1
|
Chechik O, Maman E, Kazum E, Grunstein A, Ben-Shabat D, Lin R, Efrima B, Factor S, Rotman D, Krespi R, Dolkart O, Rosenthal R. Self-reduction techniques taught via smartphone are effective for anterior shoulder dislocation: prospective randomized study. Knee Surg Sports Traumatol Arthrosc 2021; 29:2338-2341. [PMID: 33033846 DOI: 10.1007/s00167-020-06310-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To prospectively compare the effectiveness of three methods for self-assisted shoulder reduction demonstrated using a smartphone video link. BACKGROUND Anterior shoulder dislocation is very common among young adults. Patients often seek medical assistance in the emergency department to reduce their shoulder. Many techniques for shoulder reduction had been described, some of which do not require professional assistance and can be performed by patients themselves. METHODS Patients admitted with anterior shoulder dislocation were randomized to either the Stimson, Milch or the Boss-Holtzach-Matter technique. Each patient was given a link to watch a short instructional video on his smartphone and instructed to attempt self-reduction. Success of the reduction, pain level, patient satisfaction and complications were recorded. RESULTS The study cohort consisted of 58 patients (mean age was 31.6 (18-66, median = 27), 82% males, 88% right hand dominant). Success rate using Boss-Holtzach-Matter (10 of 19, 53%) and self-assisted Milch (11 of 20, 55%) were significantly higher than with the self-assisted Stimson method (3 of 19, 16%), p < 0.05. Pain levels improved from 8.4 (2-10) to 3.1 (0-10) following the reduction. Patient subjective satisfaction from the reduction attempt was 6.7 (0-10). No complications were observed. CONCLUSION Both the Self-assisted Milch and the Boss-Holtzach-Matter techniques are ideal for reduction of anterior shoulder dislocation without medical assistance. Both methods can be successfully performed without assistance or previous education and taught using an instructional video. LEVEL OF EVIDENCE Level II.
Collapse
Affiliation(s)
- Ofir Chechik
- Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel
| | - Eran Maman
- Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel
| | - Efi Kazum
- Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel
| | - Alon Grunstein
- Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel
| | - Dvir Ben-Shabat
- Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel
| | - Ran Lin
- Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel
| | - Ben Efrima
- Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel
| | - Shai Factor
- Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel
| | - Dani Rotman
- Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel
| | - Rafael Krespi
- Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel
| | - Oleg Dolkart
- Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel.
| | - Ron Rosenthal
- Shoulder Unit, Division of Orthopaedic Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel
| |
Collapse
|
2
|
Maman E, Dolkart O, Krespi R, Kadar A, Mozes G, Safran O, Mozes A, Pritsch M, Vogel G, Beyth S, Chechik O, Oran A, Klein H. A Multicenter Retrospective Study With a Minimum 5-Year Follow-up Comparing Arthroscopic Bankart Repair and the Latarjet Procedure. Orthop J Sports Med 2020; 8:2325967120941366. [PMID: 32923495 PMCID: PMC7453470 DOI: 10.1177/2325967120941366] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/12/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Arthroscopic Bankart repair (ABR) and the Latarjet procedure are surgical techniques commonly used to treat anterior shoulder instability. There is no consensus among shoulder surgeons regarding the indications for choosing one over the other. Purpose: To compare the results of the Latarjet procedure with those of ABR for the treatment of anterior shoulder instability. Study Design: Cohort study; Level of evidence, 3. Methods: Data on all patients who were treated surgically for recurrent anterior shoulder instability between 2006 and 2011 were retrospectively collected at 4 medical centers. The minimum follow-up was 5 years. Data were retrieved from medical charts, and patients were interviewed to assess their level of satisfaction (range, 0-100), functional outcomes (using the American Shoulder and Elbow Surgeons shoulder score; the Subjective Shoulder Value; and the Disabilities of the Arm, Shoulder and Hand score), and quality of life (using the 12-Item Short Form Health Survey [SF-12]). Information on return to sports activities and postoperative level of activity compared with that of the preinjury state, complications, reoperations, and recurrent instability were recorded and evaluated. Results: A total of 242 patients were included. The Latarjet procedure was performed in 27 shoulders, and ABR was performed in 215 shoulders. Patients in the ABR group had significantly higher rates of redislocation (18.5%; P = .05) and subluxation (21.4%; P = .43) but a lower rate of self-reported apprehension (43.0%; P = .05) compared with patients in the Latarjet group (3.7%, 14.8%, and 63.0%, respectively). There were 5 patients in the ABR group who underwent reoperation with the Latarjet procedure because of recurrent instability. The functional scores in the Latarjet group were better than those in the ABR group. The SF-12 physical score was significantly better in the Latarjet group than in the ABR group (98.1 vs 93.9, respectively; P = .01). Patient satisfaction and subjective scores were similar in both groups. Conclusion: These results support recently published data on the Latarjet procedure that showed its superiority over ABR in midterm stability (dislocations or subluxations). The contribution of self-reported apprehension to the broad definition of stability is not clear, and apprehension rates were not correlated with satisfaction scores or the recurrence of dislocation or subluxation.
Collapse
Affiliation(s)
- Eran Maman
- Investigation performed at the Shoulder Unit, Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Oleg Dolkart
- Investigation performed at the Shoulder Unit, Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Rafael Krespi
- Investigation performed at the Shoulder Unit, Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Assaf Kadar
- Investigation performed at the Shoulder Unit, Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Gabriel Mozes
- Investigation performed at the Shoulder Unit, Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ori Safran
- Investigation performed at the Shoulder Unit, Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Adam Mozes
- Investigation performed at the Shoulder Unit, Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Moshe Pritsch
- Investigation performed at the Shoulder Unit, Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Guy Vogel
- Investigation performed at the Shoulder Unit, Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shaul Beyth
- Investigation performed at the Shoulder Unit, Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ofir Chechik
- Investigation performed at the Shoulder Unit, Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - Ariel Oran
- Investigation performed at the Shoulder Unit, Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Hagai Klein
- Investigation performed at the Shoulder Unit, Division of Orthopedic Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| |
Collapse
|