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Arthroscopy is a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope, an endoscope that is inserted into the joint through a small incision. Arthroscopic procedures can be performed during ACL reconstruction.
The humerus is a long bone in the arm that runs from the shoulder to the elbow. It connects the scapula and the two bones of the lower arm, the radius and ulna, and consists of three sections. The humeral upper extremity consists of a rounded head, a narrow neck, and two short processes. The body is cylindrical in its upper portion, and more prismatic below. The lower extremity consists of 2 epicondyles, 2 processes, and 3 fossae. As well as its true anatomical neck, the constriction below the greater and lesser tubercles of the humerus is referred to as its surgical neck due to its tendency to fracture, thus often becoming the focus of surgeons.
Shoulder problems including pain, are one of the more common reasons for physician visits for musculoskeletal symptoms. The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. This instability increases the likelihood of joint injury, often leading to a degenerative process in which tissues break down and no longer function well.
The human shoulder is made up of three bones: the clavicle (collarbone), the scapula, and the humerus as well as associated muscles, ligaments and tendons.
An arthrogram is a series of images of a joint after injection of a contrast medium, usually done by fluoroscopy or MRI. The injection is normally done under a local anesthetic such as Novocain or lidocaine. The radiologist or radiographer performs the study using fluoroscopy or x-ray to guide the placement of the needle into the joint and then injects around 10 ml of contrast based on age. There is some burning pain from the anesthetic and a painful bubbling feeling in the joint after the contrast is injected. This only lasts 20 – 30 hours until the Contrast is absorbed. During this time, while it is allowed, it is painful to use the limb for around 10 hours. After that the radiologist can more clearly see what is going on under your skin and can get results out within 24 to 48 hours.
The shoulder joint is structurally classified as a synovial ball-and-socket joint and functionally as a diarthrosis and multiaxial joint. It involves an articulation between the glenoid fossa of the scapula and the head of the humerus. Due to the very loose joint capsule ,that gives a limited interface of the humerus and scapula, it is the most mobile joint of the human body.
The shoulder girdle or pectoral girdle is the set of bones in the appendicular skeleton which connects to the arm on each side. In humans, it consists of the clavicle and scapula; in those species with three bones in the shoulder, it consists of the clavicle, scapula, and coracoid. Some mammalian species have only the scapula.
Osteochondritis dissecans is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. OCD usually causes pain during and after sports. In later stages of the disorder there will be swelling of the affected joint that catches and locks during movement. Physical examination in the early stages does only show pain as symptom, in later stages there could be an effusion, tenderness, and a crackling sound with joint movement.
A SLAP tear or SLAP lesion is an injury to the superior glenoid labrum that initiates in the back of the labrum and stretches toward the front into the attachment point of the long head of the biceps tendon. SLAP is an acronym for "Superior Labrum Anterior and Posterior". SLAP lesions are commonly seen in overhead throwing athletes but middle-aged labor workers can also be affected, and they can be caused by chronic overuse or an acute stretch injury of the shoulder.
The glenoid fossa of the scapula or the glenoid cavity is a bone part of the shoulder. The word glenoid is pronounced or and is from Greek: gléne, "socket", reflecting the shoulder joint's ball-and-socket form. It is a shallow, pyriform articular surface, which is located on the lateral angle of the scapula. It is directed laterally and forward and articulates with the head of the humerus; it is broader below than above and its vertical diameter is the longest.
The glenoid labrum is a fibrocartilaginous structure attached around the rim of the glenoid cavity on the shoulder blade. The shoulder joint is considered a ball-and-socket joint. However, in bony terms the 'socket' is quite shallow and small, covering at most only a third of the 'ball'. The socket is deepened by the glenoid labrum, stabilizing the shoulder joint.
A dislocated shoulder is a condition in which the head of the humerus is detached from the glenoid fossa. Symptoms include shoulder pain and instability. Complications may include a Bankart lesion, Hill-Sachs lesion, rotator cuff tear, or injury to the axillary nerve.
Shoulder surgery is a means of treating injured shoulders. Many surgeries have been developed to repair the muscles, connective tissue, or damaged joints that can arise from traumatic or overuse injuries to the shoulder.
A Bankart lesion is a type of shoulder injury that occurs following a dislocated shoulder. It is an injury of the anterior (inferior) glenoid labrum of the shoulder. When this happens, a pocket at the front of the glenoid forms that allows the humeral head to dislocate into it. It is an indication for surgery and often accompanied by a Hill-Sachs lesion, damage to the posterior humeral head.
A Hill–Sachs lesion, or Hill–Sachs fracture, is a cortical depression in the posterolateral head of the humerus. It results from forceful impaction of the humeral head against the anteroinferior glenoid rim when the shoulder is dislocated anteriorly.
Hip arthroscopy refers to the viewing of the interior of the acetabulofemoral (hip) joint through an arthroscope and the treatment of hip pathology through a minimally invasive approach. This technique is sometimes used to help in the treatment of various joint disorders and has gained popularity because of the small incisions used and shorter recovery times when compared with conventional surgical techniques. Hip arthroscopy was not feasible until recently, new technology in both the tools used and the ability to distract the hip joint has led to a recent surge in the ability to do hip arthroscopy and the popularity of it.
Perthes lesion is a variant of Bankart lesion, presenting as an anterior glenohumeral injury that occurs when the scapular periosteum remains intact but is stripped medially and the anterior labrum is avulsed from the glenoid but remains partially attached to the scapula by intact periosteum.
Humeral avulsion of the glenohumeral ligament (HAGL) is defined as an avulsion of the inferior glenohumeral ligament from the anatomic neck of the humerus. In other words, it occurs when we have disruption of the ligaments that join the humerus to the glenoid. HAGL tends to occur in 7.5-9.3% of cases of anterior shoulder instability. Making it an uncommon cause of anterior shoulder instability. Avulsion of this ligamentous complex may occur in three sites: glenoid insertion (40%), the midsubstance (35%) and the humeral insertion (25%). Bony humeral avulsion of the glenohumeral ligament (BHAGL) refers when we have HAGL with bony fracture.
The Latarjet operation, also known as the Latarjet-Bristow procedure, is a surgical procedure used to treat recurrent shoulder dislocations, typically caused by bone loss or a fracture of the glenoid. The procedure was first described by French surgeon Dr. Michel Latarjet in 1954.
An acetabular labrum tear or hip labrum tear is a common injury of the acetabular labrum resulting from a number of causes including running, hip dislocation, and deterioration with ageing. Most are thought to result from a gradual tear due to repetitive microtrauma.
References
- 1 2 3 4 Sanders TG, Tirman PF, Linares R, Feller JF, Richardson R (January 1999). "The glenolabral articular disruption lesion: MR arthrography with arthroscopic correlation". American Journal of Roentgenology. 172 (1): 171–5. doi:10.2214/ajr.172.1.9888763. PMID 9888763.
- ↑ Singh, Ranjeet B; Hunter, John C; Smith, Kevin L (2003). "Mri of shoulder instability: state of the art". Current Problems in Diagnostic Radiology. 32 (3). Elsevier BV: 127–134. doi:10.1016/s0363-0188(03)00014-8. ISSN 0363-0188. PMID 12783081.
- ↑ Antonio, Gregory E.; Griffith, James F.; Yu, Alfred B.; Yung, Patrick S.H.; Chan, Kai Ming; Ahuja, Anil T. (September 25, 2007). "First-time shoulder dislocation: High prevalence of labral injury and age-related differences revealed by MR arthrography". Journal of Magnetic Resonance Imaging. 26 (4). Wiley: 983–991. doi:10.1002/jmri.21092. ISSN 1053-1807. PMID 17896393.
- 1 2 3 Neviaser, Thomas J. (1993). "The GLAD lesion: Another cause of anterior shoulder pain". Arthroscopy: The Journal of Arthroscopic & Related Surgery. 9 (1). Elsevier BV: 22–23. doi:10.1016/s0749-8063(05)80339-1. ISSN 0749-8063. PMID 8442825.
- ↑ Hay, Bruce; Fraser-Moodie, James A. (January 23, 2023). "Glenolabral Articular Disruption (GLAD)". StatPearls Publishing. PMID 36943956. Archived from the original on May 7, 2024. Retrieved January 2, 2024.
- ↑ Chang, Lou-Ren; Anand, Prashanth; Varacallo, Matthew (August 8, 2023). "Anatomy, Shoulder and Upper Limb, Glenohumeral Joint". StatPearls Publishing. PMID 30725703. Archived from the original on January 6, 2024. Retrieved January 2, 2024.
- 1 2 Robinson, G.; Ho, Y.; Finlay, K.; Friedman, L.; Harish, S. (2006). "Normal anatomy and common labral lesions at MR arthrography of the shoulder". Clinical Radiology. 61 (10). Elsevier BV: 805–821. doi:10.1016/j.crad.2006.06.002. ISSN 0009-9260.