A SURGEON’S PERSPECTIVE: CARTILAGE ALGORITHM
Dr. Nels Sampatacos discusses his approach to cartilage transplant surgery with Connor Bevans, the Arthrex and Summit Surgical Orthobiologics Specialist for Western Washington podcast…
SLAP TEAR SURGERY AND RECOVERY TIME
Most studies report good to excellent results after SLAP repairs in 84-97% of patients.5-7 However, some patients may not do as well with a SLAP repair, particularly those with biceps tendinitis or partial tearing of the biceps tendon.8 In these cases, treatment of a SLAP tear may necessitate detachment of the biceps tendon from the torn superior labrum. This can be done in several…
HOW IS A SLAP TEAR DIAGNOSED AND WHO NEEDS SURGERY?
Accurate diagnosis of SLAP lesions often requires an MRI with a special contrast injected into the joint. Although the literature is variable, most studies show that a conventional MRI allows for the detection of labral injuries only 26-62% of the time. When contrast is added, our ability to diagnose these injuries increases to over 90%…
WHAT IS A SLAP TEAR?
Superior Labrum Anterior and Posterior (SLAP) lesions describe a spectrum of injuries to the superior portion of the labrum, where one of the two biceps tendons partially attaches. The labrum is a bumper with a rubber-like consistency that surrounds the socket (i.e. glenoid) of the shoulder. It provides stability to the shoulder and is an important attachment site for the biceps tendon and other shoulder ligaments…
SHOULDER SEPARATION – PART 2: TREATMENT OPTIONS
Nonsurgical management is the treatment of choice for grades I and II AC separations. This consists of wearing a sling for 1-2 weeks, at which time patients with grade I injuries can return to full activities as pain allows. Grade II injuries often require physical therapy and avoidance of sports and heavy lifting for at least 6 weeks. Persistent pain is often minimal in the short-term, although up to 50% of grade I and II injuries develop pain…
SHOULDER SEPARATION – PART 1: ANATOMY AND CLASSIFICATION
There are a number of muscles, tendons, and ligaments attaching to the bones of the shoulder (e.g. the scapula, humerus, and clavicle) that maintain the bones in a normal position to one another.
The acromioclavicular (AC) joint is the joint between the acromion (part of the scapula) and the end of the clavicle (collar bone). The AC joint is normally stabilized by the AC joint capsule…
SHOULDER INSTABILITY – TREATING MULTI-DIRECTIONAL INSTABILITY
Patients with multi-directional instability are often successfully treated with conservative measures. The mainstay of treatment is a comprehensive shoulder and periscapular rehabilitation program emphasizing strength and proprioceptive training. For a small group of patients who continue to have an unacceptable degree of instability that interferes with their preferred activities and who have had extensive physical…
SHOULDER INSTABILITY – TREATING THE TRAUMATIC SHOULDER DISLOCATION
One general category of shoulder instability typically involves a traumatic event in an individual with normal tissue elasticity, resulting in a single-direction dislocation and tearing of soft tissue structures. This is particularly common in younger patients and is often treated with surgery. For example, in the most common scenario, the ball dislocates in an anteroinferior direction, resulting in tearing of the anteroinferior portion…
THE SPECTRUM OF SHOULDER INSTABILITY
There is considerable variability among people in terms of their shoulder anatomy and function. Because of this, we all find ourselves somewhere on the spectrum of shoulder stability. On one extreme, we find people with “tight” shoulders that are highly resistant to dislocating, but with limited shoulder motion and often some degree of pain, depending on their activities. On the other extreme, we find people with “loose,” highly mobile, unstable shoulders, some…
SHOULDER INSTABILITY – RELEVANT ANATOMY & FUNCTION
The main “ball and socket” joint of the shoulder (the glenohumeral joint) is formed between the relatively small, shallow socket of the shoulder blade (the scapula) and the large ball of the upper arm bone (the humerus), much like a golf ball balancing on a golf tee. This relationship allows for a highly mobile joint, but one that is, unfortunately, not well-stabilized by the bones alone. Therefore, the surrounding soft tissue…