Document Detail


The role of arthroscopy in revision of failed open anterior stabilization of the shoulder.
MedLine Citation:
PMID:  19801285     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The purpose of this study was to evaluate the results of revision arthroscopic stabilization after failed open anterior shoulder stabilization. METHODS: We studied a retrospective series of 22 consecutive patients with recurrent anterior shoulder instability after open surgical stabilization (12 Latarjet procedures, 4 Eden-Hybinette procedures, 3 open Bankart repairs, and 3 capsular shifts). Failure was associated with a traumatic episode in 12 patients, capsular laxity with persistent Bankart lesions in all patients, and a bone block complication in 13 patients. Labral reattachment and capsuloligamentous retensioning with suture anchors were performed in all cases. An additional rotator interval closure was performed in 4 cases and an inferior capsular application in 12. Bone block screws were removed during arthroscopy in 8 patients because of malpositioning or mobility. Nineteen patients were evaluated at a mean follow-up of 43 months. RESULTS: All patients returned to their previous occupations, including 6 cases of work-related injury. Of the patients, 1 (5%) had recurrent subluxation and 2 (11%) had persistent apprehension. The subjective shoulder value was 83% +/- 23%. A good or excellent result was found in 85% of patients according to the Walch-Duplay score and 13 patients (67%) according to the Rowe score. Shoulder pain was found in 6 patients (32%) (4 with light pain and 2 with moderate pain). Of the 5 patients with osteoarthritis before surgery, 3 progressed by 1 stage. CONCLUSIONS: Arthroscopic revision of failed open anterior shoulder stabilization provides satisfactory results in a selected patient population. Some persistent pain and osteoarthritis progression remain concerns. The main advantages of the arthroscopic approach are the avoidance of anterior dissection in front of the subscapularis, which places the axillary nerve at risk, and the ability to address the various soft-tissue pathologies encountered. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
Authors:
Pascal Boileau; Julian Richou; Andrea Lisai; Christopher Chuinard; Ryan T Bicknell
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Publication Detail:
Type:  Journal Article     Date:  2009-09-06
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  25     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-05     Completed Date:  2009-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1075-84     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery and Sports Traumatology, H??pital de L'Archet, University of Nice, Nice, France.
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MeSH Terms
Descriptor/Qualifier:
Accidents, Occupational
Adult
Arthroscopy* / methods
Athletic Injuries / surgery
Bone Screws / adverse effects
Bone Transplantation
Cartilage, Articular / injuries,  surgery
Device Removal
Female
Follow-Up Studies
Humans
Joint Instability / surgery*
Ligaments, Articular / injuries,  surgery
Male
Osteoarthritis / complications
Pain, Postoperative / epidemiology
Recurrence
Reoperation / methods*
Retrospective Studies
Shoulder Dislocation / surgery*
Shoulder Joint / injuries,  surgery*
Shoulder Pain / epidemiology
Treatment Failure
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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