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Postoperative Findings After Shoulder Instability Surgery
Julia R. Crim, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Labral repairs
              • Labrum is debrided, reattached with sutures and suture anchors to glenoid
                • Suture anchors are inserted through articular cartilage
                • Sutures are wrapped to form loops around labrum
            • Ligament repairs
              • Torn ligaments are sutured, may be plicated (shortened)
            • Bony Bankart repair
              • Screw fixation of bone fragment
              • Suture fixation of soft tissue injury
            • Bony glenoid augmentation
              • Performed when large bony defect present
                • > 20-25% loss of glenoid diameter
              • Usually performed after failure of initial Bankart repair
              • May use portion of coracoid process (Latarjet or Bristow procedure)
              • May use allograft distal tibia
              • Can cause posterior subluxation of humerus if anterior deficiency is overcorrected
            • Capsular plication
              • Reefing of redundant capsule
              • In past, thermal shrinkage of capsule has been performed
            • Drilling chondroplasty (microfracture)
              • Drilling of articular cartilage to stimulate fibrocartilage repair
            • Remplissage
              • Infraspinatus tendon is sutured into Hill-Sachs defect to improve stability

          IMAGING

          • General Features

            • Imaging Recommendations

              • Radiographic Findings

                • MR Findings

                  PATHOLOGY

                  • General Features

                    CLINICAL ISSUES

                    • Natural History & Prognosis

                      Selected References

                      1. Pierce JL et al: Postoperative shoulder imaging: rotator cuff, labrum, and biceps tendon. Radiographics. 36(6):1648-1671, 2016
                      2. Probyn LJ et al: Recurrent symptoms after shoulder instability repair: direct MR arthrographic assessment--correlation with second-look surgical evaluation. Radiology. 245(3):814-23, 2007
                      3. Sanders TG et al: Chondrolysis of the glenohumeral joint after arthroscopy: findings on radiography and low-field-strength MRI. AJR Am J Roentgenol. 188(4):1094-8, 2007
                      Related Anatomy
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                      Related Differential Diagnoses
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                      References
                      Tables

                      Tables

                      KEY FACTS

                      • Terminology

                        • Imaging

                          • Pathology

                            • Clinical Issues

                              TERMINOLOGY

                              • Definitions

                                • Labral repairs
                                  • Labrum is debrided, reattached with sutures and suture anchors to glenoid
                                    • Suture anchors are inserted through articular cartilage
                                    • Sutures are wrapped to form loops around labrum
                                • Ligament repairs
                                  • Torn ligaments are sutured, may be plicated (shortened)
                                • Bony Bankart repair
                                  • Screw fixation of bone fragment
                                  • Suture fixation of soft tissue injury
                                • Bony glenoid augmentation
                                  • Performed when large bony defect present
                                    • > 20-25% loss of glenoid diameter
                                  • Usually performed after failure of initial Bankart repair
                                  • May use portion of coracoid process (Latarjet or Bristow procedure)
                                  • May use allograft distal tibia
                                  • Can cause posterior subluxation of humerus if anterior deficiency is overcorrected
                                • Capsular plication
                                  • Reefing of redundant capsule
                                  • In past, thermal shrinkage of capsule has been performed
                                • Drilling chondroplasty (microfracture)
                                  • Drilling of articular cartilage to stimulate fibrocartilage repair
                                • Remplissage
                                  • Infraspinatus tendon is sutured into Hill-Sachs defect to improve stability

                              IMAGING

                              • General Features

                                • Imaging Recommendations

                                  • Radiographic Findings

                                    • MR Findings

                                      PATHOLOGY

                                      • General Features

                                        CLINICAL ISSUES

                                        • Natural History & Prognosis

                                          Selected References

                                          1. Pierce JL et al: Postoperative shoulder imaging: rotator cuff, labrum, and biceps tendon. Radiographics. 36(6):1648-1671, 2016
                                          2. Probyn LJ et al: Recurrent symptoms after shoulder instability repair: direct MR arthrographic assessment--correlation with second-look surgical evaluation. Radiology. 245(3):814-23, 2007
                                          3. Sanders TG et al: Chondrolysis of the glenohumeral joint after arthroscopy: findings on radiography and low-field-strength MRI. AJR Am J Roentgenol. 188(4):1094-8, 2007