Hannan Mullett – Featured Author in American Journal of Sports Medicine.
Welcome to ‘On the Table’ – Sports Surgery Clinic’s first orthopaedic advances podcast hosted by Dr Andy Franklyn-Miller.
In Episode One, we are delighted to speak to Mr Hannan Mullet, Consultant Orthopaedic Surgeon and Honorary Senior Lecturer at The Royal College of Surgeons Ireland.
This episode focuses on the topic of shoulder dislocation and the best practice evidence in its management.
In this paper we analysed the mechanism of injury sustained by rugby players. We sourced videos involving elite rugby players.We identified 4 distinct injury mechanisms. The previously described mechanisms ‘‘try scorer,’’ ‘‘tackler,’’ and ‘‘direct impact’’ were identified in 67% of cases. We describe a new injury mechanism occurring in the ‘‘poach position,’’ accounting for 18% of all shoulder dislocations studied.
We performed a randomized control trial to look at the effect of a simple safe drug ( tramexamic acid- TXA) on the effect on pain and bleeding following Latarjet procedure ( type of shoulder stabalisation) .
In this meta-analysis of return to sport following reverse geometry shoulder replacement we demonstrated a high rate of return to play in a group of generally older patients ( average 74.2 years). Patients generally got back to golf, cycling, jogging with a lower rate (50%) getting back to overhead soprts such as tennis
We looked at a group of patients where we had performed arthroscopic stabalisation in combination with a subpectoral tenodesis .Patients undergoing arthroscopic Bankart repair combined with open subpectoral biceps tenodesis had a high rate of return to play with a low rate of recurrent instability.
We reviewed 12 papers which included patients who had had a remplissage procedure in addition to arthroscopic labral repair for shoulder instability. All of the patients had a Hill Sachs lesion . We found the addition of the remplissage reduced the risk of redislocation in this group
In this study we looked at 34 shoulders of female patients we had operated on .Female patients with anterior shoulder instability treated with arthroscopic Bankart repair have low recurrence rates, with good patient-reported outcomes and high satisfaction rates. Of those participating in sport prior to surgery, there was a high rate of return to play. The overall rate of complications was low, with a low rate of revision surgery
Our network meta-analysis found the open Latarjet procedure had the lowest recurrence rates, lowest revisions rates, and highest rates of return to play in the surgical treatment of anterior shoulder instability. However, the Latarjet procedure has been shown to result in a higher complication rate, which needs to be considered when decid- ing which stabilization procedure to perform.
In this meta analysis study of 7 clinical trials including 598 patients we compared arthroscopic (keyhole) versus open biceps tenodesis . We found that both techniques had excellent clinical outcomes with no differences between either method