updates, figures and table 2 Flashcards
What muscles are impacted with Total shoulder arthoplasty
- deltoid retracted
- suscapularis released by tendon inscision or less or tubercle release
- pec major - upper part is released
How can the surgeon know if they have optimal soft tissue balance follow totals shoulder
- humeral head will sublux no more than about 50% of its diameter
How does the pathophysiology leading to a shoulder arthroplasty impact the ROM outcomes
Flex/ER
- OA- 140/40
- RA - 103/45
- Acute fx - 100/30
What considerations must you take into account with TSA following shoulder fracture?
- fractures with 3 or 4 parts typically have lower range of motion return, but better symptom
- thorough examination of pre- and post- surgery for nerve injury (particularly axillary)
How much ER ROM will the patient get after a TSA
they will never gain more than was mechanically allowed during surgery
When is a reverse total shoulder indicated?
- massive or irreparabel rotator cuff damage
- Proximal humeral fracture in a deficient rotator cuff
- revsion of previous total arthroplasty
- situations where conventional surgical approach may result in inferior outcomes
What muscle must work well for good functional outcomes followign a reverse total shoulder
deltoid
How much depth does the laburm add to the glenoid?
increased depth by 50%
desribe the relation of the superior GH to the biceps tendon
they all attach to the labrum
what is the IGHLC
inferior glenohumeral ligament complex
- anterior band
- posterior band
- interposed axillary pouch
what is the primary restraint to posterior glide of the GH joint?
- capsule
- posterior band of the IGHLC
- muscles
what is the rotator interval
- triangular region between the border of the supraspinatus and subscapularis
- superior glenomueral ligament
- coracohumeral ligament
describe superior migration of the humeral head
- 60 deg center humeral head rose 2 mm of center of glenoid
- decreased to 1 mm at 90 and 120
- decreased to 0.5mm at 150
Follow subacromial decompression when is a reasonable time frame for full ROM and return to sport
- full ROM 10-12
2. reuturn to sport 12-14
What is arthroscopic rempilssage
arthorscopic procedure to fill in Hill Sach lesions