Saturday, September 19, 2015

SLAP tears and paralabral cysts

Paralabral cysts associated with SLAP lesions are frequent findings on MRI of the shoulder. They can be addressed either with direct decompression or by a repair of the SLAP lesion alone. If there is no history of trauma or the patient is older then clinical followup without surgery is the approach of choice. If they produce pain or weakness and are associated with traumatic labral tears then decompression and repair of the SLAP tear is the debridement of choice. Below please see a case that was approached with decompression using percutaneous arthroscopic technique and an 18G spinal needle. Repair of the SLAP lesion is necessary in these cases for the treatment of pain and avoidance of recurrence of the cyst.







Tuesday, September 8, 2015

Deja vu. 2011 and 2015

In 2011, we published a study highlighting the need to reconsider using the term of "shoulder impingement" Link

 In August of 2015 the JBJS published a commentary about the classic article published by Charles Neer on acromioplasty. Link

We are glad that the leadership of the Journal of Bone and Joint Surgery adopts our suggestion to stop using the term.

Attached please see the last paragraph from the "Classics documentary"

Neer’s hypothesis that impingement caused most rotator cuff tears does not appear to have withstood the test of time, however. Arthroscopy and magnetic resonance imaging arthrography have elucidated many other conditions that cause shoulder pain that were previously misdiagnosed as impingement. Consequently, the liberal use of acromioplasty to treat “impingement” is being replaced by a trend toward making an anatomic diagnosis, such as a partial or complete tear of the rotator cuff, and performing aggressive rehabilitation prior to corrective surgery.