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J Korean Med Assoc > Volume 54(7); 2011 > Article
Kim: Orthopedic disease and sports medicine in shoulder joint

Abstract

Recent developments in biomechanics and technology have improved our understanding of the shoulder joints. While the shoulder joint is the one of the most mobile joints in the human body, its stability mostly relies on soft tissue structures such as the glenoid labrum and capsular ligament. Traumatic anterior instability is the most common instability related to sports injury. Younger individuals have a higher rate of recurrence after nonoperative treatment after the first-time episode of anterior instability. Arthroscopic repair of the Bankart lesion provides reliable outcomes in most of the anterior instability, while selected patients with significant bone loss may require bony augmentation procedures. Posterior instability has been underestimated. Sports injury is commonly associated with symptomatic posterior instability, and posterior labral lesions are commonly found. Arthroscopic reconstruction of the posteroinferior height and ligament balance is required. Superior labral lesions are a commonly diagnosed disease in the shoulder. Care must be taken to avoid unnecessary surgical procedures especially in nonathletic populations without significant traumatic episodes. Partial articular surface tears are common among sports related rotator cuff injuries. Symptomatic articular surface tears require arthroscopic treatment such as debridement or trans-tendon repair.

References

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Figure 1
Bankart lesion.
jkma-54-705-g001-l.jpg
Figure 2
Hill-Sachs lesion.
jkma-54-705-g002-l.jpg
Figure 3
Postoperative view of arthroscopic Bankart repair.
jkma-54-705-g003-l.jpg
Figure 4
The jerk test. (A) Stabilize the scapula with one hand, while the other hand holds the elbow with the arm in 90° abduction and internal rotation. Firm axial compression force is applied on the glenohumeral joint. (B) The arm is horizontally adducted while maintaining the firm axial load.
jkma-54-705-g004-l.jpg
Figure 5
The Kim test was performed in sitting position with the arm in 90° abduction. (A) With examiner holding elbow and lateral aspect of the proximal arm, firm axial loading force is applied. (B) Simultaneous 45° upward diagonal elevation was applied on the distal arm, while downward and backward force is applied on the proximal arm.
jkma-54-705-g005-l.jpg
Figure 6
Three types of the posteroinferior labral lesion in the magnetic resonance imaging-arthrogram. (A) Type I: separation without displacement. (B) Type II: incomplete avulsion-the Kim lesion. (C) Type III: loss of contour.
jkma-54-705-g006-l.jpg
Figure 7
Arthroscopic finding of the posterior and inferior labral lesion. (A) Type I: incomplete detachment. (B) Type II: marginal crack or Kim lesion.
jkma-54-705-g007-l.jpg
Figure 8
Superior labral lesion.
jkma-54-705-g008-l.jpg
Figure 9
Partial thickness tear of the articular surface of the rotator cuff.
jkma-54-705-g009-l.jpg
Table 1
Classification of the posteroinferior labral lesion based on arthroscopic findings and magnetic resonance imaging-arthrogram
jkma-54-705-i001-l.jpg

MR, Magnetic resonance



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