Posterior (backwards) dislocation of the shoulder is becoming increasingly common.
An innovative arthroscopic procedure has been developed by the St. George’s Shoulder Unit. This has been published in the leading journal of arthroscopy -Arthroscopy Techniques.
The technique has been widely acclaimed by surgeons nationally and internationally as an elegant solution to an often difficult surgical problem.
Duncan Tennent, F.R.C.S.(Orth),* Chiara Concina, M.D., and Eyiyemi Pearse, F.R.C.S.(Orth)
Arthroscopic Posterior Stabilization of the Shoulder Using a Percutaneous Knotless Mattress Suture Technique
Arthrosc Tech. Feb 2014; 3(1): e161–e164.
Posterior shoulder instability is far less common than anterior instability, and its arthroscopic treatment can be technically demanding. We describe a percutaneous arthroscopic technique for posterior shoulder stabilization using mattress sutures and knotless anchors. Spinal needles are used to pass the sutures percutaneously in a mattress fashion. Knotless anchors are used to secure the sutures under the labrum. These anchors can be used without cannulas, giving easier access to the posterior glenoid. This procedure is simple, cost-effective, and safe, avoiding the presence of both knots and suture strands in contact with the humeral head.
Posterior Labral Repair
Metallosis and Cutaneous Pigmentation in Reverse Shoulder Arthroplasty
Shoulder & Elbow 5(3) 195-197
Metallosis with an associated cutaneous pigmentation as a result of metal dispersion has not been reported in the literature. A case is described in a patient who developed an extensive metallosis that presented with cutaneous pigmentation 8 years after a reverse shoulder replacement.
Procedure Based Assessments in Shoulder and Elbow surgery
Shoulder & Elbow 5(2) 73-77 2013
The United Kingdom Trauma and Orthopaedic curriculum, containing procedure-based assessment (PBA) was the first surgical curriculum to be published in the world. PBA are used as a record of the training experience and, over time, provides a summative record of the trainees progress in developing their competence in learning procedures and performing them to the required standard. The original 14 index procedures did not include the majority of those performed in the upper limb. The Education Committee of the British Shoulder and Elbow Society undertook to produce PBA that were relevant to their trainees. The present review describes the process by which these were developed and implemented with the aim of helping both those who use PBA and those who may be considering developing them in the future.
Tennent, Duncan; Pitts, David; Foote, Julian
Thomas D. Tennent, Eyiyemi O. Pearse, Deborah M. Eastwood,
A New Technique For Stabilising Adolescent Posteriorly displaced Medial Physeal Clavicular Fractures
Journal of Shoulder and Elbow Surgery, Volume 21, Issue 12, December 2012, Pages 1734-1739,
Adolescent posteriorly displaced physeal injuries of the medial clavicle are uncommon. Up to 50% of conservatively treated patients remain symptomatic, and late surgery is hazardous. Stability is rarely achieved with closed or open reduction alone, and internal fixation is usually required. Previously described options for fixation achieve stability of the medial clavicle by securing it to the intact epiphysis. Because the epiphyseal fragment is small, fixation is achieved using sutures or wires. This relies on the size and structural integrity of the medial fragment, which in our experience can be variable. We hypothesized that a novel technique of operative stabilization of these injuries, which does not require fixation to the epiphyseal fragment and uses no metalwork, is safe and effective in treating these injuries.
Materials and methods
The operative technique involves suturing the medial clavicle to the anterior platysmal and periosteal layer using absorbable sutures passed through drill holes in the medial clavicle. Patients were assessed clinically an average of 9 months after surgery.
We treated 7 patients with this method. There were no intraoperative complications. All patients were pain-free and symptom-free and had a full range of movement at follow-up. All patients had returned to their preinjury level of sports.
We recommend this technique for treating these uncommon injuries. It is simple, safe, and reproducible and it produces good results.