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Titre du document / Document title

Quantifying the extent of a type II SLAP lesion required to cause peel-back of the glenoid labmm- : A cadaveric study

Auteur(s) / Author(s)

SENEVIRATNE Aruna (1) ; MONTGOMERY Kenneth (1) ; BEVILACQUA Babette (1) ; ZIKRIA Bashir (1) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, New York, ETATS-UNIS

Résumé / Abstract

Purpose: To quantify the extent of labral disruption required to cause it to peel back when the peel-back test is performed. Methods: Ten cadaveric shoulders were prepared by removal of the deltoid and rotator cuff muscles. The glenohumeral joint was concentrically reduced and brought into 90° abduction and maximal external rotation. The peel-back of the labrum was graded 0, 1, or 2. The labrum was sequentially detached from the glenoid in the following order: biceps anchor only, 1 o'clock, 2 o'clock, 11 o'clock, and 3 o'clock positions. After each labral cut, the peel-back test was performed. Labral repair was performed with a single suture anchor placed at the 12:30 o'clock position; labral peel-back was reassessed. Results: A progressive increase was noted in peel-back grade with sequential cutting of the labrum posteriorly. However, disruption of the anchor alone did not lead to a positive peel-back sign. Disruption to the 2 o'clock position resulted in a positive peel-back sign overall in 9 of 10 shoulders (5 were grade 1, and 4 were grade 2). No increase was seen in peel-back grade with anterior extension of the labral detachment. Labral repair with a single anchor placed at the 12:30 o'clock position eliminated labral peel-back in 100% of shoulders. Conclusions: Detachment of the biceps anchor alone does not cause peel-back. The labrum must be disrupted to at least the 2 o'clock position before overt (grade 2) peel-back is observed. A single suture anchor placed at 12:30 o'clock eliminated peel-back of the labrum. Clinical Relevance: Validation of the peel-back test as an important diagnostic tool during shoulder arthroscopy.

Revue / Journal Title

Arthroscopy    ISSN  0749-8063   CODEN ARTHE3 

Source / Source

2006, vol. 22, no11, pp. 1163-1167 [5 page(s) (article)] (10 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1985) (Revue)

Mots-clés anglais / English Keywords

Endoscopy

;

Glenohumeral joint

;

Glenoid cavity

;

Orthopedic surgery

;

Treatment

;

Diseases of the osteoarticular system

;

Nuclear medicine

;

Diagnosis

;

Progressive

;

Repair

;

External

;

Rotator cuff

;

Deltoid muscle

;

Shoulder

;

Method

;

Lesion

;

Quantitative analysis

;

Surgery

;

Arthroscopy

;

Mots-clés français / French Keywords

Endoscopie

;

Articulation glénohumérale

;

Cavité glénoide

;

Chirurgie orthopédique

;

Traitement

;

Système ostéoarticulaire pathologie

;

Médecine nucléaire

;

Diagnostic

;

Progressif

;

Réparation

;

Externe

;

Coiffe rotateur

;

Muscle deltoïde

;

Epaule

;

Méthode

;

Lésion

;

Analyse quantitative

;

Chirurgie

;

Arthroscopie

;

Mots-clés espagnols / Spanish Keywords

Endoscopía

;

Cirugía ortopédica

;

Tratamiento

;

Sistema osteoarticular patología

;

Medicina nuclear

;

Diagnóstico

;

Progresivo

;

Reparación

;

Externo

;

Músculo deltoides

;

Hombro

;

Método

;

Lesión

;

Análisis cuantitativo

;

Cirugía

;

Artroscopia

;

Localisation / Location

INIST-CNRS, Cote INIST : 20604, 35400015890818.0050

Nº notice refdoc (ud4) : 18288586



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