Arthroscopic therapy of recurrent anterior luxation of the shoulder by capsular repair

Reasons for failure after surgical repair of anterior shoulder instability

“…In addition to the traditional methods of open repair, 1,10,11,15,17,25,27 in recent years more emphasis has been placed on arthroscopic techniques. 5,8,12,13,16,18,19,22,29 Recurrence rates of 2% to 8% can be expected with open surgical stabilization techniques. 7,15,17,23,27 The recurrence rate is higher for arthroscopic stabilization depending on the procedure used.…”

“…7,15,17,23,27 The recurrence rate is higher for arthroscopic stabilization depending on the procedure used. 8,9,13,18,22 The fact that the recurrence rate is so low, especially for open surgery, makes it all the more interesting to investigate the causes of failure of surgical stabilization.…”

Arthroscopic revision of Bankart repair

“…4,15,17,21,25 Generally, it has been regarded that arthroscopic stabilization provides a slightly higher recurrence rate. 5,6,13,18,20 This may be attributed in part to unaddressed capsular redundancy and tears of the anterior labrum, which can be addressed arthroscopically with current suture anchor techniques. Thus, more recent reports on arthroscopic repair with suture anchors have yielded results comparable with open techniques.…”

Anterior instability of the shoulder after trauma

“…68,96 After arthroscopic stabilisation, neurovascular injury, [97][98][99] adhesive capsulitis 100 and synovial fistula 101 have all been encountered. Other complications are specific to the particular technique used to repair the Bankart lesion and include loosening, breakage and impingement after the use of staples; 102,103 injury to the suprascapular nerve and pain from the posterior knot after transglenoid repair; 101,104 foreign-body reaction, rapid decay leading to intra-articular dissociation of the head after repair with bioabsorbable tacks; 105,106 and pull-out after repair with suture anchors. 80 These complications are comparatively rare, but often require surgical re-exploration and are associated with a poor functional outcome or recurrent instability.…”