{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T16:50:21Z","timestamp":1785171021248,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2016,5,12]],"date-time":"2016-05-12T00:00:00Z","timestamp":1463011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,5,12]],"date-time":"2016-05-12T00:00:00Z","timestamp":1463011200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2016,5,12]],"date-time":"2016-05-12T00:00:00Z","timestamp":1463011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.jp","clinicalkey.com","clinicalkey.es","arthroscopyjournal.org","clinicalkey.com.au","clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To analyze clinical outcomes, range of motion, rate of recurrence, and complications after procedures to manage shoulder instability in patients with humeral avulsion of the glenohumeral ligament (HAGL) lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review of the literature according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses) guidelines with a PRISMA checklist and algorithm was performed. A comprehensive search of PubMed, Medline, CINAHL, Cochrane, Embase, and Google Scholar databases using various combinations of the Keywords \u201cshoulder,\u201d \u201cHAGL,\u201d \u201ctreatment,\u201d \u201clesion,\u201d \u201cdislocation,\u201d \u201cinstability,\u201d \u201cclinical,\u201d \u201coutcome,\u201d \u201cBankart\u201d since inception of databases to 2015 was performed. All the investigators independently extracted the following data: demographics, types of lesions and associated injuries, treatment, outcome measurements, range of motion, recurrent instability, and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eleven articles were included in which 42 shoulders with HAGL lesions were evaluated. Patients were assessed at a median follow\u2010up period of 25.5\u00a0months, ranging from 12 to 54\u00a0months. The overall rate of recurrence was 0% (0 of 25) in case of surgery and 90% (9 of 10) in case of nonoperative treatment. The surgical approach was associated with lower rate of recurrence when compared with nonoperative treatment (odds ratio 0.05, 95% confidence interval 0.01 to 0.42, and\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .006). Only 2 papers reported loss of external rotation after surgery. No\u00a0complications were reported after surgery. Complications after nonoperative treatment were not discussed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Recognizing HAGL lesions is important to manage patients with glenohumeral instability. Patients' complaints are often nonspecific. A high index of suspicion is required in patients with prior failed shoulder surgery. HAGL lesions are often associated with other shoulder lesions. Arthroscopic or open repairs of HAGL lesions are associated with good clinical outcomes and a lower rate of recurrence compared with nonoperative treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, systematic review of Level IV studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2016.03.009","type":"journal-article","created":{"date-parts":[[2016,5,12]],"date-time":"2016-05-12T10:24:13Z","timestamp":1463048653000},"page":"1868-1876","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":62,"title":["Humeral Avulsion of the Glenohumeral Ligaments: A\u00a0Systematic Review"],"prefix":"10.1002","volume":"32","author":[{"given":"Umile Giuseppe","family":"Longo","sequence":"first","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery Campus Bio\u2010Medico University Trigoria Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Rizzello","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery Campus Bio\u2010Medico University Trigoria Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Ciuffreda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery Campus Bio\u2010Medico University Trigoria Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Locher","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery Campus Bio\u2010Medico University Trigoria Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Berton","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery Campus Bio\u2010Medico University Trigoria Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Salvatore","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery Campus Bio\u2010Medico University Trigoria Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Denaro","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery Campus Bio\u2010Medico University Trigoria Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,5,12]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-8063(97)90012-8"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.3285.1132"},{"key":"e_1_2_2_4_2","doi-asserted-by":"crossref","unstructured":"Longo UG van der Linde JA Loppini M Coco V Poolman\u00a0RW Denaro V. 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