REMPLISSAGE PROCEDURE IN RECURRENT ANTERIOR SHOULDER INSTABILITY

Abstract

The glenohumeral joint is a multiaxial joint of ball and socket type between the roughly hemispherical humeral head and shallow scapular glenoid fossa, an arrangement allowing much movement but reducing stability. Shoulder instability is one of the most important medical complications affecting the shoulder joint, which occurs due to disturbance of the anatomical stabilizing mechanisms Sev¬eral classification systems have been proposed for instability of the glenohumeral joint, generally based on the mechanism of injury (traumatic, non-traumatic) and the direc¬tion (anterior, posterior, inferior, and multidirectional), the frequency (acute and chronic), and degree (dislocation, subluxation). The assessment of shoulder instability can be done in several steps starting with history, physical examination which include the inspection (attitude, skin and muscle wasting), palpation (range of motion, strength tests, generalized joint laxity assessment and stability assessment), neurological examination, examination under anesthesia, X-Ray, CT, MRI, fluoroscopic imaging) but the direct visualization of the joint anatomy achieved during arthroscopy allows the final comprehension of the problem and the best strategy for its treatment. The treatment of primary acute shoulder dislocation consists of closed reduction, immobilization in a special sling or bandage for three to six weeks, followed by a rehabilitation program, consisting of exercises to strengthen the rotator cuff and scapular stabilizers.