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James P. Bradley - One of the best experts on this subject based on the ideXlab platform.
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Risk Factors for Revision Posterior Shoulder Stabilization in Throwing Athletes.
Orthopaedic journal of sports medicine, 2020Co-Authors: Ravi Vaswani, Justin W. Arner, Halle Freiman, James P. BradleyAbstract:Background:Revision Posterior Shoulder capsulolabral repair has inferior outcomes compared with primary surgery. Risk factors for revision in throwing athletes are unknown.Purpose/Hypothesis:The pu...
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Arthroscopic Capsulolabral Reconstruction for Posterior Shoulder Instability Is Successful in Adolescent Athletes.
Journal of pediatric orthopedics, 2020Co-Authors: Michael P. Mcclincy, Justin W. Arner, Laura Thurber, James P. BradleyAbstract:Background Posterior Shoulder instability is an increasingly common pathology recognized in athletes. Adolescent athletes are especially at risk for this condition due to the widespread participation in numerous sports, including both overhead throwing and collision activities. Little data are available regarding surgical outcomes in these athletes with only a single small case series (N=25) currently published. Methods In total, 68 athletes (82 Shoulders) with unidirectional Posterior Shoulder instability were treated with arthroscopic Posterior capsulolabral reconstruction and underwent an evaluation at a mean of 36 months postoperatively. The average age for our cohort was 17.2 years (range, 14 to 19 y), with 66 males (80%) and 16 females (20%). A total of 55 athletes (67%) participated in contact sports and 32 athletes (39%) participated in overhead throwing. Thirty athletes (37%) participated in multiple sports. Preoperative and postoperative outcomes data were retrospectively reviewed, and included the American Shoulder and Elbow Surgeons (ASES) Shoulder score, subjective stability score, strength, range of motion, and return-to-play status. Intraoperative findings and methods of fixation were also recorded. Results Mean ASES score improved from 48.6 to 85.7 (P Conclusions Arthroscopic capsulolabral reconstruction is a reliable treatment for unidirectional Posterior Shoulder instability in an adolescent population, and does well for athletes involved in a variety of sporting activities. Level of evidence Level IV-case series.
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The Effect of Glenoid Version and Width on Outcomes of Arthroscopic Posterior Shoulder Stabilization
The American journal of sports medicine, 2016Co-Authors: Craig S. Mauro, Michael P. Mcclincy, James P. BradleyAbstract:Background:Despite an increased awareness of the condition, the diagnosis, classification, and treatment of recurrent Posterior Shoulder instability remain challenging. No clear relationship has been established between glenohumeral morphologic characteristics and the risk for Posterior Shoulder instability or with outcomes after treatment.Purpose:To examine the structure of the glenoid in a large series of athletic patients with symptomatic unidirectional Posterior instability and to correlate these findings with the objective and subjective clinical outcome of arthroscopic Posterior capsulolabral repair.Study Design:Case-control study; Level of evidence, 3.Methods:A total of 118 magnetic resonance arthrograms of athletes with unidirectional recurrent Posterior Shoulder instability treated with an arthroscopic Posterior capsulolabral repair were reviewed, and measurements of glenoid labral, chondral, and bone version and labral and bone width were performed. The patients were evaluated preoperatively and...
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Posterior Shoulder Instability in Overhead Athletes.
The Orthopedic clinics of North America, 2016Co-Authors: Edward S. Chang, Nicholas Greco, Michael P. Mcclincy, James P. BradleyAbstract:Posterior Shoulder instability in overhead athletes presents a unique and difficult challenge. Often, this group has an inherent capsular laxity and/or humeral retroversion to accommodate the range of motion necessary to throw. This adaptation makes the diagnosis of Posterior capsulolabral pathology challenging, as the examiner must differentiate between adaptive capsular laxity and pathologic instability. Further complicating matters, the intraoperative surgeon must find the delicate balance of achieving stability while still allowing the necessary range of motion.
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Arthroscopic Stabilization of Posterior Shoulder Instability Is Successful in American Football Players
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the Internation, 2015Co-Authors: Justin W. Arner, Michael P. Mcclincy, James P. BradleyAbstract:Purpose To evaluate subjective and objective clinical outcomes of arthroscopic Posterior capsulolabral repair for the treatment of symptomatic unidirectional Posterior Shoulder instability in American football players. Methods Fifty-six consecutive American football players with unidirectional Posterior Shoulder instability underwent an arthroscopic Posterior capsulolabral repair with or without suture anchors. Patients were evaluated, with return to play as the primary outcome measure supplemented with the American Shoulder and Elbow Surgeons (ASES) scoring system. Stability, range of motion, strength, pain, and function were also assessed with subjective scales. Results At a mean follow-up of 44.7 months postoperatively, 93% returned to sport and 79% returned to sport at the same level. Significant improvements ( P 60; stability Conclusions Arthroscopic capsulolabral repair for unidirectional Posterior Shoulder instability is effective in American football players because it improves stability, pain, and joint function, which optimizes the likelihood of successful return to play. Level of Evidence Case series; Level of evidence, IV.
Brett D. Owens - One of the best experts on this subject based on the ideXlab platform.
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History of surgical stabilization for Posterior Shoulder instability.
JSES open access, 2019Co-Authors: Stephen Dimaria, Steven L. Bokshan, Christopher Nacca, Brett D. OwensAbstract:Background Posterior Shoulder instability is common in young athletes. Although the Posterior Shoulder instability literature is less robust than its anterior counterpart, many surgical procedures have been developed and refined over the past several centuries to address this condition. Materials and methods This article represents a retrospective historical analysis of the most common procedures used to treat Posterior Shoulder instability after sports injuries. A systematic approach to obtain published information on Posterior Shoulder instability was performed using the PubMed/MEDLINE database, manual searches of high–impact factor journals, and conference proceedings and books. Results A wide array of both soft tissue–based and bone-based procedures have been developed for the treatment of Posterior Shoulder instability, ranging from procedures addressing the soft tissue alone (capsular shift, labral repair, reverse Putti-Platt) or bone-based procedures (glenoid and/or humeral osteotomy, glenoid bone block) to a combination of both bone and soft-tissue procedures (modified McLaughlin procedure). Discussion Over the past several centuries, a number of procedures have been developed to address Posterior Shoulder instability, particularly as this pathology has become better understood. Future work is required not only to continue to advance these procedures but also to assess their outcomes. An understanding of the historical perspective of Posterior Shoulder instability procedures is essential as surgeons continue to modify these procedures in an effort to best help their patients.
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Posterior Shoulder Instability.
Sports health, 2016Co-Authors: Ivan J. Antosh, John M. Tokish, Brett D. OwensAbstract:Context:Posterior Shoulder instability has become more frequently recognized and treated as a unique subset of Shoulder instability, especially in the military. Posterior Shoulder pathology may be more difficult to accurately diagnose than its anterior counterpart, and commonly, patients present with complaints of pain rather than instability. “Posterior instability” may encompass both dislocation and subluxation, and the most common presentation is recurrent Posterior subluxation. Arthroscopic and open treatment techniques have improved as understanding of Posterior Shoulder instability has evolved.Evidence Acquisition:Electronic databases including PubMed and MEDLINE were queried for articles relating to Posterior Shoulder instability.Study Design:Clinical review.Level of Evidence:Level 4.Results:In low-demand patients, nonoperative treatment of Posterior Shoulder instability should be considered a first line of treatment and is typically successful. Conservative treatment, however, is commonly unsucces...
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Risk Factors for Posterior Shoulder Instability in Young Athletes
The American journal of sports medicine, 2013Co-Authors: Brett D. Owens, Scot E. Campbell, Kenneth L. CameronAbstract:Background:While Posterior glenohumeral instability is becoming increasingly common among young athletes, little is known of the risk factors for injury.Purpose:To determine the modifiable and nonmodifiable risk factors for Posterior Shoulder instability in a high-risk cohort.Study Design:Case-control study (prognosis); Level of evidence, 2.Methods:A prospective cohort study in which 714 young athletes were followed from June 2006 through May 2010 was conducted. Baseline testing included a subjective history of instability, instability testing by a sports medicine fellowship–trained orthopaedic surgeon, range of motion, strength measurement with a handheld dynamometer, and bilateral noncontrast magnetic resonance imaging of the Shoulder. A musculoskeletal radiologist measured glenoid version, height, depth, rotator interval (RI) height, RI width, RI area, and RI index. Participants were followed to document all acute Posterior Shoulder instability events during the 4-year follow-up period. The time to the...
Masaki Katayose - One of the best experts on this subject based on the ideXlab platform.
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Effective stretching positions for the Posterior Shoulder capsule as determined by shear wave elastography
Journal of shoulder and elbow surgery, 2020Co-Authors: Naoya Iida, Keigo Taniguchi, Kota Watanabe, Hiroki Miyamoto, Tatsuya Taniguchi, Atsushi Teramoto, Masaki KatayoseAbstract:Background Stretching is often used to prevent and treat Posterior Shoulder capsule tightness; however, the most effective stretching positions are not clearly defined. The purpose of this study was to identify the stretching positions that specifically applied the greatest passive tension on the Posterior Shoulder capsule by evaluating the elastic characteristics of Posterior capsules and muscles in various stretching positions using ultrasound shear wave elastography (SWE). Methods We evaluated 9 fresh-frozen Shoulders (mean age 86.6 ± 7.7 years) without osteoarthritis or rotator cuff tears. All Posterior Shoulder tissues were preserved intact. Shear moduli of the middle and inferior Posterior Shoulder capsules and the Posterior Shoulder muscles were evaluated using SWE. We obtained shear modulus measurements in 9 stretching positions using a combination of glenohumeral elevation planes and angles (frontal, sagittal, scapular; –30°, 0°, 30°, 60°, respectively). A 4-Nm torque for Shoulder internal rotation or horizontal adduction was applied in each position. We also measured shear moduli in the resting position (0° elevation with neutral Shoulder internal/external rotation). We compared the shear moduli of all stretching and resting positions using 1-way repeated measures analysis of variance (P Results Shear modulus values for the middle Posterior capsules in “internal rotation at 30° in scapular plane elevation” (28.7 ± 14.3 kPa, P = .01) and in “horizontal adduction at 60° of elevation” (31.1 ± 13.1 kPa, P Conclusion Effective middle Posterior Shoulder capsule stretching positions were Shoulder “internal rotation at 30° of scapular plane elevation” and “horizontal adduction at 60° of elevation.” Shoulder “internal rotation at 30° of flexion” was the most effective position for the inferior Posterior Shoulder capsule. Stretching in these positions could relieve Posterior Shoulder capsule tightness and contribute to the prevention and treatment of throwing injuries of the Shoulder.
Toshihiro Akisue - One of the best experts on this subject based on the ideXlab platform.
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assessment of Posterior Shoulder muscle stiffness related to Posterior Shoulder tightness in college baseball players using shear wave elastography
Journal of Shoulder and Elbow Surgery, 2020Co-Authors: Yutaka Mifune, Atsuyuki Inui, Hanako Nishimoto, Takeshi Kataoka, Takashi Kurosawa, Kohei Yamaura, Shintaro Mukohara, Takahiro Niikura, Takeshi Kokubu, Toshihiro AkisueAbstract:Background Limitations of Shoulder range of motion (ROM) have been reported to be at high risk for Shoulder disorders in baseball players. In this study, we assessed Posterior Shoulder muscle stiffness using shear wave elastography in baseball players with and without Posterior Shoulder tightness. Materials and methods In total, 21 college baseball players volunteered to participate in this study. Passive ROMs for Shoulder abduction and horizontal adduction were measured using a goniometer. Subsequently, we divided all participants into 2 groups based on the differences between bilateral Shoulder ROMs: STIFF+ and STIFF− groups. Thickness and elasticity of the Posterior and inferior Shoulder muscles were assessed using ultrasound. Results Shoulder abduction ROM on the throwing side was 114.5° ± 5.3° and 131.3° ± 5.7° in the STIFF+ and STIFF− groups, respectively, which was significantly different between the 2 groups (P = .023). Horizontal adduction ROM on the throwing side was 96.6° ± 4.9° and 110.9° ± 4.8° in the STIFF+ and STIFF− groups, respectively, which was also significantly different between the 2 groups (P = .014). The elasticity of infraspinatus and lower trapezius in the STIFF+ group was significantly greater than that in the STIFF− group (P = .018 and .033, respectively). Discussion In this study, we found that the elasticity of infraspinatus and lower trapezius in stiff Shoulders was significantly greater than that in nonstiff Shoulders, which indicated that the infraspinatus and lower trapezius could be the key muscles in Posterior Shoulder tightness.
Naoya Iida - One of the best experts on this subject based on the ideXlab platform.
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Effective stretching positions for the Posterior Shoulder capsule as determined by shear wave elastography
Journal of shoulder and elbow surgery, 2020Co-Authors: Naoya Iida, Keigo Taniguchi, Kota Watanabe, Hiroki Miyamoto, Tatsuya Taniguchi, Atsushi Teramoto, Masaki KatayoseAbstract:Background Stretching is often used to prevent and treat Posterior Shoulder capsule tightness; however, the most effective stretching positions are not clearly defined. The purpose of this study was to identify the stretching positions that specifically applied the greatest passive tension on the Posterior Shoulder capsule by evaluating the elastic characteristics of Posterior capsules and muscles in various stretching positions using ultrasound shear wave elastography (SWE). Methods We evaluated 9 fresh-frozen Shoulders (mean age 86.6 ± 7.7 years) without osteoarthritis or rotator cuff tears. All Posterior Shoulder tissues were preserved intact. Shear moduli of the middle and inferior Posterior Shoulder capsules and the Posterior Shoulder muscles were evaluated using SWE. We obtained shear modulus measurements in 9 stretching positions using a combination of glenohumeral elevation planes and angles (frontal, sagittal, scapular; –30°, 0°, 30°, 60°, respectively). A 4-Nm torque for Shoulder internal rotation or horizontal adduction was applied in each position. We also measured shear moduli in the resting position (0° elevation with neutral Shoulder internal/external rotation). We compared the shear moduli of all stretching and resting positions using 1-way repeated measures analysis of variance (P Results Shear modulus values for the middle Posterior capsules in “internal rotation at 30° in scapular plane elevation” (28.7 ± 14.3 kPa, P = .01) and in “horizontal adduction at 60° of elevation” (31.1 ± 13.1 kPa, P Conclusion Effective middle Posterior Shoulder capsule stretching positions were Shoulder “internal rotation at 30° of scapular plane elevation” and “horizontal adduction at 60° of elevation.” Shoulder “internal rotation at 30° of flexion” was the most effective position for the inferior Posterior Shoulder capsule. Stretching in these positions could relieve Posterior Shoulder capsule tightness and contribute to the prevention and treatment of throwing injuries of the Shoulder.