Long-term results with the Bankart and Bristow-Latarjet procedures: Recurrent shoulder instability and arthropathy

Hovelius, Lennart; Sandström, Björn; Rösmark, Dan L.; Saebö, Modolv; Sundgren, Kent; Malmqvist, Bengt

doi:10.1067/mse.2001.117128

Cited by 272 publications

(254 citation statements)

References 23 publications

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“…In our series, patients younger than 25 years showed a trend for a higher risk of recurrence. This is similar to previous studies that have reported that younger patients are at higher risk for recurrent instability after instability surgery [8,26,58]. Although our rate of recurrent shoulder instability is disappointing, its interpretation and those reported in the literature depends on the definition of failure.…”

Section: Discussionsupporting

confidence: 90%

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Neer Modification of Open Bankart Procedure: What are the Rates of Recurrent Instability, Functional Outcome, and Arthritis?

Boileau¹,

Fourati²,

Bicknell³

2012

Clinical Orthopaedics &Amp; Related Research

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Background Neer modified the Bankart procedure by combining a superoinferior capsular shift with the labral reattachment. The theoretical advantages of the modification were that such a procedure would restore the patient's anatomy and also treat the repeated capsular stretching encountered in anteroinferior instability without limiting external rotation and, thereby reducing the risk of arthritis. Questions/purposes We therefore determined: (1) the rate of recurrent instability after this modification, (2) patient function, and (3) the incidence and stage of glenohumeral osteoarthritis at greater than 2 years followup in patients with traumatic anteroinferior instability. Methods We retrospectively reviewed all 64 patients (average age, 27 years) who had the modified Bankart procedure for recurrent dislocations (n = 39) or subluxation (n = 25) from 1991 to 1997. The labrum was reattached with suture anchors and a superoinferior capsular shift was added. We determined the rate of recurrent instability, Rowe and Walch-Duplay scores and shoulder ROM, and the presence of glenohumeral osteoarthritis (modified Samilson and Prieto classification). The minimum followup was 24 months (median, 40 months; range, 24-120 months). Results Recurrent instability occurred in seven of the 64 patients (11%) at an average of 25 months postoperatively (range, 7 days to 6 years); in six patients the recurrence was associated with trauma; five of the six patients underwent reoperation with a Latarjet procedure. Eight additional patients (13%) presented with persistent shoulder apprehension or discomfort. The average Rowe score was 83% (range, 20-100%) and average Walch-Duplay score 83% (range, 15-100%). However, only 36 of 64 (56%) patients could return to the same sport at the same level. The loss of external rotation was 13°compared with the contralateral side. Glenohumeral osteoarthritis incidence increased from 4% preoperatively to 17% postoperatively. Conclusions The open Bankart procedure modified by Neer provided high function scores but a relatively low rate of return to sport and high rate of recurrent instability. Our rate of recurrent instability, similar to that obtained with arthroscopic Bankart procedures, has prompted us to abandon the open procedure.

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Section: Discussionsupporting

confidence: 90%

“…In addition, eight patients (13%) had persistent apprehension or pain with an anterior apprehension test. Several poor prognostic factors for recurrent instability after an open Bankart repair have been described [8,10,12,22,26,37,39,58]. In our series, patients younger than 25 years showed a trend for a higher risk of recurrence.…”

Section: Discussionsupporting

confidence: 52%

Neer Modification of Open Bankart Procedure: What are the Rates of Recurrent Instability, Functional Outcome, and Arthritis?

Boileau¹,

Fourati²,

Bicknell³

2012

Clinical Orthopaedics &Amp; Related Research

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“…42 However, the development of dislocation arthropathy after the Latarjet procedure appears to be consistent with the natural history of glenohumeral instability, 43 as well as comparable to the results of softtissue Bankart repairs. 44 In conclusion, the Latarjet procedure is a reliable option for the surgical management of recurrent anterior glenohumeral instability in the setting of osseous deficiencies greater than 20% to 30% of the glenoid surface area and may also be considered for the primary treatment of recurrent instability in the high-risk contact athlete, even in the setting of limited osseous deficiency. Surgeons must be aware of the complications related to this surgical procedure to take appropriate intraoperative precautions to limit patient risk, as well as to provide proper preoperative and postoperative patient education.…”

Section: Discussionmentioning

confidence: 96%

Latarjet Technique for Treatment of Anterior Shoulder Instability With Glenoid Bone Loss

McHale

Sánchez

Lavery³

et al. 2017

Arthroscopy Techniques

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Anterior glenohumeral instability is a common clinical entity, particularly among young athletic patient populations. Nonoperative management and arthroscopic treatment of glenohumeral instability have been associated with high rates of recurrence, particularly in the setting of glenohumeral osseous defects. Coracoid transfer, particularly the Latarjet procedure, has become the treatment of choice for recurrent anterior glenohumeral instability in the setting of osseous deficiencies greater than 20% to 30% of the glenoid surface area and may also be considered for the primary treatment of recurrent instability in the high-risk contact athlete, even in the setting of limited osseous deficiency. The following Technical Note provides a diagnostic approach for suspected glenohumeral instability, as well as a detailed description of the congruent-arc Latarjet procedure, performed with a deltoid split, with its postoperative management.

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“…Many authors demonstrated that nonunion of the bone block had an impact of the final result. For Cassagnaud et al [3], the existence of pseudarthrosis impairs all the revision parameters; for Hovelius et al [9][10][11], it increases the rate of postoperative instability; for Guity et al [8], it causes pain; and for Wymenga and Morshuis [25] it impairs the mobility outcome.…”

Section: Pseudarthrosismentioning

confidence: 99%

Bristow-Latarjet procedure with specific instrumentation: study of 34 cases

Doursounian

Debet-Mejean

Chetboun

et al. 2008

International Orthopaedics (SICOT)

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A Bristow-Latarjet procedure with specific instrumentation was performed for recurrent dislocation or subluxation of the glenohumeral joint in 34 patients. The procedure was performed through a subscapularis splitting approach with three specific instruments and a special screw. The clinical outcome was assessed by the Duplay and the Constant scores. Radiographic study was conducted on 23 patients and CT scan in 11 patients. Of the 27 patients interviewed 92% were satisfied. Of the 23 patients examined, 15 had an excellent Duplay score, four a good score, three a medium score, and only one had a bad score. One patient had subluxation episodes, and one patient was revised after a redislocation following violent trauma. On the standard radiographs, all bone blocks were in the correct position. A pseudarthrosis was diagnosed in the patient with subluxation episodes. This device simplifies the surgical technique and provides reproducibility to the procedure.Résumé Le procédé de Bristow-Latarjet avec une instrumentation spécifique a été utilisé dans les luxations ou les sub-luxations récidivantes de l'épaule sur 34 patients en utilisant un abord suscaplulaire à l'aide d'instruments spécifiques et d'une vis spéciale. Le suivi clinique a été évalué selon le score de Duplay et de Constant. L'évalua-tion radiologique réalisée sur 23 patients avec un scanner chez 11 patients. Sur les 27 patients interrogés, 92% étaient satisfaits. Sur les 23 patients examinés 15 avaient un excellent score de Duplay, 4 un bon score, 3 un score moyen et un seul un mauvais score. Un patient présentait des épisodes de subluxations résiduelles et un patient a été réopéré après une récidive de la luxation secondaire à un violent traumatisme. Sur les radiographies standard, toutes les butées osseuses sont en position correcte. Une pseudarthrose a été diagnostiquée chez le patient présentant des épisodes de subluxations. Ce matériel simplifie la technique chirurgicale et permet d'avoir une technique reproductible.

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Long-term results with the Bankart and Bristow-Latarjet procedures: Recurrent shoulder instability and arthropathy

Cited by 272 publications

References 23 publications

Neer Modification of Open Bankart Procedure: What are the Rates of Recurrent Instability, Functional Outcome, and Arthritis?

Neer Modification of Open Bankart Procedure: What are the Rates of Recurrent Instability, Functional Outcome, and Arthritis?

Latarjet Technique for Treatment of Anterior Shoulder Instability With Glenoid Bone Loss

Bristow-Latarjet procedure with specific instrumentation: study of 34 cases

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