scholarly journals Arthroscopic Bankart Repair with and without Arthroscopic Infraspinatus Remplissage in Anterior Shoulder Instability with Hill-Sachs Defect: Randomized Controlled Trial

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0009
Author(s):  
Peter B. MacDonald ◽  
Jason Old ◽  
Randhir Mascarenhas ◽  
Sheila McRae ◽  
Jon Marsh ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Shoulder Instability ◽  
Controlled Trial ◽  
Bankart Repair ◽  
Anterior Shoulder Instability ◽  
Glenohumeral Instability ◽  
Glenoid Defect ◽  
Arthroscopic Bankart Repair ◽  
Patient Reported ◽  
Time Point

Objectives: The purpose of this prospective randomized, double blinded controlled trial was to compare patient-reported outcomes and clinical results between arthroscopic Bankart repair with and without arthroscopic infraspinatus remplissage in patients with anterior shoulder instability with a Hill-Sachs lesion. Failure to recognize and address large Hill Sach’s defects during arthroscopic stabilization surgery for glenohumeral instability is known to lead to high rates of recurrence. Arthroscopic remplissage has evolved in recent years as a reproducible technique with a proposed benefit of decreased dislocations. However, there are no high level clinical studies to conclusively support its efficacy in reducing redislocations. Methods: One hundred and four patients, aged 14 years and older, with a confirmed Hill Sach’s lesion on ultrasound, CT or MRI, were randomized intraoperatively after confirming an engaging Hill Sach’s lesion to either undergo arthroscopic infraspinatus remplissage (REMP) or no remplissage during arthroscopic Bankart repair (NO REMP). Exclusion criteria included a glenoid defect >15% of the AP glenoid diameter, significant shoulder arthropathy, infection, or medical comorbidities. The primary outcome measure was the Western Ontario Shoulder Instability score (WOSI). Secondary outcomes included the Simple Shoulder Test (SST), the American Shoulder and Elbow Society standardized assessment of shoulder function (ASES), active range of motion, stability tests, and incidence of revision surgery. Study time points were pre-, 3-, 6-, 12-, and 24-months post-operative. Significance level was 0.05. Results: A summary of demographics and outcomes are presented in Table 1. There were 53 patients (45 men, 8 women) randomized to REMP and 52 (46 men, 6 women) patients to NO REMP. The groups were comparable with regard to age, body mass index (BMI), and gender distribution). Both groups demonstrated a similar improvement in all subjective scores over time to 12-months post-operative with no difference between the groups (collection of data to 24-months post-operative is ongoing until 2019). The WOSI significantly improved from pre- to 12-months post-operative in both study groups. There were no differences between groups at any time point. ASES scores and SST scores followed a similar pattern. Additionally, there were no differences in range of motion between groups at any time point. There were 2/53 re-dislocations in REMP postoperatively compared to 6/52 in NO REMP; this difference was not significant (p=0.161). There were no differences between groups in reports of limitations in participation in sport attributed to the operated shoulder up to 12-months post-operative. Conclusion: Based on this study, there is no difference in subjective outcome scores and redislocations rates between remplissage and no remplissage for an engaging Hill Sach’s lesion while performing arthroscopic Bankart stabilization. As data continues to be gathered to 24-months post-operative including MRI, longer term benefits or drawbacks may become evident. [Table: see text]

scholarly journals Comparison of clinical and patient-reported outcomes of three procedures for recurrent anterior shoulder instability: arthroscopic Bankart repair, capsular shift, and open Latarjet

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yingjie Xu ◽  
Kailun Wu ◽  
Qianli Ma ◽  
Lei Zhang ◽  
Yong Zhang ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Bankart Repair ◽  
Anterior Shoulder Instability ◽  
Subjective Perception ◽  
Capsular Shift ◽  
Shift Group ◽  
Arthroscopic Bankart Repair ◽  
Significant Difference ◽  
Patient Reported ◽  
Recurrent Anterior Shoulder Instability

Abstract Background Best surgical of recurrent anterior shoulder instability remained controversial. We knew little about the superiority and choice between traditional open and modern arthroscopic techniques. We hypothesized that outcomes of all patients will be similar regardless of surgical technique. Methods A retrospective case-cohort analysis of 168 patients who had recurrent anterior shoulder instability was conducted from September 2010 to December 2013. All cases (mean age 30.8 [range 18–50] years) were performed with arthroscopic Bankart repair (33 males/20 females), open Latarjet (34 males/18 females), and capsular shift (31 males/14 females). The average follow-up was 67.6 months (range 60–72). The shoulder instability index score (ISIS) was more than 3 with an average of 6.4. Results All treatments proved to be effective in improving shoulder functional status and reducing symptoms, while Latarjet had an advantage over subjective perception. The Rowe scores in arthroscopic Bankart, open Latarjet, and capsular shift group were 92.3 ± 1.5, 96.2 ± 2.1, and 93.2 ± 2.3, respectively, with significant difference. There was no significant difference in other functional outcomes. However, the Latarjet group in subjective results (subjective shoulder value (SSV) and subjective shoulder value for sport practice (SSV Sport)) was superior to the others (P < 0.05). There were two relapsed cases in arthroscopic Bankart and capsular shift group, respectively, and no recurrence in open Latarjet group. Conclusion Arthroscopic Bankart repair has the advantage of mini-invasion and rapid recovery. Capsular shift offers stabilizing of inferior or multidirectional type, especially for little bone defect. Latarjet was more effective in reducing recurrence with higher stability. Level of evidence Therapeutic level III

scholarly journals Revision Arthroscopic Bankart Repair Versus Arthroscopic Latarjet for Failed Primary Arthroscopic Stabilization With Subcritical Bone Loss

2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110018
Author(s):  
Emilio Calvo ◽  
Gonzalo Luengo ◽  
Diana Morcillo ◽  
Antonio M. Foruria ◽  
María Valencia
Keyword(s):  
Soft Tissue ◽  
Bone Loss ◽  
Revision Surgery ◽  
Shoulder Instability ◽  
Activity Level ◽  
Bankart Repair ◽  
Anterior Shoulder Instability ◽  
Arthroscopic Bankart Repair ◽  
Functional Scores ◽  
Arthroscopic Latarjet

Background: Limited evidence is available regarding the recommended technique of revision surgery for recurrent shoulder instability. Only 1 previous study has compared the results of soft tissue repair and the Latarjet technique in patients with persistent shoulder instability after primary surgical stabilization. Purpose/Hypothesis: To evaluate the results of revision surgery in patients with previous surgical stabilization failure and subcritical glenoid bone defects, comparing repeated Bankart repair versus arthroscopic Latarjet technique. The hypothesis was that Latarjet would be superior to soft tissue procedures in terms of objective and subjective functional scores, recurrence rates, and range of movement. Study Design: Cohort study; Level of evidence, 3. Methods: Included were 45 patients (mean age, 29.1 ± 8.9 years) with subcritical bone loss (<15% of articular surface) who had undergone revision anterior shoulder instability repair after failed Bankart repair. Of these, 17 patients had arthroscopic Bankart repair and 28 had arthroscopic Latarjet surgery. Patients were evaluated at a minimum of 2 years postoperatively with the Rowe score, Western Ontario Shoulder Instability Index, and Subjective Shoulder Value. Subluxation or dislocation episodes were considered failures. Results: No statistically significant differences were found between groups in age, sex, sporting activity, preoperative Rowe score, or the presence of hyperlaxity or bony lesions. At revision arthroscopy, 20 shoulders showed a persistent Bankart lesion, 13 a medially healed labrum, and 6 a bony Bankart. In 6 patients, no abnormalities were present that could explain postoperative recurrence. In the Bankart repair group, 7 patients underwent isolated Bankart procedures; in the remaining 10 cases, a capsular shift was added. No significant differences were found between the Bankart and Latarjet groups in outcome scores, recurrence rate (11.8% vs 17.9%, respectively), or postoperative athletic activity level. The mean loss of passive external rotation at 0° and 90° of abduction was similar between groups. Conclusion: Arthroscopic Latarjet did not lead to superior results compared with repeated Bankart repair in patients with subcritical glenoid bone loss and recurrent anterior shoulder instability after Bankart repair.

The playing position significantly influences return to sports and recurrences after an arthroscopic Bankart repair in competitive rugby players

2021 ◽  
pp. 175857322199308
Author(s):  
Ignacio Pasqualini ◽  
Luciano Andrés Rossi ◽  
Franco Luis De Cicco ◽  
Ignacio Tanoira ◽  
Ignacio Alonso Hidalgo ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Functional Outcomes ◽  
The Other ◽  
Bankart Repair ◽  
Anterior Shoulder Instability ◽  
Return To Sports ◽  
Arthroscopic Bankart Repair ◽  
Rugby Players

Background The purpose of our study was to investigate the influence of the different rugby playing positions on return to sports, functional outcomes, and recurrences after an arthroscopic Bankart repair. Methods A total of 88 rugby players were treated for anterior shoulder instability in our institution between 2010 and 2018. Functional outcomes, return to sports, recurrences, complications, and revisions rates were evaluated according to the playing position. Results Overall, 73.8% of the patients returned to rugby and 60% returned at the same level as before the injury. The tight forwards and outside backs experienced a significant decrease in their competitive level after surgery, and showed the lowest functional outcomes. The tight forwards and outside backs showed a statistically significant increase in recurrence and revision rates, and an OR for recurrence of 12.8 and 9.6, respectively. Discussion The playing position significantly influenced return to sports and recurrences after an arthroscopic Bankart repair in competitive rugby players. Specifically, the tight forwards and outside backs have returned to a lower level than they had before surgery, showed the lowest functional outcomes, and a significant increase in recurrences and revisions rates than the other groups.

scholarly journals Treatment of anterior shoulder instability: a bibliometric analysis

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Mingtao Zhang ◽  
Zhitao Yang ◽  
Borong Zhang ◽  
Tao Liu ◽  
Xiangdong Yun
Keyword(s):  
United States ◽  
Risk Factors ◽  
Shoulder Instability ◽  
Sports Medicine ◽  
The United States ◽  
Bankart Repair ◽  
Anterior Shoulder Instability ◽  
Arthroscopic Bankart Repair ◽  
Number Of Citations ◽  
Research Frontiers

Abstract Purpose The treatment of anterior shoulder instability is a focus in the field of sports medicine. While much research has been conducted, few bibliometric studies have been performed in this field. This study analyzed the main characteristics and identified emerging research trends and hotspots related to the treatment of anterior shoulder instability over the past four decades. Methods We searched for (anterior shoulder instability OR anterior shoulder dislocation) AND (treatment OR reconstruction) in ARTICLE (Mesh) in the Web of Science database from 1980 to 2020. We analyzed the keywords, author, institution, country, number of citations, average number of citations, publication year, and partnership of the identified articles. Information about annual publications was analyzed using Microsoft Excel 2019; the remaining data were analyzed using VOSviewer version 1.6.11 (Leiden University, Leiden, Netherlands) and CiteSpace version 5.7.R2 (Drexel University, Philadelphia, PA, USA). Results A total of 1964 articles were published between 1980 and 2020. The American Journal of Sports Medicine, the United States, the United States Department of Defense, and Arcieio were journals, countries, institutions, and authors with the highest numbers of publications. The topic hotspots were instability, shoulder, and dislocation, while the research frontiers were arthroscopic, Bankart repair, Latarjet procedure, risk factors, recurrence, and complications. Conclusion The treatment of anterior shoulder instability has shown an increasing number of publications each year and achieved great progress. The United States made the most outstanding contributions to this important field. Arthroscopic, Bankart repair, and Latarjet procedures were research hotspots and risk factors, recurrence, and complications were likely to research frontiers.

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