Objectives:To compare clinical and radiological results of two types of rotator cuff (RC) repairs: the double row and double row-suture bridge. Methods: Forty-two patients with a complete tear (medium and large size) of the RC were repaired by a double row arthroscopic technique. Minimum follow-up was 19 months (range, 19-28 months). Clinical outcomes were assessed by the Modified Constant Scale and satisfaction rate by an independent observer; VAS, UCLA and ASES. Radiological results were assed by a postoperative MRI by a musculoskeletal radiologist. Results: Series of 22 patients in the double row technique (Group A) and 20 patients in the double-row suture bridge (Gruop B). Statistically there was a significant improvement in the Constant Scale, satisfaction rate, muscle assessment, VAS, UCLA and ASES in both groups after the surgical procedure. There were no significant clinical differences between both groups at any time after the surgical procedure. According to MRI postop, 19/22 shoulders in Group A and 18/20 in Group B remained intact, with no significant differences between the two groups Conclusion: RC repairs with double row and double-row-suture bridge techniques provide clinical and radiological good and excelent results. In our retrospective, mid-size study, we have found no differences between these two repair techniques.

Objectives:To present our functional outcomes from patients treated arthroscopically for a failed Bankart repair, using suture anchors and capsulolabral tissue only.Methods:Series of 22 patients presented with a recurrence of instability after a previous stabilization surgery (3 Latarjet, Bankart 19). We treated them by a an all-arthroscopic procedure, avoiding bone grafts, when glenoid track was found to be enough to proceed. The failure was associated with trauma in 11 patients, a non-anatomic repair in 6 patients, capsular laxity in 4 patients and a non-union of the coracoid graft in 1 patient. Revision surgery included: Bankart repair with anchors in 17 cases, a posterior-inferior capsulo-labral plication in one case, and 5 remplissages. In 4 cases subscapularis augmentation was used because of poor capsular quality. Screw removal was necessary when treating the non-union case. Patients were followed-up by a minimum of 23 months (range 23-26), and evaluated by the UCLA Test, SS test and Rowe score.Results:Thirteen patients had an excellent result, 6 good, 2 satisfactory and one bad result, according to UCLA score. The mean Rowe score was 90.4, at final follow up. The Simple Shoulder Test went from an 8 preoperative to an 11 postoperative, mean scores. 19 of 22 patients returned to the same level of activity prior to the injury. Complications: recurrence in 2 cases, subluxation in 2 and one shoulder stiffness that required an arthrolysis.Conclusion:An arthroscopic revision surgery, after a failed Bankart repair, presents satisfactory results in selected patients. Arthroscopic vision allows a correct diagnosis of injuries as possible causes of failure and subsequent treatment.

Fractures of the scapular spine are relatively uncommon and in most cases healing of the fracture is achieved following conservative treatment. We report a case of a 36 year old male who developed a painful atrophic non-union scapular spine fracture producing secondarily subacromial impingement symptoms and his sustained recovery 9 years after treatment by open reduction, internal fixation and bone grafting.

Objective:To evaluate subjective and functional mid term results of patients treated by a lattisimus dorsi tendón transfer arthroscopically assisted for massive irreparable posterolateral injuries of the Rotator Cuff.Methods:Between 2009 and 2012, 17 Lattisimus Dorsi transfers (Paribelli technique) for irreparable posterolateral rotator cuff tears were performed. Distribution by sex: 12 men and 5 women with a mean age of 53 years old (range, 40-63). Thirteen right shoulders and 4 left shoulders. Average duration of symptoms prior to surgery was 8 months (range, 6-13 months). Mean follow-up was 28 months (range, 18-44). Patients were evaluated by the VAS, satisfaction rate, the Constant Modified Scale, postoperative range of motion and strength. Postoperative radiological studies included simple AP radiographs and MRI in order to measure AC distance and asses the integrity of the plasty.Results:Postoperative Constant Modified score averaged 63.54 points. (average increase of 13 points compared to preoperative score. (P ..05)). Active Mobility: a) Mean elevation: 142° postop vs. 119° preop (p <.001). b) Mean abduction: 138.24º postop vs. 112.35º preop (p <.001). c) Mean external rotation 40° postop vs. 20.29º preop (p <.004). Insert text.Conclusion:Lattisimus Dorsi transfer in patients with posterolateral massive irreparable injuries of the RC, is a highly demanding and palliative procedure for those cases with loss of active mobility, especially lifting and shoulder abduction.