scholarly journals Risk Factors of Graft Resorption after Arthroscopic Autologous Scapular Spine Bone Graft for Recurrent Shoulder Instability

2020 ◽  
Vol 12 (5) ◽  
pp. 1388-1393
Author(s):  
Jinsong Yang ◽  
Ming Xiang ◽  
Hang Chen ◽  
Yiping Li ◽  
Qing Zhang ◽  
...  

Author(s):  
Favian Su ◽  
Albert Lin ◽  
Marcin Kowalczuk ◽  
Stephenson A. Ikpe ◽  
Hannah Lee ◽  
...  


2020 ◽  
Author(s):  
Ji Li ◽  
Wei Qi ◽  
Qiang Zhang ◽  
Ketao Wang ◽  
Wei Li ◽  
...  

Abstract Background: The optimal surgical treatment of recurrent traumatic anterior shoulder instability remains a debated topic. The soldier is a special population with high-intensity military training of shoulder. The purpose of this study was to evaluate the clinical outcomes of arthroscopic Bankart repair for recurrent shoulder instability in soldiers and identify the related risk factors. Methods: A retrospective single-center analysis was performed for soldiers with recurrent shoulder instability who underwent arthroscopic Bankart repair between 2009 and 2014. The primary outcome measure was recurrence of instability (redislocation or subluxation). Statistical analysis by binary logistic regression analysis was performed for the significance of various risk factors including sex, gender, number of preoperative dislocations (single/recurrent), the time interval between the first dislocation and the surgery (less or more than 6 months), SLAP repair and number of anchors. The functional outcomes were assessed with the visual analog scale (VAS), the American Shoulder and Elbow Surgery Score (ASES) and Rowe stability score preoperatively and at the last follow-up. Results: A total of 95 shoulders were followed for 53.81±9.37 months (range, 38 to 92 months). The overall postoperative recurrent instability rate was 16.84% (16 in 95). The statistical analysis showed significant differences in age (P=0.045, OR=0.818), and the time interval between the first dislocation and surgery (P=0.035, OR=5.289). There was a significant improvement in the mean VAS, ASES, and Rowe scores postoperatively (P<0.05), but the mean VAS and Rowe scores were lower in the patients of recurrence (P=0.022 and 0.034, respectively). Conclusions: This study suggested that surgery within 6 months of the first dislocation may be required for the young soldiers, although several repair techniques exist for anterior shoulder instability, arthroscopic Bankart repair remains a viable option.



2021 ◽  
Vol 1 (3) ◽  
pp. 263502542110071
Author(s):  
Ioanna K. Bolia ◽  
Rebecca Griffith ◽  
Nickolas Fretes ◽  
Frank A. Petrigliano

Background: The management of multidirectional instability (MDI) of the shoulder remains challenging, especially in athletes who participate in sports and may require multiple surgical procedures to achieve shoulder stabilization. Open or arthroscopic procedures can be performed to address shoulder MDI. Indications: Open capsulorrhaphy is preferred in patients with underlying tissue hyperlaxity and who had 1 or more, previously failed, arthroscopic shoulder stabilization procedures. Technique Description: With the patient in the beach-chair position (45°), tissue dissection is performed to the level of subscapularis tendon via the deltopectoral approach. The subscapularis tenotomy is performed in an L-shaped fashion, and the subscapularis tendon is tagged with multiple sutures and mobilized. Careful separation of the subscapularis tendon from the underlying capsular tissue is critical. Capsulotomy is performed, consisting of a vertical limb and an inferior limb that extends to the 5 o’clock position on the humeral neck (right shoulder). After evaluating the integrity of the labrum, the capsule is shifted superiorly and laterally, and repaired using 4 to 5 suture anchors. The redundant capsule is excised, and the subscapularis tendon is repaired in a side-to-side fashion, augmented by transosseous equivalent repair using the capsular sutures. Results: Adequate shoulder stabilization was achieved following open capsulorrhaphy in a young female athlete with tissue hyperlaxity and history of a previously failed arthroscopic soft tissue stabilization surgery of the shoulder. The athlete returned to sport at 6 months postoperatively and did not experience recurrent shoulder instability episodes at midterm follow-up. Discussion/Conclusion: Based on the existing literature, 82% to 97% of patients who underwent open capsulorrhaphy for MDI had no recurrent shoulder instability episodes at midterm follow-up. One study reported 64% return-to-sport rate following open capsulorrhaphy in 15 adolescent athletes with Ehlers-Danlos syndrome, but more research is necessary to better define the indications and outcomes of this procedure in physically active patients.





Author(s):  
Nikhil N. Verma ◽  
Joseph Liu ◽  
Ani Gowd ◽  
Grant Garcia ◽  
Alexander Beletsky ◽  
...  


2020 ◽  
Vol 102 (14) ◽  
pp. 1269-1278
Author(s):  
Jae-Woo Cho ◽  
William T. Kent ◽  
Chang-Wug Oh ◽  
Beom-Soo Kim ◽  
Won-Tae Cho ◽  
...  


2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0002
Author(s):  
Brendon C. Mitchell ◽  
Matthew Y. Siow ◽  
Alyssa Carrol ◽  
Andrew T. Pennock ◽  
Eric W. Edmonds

Background: Multidirectional shoulder instability (MDI) refractory to rehabilitation can be treated with arthroscopic capsulolabral reconstruction with suture anchors. No studies have reported on outcomes or examined the risk factors that may contribute to poor outcomes in adolescent athletes. Hypothesis/Purpose: To identify risk factors for surgical failure by comparing anatomic, clinical, and demographic variables in adolescents who underwent surgical intervention for MDI. Methods: All patients undergoing arthroscopic shoulder surgery at one institution between January 2009 and April 2017 were reviewed. Patients >20 years old at presentation were excluded. Multidirectional instability was defined by positive drive-through sign on arthroscopy plus positive sulcus sign and/or multidirectional laxity on anterior and posterior drawer testing while under anesthesia. Two-year minimum follow-up was required, but those whose treatment failed earlier were included for reporting purposes. Demographics and intraoperative findings were recorded, as were Single Assessment Numeric Evaluation (SANE) scoring, Pediatric and Adolescent Shoulder Survey (PASS), and the short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) results. Results: Eighty adolescents (88 shoulders) were identified for having undergone surgical treatment of MDI. Of these 80 patients, 42 (50 shoulders; 31 female, 19 male) were available at a minimum of 2-year follow-up. Mean follow-up was 6.3 years (range, 2.8-10.2 years). Thirteen (26.0%) shoulders experienced surgical failure defined by recurrence of subluxation and instability, all of which underwent re-operation. Time to re-operation occurred at a mean of 1.9 years (range, 0.8-3.2). Our cohort had an overall survivorship of 96% at 1 year after surgery and 76% at 3 years. None of the anatomic, clinical, or demographic variables tested, or the presence of generalized ligamentous laxity, were correlated with subjective outcomes or re-operation. Number of anchors used was not different between those that failed and those that did not fail. Patients reported a mean SANE score of 83.3, PASS score of 85.0, and QuickDASH score of 6.8. Return to prior level of sport (RTS) occurred in 56% of patients. Conclusion: Multidirectional shoulder instability is a complex disorder that can be challenging to treat. Adolescent MDI that is refractory to non-surgical management appears to have long-term outcomes after surgical intervention that are comparable to adolescent patients with unidirectional instability. In patients who do experience failure of capsulorraphy, we show that failure will most likely occur within 3 years of the index surgical treatment. [Table: see text][Figure: see text]



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