575 Arthroscopy Cases Shoulder Part 3 - Intern Arthroscopy: Slap Tear and Instability скачать в хорошем качестве

575 Arthroscopy Cases Shoulder Part 3 - Intern Arthroscopy: Slap Tear and Instability

Presented by: Mary Lloyd Ireland Professor Dept. of Orthopaedic Surgery and Sports Medicine University of Kentucky Lexington KY www.marylloydireland.com 0:00 Introduction 0:35 Case 1 Chronic SLAP & Anterior Instability •24 YO Right hand dominant high school pitcher, boxer •History of 30 times shoulder slipping out of place in overhead positions •PE: anterior apprehension, labral click, pain and weakness in maximum rotation, arm 90 deg. abducted 1:13 Bucket handle tear, labrum Video 2:22 Scope posterior Video 3:22 Anterior-inferior glenoid preparation, labral debridement Video 4:30 Removal unstable SLAP tissue Video 5:19 Mobilization of anterior-inferior capsuloligamentous complex, labral debridement Video 6:33 Osseous raptor x3, 6 sutures Video 7:57 Post-repair, arthroscope posterior Video 8:56 Arthroscope anterior, debridement degenerative non-repairable posterior labrum Video 9:15 Arthroscope anterior Video 9:44 Scope anterior-superior portal, bumper stability re-established Video 10:40 Subscapularis bursa, common location of loose bodies Scope anterior-superior Video 11:17 Case 2 Subscapularis Tear & Anterior Instability •49 YO Right-hand dominant white female, homemaker •Right shoulder injury swinging basket full of clothes overhead •PE: Significant limitation of motion •Anterior apprehension •Positive O’Brien’s test •Weakness, ER Greater than IR 12:07 Scope posterior Video 13:03 Sublabral hole Video 14:16 Biceps normal, 10% upper subscapularis tear Scope posterior Video 14:56 Scope posterior Anterior-superior and anterior portals Video 15:39 SLAP labral repair, anchors x2, mattress sutures Video 16:20 Scope posterior, s/p subscap debridement Video 16:52 CONCLUSIONS •Practice makes better, never perfect •Practice, practice arthroscopy in the wet lab •Practice, practice knot-tying •Be ready to face complications in surgery