Recurrent instability management
Principles of treatment
structural instability - traumatic or atraumatic
operative management
non-structural instability - muscles patterning
non -operative management
Structural abnormality
Anatomical repair
Bankart repair
reattachment of bankart lesion to margin of glenoid by open or arhtroscopic technique
if Hill-sach lesion , transfer infraspinatus to fill defect to prevent redislocation
Non anatomical repairs
Laterjet procedure
coracoid transfer to anterior glenoid rim with conjoined tendon
Magnuson -stock - advancement of subscsapularis
Putti - Platt - imbrication and shortening of subscapularis
Glenoid or humeral osteotomies - if there's excessive anteversion of GH joint.
Strucutral posterior instability
Reverse Bankart procedure and capsular shift
Reverse Putti-platt
Boyd-sisk -transfer of long head of biceps to posterior glenoid
Reverse Hill Sachs - transfer of subscapularis to lesser tuberosity
Non structural instability and muscle patterning
multidisciplinary approach
EMG
muscle patterning , exercises ,endurance , co-ordination
structural instability - traumatic or atraumatic
operative management
non-structural instability - muscles patterning
non -operative management
Structural abnormality
Anatomical repair
Bankart repair
reattachment of bankart lesion to margin of glenoid by open or arhtroscopic technique
if Hill-sach lesion , transfer infraspinatus to fill defect to prevent redislocation
Non anatomical repairs
Laterjet procedure
coracoid transfer to anterior glenoid rim with conjoined tendon
Magnuson -stock - advancement of subscsapularis
Putti - Platt - imbrication and shortening of subscapularis
Glenoid or humeral osteotomies - if there's excessive anteversion of GH joint.
Strucutral posterior instability
Reverse Bankart procedure and capsular shift
Reverse Putti-platt
Boyd-sisk -transfer of long head of biceps to posterior glenoid
Reverse Hill Sachs - transfer of subscapularis to lesser tuberosity
Non structural instability and muscle patterning
multidisciplinary approach
EMG
muscle patterning , exercises ,endurance , co-ordination
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