Instability Cases Arthroscopic Rx for 21yr Stabilization now Old - PowerPoint PPT Presentation

Mar 28, 2023 •252 likes •684 views

Instability Cases Arthroscopic Rx for 21yr Stabilization now Old Linebacker Open Stabilization with now Nonoperative Subluxation Treatment and Bony Stabilization at end Bankart?? of Season Case Report 21 Yr Old

Instability Cases ฀ Arthroscopic ฀ Rx for 21yr Stabilization now Old Linebacker ฀ Open Stabilization with now ฀ Nonoperative Subluxation Treatment and Bony ฀ Stabilization at end Bankart?? of Season
Case Report ฀ 21 Yr Old All-ACC Linebacker ฀ Subluxation Episode mid-season ฀ MRI Bony Bankart ฀ Completes Season with intermittent symptoms
What Would the Panel Do????
Posterior Approach For Inferior Anchor ฀ Beach Chair Position ฀ Spider Arm Holder ฀ Anterior Viewing ฀ Posteriolateral Axillary Portal ฀ 6:00 Inferior “Home- Run” Anchor
Instability Collision Athlete Summary • Three Anchors • Inferior Anchor From Posteior Approach • Usually 4 total
Case #1: Soccer Player
History 29y, male - First consultation 09.01.2017 - Recurrent ant. inf. dislocations - Exacerbation following fall 2012 - Unknown prior shoulder surgery 2012
X-Ray 09.01.2017
MRI 10.01.2017
Whats wrong?
History 29y, male - First consultation 09.01.2017 - Recurrent ant. inf. dislocations - Exacerbation following fall 2012 - Unknown prior shoulder surgery 2012 - Secondary diagnosis: Epilepsy
Hospitalisation- X-ray 17.01.2017
CT 17.01.2017
CT 17.01.2017
Treatment options?
Comb. Latarjet and post. bone block (17.01.2017 / 07.02.2017)
Comb. Latarjet and post. bone block (17.01.2017 / 07.02.2017)
Comb. Latarjet and post. bone block (17.01.2017 / 07.02.2017)
Comb. Latarjet and post. bone block (17.01.2017 / 07.02.2017)
Comb. Latarjet and post. bone block (17.01.2017 / 07.02.2017)
CT 09.02.2017
Next visit – 26.04.0217 - Recurrent shoulder dislocation due to epileptic seizure - Refused to take anticonvulsant medication (3 days) CT – 09.02.2017 CT – 26.04.2017
CT 26.04.2017
Computed tomography - 26.04.2017
Treatment options?
Surgical procedure – 03.05.2017 - Glenoid augmentation with iliac crest bone block - Secured with two cannulated screws
Case #2: Ice Hockey Player
History 40y, male - 02/2017 fall during ice skating - Reduction by third person - Persistent apprehension sign ++
X-Ray 02/2017
MRI 02/2017
Treatment options?
Modified arthroscopic McLaughlin procedure with bony mosaicplasty Normal Locked posterior dislocation Modified McLaughlin with bony mosaicplasty Reduced
6w postop. (04/2017)
Strategie 0 % Impression • Konservativ Humerus ? • ASK (instabil) <10 % • Konservativ • ASK McLaughlin Männlich, 40J 10-20 % Posteriore ASK / McLaughlin • Dislokation • OCT (Athletes) Treatment • Bone Grafting of HH 20-45 % ASK McLaughlin/OCT • (Athlete) • Arthroplastik (low demand) Konservativ >45 % • Arthroplastik • Allograft HH Paul, Beitzel, Imhoff et al., Arthroscopy, 2011
Evidenz (1940 – 2010): Artikel in PubMed: 242 Kleine Case Reports, Reviews etc. 41 Mindestens 4 Patienten eingeschlossen: 11 Paul, Beitzel, Imhoff et al., Arthroscopy, 2011

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