Shoulder instability : a clinical and MRI-based analysis
Author: Salomonsson, Björn
Date: 2009-06-05
Location: Föreläsningssal 1 Danderyds sjukhus
Time: 09.00
Department: Institutionen för kliniska vetenskaper, Danderyds sjukhus / Department of Clinical Sciences, Danderyd Hospital
View/ Open:
thesis.pdf (1.969Mb)
Abstract
Shoulder instability is a common but complex and challenging area of
shoulder pathology, and new diagnostic methods and treatments are
continuously developed. We conducted this study to evaluate the clinical
outcome of shoulder instability with respect to different diagnostic
possibilities and surgical treatments.
We have studied the patient material from our department, consisting of atraumatic instability, posttraumatic recurrent anterior instability, and primary shoulder dislocations. This was done by following up surgical treatments. We also evaluated diagnostic enhancement by arthroscopy and MR-arthrography, as well as the use of MRI as a prognostic tool in primary dislocations. To measure the clinical outcome, we have validated a Swedish translation of a self-evaluating shoulder instability score.
Study I: 27 shoulders with atraumatic shoulder instability were treated with a capsular imbrication procedure and followed up after 2 years or more. Capsular imbrication was found to be a good treatment for involuntary atraumatic shoulder instability in cases where physical rehabilitation and lifestyle adjustment have failed.
Study II: A prospective study comparing detection of lesions in recurrent instability of the shoulder on MR arthrography imaging (MRA) and arthroscopy was made in 50 patients. An assessment of agreement between MRA observers and observer repeatability show that MRA is a potentially useful tool for the detection of lesions associated with shoulder instability, and promises acceptable reliability and repeatability.
Study III: The WOSI score questionnaire is a tool designed for self-assessment of shoulder function for patients with instability problems. We retested a translation of the score into Swedish. At this retest the WOSI score had good validity, high reliability, and high responsiveness, at the same level as in the original publication.
Study IV: 60 patients with primary posttraumatic shoulder dislocation were treated with closed reduction and examined by MRI within 2 weeks. Ages above 30, isolated fractures of the major tubercle, and Bony Bankart lesions were all prognostic factors for a good functional result and a stable shoulder at 8-year follow-up after a primary dislocation.
Study V: This randomised study compares an anatomical repair (Bankart suture) with a less anatomical method (Putti-Platt procedure). The Putti-Platt procedure was found to be quicker and less demanding. After assessment of pain and general shoulder function, only a small difference was found between the two surgical methods, with a slightly better outcome (in terms of pain and ROM) with a Bankart suture compared to the Putti-Platt procedure.
We have studied the patient material from our department, consisting of atraumatic instability, posttraumatic recurrent anterior instability, and primary shoulder dislocations. This was done by following up surgical treatments. We also evaluated diagnostic enhancement by arthroscopy and MR-arthrography, as well as the use of MRI as a prognostic tool in primary dislocations. To measure the clinical outcome, we have validated a Swedish translation of a self-evaluating shoulder instability score.
Study I: 27 shoulders with atraumatic shoulder instability were treated with a capsular imbrication procedure and followed up after 2 years or more. Capsular imbrication was found to be a good treatment for involuntary atraumatic shoulder instability in cases where physical rehabilitation and lifestyle adjustment have failed.
Study II: A prospective study comparing detection of lesions in recurrent instability of the shoulder on MR arthrography imaging (MRA) and arthroscopy was made in 50 patients. An assessment of agreement between MRA observers and observer repeatability show that MRA is a potentially useful tool for the detection of lesions associated with shoulder instability, and promises acceptable reliability and repeatability.
Study III: The WOSI score questionnaire is a tool designed for self-assessment of shoulder function for patients with instability problems. We retested a translation of the score into Swedish. At this retest the WOSI score had good validity, high reliability, and high responsiveness, at the same level as in the original publication.
Study IV: 60 patients with primary posttraumatic shoulder dislocation were treated with closed reduction and examined by MRI within 2 weeks. Ages above 30, isolated fractures of the major tubercle, and Bony Bankart lesions were all prognostic factors for a good functional result and a stable shoulder at 8-year follow-up after a primary dislocation.
Study V: This randomised study compares an anatomical repair (Bankart suture) with a less anatomical method (Putti-Platt procedure). The Putti-Platt procedure was found to be quicker and less demanding. After assessment of pain and general shoulder function, only a small difference was found between the two surgical methods, with a slightly better outcome (in terms of pain and ROM) with a Bankart suture compared to the Putti-Platt procedure.
List of papers:
I. Salomonsson B, Sforza G, Revay S, Abbaszadegan H, Jonsson U (1998). "Atraumatic shoulder instability. Discussion of classification and results after capsular imbrication." Scand J Med Sci Sports 8(6): 398-404
Pubmed
II. Salomonsson B, von Heine A, Dahlborn M. Lillkrona U, Nils Dalén, Abbaszadegan H (2009). "MRA, MR and arthroscopy in shoulder instability. Agreement between methods and observers." (Submitted)
III. Salomonsson B, Ahlström S, Dalén N, Lillkrona U (2009). "The Western Ontario Shoulder Instability Index (WOSI): validity, reliability, and responsiveness retested with a Swedish translation." Acta Orthop 80(2): 233-8
Pubmed
IV. Salomonsson B, von Heine A, Dahlborn M. Abbaszadegan H, Ahlström S, Dalén N, Lillkrona U (2009). "Bony Bankart at MRI of primary shoulder dislocation only finding of predictive value: an 8-year follow-up." (Submitted)
V. Salomonsson B, Abbaszadegan H, Revay S, Lillkrona U (2009). "The Bankart repair versus the Putti-Platt procedure; a randomized study with WOSI score at 10-year follow-up in 62 patients" Acta Orthop 80(3): Epub ahead of print
Pubmed
I. Salomonsson B, Sforza G, Revay S, Abbaszadegan H, Jonsson U (1998). "Atraumatic shoulder instability. Discussion of classification and results after capsular imbrication." Scand J Med Sci Sports 8(6): 398-404
Pubmed
II. Salomonsson B, von Heine A, Dahlborn M. Lillkrona U, Nils Dalén, Abbaszadegan H (2009). "MRA, MR and arthroscopy in shoulder instability. Agreement between methods and observers." (Submitted)
III. Salomonsson B, Ahlström S, Dalén N, Lillkrona U (2009). "The Western Ontario Shoulder Instability Index (WOSI): validity, reliability, and responsiveness retested with a Swedish translation." Acta Orthop 80(2): 233-8
Pubmed
IV. Salomonsson B, von Heine A, Dahlborn M. Abbaszadegan H, Ahlström S, Dalén N, Lillkrona U (2009). "Bony Bankart at MRI of primary shoulder dislocation only finding of predictive value: an 8-year follow-up." (Submitted)
V. Salomonsson B, Abbaszadegan H, Revay S, Lillkrona U (2009). "The Bankart repair versus the Putti-Platt procedure; a randomized study with WOSI score at 10-year follow-up in 62 patients" Acta Orthop 80(3): Epub ahead of print
Pubmed
Issue date: 2009-05-15
Rights:
Publication year: 2009
ISBN: 978-91-7409-478-7
Statistics
Total Visits
Views | |
---|---|
Shoulder ...(legacy) | 818 |
Shoulder ... | 241 |
Total Visits Per Month
March 2024 | April 2024 | May 2024 | June 2024 | July 2024 | August 2024 | September 2024 | |
---|---|---|---|---|---|---|---|
Shoulder ... | 3 | 0 | 2 | 4 | 2 | 3 | 2 |
File Visits
Views | |
---|---|
thesis.pdf(legacy) | 980 |
thesis.pdf | 523 |
thesis.pdf.txt(legacy) | 2 |
Top country views
Views | |
---|---|
United States | 343 |
Sweden | 141 |
Germany | 60 |
China | 58 |
India | 50 |
Russia | 24 |
South Korea | 23 |
United Kingdom | 15 |
Mexico | 14 |
Finland | 10 |
Top cities views
Views | |
---|---|
Romeo | 38 |
Stockholm | 37 |
Sunnyvale | 33 |
Beijing | 27 |
Kiez | 20 |
Seoul | 17 |
Berlin | 10 |
Hyderabad | 8 |
Mountain View | 8 |
Dublin | 7 |