Chronic anterior shoulder instability with significant Hill–Sachs lesion: Arthroscopic Bankart with remplissage versus open Latarjet procedure

Aliou, Bah; Lateur, Gabriel; Kouevidjin, B.T.; Bassinga, J.Y.S.; Issa, Mohammed; Jaafar, A.; Beaudouin, Emmanuel

doi:10.1016/j.otsr.2017.11.009

Cited by 46 publications

(53 citation statements)

References 28 publications

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“…There was no difference at one year between patients who underwent surgery on an outpatient or inpatient basis. Besides, the clinical results of both groups according to persistent pain and apprehension and loss of external rotation were similar to what was already reported in the literature [5][6][7][8][9]. The use of interscalene block with long-acting local anesthetic is a well-accepted approach that produces 8 to 12 hours of postoperative analgesia [10].…”

Section: Discussionsupporting

confidence: 81%

Outpatient Latarjet Procedure: Early Complications and Feasibility Validation

Zilber

Raboudi

2019

OSMOAJ

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Background:The Latarjet procedure may be amenable to outpatient elective surgery as it is often performed on young and healthy patients. Thus, ambulatory surgery for Latarjet procedure is recently rapidly increasing in France with very few validation studies. This feasibility study presents early adverse events following outpatient Latarjet surgery compared to Latarjet surgery performed as an inpatient procedure. Hypothesis:There is no difference between outpatient or inpatient Latarjet procedure.Patients and Methods: Thirty patients operated on an outpatient basis and prospectively followed were compared to 30 patients operated on an inpatient basis. All procedures were performed by the same surgeon. Complication rates as well as clinical outcomes at one year were compared between groups.Results: Post-operative hematomas which did not require surgery occurred more frequently in outpatient group in which no drain was used. No other differences occurred between groups. All outpatients but one was satisfied with the procedure. Discusion:The latarjet procedure was found to be safe when performed on an outpatient basis. The addition of wax to the base of the coracoid seemed to diminish hematoma formation.

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Section: Discussionsupporting

confidence: 81%

Outpatient Latarjet Procedure: Early Complications and Feasibility Validation

Zilber

Raboudi

2019

OSMOAJ

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“…The failure rate of closed reduction was high due to soft tissue obstruction (long head of biceps, intra-glenoid scar, or posterior capsular contracture) and osseous block (glenoid fractures or engaging Hill-Sachs lesions), meanwhile the danger of an iatrogenic fracture or neurovascular damage was also high 8,22 . The pathophysiological changes of the chronic anterior shoulder dislocation were different from those of recurrent anterior dislocation, which also limited the application of arthroscopy 6,23,24 . In this study, the duration of dislocation was more than 3 weeks in all cases, and all patients underwent open reduction and stabilization of the involved shoulder.…”

Section: Discussionmentioning

confidence: 99%

“…They concluded that the post‐RTSA instability had two distinct etiologies: (i) instability due to inadequate soft tissue tensioning and/or axillary nerve palsy; and (ii) instability due to impingement or liner failure. Bah et al 24 . compared arthroscopic Bankart with remplissage with open Latarjet procedure for chronic anterior shoulder instability with significant Hill–Sachs lesion.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Chronic Anterior Shoulder Dislocation by Coracoid Osteotomy with or without Bristow–Latarjet Procedure

Yang

Zhang

et al. 2020

Orthopaedic Surgery

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Objective: To investigate the clinical efficacy and outcomes of the coracoid osteotomy with or without Bristow-Latarjet procedures in the treatment of chronic anterior shoulder dislocation (CASD). Methods: Between January 2013 and January 2019, 20 shoulders of 18 patients who were diagnosed with chronic anterior dislocation and underwent open reduction in our trauma center were retrospectively studied. Open coracoid osteotomy with Bristow-Latarjet procedures were performed on 16 shoulders and open coracoid osteotomy without Bristow-Latarjet procedures were performed on four shoulders. Open coracoid osteotomy with or without Bristow-Latarjet procedures were chosen on the basis of the stability of the shoulder after reduction. Outcomes were assessed preoperatively and postoperatively with the visual analog scale (VAS) for pain, the American Shoulder and Elbow Surgeons (ASES) score, the University of California Los Angeles (UCLA) shoulder rating scale, and the range of motion (ROM) for shoulder activity. Results: There were three males and 15 females with an average age of 60.94 AE 2.69 years. The time between dislocation and treatment ranged from 21 to 240 days with an average of 73.3 AE 14.4 days. All patients were available for a mean follow-up of 15.2 AE 4.3 months. No procedure-related death or incision-related superficial or deep tissue infection was identified in all cases. No iatrogenic neurovascular injuries or fractures were found in this study. At the time of 12 months follow-up, the range of motion and the shoulder functional evaluation (VAS [P < 0.001], ASES [P < 0.001], and UCLA score [P < 0.001]) in patients who underwent Bristow-Latarjet procedures were significantly improved. Subluxation after surgical procedure was found and confirmed in one patient and this patient refused to undergo revision surgery. According to the Samilson and Prieto classification system, 16 shoulders were assessed as grade 0, three shoulders were grade 1, one shoulder was grade 2. Conclusions: Coracoid osteotomy with or without Bristow-Latarjet procedure yielded an acceptable clinical result in this study. This method has the advantages of enlarging the exposure of surgical field, assisting reduction of shoulder, and convenient conversion to Bristow-Latarjet procedure. It is an efficient and reliable method for treatment of chronic anterior shoulder dislocation. A 69-year-old woman diagnosed with right chronic anterior shoulder dislocation with large Hill-Sachs lesion. The latarjet procedure with remplissage technique was applied for this patient.

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“…8,9 For many surgeons, the amount of glenoid and humeral bone loss in this study's patient population would encourage additional stabilizing measures in the form of Latarjet or Bankart repair with the addition of remplissage (the debate wears on). [10][11][12] Thus, another way to interpret the potential value anterior glenoid cartilage curettage is as an additional tool when treating patients in subcritical bone loss. Perhaps removing 5 mm of glenoid cartilage allows for anchor placement further posterior on the glenoid face, thus further closing off of the anterior glenohumeral joint space while providing potential added biologic benefit of increased bone to capsulolabral apposition.…”

Section: See Related Article On Page 837mentioning

confidence: 99%

Editorial Commentary: Improving Arthroscopic Bankart Repair Outcomes in Patients With Subcritical Bone Loss: Does Giving Up a Little (Cartilage), Give Us a Lot (of Stability)?

Schillhammer

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Over the past 3 decades, arthroscopic Bankart repair has become the gold standard for anterior shoulder instability in the absence of significant bone loss. Glenoid curettage may seem unusual in the setting of Bankart repair, but the advantage of a bleeding bony surface in reconstructive procedures is nearly universal in sports medicine, from cartilage restoration in the knee to rotator cuff repair. Intuitively, maximizing the surface of bleeding bone should improve healing, but is it really necessary to remove undamaged cartilage to create a healing response? Perhaps not in general, but in high-risk patients with subcritical bone loss curettage it could make sense. It has been well established that as the amount of bone loss drifts above 10%, recurrent instability after standard Bankart repair begins to rise. For many surgeons, the amount of glenoid and humeral bone loss in this patient population would encourage additional stabilizing measures in the form of Latarjet or Bankart repair with the addition of remplissage. Anterior glenoid cartilage curettage could be an additional tool when treating patients in subcritical bone loss. Removing 5 mm of glenoid cartilage may allow for anchor placement further posterior on the glenoid face, thus further closing off of the anterior glenohumeral joint space while providing potential added biologic benefit of increased bone to capsulolabral apposition. The addition of remplissage could further enhance stability and help hold the humeral head posteriorly and perhaps obviate the need for a bone block procedure.

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Chronic anterior shoulder instability with significant Hill–Sachs lesion: Arthroscopic Bankart with remplissage versus open Latarjet procedure

Abstract: III; comparative retrospective study.

Cited by 46 publications

References 28 publications

Outpatient Latarjet Procedure: Early Complications and Feasibility Validation

Outpatient Latarjet Procedure: Early Complications and Feasibility Validation

Treatment of Chronic Anterior Shoulder Dislocation by Coracoid Osteotomy with or without Bristow–Latarjet Procedure

Editorial Commentary: Improving Arthroscopic Bankart Repair Outcomes in Patients With Subcritical Bone Loss: Does Giving Up a Little (Cartilage), Give Us a Lot (of Stability)?

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