Shoulder joint is the joint with largest exercise range. Because of its surgical and functional features, glenohumeral arm joint is the joint with the highest rate of luxation in the body. There are many methods of surgery, however laparoscopic surgery has been proven to have prominent advantages which are less invasive, less pain, good rehabilitation, avoid complications of big surgery, reduce hospitalization time and use of antibiotics. This technique allows to access the deep and narrow surgical areas which are difficult to operate in open surgery
Arthroscopy ; Shoulder Joint ; Surgery

Posterior dislocation of the shoulder may be missed or neglected at initial presentation especially in developing countries. We present a case of 40-year-old Indian man who had 3-month missed posterior dislocation of the right shoulder along with malunited fracture of the anatomical neck of the humerus. Open reduction and stabilization with modified McLaughlin procedure was performed. Rotational osteotomy of proximal humerus had to be performed as supplementary procedure to keep the humeral head stable in glenoid cavity during functional range of movements. The patient had excellent result of the shoulder at 3 years follow-up.
Humans ; Humerus ; Osteotomy ; Shoulder Dislocation ; surgery ; Shoulder Fractures ; surgery

Arthroscopy ; Humans ; Joint Instability/surgery* ; Recurrence ; Scapula ; Shoulder ; Shoulder Dislocation/surgery* ; Shoulder Joint/surgery*

Arthroscopy ; China ; Elbow ; surgery ; Humans ; Shoulder ; surgery

The incidence of posterior instability of shoulder joint was significantly lower than that of anterior instability, but the clinical diagnosis and treatment was difficult, and the misdiagnosis and missed diagnosis rate were high. Its etiology, clinical manifestation and treatment strategy are totally different from the anterior instability. Therefore, the deep understanding of the anatomical structure around the shoulder joint, the mastery of the examination method, and the classification of the shoulder instability based on the anatomy and injury mode are of great importance to improve the accuracy of diagnosis. CT three-dimensional reconstruction is helpful to evaluate the defect of humeral head and glenoid bone, and MRA is helpful for the accurate diagnosis of posterior glenoid lip and joint capsule. The treatment was divided into conservative treatment and surgical treatment. Conservative treatment is recommended for muscular instability. Surgical treatment is recommended for traumatic and dysplastic instability. Different operative methods should be performed according to the injury of glenoid side or humeral head side. According to the condition of bone defect, soft tissue operation, bone grafting or osteotomy were performed to reconstruct the posterior stable structure of the glenoid injury; according to the area of the anterior bone defect, bone grafting or subscapular muscle packing were performed to the head of humerus defect. The former has the advantages of short learning curve and firm fixation, while the latter has the advantages of minimally invasive operation and the ability to observe the lesions from multiple angles and accurately control the location of bone masses. This paper summarizes the above problems.
Humans ; Humeral Head ; Joint Instability/surgery* ; Scapula ; Shoulder ; Shoulder Dislocation ; Shoulder Joint/surgery*

INTRODUCTION: Shortening of the tendon and muscle is recognised as a strong predictor of surgical failure of supraspinatus tendon tears. Changes in muscle architecture following repair have not been thoroughly investigated. Hence, we aimed to compare the pre- and postoperative architecture of the supraspinatus. METHODS: We recruited eight participants with full-thickness supraspinatus tears. Images of the supraspinatus were captured preoperatively (pre-op) and postoperatively at one month (post-op1), three months (post-op2) and six months (post-op3) in relaxed and contracted states (0º and 60º glenohumeral abduction). Fibre bundle length (FBL), pennation angle (PA) and muscle thickness were quantified. Self-reported function, and maximal isometric abduction and external rotation strengths were assessed. RESULTS: The mean FBL increased from pre-op to post-op1 (p = 0.001) in the relaxed state and from pre-op to post-op2 (p = 0.002) in the contracted state. Decrease in FBL was observed from post-op2 to post-op3 in the relaxed state. The mean PA decreased from pre-op to post-op1 (p < 0.001) in the relaxed state, but increased from post-op2 to post-op3 in both relaxed (p = 0.006) and contracted (p = 0.004) states. At post-op3, external rotation (p = 0.009) and abduction (p = 0.005) strengths were greater than at post-op2. Overall function increased by 47.67% from pre-op to post-op3. CONCLUSION Lengthening of the supraspinatus occurs with surgery, altering the length-tension relationship of the muscle, which can compromise muscle function and lead to inferior surgical outcomes. These findings may guide clinicians to optimise loads, velocities and shoulder ranges for effective postoperative rehabilitation.
Humans ; Rotator Cuff/surgery* ; Rotator Cuff Injuries/surgery* ; Shoulder/surgery* ; Shoulder Joint/surgery* ; Tendons

Arthroplasty, Replacement ; methods ; Clavicle ; injuries ; Fractures, Bone ; surgery ; Humans ; Joint Instability ; surgery ; Shoulder Fractures ; surgery ; Shoulder Injuries ; Shoulder Joint ; surgery

The shoulder joint is the most prone to dislocation in the whole body, and more than 95% of them are anterior dislocation. Improper treatment after the initial dislocation is easy to lead to recurrent anterior dislocation or anterior shoulder instability, and the outcomes following conservative treatment is poor. Anterior shoulder instability can damage the soft tissue structure and bone structure that maintain the stability of shoulder joint, among which bone structure is the most important factor affecting the stability of shoulder joint. Diagnosis should be combined with medical history, physical examination, and auxiliary examination. Currently, three-dimensional CT is the most commonly used auxiliary examination means. However, various bone defect measurement and preoperative evaluation methods based on three-dimensional CT and the glenoid track theory have their own advantages and disadvantages, and there is still a lack of gold standard. Currently, the mainstream treatment methods mainly include Bankart procedure, coracoid process transposition, glenoid reconstruction with free bone graft, Bankart combined with Remplissage procedure, and subscapular tendon binding tamponade, etc. Each of these procedures has its own advantages and disadvantages. For the diagnosis and treatment of anterior shoulder instability, there are still too many unknown, further research and exploration need to be studied.
Humans ; Shoulder Joint/surgery* ; Shoulder Dislocation/surgery* ; Shoulder ; Joint Instability/surgery* ; Scapula ; Joint Dislocations ; Recurrence ; Arthroscopy/methods*

OBJECTIVETo investigate the relationship of the greater tuberosity and the lateral fin of the prosthesis by using cadaveric research.

METHODSNine pairs of fresh-frozen upper extremity specimens (n = 18) were collected. Two-part anatomical neck fracture models were created by osteotomy along the anatomical neck. A standardized humeral head replacement procedure was carried out. The prosthesis was implanted in 20 degrees and 40 degrees of retroversion respectively, and the distance between the bicipital groove and lateral fin of the prosthesis was measured.

RESULTSThe lateral fins of prostheses in all specimens were located behind the bicipital groove. The average distances were 7.3 mm in 20 degrees retroversion and 4.0 mm in 40 degrees retroversion.

CONCLUSIONIt is better to fix the greater tuberosity over the lateral fin during humeral head replacement.

Arthroplasty, Replacement ; methods ; Humans ; Humerus ; anatomy & histology ; surgery ; Shoulder Fractures ; surgery ; Shoulder Joint ; anatomy & histology ; surgery

Superior labrum anterior posterior (SLAP) injury is a major challenge for orthopedic surgeons, due to the poor healing ability of the injured labrum. Although arthroscopic surgery is the gold standard for the treatment of SLAP injury, there are still disputes about the adaptation of different surgical techniques, the choice of anchors during operation, knotted or knotless anchors, and fixation methods. The authors believe that arthroscopic repair of SLAP lesions is effective for young patients with intact glenoid labrum(<35 years old) or with extensive activity, where single and knotless anchor is preferred. For the older patients(≥35 years old) with degeneration and wear of glenoid labrum, biceps tenodesis is more preferable, and interference screw fixation technique is recommended. As for patients with failed SLAP repair, biceps tenodesis can achieve a high success rate as a revision surgery. By review of the relevant literature in recent years, this paper summarizes the adaptation of different surgical methods of arthroscopic treatment of SLAP injury, intraoperative anchoring techniques, fixation methods and other improved surgical techniques.
Humans ; Adult ; Shoulder Joint/surgery* ; Arthroscopy/methods* ; Tendon Injuries/surgery* ; Shoulder Injuries/surgery* ; Tenodesis/methods*