Cedars-Sinai Kerlan-Jobe Institute

Shoulder Institute

Home

Our Physicians

FAQ's

Patient Forms

Game Ready

Patient Education

AC Joint Arthritis

AC Joint Separations

Adhesive Capsulitis

Anatomy

Biceps Tendinitis

Burners and Stingers

Bursitis / Tendinitis

Calcific Tendinitis

Cervical Spine

Clavicle Fractures

Labral Tears

Rotator Cuff Tears

Shoulder Arthritis

Shoulder Arthroscopy Info

Shoulder Dislocations

STOP Sports Injuries

Yoga Injury Prevention

Post-Op Rehabilitation

Biceps Tenodesis Rehab

Instability Rehab

Irreparable Cuff Tears

Knapp Sak II

Labral Tear Rehab

My Therapy Exercises

Pendulum & Pulleys

Post-Op Instructions

Post-Op Shoulder Exercise

Post Capsule Stretches

Rotator Cuff Rehab

KJI HIPAA Privacy Policy

KJI Pain Program

Locations

Sports Medicine Fellows

Fellowship Information

Fellowship Info Videos

Fellows List

Interesting Shoulder Case

Videos

History

This is a 22 year old right-hand dominant male who had a history of recurrent anterior instability of his right shoulder. He had an open anterior stabilization procedure in 2003, and was pain-free and without instability symptoms until 2007. Over the past two years, however, he had several episodes of painful anterior subluxation. He had moderate pain at night and denied any numbness or tingling.


Physical Examination
This is a 6 feet 2 inch, 168 pound male. Cervical spine exam is benign. There is full range of motion with a negative Spurling’s sign. No abnormal swelling is noted. There is a negative sulcus sign. Thumb to forearm index is 2cm.

The right shoulder is well-muscled. There is a well-healed deltopectoral scar. Forward flexion is to 165 degrees with abduction to 165 degrees, external rotation is to 60 degrees with internal rotation to T6. Subscapularis push-off test is negative. Supraspinatus test is negative. Speed test is negative. O’Brien’s test is negative. Palpation reveals no areas of tenderness. Supine there are slightly positive impingement signs present. Supine abduction, external rotation is to 85 degrees with significant anterior apprehension and a positive relocation test. Supine abduction internal rotation is to 85 degrees. Resisted external rotation is negative. Abdominal press test is negative. Biceps 2 test is negative.


Studies

Right shoulder series includes AP, axillary and outlet views and shows a Type IIb acromion and three metal anchors in the glenoid.

Significant MRI series appear below. Click on thumbnails to enlarge.
.


Image: 
Diagnosis

Right shoulder recurrent instability due to capsular shift suture failure from previous open Bankart with capsular shift. Repaired arthroscopically with two #2 Orthocord sutures and 3 Lupine Loop BR anchors using 3 portals and Chia PercPasser.


Surgical Pictures
Image: