Rationales of arthroscopic shoulder stabilization

Abstract

Arthroscopic reconstruction of glenohumeral instability has become more common during the past decade. Compared with open reconstruction, which is still the gold standard in the treatment of shoulder instability, arthroscopic techniques allow for improved diagnosis of numerous intraarticular findings. This review presents an appropriate system for the arthroscopic classification of most pathological findings in patients with anterior shoulder instability. Based on the presented classification, a rationale for arthroscopic reconstruction under special conditions is given. Several operative techniques and implants are discussed and their use in certain circumstances analyzed. Special emphasis is targeted on techniques of realizing sufficient capsular shift or plication. Arthroscopic procedures remain technically demanding and require skills to address the great variety of possible situations. On the other hand, arthroscopic techniques in shoulder reconstruction benefit patients by avoiding the morbidity of open surgery. However, the surgeon must be prepared to address numerous conditions beyond a mere Bankart lesion, especially those involving capsular laxity, rotator interval lesions, and SLAP (superior labrum lesions from anterior to posterior) lesions. Nowadays, considering all the new technical possibilities of arthroscopic shoulder reconstruction including capsular shift procedures, most cases of anterior shoulder instability are suitable for arthroscopic reconstruction. Further studies are necessary to validate the continued efficacy of arthroscopic stabilization.

Midterm results after operatively stabilised shoulder dislocations in elderly patients

“…Standardised methods of stabilisation have been established using different types of anchors and sutures. In young patients, at high risk for repeated shoulder dislocation, early operative intervention is recommended [16]. Though promising results have been achieved it is still difficult to predict the individual patient's risk of redislocation [20].…”

Joint Position Awareness and Sports Activity After Capsulolabral Reconstruction in the Overhead Athlete

“…Nevertheless, the open reconstruction technique, together with arthroscopic methods, is a sufficient method to treat posttraumatic, unidirectional shoulder instability [3,16]. It has been shown that the anterior capsulolabral reconstruction according to Jobe [12] enables a reliable restoration of shoulder stability together with a low rate of complications.…”

Comprehensive Arthroscopic Shoulder Stabilization in the Lateral Decubitus Position

“… 9 , 10 Benefits of arthroscopic stabilization include limited disruption to the subscapularis, increased ability to address concomitant intra-articular shoulder pathology, improved postprocedural external rotation, minimized postoperative pain, and decreased morbidity. 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 …”

“…9,10 Benefits of arthroscopic stabilization include limited disruption to the subscapularis, increased ability to address concomitant intra-articular shoulder pathology, improved postprocedural external rotation, minimized postoperative pain, and decreased morbidity. [11][12][13][14][15][16][17][18] When considering arthroscopic stabilization, there are 2 main patient positioning options: "beach chair" and lateral decubitus. It is our preference to address shoulder instability in the lateral decubitus position when treating it arthroscopically.…”