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Alexandre Lädermann Division of Orthopaedics and Trauma Surgery, Department of Surgery, University Hospitals of Geneva, Switzerland
Faculty of Medicine, University of Geneva, Switzerland

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Jérome Tirefort Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Switzerland

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Davide Zanchi Department of Psychiatry (UPK), University of Basel, Switzerland

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Sven Haller Faculty of Medicine, University of Geneva, Switzerland
Affidea Centre de Diagnostic Radiologique de Carouge CDRC, Geneva, Switzerland
Department of Surgical Sciences, Uppsala University, Sweden
Department of Neuroradiology, University Hospital Freiburg, Germany

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Caecilia Charbonnier Faculty of Medicine, University of Geneva, Switzerland
Medical Research Department, Artanim Foundation, Geneva, Switzerland

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Pierre Hoffmeyer Division of Orthopaedics and Trauma Surgery, Department of Surgery, University Hospitals of Geneva, Switzerland

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Gregory Cunningham Division of Orthopaedics and Trauma Surgery, Department of Surgery, University Hospitals of Geneva, Switzerland

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latter can lead to increased pain, decreased level of activity, prolonged absence from work and sport, and a general decrease in quality of life. 2 , 3 Apprehension can be difficult to diagnose pre- or post-operatively, as it seems more complex than

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Jakub Stefaniak Department of Traumatology, Orthopaedics and Hand Surgery, Poznan University of Medical Sciences, Poznan, Poland
Sport Traumatology and Biomechanics Unit, Rehasport Clinic, Poznan University of Medical Sciences, Poznan, Poland

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Przemyslaw Lubiatowski Sport Traumatology and Biomechanics Unit, Rehasport Clinic, Poznan University of Medical Sciences, Poznan, Poland

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Anna Maria Kubicka Institute of Zoology, Poznan University of Life Sciences, Poznan, Poland

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Anna Wawrzyniak Sport Traumatology and Biomechanics Unit, Rehasport Clinic, Poznan University of Medical Sciences, Poznan, Poland

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Joanna Wałecka Sport Traumatology and Biomechanics Unit, Rehasport Clinic, Poznan University of Medical Sciences, Poznan, Poland

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Leszek Romanowski Department of Traumatology, Orthopaedics and Hand Surgery, Poznan University of Medical Sciences, Poznan, Poland

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). 10 Suspicion of a bony problem may also come from physical examination of the shoulder. In 2008, Bushnell et al, 11 presented the concept of a bony apprehension test in patients with significant bone lesions in shoulder instability. The

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Megan Conti Mica University of Chicago, Chicago, Illinois, USA
Department of Orthopedics, AZ Monica, Deurne, Belgium
Department of Orthopedics, AZ Monica, Deurne, and University Hospital Antwerp, Edegem, Belgium

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Pieter Caekebeke University of Chicago, Chicago, Illinois, USA
Department of Orthopedics, AZ Monica, Deurne, Belgium
Department of Orthopedics, AZ Monica, Deurne, and University Hospital Antwerp, Edegem, Belgium

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Roger van Riet University of Chicago, Chicago, Illinois, USA
Department of Orthopedics, AZ Monica, Deurne, Belgium
Department of Orthopedics, AZ Monica, Deurne, and University Hospital Antwerp, Edegem, Belgium

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hypersupinated and a valgus stress along with axial load are applied to the elbow while moving from extension to flexion. The pivot-shift test on a conscious patient is considered positive with apprehension. Under general anaesthesia, the pivot-shift test is

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Victor Housset Clinique de l'épaule, Clinique Maussins-Nollet, Paris, France

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Sean Wei Loong Ho Department of Orthopedic Surgery, Tan Tock Seng Hospital, Singapore

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Alexandre Lädermann Division of Orthopaedics and Trauma Surgery, Hôpital de La Tour, Meyrin, Switzerland
FORE (Foundation for Research and Teaching in Orthopedics, Sports Medicine, Trauma, and Imaging in the Musculoskeletal System), Meyrin, Switzerland
Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland

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Sean Kean Ann Phua Department of Orthopedic Surgery, Tan Tock Seng Hospital, Singapore

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Si Jian Hui Department of Orthopaedic Surgery, National University Health System, Singapore

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Geoffroy Nourissat Clinique de l'épaule, Clinique Maussins-Nollet, Paris, France

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which used inferior apprehension or subluxation ( 20 , 32 , 35 , 50 ) and six studies where it was not explicitly mentioned ( 1 , 18 , 49 , 77 , 78 , 79 ). Figure 2 Clinical photograph showing the presence of the sulcus sign of the left

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Cécile Batailler Hôpital de la Croix Rousse, Hospices Civils de Lyon, France

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Philippe Neyret Burjeel Hospital, Abu Dhabi; UAE

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studies, reported that before trochleoplasty, a positive apprehension test was found in 100% of patients and postoperatively a positive apprehension test was found in 20%. After surgery, the dislocation rate was 2% and the rate of subluxation was 6% at a

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Peter Ström Uppsala University Hospital – Department of Orthopaedics, Uppsala, Sweden

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mechanism, especially paying attention to dislocation of the shoulder and any residual instability. Full physical examination of the shoulder girdle both active and passive motion, strength, neurovascular status, and apprehension test is essential. Plain

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Daan Vermeulen Department of Orthopaedic Surgery, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands

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Mara Rosa van der Valk Department of Orthopaedic Surgery, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands

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Laurens Kaas Department of Orthopaedic Surgery, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands

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removable character of the splint. In comparative post-treatment apprehension tests, both the cylinder plaster and the splint show the same percentage of positive apprehension tests (53%) and in terms of redislocation of the patella after treatment, the

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Stefan Bauer Ensemble hospitalier de la Côte, Chirurgie de l’épaule, Chemin du Crêt 2, Morges, Vaud, Switzerland
The University of Western Australia, Perth, Australia

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Phillipe Collin CHP Saint-Gregoire, 6 Boulevard de la Boutière 35760 Saint-Grégoire, France
Clinique Victor Hugo, 5 Bis rue du Dôme 75016 Paris, France
American Hospital of Paris, 55 Boulevard du Château, 92200 Neuilly-sur-Seine, France

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Matthias A Zumstein Shoulder, Elbow and Orthopaedic Sports Medicine, Sonnenhof Orthopaedics, Bern, Switzerland
Shoulder, Elbow Unit, Sportsclinicnumber1, Papiermuehlestrasse 73, 3014 Bern, Switzerland
Shoulder, Elbow and Orthopaedic Sports Medicine, Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, Bern, Switzerland

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Lionel Neyton Ramsay Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France

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William G Blakeney The University of Western Australia, Perth, Australia
Royal Perth Hospital, Perth, Australia

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(Bankart and variants or humeral avulsion of glenohumeral ligament (HAGL)). Recurrent episodes may include further dislocations, symptomatic subluxations or apprehension. The clinical assessment, imaging and injury patterns were previously described in

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Patrick Goetti Department of Orthopaedics and Traumatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland

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Patrick J. Denard Department of Orthopaedic & Rehabilitation, Oregon Health & Science University, Portland, Oregon, USA

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Philippe Collin Centre Hospitalier Privé Saint-Grégoire (Vivalto Santé), Saint- Grégoire, France

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Mohamed Ibrahim Department of Orthopaedics and Trauma Surgery, Faculty of Medicine, Fayoum University, Fayoum, Egypt

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Pierre Hoffmeyer Hirslanden Clinique des Grangettes, Geneva, Switzerland

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Alexandre Lädermann Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland
Faculty of Medicine, University of Geneva, Geneva, Switzerland
Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland

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joint is above 105 degrees, there is apprehension above 90 degrees of abduction, or if a difference of more than 20 degrees between the two shoulders is noted. 13 , 14 Pathological laxity is often multidirectional and associated with a redundant

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Abdul-ilah Hachem Department of Orthopedic Surgery, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain

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Andres Molina-Creixell Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Mexico

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Xavier Rius Department of Orthopedic Surgery, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain

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Karla Rodriguez-Bascones Department of Orthopedic Surgery, Asepeyo Hospital, Barcelona, Spain

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Francisco Javier Cabo Cabo Department of Orthopedic Surgery, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain

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Jose Luis Agulló Department of Orthopedic Surgery, Bellvitge University Hospital, L’Hospitalet de Llobregat, Barcelona, Spain

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Miguel Angel Ruiz-Iban Ramón y Cajal University Hospital, Madrid, Spain

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indicated ( 12 ). Clinical assessment Patients with recurrent posterior shoulder instability will present with a characteristic history and clinical presentation. While posterior labral lesions can also yield pain and apprehension, posterior

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