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New Technique in Shoulder Surgery for Sports Injury

New Technique in Shoulder Surgery for Sports Injury. Dennis Crawford MD, PhD Assistant Professor Surgical Director, Sports Medicine Program Department of Orthopedics & Rehabilitation Oregon Health Sciences University Center for Health & Healing Portland Oregon.

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New Technique in Shoulder Surgery for Sports Injury

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  1. New Technique in Shoulder Surgery for Sports Injury Dennis Crawford MD, PhD Assistant Professor Surgical Director, Sports Medicine Program Department of Orthopedics & Rehabilitation Oregon Health Sciences University Center for Health & Healing Portland Oregon

  2. Shoulder Surgery: State of the Art ‘07 • All Arthroscopic • Stabilization for dislocation • Stabilization for instability • Rotator cuff repairs • SLAP repairs • Biceps tendon repair • Capsular release • Internal Rotation contracture • Frozen Shoulder • Open • Clavicle fixation • Improved outcomes

  3. Definitions • Instability • Failure of the dynamic and static mechanisms of joint biomechanics to maintain a functional position of two articulating surfaces • Subluxation • Partial, transient loss of articulating congruency • Dislocation • Complete loss of articulating congruency

  4. Shoulder Dislocations • First time dislocators • < 20 yrs • > 75% redislocation rate • 20-30 yrs • 30-50% redislocation rate • Arthroscopic repair • Out-patient • Reduce re-dislocation rate • <2-5% • Return to Sports • 3-6 months

  5. Type of Instability> Surgical Timing • Traumatic Injury • Most commonly • anterior dislocation • Anatomic Injury • “Bankart” Lesion • Labral Tear • Acquired laxity • Swimmers/Gymnasts • multidirection • Subtle capsular injuries • Globally “stretched”

  6. Fundamental Shoulder Arthroscopy

  7. Arthroscopic Exam of Shoulder

  8. Arthroscopic Exam: SLAP ? & Biceps

  9. Arthroscopic Exam: Bankart lesion

  10. Arthroscopic Bankart Repair: 1

  11. Arthroscopic Bankart Repair: 2

  12. Arthroscopic Bankart Repair: 3

  13. Arthroscopic Bankart Repair: 4

  14. Return to Sports after Scope Bankart • Sling for 4-6 weeks • Immediate • Rhomboid strengthening • Core & conditioning • Weeks 4-10 • Restore normal ROM • Weeks 8-16 • Restore Rotator Cuff strength • Restore Scapulo-thoracic kinetics • Weeks 12-20 • Return to sports • Throwing/overhead athletes • Graded increase in stress • Throwing programs • 6 months • Unrestricted activity • Assuming full strength and ROM

  15. Thank you Dennis C. Crawford, MD. PhD Assistant Professor Director, Sports & Arthroscopic Surgery Department of Orthopedics Oregon Health & Science University

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