Surgical treatment and rehab for instability

Question 1

Initial dichotomy

Answer 1

tubs- traumatic, unilateral, Bankart lesion, surgery

ambri- traumatic, multidirectional, bilateral rehabilitation, inferior capsule shift

Question 2

stanmore classification

Answer 2

Traumatic
Atraumatic
Acquired

Question 3

FEDS classification

Answer 3

frequency
etiology
Direction
Severity

Question 4

Phased approach
conservative management of dislocation

Answer 4

1- pain reduction, production of tissues reduction of inflammation
2- mobilization, motor control and strength of the dynamic stabilizers
3- strength, stabilization near end range, endurance, plyometrics
4- return to activity with focus on strength, dynamics, stability in tasks similar to sport

Question 5

surgery for shoulder instability

Answer 5

Capulolabral repair with optional add-ons

-Scope to confirm Bankart lesion and engaging hill sachs lesion
-Bankhart repair
-capsular plication
-remplissage for hill sachs lesion
-latarjet technique

Question 6

Pathology associated with anterior instability

Answer 6

Hills sachs lesion- compression fracture of the posterior humeral head against anterior glenoid rim

Bankart lesion- tear of anterior glenoid labrum with humeral head shear force during dislocation

Bony Bankart lesion- avulsion of the glenoid rim in the area of a Bankart lesion

Question 7

When do you start passive range of motion for postop rehab for anterior dislocation?

Answer 7

phase 1
Four weeks

Question 8

Postop week three- range of motion for anterior dislocation

Answer 8

90° flexion
10 to 30° external rotation

Question 9

Postop week six- range of motion for anterior dislocation

Answer 9

135° flexion
35 to 50° external rotation
45° external rotation at 90° abduction

Question 10

pathology associated with posterior instability

Answer 10

Reverse hill sachs lesion-compression fracture of anterior humeral head against posterior glenoid rim

Reverse bankart lesion- tear of posterior glenoid labrum with humeral head shear force during posterior dislocation

Bony Bankart lesion- avulsion of the glenoid rim in the area of a reverse Bankart lesion

Question 11

inferior instability

Answer 11

Particularly with an abducted humerus
Direct blow to abducted humerus
Falling onto head or shoulder