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- Hovelius, Lennart, et al.
(author)
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One hundred eighteen Bristow-Latarjet repairs for recurrent anterior dislocation of the shoulder prospectively followed for fifteen years : Study I - clinical results
- 2004
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In: Journal of shoulder and elbow surgery. - : Elsevier BV. - 1058-2746 .- 1532-6500. ; 13:5, s. 509-16
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Journal article (peer-reviewed)abstract
- In this prospective study on the Bristow-Latarjet repair, which started in 1980 and ended in 2001, we report the outcome in 118 shoulders where the patients have been followed up for 15 years (mean, 15.2 years; range, 14.3-20.8 years). The study was based on a physical examination, scoring with the system of Rowe et al, and the patients' subjective assessment of the operative result. After 2 years, 1 of 118 shoulders had redislocated and 98% of patients were satisfied with the operative repair. At 15 years' follow-up, 1 patient had undergone revision surgery as a result of recurrence of instability. One patient had had one redislocation during the follow-up period, and one patient reported three recurrences 3 years postoperatively.This patient has had no redislocations during the last 12 years. Furthermore, one more patient had had two recurrences 9 and 12 years after surgery but was very satisfied at follow-up. Subluxations occurred once in 4 patients and several times in 7 patients. These patients were, however, satisfied with the procedures at follow-up. One patient reported posterior subluxations at follow-up. Apprehension was significantly more common in patients with bilateral instability (P =.04) and was found in 19 of 109 shoulders. Of the patients, 90 (76%) were very satisfied with the operative result, 26 were satisfied (22%), and 1 did not know. The patient with revision surgery was considered to be dissatisfied. The incidence of bilateral shoulder instability increased from 22 of 118 (19%) at the time of surgery to 41 of 117 (35%) at 15 years after surgery. We conclude that the overall clinical results, with a satisfaction rate of 98% 15 years after the Bristow-Latarjet repair, were as good as the results reported after any operative method for recurrent anterior shoulder dislocation. However, until the radiologic part of this study is completed, we recommend the procedure only for shoulders with revision because of failed previous surgery and to surgeons familiar with the method.
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| 2. |
- Tillander, Bo, et al.
(author)
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Intraoperative measurement of shoulder translation
- 2001
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In: Journal of shoulder and elbow surgery. - : Elsevier BV. - 1058-2746 .- 1532-6500. ; 10:4, s. 358-364
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Journal article (peer-reviewed)abstract
- Assessing laxity of the shoulder joint in patients who are under anesthesia is a standard procedure before arthroscopy. The aim of this study was to evaluate a novel instrument for quick and reliable intraoperative measurement of glenohumeral translation. Previous testing of various designs has resulted in a device secured by 1 pin in the acromion and 1 pin in the proximal humerus. These pins are interconnected by a sliding ruler that gives translation values in millimeter increments as the laxity tests are performed. Comparison between manual arbitrary approximation of laxity and instrumented translation measurements showed that manual testing is reasonably good for assessment of anterior and posterior translation, without, however, providing values of translation in millimeter increments. The low correlation between manual assessment and instrumented inferior translation measurements indicates that inferior translation is more difficult to approximate manually. The shoulder translation tester was used in 102 patients. The mean values for clinically stable shoulders (n = 58) were 5 mm for anterior translation, 5 mm for posterior translation, and 4 mm for inferior translation. The corresponding values in unstable shoulders were significantly higher than in the stable shoulders, especially in patients with multidirectional instability. We conclude that the shoulder translation tester is easy and quick to use. It provides quantitative values of translation and will thus contribute information for correct diagnosis, therapy, and documentation.
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