Results of Modified Mini-Open Arthroscopically Assisted Bristow - Latarjet - Bankart Procedure

The aim of the study — to evaluate clinical outcomes, complications, bone-block healing, positioning and subscapularis muscle insufficiency after modified mini-open arthroscopically assisted Bristow - Latarjet - Bankart procedure.Materials and Methods. The study included 133 patients who underwent modified mini-open arthroscopically assisted Bristow - Latarjet - Bankart procedure, assessed the functional outcome using the Rowe and Walch-Duplay scales, the range of motion and stability of the joint, and the function of the subscapularis muscle. All patients underwent CT, 82 patients were assessed for MR-signs of subscapularis muscle atrophy.Results. All patients were satisfied with the treatment results. The mean value on the Rowe scale increased from 35.7 [31,2; 41,0] to 91.3 [82,1; 96,8] (38 to 100 Me 90) (p<0.001) and on the Walch-Duplay scale from 41.5 [34,2; 44,5] to 88.9 [80,4; 97,2] (32 to 100, Me 88) (p<0.001). In 2 (1.5%) patients, shoulder dislocation recurred, in 9 (6.8%) patients, a positive test of premonition of dislocation or periodic feelings of instability were observed. There were no persistent contractures. In 6 (4.5%) cases, the graft was located medially and in 3 (2.3%) cases — laterally. The average α-angle was 14° [5°; 24°] (2° to 39°, Me 15). The proportion of the graft area lost due to resorbtion was 19% [9%; 30%] (from 6 to 58%, Me 20). Nonunion of the graft was observed in 4 (3.0%) patients, 2 (1.5%) of whom had a fracture and bone block migration. A significant (p = 0.021) decrease in the intensity of the MR-signal of the subscapularis muscle was observed, most pronounced in the lower portion. In 9 patients with a positive test of anticipation of dislocation or sensations of instability, the degree of bone block resorption (p = 0.038) and MR-signs of atrophy of the upper and lower portions of the subscapularis muscle were significantly higher (p = 0.031 and p<0.001), and the results of stress testing significantly worse (p<0.001) than in 122 patients without signs of instability.Conclusion. The results of this study show the efficacy of the modified arthroscopically-assisted Bristow - Latarjet - Bankart procedure in patients with large bone defects, when the soft tissue technique is not a reasonable option.

Download Full-text

Use of Adipose Derived Stem Cells to Treat Large Bone Defects. Addendum

10.21236/ada586568 ◽

2009 ◽

Author(s):

Barbara D. Boyan ◽

Robert E. Gulderg

Keyword(s):

Stem Cells ◽

Bone Defects ◽

Adipose Derived Stem Cells ◽

Large Bone ◽

Large Bone Defects

Download Full-text

Factors related to large bone defects of bipolar lesions and a high number of instability episodes with anterior glenohumeral instability

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02395-5 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Noboru Matsumura ◽

Kazuya Kaneda ◽

Satoshi Oki ◽

Hiroo Kimura ◽

Taku Suzuki ◽

...

Keyword(s):

Humeral Head ◽

Glenohumeral Joint ◽

Three Dimensional ◽

Clinical Results ◽

Bone Defects ◽

Symptom Duration ◽

Glenohumeral Instability ◽

Explanatory Variables ◽

Large Bone ◽

Large Bone Defects

Abstract Background Significant bone defects are associated with poor clinical results after surgical stabilization in cases of glenohumeral instability. Although multiple factors are thought to adversely affect enlargement of bipolar bone loss and increased shoulder instability, these factors have not been sufficiently evaluated. The purpose of this study was to identify the factors related to greater bone defects and a higher number of instability episodes in patients with glenohumeral instability. Methods A total of 120 consecutive patients with symptomatic unilateral instability of the glenohumeral joint were retrospectively reviewed. Three-dimensional surface-rendered/registered models of bilateral glenoids and proximal humeri from computed tomography data were matched by software, and the volumes of bone defects identified in the glenoid and humeral head were assessed. After relationships between objective variables and explanatory variables were evaluated using bivariate analyses, factors related to large bone defects in the glenoid and humeral head and a high number of total instability episodes and self-irreducible dislocations greater than the respective 75th percentiles were evaluated using logistic regression analyses with significant variables on bivariate analyses. Results Larger humeral head defects (P < .001) and a higher number of total instability episodes (P = .032) were found to be factors related to large glenoid defects. On the other hand, male sex (P = .014), larger glenoid defects (P = .015), and larger number of self-irreducible dislocations (P = .027) were related to large humeral head bone defects. An increased number of total instability episodes was related to longer symptom duration (P = .001) and larger glenoid defects (P = .002), and an increased number of self-irreducible dislocations was related to larger humeral head defects (P = .007). Conclusions Whereas this study showed that bipolar lesions affect the amount of bone defects reciprocally, factors related to greater bone defects differed between the glenoid and the humeral head. Glenoid defects were related to the number of total instability episodes, whereas humeral head defects were related to the number of self-irreducible dislocations.

Download Full-text

Arthroscopically assisted mini-open rotator cuff repair

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1053/jars.2002.26480 ◽

2002 ◽

Vol 18 (1) ◽

pp. 21-26 ◽

Cited By ~ 52

Author(s):

Theodore J. Shinners ◽

Peter G. Noordsij ◽

John F. Orwin

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Repair ◽

Arthroscopically Assisted ◽

Cuff Repair ◽

Mini Open

Download Full-text

Vascularization of Nanohydroxyapatite/Collagen/Poly(L-lactic acid) Composites by Implanting Intramuscularly In Vivo

International Journal of Polymer Science ◽

10.1155/2014/153453 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Hai Wang ◽

Xiao Chang ◽

Guixing Qiu ◽

Fuzhai Cui ◽

Xisheng Weng ◽

...

Keyword(s):

Lactic Acid ◽

Orthopaedic Surgery ◽

Bone Substitutes ◽

Bone Defects ◽

Large Defect ◽

Natural Bone ◽

Composition And Structure ◽

Large Bone ◽

Large Bone Defects

It still remains a major challenge to repair large bone defects in the orthopaedic surgery. In previous studies, a nanohydroxyapatite/collagen/poly(L-lactic acid) (nHAC/PLA) composite, similar to natural bone in both composition and structure, has been prepared. It could repair small sized bone defects, but they were restricted to repair a large defect due to the lack of oxygen and nutrition supply for cell survival without vascularization. The aim of the present study was to investigate whether nHAC/PLA composites could be vascularized in vivo. Composites were implanted intramuscularly in the groins of rabbits for 2, 6, or 10 weeks (n=5×3). After removing, the macroscopic results showed that there were lots of rich blood supply tissues embracing the composites, and the volumes of tissue were increasing as time goes on. In microscopic views, blood vessels and vascular sprouts could be observed, and microvessel density (MVD) of the composites trended to increase over time. It suggested that nHAC/PLA composites could be well vascularized by implanting in vivo. In the future, it would be possible to generate vascular pedicle bone substitutes with nHAC/PLA composites for grafting.

Download Full-text