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  • 1
    Online Resource
    Online Resource
    The Latarjet Procedure: Effective and Safe
    Bentham Science Publishers Ltd. ; 2019
    In:  The Open Orthopaedics Journal Vol. 13, No. 1 ( 2019-12-31), p. 272-275
    Details
    In: The Open Orthopaedics Journal, Bentham Science Publishers Ltd., Vol. 13, No. 1 ( 2019-12-31), p. 272-275
    Abstract: The Latarjet procedure is used to treat recurrent anterior shoulder instability in patients with bony glenoid loss and/or failed previous stabilisation surgery. It has reportedly high success rates, but recent publications have reported concerns of high complication rates. This study aims to assess the complications and outcomes of the Latarjet procedure in our institution, with a minimum 2-year follow-up and compared it to the current literature. Methods: Patients who underwent the procedure over a 36-month period were included in this study (n=81). Seventy-three (90%) patients in our cohort competed in amateur to professional level sports. The indications for surgery were recurrent instability with associated bony glenoid deficiency and/or previous failed arthroscopic stabilisations. The Oxford Shoulder Instability, Constant Shoulder and QuickDASH scores were recorded pre- and post-operatively, along with post-operative complications and failures. Results: Eight (9.9%) complications were recorded: three re-dislocations, two deep infections, one haematoma, one screw breakage and one case of biceps tendinopathy. The mean pre-operative Oxford Shoulder Instability Score improved from 23.2 ± 10.1 to 37 ± 9.2 following the procedure. The mean Constant Shoulder and quickDASH scores also improved from 55.1 ± 21.2 and 30.3 ± 24.3 to 88.1 ± 9.2 and 17.7 ± 23.5 respectively. 98.6% of the patients returned to their pre-injury level of sports. Conclusion: From this study it can be concluded the Latarjet procedure is an effective surgical treatment for recurrent anterior shoulder instability associated with bony glenoid loss, even in high contact professional athletes. Complication rates are lower than previous recent studies have stated.
    Type of Medium: Online Resource
    ISSN: 1874-3250
    URL: Article
    DOI: 10.2174/1874325001913010272
    Language: English
    Publisher: Bentham Science Publishers Ltd.
    Publication Date: 2019
    detail.hit.zdb_id: 2395994-0
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  • 2
    Online Resource
    Online Resource
    Simple Double-Row Rotator Cuff Repair Technique for Large and Massive Cuff Tears
    Ovid Technologies (Wolters Kluwer Health) ; 2009
    In:  Techniques in Shoulder & Elbow Surgery Vol. 10, No. 1 ( 2009-03), p. 39-42
    Details
    In: Techniques in Shoulder & Elbow Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 10, No. 1 ( 2009-03), p. 39-42
    Type of Medium: Online Resource
    ISSN: 1523-9896
    URL: Article
    DOI: 10.1097/BTE.0b013e318197490d
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2009
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  • 3
    Online Resource
    Online Resource
    A Surgical Technique for Revision of Failed Acromioclavicular Joint Reconstruction
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Techniques in Shoulder & Elbow Surgery Vol. 21, No. 2 ( 2020-05-08), p. 37-41
    Details
    In: Techniques in Shoulder & Elbow Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 21, No. 2 ( 2020-05-08), p. 37-41
    Type of Medium: Online Resource
    ISSN: 1523-9896
    URL: Article
    DOI: 10.1097/BTE.0000000000000190
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 4
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    Online Resource
    Recurrence After Arthroscopic Labral Repair for Traumatic Anterior Instability in Adolescent Rugby and Contact Athletes
    SAGE Publications ; 2018
    In:  The American Journal of Sports Medicine Vol. 46, No. 12 ( 2018-10), p. 2969-2974
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 46, No. 12 ( 2018-10), p. 2969-2974
    Abstract: Traumatic glenohumeral dislocation of the shoulder is one of the most common shoulder injuries, especially among adolescent athletes. The treatment of instability for young athletes continues to be controversial owing to high recurrence rates. Purpose: To investigate the recurrence rate of shoulder instability after arthroscopic capsulolabral repair for adolescent contact and collision athletes. Study Design: Case series; Level of evidence, 4. Methods: Sixty-seven patients aged 〈 18 years underwent an arthroscopic labral repair over a 5-year period. The mean ± SD age of the cohort was 16.3 ± 0.9 years (range, 14-17 years) and consisted of 1 female and 66 males. All patients were contact athletes, with 62 of 67 playing rugby. Demographic, clinical, and intraoperative data for all patients with shoulder instability were recorded in our database. Recurrence rates were recorded and relative risks calculated. Results: At a follow-up of 33 ± 20 months, 34 of 67 patients had recurrent instability for an overall recurrence rate of 51% among adolescent contact athletes after arthroscopic labral repair surgery. The mean time to recurrence was 68.1 ± 45.3 weeks. All recurrences occurred as a result of a further sporting injury. Relative risk analysis demonstrated that athletes aged 〈 16 years had 2.2 (95% CI, 1.2-2.1) times the risk of developing a further instability episode as compared with athletes aged ≥16 years at the time of index surgery ( P = .0002). The recurrence rate among adolescent athletes after bony Bankart repairs was 57.9% versus 47.9% for soft tissue labral repairs ( P = .4698). The incidence of Hill-Sachs lesions ( P = .0002) and bony Bankart lesions ( P = .009) among adolescent athletes was significantly higher than among adult controls ( P = .002). The presence of bone loss did not lead to a significant increase in recurrence rate over and above the effect of age. Conclusion: Adolescent contact athletes undergoing arthroscopic labral repair have an overall recurrence rate of 51%. Rugby players who undergo primary arthroscopic shoulder stabilization aged 〈 16 years have 2.2 times the risk of developing a further instability episode when compared with athletes aged ≥16 years at the time of index surgery, with a recurrence rate of 93%.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546518794673
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
    detail.hit.zdb_id: 2063945-4
    SSG: 31
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  • 5
    Online Resource
    Online Resource
    The development and validation of a scoring system for shoulder injuries in rugby players
    BMJ ; 2013
    In:  British Journal of Sports Medicine Vol. 47, No. 14 ( 2013-09), p. 920-926
    Details
    In: British Journal of Sports Medicine, BMJ, Vol. 47, No. 14 ( 2013-09), p. 920-926
    Type of Medium: Online Resource
    ISSN: 0306-3674 , 1473-0480
    URL: Article
    DOI: 10.1136/bjsports-2012-091852
    Language: English
    Publisher: BMJ
    Publication Date: 2013
    detail.hit.zdb_id: 2003204-3
    SSG: 31
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  • 6
    Online Resource
    Online Resource
    Stress fracture of the clavicle in a patient with no obvious risk factors
    Royal College of Surgeons of England ; 2005
    In:  Annals of The Royal College of Surgeons of England Vol. 87, No. 1 ( 2005-01-01), p. 5-8
    Details
    In: Annals of The Royal College of Surgeons of England, Royal College of Surgeons of England, Vol. 87, No. 1 ( 2005-01-01), p. 5-8
    Type of Medium: Online Resource
    ISSN: 0035-8843 , 1478-7083
    URL: Article
    DOI: 10.1308/147870804885
    Language: English
    Publisher: Royal College of Surgeons of England
    Publication Date: 2005
    detail.hit.zdb_id: 2100560-6
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  • 7
    Online Resource
    Online Resource
    Infrapectoral Biceps Tenodesis for Chronic Long Head of Biceps Rupture
    Ovid Technologies (Wolters Kluwer Health) ; 2012
    In:  Techniques in Shoulder & Elbow Surgery Vol. 13, No. 1 ( 2012-03), p. 14-16
    Details
    In: Techniques in Shoulder & Elbow Surgery, Ovid Technologies (Wolters Kluwer Health), Vol. 13, No. 1 ( 2012-03), p. 14-16
    Type of Medium: Online Resource
    ISSN: 1523-9896
    URL: Article
    DOI: 10.1097/BTE.0b013e3182443d1d
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2012
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  • 8
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    Online Resource
    The combined shoulder assessment: a convenient method for obtaining equivalent outcome scores
    SAGE Publications ; 2019
    In:  Shoulder & Elbow Vol. 11, No. 3 ( 2019-06), p. 182-190
    Details
    In: Shoulder & Elbow, SAGE Publications, Vol. 11, No. 3 ( 2019-06), p. 182-190
    Abstract: Outcome scores are useful tools with respect to quantifying how pain and limitations in strength and movement affect the patient’s functionality and lifestyle. Three shoulder outcome methods [Oxford, Constant and QuickDASH (Disability of the Arm, Shoulder and Hand)] are commonly used in practice but collectively consist of 34 questions, taking approximately 7 min to complete. We have developed a concise shoulder assessment to derive three equivalent outcome scores in a 12-item patient-reporting questionnaire. Methods Outcome scores from 1285 outpatients of an upper limb clinic were collected. The patient cohort consisted of 462 females and 823 males with a mean (SD) age of 47.2 (16.79) years (range 13 years to 90 years). Using a correlation matrix, a 12-item questionnaire was drafted. The combined shoulder assessment was validated by 227 patients; consisting of 101 females and 126 males with a mean (SD) age of 47.91 (16.63) years (range 13 years to 88 years). Results Agreement was achieved between the two methods, with an equivalent Oxford Shoulder Score intraclass correlation (ICC) of 0.930, equivalent Constant Shoulder Score ICC of 0.942 and equivalent QuickDASH ICC of 0.869. Bland–Altman analyses showed no systematic differences. Large effect sizes highlighted the responsiveness to change. Conclusions The new combined shoulder assessment is a more convenient and patient-friendly method to obtain equivalent Oxford, Constant and QuickDASH shoulder outcome scores.
    Type of Medium: Online Resource
    ISSN: 1758-5732 , 1758-5740
    URL: Article
    DOI: 10.1177/1758573217736748
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2503300-1
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  • 9
    Online Resource
    Online Resource
    Magnetic Resonance Arthrogram and Arthroscopy of the Shoulder: A Comparative Retrospective Study with Emphasis on Posterior Labral Lesions and Radiologist Locality
    SAGE Publications ; 2011
    In:  Shoulder & Elbow Vol. 3, No. 4 ( 2011-10), p. 210-214
    Details
    In: Shoulder & Elbow, SAGE Publications, Vol. 3, No. 4 ( 2011-10), p. 210-214
    Abstract: Magnetic resonance arthrography(MRA) is a routine diagnostic investigation for glenohumeral lesions; however, diagnostic arthroscopy remains the gold standard. The present study aimed tto investigate the diagnostic accuracy of glenohumeral MRA compared to arthroscopy, with particular interest in previously unreported aspects, such as posterior labral lesions and the locality of the reporting radiologists. Methods Ninety-five consecutive patients with pre-operative MRA and subsequent arthroscopy were included. Patients were grouped into MRA reported by specialist radiologists within the specialist shoulder unit ( n = 58) or reported by nonlocal musculoskeletal radiologists ( n = 37). Results In the local radiologist group, the sensitivity/specificity for Hill – Sachs lesions was 0.71/0.85, anterior labral tears 0.75/0.73, posterior labral tears 0.50/0.92, superior labral tear from anterior to posterior (SLAP) lesions 0.71/0/91 and rotator cuff tears (RCTs) 0.40/0.81. In the nonlocal radiologist group, the sensitivity/specificity for Hill – Sachs lesions was 0.64/0.88, anterior labral tears 0.70/0.79, posterior labral tears 0.40/0.81, SLAP lesions 0.66/0/82 and RCT 0.40/0.81. A nonsignificant trend of lower sensitivity/specificity for lesions reviewed by the nonlocal radiologists was found. Discussion MRA is not 100% sensitive or specific and does not negate arthroscopy. There is a lower diagnostic accuracy of posterior compared to anterior labral lesions and improved accuracy of glenohumeral MRA diagnosis may be achieved with the increased experience of radiologists within specialist units and regular surgical feedback of cases.
    Type of Medium: Online Resource
    ISSN: 1758-5732 , 1758-5740
    URL: Article
    DOI: 10.1111/j.1758-5740.2011.00149.x
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2011
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  • 10
    Online Resource
    Online Resource
    Stiffness after Arthroscopic Shoulder Surgery: Incidence, Management and Classification
    SAGE Publications ; 2012
    In:  Shoulder & Elbow Vol. 4, No. 3 ( 2012-07), p. 169-173
    Details
    In: Shoulder & Elbow, SAGE Publications, Vol. 4, No. 3 ( 2012-07), p. 169-173
    Abstract: Stiffness after arthroscopic shoulder surgery is of significant concern to the patient, surgeon and therapist. The present study aimed to investigate the natural history of stiffness after shoulder arthroscopic procedures. Methods Postoperative recovery of range of motion (ROM) in patients who underwent 234 consecutive arthroscopic procedures over a 1-year period was reviewed. The time needed to regain full ROM was recorded for every patient. Stiffness was graded from 0 to 3 depending on the loss of movements as compared to the opposite side. Results Postoperative ROM returned to normal in 63% of patients within 3 months, 94% of patients within 6 months, 96% of patients within 9 months and 97% of patients within 1 year after surgery. Stiffness was graded as a loss of ROM compared to the contralateral shoulder, with less than a third loss as grade 1, one third to two-thirds loss as grade 2 and more than two thirds loss as grade 3. Some 85% patients with Grade 1 stiffness recovered complete ROM at 6 months, whereas only 43% of grade 2/3 stiffness returned to normal at 6 months. Only four patients required further active intervention for recovery from stiffness. Risk of developing stiffness was related to the pre-operative diagnosis. Conclusions Although, minor (grade 1) stiffness after shoulder surgery occurs commonly despite early mobilization rehabilitation protocols; it resolves rapidly without further surgical intervention in a majority of the patients.
    Type of Medium: Online Resource
    ISSN: 1758-5732 , 1758-5740
    URL: Article
    DOI: 10.1111/j.1758-5740.2012.00184.x
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2012
    detail.hit.zdb_id: 2503300-1
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