Osteochondral defects
Definition
Defect of cartilage +/bone
Typically on talus
Options
Defect of cartilage +/bone
Typically on talus
Inflammation and degeneration of the achilles tendon in the midsubstance 2 - 6 cm from insertion
Chronic lateral trochanteric pain
- abductor tendon tendonitis
- trochanteric bursitis
Women 40 - 60 years old
? repetitive friction of iliotibial tract over GT
Pain over upper lateral thigh with activity
- often related to hip flexion
1. Open antero-lateral approach
Large / Massive Cuff Tear
2. Deltopectoral approach
Large Subscapularis tear
3. Arthroscopic Assisted Mini-open
Indication
- Small / Moderate Cuff Tear < 3cm
- no retraction
Technique
- arthroscopic SAD
Pain & Stiffness
- often more pain than FT tears
Bursal side tears more painful than articular
Articular side more common
May see in young patient overhead throwing
Painful arc
Impingement signs
No weakness
- function good
Full thickness tear (FTT)
- variable amount retraction from insertion
Partial thickness tear (PTT)
- incomplete
- bursal or articular sided
Idiopathic inflammatory condition
- characterised by progressive shoulder pain & stiffness
- due to contracture of capsuloligamentous structures
- spontaneously resolves
2% incidence
- 40 - 60 years
- Women 2:1
Sedentary workers
- Non-dominant limb
Bilateral in 10 - 40%
Lateral : Medial 9:1
4th & 5th decades
- M = F
- 75% dominant arm
50% of regular tennis players
- especially > 2 hrs / week
Insertion pathology / Enthesopathy
Over-extension of the elbow with supination / pronation
Lateral epicondyle
- anconeus from posterior face
- ECRB and EDC from anterior face (CEO)