MedStar Authors catalog › Details for: Conjoined Tendon Transfer for Traumatic Anterior Glenohumeral Instability in Patients With Large Bony Defects and Anterior Capsulolabral Deficiency.
Citation: Arthroscopy. 34(1):12-20, 2018 Jan.Journal: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.Published: 2018ISSN: 0749-8063.Full author list: Douoguih WA; Goodwin D; Churchill R; Paulus M; Maxwell A.UI/PMID: 28843480.Subject(s): Adolescent | Adult | *Arthroscopy/mt [Methods] | Athletes | Female | Humans | *Joint Instability/su [Surgery] | Male | Middle Aged | Postoperative Period | Range of Motion, Articular | Retrospective Studies | *Shoulder Injuries/su [Surgery] | Shoulder Joint/in [Injuries] | Shoulder Joint/su [Surgery] | *Tendon Transfer/mt [Methods] | Treatment Outcome | Young AdultInstitution(s): MedStar Union Memorial HospitalDepartment(s): Orthopaedic Surgery | Sports MedicineActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access onlineDigital Object Identifier: https://dx.doi.org/10.1016/j.arthro.2017.06.044 (Click here)Abbreviated citation: Arthroscopy. 34(1):12-20, 2018 Jan.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:2004 - 2007.Abstract: PURPOSE: To report outcomes of a conjoined tendon transfer procedure in a small case series of young active patients of various activity levels with recurrent traumatic anterior shoulder instability.Abstract: METHODS: A retrospective chart review identified 10 consecutive patients who underwent conjoined tendon transfer (8 open and 2 arthroscopic) for anterior glenohumeral instability from January 2009 through December 2012. The indications were traumatic anterior shoulder instability with 25% or greater anterior glenoid bone loss, engaging Hill-Sachs lesion, or absent anterior-inferior labral tissue with anterior capsular tissue that did not readily hold sutures or a combination of these deficiencies. Patients did not undergo the procedure if they had healthy capsulolabral tissue and small bony defects or if they competed in high-level collision sports or were overhead throwers. The American Shoulder and Elbow Surgeons (ASES) questionnaire and a physical examination were completed preoperatively. Postoperatively, patients answered questions about shoulder stability and completed ASES and Western Ontario Shoulder Index questionnaires. A physical examination was performed postoperatively to assess range of motion.Abstract: RESULTS: Of 10 patients, 9 were available for follow-up. The mean age was 33.0 years (range, 18-51 years) at the time of surgery. Eight of nine patients underwent a physical examination at 31.3 +/- 10.5 months (range, 24-58 months) postoperatively. There were no revisions or complications except for recurrent instability in 1 patient who underwent the arthroscopic procedure and reported gross deviation from the postoperative protocol. The ASES score improved significantly (62.8 +/- 21.2 at baseline vs 89.2 +/- 11.5 at final follow-up, P = .01). The postoperative Western Ontario Shoulder Index score was 74.5 +/- 19.7. No significant change was found in external rotation in 90degree of abduction (80.6degree +/- 12.9degree at baseline vs 88.4degree +/- 6.1degree at final follow-up, P = .11) or in flexion (145.6degree +/- 14.9degree at baseline vs 153.1degree +/- 16.4degree at final follow-up, P = .19). All patients returned to their previous activity level.Abstract: CONCLUSIONS: Stability was restored and no significant range-of-motion loss was observed in noncollision athletes who underwent conjoined tendon transfer. Recurrent instability occurred in 1 patient who underwent the arthroscopic procedure. There were no other complications.Abstract: LEVEL OF EVIDENCE: Level IV, therapeutic case series. Copyright (c) 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
