ARTHROSCOPIC SHOULDER INSTABILITY SURGERY : Complications - 08/09/11
Résumé |
“Those diseases which medicines do not cure, iron [scalpel] cures; those which iron cannot cure, fire [thermal devices] cures; and those which fire cannot cure, are to be reckoned wholly incurable.”
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— HIPPOCRATES 400 BCE1
In the nearly 2 decades since Johnson's37, 77 pioneering efforts to arthroscopically correct shoulder instability, arthroscopic stabilization has received considerable attention. But despite the potential advantages of cosmesis, preservation of motion, and improved function, outcomes following arthroscopic stabilization have lagged behind expectations, with recurrence rates consistently higher than the 2% to 5% failure rate reported following open repairs.53, 56, 103, 134, 172 Other complications, including nerve injury, articular damage, stiffness, loose and migrating hardware, and foreign body reactions, are much less common and do not usually result in permanent disability. Complications are frequently technique-specific and can be prevented by familiarity with the common pitfalls inherent in each arthroscopic repair procedure. Complications can be further minimized through familiarity with normal, variational, and pathologic shoulder anatomy. This article reviews the documented complications of arthroscopic shoulder stabilization and emphasizes their causes and the strategies by which they may be minimized or avoided. Because most clinical experience and literature reviews involve the treatment of patients with anterior and anterior-inferior shoulder instability, the focus of this discussion is on errors and complications of these instability patterns.
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| Address reprint requests to Benjamin Shaffer, MD, Department of Orthopaedics, Georgetown University Medical Center, 3800 Reservoir Road NW, Washington, DC 20007 |
Vol 18 - N° 4
P. 737-767 - octobre 1999 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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