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Posterior shoulder instability

Journal of Clinical Orthopaedics | Vol 5 | Issue 1 |  Jan-Jun 2020   | page: 31-35 | E. Taverna, A.Spreafico, C. Perfetti, V. Guarrella


Author: E. Taverna [1], A.Spreafico [1,2], C. Perfetti [1], V. Guarrella [1]

[1] IRCCS Istituto ortopedico Galeazzi, Milan, Italy
[2] Università degli studi di Milano, Scuola di specializzazione in Ortopedia e Traumatologia

Address of Correspondence
Dr. E. Taverna,
IRCCS Istituto ortopedico Galeazzi, Milan, Italy
E-mail: vguarrella@hotmail.com


Abstract

Normally, shoulder movements are well balanced through an interplay between static structures (bone and soft tissues as capsule, ligaments and labrum) and muscular dynamic stabilizers (muscles and tendons). Dysfunction of one or more of these components due to an injury, degeneration or congenital abnormalities may lead to shoulder instability with concomitant pain and dysfunction. This article provides an overview of the soft tissue and bony anatomy of the shoulder joint and pathopysiology of shoulder instability. It also covers the important aspects of clinical examination and special test for diagnosis of shoulder instability. A brief over view of conservative and surgical management protocols for shoulder instability are also covered in view of recent literature and authors experience.
Keywords: Posterior shoulder instability, conservative treament, Surgical management, arthroscopy.


References

1. Robinson CM, Dobson RJ. Anterior instability of the shoulder after trauma. J Bone Joint Surg [Br] 2004;86-B(4):469–479.
2. Rowe CR, Yee LB. A posterior approach to the shoulder. J Bone Joint Surg. 1944;26:580.
3. Steinmann SP. Posterior shoulder instability. Arthroscopy 2003; 19 Suppl 1: 102
4. Owens BD, Duffey ML, Nelson BJ, et al. The incidence and characteristics of shoulder instability at the United Statesmilitary academy. Am J Sports Med. 2007;35:1168–1173.
5. Robinson CM, Aderinto J. Current concepts review: recurrent posterior shoulder instability. J Bone Joint Surg Am. 2005;87: 883–892.
6. Tannenbaum EP, Sekiya JK. Posterior shoulder instability in the contact athlete. Clin Sports Med. 2013;32:781–796.
7. Brewer BJ, Wubben RC, Carrera GF. Excessive retroversion of the glenoid cavity. A cause of non- traumaticposterior instability of the shoulder. J Bone Joint Surg Am. 1986;68:724–31.
8. Dekker TJ, Peebles LA, Goldenberg BT, Millett PJ, Bradley JP, Provencher MT. Location of the Glenoid Defect in Shoulders With Recurrent Posterior Glenohumeral Instability. Am J Sports Med. 2019 Oct 16:363546519876282
9. Meyer DC, Ernstbrunner L, Boyce G, Imam MA, El Nashar R, Gerber C. Posterior Acromial Morphology Is Significantly Associated with Posterior Shoulder Instability.J Bone Joint Surg Am. 2019 Jul 17;101(14):1253-1260.
10. Blasier RB, Soslowsky LJ, Malicky DM, Palmer ML. Posterior glenohumeral subluxation: active and passive stabilization in a biomechanical model. J Bone Joint Surg Am 1997; 79: 433-440.
11. Kim S, Ha K, Park J, Kim Y, Lee Y, Lee J, Yoo J. Arthroscopic posterior labral repair and capsular shift for traumatic unidirectional recurrent posterior subluxation of the shoulder. J Bone Joint Surg Am. 2003;85:1479–87.
12. Beighton P, Solomon L, Soskolne CL. Articular mobility in an African population. Ann Rheum Dis. 1973;32:413–418.
13. Saliken DJ, Bornes TD, Bouliane MJ, Sheps DM, Beaupre LA. Imaging methods for quantifying glenoid and Hill-Sachs bone loss in traumatic instability of the shoulder: a scoping review. BMC Musculoskelet Disord. 2015 Jul 18;16:164.
14. Burkhead Jr WZ, Rockwood Jr CA. Treatment of instability of the shoulder with an exercise program. J Bone Joint Surg Am. 1992;74:890–6.
15. McIntyre K, Be´langer A, Dhir J, et al. Evidence-based conservative rehabilitation for posterior glenohumeral instability: a systematic review. Phys Ther Sport. 2016;22:94–100.
16. Schwartz E, Warren RF, O’Brien SJ, Fronek J. Posterior shoulder instability. Orthop Clin N Am. 1987;18:409–19.
17. Woodmass JM, Lee J, Johnson NR, Wu IT, Camp CL, Dahm DL, Krych AJ. Nonoperative Management of Posterior Shoulder Instability: An Assessment of Survival and Predictors for Conversion to Surgery at 1 to 10 Years After Diagnosis. Arthroscopy. 2019 Jul;35(7):1964-1970.
18. Saupe N, White LM, Bleakney R, Schweitzer ME, Recht MP, Jost B, Zanetti M. Acute traumatic posterior shoulder dislocation: MR findings. Radiology 2008; 248: 185-193.
19. Peat M. Functional anatomy of the shoulder complex. Phys Ther 1986; 66: 1855-1865.
20. Barbier O, Ollat D, Marchland JP, Versier G. Iliac bone-block autograft for posterior shoulder instability. Rev Chir Orthop Traumatol. 2009;95:100–7.
21. Métais P, Grimberg J, Clavert P, Kouvalchouk JF, Sirveaux F, Nourissat G, Garret J, Mansat P, Godenèche A; French Arthroscopy Society. Posterior shoulder instability managed by arthroscopic acromial pediculated bone-block. Technique. Orthop Traumatol Surg Res. 2017 Dec;103(8S):S203-S206
22. D’Ambrosi R, Perfetti C, Garavaglia G, Taverna E. One step arthroscopically assisted Latarjet and posterior bone-block, for recurrent posterior instability and anterior traumatic dislocation. Int J Shoulder Surg. 2015 Jul-Sep;9(3):94-8
23. Cerciello S, Enrico V, Morris BJ, Corona K. Bone block procedures in posterior shoulder instability. Knee Surg Sports Traumatol Arthrosc. 2016;24(2):604–11.
24. Inui H, Nobuhara K.Glenoid osteotomy for atraumatic posteroinferior shoulder instability associated with glenoid dysplasia. Bone Joint J 2018;100-B:331-7.
25. Mc LH. Posterior dislocation of the shoulder. J Bone Joint Surg Am. 1952;24 a:584–590.
26. Dueya RE, Burkhart SS. Arthroscopic treatment of a reverse Hill-Sachs lesion. Arthrosc Tech. 2013;2:e155–9.
27. Meuffels DE, Schuit H, van Biezen FC, Reijman M, Verhaar JA. The posterior bone block procedure in posterior shoulder instability: a long-term follow-up study. J Bone Joint Surg Br 2010; 92: 651-655
28. Bradley JP, McClincy MP, Arner JW, Tejwani SG. Arthroscopic capsulolabral reconstruction for posterior instability of the shoulder: a prospective study of 200 shoulders. Am J Sports Med 2013; 41: 2005-2014
29. Seppel G, Braun S, Imhoff AB. Surgical Management of Posterior Shoulder Instability. ISAKOS: Brockmeier SF, 2013.


How to Cite this article: Taverna E, Spreafico A, Perfetti C, Guarrella V. Posterior shoulder instability. Journal of Clinical Orthopaedics Jan-June 2020;5(1):31-35.

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