Humeral Avulsion of the Glenohumeral Ligaments: A Systematic Review
| Autor: | Giuseppe Salvatore, Joel Locher, Alessandra Berton, Giacomo Rizzello, Umile Giuseppe Longo, Mauro Ciuffreda, Vincenzo Denaro |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Joint Instability
medicine.medical_specialty Rotation Shoulder surgery Shoulders medicine.medical_treatment Arthroscopy 03 medical and health sciences 0302 clinical medicine Recurrence Outcome Assessment Health Care Odds Ratio medicine Humans Orthopedics and Sports Medicine Range of Motion Articular Physical Therapy Modalities 030222 orthopedics medicine.diagnostic_test Shoulder Joint business.industry Shoulder Dislocation Humeral avulsion of the glenohumeral ligament 030229 sport sciences Odds ratio medicine.disease Surgery Bankart lesion Glenohumeral ligaments medicine.anatomical_structure Ligaments Articular Bankart Lesions business Range of motion |
| Zdroj: | Arthroscopy: The Journal of Arthroscopic & Related Surgery. 32:1868-1876 |
| ISSN: | 0749-8063 |
| DOI: | 10.1016/j.arthro.2016.03.009 |
| Popis: | Purpose To analyze clinical outcomes, range of motion, rate of recurrence, and complications after procedures to manage shoulder instability in patients with humeral avulsion of the glenohumeral ligament (HAGL) lesions. Methods A systematic review of the literature according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines with a PRISMA checklist and algorithm was performed. A comprehensive search of PubMed, Medline, CINAHL, Cochrane, Embase, and Google Scholar databases using various combinations of the Keywords "shoulder," "HAGL," "treatment," "lesion," "dislocation," "instability," "clinical," "outcome," "Bankart" since inception of databases to 2015 was performed. All the investigators independently extracted the following data: demographics, types of lesions and associated injuries, treatment, outcome measurements, range of motion, recurrent instability, and complications. Results Eleven articles were included in which 42 shoulders with HAGL lesions were evaluated. Patients were assessed at a median follow-up period of 25.5 months, ranging from 12 to 54 months. The overall rate of recurrence was 0% (0 of 25) in case of surgery and 90% (9 of 10) in case of nonoperative treatment. The surgical approach was associated with lower rate of recurrence when compared with nonoperative treatment (odds ratio 0.05, 95% confidence interval 0.01 to 0.42, and P = .006). Only 2 papers reported loss of external rotation after surgery. No complications were reported after surgery. Complications after nonoperative treatment were not discussed. Conclusions Recognizing HAGL lesions is important to manage patients with glenohumeral instability. Patients' complaints are often nonspecific. A high index of suspicion is required in patients with prior failed shoulder surgery. HAGL lesions are often associated with other shoulder lesions. Arthroscopic or open repairs of HAGL lesions are associated with good clinical outcomes and a lower rate of recurrence compared with nonoperative treatment. Level of Evidence Level IV, systematic review of Level IV studies. |
| Databáze: | OpenAIRE |
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