Select a Community
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
30-year old female, recreational soccer player with ligamentous laxity and an x-ray showing a Hill-Sachs lesion and loss of glenoid contour
39%
1337/3423
16-year old male, who plays hockey recreationally with no laxity and an x-ray showing a loss of glenoid contour
13%
435/3423
18-year old female, competitive tennis player with no laxity and x-ray findings of a Hill-Sachs lesion and loss of glenoid contour
1330/3423
45-year old male, recreational basketball player with ligamentous laxity and x-ray findings of a Hill-Sachs lesion
4%
130/3423
28-year old male, competitive football player with no laxity and no abnormal x-ray findings.
2%
58/3423
Select Answer to see Preferred Response
The 18-year old competitive tennis player with no ligamentous laxity and x-ray findings consistent with a Hill-Sachs lesion and loss of glenoid contour has an instability severity index score (ISIS) of 9, which is associated with a >70% chance of recurrent instability after a arthroscopic Bankart procedure. The surgical management of anterior shoulder instability consists of both arthroscopic and open approaches. The guiding principles for treatment are the restoration of the normal glenoid labrum anatomy and retensioning of the inferior glenohumeral ligament which is achieved via soft-tissue reconstructions (repair of any labral detachment +/- capsular shift) or bony procedures (such as transfer of the coracoid process). Ahmed et al. reviewed 302 patients who had undergone arthroscopic Bankart repair and capsular shift for the treatment of recurrent anterior glenohumeral instability. The prevalence of patient and injury-related risk factors for recurrence was assessed. The rate of recurrent glenohumeral instability after arthroscopic Bankart repair and capsular shift was 13.2%. The risk of recurrence was independently predicted by the patient’s age at surgery, the severity of glenoid bone loss, and the presence of an engaging Hill-Sachs lesion. Balg et al. identified risk factors for recurrent instability after arthroscopic Bankart procedure in 131 consecutive patients. Age under 20 years at the time of surgery; involvement in competitive or contact sports or those involving forced overhead activity; shoulder hyperlaxity; a Hill-Sachs lesion present on an AP radiograph of the shoulder in external rotation and/or loss of the sclerotic inferior glenoid contour were all identified as risk factors. These factors were integrated into a 10-point pre-operative instability severity index score (ISIS). Patients with a score over 6 points had an unacceptable recurrence risk of 70%. Illustration A summarizes the components of the ISIS as developed by Balg and Boileau. Incorrect Answers: Answer 1 & 2: These patients have an instability severity index score of 5. This is associated with a 10% risk of recurrence. Answer 4: This patients instability severity index score is 4. This is associated with a 10% risk of recurrence. Answer 5: This patients instability severity index score is 3. This is associated with a 5% risk of recurrence.
1.4
(41)
Please Login to add comment