New Technique in Shoulder Surgery for Sports Injury

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New Technique in Shoulder Surgery for Sports
Injury

• Dennis Crawford MD, PhD
• Assistant Professor
• Surgical Director, Sports Medicine Program
• Department of Orthopedics Rehabilitation
• Oregon Health Sciences University
• Center for Health Healing
• Portland Oregon

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Shoulder Surgery State of the Art 07

• All Arthroscopic
• Stabilization for dislocation
• Stabilization for instability
• Rotator cuff repairs
• SLAP repairs
• Biceps tendon repair
• Capsular release
• Internal Rotation contracture
• Frozen Shoulder
• Open
• Clavicle fixation
• Improved outcomes

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Definitions

• Instability
• Failure of the dynamic and static mechanisms of
  joint biomechanics to maintain a functional
  position of two articulating surfaces
• Subluxation
• Partial, transient loss of articulating
  congruency
• Dislocation
• Complete loss of articulating congruency

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Shoulder Dislocations

• First time dislocators
• lt 20 yrs
• gt 75 redislocation rate
• 20-30 yrs
• 30-50 redislocation rate
• Arthroscopic repair
• Out-patient
• Reduce re-dislocation rate
• lt2-5
• Return to Sports
• 3-6 months

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Type of Instabilitygt Surgical Timing

• Traumatic Injury
• Most commonly
• anterior dislocation
• Anatomic Injury
• Bankart Lesion
• Labral Tear
• Acquired laxity
• Swimmers/Gymnasts
• multidirection
• Subtle capsular injuries
• Globally stretched

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Fundamental Shoulder Arthroscopy
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Arthroscopic Exam of Shoulder
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Arthroscopic Exam SLAP ? Biceps
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Arthroscopic Exam Bankart lesion
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Arthroscopic Bankart Repair 1
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Arthroscopic Bankart Repair 2
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Arthroscopic Bankart Repair 3
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Arthroscopic Bankart Repair 4
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Return to Sports after Scope Bankart

• Sling for 4-6 weeks
• Immediate
• Rhomboid strengthening
• Core conditioning
• Weeks 4-10
• Restore normal ROM
• Weeks 8-16
• Restore Rotator Cuff strength
• Restore Scapulo-thoracic kinetics
• Weeks 12-20
• Return to sports
• Throwing/overhead athletes
• Graded increase in stress
• Throwing programs
• 6 months

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Thank you

• Dennis C. Crawford, MD. PhD
• Assistant Professor
• Director, Sports Arthroscopic Surgery
• Department of Orthopedics
• Oregon Health Science University