POSTER ABSTRACTS - ISAKOS

portal. He described this portal as bordered by
the clavicle, the acromioclavicular joint and the
spine of the scapula. A cannula was inserted 15-
20 degrees from vertical aimed laterally and 15
degrees anteriorly. The authors will demonstrate
their technique and review the anatomy of this
portal. The Neviaser portal is illustrated as an
important working portal and not merely for
inflow or outflow. Additionally, by not using a
cannula, a much smaller hole is produced in the
rotator cuff. By placing the arm at 30 degrees of
abduction, the track is through the muscle and
not through the tendon. This further protects the
rotator cuff tendon during SLAP repair. The
authors will demonstrate that this is a safe and
easy technique for SLAP repair.
E-poster #903
Further Classification of SLAP Tears(Superior
Labrum Anterior Posterior)
Keith D. Nord, Jackson, TN, USA, Presenter
Richard K.N. Ryu, Santa Barbara, CA USA
Sports, Orthopedics & Spine, Jackson, TN, USA
The superior labrum anterior posterior (SLAP)
lesion was described by Snyder et al in 1990, as an
injury of the superior glenoid labrum that begins
posteriorly and extends anteriorly stopping at the
mid-glenoid notch. SLAP lesions are classified
into seven subtypes based upon morphologic
pattern and involvement of the biceps brachii
tendon. Type I lesions are associated with
degenerative tears or fraying of the superior
glenoid labrum without the detachment of the
biceps tendon. Type II lesions, the most common
type of SLAP lesions, are associated with the
detachment of the superior labrum at the biceps
tendon anchor. Type II lesions are subsequently
divided into three subtypes depending the
location of the detached labrum i.e. anterior,
posterior, or both. Type III lesions involve a
bucket-handle tear of the superior labrum without
the involvement of the biceps tendon. Type IV
lesions are described as a bucket-handle tear of
the superior aspect of the labrum with a tear that
extends into the biceps tendon. Portions of the
biceps tendon tend to displace with the labral flap
into the joint. Maffet et al described Type V, Type
VI, and Type VII lesions that did not fit into the
standard four lesions presented by Snyder et al.
Type V lesions are associated with continuation of
a Bankart detachment superiorly to involve the
anterosuperior labrum and the biceps anchor. A
Type VI lesion is a biceps tendon separation
accompanied by either an anterior- or posteriorbased
flap tear of the superior labrum. A Type VII
lesion involves an extension of the biceps tendon
superior labrum separation anteriorly to the area
below the middle glenohumeral ligament. The
authors present their experience and introduce
the classification for three additional types of
SLAP lesions. A type VIII lesion involves a
superior labral tear with extension as far as 6
O'clock, a type IX lesion involves the continuation
of the SLAP tear entirely around the glenoid and
Type X involves a posterior inferior labral tear
associated with a Type II SLAP tear. Classification
and treatment of each type of SLAP lesion will be
reviewed.
E-poster #904
A Capsular Distention to Facilitate Shoulder
Manipulation in Patients with Frozen Shoulder
Somsak Kuptniratsaikul, Bangkok, THAILAND,
Presenter
Chulalongkorn University Hospital, Bangkok,
THAILAND
Abstract
Eighty patients with a diagnosis of frozen
shoulder who had symptom for an average of 8
months and failed conservative treatment of at
least 6 weeks of physical therapy were treated with
capsular dilatation facilitated shoulder
manipulation. Post-manipalation, the patient
underwent arthroscopy for visualization, fibrin
debridement and bleeding point coagulation. All
the essential intra-articular structures ie,
glenohumeral ligament, rotator cuff were intact.
Post-operatively, all patients revealed substantial
gain in shoulder range of motion as well as
diminished shoulder pain. The average flexion,
abduction, and internal rotation gain wee
77.8+7.2, 17.5+5.7, 9.5+7.2degrees respectively.
External rotation gain in the position of 90
degrees shoulder abduction and shoulder
adduction were 55.3+9.2and 32.5+6.9degrees
respectively. The average pain score by visual
analogue scale pre and 6-month postmanipulation
were 81.2+8.2and
7.8+6.6respectively with the average of pain score
of 75.2+8.7. The authors proposed an effective and
safe technique employing intra-articular pressure
to facilitate shoulder manipulation in order to
treat frozen shoulder.
The correlation coefficient between intra-articular
volume and pressure was proposed for