The “Floating Labrum”: Bankart Lesion Repair With Anterior Capsular Extension Using 2 Anterior Working Portals

Rao, Allison J.; Verma, Nikhil N.; Trenhaile, Scott W.

doi:10.1016/j.eats.2017.06.017

Cited by 7 publications

(8 citation statements)

References 12 publications

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“…The time from the index OLP to screw removal was 29 6 37 months (median, 16; range, 6-138). Age at screw removal was 25 6 6 years (median, 25; range [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. All patients had surgery under general anesthesia with an interscalene block and in the beach-chair position performed by 1 experienced surgeon (A.G.).…”

Section: Arthroscopic Assessment and Screw Removalmentioning

confidence: 99%

“…Anterior shoulder instability is a common indication for surgery, especially in young athletes. 6,29,31 Its common surgical treatments include Bankart (labral) repairs, which involve sewing the joint capsule and detached labrum to the glenoid, 25,32 and Latarjet (bone block) procedures, which require transferring the coracoid process, with attached soft tissue, to the anteroinferior border of the glenoid through a split in the subscapularis muscle. 12,13,40 The Latarjet procedure enables fast recovery 2 and return to sports, 22 has a low recurrence of instability (\7%), 9,19 and includes favorable long-term outcomes, 14,20,41 despite some complications, such as pain at the tip of the screw, 11,28,33 bone-block lyses, malposition, nonunion, 11,23,33,35 and neurological dysfunction.…”

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confidence: 99%

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Screw Removal Can Resolve Unexplained Anterior Pain Without Recurrence of Shoulder Instability After Open Latarjet Procedures

et al. 2020

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Background: Anterior shoulder instability can be successfully treated using Latarjet procedures, although a small proportion of patients report unexplained pain. Purpose/Hypothesis: The purpose was to report the prevalence and characteristics of patients with unexplained pain without recurrent instability after open Latarjet procedures and to determine whether screw removal can alleviate pain. The hypothesis was that unexplained pain without recurrent instability might be due to soft tissue impingements against the screw heads and that the removal of screws would alleviate or reduce pain. Study Design: Case series; Level of evidence, 4. Methods: We retrospectively reviewed the clinical and radiographic records of 461 consecutive shoulders treated by open Latarjet procedures for anterior instability between 2002 and 2014. Unexplained anterior pain was present in 21 shoulders (4.6%) and treated by screw removal at 29 ± 37 months (mean ± SD). Postoperative assessment at >12 months after screw removal included complications, visual analog scale for pain (pVAS), subjective shoulder value, Rowe score, Walch-Duplay score, and ranges of motion. The study cohort comprised the shoulders of 20 patients (9 women, 11 men) aged 25 ± 6 years (median, 25 years; range, 16-34 years) at screw removal and involved the dominant arm in 13 (62%) shoulders. Results: Screw removal alleviated pain completely in 14 shoulders (67%; pVAS improvement, 6.4 ± 1.8; median, 6; range, 3-8) and reduced pain in the remaining 7 (33%; pVAS improvement, 2.4 ± 1.4; median, 2; range, 1-5). At 38 ± 23 months after screw removal, 2 recurrences of instability unrelated to screw removal occurred. The subjective shoulder value was 79% ± 22% (median, 90%; range, 0%-95%); Rowe score, 85 ± 20 (median, 95; range, 30-100); and Walch-Duplay score, 82 ± 19 (median, 85; range, 25-100). Mobility improved in active forward elevation (171°± 14°), external rotation with the elbow at the side (61°± 12°), and external rotation with the arm at 90° of abduction (67°± 13°) and especially in internal rotation, with only 2 shoulders (10%) limited to T12 spine segment. Conclusion: The present findings confirm that unexplained anterior pain after Latarjet procedures can be related to the screws used to fix bone blocks, which can safely be alleviated or reduced by screw removal.

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Section: Arthroscopic Assessment and Screw Removalmentioning

confidence: 99%

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confidence: 99%

Screw Removal Can Resolve Unexplained Anterior Pain Without Recurrence of Shoulder Instability After Open Latarjet Procedures

et al. 2020

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“…Anterior shoulder instability often requires surgical treatment, particularly in young athletes that wish to resume sports [5, 29, 31]. The most common surgical procedures involve arthroscopic labral or capsular repair [27, 32], and open or arthroscopic bone‐block procedures [9, 21], which transfer the coracoid process through a subscapularis split to the anteroinferior margin of the glenoid [12, 40].…”

Section: Introductionmentioning

confidence: 99%

Latarjet procedure enables 73% to return to play within 8 months depending on preoperative SIRSI and Rowe scores

Bohu

Abadie

Rooij

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose Systematic reviews report return to play (RTP) within 5.8 months (range, 3–8) following the Latarjet procedure, but the factors that influence RTP remain unknown. The present study aimed to report the rate and time of return to play (RTP) during the first 8 months following the Latarjet procedure, and to determine the influence of sport type or patient characteristics. Methods The authors retrospectively collected the records of patients that underwent Latarjet procedures for anterior shoulder instability between 2015 and 2017. Patients were excluded if they had any concomitant rotator cuff tendon lesions, or previous ipsilateral shoulder surgery. The authors retrieved patient demographics, time from injury to surgery, type of sport practiced (overhead/non-overhead, contact/non-contact), as well as pre- and postoperative Western Ontario Shoulder Instability index (WOSI), Shoulder Instability-Return to Sport After Injury index (SIRSI), and Rowe score. Results A total of 217 patients (217 shoulders) were eligible for inclusion, comprising 184 males and 33 females, aged 26.8 ± 7.3 years at index surgery. The main sport practiced prior to surgery involved overhead (n = 173, 80%) and/or contact (n = 152, 70%) activities. By 8 month follow-up, 158 patients (73%) resumed their main sport, at a mean of 5.1 ± 1.5 months. Multivariable analysis revealed that RTP was more likely in patients with higher preoperative Rowe score (OR, 1.02; p = 0.024) and SIRSI score (OR, 1.02; p = 0.008). Conclusions By 8 months following the Latarjet procedure, 73% of patients had resumed their main sport. The likelihood of RTP was significantly associated with preoperative Rowe and SIRSI scores, but not with sport type. Level of evidence IV.

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“…3 Some patients show a recurrent dislocation rate of up to 90 percent and are commonly treated with arthroscopic labrum repair, capsular repair, and open bone-block techniques. 4,5,6,7 The rates of recurrent instability are documented up to 10-22.5 percent in a few case series and are mostly found in younger patients and patients with substantial bone loss. 8,9,10,11 It has been observed that the arthroscopic recurrence rate is 67 per cent in case of bone loss, whereas Bankart repair has reported a recurrence rate of 4 per cent without a bone loss Michel Latarjet, in 1954, described a blocking technique of later-jet and preferred it for patients having recurrent anterior dislocation of the shoulder with a bone loss.…”

Section: Introductionmentioning

confidence: 99%

Functional Outcome of Open Latarjet Procedure for Recurrent Anterior Shoulder Dislocation

Siraj

Azim

Sajjad

et al. 2023

J Gandhara Med Dent Sci

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OBJECTIVES To find the functional outcome of the open Latarjet method for recurrent anterior shoulder dislocation. METHODOLOGY The current retrospective study was conducted at the Orthopedic and Trauma Department of the Khyber Teaching Hospital in Peshawar from September 2020 to August 2021. A total of 31 patients were included in the study, of which 29 were males and 2 were females. A detailed medical history was obtained through physical examination, and all necessary laboratory tests were requested. AP and axillary views of plain X-ray radiographs were taken. We used a CT scan on all the patients to calculate the humeral and glenoid bone loss. We had all patients undergo an MRI to rule out soft tissue pathology. Six months after surgery, the outcome was graded using the Constant Murley Score on a good, good, fair, and poor scale. RESULTS In this study open Latarjet procedure was done in 31 patients with 29 males (93.4%) and two females (6.45%). The right-sided shoulder was involved in 24 (77.14 %) patients, while the left shoulder was involved in 7 patients (22.58%). A bipolar lesion in the shoulder with bone loss was seen on the glenoid side at 17.5% (range 10-25%), and the humeral side was 22.5%. Follow-up was done for six months in which 22 patients had a very good outcome (70.96%), six patients had a good outcome(19.35%), two patients had a fair outcome(6.45%), and one patient had a poor outcome(3.22%). There were no major complications seen like graft fractures, graft malposition, neurovascular compromise, and hardware breakage CONCLUSION Recurrent anterior shoulder instability can be effectively treated with open Latarjet with excellent functional outcomes and a very low complication rate and recurrence.

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The “Floating Labrum”: Bankart Lesion Repair With Anterior Capsular Extension Using 2 Anterior Working Portals

Cited by 7 publications

References 12 publications

Screw Removal Can Resolve Unexplained Anterior Pain Without Recurrence of Shoulder Instability After Open Latarjet Procedures

Screw Removal Can Resolve Unexplained Anterior Pain Without Recurrence of Shoulder Instability After Open Latarjet Procedures

Latarjet procedure enables 73% to return to play within 8 months depending on preoperative SIRSI and Rowe scores

Functional Outcome of Open Latarjet Procedure for Recurrent Anterior Shoulder Dislocation

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