The effectiveness of rehabilitation for nonoperative management of shoulder instability: a systematic review

2004 ◽  
Vol 17 (2) ◽  
pp. 229-242 ◽  
Author(s):  
Kylie Gibson ◽  
Angela Growse ◽  
Lesley Korda ◽  
Emily Wray ◽  
Joy C MacDermid
Keyword(s):  
Systematic Review ◽  
Shoulder Instability ◽  
Nonoperative Management

scholarly journals Differences in Outcomes Between Anterior and Posterior Shoulder Instability After Arthroscopic Bankart Repair: A Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110064
Author(s):  
Matthew L. Vopat ◽  
Reed G. Coda ◽  
Nick E. Giusti ◽  
Jordan Baker ◽  
Armin Tarakemeh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Instability ◽  
Anterior Shoulder Instability ◽  
Posterior Shoulder Instability ◽  
Anterior Instability ◽  
Posterior Instability ◽  
Female Patients ◽  
Posterior Shoulder ◽  
Male Patients ◽  
Postoperative Instability

Background: The glenohumeral joint is one of the most frequently dislocated joints in the body, particularly in young, active adults. Purpose: To conduct a systematic review and meta-analysis to evaluate and compare outcomes between anterior versus posterior shoulder instability. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed using the PubMed, Cochrane Library, and MEDLINE databases (from inception to September 2019) according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included if they were published in the English language, contained outcomes after anterior or posterior shoulder instability, had at least 1 year of follow-up, and included arthroscopic soft tissue labral repair of either anterior or posterior instability. Outcomes including return-to-sport (RTS) rate, postoperative instability rate, and pre- and postoperative American Shoulder and Elbow Surgeons (ASES) scores were recorded and analyzed. Results: Overall, 39 studies were included (2077 patients; 1716 male patients and 361 female patients). Patients with anterior instability had a mean age of 23.45 ± 5.40 years (range, 11-72 years), while patients with posterior instability had a mean age of 23.08 ± 8.41 years (range, 13-61 years). The percentage of male patients with anterior instability was significantly higher than that of female patients (odds ratio [OR], 1.36; 95% CI, 1.04-1.77; P = .021). Compared with patients with posterior instability, those with anterior instability were significantly more likely to RTS (OR, 2.31; 95% CI, 1.76-3.04; P < .001), and they were significantly more likely to have postoperative instability (OR, 1.53; 95% CI, 1.07-2.23; P = .018). Patients with anterior instability also had significantly higher ASES scores than those with posterior instability (difference in means, 6.74; 95% CI, 4.71-8.77; P < .001). There were no significant differences found in postoperative complications between the anterior group (11 complications; 1.8%) and the posterior group (3 complications; 1.6%) (OR, 1.12; 95% CI, 0.29-6.30; P = .999). Conclusion: Patients with anterior shoulder instability had higher RTS rates but were more likely to have postoperative instability compared with posterior instability patients. Overall, male patients were significantly more likely to have anterior shoulder instability, while female patients were significantly more likely to have posterior shoulder instability.

Reporting of glenoid bone loss measurement in clinical studies and the need for standardization

2022 ◽  
Vol 104-B (1) ◽  
pp. 12-18
Author(s):  
Simon Weil ◽  
Magnus Arnander ◽  
Yemi Pearse ◽  
Duncan Tennent
Keyword(s):  
Systematic Review ◽  
Bone Loss ◽  
Shoulder Instability ◽  
Clinical Studies ◽  
Imaging Modality ◽  
Measurement Techniques ◽  
Specific Treatment ◽  
Glenoid Bone Loss ◽  
Anterior Shoulder Instability ◽  
Significant Heterogeneity

Aims The amount of glenoid bone loss is an important factor in deciding between soft-tissue and bony reconstruction when managing anterior shoulder instability. Accurate and reproducible measurement of glenoid bone loss is therefore vital in evaluation of shoulder instability and recommending specific treatment. The aim of this systematic review is to identify the range methods and measurement techniques employed in clinical studies treating glenoid bone loss. Methods A systematic review of the PubMed, MEDLINE, and Embase databases was undertaken to cover a ten-year period from February 2011 to February 2021. We identified clinical studies that incorporated bone loss assessment in the methodology as part of the decision-making in the management of patients with anterior shoulder instability. The Preferred Reporting Items for Systematic Reviews (PRISMA) were used. Results A total of 5,430 articles were identified from the initial search, of which 82 studies met the final inclusion criteria. A variety of imaging methods were used: three studies did not specify which modality was used, and a further 13 used CT or MRI interchangeably. There was considerable heterogeneity among the studies that specified the technique used to quantify glenoid bone loss. A large proportion of the studies did not specify the technique used. Conclusion This systematic review has identified significant heterogeneity in both the imaging modality and method used to measure glenoid bone loss. The recommendation is that as a minimum for publication, authors should be required to reference the specific measurement technique used. Without this simple standardization, it is impossible to determine whether any published paper should influence clinical practice or should be dismissed. Cite this article: Bone Joint J 2022;104-B(1):12–18.

scholarly journals Knowing When Not to Intervene: A Systematic Review of Nonoperative Management in Blunt Thoracic Aortic Injury

2018 ◽  
Vol 68 (3) ◽  
pp. e70
Author(s):  
Jean Jacob-Brassard ◽  
Konrad Salata ◽  
Ahmed Kayssi ◽  
Mohamad Hussain ◽  
Thomas Forbes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Nonoperative Management ◽  
Aortic Injury ◽  
Blunt Thoracic Aortic Injury ◽  
Thoracic Aortic Injury

scholarly journals Outcomes and Return to Sport and Work After Open Bankart Repair for Recurrent Shoulder Instability: A Systematic Review

2021 ◽  
Vol 9 (10) ◽  
pp. 232596712110269
Author(s):  
Khalid AlSomali ◽  
Erica Kholinne ◽  
Thanh Van Nguyen ◽  
Chang-Ho Cho ◽  
Jae-Man Kwak ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Instability ◽  
Return To Sport ◽  
Bankart Repair ◽  
Cochrane Library ◽  
Anterior Shoulder Instability ◽  
Functional Score ◽  
High Demand ◽  
Recurrent Instability ◽  
Instability Rate

Background: Open Bankart repair provides surgeons and patients with an alternative solution for managing recurrent instability in young athletes with or without minimal bone loss. Despite many studies that have reported low recurrence rates and good functional outcomes after open Bankart repair, we have limited knowledge about the return to sport and work for high-demand populations. Purpose: To assess the return to sport and work for high-demand populations after open Bankart repair for recurrent anterior shoulder instability, outcomes of open Bankart repair with regard to recurrence, and development of osteoarthritic (OA) changes. Study Design: Systematic review; Level of evidence, 4. Methods: We searched PubMed, EMBASE, Cochrane Library, Scopus, and Google Scholar databases using keywords as well as Medical Subject Headings terms and Emtree using “(Open Bankart OR Bankart surgery) (NOT arthroscopy NOT revision)” for English-language studies. We conducted a systematic review in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: In total, 11 articles (10 with level 4 and 1 with level 3 evidence) including 563 patients (566 shoulders) were identified. The majority of patients were male (82%), the average age at the time of surgery was 27.4 years, and the mean follow-up was 11.5 years (range, 2.5-29 years). The most common functional score used was the Rowe score (95%) for the reported outcome measures, which showed good to excellent results (mean, 88.5 points). The overall recurrent instability rate, including dislocation and subluxation as a postoperative complication, was 8.5%. A total of 87% of patients were able to return to sport and work postoperatively. Overall, OA changes were reported in 33% of the patients, and the overall revision rate was 1%. Conclusion: Open Bankart repair exhibited favorable results, with a low postoperative instability rate. It is a reliable surgical procedure that allows high-demand patients to return to sport and work.

Posterior shoulder instability: a systematic review

2020 ◽  
Vol 134 (1) ◽  
pp. 34-53
Author(s):  
Umile Giuseppe Longo ◽  
Mauro Ciuffreda ◽  
Joel Locher ◽  
Carlo Casciaro ◽  
Nicholas Mannering ◽  
...  
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Shoulder Instability ◽  
Optimal Treatment ◽  
Treatment Modalities ◽  
Posterior Shoulder Instability ◽  
Posterior Instability ◽  
Posterior Shoulder ◽  
Comprehensive Search ◽  
Tissue Abnormalities

Abstract Introduction This review aims to provide information on outcomes of surgical procedures for soft tissue or bony glenoid and/or humeral abnormalities in case of posterior shoulder instability. Source of data A systematic review of the literature according to the PRISMA guidelines was performed. A comprehensive search of PubMed, Medline, CINAHL, Cochrane, Embase, Ovid and Google Scholar databases using various combinations of the keywords ‘shoulder’, ‘posterior instability’, ‘dislocation’, ‘reversed bony bankart’, ‘reversed Hill Sachs’, and ‘capsulolabral’ was performed. Areas of agreement A total of 847 shoulders in 810 patients were included. A redislocation event occurred in 33 (8.7%) of 411 shoulders with soft tissue abnormalities and in 12 (9.1%) of 132 shoulders with bony abnormalities of the glenoid, humeral head or both. Areas of controversy The optimal treatment modalities for posterior shoulder dislocation remain to be defined. Growing points Operative stabilization for posterior shoulder instability should be lesion-specific and should correct all components of the posterior instability. Areas timely for developing research Future prospective studies should aim to establish the optimal treatment modalities for posterior shoulder instability.

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