Prof Hannan Mullett

Education & Research

Education & Research

Educational Videos

 

 

 

 

Education & Research

Publications

01

Mesenteric Lymphangiomatous Cyst. Mullett H, Rahim A, Hegarty J, Sheehan K, Murphy JJ. Ir. J Med Sci. 1996 Oct-Dec; 165(4): 299.

02

Vascular Complication of Anterior Dislocation of Shoulder With Associated Brachial Plexus Injury. Mullett H, Babu J, McMahon B, Burke P Ir. J Med Sci. 1998 Jul-Sep; 167(3): 196.

03

Occupational Noise Levels in Orthopaedic Surgery Mullett H, Synnott K, Quinlan W Ir. J Med. Sci. 1999 Apr-Jun; 168(2): 106.

04

Use of the “S” Quattro Dynamic External Fixator in the Treatment of Difficult Hand Fractures Mullett H, Synnott K, Noel J, Kelly EP J Hand Surg [Br]. 1999 Jun; 24(3): 350-4.

05

Subchondral Talar Cyst Following Open Reduction and Internal Fixation of an Ankle Fracture Mullett H, Kennedy J.G, Quinlan W Foot and Ankle Surgery 1999 Vol. 4 147-149.

06

Fatigue Failure of an AO Spiral Blade Syed AA, Kennedy JG, Mullet H, O’Flanagan J, Taylor D Arch Orthop Trauma Surg 2000; 120(5-6): 366-8.

07

The Seidel Nail Revisited-An Evaluation of Recent Recent Design Change Mullett H, O’Donnell T, Butler P, Burke T Eur J Orthop Surg Traumatol (2000) 10: 211-213.

08

Cauda Equina Syndrome Kennedy J, Mullett H, O’Rourke K Current Concepts in Orthopaedics Vol. 11 (3): 192-195.

09

K-Wire Position in Tension Band Wiring of the Olecranon – A Comparison of Two Techniques. Mullett JH, Shannon F, Noel J, Lawlor G, Lee TC, O’Rourke SK INJURY. 2000 Jul; 31(6): 427-31.

10

Tension Band Wiring of Transverse Olecranon Fractures in the Elderly-Transcortical K-wires Prevent Backout Mullett H, Nöel J, Shannon F, O’Rourke S.K Eur J Orthop Surg Traumatol (2000) 10: 65-67.

11

Outcome Measures Following Metacarpophalangeal Joint Replacement. Synnott K, Mullett H, Faull H, Kelly EP J Hand Surg [Br]. 2000 Dec; 25(6): 601-3.

12

Fatigue Failure of an AO Spiral Blade Syed AA, Kennedy JG, Mullett H, O’Flanagan J, Taylor D Arch Orthop Trauma Surg. 2000 ; 120 (5-6): 366-8.

13

Successful Operative Treatment of Bilateral Clavicle Non-union Mullett H, Laing A, Curtin W INJURY 2001 Jan; 32 (1) 69-70.

14

Irish Patients Attitudes to Blood Transfusion McCarthy T, Mullett H, Carey M, Burke T Ir. J Med. Sci. 2001 May; 94 (4): 106.

15

Outcome of Compartment Syndrome Following Intramedullary Nailing of Tibial Diaphyseal Fractures. Mullett H, Al-Abed K, Prasad CV, O’ Sullivan M INJURY. 2001 Jun; 32(5): 411-3.

16

Cauda Equina Syndrome Kennedy JG, Mullett H, O’Rourke K Contemporary Spine Surgery 2001 April 2 (4) 23-27.

17

Subchondral Talar Cysts: Letter to the Editor Mullett H Foot and Ankle Surgery 2001 7:123.

18

Non-union of Capitate with Associated Tear of Triangular Fibrocartilage Complex Mullett H, Shannon F, Syaed A, Colville J Arch Orthop Trauma Surg. 2001 Jun; 121(6): 362-3.

19

Occipital Fixation: Effect of Inner Occipital Protuberance Alignment on Screw Position. Mullett JH, McCarthy P, O’Keefe D, McCabe JP J Spinal Disord. 2001 Dec;14(6):504-6.

20

Multiple Schwannomas of the Posterior Tibial Nerve Joyce M, Laing A, Mullett H, Mofidi A, Connolly C, McCabe J. Foot and Ankle Surgery 2002 (8) 1001-103.

21

Development of a Model for Occipital Fixation–Validation of an Analogue Bone Material. Mullett H, O’Donnell T, Felle P, O’Rourke K, FitzPatrick Proc Inst Mech Eng [H]. 2002; 216(1): 37-42.

22

Acute Osteomyelitis of the Talus O’Donnell T, Mullett H, Tansey C ,McCormack D. Foot and Ankle Surgery 2002; 8;67-70.

23

Unreamed Intramedullary Nail versus External Fixation in Grade III Open Tibial Fractures. Shannon FJ, Mullett H, O’Rourke K J Trauma. 2002 Apr; 52(4): 650-4.

24

Acupuncture-associated Arthritis in a Joint with an Orthopaedic Implant Laing A.J, Mullett H, Gilmore F.X Journal of Infection (2002) 44.43-51.

25

Segmental Femoral Cement Extraction at Revision Hip Arthroplasty-A Safe Technique Laing A, Mullett H, Curtin W Eur J Orthop Surg Traumatol 2002 12:132-136.

26

Hangman’s Fracture Caused by Suspected Child Abuse. A Case Report Ranjith RK, Mullett H, Burke TE J Pediatr Orthop B. 2002 Oct; 11(4): 329-32.

27

Minimally displaced Colles’ fractures: a prospective randomized trial of treatment with a wrist splint or a plaster cast O’Connor D, Mullett H, Doyle M,O’Sullivan M J Hand Surg [Br]. 2003 Feb; 28(1): 50-3.

28

Isolated septic arthritis:meningococcal infection Joyce M, Laing A, Mullett H, Gilmore MF, Cormican M. J R Soc Med. 2003 May 96 (5): 237-8.

29

Bilateral asymmetric traumatic hip dislocation in adolescence: a report of two cases and review of the literature Donnelly M, Mullett D, Moore D Eur J Orthop Surg Traumatol 2004 15:166-169.

30

Diagnosis of thoracic neurilemoma incidental to a traumatic clavicle fracture Cleary M, Mullett H, Tolan M, O’Rourke K. J Orthop Trauma. 2005 May-Jun;19(5):346-8.

31

Single Side Hole Irrigation-A Simple Method of Catheter Irrigation of the Tendon Sheath Mullett H, Hausman M Acta Orthop Belg 2006 Jan 72 (1): 87-9.

32

Arthroscopic Treatment of Lateral Epicondylitis:Clinical and Cadaveric Studies Mullett H, Sprague M, Brown G, Hausman M. Clin Orthop Relat Res 2005 Oct;439:123-8.

33

Purse-String Suture Technique: A New Method of Arthroscopic Shoulder Stabilization. Mullett H, Levy O. Techniques in Shoulder & Elbow Surgery. 7(2):102-105, June 2006.

34

Stress Fracture of the acromium presenting as a suspected metastasis: A rare consequence of deltoid strengthening program in rotator cuff arthropathy Gowreeson T,Mullett H,Levy O. Injury 37, Issue 9, Pages 319-356 September 2006me.

35

Treatment of femoral shaft fractures in children using the “Tobruk” method. O’Donnell TM, Murphy DP, Mullett H, Moore DP, Fogarty EE, Dowling FE. Am J Orthop. 2006 Aug;35(8):356-61;.

36

The Use of the Zebris Motion Analysis System for Measuring Cervical Spine Movements in Vivo Quinlan JF, Mullett H, Stapleton R, FitzPatrick D, McCormack D. Proc Inst Mech Eng [H]. 2006 Nov, 220 (8): 889-96.

37

Arthroscopic Treatment of a Massive Acromioclavicular Joint Cyst H. Mullett,R. Benson,O. Levy Arthroscopy 2007 Apr; 23 (4) 446.

38

Adhesive Capsulitis: Does the Timing of Manipulation Influence Outcome? Flannery O, Mullett H, Colville J. Acta Orthop Belg. 2007 Feb ; 73(1): 2-5.

39

Proliferation and Apoptosis in Human Fibroblasts in Response to Aspirate Obtained from Frozen Shoulders H. Mullett , D. Byrne,S. Byrne, J. Colville J Shoulder & Elbow Surgery 2007 May-June 16 (3): 290-4.

40

Peripheral Parasthesia in Patients with Subacromial Impingement Syndrome Sivan M,Venkateswaran B, Mullet H, Even t, Khan S, Copeland S,Levy O. Arch Orthop Trauma Surg 2007 Sep; 127 (7): 609-12.

41

Quantification of the coupled motion that occurs with axial rotation and lateral bending of the head-neck complex: an experimental examination Senouci M, FitzPatrick D, Quinlan JF, Mullett H, Coffey L, McCormack D. Proc Inst Mech Eng [H]. 2007 Nov;221(8):913-9.

42

Copeland Shoulder Resurfacing Arthroplasty- Results in Patients over 80. H. Mullett, D. Raj, O. Levy, S. Copeland. J Bone Joint Surg Br. 2007 Nov;89(11):1466-9.

43

Flexor pollicis longus rupture 25 years after silicone lunate replacement for stage IV Kienbock’s disease Byrne F, Walls R, Mullett H. J Hand Surg Eur Vol. 2008 Feb;33(1):84.

44

Recalcitrant distal humeral and proximal forearm nonunion: salvage using an extended pedicled radial forearm osseous flap Mullett H, Hausman M, Zaidemberg C. J Trauma. 2008 Apr;64 (4).

45

Extensor tendon sheath fistula formation as a complication of wrist arthroscopy Shirley DS, Mullett H, Stanley JK Arthroscopy. 2008 Nov; 24 (11) : 1311-2.

46

The role of anterior deltoid reeducation in patients with massive irreparable degenerative rotator cuff tears. Levy O, Mullett H, Roberts S, Copeland S. J Shoulder Elbow Surg. 2008 Nov-Dec;17(6):863-70.

47

Chronic Mycobacterium infection of first dorsal web space after accidental Bacilli Calmette-Guérin injection in a health worker: case report. Vigler M, Mulett H, Hausman MR. J Hand Surg Am. 2008 Nov;33.

48

Day case shoulder surgery: satisfactory pain control without regional anaesthesia. A prospective analysis of a perioperative protocol. Daruwalla ZJ, Halpenny M, Mullett H. Ir J Med Sci. 2009 Mar;178(1):57-60.

49

The active elevation lag sign and the triangle sign: new clinical signs of trapezius palsy. Levy O, Relwani JG, Mullett H, Haddo O, Even T. J Shoulder Elbow Surg. 2009 Jul-Aug;18(4):573-6.

50

An application of principal component analysis to the clavicle and clavicle fixation devices. Daruwalla ZJ, Courtis P, Fitzpatrick C, Fitzpatrick D, Mullett H. J Orthop Surg Res. 2010 Mar 26;5:21.

51

Anatomic variation of the clavicle: A novel three-dimensional study. Daruwalla ZJ, Courtis P, Fitzpatrick C, Fitzpatrick D, Mullett H. Clin Anat. 2010 Mar;23(2):199-209.

52

Free-hand versus novel specialised jig guidance for the passing of intramedullary wires in olecranon fracture fixation: A comparative study. Molony DC, Kennedy J, Gheiti A, Mullett JH. Injury. 2010 Mar 29.

53

Clavicle Non-union : Autogenous bone graft is not a necessary augment to internal fixation. Baker JF, Mullett H. Acta Orthop Belg. 2010 Dec: 76 (6): 725-9.

54

A Hero’s Woe: Rotator Cuff Tear after Performing the Heimlich Manoeuvre; Baker,J. Mullett H. Emerg Med J 2010; 27:566-567.

55

The Hounsfield value for cortical bone geometry in the proximal humerus-an in vitro study. Lim Fat D, Kennedy J, Galvin R, O’Brien F, Mc Grath F, Mullett H. Skeletal Radiol. 2011 Sep 20.

56

Tennis Elbow Kumar S, Stanley D, Burke NG, Mullett H. Ann R Coll Surg Engl. 2011 Sep;93(6):432-6.

57

A cadaveric model for suprascapular nerve injury during glenoid component screw insertion in reverse-geometry shoulder arthroplasty. Molony DC, Cassar Gheiti AJ, Kennedy J, Green C, Schepens A, Mullett HJ. J Shoulder Elbow Surg. 2011 Dec;20(8):1323-7. Epub 2011 May 20.

58

Locking plate fixation for proximal humerus fractures. Burke NG, Kennedy J, Green C, Dodds MK, Mullett H. Orthopedics. 2012 Feb 17;35(2):e250-4.

59

Posterior interosseous neurectomy for extensive idiopathic avascular necrosis of the capitate in an adolescent. Leonard M, Mullett H. J Hand Surg Eur Vol. 2012 Jul;37(6):582-3. Epub 2012 Mar 28.

60

Investigation of metallic and carbon fibre PEEK fracture fixation devices for three-part proximal humeral fractures. Feerick EM, Kennedy J, Mullett H, Fitzpatrick D, McGarry P. Med Eng Phys. 2012 Sep 15.

61

Effect of calcium triphosphate cement on proximal humeral fracture osteosynthesis: a cadaveric biomechanical study. Kennedy J, Molony D, Burke NG, FitzPatrick D, Mullett H. J Orthop Surg (Hong Kong). 2013 Aug;21(2):173-7.

62

Effect of calcium triphosphate cement on proximal humeral fracture osteosynthesis: a finite element analysis. Kennedy J, Feerick E, McGarry P, FitzPatrick D, Mullett H. J Orthop Surg (Hong Kong). 2013 Aug;21(2):167-72.

63

Upper Limb Ischaemia Secondary to a Bifurcated Distal Biceps Tendon: A Case Report Citation DataEJVES Extra, ISSN: 1533-3167, Vol: 27, Issue: 5, Page: e39-e40 Publication Year2014.

64

A patient-derived Constant-Murley score is comparable to a clinician-derived score. Levy O, Haddo O, Massoud S, Mullett H, Atoun E. Clin Orthop Relat Res. 2014 Jan;472(1):294-303.

65

Reverse Total Shoulder Replacement with Minimal ACJ Excision Arthroplasty for Management of Massive ACJ Cyst – A Case Report. Shaarani SR, Mullett H. Open Orthop J. 2014 Sep 24;8:298-301.

66

Computerized dynamic posturography analysis of balance in individuals with a shoulder stabilization sling. Lui DF, Memon A, Kwan S, Mullett H. Eur J Trauma Emerg Surg. 2013 Dec;39(6):635-9.

67

Aberrant right retroesophageal subclavian artery causing esophageal compression. Reynolds I, McGarry J, Mullett H. Clin Case Rep. 2015 Oct;3(10):897-8.

68

The Efficacy of Platelet-Rich Plasma and Platelet-Rich Fibrin in Arthroscopic Rotator Cuff Repair: A Meta-analysis of Randomized Controlled Trials. Hurley ET, Lim Fat D, Moran CJ, Mullett H. Am J Sports Med. 2018 Feb.

69

Open Versus Arthroscopic Latarjet Procedure for Anterior Shoulder Instability: A Systematic Review and Meta-analysis. Hurley ET, Lim Fat D, Farrington SK, Mullett H. Am J Sports Med. 2018 Mar.

70

Biceps tenodesis versus labral repair for superior labrum anterior-to-posterior tears: a systematic review and meta-analysis. Hurley ET, Fat DL, Duigenan CM, Miller JC, Mullett H, Moran CJ. J Shoulder Elbow Surg. 2018 May 23.

71

Chylous-Related Complications Following Surgical Management of Clavicular Fractures: A Report of Two Cases. Downey C, O’Neill D, Lee M, Donnelly M, Mullett H. JBJS Case Connect. 2018 Aug 8.

72

Long-term outcomes of the Latarjet procedure for anterior shoulder instability: a systematic review of studies at 10-year follow-up. Hurley ET, Jamal MS, Ali ZS, Montgomery C, Pauzenberger L, Mullett H. J Shoulder Elbow Surg. 2019 Feb;28(2):e33-e39. doi: 10.1016/j.jse.2018.08.028. Epub 2018.

73

Return to Sport After Surgical Treatment for Anterior Shoulder Instability: A Systematic Review: Letter to the Editor. Hurley ET, Shimozono Y, Montgomery C, Jamal MS, Ali Z, Pauzenberger L, Mullett H. Am J Sports Med. 2019 Mar;47(3):NP23-NP24. doi: 10.1177/0363546519825643.

74

Arthroscopic Rotator Cuff Repair: A Systematic Review of Overlapping Meta-Analyses. Hurley ET, Maye AB, Mullett H. JBJS Rev. 2019 Apr 2. doi: 10.2106/JBJS.RVW.18.00027.

75

Nonoperative Treatment of Rotator Cuff Disease With Platelet-Rich Plasma: A Systematic Review of Randomized Controlled Trials. Hurley ET, Hannon CP, Pauzenberger L, Fat DL, Moran CJ, Mullett H. Arthroscopy. 2019 Apr 15. pii: S0749-8063(18)30976-9. doi: 10.1016/j.arthro.2018.10.115. [Epub ahead of print] Review.

76

Return to Sport After Surgical Treatment for Anterior Shoulder Instability: A Systematic Review. Hurley ET, Montgomery C, Jamal MS, Shimozono Y, Ali Z, Pauzenberger L, Mullett H. Am J Sports Med. 2019 Apr 30:363546519831005. doi: 10.1177/0363546519831005.

77

Open Compared with Arthroscopic Biceps Tenodesis: A Systematic Review. Hurley DJ, Hurley ET, Pauzenberger L, Lim Fat D, Mullett H. JBJS Rev. 2019 May;7(5):e4.

78

Editorial Commentary: Which to Fix-the Biceps or the Labrum? The Shoulder SLAP Tear Is Still Controversial. Hurley ET, Pauzenberger L, Mullett H. Arthroscopy. 2019 Jun;35(6):1939-1940.

79

Long-term outcomes of the arthroscopic Bankart repair: a systematic review of studies at 10-year follow-up. Murphy AI, Hurley ET, Hurley DJ, Pauzenberger L, Mullett H J Shoulder Elbow Surg. 2019 Jul 13.

80

Video Analysis of Shoulder Dislocations in Rugby: Insights Into the Dislocating Mechanisms. Montgomery C, O’Briain DE, Hurley ET, Pauzenberger L, Mullett H, Moran CJ. Am J Sports Med. 2019 Dec;47(14):3469-3475.

81

Scaphoid fractures: has magnetic resonance imaging become a cost-effective alternative to definitive diagnosis? Davey M, Feeley I, Hayes J, Grant-Freemantle M, Gaafar M, Pauzenberger L, Byrne AM, Mullett H. Ir J Med Sci. 2020 Jan 7. doi: 10.1007/s11845-020-02169-8.

82

Surgical treatment for long head of the biceps tendinopathy: a network meta-analysis. Anil U, Hurley ET, Kingery MT, Pauzenberger L, Mullett H, Strauss EJ. J Shoulder Elbow Surg. 2020 Feb 6.

83

Outcomes following arthroscopic Bankart repair in female patients. Moore TK, Hurley ET, Rowe DN, Hogan RE, Kilkenny CJ, Pauzenberger L, Mullett H. J Shoulder Elbow Surg. 2020 Feb 19.

84

The majority of patients return to athletic activity following biceps tenodesis. Cassidy JT, Hurley ET, Moore D, Pauzenberger L, Mullett H. Knee Surg Sports Traumatol Arthrosc. 2020 Mar 17.

85

Outcomes of mini-open carpal tunnel release for severe carpal tunnel syndrome: a 10-year follow-up. McAleese T, Curtin M, Murphy EP, Mullett H.J Hand Surg Eur Vol. 2021 Mar;46(3):320-322.

86

Tranexamic acid for the Latarjet procedure: a randomized controlled trial. Hurley ET, Lim Fat D, Pauzenberger L, Mullett H. J Shoulder Elbow Surg. 2020 May;29(5):882-885.

87

Letter to the Editor regarding Utkarsh et al: Surgical treatment for long head of the biceps tendinopathy : a network meta-analysis Eoghan T. Hurley, Utkarsh Anil, Matthew T. Kingery, Leo Pauzenberger, Hannan Mullett , Eric Strauss Journal of Shoulder and Elbow Surgery Published online September 18 , 2020.

88

Remplissage for Anterior Shoulder Instability with Hill-Sachs Lesions- A Systematic Review & Meta-Analysis Eoghan T. Hurley, James P. Toale, Martin S. Davey, Christopher Colasanti, Leo Pauzenberger, Eric J. Strauss, Hannan Mullett Journal of Shoulder and Elbow Surgery Published on Line July 7 2020.

89

Return to sports following 270 degree labral tears Emma Pounder,Eoghan T Hurley, Zakariya S Ali, Leo Pauzenberger, Hannan Mullett Arthroscopy, Sports Medicine and Rehabilitation, Vol 2, No 3 (June),2020:.

90

Outcomes following arthroscopic Bankart repair in female patients. Moore TK, Hurley ET, Rowe DN, Hogan RE, Kilkenny CJ, Pauzenberger L, Mullett H. J Shoulder Elbow Surg. 2020 Jul;29(7):1332-1336.

91

Return to Sport following Reverse Shoulder Arthroplasty: A Systematic Review. Davey MG, Davey MS, Hurley ET, Gaafar M, Pauzenberger L, Mullett H. J Shoulder Elbow Surg. 2020 Aug 25.

92

Low rate of recurrent instability following the open Latarjet procedure as a revision procedure for failed prior stabilization surgery. Ali ZS, Hurley ET, Jamal MS, Horan MP, Montgomery C, Pauzenberger L, Millett PJ, Mullett H. Knee Surg Sports Traumatol Arthrosc. 2020 Jul 24.

93

Use of Platelet-Rich Plasma for the Improvement of Pain and Function in Rotator Cuff Tears: Letter to the Editor. Hurley ET, Pauzenberger L, Mullett H, Jazrawi LM. Am J Sports Med. 2020 May;48(6):.

94

Bilateral Scapulothoracic Fusions Fixed with High-Strength Suture Tapes for Facioscapulohumeral Dystrophy: A Case Report. Davey MS, Kenyon R, Pauzenberger L, Grant Freemantle MC, Mullett H.JBJS Case Connect. 2020 Jul-Sep;10(3):e2000042.

95

Current practices in the management of anterior glenohumeral instability in rugby union players. Moore DM, Hurley ET, Mullett H. Surgeon. 2020 Sep.

96

Operative Treatment of Anterior Shoulder Instability A Network Meta-Analysis. Hurley E, Anil U, Lim Fat D, Pauzenberger L, Strauss E, Mullett H. Bull Hosp Jt Dis (2013). 2020 Sep;78(3):202-209.

97

Arthroscopic Bankart Repair Versus Conservative Management for First-Time Traumatic Anterior Shoulder Instability: A Systematic Review and Meta-analysis. Hurley ET, Manjunath AK, Bloom DA, Pauzenberger L, Mullett H, Alaia MJ, Strauss EJ. Arthroscopy. 2020 Sep;36(9):2526-2532.

98

Arthroscopic Suture-Button Versus Hook-Plate Fixation for Acromioclavicular Joint Injuries—A Systematic Review of Comparative Studies.

99

Return to Play after Arthroscopic Bankart Repair Combined with Open Subpectoral Biceps Tenodesis Toale JP, Hurley E.T, Davey MS , Cassidy T, Pauzenberger L, Mullett,H. Arthroscopy, Sports Medicine, and Rehabilitation Volume 2, Issue 5, October 2020, Pages e499-e50.

100

Clinical Outcomes of Patients With Anterior Shoulder Instability and Glenolabral Articular Disruption Lesions: A Retrospective Comparative Study. Davey MS, Hurley ET, Colasanti CA, Scanlon JP, Gaafar M, Hogan BA, Pauzenberger L, Mullett H. Am J Sports Med. 2020 Oct. Online ahead of print.

101

.90-Day Complication Rate After the Latarjet Procedure in a High-Volume Center. Scanlon JP, Hurley ET, Davey MS, Gaafar M, Pauzenberger L, Moran CJ, Mullett H. Am J Sports Med. 2020 Oct 30:.

102

Response to Cao et al regarding: “Surgical treatment for long head of the biceps tendinopathy: a network meta-analysis”. Hurley ET, Anil U, Kingery MT, Pauzenber L, Mullett H, Strauss EJ.J Shoulder Elbow Surg. 2021 Jan;30(1):e36-e37.

103

Excellent Clinical Outcomes and Rates of Return to Play After Arthroscopic Rotator Cuff Repair for Traumatic Tears in Athletes Aged 30 Years or Less. Davey MS, Hurley ET, Scanlon JP, Gaafar M, Pauzenberger L, Mullett H. Arthrosc Sports Med Rehabil. 2021 Mar 22;3(3):e667-e672.

104

Excellent Clinical Outcomes and Rates of Return to Play After Arthroscopic Rotator Cuff Repair for Traumatic Tears in Athletes Aged 30 Years or Less. Davey MS, Hurley ET, Scanlon JP, Gaafar M, Pauzenberger L, Mullett H. Arthrosc Sports Med Rehabil. 2021 Mar 22;3(3):e667-e672.

105

Magnetic Resonance Arthrography in Rugby Players Undergoing Shoulder Stabilization for Glenohumeral Instability: Professionals Have Higher Frequencies of More Pathologies. Davey MS, Hurley ET, Hurley DJ, Pauzenberger L, Mullett H. Arthrosc Sports Med Rehabil. 2021 Feb 23;3(2):e543-e547. doi: 10.1016/j.asmr.2020.12.006. eCollection 2021 Apr.

106

Long-term outcomes of total elbow arthroplasty: a systematic review of studies at 10-year follow-up. Davey MS, Hurley ET, Gaafar M, Molony D, Mullett H, Pauzenberger L.J Shoulder Elbow Surg. 2021 Jun;30(6):1423-1430.

107

Platelet-rich plasma in non-operative management of mild to moderate carpal tunnel syndrome – A systematic review & meta-analysis of short-term outcomes. Davey MS, Davey MG, Hurley ET, Cassidy JT, Mullett H, McInerney NM, Galbraith JG.J Orthop. 2021 May 7;25:155-161.

108

Type V superior labral anterior-posterior tears results in lower rates of return to play. Hogan RE, Hurley ET, Kilkenny CJ, Moore TK, Rowe DN, Davey MS, Pauzenberger L, Mullett H. Knee Surg Sports Traumatol Arthrosc. 2021 Jul;29(7):2364-2369.

109

Arthroscopic Bankart Repair Versus Open Latarjet for First-Time Dislocators in Athletes. Hurley ET, Davey MS, Montgomery C, O’Doherty R, Gaafar M, Pauzenberger L, Mullett H. Orthop J Sports Med. 2021 Aug 31;9(8).

110

Arthroscopic Bankart Repair for Primary Versus Recurrent Anterior Instability in Athletes Results in Excellent Clinical Outcomes, High Rates of Return to Play, and Low Recurrence Rates. Davey MS, Hurley ET, Gaafar M, Mullett H, Pauzenberger L. Arthrosc Sports Med Rehabil. 2021 Aug 26;3(5):e1499-e1504.

111

The fragility Index of Statistically significant findings from randomized controlled trials comparing the management strategies of anterior shoulder instability Davey, M., Hurley ET, Doyle, TR.,Dashti H,Gaafar M., Mullett H. Arthroscopy 2021 Aug, 37 (8) 2412-2417.

112

Open Latarjet Procedure in Athletes following failed prior instability surgery results in lower rates of return to play Davey, M., Hurley ET, O’Doherty, R, Stafford P.,Delahunt E.,Gaafar M., Pauzenberger L.,Mullett H.

113

Long-term outcomes of radial head arthroplasty for radial head fractures-a systematic review at minimum 8-year follow-up. Davey MS, Davey MG, Hurley ET, Galbraith JG, Molony D, Mullett H, Pauzenberger L.J Shoulder Elbow Surg. 2021 Oct;30(10):2438-2444.

114

Ulnar collateral ligament reconstruction of the elbow at minimum 48-month mean follow-up demonstrates excellent clinical outcomes with low complication and revision rates: systematic review. Davey MS, Hurley ET, Gaafar M, Galbraith JG, Mullett H, Pauzenberger L.J ISAKOS. 2021 Sep;6(5):290-294.

115

Analysis of Athletes Who Did Not Return to Play After Open Latarjet. Hurley ET, Davey MS, Montgomery C, Moore DM, Mojica ES, Gaafar M, Pauzenberger L, Jazrawi LM, Mullett H. Orthop J Sports Med. 2022 Feb 15;10(2).

116

Analysis of patients Unable to return to play following arthroscopic Bankart repair Hurley E, Davey D, Mojica E, Montgomery C, Gaafer M, Jazrawi L, Mullett H, Pauzenberger L Surgeon 2022 Aug;20(4):e158-e162.

117

Anterior Shoulder Instability Part I-Diagnosis, Nonoperative Management, and Bankart Repair-An International Consensus Statement. Hurley ET, Matache BA, Wong I, Itoi E, Strauss EJ, Delaney RA, Neyton L, Athwal GS, Pauzenberger L, Mullett H, Jazrawi LM; Anterior Shoulder Instability International Consensus Group. Arthroscopy. 2022 Feb;38(2):214-223.

118

Anterior Shoulder Instability Part II-Latarjet, Remplissage, and Glenoid Bone-Grafting-An International Consensus Statement. Hurley ET, Matache BA, Wong I, Itoi E, Strauss EJ, Delaney RA, Neyton L, Athwal GS, Pauzenberger L, Mullett H, Jazrawi LM; Anterior Shoulder Instability International Consensus Group. Arthroscopy. 2022 Feb;38(2):224-233.e6.

119

Anterior Shoulder Instability Part III-Revision Surgery, Rehabilitation and Return to Play, and Clinical Follow-Up-An International Consensus Statement. Matache BA, Hurley ET, Wong I, Itoi E, Strauss EJ, Delaney RA, Neyton L, Athwal GS, Pauzenberger L, Mullett H, Jazrawi LM; Anterior Shoulder Instability International Consensus Group. Arthroscopy. 2022 Feb;38(2):234-242.e6.

120

Management options for proximal humerus fractures – A systematic review & network meta-analysis of randomized control trials. Davey MS, Hurley ET, Anil U, Condren S, Kearney J, O’Tuile C, Gaafar M, Mullett H, Pauzenberger L. Injury. 2022 Feb;53(2):244-249.

121

Clinical Outcomes in Patients With Humeral Avulsion Glenohumeral Ligament Lesions in the Setting of Anterior Shoulder Instability: A Retrospective Comparative Study. Davey MS, Hurley ET, Gaafar M, Delaney R, Mullett H. Am J Sports Med. 2022 Feb;50(2):327-333.

122

Clinical outcomes of Gaelic Athletic Association athletes after surgical stabilization in the setting of anterior shoulder instability Davey,M. Hurley,ET. Mullett, H Am J Sports Med 2022 Apr 13.

123

Athletes with primary glenohumeral instability demonstrate lower rates of bone loss than those with recurrent instability and failed prior stabilization. Lennon DT, Davey MS, Hurley ET, Gaafar M, Pauzenberger L, Mullett H.J Shoulder Elbow Surg. 2022 Apr;31(4):813-818.

124

Evaluation of the quality of information online for arthroscopic Bankart repair. Shazil Jamal M, Hurley ET, Davey MS, Asad H, Gaafar M, Mullett H. Ann R Coll Surg Engl. 2022 May 31.

125

Subscapularis management during open Latarjet procedure: does subscapularis split versus tenotomy matter? A systematic review and meta-analysis. Davey MS, Davey MG, Hurley ET, Mullett H.J Shoulder Elbow Surg. 2022 Apr 21:S1058-2746(22)00371-8. doi:.

126

Evaluation of factors associated with successful 5-year outcomes following arthroscopic Bankart repair in athletes. Hurley ET, Davey MS, Mojica ES, Fried JW, Gaafar M, Pauzenberger L, Mullett H. Knee Surg Sports Traumatol Arthrosc. 2022 Jun;30(6):2092-2098.

127

Return to play following open Bankart repair in collision athletes aged 18 years or less. Hickey IPM, Davey MS, Hurley ET, Gaafar M, Delaney RA, Mullett H.J Shoulder Elbow Surg. 2022 Jun;31(6S):S8-S12.

128

The Fragility Index of Statistically Significant Findings From Randomized Controlled Trials Comparing the Management Strategies of Anterior Shoulder Instability. Davey MS, Hurley ET, Doyle TR, Dashti H, Gaafar M, Mullett H. Am J Sports Med. 2022 Apr 13:3635465221077268. doi: 10.1177/03635465221077268. Online ahead of print.

129

Long -term outcomes of anterior shoulder instability treated with open latarjet procedure-a systematic review of outcomes at a minimum of 15-year follow-up. Davey MS,Hurley ET,Kilkenny C,Anakwenze OA, Klifto CS. Shoulder Elbow 2022. Online ahead of print.

130

Arthroscopic Rotator Cuff Repair results in Improved Clinical Outcomes and Low Revision Rates at 10-Year Follow-uo: A systematic Review Davey MS, Hurley ET, Carroll PJ, Galbraith JG, Shannon F, Kaar K, Mullett H. Arthroscopy. 2023 Feb;39(2):452-458. doi: 10.1016/j.arthro.2022.11.002. Epub 2022 Dec 7.

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Return to Play After Surgical Treatment for Acromioclavicular Joint Dislocation : A Systematic Review Cleary BP, Hurley ET,Kilkenny CJ, Robinson J, Khan SU,Davey M, Anakwenze A , Klifto CS,Mullett H. Am J Sports Med 2023 June 3635465231178784.

132

Evaluation of the quality of information online for arthroscopic Bankart repair. Jamal MS,Hurley ET,Davey MS,Asad H,Gaafar,H. Mullett Ann R Coll Surg Engl May 2023 394-399.

133

Primary Latarjet procedure versus Latarjet in the setting of previously failed Bankart repair: a systematic review. Karavan MP Jr, Hurley ET, Mills FB 4th, Pasqualini I, Rossi L, Dickens JF, Anakwenze O, Mullett H, Millett PJ, Klifto CS.J ISAKOS. 2023 Sep 2:S2059-7754(23)00552-7. doi: 10.1016/j.jisako.2023.08.009. Online ahead of print.

134

. Posterior Shoulder Instability but not Anterior Instability is Related to Glenoid Version Moore TK, Kilkenny CJ, Hurley ET, Magee BM, Levin JM, Khan SU, Dickens JF, Mullett H. Arthrosc Sports Med Rehabil. 2023 Sep 9;5(5):100794. doi: 10.1016/j.asmr.2023.100794. eCollection 2023 Oct.PMID: 37711163.

135

Young Collision Athletes Have High Rate of Return to Play and Good Clinical Outcomes Following Open Latarjet Procedure. Hurley ET, Moore TK, Kilkenny C, Khan S, White-Gibson A, Dickens JF, Klifto CS, Mullett H. Arthroscopy. 2023 Sep 27:S0749-8063(23)00778-8. doi: 10.1016/j.arthro.2023.09.007. Online ahead of print.PMID: 37769824.

136

The Effects of Pre-existing Mood Disorders on Patient-Reported Outcomes After Arthroscopic Rotator Cuff Repair: A Systematic Review and Meta-analysis. Davey MS, Davey MG, Hurley ET, Mullett H.JBJS Rev. 2023 Oct 23;11(10). doi: 10.2106/JBJS.RVW.22.00187. eCollection 2023 Oct 1.PMID: 37871152.

137

Studies on Bankart Repair for Anterior Shoulder Instability Show Poor Reporting of Data and Reflect Low Level of Evidence-A Systematic Review. Moran FG, Hurley ET, Storme JG, Karavan MP, Downey SA, Klifto CS, Delaney RA, Mullett H. Arthroscopy. 2023 Jul 18:S0749-8063(23)00560-1. doi: 10.1016/j.arthro.2023.07.010. Online ahead of print.

138

Shoulder arthroplasty in the setting of previous stabilization surgery: a systematic review of matched case control studies at minimum 2 years follow-up. O’Driscoll CS, Davey MS, Molony DC, Shannon FJ, Mullett H.JSES Rev Rep Tech. 2023 Feb 4;3(2):166-180. doi: 10.1016/j.xrrt.2023.01.003. eCollection 2023 May.PMID: 37588435 Free PMC article. Review.

139

The clinical utility of immediate post-operative PACU plain film radiographs following uncomplicated open Latarjet procedure – An institutional series of consecutive patients. Davey MS, Hurley ET, Liu K, White-Gibson A, Molony DC, Moran CJ, Delaney RA, Mullett H.J Orthop. 2023 Nov 8;46:178-181. doi: 10.1016/j.jor.2023.11.008. eCollection 2023 Dec.PMID: 38037554.

140

Low complication rate following reverse total shoulder arthroplasty at 90-days follow-up – A systematic review. Kent LM, Hurley ET, Davey MS, Klifto CS, Mullett H.J ISAKOS. 2023 Nov 16:S2059-7754(23)00596-5. doi: 10.1016/j.jisako.2023.11.006. Online ahead of print.PMID: 37979691 Free article. Review.

141

The statistical fragility of the management options for reverse shoulder arthroplasty: a systematic review of randomized control trial with fragility analysis. Doyle TR, Hurley ET, Davey MS, Klifto C, Mullett H.JSES Rev Rep Tech. 2023 Apr 7;3(3):279-284. doi: 10.1016/j.xrrt.2023.03.002. eCollection 2023 Aug.PMID: 37588503 Free PMC article. Review.

142

Upper Limb Strength and performance deficits after glenohumeral joint stabilisation surgery in contact on collision athletes. Med Sci Sports Exerc. 2024 Jan 1;56(1):13-21. doi: 10.1249/MSS.0000000000003290. Epub 2023 Aug 31. Edel Fanning, Katherine Daniels 1, Ann Cools 2, Hannan Mullett 3, Ruth Delaney 3, Ciaran McFadden 3, Eanna Falvey 4.

143

Long-term outcomes of anterior shoulder instability treated with open latarjet procedure – a systematic review of outcomes at a minimum 15-year follow-up. Davey MS, Hurley ET, Kilkenny C, Anakwenze OA, Klifto CS, Mullett H. Shoulder Elbow. 2024 Feb;16(1):8-14. doi: 10.1177/17585732221141062. Epub 2022 Nov 29.PMID: 38435043 Review.

144

Midterm outcomes of primary reverse shoulder arthroplasty: a systematic review of studies with minimum 5-year follow-up. Doyle TR, Downey S, Hurley ET, Klifto C, Mullett H, Denard PJ, Garrigues GE, Menendez ME.JSES Rev Rep Tech. 2023 Oct 3;4(1):1-7. doi: 10.1016/j.xrrt.2023.09.003. eCollection 2024 Feb.PMID: 38323206.

145

Posterior Shoulder Instability but Not Anterior Shoulder Instability Is Related to Glenoid Version. Moore TK, Kilkenny CJ, Hurley ET, Magee BM, Levin JM, Khan SU, Dickens JF, Mullett H. Arthrosc Sports Med Rehabil. 2023 Sep 9;5(5):100794. doi: 10.1016/j.asmr.2023.100794. eCollection 2023 Oct.PMID: 37711163.

146

Posterior Shoulder Instability Part I – Diagnosis, Non-Operative Management, and Labral Repair for Posterior Shoulder Instability – An International Expert Delphi Consensus Statement. Hurley ET, Aman ZS, Doyle TR, Levin JM, Jazrawi LM, Garrigues GE, Namdari S, Hsu JE, Klifto CS, Anakwenze OA, Dickens JF; Posterior Shoulder Instability International Consensus Group. Arthroscopy. 2024 May 10:S0749-8063(24)00341-4. doi: 10.1016/j.arthro.2024.04.035. Online ahead of print.PMID: 38735410.

147

Posterior Shoulder Instability Part II – Glenoid Bone-Grafting, Glenoid Osteotomy, and Rehabilitation/Return to Play – An International Expert Delphi Consensus Statement. Hurley ET, Aman ZS, Doyle TR, Levin JM, Jazrawi LM, Garrigues GE, Namdari S, Hsu JE, Klifto CS, Anakwenze OA, Dickens JF; Posterior Shoulder Instability International Consensus Group. Arthroscopy. 2024 May 10:S0749-8063(24)00340-2. doi: 10.1016/j.arthro.2024.04.034. Online ahead of print.PMID: 3873541.

148

Return to Play After Surgical Treatment for Acromioclavicular Joint Dislocation: A Systematic Review. Cleary BP, Hurley ET, Kilkenny CJ, Robinson J, Khan SU, Davey MS, Anakwenze O, Klifto CS, Mullett H. Am J Sports Med. 2024 Apr;52(5):1350-1356. doi: 10.1177/03635465231178784. Epub 2023 Jun 21.PMID: 37345238.

149

Low complication rate following reverse total shoulder arthroplasty at 90-days follow-up – A systematic review. Kent LM, Hurley ET, Davey MS, Klifto CS, Mullett H.J ISAKOS. 2024 Apr;9(2):205-210. doi: 10.1016/j.jisako.2023.11.006. Epub 2023 Nov 16.PMID: 37979691.

150

Glenohumeral morphological predictors of recurrent shoulder instability following arthroscopic Bankart repair. Hurley ET, O’Grady J, Davey MS, Levin JM, Mojica ES, Gaafar M, Dickens JF, Delaney RA, Mullett H. Knee Surg Sports Traumatol Arthrosc. 2024 Apr 4. doi: 10.1002/ksa.12169. Online ahead of print.PMID: 38572679.

151

Glenohumeral joint osteoarthritis is not associated with clavicle fractures in a large arthroplasty cohort. Carroll PJ, Gaafer M, O’Briain D, Hynes D, Flannery O, Mullett H, O’Shea K.J Orthop. 2023 Nov 22;48:68-71. doi: 10.1016/j.jor.2023.11.052. eCollection 2024 Feb.

152

Young Collision Athletes Have High Rate of Return to Play and Good Clinical Outcomes Following Open Latarjet Procedure. Hurley ET, Moore TK, Kilkenny C, Khan S, White-Gibson A, Dickens JF, Klifto CS, Mullett H. Arthroscopy. 2024 Apr;40(4):1075-1080. doi: 10.1016/j.arthro.2023.09.007. Epub 2023 Sep 27.PMIDArethr: 37769824.

153

A bibliometric analysis of the top 50 cited studies related to acromioclavicular joint instability Conor J Kilkenny 1, Fahad Farooq 2, Eoghan T Hurley 3, Gordon R Daly 1, Gavin P Dowling 1, Sean P Whelehan 4, Hannan Mullett 5 J. Orthop 2024 Jun 27:58:46-51. doi: 10.1016/j.jor.2024.06.037. eCollection 2024 Dec.

154

The Majority of Systematic Reviews and Meta-Analyses Reporting Clinical Outcomes of The Remplissage Procedure have at Least One Form of Spin Arthroscopy ,Sports Medicine White,M. Hurley,ET.,Klifto,CS., Dickens JF., Mullett,H.

155

The impact of glenohumeral bone loss on range of motion in patients with anterior shoulder instability Mohamed Gaafar, Tom R Doyle, Kulia K Frank, Eoghan T Hurley,Martin S Davey, Ailbhe White-Gibson, Sami Khan , Hannan Mullett J Med Sci 2024 Aug 13 Doi: 10.1007/s11845-024-0375-8.

156

Hurley ET, Meyer AM, Lorentz SG, Oeding JF, Glover MA, Pasqualini I, Rossi L, Mullett H, Dickens JF. The Open Latarjet is More Cost-Effective than Arthroscopic Bankart Repair for First-Time Shoulder Dislocations in Male Patients with< 10% Glenoid Bone-Loss. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2025 May 7.

157

Mathúna ÓE, Doyle TR, Hurley ET, Klifto CS, Dickens JF, Mullett H. Artificial intelligence is inferior to surgeons at assessing for the presence of reporting bias (spin) in orthopaedic sports medicine literature: 415. Annals of the Royal College of Surgeons of England. 2025 Feb 24;107:S17-8.

158

da Silva MR, Van Tongel A, Collin P, Calvo E, Demirhan M, Bauer S, Savvidou O, Domos P, Mullett H, Brzoska R, Castoldi F. Core curriculum of shoulder and elbow surgery: the proposal from the European Society for Surgery of the Shoulder and Elbow. JSES international. 2025 Mar 1;9(2):343-5.

159

Baig M, Mohan K, Low L, Groarke MP, Mullet H. Mapping the Research Landscape of Adhesive Capsulitis: A Bibliometric Approach. Journal of Orthopaedic Reports. 2025 May 13:100684.

160

Davey MS, O’Dwyer L, Kilkenny C, Hurley ET, Mullett H. Are there significant differences in the clinical outcomes following arthroscopic rotator cuff repair which are reported in retrospective compared with prospective studies? : a systematic review including 60,505 repairs. Bone Joint J. 2025 Oct 1;107-B(10):989-994.

161

Hurley ET, Meyer AM, Lorentz SG, Oeding JF, Glover MA, Pasqualini I, Rossi LA, Mullett H, Dickens JF. The Open Latarjet Is More Cost-Effective Than Arthroscopic Bankart Repair for First-Time Shoulder Dislocations in Male Patients With <10% Glenoid Bone Loss. Arthroscopy. 2025 Nov;41(11):4419-4428. doi: 10.1016/j.arthro.2025.04.053. Epub 2025 May 7. PMID: 40345635.

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O’Sullivan D, Davey MS, Hurley ET, Dickens JF, Mullett H. Latarjet procedure for patients with pre-existing seizure disorders vs. controls: a systematic review and meta-analysis. J Shoulder Elbow Surg. 2025 Jul;34(7):1841-1846. doi: 10.1016/j.jse.2024.10.002. Epub 2024 Dec 3. PMID: 39638115.

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Doyle TR, Rotaru J, Landers S, Davey MS, Kilkenny CJ, Rasidovic D, Hurley ET, Mullett H. Anterior shoulder instability in patients older than 40 years treated with arthroscopic Bankart repair. J Shoulder Elbow Surg. 2025 Jun;34(6):1426-1432. doi: 10.1016/j.jse.2024.09.022. Epub 2024 Nov 20. PMID: 39577737.

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Doyle TR, Davey MS, Moore TK, White M, Hurley ET, Klifto CS, Dickens JF, Mullett H. Most Systematic Reviews and Meta-analyses Reporting Clinical Outcomes of the Remplissage Procedure Have at Least 1 Form of Spin. Arthrosc Sports Med Rehabil. 2024 Jun 29;6(5):100969. doi: 10.1016/j.asmr.2024.100969. PMID: 39534027; PMCID: PMC11551395.

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Hurley ET, Doyle TR, Levin JM, Klifto CS, Anakwenze O; Pseudoparalysis/Pseudoparesis Consensus Group. Defining pseudoparalysis and pseudoparesis: a consensus study. J Shoulder Elbow Surg. 2024 Oct;33(10):2111-2117. doi: 10.1016/j.jse.2024.04.018. Epub 2024 Jun 12. PMID: 38871046.

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Geuskens W, Lakdawala HA, Jaspers M, Doyle T, Rasidovic D, Verborgt O, Flanagan O, Hurley E, Mullett H. Female Patients Exhibit a Narrower Glenoid Rim and Lower Bone Density in the Anteroinferior Quadrant Compared With Male Patients. Arthroscopy. 2026 Jun 28. doi: 10.1002/arj.70380. Epub ahead of print. PMID: 42365619.

Education & Research

Fellowship

My team has run a fellowship program since 2005 initially at National Orthopaedic Hospital, Cappagh and since 2010 at Sports Surgery Clinic. Clinical fellows have completed specialist orthopaedic training and are undertaking specialist training in shoulder surgery.

During the fellowship the fellow is immersed in all aspects of shoulder surgery including diagnosis & treatment including surgery, research and teaching.

The fellowship involves a high volume practice with exposure to Sports Shoulder surgery particularly shoulder instability, arthroplasty and all areas of elective shoulder practice. The fellow also has exposure to complex shoulder trauma which is performed at Beaumont Hospital , a major trauma center and main teaching hospital for Royal College of Surgeons in Ireland. I perform complex reconstructive surgery and run a specialist tertiary referral shoulder clinic at National Orthopaedic Hospital, Cappagh.

There are operating sessions on four days per week. I am actively involved in research and leads a research team involved in clinical and biomechanical research. I am also involved in research to improve outcomes following shoulder surgery particularly in return to play following athletic injuries. I have performed biomechanical research in conjunction with R.C.S.I., U.C.D., and Trinity College and has helped evaluate orthopaedic implants and techniques. I am also involved in designing orthopaedic implants. Some of our projects are outlined in the research project and papers section.

Recent fellows have been highly successful in completing research projects to level of international presentation and publication and the research team has published papers in high impact journals ( see publications & presentations)

Previous fellows have come from countries including Ireland, Northern Ireland, Belgium, Netherlands, Austria, Pakistan, Singapore, Australia, Sudan.

Education & Research

Bones & Joints

The shoulder is made of up 3 bones that interact together to for a supporting structure for the upper limb. We refer to this grouping of bones as “the shoulder girdle”. The bones of the shoulder girdle are;

  • The Humerus – the upper arm bone with the ‘humeral head’ (the ball of the shoulder joint) on the top end
  • The Scapula – the shoulder blade. There a number of parts to the scapula.
  • the ‘glenoid’ (the socket of the shoulder joint)
  • the ‘acromion’ (which covers the top of the glenohumeral joint and attaches the scapula to the clavicle)
  • the ‘coracoid’ (a bony ridge at the front of the scapular to which a number of ligaments and muscles attach)
  • The Clavicle – the collar bone which connects the acromion part of the scapula to the sternum (the breast bone) ‘strutting’ the shoulder out. This is the only direct bone connection that the shoulder girdle has with the rest of the skeleton.

Where a bone come into contact with another is known as a joint. The joints of the shoulder are;

  • The Glenohumeral Joint – formed between the humeral head (ball) and the glenoid (socket).
  • The Acromioclavicular Joint – the joint that connects the scapula to the outer end of the clavicle
  • The Sternoclavicular Joint- the joint that connects the inner end of the clavicle to sternum. This is the only bony connection between the ‘shoulder girdle’ and the main the skeleton
  • The Scapulothoracic Joint – this joint involves the movement of the scapula over the ribs at the back of the chest. This is a ‘psuedo’ joint (not a real joint as it does not have any articular cartilage.

Capsule and Ligaments

The tissue components within the Shoulder Joint itself;

  • The Glenoid Labrum – this is a ‘rim’ of tissue that goes around the outer edge of the glenoid, the tendon of the long head of biceps attaches to the top part of the labrum. The labrum effectively deepens the glenoid socket which helps to increase the stability of the humeral head. It works a bit like a ‘chock’ under a wheel preventing the head from ‘rolling’ over the edge.
  • The Joint Capsule – this is a watertight sac that surrounds the joint. It is formed circumferentially from around the base of the glenoid socket and passes outwards to join circumferentially around the neck of the humeral head. The inner lining of the sac is covered with synovial tissue which produces synovial fluid that lubricates the joint and provides joint nutrition.

 

The bones and joint of the shoulder are held in position by strips of very strong tissue, known as ligaments. They attach bone to bone where as a tendon attaches muscle to bone. The main ligaments of the shoulder girdle are:

  • The Glenohumeral Ligaments (GHL)– within the joint capsule there are 4 strong ligaments that connect the glenoid to the humerus. These are the main structures that keep the shoulder in place and stop it from dislocating. There are 3 ligaments at the front (Superior, Middle & Anterior Inferior Glenohumeral Ligaments) and 1 ligament at the back of the joint (Posterior Inferior Glenohumeral Ligament).
  • The CoracoAcromial Ligament (CAL) – this ligament connects the acromion to the coracoid forming a tunnel. The Rotator Cuff tendons pass under this tunnel. In some circumstances the tip of the acromion and the ligament can thicken and cause Impingement to the tendons as they run underneath
  • The Acromioclavicular Ligaments (ACL) – these are short ligaments that attach the clavicle to the acromion within the acromioclavicular joint (AC jt)
  • The Coracoclavicular Ligaments (CCL) – these are 2 ligaments that connect the clavicle to the coracoid. They help to supply additional stability to the clavicle and the ACjt.

Rotator cuff

 

The Rotator Cuff

This refers to a group of muscles that hold the head of the upper arm into the socket of the shoulder. These muscles all insert into the bone as tendons so we often refer to the structure as the rotator cuff tendons. This layer lies on top of the bones and connective tissue.

 

The Rotator Cuff Tendons – this is formed by a group of 4 tendons that connect the deepest layer of 4 muscles to the humerus. These muscles are,

  • Subscapularis
  • Supraspinatus
  • Infraspinatus
  • Teres Minor

 

The muscles surround the shoulder and as their 4 tendons pass over the joint they converge together. As these bands of tissue attach onto the humerus they blend together and form a ‘tendon cuff’. This is known as the Rotator Cuff

 

The Biceps Tendon – the Biceps muscle, on the front of the arm, is formed from 2 tendons; the long head and short head. The Long Head of Biceps tendon begins at the top of the glenoid (with the labrum) and passes out through the shoulder joint to connect to the biceps muscle. The Rotator Cuff tendons and the Long Head of Biceps tendon are positioned very close to each other and are often both affected by injury at the same time. The Rotator Cuff tendons pass underneath the acromion through the Subacromial Space as they insert into the humerus (Fig 9). The narrow ‘clearance space’ underneath the acromion is the commonest place for Rotator Cuff problems to occur.

 

Additional supporting muscles

There are a large number of muscles around the shoulder which are responsible for moving, stabilising and supporting the shoulder girdle. The muscles can be divided into 4 groups.

Deep Muscles (Intrinsic / Rotator Cuff Muscles) – these are the 4 muscles mentioned earlier whose tendons form the rotator cuff. The muscles all arise from the blade (flat surface) of the scapula and pass over the shoulder joint with the tendons attaching onto the humerus.

  • Subscapularis
  • Supraspinatus
  • Infraspinatus

 

Teres Minor These muscles often function as a group and are involved in raising, rotating and moving the shoulder in many directions. The combined pull of the Rotator Cuff muscles also pulls the humeral head into the socket of the glenoid helping to stabilise the glenohumeral joint.

 

Intermediate Muscles – These muscles provide additional stability and strength to the glenohumeral joint and the shoulder girdle.

 

Superficial Muscles (Extrinsic) – These are the large muscles that can be seen around the shoulder externally and provide strength and powerful movements. • Deltoid – this is the large muscle over the top and the front of the shoulder which provides the power to lift the shoulder after the rotator cuff muscles have begun the movement

 

Pectoralis Major – this is the large muscle over the front of the chest.

 

Biceps – this is the powerful muscle over the front of the upper arm that flexes the elbow. One of the Biceps tendons (the Long Head) arise from within the shoulder joint. Problems can occur with the stability of the Shoulder if the sequential rhythm in which these muscles contract to move the shoulder is disturbed

 

Back Muscles (Posterior) – these muscles are involved in suspending the scapula onto the back of the chest wall, stabilising the scapula and moving the scapula over the chest wall (scapulothoracic joint). A number of these muscles, including trapezius, levator scapulae and the rhomboids, originate from the vertebrae of the cervical and thoracic spine. Problems can occur with the smooth movement of the scapula over the chest wall if these muscles are weakened or are not working properly.