Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Apr 17;14(4):e24198.
doi: 10.7759/cureus.24198. eCollection 2022 Apr.

Complex Posterior Glenohumeral Instability Case Management

Rony H Melhem  1 , Eliane K Doumith  2 , Marc Soubeyrand  3
Affiliations
Case Reports

Complex Posterior Glenohumeral Instability Case Management

Rony H Melhem et al. Cureus. .

Abstract

A 21-year-old male patient suffering from insidious shoulder instability from neurogenic and structural attenuation of shoulder stabilizer, due to old minor cerebrovascular accident, presented with a two-year history of repetitive shoulder dislocation, operated by fixing the biceps tendon to its insertion on the superior labrum, correction of the glenoid version and reattaching the subscapular tendon along with a new technique for stabilization of the shoulder replicating the coracohumeral ligament with a ligament advanced reinforcement system (LARS) transplant. Following structured physical therapy, our patient returned to normal daily activities at 15 months.

Keywords: coracohumeral ligament; glenohumeral joint; labrum; posterior shoulder instability; surgical technique.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Standard X-ray showing an absence of congruence of the glenohumeral joint upon abduction of the arm
Figure 2
Figure 2. MRI scan showing a significant reverse Bankart lesion with a loose subscapularis tendon
Figure 3
Figure 3. CT scan showing glenoid dysplasia with a loss of posteroinferior concavity with 28 degrees of retroversion
Figure 4
Figure 4. X-rays showing posterior dislocation of the right shoulder 15 days after the intervention.
Figure 5
Figure 5. CT scan showing the tunnel drilled in the humeral head to pass the transplant
Figure 6
Figure 6. Image showing the LARS transplant passing through the humeral head drilled tunnel
A) LARS transplant, B) humeral head LARS - ligament advanced reinforcement system
Figure 7
Figure 7. Image showing the LARS transplant tied around the conjoint tendon
A) detached subscapularis tendon, B) conjoint tendon LARS - ligament advanced reinforcement system
Figure 8
Figure 8. X-ray showing a congruent shoulder joint
See this image and copyright information in PMC

References

    1. Rehabilitation for shoulder instability. Jaggi A, Lambert S. Br J Sports Med. 2010;44:333–340. - PubMed
    1. Posterior shoulder instability in the athletic population: variations in assessment, clinical outcomes, and return to sport. DeLong JM, Bradley JP. World J Orthop. 2015;6:927–934. - PMC - PubMed
    1. Posterior-inferior capsular shift for the treatment of recurrent, voluntary posterior subluxation of the shoulder. Fuchs B, Jost B, Gerber C. J Bone Joint Surg Am. 2000;82:16–25. - PubMed
    1. Thoracohumeral muscle activity alters glenohumeral joint biomechanics during active abduction. Konrad GG, Jolly JT, Labriola JE, McMahon PJ, Debski RE. J Orthop Res. 2006;24:748–756. - PubMed
    1. Muscle activity and coordination in the normal shoulder. An electromyographic study. Kronberg M, Nemeth G, Brostrom LA. https://europepmc.org/article/med/2379377 Clin Orthop Relat Res. 1990;257:76–85. - PubMed

Publication types

LinkOut - more resources