Recurrent Shoulder Insability

 Principles of Treatment 

    1. Structural Instability 

        traumatic or atraumatic - Operative Procedures required 

    2. Non-structural Instability

        Muscles patterning - Non operative treatment 



https://medium.com/@JFSCunha/shoulder-instability-bankart-injury-32325c1fb853


  Structural Abnormalities 

   Anatomical Repairs 

        Bankart Repair     - reattachment of Bankart lesion to margin of glenoid by open or arthroscopic                 technique 

        Hill-Sachs lesion repair- transfer infraspinatus to fill defect to prevent redislocation 

    Non Anatomical Repairs 

        Latarject  Procedures - Coracoid to anterior glenoid rim with conjoint tendons


     Magnuson -Stack Procedure- 

        advancement of subscapularis 

    Putti-Plat procedure 

        imbirication and shortening of subscapularis 

    Glenoid or Humeral Osteotomies

        if there is excessive anteversion of Glenuohumeral joint. 

    

    Structural Posterior Abnormalities treatment 

        Reverse Bankart Procedure and Capsular Procedure 

        Reverse Putti-Platt 

        Boyd - Sisk - transfer long head of Biceps to posterior glenoid. 

        Reverse Hill-Sachs lesion - transfer of subscapularis or lesser tuberosity 

                

     Non structural and muscle patterning 

        Multi-disciplinary approach

        EMG 

        Muscle patterning , exercises, endurance, co-ordination 


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