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      Arthroscopic Bone Graft Procedure Combined With Arthroscopic Subscapularis Augmentation for Recurrent Anterior Instability With Glenoid Bone Defect

      brief-report
      Author(s): , M.D. a , , M.D. b , ∗ , , M.D. c , , M.D. d
      Publication date (Electronic):
      Journal: Arthroscopy Techniques
      Publisher: Elsevier

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          Abstract

          Glenoid bone loss and capsular deficiency represent critical points of arthroscopic Bankart repair failures. The purpose of this Technical Note is to present an all-arthroscopic bone block procedure associated with arthroscopic subscapularis augmentation for treating glenohumeral instability with glenoid bone loss and anterior capsulolabral deficiency. Two glenoid tunnels are set up from the posterior to the anterior side using a dedicated bone block guide, and 4 buttons are used to fix the graft to the glenoid. The subscapularis tenodesis is performed using a suture tape anchor. This combined arthroscopic technique (bone block associated with arthroscopic subscapularis augmentation) could be a valid and safe alternative to the arthroscopic or open Latarjet procedures.

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          The Bankart procedure: a long-term end-result study.

          C Rowe, D. Patel, W Southmayd (1978)
          Of 161 patients with 162 shoulders operated on during a thirty-year period (1946 to 1976), 124 were re-examined and twenty-one answered a questionnaire. The lesions found at surgery were separation of the capsule from the anterior glenoid rim in 85 per cent, a Hill-Sachs lesion of the humeral head in 77 per cent, and damage to the anterior glenoid rim (including fracture) in 73 per cent. There were five recurrences (3.5 per cent) after repair by the method described in the 145 shoulders that were followed. Only one of the forty-six patients with dislocation on the dominant side and one of the thirty-one with dislocation on the non-dominant side failed to return to the competitive athletic activities in which they participated prior to injury. The results at follow-up were rated excellent in 74 per cent, good in 23 per cent, and poor in 3 per cent. Ninety-eight per cent of the patients rated their result as excellent or good. Sixty-nine per cent of the shoulders had a full range of motion, and only 2 per cent of these shoulders redislocated. A fracture of the rim of the glenoid did not increase the risk of recurrence, while a moderate to severe Hill-Sachs lesion increased the risk only slightly. We concluded that with the meticulous technique of the Bankart repair as described, postoperative immobilization is not necessary, early return of motion and function can be expected, and resumption of athletic activities with no limitation of shoulder motion is possible for most patients.
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            [Treatment of recurrent dislocation of the shoulder].

            M LATARJET (2015)
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              Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder.

              C Glorion, D Goutallier, T. J. Allain (1998)
              We performed ninety-five consecutive Latarjet procedures for the treatment of recurrent anterior instability of the shoulder between 1969 and 1983. In 1993, we retrospectively reviewed the clinical and radiographic results that were available for fifty-six patients (fifty-eight shoulders) who had been followed for an average of 143 years (range, ten to twenty-three years). The purpose of the study was to determine the prevalence of glenohumeral osteoarthrosis and the factors related to its development after the Latarjet procedure. The procedure was performed for the treatment of recurrent anterior dislocation in fifty shoulders and painful recurrent anterior subluxation in eight. All patients had a radiographic evaluation (three anteroposterior radiographs, with the humerus in external, neutral, and internal rotation, and one lateral radiograph) before the operation and at the latest follow-up examination. At the time of the latest follow-up, none of the patients had recurrent dislocation, six patients had apprehension with regard to possible dislocation, and one had occasional subluxation. According to the system of Rowe et al., fifty-one (88 per cent) of the fifty-eight shoulders had an excellent or good result; five (9 per cent), a fair result; and two (3 per cent), a poor result. Twenty-two shoulders had no glenohumeral osteoarthrosis. Thirty-four shoulders had centered glenohumeral osteoarthrosis (the humeral head remained in front of the center of the glenoid cavity), which was grade 1 in twenty-five shoulders, grade 2 in four, grade 3 in three, and grade 4 in two, and two shoulders had grade-4 eccentric glenohumeral osteoarthrosis (the humeral head was more proximal than normal in relation to the center of the glenoid cavity). Postoperative grade-1 glenohumeral osteoarthrosis, unlike the higher grades, had no effect on the function of the shoulder.
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                Author and article information

                Contributors
                Marco Maiotti
                Journal
                Journal ID (nlm-ta): Arthrosc Tech
                Journal ID (iso-abbrev): Arthrosc Tech
                Title: Arthroscopy Techniques
                Publisher: Elsevier
                ISSN (Electronic): 2212-6287
                Publication date PMC-release: 14 May 2018
                Publication date Collection: June 2018
                Publication date (Electronic): 14 May 2018
                Volume: 7
                Issue: 6
                Pages: e623-e632
                Affiliations
                [a ]Orthopedics and Traumatology Unit, Pellegrini Hospital, Naples, Italy
                [b ]Sports Medicine Unit and Orthopedic Center, San Giovanni Addolorata Hospital, Rome, Italy
                [c ]Orthopedics and Traumatology Unit, Galeazzi Hospital, Milan, Italy
                [d ]Orthopedics and Traumatology Unit, University of Tor Vergata, Rome, Italy
                Author notes
                [∗ ]Address correspondence to Marco Maiotti, M.D., Sports Medicine Center, Via Archimede 153, 00184 Rome, Italy. maiotti.marco@ 123456gmail.com
                Article
                Publisher ID: S2212-6287(18)30025-2
                DOI: 10.1016/j.eats.2018.02.009
                PMC ID: 6020248
                SO-VID: 05571626-ae24-4ce0-a3ce-06af6573ee40
                Copyright © © 2018 by the Arthroscopy Association of North America. Published by Elsevier.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 16 November 2017
                Date accepted : 17 February 2018
                Categories
                Subject: Technical Note

                Data availability:

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