A comprehensive comparison and evaluation of surgical techniques for anterior shoulder instability: a Bayesian network meta-analysis

Masud, Saad; Momtaz, David; Betsch, Marcel; Migliorini, Filippo; Ghali, Abdullah; Popa, Alexander; Gouveia, Kyle; Leroux, Timothy; Degen, Ryan M.; Khan, Moin

doi:10.1016/j.jse.2023.07.004

Cited by 3 publications

(1 citation statement)

References 78 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The first treatment for a bony Bankart lesion was single-point fixation. This gradually evolved from screw single-point fixation during open surgery to arthroscopic anchor fixation; the latter provided better functional outcomes and somewhat better stability [4,18]. Shoulder arthroscopic surgery is less traumatic than open surgery; the operation is more delicate and other injuries can also be repaired.…”

Section: Discussionmentioning

confidence: 99%

Modified double‐pulley fixation provides better reduction of bone fragments and union compared to single‐point fixation in bony Bankart lesions

Qu,

Fu,

Shen

et al. 2024

Knee surg. sports traumatol. arthrosc.

View full text Add to dashboard Cite

PurposeThe purpose of this study was to compare clinical scores and imaging outcomes of bony Bankart lesions that underwent single‐point and modified double‐pulley fixation after at least 2 years of follow‐up.MethodsPatients who underwent surgery to treat bony Bankart injuries were included and divided into groups A and B. A total of 69 patients were included (32 in group A and 37 in group B). Patients in group A underwent arthroscopic modified double‐pulley fixation and patients in group B underwent arthroscopic single‐point fixation. Three‐dimensional computed tomography (3D‐CT) was used to assess glenoid reduction one day after surgery. Postoperative bony union was assessed using 3D‐CT and multiplanar reconstruction images 6 months after surgery. Constant–Murley, Rowe rating system, visual analogue scale and University of California at Los Angeles and American Shoulder and Elbow Surgeons scores were recorded before and after surgery.ResultsIn terms of imaging measurements, there was no significant group difference in the preoperative size of the glenoid defect, the size of the bony fragment or the expected postoperative size of the glenoid defect. The sizes of the actual postoperative glenoid defects differed significantly between the groups (p = 0.027), as did the absolute difference between the expected and actual glenoid defect sizes (p < 0.001). At 6 months postoperatively, 50.0% of group A patients and 24.3% of group B patients exhibited complete bony union (p = 0.027); the rates of partial union were 37.5% and 56.8%, respectively. At the final follow‐up, all clinical scores were significantly better than the preoperative scores (all p < 0.05), with no significant group differences (not significant).ConclusionsThe use of the modified double‐pulley technique with two anchors to treat bony Bankart injuries provides a better reduction of bone fragments than single‐point fixation with two anchors and was associated with a higher rate of early bone union.Level of EvidenceLevel III.

show abstract

Section: Discussionmentioning

confidence: 99%

Modified double‐pulley fixation provides better reduction of bone fragments and union compared to single‐point fixation in bony Bankart lesions

Qu,

Fu,

Shen

et al. 2024

Knee surg. sports traumatol. arthrosc.

View full text Add to dashboard Cite

show abstract

Latarjet and Bankart Repairs: Instagram-Based Perception Analysis Shows Comparable Patient Experiences

Gutiérrez-Zúñiga,

Candura,

Delgado

et al. 2024

Arthroscopy, Sports Medicine, and Rehabilitation

View full text Add to dashboard Cite

What’s New in Shoulder and Elbow Surgery

Harrison,

Braman,

Cagle

2024

Journal of Bone and Joint Surgery

View full text Add to dashboard Cite

The aim of this Guest Editorial is to highlight recent advancements in the study and practice of shoulder and elbow surgery for the practicing orthopaedic surgeon. Rotator Cuff Nonoperative ManagementNonoperative management remains a primary method of treatment for rotator cuff tears, with platelet-rich plasma (PRP) and corticosteroid injections as components of this treatment option. A recent systematic review and meta-analysis reviewed 9 studies with 537 patients. The authors found no difference in pain, function, complications, or retear rates when repair with and without PRP was analyzed 1 . Another systematic review and meta-analysis examined 9 randomized controlled trials (RCTs) that compared PRP with corticosteroids to treat rotator cuff disease in 469 patients 2 . The Constant score, Simple Shoulder Test, and American Shoulder and Elbow Surgeons score were reviewed at short-term, intermediate-term, and long-term follow-ups. Corticosteroids were superior in the short term, and PRP was demonstrated to be more beneficial in the long term.Perioperative management during rotator cuff repair continues to evolve. Nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclooxygenase-2 (COX-2) inhibitors have been a mainstay, but their utilization in the immediate postoperative period following rotator cuff repair remains controversial. A recent systematic review and meta-analysis examined whether NSAIDs or COX-2 inhibitors influenced healing rates, functional outcomes, or patient satisfaction after rotator cuff repair 3 . The authors included 7 RCTs with 507 patients. NSAIDs did not affect the cuff healing rate, but NSAID use significantly improved postoperative pain and functional outcomes. Postoperative pain and functional outcomes were not different with COX-2 inhibitors. Zoledronic acid has also been the subject of recent investigation. A recent prospective, single-blinded randomized study enrolled 138 female patients with postmenopausal osteoporosis undergoing rotator cuff repair. Tendon healing was evaluated with ultrasound at 6 weeks and 24 months. The results demonstrated that zoledronic acid reduced the retear rate but did not significantly influence the clinical standardized outcomes 4 .Finally, the use of a brace compared with a simple sling was examined with a systematic review and meta-analysis 5 . The authors reviewed 275 articles, but only 4 articles (302 patients) met inclusion criteria. There was no advantage in brace compared with sling use in standardized outcome scores, a visual analog scale (VAS) for pain, and shoulder range of motion. The authors suggested that a simple sling may be a superior choice because of the potential cost savings. Surgical Technique and Biologic AugmentationImproving the biologic environment for rotator cuff repairs may improve healing rates and outcomes. A recent RCT compared 60 patients treated with arthroscopic rotator cuff repair with and without bone marrow stimulation. Fifty of the patients were available at the 2-year follow-up. Clinical outcomes and retear rates w...

show abstract

A comprehensive comparison and evaluation of surgical techniques for anterior shoulder instability: a Bayesian network meta-analysis

Cited by 3 publications

References 78 publications

Modified double‐pulley fixation provides better reduction of bone fragments and union compared to single‐point fixation in bony Bankart lesions

Modified double‐pulley fixation provides better reduction of bone fragments and union compared to single‐point fixation in bony Bankart lesions

Latarjet and Bankart Repairs: Instagram-Based Perception Analysis Shows Comparable Patient Experiences

What’s New in Shoulder and Elbow Surgery

Contact Info

Product

Resources

About