Common Shoulder surgeries Flashcards
1
Q
Bankert lesion
A
- caused typically in the labrum from an anterior dislocation that tears part of the labrum
2
Q
Bankart repair (open)
- indications
- expectations
A
- usually an open procedure
- indications: anterior instability bankart lesion “torn loose”
- expectations: eliminate instability, full or near full external rotation
3
Q
How does an open bankart repair occur
A
- deltopetoral interval
- reflect the deltoid and pec not cut
- subscapularis is cut and reflected to expose joint capsule
- vertical incision to access the joint
- anterior labrum will be reanchored
- jt capsule is pulled/tighened
- subscapularis is repaired
4
Q
what motions should be under caution with a bankart repair
A
- careful with ER (the subscapularis is healing)
- first 1-3 weeks = 30º ER
- 3-6 weeks = 45º
- after 6 weeks get back to normal
- also limit forcefully contraction IR
5
Q
bankart repair: week 0-2 goal
A
- protect the surgical procedure
- minimize the effects of immobilization
- diminish pain and inflammation
6
Q
Open bankar repair: week 0-2 cautions/interventions
A
- sling 1-2 weeks
- submaximal isometrics: no resisted IR until 2-3 weeks
- PROM/AAROM: flexion to tolerance; ER/IR in scapular plane but not to end range
7
Q
How long is an arthroscopic bankart repair in a sling for
A
- 4 weeks
- they feel better sooner so they are in the sling longer to stop them from disrupting the healing
8
Q
Weeks 3-4 open bankart repair post op
A
- gradually progress ROM
- flexion to 120-140 degrees
- ER 35-45º (scapular plane)
- IR 45-60ºscapular plane
- light isotonics: tubing ER, dumbells
- gentle self capsular stretching
9
Q
weeks 5-6 open bankart lesion repair post op typical rehab
A
- progress ROM
- IR/ER at 90ºof abduction
- ER 70-75º
- iR 75º
- progress all strengthening exercises
10
Q
Week 8-10 open bankart lesion repair post op
A
- re-establish full ROM
- normalize arthrokinematics
- improve muscular strength
- enhance neuromuscular control
11
Q
return to sport for bankart repair post op - time frame
A
- 6-9 months especially for high demand or throwing athletes
12
Q
Arthroscopic bankart procedure
A
- capsule is tightened/sewed together
- open will get more tightness/stability
- if glenoid needs to be repairs
- this may loosen up more rapidly
13
Q
precautions after After Anterior Glenohumeral Stabilization and/or Bankart Repair
A
- 1st 6 weeks limit ER, horizontal abduction and extension (stretch anterior capsule)
- arthorscopic procedures should limit flexion more than open
14
Q
Bristow-latarjet procedure
A
- anterior instability with glenoid defect
- bony block with additional dynamic stability
- coracoid transfer with biceps short head
- resection of coracoacromial ligament
- biceps short head provides a sling to support anteriorly
15
Q
outcome of Bristow-latarjet procedure
A
- average 5 year follow up no significant instability
- improved subjective reports with arthroscopic tendency toward increase recurrence compared to open
- high demand UE activities less RTS in both groups
