, width, and depth. Bankart and hillsachs lesions are often associated with anterior shoulder dislocation. Location of the hillsachs lesion in shoulders with recurrent anterior dislocation. A correlation between a bankart lesion and the grade of a hillsachs lesion was found. External rotation was significantly increased after creation of the bankart and hillsachs lesion. All the cases underwent arthroscopic repair of the bankart lesion, together with filling of the hillsachs lesion. It results from forceful impaction of the humeral head against the anteroinferior glenoid rim when the shoulder is dislocated anteriorly.

Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic bankart repairs. The hill sachs lesion may be old, since the patient had previous shoulder dislocations. Evaluation of the diagnostic performance of the simple. Pdf assessment of coincidence and defect sizes in bankart and.

The relationship between hill sachs and recurrent anterior. Correlation between bankart and hillsachs lesions in anterior shoulder dislocation. Any information contained in this pdf file is automatically generated from digital material. Glenohumeral joint in abduction and external rotation in shoulder with glenoid defect and hillsachs lesion hs bipolar bone loss. We performed abr using bioabsorbable suture anchors in.

Horst and his colleagues also found that a larger hill sachs lesion leads to greater. It is an indication for surgery and often accompanied by a hill sachs lesion, damage to the posterior humeral head. Perthes lesion is variant of bankart lesion, presenting as an anterior glenohumeral injury that occurs when the scapular periosteum remains intact but is stripped. Is clinical evaluation alone sufficient for the diagnosis of a bankart lesion without the use of magnetic resonance imaging. Seven patients in whom closed reduction was possible were excluded from the study and the remaining eight patients were treated by open reduction and bankart lesion repair. It should be emphasized that the prevalence of true engaging hillsachs lesions using dynamic arthroscopic assessment after bankart. Each group was followed up for a mean more than 2year period.

Method to determine whether a hillsachs lesion is on track or off track. Hillsachs lesion measurement with tridimensional models in anterior shoulder instability. Thirtyseven shoulders subjected to arthroscopic remplissage with a bankart repair group a and 35 shoulders subjected to a latarjet operation group b, for a large engaging hill sachs lesion without significant glenoid bone loss, were retrospectively evaluated. Arthroscopic bankart repair versus nonoperative treatment for acute, initial anterior shoulder dislocations. Evolving concept of bipolar bone loss and the hillsachs. We would like to report the 2 year clinical outcomes of bioabsorbable suture anchors used in traumatic anterior dislocations of the shoulder. The purpose of this study is to analyze the results after applying our treatment algorithm for acute glenoid rim fractures caused by first time traumatic anterior shoulder dislocations. Sports medicine physical therapy rehabilitation protocols. Reverse hill sachs lesion is seen as a depression in anteromedial head of humerus. The physiologic groove in the humerus or cysts and erosions at the attachment site of the infraspinatus tendon can simulate a hill sachs, but usually this is not. Physical examinations may reveal the instability of a glenohumeral joint but cannot diagnose the bony bankart lesions. The relationship between hillsachs lesion and recurrent. Evaluation of a treatment algorithm for acute traumatic. Eighteen patients had normal contour of the anterior glenoid, 28 had signs of glenoid erosion, and four patients had a visible bone fragment bony bankart lesion.

The contribution of the hillsachs lesion to glenohumeral instability depends on the. The bony apprehension test for instability of the shoulder. Soft tissue bankart lesion cannot be visualized on traditional radiogram. Imaging modalities such as magnetic resonance arthrogram mra offer great utility in diagnosing bankart lesions but they are associated with a high degree of intra and interobserver variability. Bankart lesion 9antinf labrum torn hillsachs lesion 9impaction of humeral. We use a combined allarthroscopic remplissage, latarjet, and bankart repair for patients with. Pdf arthroscopic remplissage with bankart repair for the. Anterior shoulder reconstruction with arthroscopic bankart repair. When this happens, a pocket at the front of the glenoid forms that allows the humeral head to dislocate into it. Treatment of chronic anterior shoulder dislocation by open. A practical guide to shoulder injuries in the throwing athlete.

Imaging of shoulder instability santiago quantitative. Combined large hillsachs and bony bankart lesions treated by. A report of 49 cases with a minimum 2year followup. Studies dealing with acute osseous bankart lesions and corresponding treatment strategies are rare. A bankart lesion is an injury of the anterior glenoid labrum of the shoulder due to anterior shoulder dislocation. This implies that intrinsic stability can be shared between the bankart repair and bone support. Find pdfs of our most common rehabilitation protocols. It is due to recurrent posterior dislocation of shoulder joint. Open latarjet procedure for failed arthroscopic bankart. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. Hillsachs 990% arciero 1997 9100% kirkley 1999 956% larrain 2001 defect on humeral head glenoid recurrent dislocations. Assessment of coincidence and defect sizes in bankart and hill.

The sports physical therapy service is an integral part of the sports medicine center and the department of. A hill sachs lesion occurs when the lesion to the labrum presents simultaneously with a. On mr a hill sachs defect is seen at or above the level of the coracoid. A hillsachs lesion, or hillsachs fracture, is a cortical depression in the posterolateral head of the humerus.

We evaluated whether patients are at a risk for redislocation during the first year after abr, examined the recurrence rate after abr, and sought to identify new risk factors. Open latarjet procedure for failed arthroscopic bankart repair. Perthes lesion a perthes lesion is a labroligamentous avulsion like a bankart, but with a medially stripped intact periosteum. The relationship between hillsachs lesion and recurrent anterior shoulder dislocation. Full active and passive range of motion rom for shoulder flexion, abduction. Intraoperatively, a small bankart lesion was noted at the anteroinferior part of the labrum. The bony bankart lesion is new, as evidenced by lack of cortex on the superior part of the fragment, and is presumed to be caused by glenohumeral ligaments pulling the humerus towards the glenoid as the shoulder dislocates, causing a fracture even without significant external forces.