Podcasts about bankart

Our last poster is titled Outcomes and Return to Sport Following Arthroscopic Bankart Repair for Anterior Shoulder Instability in Contact versus Non-contact Athletes: A Systematic Review and Meta-Analysis.  We've spoken a lot about the surgical treatment for anterior shoulder instability on this podcast – most recently with Dr. Brian Lau.  That is episode #48 and 49 if you want to check it out.This study focused on outcomes of arthroscopic Bankart repair for the treatment of anterior shoulder instability, specifically comparing outcomes in contact athletes versus noncontact athletes.  This systematic review included 18 studies with 1-year minimum follow-up.The authors found that contact and noncontact athletes had similar rates of return to sport as well as similar rates of return to preinjury level of play.  However, they also found that contact athletes demonstrated significantly greater rates of recurrent instability, at 28% compared to 8% in noncontact athletes.  Contact athletes also demonstrated significantly greater need for revision surgery, at 12% compared to 3% in noncontact athletes.

Welcome to Season 2 of the Orthobullets Podcast. Today's show is Podiums, where we feature expert speakers from live medical events. Today's episode will feature ⁠⁠⁠⁠⁠⁠Dr. ⁠Patrick Denard⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠and is titled ⁠⁠⁠⁠⁠⁠⁠Knotless Bankart + Remplissage.⁠ Follow ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Orthobullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on Social Media: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Twitter⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠LinkedIn⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube

A multicenter, double-blinded randomized controlled trial comparing isolated Bankart repair (NO REMP) to Bankart repair with remplissage (REMP) reported benefits of remplissage in reducing recurrent instability at 2 years postoperative. The ongoing benefits beyond this time point are yet to be explored.   In conclusion, for the treatment of traumatic recurrent anterior shoulder instability with a Hill-Sachs lesion and subcritical glenoid bone loss (

Specialist shoulder physiotherapists, Marianne van Gastel and Karin Hekman, are back for the second part of their discussion on rehabilitation for peple with anterior shoulder dislocation and Bankart repair. Marianne and Karin share how they use a psychologically-informed practice type of approach to support athletes and patients to work through and overcome anxiety and apprehension. The chat focuses on supporting patients to return to high levels of function, including sport, after their shoulder surgery. ------------------------------ RESOURCES Rehabilitation guideline for managing apprehension after anterior shoulder dislocation and Bankart repair: https://www.jospt.org/doi/10.2519/jospt.2024.12106 To find out more and register for the YAHiR-JOSPT Young athlete's Hip Webinar Series: https://semrc.blogs.latrobe.edu.au/events/yahir/

Physiotherapists and clinician-researchers, Marianne van Gastel and Karin Hekman, share a new rehabilitation guideline on managing apprehension in people with anterior shoulder dislocation and Bankart repair. Over the next 2 episodes of JOSPT Insights, Marianne and Karin will take us through the rehabilitation guideline, explain what's new in shoulder rehabilitation, and share their approaches to helping people feel confident to get back to the sports and recreation activities they love after shoulder dislocation. ------------------------------ RESOURCES Rehabilitation guideline for managing apprehension after anterior shoulder dislocation and Bankart repair: https://www.jospt.org/doi/10.2519/jospt.2024.12106 Patients' perspectives after treatment for anterior instability: https://pubmed.ncbi.nlm.nih.gov/37811392/ To find out more and register for the YAHiR-JOSPT Young athlete's Hip Webinar Series: https://semrc.blogs.latrobe.edu.au/events/yahir/

While many people are familiar with meniscus injuries and ACL tears, when they hear they've injured their labrum - the question marks pop up a'plenty. What exactly is going on with this injury and what can three orthopedic surgeons tell us about it? That and the process of recovery after this injury are the focus of this episode of The 6 to 8 Weeks Podcast... Connect with The 6-8 Weeks Podcast: There's a LOT of detail included in this program. Do you want to share YOUR perspective about it? Connect with The 6-8 Weeks Podcast Now! Subscribe to, Like and Share The 6-8 Weeks Podcast Everywhere:               The Detailed Shownotes for This Episode of The 6-8 Weeks Podcast: Questions Answered Inside This Episode; 1. What are the primary roles of the labrum in shoulder stability and function, and how does a labral tear impact these roles? 2. Can you describe the differences between the various types of labral tears, such as Bankart and SLAP tears, and how their treatments might differ? 3. Why are superior labral tears commonly found in aging populations, and how should this influence our approach to diagnosis and treatment? 4. What factors contribute to the long recovery time for labral tear surgeries, despite the procedure itself being relatively straightforward? 5. How do the hosts differentiate between a labral tear that needs surgical intervention and one that can be managed conservatively? 6. Could you elaborate on the potential implications of a biceps tenodesis procedure for middle-aged or older athletes with labral tears? 7. In what ways might our understanding of the biceps's role in shoulder mechanics change the future of labral tear treatment, especially for elite athletes? 8. What are the particular challenges in managing labral injuries in pediatric and adolescent populations, as compared to adults? 9. How can we effectively communicate MRI results pertaining to labral tears to patients, ensuring they understand what findings are clinically significant versus age-related changes? 10. What are the key considerations for a clinician when deciding whether an in-season athlete with a labral tear should continue to play or rest and undergo therapy? Timestamps from This Episode of The 6-8 Weeks Podcast: 06:19 Siakam's shoulder injury hampers elite performance. 10:00 Young throwing athletes may experience shoulder injuries due to throwing. MRI may show labral pathology, often incidental. Management includes monitoring pain, rest, and potential physical therapy. Caution is advised to avoid worsening the condition. 13:35 Labrum tear treatment options: rest, therapy, surgery. 14:40 Avoid surgery over 37 to prevent 33% failure. Connect with the Hosts of The 6-8 Weeks Podcast: It's never been easier to connect with the hosts of The 6-8 Weeks Podcast. Read on below to share your perspectives on this episode of The 6-8 Weeks Podcast. === Connect with Dr. Brian Feeley: On the Web -- On X === Connect with Dr. Nirav Pandya: On the Web:-- On X:  === Connect with Dr. Drew Lansdown: On the Web

Our next poster is titled Primary Latarjet Procedure versus Latarjet in the Setting of Previously Failed Bankart Repair: A Systematic Review. We've spoken a lot about shoulder instability on this podcast, most recently with Yoni Rosenblatt last month discussing rehab tips and tricks after various shoulder stabilization surgeries. We also had Dr. Brian Lau on Episodes 48 and 49 to chat about the different surgical options for anterior shoulder instability. So, we're excited to review this poster today and add some new literature to this discussion.

In this episode, we're going to continue our discussion with Dr. Yoni Rosenblatt and focus on the rehab of different stabilization surgeries, including arthroscopic Bankart repair, Bankart with the addition of a remplissage procedure, and Latarjet reconstruction. We then wrap up with a discussion on return to play and an important conversation on the psychological aspects of recovery.Our conversation picks back up with an article from the March 2020 issue of Sports Health titled “A Comparison of Physical Therapy Protocols Between Open Latarjet Coracoid Transfer and Arthroscopic Bankart Repair.” Dr. Nik Verma and team at Rush reviewed 31 PT protocols and found a high degree of variability with regard to exercises and motion goal recommendations. Despite the variability, many milestones and start dates occur earlier in Latarjet protocols when compared with Bankart-specific protocols, which may contribute to the earlier return to play metrics identified in the literature for Latarjet compared to Bankart repair.Next, we review an article titled “Functional Rehabilitation and Return to Play After Arthroscopic Surgical Stabilization for Anterior Shoulder Instability” published in the December 2021 issue of Sports Health. In this case series, Dr. Brian Busconi and colleagues at UMass evaluated 62 athletes who underwent arthroscopic Bankart repair and were subsequently cleared to return to sports using both functional and psychological testing. The average time to pass psychological testing was 5 months, while the average time to pass functional testing was 6 months. The re-dislocation rate of 2 years was 6.5%, lower than what is currently published for this population.We finish up today with an article from the October issue of AJSM titled “Relationship of the SIRSI Score to Return to Sports After Surgical Stabilization of Glenohumeral Instability.” Dr. Rossi and colleagues in Argentina reported that patients who returned to sports and those who returned to their preinjury sports level were significantly more psychologically ready than those who did not return. In fact, for every 10-point increase in the SIRSI score, the odds of returning to sports increased by 2.9 times. Furthermore, those who did not achieve their preinjury sports level showed poorer psychological readiness to return to play and SIRSI score results.

We're back for 2024! On today's episode, Ben and Tom discuss Bankart lesions and repairs. Research mentioned in today's podcast: Defroda, S., Mehta, N., and Owens, B. Physical Therapy Protocols for Arthroscopic Bankart Repair. Sports Health. 2018 Jan 3, 10(3): 250–258doi: 10.1177/1941738117750553 Gaunt, B., Shaffer, M., Sauers, E., Michener, L., Mccluskey, G., Thigpen, C. The American Society of Shoulder and Elbow Therapists' Consensus Rehabilitation Guideline for Arthroscopic Anterior Capsulolabral Repair of the Shoulder. Journal of Orthopaedic & Sports Physical Therapy. 2010;40(3):155-168. doi:10.2519/jospt.2010.3186 Ialenti MN, Mulvihill JD, Feinstein M, Zhang AL, Feeley BT. 2017. Return to Play Following Shoulder Stabilization: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2017 Sep 14;5(9):2325967117726055. doi: 10.1177/2325967117726055. PMID: 28944249; PMCID: PMC5602217. Kasik CS, Rosen MR, Saper MG, Zondervan RL. High rate of return to sport in adolescent athletes following anterior shoulder stabilisation: a systematic review. J ISAKOS. 2019 Jan;4(1):33-40. doi: 10.1136/jisakos-2018-000224. Epub 2018 Nov 10. PMID: 31044093; PMCID: PMC6487304. Provencher MT, Sanchez G, Bernhardson AS, Peebles LA, Haber DB, Murphy CP, Sanchez A. The Instability Severity Index Score Revisited: Evaluation of 217 Consecutive Cases of Recurrent Anterior Shoulder Instability. Orthop J Sports Med. 2019 Jul 29;7(7 suppl5):2325967119S00269. doi: 10.1177/2325967119S00269. PMCID: PMC6668005. Saper MG, Milchteim C, Zondervan RL, Andrews JR, Ostrander RV. Outcomes After Arthroscopic Bankart Repair in Adolescent Athletes Participating in Collision and Contact Sports. Orthopaedic Journal of Sports Medicine. 2017;5(3). doi:10.1177/2325967117697950 Schwank A, Blazey P, Asker M, Møller M, Hägglund M, Gard S, Skazalski C, Haugsbø Andersson S, Horsley I, Whiteley R, Cools AM, Bizzini M, Ardern CL. 2022 Bern Consensus Statement on Shoulder Injury Prevention, Rehabilitation, and Return to Sport for Athletes at All Participation Levels. J Orthop Sports Phys Ther. 2022 Jan;52(1):11-28. doi: 10.2519/jospt.2022.10952. PMID: 34972489. Swindell HW, McCormick KL, Tedesco LJ, Herndon CL, Ahmad CS, Levine WN, Popkin CA. Shoulder instability, performance, and return to play in National Hockey League players. JSES Int. 2020 Sep 22;4(4):786-791. doi: 10.1016/j.jseint.2020.08.008. PMID: 33345216; PMCID: PMC7738589. Wilk KE, Bagwell MS, Davies GJ, Arrigo CA. RETURN TO SPORT PARTICIPATION CRITERIA FOLLOWING SHOULDER INJURY: A CLINICAL COMMENTARY. Int J Sports Phys Ther. 2020 Aug;15(4):624-642. PMID: 33354395; PMCID: PMC7735686. White, Alex E. BA; Patel, Nirav K. MD, FRCS; Hadley, Christopher J. BS; Dodson, Christopher C. MD. An Algorithmic Approach to the Management of Shoulder Instability. JAAOS: Global Research and Reviews 3(12):p e19.00168, December 2019. | DOI: 10.5435/JAAOSGlobal-D-19-00168 Ben Ashworth's website: https://athleticshoulder.com Mike Reinold's podcast: https://podcasts.apple.com/us/podcast/the-sports-physical-therapy-podcast/id1618458855

「本期内容」在这期的播客中，我们有幸邀请到了香港城市大学的副教授Ray LC。他最近与团队合作进行了一项前沿的media art项目，探索了舞蹈与机器科技之间的交汇。在这次深入的对话中，Ray教授将分享他在项目中的经验，以及如何看待舞者与机器的结合带来的创新与挑战。随着技术的进步，艺术与科技之间的边界似乎越来越模糊。那么，当舞蹈与机器相遇，会产生怎样的火花？让我们一起探索这个充满无限可能的新世界。「嘉宾介绍」罗锐，加利福尼亚大学洛杉矶分校神经科学哲学博士，帕森设计学院设计与科技艺术创作硕士。作为一位新媒体艺术家，他擅长构建社区与机器之间的连接，从人机互动与合作叙事角度出发创作互动环境。他的主要作品曾在Elektra（蒙特利尔）、ArtLab（拉合尔）等展览中展出，同时也曾参与東京BankArt、紐约科学馆等知名驻场项目。「时间线」00:00:00 嘉宾介绍00:02:52 如何看待人与机器在舞蹈中的合作00:13:42 舞者是否需要全程参与表演00:15:24 展览的地点介绍00:18:15 之前有关的项目介绍00:19:45 如何看待机器和感情的未来发展00:29:45 如何看待AI和人类合作的关系00:37:21 对于AI的未来的态度00:39:42 从神经智能的角度来看待人工智能对人类的影响00:44:49 对于想跨界学习神经科学的年轻人有什么建议00:51:35 总结「联系我们」微博「ARTsOUT艺术出圈」公众号「ARTsOUT艺术出圈」即刻「ARTsOUT-Lingzi」欢迎加入我们的听友群，添加微信号artsout_official 即可入群商业合作：artsoutofficial@gmail.com欢迎支持我们的创作，爱发电：https://afdian.net/@artsout

And we are back for Part II of our discussion with Dr. Brian Lau. Our conversation picks back up with a discussion of surgical treatment options for more significant glenoid bone loss. There is a 2021 yellow journal article titled Diagnosis and Management of Traumatic Anterior Shoulder Instability that nicely outlines a treatment algorithm based on percentage of glenoid bone loss as well as the presence and severity of a Hill Sachs lesion. Matt Provencher and colleagues explain that good results can be expected after Bankart repair in on-track Hill-Sachs lesions with glenoid bone loss less than 13.5%. Bankart repair without additional procedures is not recommended in off-track Hill Sachs lesions, regardless of the extent of glenoid bone loss. Bone block procedures are recommended when glenoid bone loss is greater than 20% to 25% or when the Hill Sachs lesion is off-track. Then, from the April issue of AJSM this year, we discuss the study performed by our guest Dr. Lau and his team at Duke, titled Distal Clavicle Autograft Versus Traditional and Congruent Arc Latarjet Procedures. This laboratory analysis compared five different configurations of two local autograft options – coracoid and distal clavicle – using both 3D CT and 3D MRI. They looked at how much the glenoid surface area was augmented (important to address the glenoid bone loss) and the amount of glenoid apposition provided (bone-to-bone contact being important for graft healing). The authors found that the congruent arc Latarjet procedure had the largest graft surface area, the standard Latarjet procedure had the most bone-on-bone contact and the distal clavicle attached by its inferior surface had the largest graft width. This paper also found that differences between 3D CT and 3D MRI were small and likely not clinically significant.We finish up our conversation with a focus on rehab and returning to play after shoulder stabilization surgery. The last article we reference is titled Criteria-based Return-to-Sport Testing is Associated with Lower Recurrence Rates following Arthroscopic Bankart Repair. Albert Lin and colleagues and UPMC evaluated the use of a criteria-based return-to-sport testing protocol, which includes assessments of strength and function using the closed kinetic chain upper extremity stability test and the unilateral seated shot-put test. The authors found that athletes who underwent this testing protocol to guide their clearance to return to sports had a lower rate of recurrent instability than those cleared to return based on the time from surgery (5% vs. 22%).

On today's episode we're focusing on anterior shoulder instability with Dr. Brian Lau, orthopedic sports medicine surgeon, team physician for Duke Athletics and Director of the FIFA Medical Center at Duke.We have some great articles for you that contribute well to our conversation on the treatment of primary anterior shoulder instability. We'll start off our discussion today with a level I RCT published in the March 2020 issue of JBJS titled Primary Arthroscopic Stabilization for a First-Time Anterior Dislocation of the Shoulder, a single-center double-blinded clinical trial compared arthroscopic washout to arthroscopic Bankart repair for the management of primary anterior shoulder instability. At an average follow up of 14 years, the rate of recurrent dislocation was significantly higher in the washout group compared to the Bankart repair group, at 47% compared to 12%. The arthroscopic Bankart repair group also demonstrated significantly better clinical outcome scores, including the WOSI and DASH scores. Then, from the June issue of JSES this year, we review the publication titled Remplissage reduces recurrent instability in high-risk patients with on-track Hill-Sachs lesions.  Albert Lin and Pat Denard performed a multicenter retrospective study of patients with on-track Hill Sachs lesions who underwent arthroscopic Bankart repair with or without the addition of a Remplissage procedure. We'll discuss on-track versus off-track Hill Sachs lesions, how you go about calculating this and what to do with this information in a little bit with our guest. So, for now, we'll just focus on the results of this study, which showed that the addition of a remplissage was associated with a lower rate of recurrent dislocation (1.8% vs. 11%) and revision surgery (0% vs. 6%). Remplissage protected against recurrent instability, particularly in high-risk patients.We are joined today by Dr. Brian Lau, a board-certified orthopedic surgeon dual-fellowship-trained in both sports medicine surgery and foot & ankle surgery. Dr. Lau obtained his medical degree from the University of Pittsburgh and completed his orthopedic residency at UC San Francisco. He then went on to complete two fellowships – the first in Sports Medicine and Shoulder Surgery at Duke University and the second in Foot & Ankle Surgery at Stanford University. Following training, Dr. Lau returned to Duke University, where he is a team physician for Duke Athletics and the Director of the FIFA Medical Center at Duke. Dr. Lau is the associate program director of the Duke Orthopedic Sports Medicine and Shoulder fellowship and serves on numerous educational committees in AOSSM, AANA and ASES. He is passionate about research and leads the Duke Sports Medicine Research Committee.

A 2-Year Follow-up May Not be Enough to Accurately Evaluate Recurrences After Arthroscopic Bankart Repair: A Long-term Assessment of 272 Patients With a Mean Follow-up of 10.5 Years Rossi LA, Pasqualini I, Huespe I, et al. Am J Sports Med. Published Ahead of Print. doi:10.1177/03635465221139290 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight

Today, we continue our discussion on topics related to shoulder instability. In this episode, we cover the following:What is the shoulder labrum?What is the purpose of the shoulder labrum?What is a Bankart Lesion?What are some types of Bankart Lesions?What do we do for patients with these injuries?Don't forget! The PT Snacks Service Challenge is still going on until March 31st. Get more information here.Support the showThe purpose of this podcast is to provide useful, condensed information for exhausted, time-crunched Physical Therapists and Student Physical Therapists who looking to build confidence in their foundational knowledge base and still have time to focus on other important aspects of life. Hit follow to make sure you never miss an episode. Have questions? Want to connect? Contact me at ptsnackspodcast@gmail.com or check out more at ptsnackspodcast.com. On Instagram? Check out the unique content on @PT_Snacks! Need CEUs but low on time and resources? Go to https://www.medbridgeeducation.com/pt-snacks-podcast for over 40% off a year subscription. Use the promo code PTSNACKSPODCAST. This is an affiliate link, but I wouldn't recommend MedBridge if I didn't think they offered value. Willing to support monetarily? Follow the link below to help me continue to create free content. You can also support the show by sharing the word about this show with someone you think would benefit from it.

The right surgery for an unstable shoulder remains a topic of controversy. What is the right approach? If performing a soft tissue stabilization, is Bankart repair alone sufficient? What is the amount of critical bone loss that would tip the scales towards a Laterjet? World-renowned shoulder specialist Dr. Patrick Denard of the Oregon Shoulder Institute joins us to discuss his recent study, “Arthroscopic Bankart Repair with Remplissage as an Alternative to Laterjet for Anterior Glenohumeral Instability with More Than 15% Glenoid Bone Loss,” published in OJSM in December. 15% glenoid bone loss has commonly been referred to as the threshold beyond which a soft tissue only procedure should not be performed. Dr. Denard shares his wisdom with us and why the addition of Remplissage may change the decision-making when dealing with bone loss above this limit. 

We're excited to be in the studio today recording this episode on returning to play after arthroscopic stabilization for anterior shoulder instability. Now, we did a whole episode on shoulder instability back in March of 2021 with Dr. Mark Price – shoulder surgeon at Massachusetts General Hospital and teamphysician for the New England Patriots.We discussed a lot on that two-part episode, including anterior and posterior instability, nonoperative and surgical treatment, and different surgical  approaches including arthroscopic versus open Bankart repair and bone block procedures. It was a great discussion, and we definitely recommend checking it out if you haven't listened to it already. But today we're narrowing our focus to post-op rehab and return to play testing after arthroscopic anteriorshoulder stabilization. We've spoken about return to play testing a lot on previous episodes. We even did an entire episode with Dr. Robin West – team physician for the Washington Nationals and the Washington Commanders – dedicated to this very topic: returning athletes to play after various orthopedic injuries. In that episode we highlighted that there is often little to no data to guide safe return to sport after an orthopedic injury, particularly those treated surgically. That is also case for athletes who undergo surgery for anterior shoulder instability. On today's episode, we're going to review an article titled “Functional Rehabilitation and Return to Play After Arthroscopic Surgical Stabilization for Anterior Shoulder Instability” published in the December 2021 issue of SportsHealth. In this case series, Dr. Brian Busconi and colleagues at UMass evaluated 62 athletes who underwent arthroscopic Bankart repair and were subsequently cleared to return to sports using both functional and psychological testing.Before we dive into the results of this paper, it is worthwhile to review the traditional methods of clearing athletes after Bankart repair as there is currently no validated return to sport assessment for this particular surgery. Ciccotti and colleagues performed a systematic review of 58 studies assessing return to play criteria in a 2018 article published in Arthroscopy.Unsurprisingly, the most common criterion used to clear an athlete after arthroscopic Bankart repair was time. 75% of studies used time from surgery as the sole criterion, with the most commonly used time point being 6 months post-op. 19% used strength and 14% used range of motion. Only 1 of the studies evaluated proprioceptive control as a metric for guiding return to play.https://journals.sagepub.com/doi/abs/10.1177/19417381211062852

Bright on Buddhism Episode 40 - What is Buddhist psychology? What are its doctrinal foundations? What is its influence in the West? Resources: Caroline Brazier: A Buddhist Perspective On Mental Health. Paper for Nurturing Heart and Spirit: A National Multi-Faith Symposium; Held under the auspices of the Nimhe Spirituality Project, Staffordshire University and The Spirituality and Mental Health Forum, Wednesday November 1st 2006; Davidson, Richard J. & Anne Harrington (eds.) (2002). Visions of Compassion: Western Scientists and Tibetan Buddhists Examine Human Nature. NY: Oxford University Press. ISBN 0-19-513043-X.; Dockett, K. H., Dudley-Grant, G. R., & Bankart, C. P. (2003). Psychology and Buddhism: From individual to global community: Springer Science & Business Media.; Epstein, Mark (2004), Thoughts Without A Thinker: Psychotherapy from a Buddhist Perspective, Basic Books, Kindle Edition; Fromm, Erich, D. T. Suzuki & Richard De Martino (1960). Zen Buddhism and Psychoanalysis. NY: Harper & Row. ISBN 0-06-090175-6.; Fromm, Erich (1989, 2002). The Art of Being. NY: Continuum. ISBN 0-8264-0673-4.; Goleman, Daniel (ed.) (1997). Healing Emotions: Conversations With the Dalai Lama on Mindfulness, Emotions, and Health. Boston: Shambhala Publications. ISBN 1-57062-212-4.; Goleman, Daniel (2004). Destructive Emotions: A Scientific Dialogue with the Dalai Lama. NY: Bantam Dell. ISBN 0-553-38105-9.; Virtbauer, Gerald (March 2012). "The Western reception of Buddhism as a psychological and ethical system: developments, dialogues, and perspectives". Mental Health, Religion & Culture. 15 (3): 251–263. doi:10.1080/13674676.2011.569928. S2CID 145760146.; Virtbauer, Gerald (1 April 2014). "Characteristics of Buddhist Psychology". SFU Forschungsbulletin: 1–9. doi:10.15135/2014.2.1.1-9.; Wallace, B. A., & Shapiro, S. L. (2006). Mental balance and well-being: building bridges between Buddhism and Western psychology. American psychologist, 61(7), 690.; Watts, Alan W. (1959). The Way of Zen. NY: New American Library. Cited in Ellis (1991).; Watts, Alan W. (1960). Nature, Man and Sex. NY: New American Library. Cited in Ellis (1991).; Watts, Alan W. (1961, 1975). Psychotherapy East and West. NY: Random House. ISBN 0-394-71610-8.; Bodhi, Bhikkhu (ed.) (2000). A Comprehensive Manual of Abhidhamma: The Abhidhammattha Sangaha of Ācariya Anuruddha. Seattle, WA: BPS Pariyatti Editions. ISBN 1-928706-02-9. - also online: http://www.accesstoinsight.org/lib/authors/bodhi/abhiman.html; Brazier, David (2001), The Feeling Buddha, Robinson Publishing; Curtis, C. (2016). The Experience of Self/No-Self in Aikido. Journal of Consciousness Studies, 23(1-2), 58–68.; Flanagan, Owen (2011-08-12). The Bodhisattva's Brain: Buddhism Naturalized. MIT Press. p. 107. ISBN 978-0-262-29723-3.; Rick Hanson: Buddha's Brain: The Practical Neuroscience of Happiness, Love, and Wisdom. New Harbinger Publications (2009); Stephen Batchelor: After Buddhism: Rethinking the Dharma for a Secular Age. Yale University Press (2017) Do you have a question about Buddhism that you'd like us to discuss? Let us know by finding us on email or social media! https://linktr.ee/brightonbuddhism Credits: Nick Bright: Script, Cover Art, Music, Voice of Hearer, Co-Host Proven Paradox: Editing, mixing and mastering, social media, Voice of Hermit, Co-Host

Torn shoulder labrum? DocJen and Dr. Dom discuss the anatomy of the shoulder labrum and symptoms that may indicate a shoulder labrum injury. They discuss potential causes of the shoulder labrum tear, and the different types of tears: SLAP and Bankart. Furthermore, they describe tests for shoulder labrum tears, research on approaching shoulder labrum tears with physical therapy or surgery, and what your MRI scan may be indicating. Finally, they discuss how to rehabilitate a shoulder labrum injury, including mobility, isometric exercises, and dynamic strength. Let's dive in. We're bringing the Jen Health community together to do the FULL BODY LOW IMPACT PLAN together starting TODAY, August 1st. You're getting strength, mobility flows, core activations and muscle activations - a well rounded view starting from the foundations and educating up to move optimally and efficiently. We're moving, educating, and providing the opportunity to win prizes! We've never had a challenge this low before - $24.99. Let's do this before it's too late! What You Will Learn In This PT Pearl: 03:57 - Anatomy of shoulder labrum 05:31 - Symptoms of shoulder labrum tear 06:07 - Causes of shoulder labrum tear 06:44 - Types of tear 10:57 - Tests for shoulder labrum tear 12:45 - Conservative vs Surgery 14:32 - Does your MRI explain your symptoms? 15:14 - Has Dr. Dom had labral issues? 16:20 - How to restore external rotation function? 18:01 - Active Range of motion & loading 20:37 - Should you ice and rest? Watch Episode 228 on Youtube For research and full show notes, visit the full website at: https://www.docjenfit.com/podcast/episode228/ Thank you so much for checking out this episode of The Optimal Body Podcast. If you haven't done so already, please take a minute to subscribe and leave a quick rating and review of the show! --- Send in a voice message: https://anchor.fm/tobpodcast/message

Welcome Harrison Kuroda to the HNL Movement Podcast! There's many great insights he shares from his experiences as an athlete and a coach. He talks about how baseball grew into his primary sport that led him to play at the University of Hawaii. His road wasn't without obstacles and adversity as he persevered to return after shoulder surgery during his collegiate career. He talks about suffering multiple shoulder dislocations on his throwing shoulder. The first incident happened while playing soccer in high school and eventually led to a Bankart and labral repair. He shares many great firsthand insights through his recovery process to get back to pitching in college. He greatly credits Tommy Heffernan (Episode 100) with restoring his strength to play Division-I baseball again.All of Harrison's experiences have led him toward helping pitchers with strength & conditioning, throwing mechanics, and progressing on and off the field. In 2016, Harrison opened his facility Pitching Performance Hawaii, which is now in a 10,000 sq. ft. training space that includes a strength & conditioning, pitching, and hitting space. He encourages his athletes to be curious about learning and improving and prides himself on being a fresh set of eyes when coaching players of all ages. There are many great gems in this episode that will help athletes throughout their journey. Check out what he is doing on social media and his website below. Listen in and enjoy the episode!Website: https://pitchingperformancehawaii.com/FB: https://www.facebook.com/PitchingPerformanceHawaii/IG: https://www.instagram.com/pitching_performance_hawaiiEmail: pitchingperformancehawaii@gmail.com Phone: (808) 352-0478Did you enjoy this episode?Please subscribe and leave a review on:AppleSpotifyGooglePandoraiHeartRadio

Golfballen på en peg. Det runde hodet på den flate skålen. Skulderleddet er beskrevet på mange forskjellige måter, hvor man understreker leddets iboende strukturelle instabilitet. Labrum, eller leddleppen, er en struktur som skal sørge for bedre stabilitet rundt skulderleddet. Men hva er labrum? Hva slags funksjon har den? Hva slags skader forekommer i leddleppen – og skal disse skadene opereres?Med dårlig strukturell stabilitet er vi avhengig av god muskulær kontroll. Rotatorcuffen er sentral for å ivareta skulderfunksjon og styrke. Rotatorcuffrupturer er derfor potensielt sett en alvorlig skade som kan kompromitere skulderfunksjonen. Men studier har allikevel vist at mange pasienter klarer seg fint uten operasjon av en rotatorcuffskade. Og selv om mange rupturer blir større over tid, så påvirkes tilsynelatende ikke pasienten i like stor grad av smerter og nedsatt funksjon.   I denne episoden dukker vi dypt ned i skuldernerderiet når vi snakker om Biceps-labrumskader, herunder Bankart- og SLAP-skader. Vi går dypt ned i materien og snakker om skulderinstabilitet, overbelastningsskader, operasjonsindikasjoner og placebokirurgi. For å veilede oss gjennom dette har vi fått med oss ingen ringere enn Berte Bøe.  Berte Bøe jobber som ortopedisk kirurg og er seksjonsleder ved Artroskopiseksjonen, Oslo Universitetssykehus og er deltidskonsulent ved Volvat. Hun har bred erfaring innen ortopedi/traumatologi og subspesialisering innen kompleks skulder og knekirurgi. Berte Bøe er utdannet ved Universitetet i Oslo i 2001, hun har vært spesialist i ortopedi siden 2010 og tok doktorgrad i 2012. Hun er aktiv klinisk forsker med flere internasjonale publikasjoner og deltar ofte på internasjonale kongresser og webinarer innen sine spesialfelt. Leder i Norsk forening for skulder og albuekirurgi. Vise-Generalsekretær i ESSKA.Musikk: Joseph McDade - Mirrors

Criteria-based return-to-sport testing is associated with lower recurrence rates following arthroscopic Bankart repair. Junior MD, Popchak A, Wilson K, et al. J Shoulder Elbow Surg. 2021;30(7):S14-S20. doi:10.1016/j.jse.2021.03.141 Due to copyright laws, unless the article is open source we cannot legally post the PDF on the website for the world to download at will. Brought to you by CSMi – https://www.humacnorm.com/ptinquest Learn more about/Buy Erik's courses – The Science PT Support us on the Patreons! Music for PT Inquest: “The Science of Selling Yourself Short” by Less Than Jake Used by Permission Other Music by Kevin MacLeod – incompetech.com: MidRoll Promo – Mining by Moonlight

PART 2 If you missed, Part 1, go check that out before diving into today's episode. It's been ONE YEAR {literally to the day} since I got the MRI results on my left shoulder. The final blow to my shoulder happened on March 20th, 2021. We were rock climbing for my son's 12th birthday, and I reached out just a little too far with my left arm. I didn't feel a tear or hear a pop, but as the afternoon went on, my shoulder became extremely painful. **Note that this was most likely an injury that had been brewing for a long time...I speak to the prior events in the podcast.** I had an MRI on March 30th, 2021 and received the results one day later. The report was lengthy, but here are the highlights.... SLAP (superior labral anterior posterior) tear Soft tissue Bankart/inferior labral tear Small rotator cuff tear (infraspinatus) Moderate tendinosis of subscapularis insertion Moderate AC joint arthrosis Ugh...the recommendation I received {from multiple medical professionals} was that surgery would be my only option if I wanted to regain full shoulder function and continue to workout and do the things I like to do. I decided to challenge this opinion and see what would happen if I committed...fully committed...to rehab. It's been a year, so I want to share my rehab journey. It's been a LONG road, but I've learned so much, I've grown so much, and I really can see all of the great things that happened to me through this process. I share this quote in today's episode, but this quote hit me hard, and it became a bit of a mantra for me on days that I felt tired or frustrated with the process. It's from the book, The Obstacle is the Way. "This thing in front of you. This issue. This obstacle—this frustrating, unfortunate, problematic, unexpected problem preventing you from doing what you want to do. That thing you dread or secretly hope will never happen. What if it wasn't so bad? What if embedded inside it or inherent in it were certain benefits—benefits only for you?" - Ryan Holiday In part 1, I will detail the timeline of the start of my shoulder issues all the way through the actual injury. I'll also discuss the mental struggle that accompanied the injury...this was something I wasn't prepared for...AT ALL. In part 2, I will go through the physical rehab process. Enjoy!

It's been ONE YEAR {literally to the day} since I got the MRI results on my left shoulder. The final blow to my shoulder happened on March 20th, 2021. We were rock climbing for my son's 12th birthday, and I reached out just a little too far with my left arm. I didn't feel a tear or hear a pop, but as the afternoon went on, my shoulder became extremely painful. **Note that this was most likely an injury that had been brewing for a long time...I speak to the prior events in the podcast.** I had an MRI on March 30th, 2021 and received the results one day later. The report was lengthy, but here are the highlights.... SLAP (superior labral anterior posterior) tear Soft tissue Bankart/inferior labral tear Small rotator cuff tear (infraspinatus) Moderate tendinosis of subscapularis insertion Moderate AC joint arthrosis Ugh...the recommendation I received {from multiple medical professionals} was that surgery would be my only option if I wanted to regain full shoulder function and continue to workout and do the things I like to do. I decided to challenge this opinion and see what would happen if I committed...fully committed...to rehab. It's been a year, so I want to share my rehab journey. It's been a LONG road, but I've learned so much, I've grown so much, and I really can see all of the great things that happened to me through this process. I share this quote in today's episode, but this quote hit me hard, and it became a bit of a mantra for me on days that I felt tired or frustrated with the process. It's from the book, The Obstacle is the Way. "This thing in front of you. This issue. This obstacle—this frustrating, unfortunate, problematic, unexpected problem preventing you from doing what you want to do. That thing you dread or secretly hope will never happen. What if it wasn't so bad? What if embedded inside it or inherent in it were certain benefits—benefits only for you?" - Ryan Holiday In part 1, I will detail the timeline of the start of my shoulder issues all the way through the actual injury. I'll also discuss the mental struggle that accompanied the injury...this was something I wasn't prepared for...AT ALL. In part 2, I will go through the physical rehab process. Enjoy!

Dr. John D. Kelly, IV, has an engaging conversation with Professor Josef Eichinger on the management of shoulder instability. Listen to hear pearls on managing the first time dislocator, bracing the athlete, arthroscopic fixation of Bankart lesions, portals, glenoid osteotomies, and much more. For more educational resources, visit: https://www.eoa-assn.org/

Humeral avulsion glenohumeral ligament (HAGL) lesions are often underreported but have been shown to occur in up to 10% of cases of anterior shoulder instability. In conclusion, patients with anterior shoulder instability undergoing surgical stabilization with open HAGL repair demonstrate excellent functional outcomes and high rates of RTP, with low rates of recurrence in the medium term compared with a control group without HAGL lesions who underwent arthroscopic Bankart repair alone.   Click here to read the article.

Drs Dekker and Millett discuss The "Bony Bankart Bridge" Procedure: A New Arthroscopic Technique for Reduction and Internal Fixation of a Bony Bankart Lesion

Drs Dekker and Kelly discuss Arthroscopic Remplissage With Bankart Repair for the Treatment of Glenohumeral Instability With Hill-Sachs Defects

Kevin Plancher, MD, MPH is the Founder of Plancher Orthopaedics & Sports Medicine. Dr. Plancher is a Clinical Professor, Department of Orthopaedic Surgery, at Montefiore Medical Center/Albert Einstein College of Medicine and an Adjunct Clinical Assistant Professor of Orthopaedic Surgery, at Cornell University in New York. In addition, Dr. Plancher is the Fellowship Director of an ACGME accredited sports medicine program in NYC and CT. Dr. Plancher is a leading orthopaedic surgeon and sports medicine expert with extensive knowledge in knee, shoulder, elbow, and hand injuries. He specializes in treating anterior cruciate ligament tears and shoulder injuries, which he sees frequently as a physician for the U.S. Ski Team and as a League Physician for Major League Lacrosse. He specializes in minimally invasive procedures including: partial knee replacements, arthroscopic rotator cuff repairs, arthroscopic Bankart repairs, and endoscopic elbow release for severe tennis elbow. He is also an expert in total and reverse shoulder, and knee replacements procedures. Dr. Plancher developed the arthroscopic technique for releasing a nerve for posterior shoulder pain. He has a paticular interest in adolescent sports injuries and injury prevention for young female athletes. Topics include: -Dr. Plancher's story of becoming an orthopedic surgeon, along with shared experiences and overlap with Dr. Sigman. -We hear about his sports medicine fellowship, including stories with previous fellow, Dr. Shariff Bishai. -We discuss Dr. Plancher's responsibilities being named chair of the American Academy of Orthopaedic Surgeons' (AAOS) Board of Specialty Societies (BOS). The BOS brings together the leaders of the 23 musculoskeletal societies to address advocacy, continuing medical education, research, and membership, residency, and fellowship issues. It also serves as an advisory body to the AAOS Board of Directors and promotes unity and collaboration between specialty societies and the Academy. -Dr. Plancher lectures globally on issues related to orthopaedic procedures and sports injury management. He is the founder of the “Orthopaedic Summit: Evolving Techniques”, (OSET) a national conference. Tune in to hear about the intriguing "Journal of Retraction" session held at OSET. Find out more about OSET here. Find out more about Dr. Kevin Plancher here. For MD's, click on the EARN CME link below to capture quick reflections on each learning & how it applies to your day-to-day to unlock a total of 1 AMA PRA Category 1 CMEs.

Drs Tucker and Savoie discuss Bankart Repair with Subscapularis Augmentation in Athletes with Shoulder Hyperlaxity

As we continue our series in Innovation join Dr. Lehman as he discusses Bankart Repairs using a Remplissage procedure with Dr. Paul Brady, joined by Physical Therapists Wilson Raines and Alex Diegle. The type of labral repair that uses infraspinatus tendon to attach into the Hill-Sachs deficit. 

Neste episódio da série Controvérsias na Ortopedia, os especialistas Mauricio Raffaelli, Jair Simmer Filho e Paulo César Pilusk debatem a instabilidade no atleta de contato sobre o ponto de vista do tratamento de Latarjet ou Bankart.

Nič več čakanja na urnike plačilnega prometa in vnašanja bančnih računov. Denar lahko prestavite v denarnico denimo družinskega člana že v parih sekundah. In to brezplačno! Takošnja plačila oziroma instant payments so relativno nov plačilni instrument. Že samo ime pa pove, da se plačilo oziroma nakazilo zgodi takoj oziroma v nekaj sekundah. Takojšnja plačila lahko uporabimo v vseh primerih, kot bi sicer uporabili gotovino. Recimo, ko želimo sodelavcu vrniti denar za malico ali otroku nakazati žepnino. Potrebujemo le telefon in mobilno aplikacijo, ki omogoča takojšnje plačilo. Takšna plačila že dalj časa omogočajo tuje digitalnih bank, od lanskega leta pa tudi naše banke preko nacionalne sheme takojšnjih plačil Flik. Ta storitev je brezplačna. Torej, do 15 tisoč evrov lahko brezplačno nakažete ali prejmete denar iz ali na svoj svojega računa od kogarkoli, ne glede na to, pri kateri banki je komitent in to v le parih sekundah. Poznati morate le njegovo telefonsko številko O uporabnosti takojšnjih plačilih v vsakdanjem življenju, sem se pogovarjala z Maticem Dolarjem, ki je bil eden prvih pri nas, ki je sprožil diskusijo okoli takojšnjih plačil in imel eno od osrednjih vlog pri vzpostavitvi ekosistema Flik. Torej, sheme, ki omogoča takojšnja plačila pri nas. Je vodja poslovnega področja plačilni sistemi pri podjetju Bankart, kjer se ukvarjajo s procesiranjem sodobnih načinov plačil. Povzetek: Takojšnja plačila preko aplikacije Flik omogočajo prejem ali nakazilo do 15 tisočakov, transakcija se opravijo v le nekaj sekundah, so brezplačne, ni potrebno izpolnjevanje bančnih nalogov, zadostuje le mobilna številka.

I denne episoden snakker vi med ortoped Kaare Midtgaard. Kaare har nylig publisert en leder hvor han peker på at pasienter med traumatisk, fremre skulderluksasjon antageligvis bør opereres langt tidligere og langt hyppigere enn det man gjør i dag. Han viser til en systematisk gjennomgang fra 2020 som viser at pasienter som ikke blir opereret etter førstegangsluksasjon har 7 ganger høyere sjanse for å reluksere enn pasienter som stabiliseres kirurgisk allerede etter første traumet. I denne podcasten diskuterer vi de mange momentene rundt dette. Ser du pasienter med skulderinstabilitet i din kliniske praksis er dette en podcast vi virkelig kan anbefale. AKTUELLE REFERANSER: Antonio, G.E., et al.: First-time shoulder dislocation: High prevalence of labral injury and age-related differences revealed by MR arthrography. J Magn Reson Imaging, 2007. 26(4): p. 983-91.Brownson, P., et al.: BESS/BOA Patient Care Pathways: Traumatic anterior shoulder instability. Shoulder Elbow, 2015. 7(3): p. 214-26.Easwaran, R., et al.: Imaging in shoulder instability with focus on identifying and measuring bone loss: A narrative review. Journal of Arthroscopy and Joint Surgery, 2018. 5(2): p. 71-78.Enger, M., et al.: Shoulder injuries from birth to old age A 1-year prospective study of 3031 shoulder injuries in an urban population. Injury, 2018.Gooding, B.W.T., et al.: The Management of Acute Traumatic Primary Anterior Shoulder Dislocation in Young Adults. Shoulder & Elbow, 2017. 2(3): p. 141-146.Hasebroock, A.W., et al.: Management of primary anterior shoulder dislocations: a narrative review. Sports Med Open, 2019. 5(1): p. 31.Hurley, E.T., et al.: Arthroscopic Bankart Repair Versus Conservative Management for First-Time Traumatic Anterior Shoulder Instability: A Systematic Review and Meta-analysis. Arthroscopy, 2020. 36(9): p. 2526-2532.Kavaja, L., et al.: Treatment after traumatic shoulder dislocation: a systematic review with a network meta-analysis. Br J Sports Med, 2018. 52(23): p. 1498-1506.King, S.W., et al.: Management of first time shoulder dislocation. Journal of Arthroscopy and Joint Surgery, 2018. 5(2): p. 86-89.Liavaag, S., et al.: The epidemiology of shoulder dislocations in Oslo.Scand J Med Sci Sports, 2011. 21(6): p. e334-40.Nakagawa, S., et al.: The Development Process of Bipolar Bone Defects From Primary to Recurrent Instability in Shoulders With Traumatic Anterior Instability. Am J Sports Med, 2019. 47(3): p. 695-703.Olds, M.K., et al.: Who will redislocate his/her shoulder? Predicting recurrent instability following a first traumatic anterior shoulder dislocation.BMJ Open Sport & Exercise Medicine, 2019. 5(1).Ozbaydar, M., et al.: Results of arthroscopic capsulolabral repair: Bankart lesion versus anterior labroligamentous periosteal sleeve avulsion lesion.Arthroscopy, 2008. 24(11): p. 1277-83.Provencher, C.M.T., et al.: Editorial Commentary: Evidence to Support Surgical Intervention for First-Time Shoulder Instability: Stabilize Them Early! Arthroscopy, 2020. 36(9): p. 2533-2536.Robinson, C.M., et al.: Functional outcome and risk of recurrent instability after primary traumatic anterior shoulder dislocation in young patients. J Bone Joint Surg Am, 2006. 88(11): p. 2326-36.Rugg, C.M., et al.: Surgical stabilization for first-time shoulder dislocators: a multicenter analysis. J Shoulder Elbow Surg, 2018. 27(4): p. 674-

• Host Cory Smith, MD • Guest interviewee Anthony Romeo, MD, discussing his review article “The Evaluation and Management of the Failed Primary Arthroscopic Bankart Repair” • Article summarized from August 1 issue [link to August 1 issue here]: o Review article “Evaluation and Management of Carpal Fractures other than the Scaphoid” • Article summarized from August 15 issue [link to August 15 issue here] o Research article “Mortality and Morbidity of Operative Management of Geriatrics Ankle Fractures” Follow this link to download these and other articles from the August 1, 2020 issue of JAAOS and August 15, 2020 issue of JAAOS. The JAAOS Unplugged podcast series is brought to you by the Journal of the American Academy of Orthopaedic Surgeons and the AAOS Resident Assembly. In addition, this podcast is brought to you by our sponsor, PICO: visit www.possiblewithpico.com

Drs Sheean and Lin discuss Labral Morphology and Number of Preoperative Dislocations Are Associated with Recurrent Instability After Arthroscopic Bankart Repair

Drs Sheean and Lin discuss Labral Morphology and Number of Preoperative Dislocations Are Associated with Recurrent Instability After Arthroscopic Bankart Repair

We should always look for two eponymous fractures of the shoulder on the post reduction radiographs.   Worth reading the Orthobullets page on traumatic anterior shoulder instability and the radiopaedia articles on Hills Sachs and Bankart lesions. https://www.orthobullets.com/shoulder-and-elbow/3050/traumatic-anterior-shoulder-instability-tubs https://radiopaedia.org/articles/bankart-lesion https://radiopaedia.org/articles/hill-sachs-lesion   Bankart's original paper https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2317614/   www.rnzcuc.org.nz podcast@rnzcuc.org.nz https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by ScoreSquad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For personal medical advice always consult your usual doctor

Welcome to the podcast review of JISAKOS volume 1, issue 6. See full issue here: http://jisakos.bmj.com/content/1/6 Social Media Editor, Peter D. Fabricant, MD, MPH, reviews this issue, including the introductory Editorial by Editor-in-Chief Prof. Niek van Dijk, MD, PhD, which touches upon the idea that “less is more”, and that for some clinical conditions, conservative treatment may be more beneficial than surgery. See Editorial here: http://jisakos.bmj.com/content/1/6/303. Additional topics include proprioception after tibial remnant-sparing ACL reconstruction, current concepts of taping and bracing to prevent ankle sprains, OCD of the elbow, and a review of Arciero's article (1994) on arthroscopic Bankart repair versus non-operative treatment for acute, initial anterior shoulder dislocations.

Patients who suffer anterior shoulder dislocations are at higher risk of developing glenohumeral arthropathy, but little is known about the initial cartilage damage after a primary shoulder dislocation. T1ρ is a magnetic resonance imaging (MRI) technique that allows quantification of cartilage proteoglycan content and can detect physiologic changes in articular cartilage. This study concluded that humeral head cartilage sustained greater damage than glenoid cartilage in primary dislocation. T1ρ values were higher in glenohumeral zones associated with Bankart and Hill-Sachs lesions. Widespread initial cartilage damage may predispose patients to glenohumeral arthropathy.   Click here to read the article. 

9月21日のゲストは、クリエイティブディレクターの小池一子さんです。 「無印良品」創業以来のアドヴァイザリー・ ボード。 また1983年から2000年日本初のオルタナティブ・スペース「佐賀町エキジビット・スペース」創設・主宰。現代美術の新しい才能を国内外に送り出したほか、鹿児島県霧島アートの森、十和田市現代美術館、横浜BankARTなどでインディペンデント・キュレーターとして公私立の美術館等への企画参加を重ねています。 本日から東京ミッドタウンの２１＿２１デザインサイトで始まった展覧会 『田中一光とデザインの前後左右』で展覧会のディレクターを務めています。

Episode 9: Bankart Repair and High Ankle Sprain Prognostic Predictors. Go to ptpodcast.com/pt-inquest for the articles discussed on this episode.

In der staatlich orthopädischen Klinik München Harlaching wurden im Zeitraum vom Februar 1993 bis März 1995 42 Patienten mit der Diagnose einer posttraumatischen rezidivierenden Schulterluxation operiert. Bei 20 Patienten wurde eine arthroskopische Labrumrefixation durchgeführt. Bei den übrigen Patienten kam, nach diagnostischer Arthroskopie eine offenen Kapsel-Labrum- Refixation nach Bankart mit Kapsel–Shift nach Neer (119) zur Anwendung.18 Patienten konnten nachuntersucht (1994-1995) werden ( follow up=14 Mon ,SD = 4,46). Zusätzlich erfolgte 1997 eine zweite telephonische Befragung( follow up=3,4a ,SD = 0,59).Zusammenfassend wurden folgende Ergebnisse wurden ermittelt:50 % (n=9) wurden mit sehr gut, ein Patient mit gut, 3 Patienten mit mäßig und 5 Patienten mit schlecht bewertet. 5 Patienten (28,5 %) erlitten ein Rezidiv davon wurden 4 Patienten erneut operiert. Patienten mit Erstluxation hatten alle ein „sehr gutes“ Ergebnis. Patienten mit mehr als drei Luxationen hatten einen schlechteren Outcome als „Erstluxierte“.Die jungen Patienten (16-29 Jahre) wiesen ein signifikant (Wilcoxon-Test p = 0,028) schlechteres Ergebnis auf, als ältere Patienten (31-58 Jahre).Patienten, die selbständig und regelmäßig „Heimtraining“ durchführten hatten ein signifikant besseres Ergebnis (Wilcoxon-Test p = 0,012) als Patienten ohne selbständige Übungen. Die Indikationen zur arthroskopischen Stabilisierung sehen wir bei: traumatischer Erstluxation bei Patienten mit hohem sportlichem Anspruch wobei die sportliche Belastung keine extremen Überkopfbelastungen oder körperlichen Belastungen (z. B. Kontaktsport) erfordern sollte. chronisch posttraumatischer Instabilität mit Bankart-Läsion, Hill-Sachs-Läsion, ohne Hyperlaxität, abgelösten IGHL, humorale Ablösung der Kapsel ( HAGL-Läsion) oder ausgeprägter Kapseltasche. Keine Altersbeschränkung und keine strenge Beschränkung hinsichtlich der präoperativen Luxationen wie von vielen Autoren gefordert. Eine diagnostische ASK notwendig zu Beurteilung um ggf. zu einem offenen Verfahren zu wechseln.Wichtig ist, dass bei allen in Frage kommenden Patienten eine entsprechend hohe Motivation und Compliance vorliegt.

Das Ziel der Studie ist die Erfassung und Darstellung langfristiger Er-gebnisse offener Schulterstabilisierungen bei Skapulafrakturen der Ty-pen D1 bis D3 nach Habermeyer. Zu beurteilen waren die Schultersta-bilität und -funktion, die Schmerzfreiheit im Alltag, das Wiedererlan-gen der Arbeits- bzw. Sportfähigkeit sowie der Versorgungsverlauf. Untersucht wurden 61 Patienten, 47 Männer und 14 Frauen. Das Pati-entenalter lag zum Zeitpunkt des Traumas zwischen 15 und 76 Jahren. Die dominante Seite war in 30 Fällen (50 %) verletzt. Die durchschnitt-liche stationäre Behandlungsdauer betrug 7 Tage, die mittlere Dauer der Arbeitsunfähigkeit war 11 Wochen. Die Zeitspanne zwischen Ope-ration und Nachuntersuchung reichte von 2 bis zu 10 Jahren. Die Bewertung beruht auf den Scores nach Kohn, Rowe und Zarins sowie Constant und auf 2 eigens für die Studie entwickelten Untersu-chungsbögen. Dargestellt wird einmal das Gesamtergebnis für jeden Untersuchungsparameter. Zum anderen erfolgt eine Auswertung unter Berücksichtigung des Versorgungszeitpunktes nach dem Trauma: Gruppe 3T, Versorgung zwischen dem 1. und 3. Tag, Gruppe 14T, Versorgung zwischen dem 4. und 14. Tag, Gruppe 3M, Versorgung zwischen dem 15. Tag und dem 3. Monat sowie Gruppe 3M

Die vorliegende Studie beschreibt klinische Langzeitergebnisse (8-11 Jahresresultate) offener Instabilitätsoperationen im kombinierten Verfahren nach Bankart und Neer oder nach alleiniger Neerscher Kapselplastik. In den Jahren 1988 bis 1990 wurde an der Chirurgischen Universitätsklinik München, Klinikum Innenstadt, bei insgesamt 71 nicht voroperierten Patienten mit vorderer / vorderer unterer Schulterinstabilität eine offene Operation zur Stabilisierung vorgenommen. Von diesen Patienten konnten 59 Patienten nachuntersucht werden, was einem Follow-up von 83% entspricht. Neben der Anamneseerhebung, die den prä- und postoperativen Zeitraum sowie den genauen Unfallmechanismus einschloß, wurden die Patienten klinisch untersucht. Die Beurteilung der Schulterfunktion erfolgte nach dem „Rowe-Score“ (Maximum 100 Punkte) und untergliedert sich in die Teilbereiche Schmerz (15 Punkte), Stabilität (25 Punkte), Funktion (25 Punkte), Bewegung (25 Punkte) und Kraft (10 Punkte). Zusätzlich wurden die Patienten gebeten, im Matsen-Test Fragen nach der Funktionalität zu beantworten, um so ausführliche Informationen wie möglich zur Einschätzung der postoperativen Alltagstauglichkeit des Gelenkes zu erhalten. Der mittlere Nachuntersuchungszeitraum lag bei 9,2 Jahren (8,4 Jahre bis 11,1 Jahre). Das Durchschnittsalter der Patienten betrug 29,4 Jahre. 78% waren männlichen, 22% weiblichen Geschlechts. Anhand der anamnestischen Kriterien „Trauma“ und „Grad der Luxation“ wurden die Patienten in drei Gruppen unterteilt: - Gruppe A: Kein Trauma, mit oder ohne vollständige Luxation, n = 10 - Gruppe B: Trauma und vollständige Luxation: n = 42 - Gruppe C: Trauma ohne vollständige Luxation, n = 7 In Gruppe A (n=10) erreichten die Patienten im Mittel einen Gesamtscore von 87 Punkten, entsprechend einem Gesamturteil von „sehr gut“. Es traten keine Rezidive auf. Die mittleren Punktzahlen in den einzelnen Kategorien lagen bei 11,4 Punkten (Schmerz), 22,5 Punkten (Stabilität), 21 Punkten (Funktion), 23,3 Punkten (Bewegung) und 10 Punkten (Kraft). In Gruppe B (n=42) erreichten die Patienten im Mittel ein Gesamtergebnis von 87,2 Punkten, was einem Gesamturteil von „sehr gut“ entspricht. Es wurden acht Rezidive festgestellt, die Rezidivquote betrug in dieser Gruppe somit 19%. Vier Patienten hatten Subluxationen erlitten. Die mittleren Punktzahlen in den einzelnen Kategorien lagen bei 13 Punkten (Schmerz), 20,7 Punkten (Stabilität), 20,8 Punkten (Funktion), 23,2 Punkten (Bewegung) und 9,5 Punkten (Kraft). 86 In der Gruppe C (n=7) erreichten die Patienten einen Gesamtscore von 73, was einem Gesamtergebnis von „gut“ entspricht. Bei zwei Rezidiven betrug die Rezidivquote 28,6%. Die mittleren Punktzahlen lagen bei 7,7 Punkten (Schmerz), 17,1 Punkten (Stabilität), 17,1 Punkten (Funktion), 22,7 Punkten (Bewegung) und 8 Punkten (Kraft). Insgesamt errechnet sich eine Gesamtrezidivrate von 16,9% (10 Patienten). Dabei betrug die Rezidivquote der nach dem kombinierten Verfahren Bankart-Neer operierten Patienten (n=49) 10,4%. Von den Patienten, welche lediglich mittels einer Neerschen Kapselplastik versorgt worden waren (n=10), trat bei fünf Patienten ein Rezidiv auf (50% der Neer Gruppe und 50% der Gesamtrezidive). Bei drei dieser Patienten wurde ein Bankart-Defekt festgestellt. Die Rezidivursachen wurden im Rahmen der Untersuchung in vier Kategorien unterteilt: - Kategorie 1: Gelenkzustand (n=3) - Kategorie 2: Erneutes Trauma / verletzungsspezifische Non-Compliance (n=6) - Kategorie 3: Wahl des Operationsverfahrens (n=3) - Kategorie 4: Unbekannt / operationstechnische Probleme (n=5) Eine mehrfache Zuordnung war möglich. Die Operationsergebnisse der Kategorie 1 wurden erheblich durch degenerativ veränderte Gelenke beeinflußt. Kategorie 2 umfaßt die meisten Patienten dieser Kategorien (n=6), und zeigt, daß von allen eruierbaren Ursachen erneute (z.T. massive) Traumata das Rezidivrisiko am stärksten erhöhen. Kategorie 3 unterstreicht die Bedeutung der Korrektur eines vorhandenen Bankart Defektes, da bei ihren Patienten nur eine der Pathologie nicht völlig gerecht werdende Neersche Kapselplastik zur Anwendung gekommen war. Lediglich vage Hinweise in vier Fällen auf Probleme im perioperativen Umfeld und überhaupt keine Erklärung der Rezidivursache in zwei Fällen bieten die Patienten der Kategorie 4. Eindeutige Aussage über ursächliche Zusammenhänge sind hier nicht oder nur stark eingeschränkt möglich. Im Laufe der Untersuchungen wurde ebenfalls deutlich, daß die Bewertung des Erfolges von Instabilitätsoperationen nicht alleine von bloßen Stabilitätskriterien oder gar der reinen Anzahl auftretender Reluxationen abhängig gemacht werden darf. Faktoren wie Einschränkungen in der Alltagstauglichkeit und Schmerzen müssen in die Bewertung einbezogen werden. Der Rowe-Score bietet ein gutes, Gesamtzustand und Gebrauchsfähigkeit des Gelenkes quantifizierendes Instrument zur Bewertung von Operationsergebnissen. Der wesentlich geringere Gesamtscore und die ebenfalls meist niedrigeren Einzelpunktwerte der Patienten ohne eine volle Luxation bei instabilitätsauslösendem oder begünstigendem Trauma (Gruppe C) deutet tendenziell auf eine schlechtere Prognose von Patienten dieser Anamnesekonstellation hin, wobei aufgrund der kleinen Gruppengröße (n=7) eine statistische Bestätigung dieses Zusammenhanges nur eingeschränkt möglich ist. Als Ansätze für mögliche Verbesserungen für zukünftige offene Instabilitätsoperationen lassen sich folgende Punkte anführen: - präoperative Diagnostik und intraoperative Schadensabklärung, dabei insbesondere genaue Begutachtung des Zustandes des Pfannenrandes - Genaue Kenntnis und Einschätzung der Verletzungspathologie bei der Wahl des Operationsverfahrens - Nutzung ausschließlich knöcherner Strukturen zur Refixation - Eindringliche und redundante Aufklärung über die Wichtigkeit der Meidung extremer sportlicher und traumatischer Beanspruchungen des Gelenkes sowie patientenseits ein Verzicht auf besonders unfallträchtige Tätigkeiten oder unverhältnismäßig hohe Schulter-Arm Belastungen. Durch die Beachtung dieser Vorgaben und durch sorgfältige und zeitgemäße Umsetzung der in der Literatur beschriebenen Empfehlungen sollte es gelingen, die Rezidivquote auch im postoperativen Langzeitverlauf weiter deutlich zu senken.