“…1,3,8,15-17,23,26,29,32-34,36,41,43,45,46,48,54,57,62,64,66-70,74-79,82,84 c Open bone. 6,8,14,20,31,35,37,44,51-53,79,80,84 d Arthroscopic bone. 20,21,35,38,51,83 e Arthroscopic soft tissue and remplissage.…”
Background: The surgical treatment of recurrent shoulder instability has evolved in recent years to include a variety of soft tissue and bone block procedures, undertaken with either an open or arthroscopic approach. Although the utilization of such techniques has rapidly expanded, the associated risk of complications remains poorly defined. This information is vital for clinical decision making and patient counseling. Purpose: To quantify the complication rate associated with all types of surgery for anterior glenohumeral joint dislocation. Study Design: Systematic review. Methods: A systematic search was undertaken of studies reporting complications from anterior shoulder stabilization surgery. Inclusion criteria were studies published in English between 2000 and 2017 with a minimum 2-year follow-up. Methodological quality of the included studies was assessed with the Methodological Index for Non-Randomized Studies criteria. Complication rates for all undesirable events contributing to the patient outcome were extracted and cumulative rates calculated. Results: Out of 1942 references, 56 studies were included, totaling 4362 procedures among 4336 patients. Arthroscopic soft tissue repair had a complication rate of 1.6% (n = 2805). When repair was combined with arthroscopic remplissage, the rate was 0.5% (n = 219). Open soft tissue repair had a complication rate of 6.2% (n = 219) and open labral repair with remplissage, a rate of 2.3% (n = 79). An open bone block procedure had a complication rate of 7.2% (n = 573) and an arthroscopic bone block procedure, a rate of 13.6% (n = 163). Conclusion: This large systematic review demonstrates the overall complication rates (not purely recurrence rates) in modern shoulder stabilization surgery. With the growing interest in bone block stabilization procedures, including those performed arthroscopically, surgeons should be aware of the 10-fold increase in complications for these procedures over soft tissue arthroscopic surgery and counsel their patients accordingly.
“…1,3,8,15-17,23,26,29,32-34,36,41,43,45,46,48,54,57,62,64,66-70,74-79,82,84 c Open bone. 6,8,14,20,31,35,37,44,51-53,79,80,84 d Arthroscopic bone. 20,21,35,38,51,83 e Arthroscopic soft tissue and remplissage.…”
Background: The surgical treatment of recurrent shoulder instability has evolved in recent years to include a variety of soft tissue and bone block procedures, undertaken with either an open or arthroscopic approach. Although the utilization of such techniques has rapidly expanded, the associated risk of complications remains poorly defined. This information is vital for clinical decision making and patient counseling. Purpose: To quantify the complication rate associated with all types of surgery for anterior glenohumeral joint dislocation. Study Design: Systematic review. Methods: A systematic search was undertaken of studies reporting complications from anterior shoulder stabilization surgery. Inclusion criteria were studies published in English between 2000 and 2017 with a minimum 2-year follow-up. Methodological quality of the included studies was assessed with the Methodological Index for Non-Randomized Studies criteria. Complication rates for all undesirable events contributing to the patient outcome were extracted and cumulative rates calculated. Results: Out of 1942 references, 56 studies were included, totaling 4362 procedures among 4336 patients. Arthroscopic soft tissue repair had a complication rate of 1.6% (n = 2805). When repair was combined with arthroscopic remplissage, the rate was 0.5% (n = 219). Open soft tissue repair had a complication rate of 6.2% (n = 219) and open labral repair with remplissage, a rate of 2.3% (n = 79). An open bone block procedure had a complication rate of 7.2% (n = 573) and an arthroscopic bone block procedure, a rate of 13.6% (n = 163). Conclusion: This large systematic review demonstrates the overall complication rates (not purely recurrence rates) in modern shoulder stabilization surgery. With the growing interest in bone block stabilization procedures, including those performed arthroscopically, surgeons should be aware of the 10-fold increase in complications for these procedures over soft tissue arthroscopic surgery and counsel their patients accordingly.
“…7 Intraoperative assessment adds to identifying potential articular injuries that can place the surgical procedure at risk for failure. 8 Douoguih, Goodwin, Churchill, Paulus, and Maxwell in the article "Conjoined Tendon Transfer for Traumatic Anterior Glenohumeral Instability in Patients With Large Bony Defects and Anterior Capsulolabral Deficiency" 9 have modified the bone block transfer by creating a surgical procedure that transfers the conjoined tendon without the bone, allowing for suture anchor fixation. This procedure can be performed as an open procedure or arthroscopically performed.…”
Surgical repair of shoulder instability is challenging, and multiple procedures have been proposed. In an attempt to reduce risk of recurrence following surgical reconstruction, some surgeons have added steps to prior arthroscopic procedures, and other surgeons have selected a bone reinforcement procedure. These additional augmented repair techniques have reduced the risk of postoperative recurrence, but introduced additional risk of complications related to hardware, fixation, and possible need for additional surgery. Surgeons should become familiar with multiple surgical procedures to treat patients with recurrent shoulder instability, and select the appropriate procedure that addresses the demands of the athlete's shoulder and minimize the risk of complication.
“…28 Considering the good clinical results with small bone blocks as in the Bristow procedure, 20 is bone reconstruction necessary or could an isolated sling effect give similar results, as proposed recently by Collin and Lädermann in Arthroscopy Techniques and by Douoguih, Goodwin, Churchill, Paulus, and Maxwell in Arthroscopy? 29,30 All these debates and open questions may remain unanswered for even the younger shoulder surgeons through the rest of their careers, as there still is a substantial amount of work to be done to make the wheel rounder.…”
Section: See Related Article On Page 2128mentioning
Arthroscopic Latarjet procedure has shown satisfactory clinical outcomes in the treatment of anteroinferior shoulder instability. Although as of today there is no proven advantage of the arthroscopic procedure over an open one, it is too early to give up. At the same time, crucial to understand the causes of failure, to find the solutions to every single difficulty to simplify this surgery and to make it as accessible as possible.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.