Evaluation of the Results From Arthroscopic Surgical Treatment for Traumatic Anterior Shoulder Instability Using Suturing of the Lesion at the Opened Margin of the Glenoid Cavity

Abstract

Objective: To evaluate the clinical results from patients with traumatic anterior shoulder instability that was treated surgically through arthroscopic viewing, using bioabsorbable anchors and a technique for remove the cartilage of the anterior glenoid rim for repairing a Bankart lesion. Method: Between March 2006 and October 2008, 27 shoulders in 27 patients with a diagnosis of traumatic anterior shoulder instability were operated. The patients’ mean age was 28 years and they had had between two and 25 previous episodes of dislocation. The patients were predominantly male (24; 89%). The minimum length of follow-up was 24 months and the mean was 36 months. None of the patients had previously undergone surgery on the affected shoulder or had any significant bone lesion at the glenoid margin. The postoperative clinical assessment was done using the Rowe scale. To measure the preoperative and postoperative joint range of motion, we used the method described by the American Academy of Orthopaedic Surgeons (AAOS). Results: According to the Rowe criteria, 25 patients (93%) achieved excellent results and two (7%) had poor results. None of the patients presented good or fair results. Twenty-three patients were satisfied with the results obtained (85%), and returned to their activities without limitations, while four patients (15%) had some degree of limitation. There was recurrence of instability in two patients (7%). Conclusion: Treatment of traumatic anterior shoulder instability through arthroscopic viewing using a technique for remove the cartilage of the anterior glenoid rim for repairing a Bankart lesion provided excellent results for 93% of the patients operated.

Analysis of postoperative monitoring of patients undergoing shoulder arthroscopy for anterior instability

“…Those authors did not include in the analysis cases that presented recurrence. 9 In the present study, presence of shoulder pain complaints was observed in 30% of the sample. Presence of pain does not appear to be related to treatment success or failure.…”

“… 19 The sample recurrence rate was 10%, but most athletes presented pain complaints even without recurrence, especially when doing activities that required excessive effort shoulder. 19 Miyazaki et al 9 observed a rate of 8% for persistence of postoperative pain without a plausible explanation for patients with good result at the end of treatment. Those authors did not include in the analysis cases that presented recurrence.…”

“…In recent years, a tendency to increase indications for arthroscopic treatment has been observed. 1 , 4 , 6 , 7 , 8 , 9 , 10 In the United States, between 2003 and 2005, 71.2% of all Bankart lesions were treated with arthroscopy, while between 2006 and 2008 this percentage increased to 87.7%. 2 The literature is controversial regarding which method achieves better results, especially when the prevalence of recurrence of dislocation after surgery is assessed.…”

“… 11 More recent studies demonstrated that the standardization of the arthroscopic technique and careful selection of patients decreased the prevalence of recurrence, with rates similar to the open technique. 2 , 3 , 8 , 9 …”

Arthroscopic Treatment of First-Time Shoulder Dislocations in Younger Athletes

“…The incidence of glenohumeral instability is approximately 1.7 injuries for each 1000 people in the American and European population, and a traumatic cause is responsible for the vast majority of cases. 20,21…”