IC 107-2022: A Case-Based Approach to Managing Complex Problems in the Young Adult: Arthritis, Irreparable Rotator Cuff, and Recurrent Instability-A Case-Based Approach to Managing Complex Problems in the Young Adult: Arthritis, Irreparable Rotator Cuff, and Recurrent Instability (3/3)

A Case-Based Approach to Managing Complex Problems in the Young Adult: Arthritis, Irreparable Rotator Cuff, and Recurrent Instability (3/3)

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Video Transcription

Video Summary

In the video, the speaker discusses two cases of shoulder instability. In the first case, a 38-year-old patient had a previous shoulder dislocation and multiple subsequent dislocations. The speaker analyzes X-rays and suggests that screws used in a previous surgery may have been positioned slightly too high. The speaker also examines an MRI, which indicates that the patient's cuff is intact and the capsule is similar to that of a post-open Latter-day capsule. Based on the evaluation, the speaker recommends examining the hillsacs further to determine their size and considering an arthroscopic procedure to rectify the issue.<br /><br />In the second case, a 35-year-old patient had a labral repair 14 years prior and is experiencing recurrent instability for the past three months. X-rays show no significant bone loss, but the humeral head appears abnormal. The speaker suggests that there may be a posterior capsular tear due to kiteboarding trauma. Arthroscopy is recommended to assess the labrum and capsule. During the arthroscopic procedure, the posterior capsular tear is repaired, and the labrum is reattached. The patient experiences successful outcomes after three years.<br /><br />The speakers provide tips on graft positioning during a latter-day procedure, as well as the use of anchors and repairing a posterior capsular tear. They also discuss the decision-making process for addressing a slap tear and the possibility of performing both a slap repair and a bicep tenodesis concurrently.

Asset Caption

Peter Chalmers, MD

Keywords

shoulder instability

screws positioning

MRI evaluation

hillsacs examination

arthroscopic procedure

posterior capsular tear

labral repair