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What is an Alpsa lesion?

What is an Alpsa lesion?

An ALPSA lesion refers to a detachment of the anteroinferior labrum from the glenoid. The scapular periosteum is unruptured but widely lifted or stripped. The labrum remains attached to the periosteum and can rotate medially to a position along the anterior surface of the scapular neck.

Can Bankart lesion heal without surgery?

Bankart lesions may be treated through conservative methods such as rest, immobilization and physical therapy, particularly in older patients. However, many cases require surgery to reattach the torn labrum to the socket of the shoulder.

What is periosteal sleeve avulsion?

Anterior labrum periosteal sleeve avulsion (ALPSA) is the avulsion of the labrum and of the non-disrupted periosteum with the subsequent healing of the labrum in a medialized nonfunctional position on the glenoid neck.

What is a glad lesion in shoulder?

A GLAD (glenolabral articular disruption) lesion is caused by a forced adduction injury to the shoulder from an abducted and external rotated position; patients with GLAD lesions present with anterior shoulder pain as their chief complaint.

What is an Alpsa?

An ALPSA (anterior labral periosteal sleeve avulsion) lesion is an injury at the front of the shoulder associated with shoulder dislocation.

What is Remplissage procedure?

Remplissage is an arthroscopic procedure that insets the posterior shoulder capsule and infraspinatus tendon into the Hill-Sachs defect, converting the intra-articular location of the defect to an extra-articular one.

How long does a Bankart repair surgery take?

‍The arthroscopic Bankart repair is performed under a general anaesthetic. The surgery takes about an hour. You will be in the operating theatre complex for several hours as you need to be prepared for anaesthesia and then will need to wake up from the anaesthetic. Normally patients stay one night in hospital.

How much does Bankart surgery cost?

Results: The incremental cost-effectiveness ratio (ICER) for arthroscopic bankart versus non-operative treatment was $43,500. The estimated cost of surgical treatment must increase from approximately $11,000 to over $24,000 for surgery to no longer be cost-effective.

What is Kim lesion?

Kim lesions are superficial tears between the posterior glenoid labrum and glenoid articular cartilage without labral detachment. Failure to identify and treat this lesion may lead to permanent posterior instability.

What is a Bennett lesion?

A Bennett lesion is a bony spur at the posterior glenoid that is often seen in baseball players and usually asymptomatic. However, it sometimes becomes painful, but the mechanism of throwing pain is still unknown.

What is a bony Bankart lesion?

An osseous Bankart lesion is commonly seen in patients with an anterior shoulder dislocation. It is defined as a detachment of the anteroinferior labrum associated with a glenoid rim fracture. Radiological studies are crucial not only for detecting glenoid bone defects but also for measuring the amount of bone loss.

What is a Remplissage repair?

Remplissage is a French term that means “To Fill the Defect”. Thus in this procedure an additional pair of anchors are placed into the Hill-Sachs lesion and the infraspinatus rotator cuff tendon is repaired into the defect to fill the defect. This serves as a checkrein to prevent any further anterior instability.

What kind of injury causes an ALPSA lesion?

It is often the result of chronic injury rather than acute dislocation; the incidence of ALPSA lesions increases in patients with multiple dislocations. An ALPSA lesion refers to a detachment of the anteroinferior labrum from the glenoid. The scapular periosteum is unruptured but widely lifted or stripped.

Can a Bankart or ALPSA lesion heal?

As a result, an ALPSA lesion may heal (as opposed to a Bankart lesion which does not), however it can do so in an abnormal position requiring identification and early surgical repair.

How is the anterior labroligamentous periosteal sleeve avulsion treated?

An arthroscopic technique that converts the ALPSA lesion to a Bankart lesion and subsequently reconstructs the supporting anterior inferior structures of the shoulder has been successful in 26 cases (4 acute and 22 chronic) which were followed for > or = 2 years. Only one dislocation occurred, and it was the result of severe trauma.