Anterior Capsulolabral Reconstruction with Semitendinosus Autograft after Latarjet Failure: A Case Report

Introduction: The treatment of chronic shoulder instability, associated with poor tissue quality, remains challenging in the setting of anterior capsular deficiency. There are a few viable alternatives in the end-stage shoulder instability when multiple surgical attempts to correct the pathology have failed. The purpose of the present paper is to demonstrate the efficacy of anterior capsular reconstruction with semitendinosus autograft for the management of capsulolabral deficiency without associated bone loss. Case Report: A 39-year-old female admitted in our institution with a history of recurrent atraumatic anterior dislocation of the left shoulder after three unsuccessful surgical attempts: Arthroscopic and open capsulorrhaphy and a Latarjet coracoid transfer. CT scan images showed adequate placement (flush) of the coracoid transfer without any sign of reabsorption. Reconstruction of anterior capsulolabral structure was performed using a Semitendinosus autograft. The middle and inferior glenohumeral ligaments, the more crucial ligaments for anterior-inferior shoulder stability, were effectively recreated. The patient did not suffer any recurrent dislocation or subjective symptoms of instability at the time of the final follow-up, 2 years after surgery, and the ASES score increased from 36 preoperatively to 86. Conclusion: This technique, described for the first time as a salvage procedure after Latarjet failure, could represent a safe and viable treatment option in the context of multiple ineffective surgeries. Keywords: Autograft, capsulolabral reconstruction, latarjet, recurrent shoulder instability.

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Intrathoracic migration of an unbent Steinmann pin

Annals of The Royal College of Surgeons of England ◽

10.1308/003588414x13814021678916 ◽

2014 ◽

Vol 96 (2) ◽

pp. e21-e23 ◽

Cited By ~ 2

Author(s):

Mozaffari M ◽

Estfan R ◽

Sarkar S

Keyword(s):

Case Report ◽

Shoulder Dislocation ◽

Recurrent Dislocation ◽

Left Shoulder ◽

Steinmann Pin

Steinmann pins are known to be used as a shoulder stabilisation device in recurrent dislocation. Although rare, their potential to migrate within the thorax has been reported. We present the case of an 87-year-old man who was treated for recurrent left shoulder dislocation with pinning using a Steinmann pin. He presented eight days postoperatively with the pin impaling the aortic adventitia. To our knowledge, this is only the fifth case report of such an event. Awareness of this complication and attempts to prevent its occurrence are critical as the outcome can be fatal.

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Evaluation and Management of Failed Shoulder Instability Surgery

The Open Orthopaedics Journal ◽

10.2174/1874325001711010897 ◽

2017 ◽

Vol 11 (1) ◽

pp. 897-908 ◽

Cited By ~ 4

Author(s):

António Cartucho ◽

Nuno Moura ◽

Marco Sarmento

Keyword(s):

Soft Tissue ◽

Bone Loss ◽

Shoulder Instability ◽

Bone Defects ◽

Glenoid Bone Loss ◽

Rotator Cuff Tears ◽

Bone Block ◽

Salvage Procedure ◽

Tissue Quality ◽

Contact Sports

Background: Failed shoulder instability surgery is mostly considered to be the recurrence of shoulder dislocation but subluxation, painful or non-reliable shoulder are also reasons for patient dissatisfaction and should be considered in the notion. Methods: The authors performed a revision of the literature and online contents on evaluation and management of failed shoulder instability surgery. Results: When we look at the reasons for failure of shoulder instability surgery we point the finger at poor patient selection, technical error and an additional traumatic event. More than 80% of surgical failures, for shoulder instability, are associated with bone loss. Quantification of glenoid bone loss and investigation of an engaging Hill-Sachs lesion are determining facts. Adequate imaging studies are determinant to assess labrum and capsular lesions and to rule out associated pathology as rotator cuff tears. CT-scan is the method of choice to diagnose and quantify bone loss. Arthroscopic soft tissue procedures are indicated in patients with minimal bone loss and no contact sports. Open soft tissue procedures should be performed in patients with small bone defects, with hiperlaxity and practicing contact sports. Soft tissue techniques, as postero-inferior capsular plication and remplissage, may be used in patients with less than 25% of glenoid bone loss and Hill-Sachs lesions. Bone block procedures should be used for glenoid larger bone defects in the presence of an engaging Hill-Sachs lesion or in the presence of poor soft tissue quality. A tricortical iliac crest graft may be used as a primary procedure or as a salvage procedure after failure of a Bristow or a Latarjet procedure. Less frequently, the surgeon has to address the Hill-Sachs lesion. When a 30% loss of humeral head circumference is present a filling graft should be used. Conclusion: Reasons for failure are multifactorial. In order to address this entity, surgeons must correctly identify the causes and tailor the right solution.

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Intra-articular ganglion cyst (paralabral cyst) of the shoulder associated with recurrent anterior dislocation: A case report

Journal of Shoulder and Elbow Surgery ◽

10.1067/mse.2002.118413 ◽

2002 ◽

Vol 11 (1) ◽

pp. 95-97 ◽

Cited By ~ 7

Author(s):

Kiminori Yukata ◽

Koichi Imada ◽

Yusuke Yoshizumi ◽

Kenichi Tamano ◽

Satoshi Hosokawa ◽

...

Keyword(s):

Case Report ◽

Ganglion Cyst ◽

Anterior Dislocation ◽

Recurrent Anterior Dislocation

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Persistent anterior shoulder pain after the Oudard–Iwahara–Yamamoto procedure in a patient with anterior shoulder instability: A case report

Journal of Orthopaedic Science ◽

10.1016/j.jos.2021.04.011 ◽

2021 ◽

Author(s):

Hirotaka Kurata ◽

Hirotaka Sano ◽

Takashi Inawashiro ◽

Daizo Sasaki ◽

Moriyuki Noguchi ◽

...

Keyword(s):

Case Report ◽

Shoulder Pain ◽

Shoulder Instability ◽

Anterior Shoulder Instability ◽

Anterior Shoulder Pain

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Anterior Dislocation of Distal Radio-Ulnar Joint: A Case Report

Journal of the Korean Fracture Society ◽

10.12671/jkfs.2008.21.1.66 ◽

2008 ◽

Vol 21 (1) ◽

pp. 66

Author(s):

Shin-Kun Kim ◽

Sang-Bong Ko ◽

Seung-Bum Chae

Keyword(s):

Case Report ◽

Anterior Dislocation

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Arthroscopic Capsulolabral Reconstruction for Posterior Shoulder Instability in Patients 18 Years Old or Younger

Journal of Pediatric Orthopaedics ◽

10.1097/bpo.0000000000000315 ◽

2015 ◽

Vol 35 (5) ◽

pp. 462-466 ◽

Cited By ~ 25

Author(s):

Clint J. Wooten ◽

Aaron J. Krych ◽

Cathy D. Schleck ◽

Josh L. Hudgens ◽

Jedediah H. May ◽

...

Keyword(s):

Shoulder Instability ◽

Posterior Shoulder Instability ◽

Posterior Shoulder ◽

Capsulolabral Reconstruction

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A 6-Month-Old Neglected Obturator Inferior Variety of Anterior Hip Dislocation in A Young Male Managed with an Intermediary Salvage Measure Without the Need for Osteotomy or Excision Arthroplasty with A Resultant Ambulatory Natural Hip – A Case Report

Journal of Orthopaedic Case Reports ◽

10.13107/jocr.2021.v11.i07.2316 ◽

2021 ◽

Vol 11 (7) ◽

Author(s):

Spandan R Koshire ◽

Rajesh R Koshire ◽

Sangam Jain

Keyword(s):

Case Report ◽

Open Reduction ◽

Hip Dislocation ◽

Young Male ◽

Anterolateral Approach ◽

Salvage Procedure ◽

Replacement Procedure ◽

Anterior Hip Dislocation ◽

Excision Arthroplasty

Introduction: Among all the traumatic hip dislocations, anterior hip dislocation is a rarity in which the obturator inferior variety is one of the rarest to be documented [1]. Here we present to you the case of our patient, a 35-year-old male with a six month neglected obturator variety of anterior hip dislocation treated by salvage procedure of open reduction without the need for intertrochanteric osteotomy and resultant preserved natural hip for ambulation as an intermediary procedure. Case Report: Mr. SH a 35-year-old male had a fall from 15 feet in his village and was treated by a local quack, Meanwhile the patient continued to experience pain and difficulty walking and after an ordeal of nearly 6 months during the lockdown period in coronavirus disease pandemic, showed up in our emergency room and was diagnosed with an obturator type anterior hip dislocation for which we carried out open reduction aided with Murphys skid through an anterolateral approach and stabilization using two Steinman pins and further immobilization by Thomas splint for a period of 15 days, which was done after confirmation of intact head vascularity under general anesthesia after which gradual mobilization was initiated. 3 months post operative, now patient is ambulatory with stick support with no deformity, no pain and with early radiological features of avascular necrosis (AVN) for which Total Hip Replacement (THR) is planned at a later date. Conclusion: Utilisation of salvage procedures and moreover those with minimal operative complications will result in better, natural long-term intermediary measure outcome with a resultant delay in joint replacement procedure which is in the better interest of the patient. Keywords: Anterior hip dislocation, open reduction, obturator inferior type, neglected dislocation, Anterolateral approach.

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