Risk Factors for Failure of Arthroscopic Revision Anterior Shoulder Stabilization

Su, Favian; Kowalczuk, Marcin; Ikpe, Stephenson; Lee, Hannah; Sabzevari, Soheil; Lin, Albert

doi:10.2106/jbjs.17.01028

Cited by 53 publications

(56 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The rates of recurrence documented in the literature are between 3.4% and 35%. 7,17,18,22 –25 The recurrence rate of 10.3% in the current study is comparable with the literature. Preoperative and intraoperative assessments of the risk factors for recurrence could help the surgeon in deciding the surgical repair procedure.…”

Section: Discussionsupporting

confidence: 88%

Multiple Subscapularis Tendon Sign: A New Risk Factor for Recurrence After Arthroscopic Anterior Shoulder Instability Surgery

Kanatlı

Özer

Gem

et al. 2019

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Being able to predict recurrence after the treatment of shoulder instability would be helpful in planning the appropriate treatment. Purpose: To define the multiple subscapularis tendon sign (MSTS) as a novel anatomic variant and a possible risk factor for the recurrence of shoulder instability after anterior stabilization and to evaluate it, together with the other risk factors as described in the literature. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 87 patients met the study criteria and underwent arthroscopic stabilization for anterior shoulder instability. The MSTS was evaluated in this study group. Age, sex, hand dominance, number of preoperative shoulder dislocations, history of overhead or contact sports participation, type of labral lesion, number of anchors used in surgery, presence of the drive-through sign, presence of the MSTS, Oxford Shoulder Score results, and the association of these parameters with recurrence were assessed. The mean follow-up time was 81.0 ± 27.9 months (range, 48-139 months). Results: Nine (10.3%) patients experienced recurrent instability. The presence of the MSTS ( P = .009), existence of an anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesion ( P = .04), and history of overhead or contact sports participation ( P = .04) were significant risk factors for recurrence. The recurrence rates were as follows: 30.7% with the MSTS; 40% with the MSTS and an ALPSA lesion; and 75% with the MSTS, an ALPSA lesion, and a history of overhead or contact sports participation. Conclusion: The MSTS is a variation of the anterior shoulder joint capsule. It is a sign of capsular insufficiency or thinning, which may be a risk factor for recurrence after anterior stabilization. Considering the low success rates of anterior capsulolabral repair in patients participating in overhead or contact sports, especially when an ALPSA lesion is present, encountering the MSTS during surgery in this at-risk group may be an indicator for the surgeon to choose the surgical procedure more carefully.

show abstract

Section: Discussionsupporting

confidence: 88%

Multiple Subscapularis Tendon Sign: A New Risk Factor for Recurrence After Arthroscopic Anterior Shoulder Instability Surgery

Kanatlı

Özer

Gem

et al. 2019

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…Dickens et al 15 reported a similar cutoff to that used by Shaha et al 51 in their group of intercollegiate football players, recommending a cutoff of 13.5% bone loss at which to abandon the arthroscopic repair. Su et al 56 reported similar high rates of postoperative instability correlated with increasing amounts of glenoid bone loss with the revision arthroscopic Bankart procedure. Klemt et al 31 utilized a finite element model for simulating the stability of the glenohumeral joint under varying conditions and stressors.…”

Section: Discussionmentioning

confidence: 94%

“…Owens et al 43 compared the glenoid height and width to deduce the amount of bone loss. Huysmans et al 26 taught us that the inferior glenoid shape is a “perfect circle.” Their group and others described methods of utilizing a “circle tool” on sagittal imaging to quantify bone loss 25,26,56 (Figure 3). Bakshi et al 3 calculated that surface area is more accurate in measuring defect size than linear measurements.…”

Section: Discussionmentioning

confidence: 99%

When to Abandon the Arthroscopic Bankart Repair: A Systematic Review

Levy

Grimm

Arciero

2020

Sports Health: A Multidisciplinary Approach

View full text Add to dashboard Cite

Context: Bone loss is a major factor in determining surgical choice in patients with anterior glenohumeral instability. Although bone loss has been described, there is no consensus on glenoid, humeral head, and bipolar bone loss limits for which arthroscopic-only management with Bankart repair can be performed. Objective: To provide guidelines for selecting a more complex repair or reconstruction (in lieu of arthroscopic-only Bankart repair) in the setting of glenohumeral instability based on available literature. Data Sources: An electronic search of the literature for the period from 2000 to 2019 was performed using PubMed (MEDLINE). Study Selection: Studies were included if they quantified bone loss (humeral head or glenoid) in the setting of anterior instability treated with arthroscopic Bankart repair. Study Design: Systematic review. Level of Evidence: Level 4. Data Extraction: Study design, level of evidence, patient demographics, follow-up, recurrence rates, and measures of bone loss (glenoid, humeral head, bipolar). Results: A total of 14 studies met the inclusion criteria. Of these, 10 measured glenoid bone loss, 5 measured humeral head bone loss, and 2 measured “tracking” without explicit measurement of humeral head bone loss. Measurement techniques for glenoid and humeral head bone loss varied widely. Recommendations for maximum glenoid bone loss for arthroscopic repair were largely <15% of glenoid width in recent studies. Recommendations regarding humeral head loss were more variable (many authors providing only qualitative descriptions) with increasing attention on glenohumeral tracking. Conclusion: It is essential that a standardized method of glenoid and humeral head bone loss measurements be performed preoperatively to assess which patients will have successful stabilization after arthroscopic Bankart repair. Glenoid bone loss should be <15%, and humeral head lesions should be “on track” if an arthroscopic-only Bankart is planned. If there is greater bone loss, adjunct or open procedures should be performed.

show abstract

“…However, in the case of bone loss exceeding 25% of the glenoid fossa, soft tissue procedures have high failure rates. In these cases, it is necessary to address the bone loss, and the Bristow/Latarjet procedure is usually advocated [1].…”

Section: Introductionmentioning

confidence: 99%

A Novel Technique for Labral Reconstruction Using Long Head of Biceps Tendon: Duru Technique

Acar¹,

Köse²,

Kırçıl³

et al. 2021

Cureus

View full text Add to dashboard Cite

Arthroscopic capsulolabral repair is a well-established surgical treatment for traumatic anterior shoulder instability. When there is insufficient labral tissue during arthroscopic primary or revision Bankart repairs, various soft tissue procedures have been recommended. All these procedures aim to reattach glenohumeral ligaments to the glenoid rim and regain the tight anterior structures to prevent re-dislocation or subluxation. Some authors recommend the Latarjet procedure, even in the absence of critical bone loss in this patient group. The labrum increases the depth of the glenoid cavity, thereby, increasing the glenoid track. It behaves like a block for the humeral head. Reconstruction of the labral tissue may strongly contribute to shoulder joint stability when it is totally absent. In this article, we describe a novel labral reconstruction technique (Duru technique) using the long head of the biceps tendon in two patients without an existing labral tissue.

show abstract

Risk Factors for Failure of Arthroscopic Revision Anterior Shoulder Stabilization

Abstract: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Cited by 53 publications

References 36 publications

Multiple Subscapularis Tendon Sign: A New Risk Factor for Recurrence After Arthroscopic Anterior Shoulder Instability Surgery

Multiple Subscapularis Tendon Sign: A New Risk Factor for Recurrence After Arthroscopic Anterior Shoulder Instability Surgery

When to Abandon the Arthroscopic Bankart Repair: A Systematic Review

A Novel Technique for Labral Reconstruction Using Long Head of Biceps Tendon: Duru Technique

Contact Info

Product

Resources

About