2010, Number 3
Ortho-tips 2010; 6 (3)
Cruz LF, Trueba BC, Almazán DA, Pérez JFJ, Sierra SL, Villalobos E, Ibarra PC
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ABSTRACTGlenoid and humeral head bone injuries with lesions of the capsulolabral and ligamentary structures are common reason for recurrent anterior shoulder instability. Clinical evaluation, advanced imaging, examination under anesthesia, and diagnostic arthroscopy are important in decision making. Almost all cases can be treated by arthroscopy, except when tissue to repair quality is not good, when there is a glenoid bone loss greater than 20%, an engaging Hill-Sachs lesion, or Instability Severity Index Score greater than 6. To fix these lesions we use metal or bioabsorbable anchors with sutures, some of them require knots and others, the so-called «Knotless» not, laying their sutures for interference. Postoperative patient must use a shoulder immobilizer with an abductor cushion for six weeks and start rehabilitation almost immediate, first with pendulous exercises, then isotonics muscle contractions and finally strengthening training.