scholarly journals Comparison of anterior single- and standard two-portal techniques in arthroscopic Bankart repair

2021 ◽  
Vol 32 (2) ◽  
pp. 437-445
Author(s):  
Erdal Uzun ◽  
Fatih Doğar ◽  
Duran Topak ◽  
Ahmet Güney
Keyword(s):  
Functional Outcomes ◽  
Rating Scale ◽  
External Rotation ◽  
Bankart Repair ◽  
Sports Activity ◽  
Arthroscopic Bankart Repair ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Objectives: This study aims to compare the outcomes of patients undergoing a single anterior portal or a standard two-portal arthroscopic procedure for Bankart repair. Patients and methods: Between January 2015 and March 2018, a total of 71 consecutive patients (53 males and 18 females; mean age: 33.3±10.3 years; range, 17 to 56 years) who underwent arthroscopic Bankart repair with a minimum two-year follow-up period were included. The patients were divided into two groups according to the arthroscopic technique used: single anterior portal group (Group 1, n=32) and standard two-portal group (Group 2, n=39). Demographic and surgical characteristics of the patients were recorded. Pre- and postoperative clinical and functional outcomes were evaluated using the external rotation degree, as well as Visual Analog Scale (VAS), American Shoulder and Elbow Surgeons (ASES), University of California at Los Angeles (UCLA) Shoulder Rating Scale, Constant-Murley Score (CMS), Oxford Shoulder Instability Score (OSIS), and Rowe scores. The clinical and functional outcomes and revision rates were compared between the groups. Results: The mean follow-up was 32.0±7.4 months in Group 1 and 38.0±13.4 months in Group 2 (p=0.222). Good-to-excellent postoperative functional and clinical outcomes were achieved in both groups at the final follow-up, compared to baseline (p<0.001 for all). No significant difference was observed in the postoperative outcomes including daily sports activity, VAS, ASES, UCLA Shoulder Rating Scale, CMS, OSIS, and Rowe scores, and external rotation restriction degrees between the groups (p=0.270, p=0.190, p=0.313, p=0.248, p=0.125, p=0.203, p=0.318, p=0.083, respectively). The operative time in Group 1 was significantly lower than that in Group 2 (60.3±8.3 vs. 71.4±7.2, respectively; p=0.001). Four patients (5.6%) experienced recurrent dislocation with no significant difference between the groups (p=0.622). No significant complications occurred in the peri- or postoperative period. Fifty-eight (81.7%) patients returned to their preoperative sports activity level. The mean time to return to sports was 7.2±1.7 months. Conclusion: Good-to-excellent clinical and functional outcomes can be obtained after arthroscopic Bankart repair, regardless of the use of a single or two anterior working portals. However, the single-portal technique is associated with reduced the operative time, compared to two-portal technique.

scholarly journals The Comparison of Results of Early and Late Rehabilitation Following Arthroscopic Bankart Repair with Knotless Anchor in Recurrent Traumatic Anterior Shoulder Dislocation

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0012
Author(s):  
Harun Kütahya ◽  
Mustafa Yel ◽  
Onur Bilge ◽  
Ali Güleç ◽  
Burkay Kutluhan Kaçıra ◽  
...  
Keyword(s):  
Shoulder Dislocation ◽  
External Rotation ◽  
Bankart Repair ◽  
Knotless Anchor ◽  
Arthroscopic Bankart Repair ◽  
Significant Difference ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Objectives: The aim of this study was to compare the clinical and functional results of early and late rehabilitation of patients who had undergone arthroscopic Bankart repair with knotless anchor for recurrent shoulder dislocation and to define the most appropriate rehabilitation time and the effect of this on recurrence. Methods: 34 patients (32 male and 2 female) were included in this study. The patients were diagnosed with recurrent anterior shoulder dislocation with Bankart lesion in our institution. The exclusion criteria in this study were multi-directional shoulder instability, wide osseous Bankart lesion, wide Hill-Sachs lesion or rotator cuff tear. All patients underwent arthroscopic Bankart repair. Knotless anchor was used in all patients. The patients were grouped into 2 groups postoperatively according to the immobilization period and rehabilitation regimen. Both groups equally consisted of 17 patients. (Group 1; early rehabilitation group, Group 2; late rehabilitation group) All patients were examined retrospectively. Gender, age, dislocated side, dominant hand, recurrence, presence of additional pathologies, time of first and last dislocations preoperatively and numbers of dislocations were the demographic data recorded. At the final follow-up; the restriction in external rotation was measured by comparative goniometry and clinical evaluation was made using the Constant and Rowe scores. One-sample T-test, Mann-Whitney U Test, Crosstabs Chi Square Test and Shapiro-Wilk Tests used for statistical analysis. Results: The mean age of the patients in Group 1 was found to be 25.1 ± 6.5 ( 17-43) years and in Group 2, 30.8 ± 6.8 (21-46) years. After a mean follow-up period of 14.7 months, no patients in Group 1 experienced a recurrence, whereas in Group 2 over the mean follow-up period of 38.5 months, there was dislocation, following episodes of subluxation, in only 1 patient (5.8%). When the parameters of first dislocation, last dislocation and number of dislocations were evaluated separately in two groups, no statistical difference was observed between the groups in the relevant parameters (n.s.). A statistically significant difference was determined between the groups in respect to the restriction in external rotation (p<0.05). There was no statistically significant difference between the groups in respect to the Constant and Rowe scores (n.s.). Conclusion: The most important result of this study was that the early beginning of rehabilitation yielded less external rotation restriction than late beginning of rehabilitation. The absence of recurrence in the group of early beginning of rehabilitation reminds the question “does early rehabilitation reduce recurrence rates?” The findings in this study should be confirmed with further prospective, randomized and longer follow-up studies.

scholarly journals Arthroscopic Bankart repair with knotless suture anchors: A comparison of the permanent and absorbable types

2020 ◽  
Vol 27 (2) ◽  
pp. 202-207
Author(s):  
Abdulrahman D Algarni
Keyword(s):  
External Rotation ◽  
Shoulder Function ◽  
Bankart Repair ◽  
Suture Anchors ◽  
Glenohumeral Instability ◽  
Arthroscopic Bankart Repair ◽  
Significant Difference ◽  
Functional Scores ◽  
Group 2 ◽  
Group 1

Aim: The aim of this study was to compare the clinical outcomes of arthroscopic Bankart repair (ABR) using two types of knotless suture anchors (KSAs) in patients with post-traumatic recurrent anterior glenohumeral instability (AGHI). Methods: Thirty-two patients underwent an ABR using KSAs: a permanent KSA (PushLock) and an absorbable counterpart (BioKnotless). There were 16 patients in each group. Pre-and post-operative assessment for shoulder function using the American Shoulder and Elbow Surgeons and Constant–Murley scores, recurrence of instability, post-operative limitation of external rotation (ER) and ability to return to pre-injury level were recorded in both groups. Results: Both groups displayed significant improvements in functional scores ( p < 0.0001) without a significant difference between the groups. Of the 32 patients, 9.4% had recurrence of instability (one re-dislocation in group 1 and two symptomatic subluxations in group 2). Return to pre-injury level occurred in 87.5% and 81.3% of group 1 and group 2, respectively. There was 2° to 3° loss of ER after ABR in both groups; the difference between the groups was not significant ( p = 0.45). Conclusion: ABR for recurrent AGHI using a permanent or absorbable KSA offers comparable successful outcomes; no significant statistical difference was found.

scholarly journals Arthroscopic Bankart Repair vs. Open Latarjet Procedure: A Comparative Study of Clinical and Functional Results.

2020 ◽  
Author(s):  
Binod Sherchan ◽  
Saroj Rai ◽  
Nira Tamang ◽  
Siddhartha Dhungana ◽  
Laxmi Kanta Sharma ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
External Rotation ◽  
Operating Cost ◽  
Bankart Repair ◽  
Dash Score ◽  
Latarjet Procedure ◽  
Arthroscopic Bankart Repair ◽  
Significant Difference ◽  
Quick Dash

Abstract Background The primary aim of this study was to compare the clinical outcomes of patients undergoing arthroscopic Bankart repair and open Latarjet procedure for recurrent dislocation of the shoulder. Secondary aims were to assess and compare the cost-effectiveness, satisfaction and complications, including recurrence and infection. Methods We retrospectively evaluated the patients who underwent either arthroscopic Bankart repair with or without Remplissage procedure or open Latarjet procedure between May 2015 and May 2018. The preoperative data were collected from the hospital records, and the postoperative data were collected during the follow-up visit. At the final follow-up, 41(male=32, female=9) patients in the Bankart group and 40(male=34 and female=6) patients in the Latarjet group were included in the study. Clinical outcomes were assessed using the ASES score, Rowe score, and Quick DASH score. A self-constructed scale that consisted of satisfied and dissatisfied was used to measure the level of satisfaction. Any complications were recorded in every follow-up visit. Collected data were analyzed using SPSS version 25. Results There was no statistically significant difference regarding the age (p=0.401), gender (p=0.569), site of involvement (p=0.158), number of preoperative dislocations (p=0.085), follow-up (p=0.061), between the two groups. Similarly, no statistically significant difference existed regarding the ASES score (p=0.388), Rowe score (p=0.211), and Quick DASH score (p=0.713). The average external rotation was 83 degrees in the Bankart group and 85 degrees in the Latarjet group (p=0.140). Functional satisfaction was higher in the Laterjet group compared to the Bankart group (p=0.482). Hundred percent of the patients were cosmetically satisfied in the Bankart group, whereas only 32(80%) patients were cosmetically satisfied in the Latarjet group (p=0.002). There was a significantly higher operating cost for arthroscopic Bankart repair compared to open Latarjet procedure (p<0.001). Three patients had a recurrence in the Bankart group, whereas no recurrence occurred in the Latarjet group. And, 2 superficial infections occurred in the Latarjet group. Conclusion These results provide the fact that arthroscopic Bankart repair might be a fancy and minimally invasive procedure, Latarjet procedure should still be a priority in a developing country like Nepal, where financial cost is a huge burden.

scholarly journals Outcomes of the Latarjet Procedure for the Treatment of Chronic Anterior Shoulder Instability: Patients With Prior Arthroscopic Bankart Repair Versus Primary Cases

2019 ◽  
Vol 48 (1) ◽  
pp. 27-32 ◽  
Author(s):  
Jean-David Werthel ◽  
Vincent Sabatier ◽  
Bradley Schoch ◽  
Lior Amsallem ◽  
Geoffroy Nourissat ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Bankart Repair ◽  
Anterior Shoulder Instability ◽  
Latarjet Procedure ◽  
Recurrent Instability ◽  
Simple Shoulder Test ◽  
Arthroscopic Bankart Repair ◽  
Group 2 ◽  
Group 1

Background: It remains unclear whether results differ between a Latarjet procedure performed after a failed arthroscopic Bankart repair and one performed as the primary operation. Purpose: To compare the postoperative outcomes of the Latarjet procedure when performed as primary surgery and as revision for a failed arthroscopic Bankart repair. Study Design: Cohort study; Level of evidence, 3. Methods: A multicenter retrospective comparative case-cohort analysis was performed for all patients undergoing a Latarjet procedure for recurrent anterior shoulder instability. Patients were separated into 2 groups depending on if the Latarjet procedure was performed after a failed arthroscopic Bankart repair (group 1) or as the first operation (group 2). Outcome measures included recurrent instability, reoperation rates, complications, pain, Walch-Duplay scores, and Simple Shoulder Test. Results: A total of 308 patients were eligible for participation in the study; 72 (23.4%) did not answer and were considered lost to follow-up, leaving 236 patients available for analysis. Mean follow-up was 3.4 ± 0.8 years. There were 20 patients in group 1 and 216 in group 2. Despite similar rates of recurrent instability (5.0% in group 1 vs 2.3% in group 2; P = .5) and revision surgery (0% in group 1 vs 6.5% in group 2; P = .3), group 1 demonstrated significantly worse pain scores (2.56 ± 2.7 vs 1.2 ± 1.7; P = .01) and patient-reported outcomes (Walch-Duplay: 52 ± 25.1 vs 72.2 ± 25.0; P = .0007; Simple Shoulder Test: 9.3 ± 2.4 vs 10.7 ± 1.9; P = .001) when compared with those patients undergoing primary Latarjet procedures. Conclusion: Functional outcome scores and postoperative pain are significantly worse in patients undergoing a Latarjet procedure after a failed arthroscopic Bankart repair when compared with patients undergoing primary Latarjet. The assumption that a failed a Bankart repair can be revised by a Latarjet with a similar result to a primary Latarjet appears to be incorrect. Surgeons should consider these findings when deciding on the optimal surgical procedure for recurrent shoulder instability.

Is It Safe to Inject Corticosteroids Into the Glenohumeral Joint After Arthroscopic Rotator Cuff Repair?

2019 ◽  
Vol 47 (7) ◽  
pp. 1694-1700 ◽  
Author(s):  
Yang-Soo Kim ◽  
Hong-Ki Jin ◽  
Hyo-Jin Lee ◽  
Hyung-Lae Cho ◽  
Wan-Seok Lee ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Significant Difference ◽  
Group 2 ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Group 1

Background: Injection of intra-articular corticosteroids is effective for improving the recovery of range of motion (ROM) and pain in various conditions of the shoulder but its use is limited after rotator cuff repair owing to concern over the possible harmful effects of steroids on the repaired tendon. Purpose: To evaluate the effect of intra-articular corticosteroid injections on the clinical outcomes and cuff integrity of patients after rotator cuff repair. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Between March 2011 and April 2014, 80 patients with a small- to medium-sized rotator cuff tear were enrolled in this study and underwent arthroscopic rotator cuff repair. Forty patients received an injection of triamcinolone (40 mg) and lidocaine (1.5 mL) into the glenohumeral joint 8 weeks after surgery (group 1), while the remaining 40 patients received normal saline injection (group 2). Outcome measures—including ROM, American Shoulder and Elbow Surgeons (ASES) score, Constant score, pain visual analog scale, and Simple Shoulder Test score—were evaluated at 3, 6, and 12 months after surgery and at the last follow-up. The integrity of the repaired tendon was evaluated by magnetic resonance imaging (MRI) and classified per Sugaya classification at 8 weeks (before injection) and 12 months after surgery. Results: The mean follow-up period was 25.7 months. At 3 months postoperatively, patients in group 1 had a significantly higher ROM with respect to forward flexion ( P = .05), external rotation at the side ( P = .05), and external rotation at abduction ( P = .04) as compared with group 2, whereas no significant difference was noted between the groups for internal rotation behind the back ( P = .65). Patients in group 1 had significantly lower visual analog scale pain scores ( P = .02) and higher ASES scores (group 1, 68.90; group 2, 60.28; P = .02) at 3-month follow-up. However, there was no significant difference after 6 months with respect to ROM and ASES scores (group 1, 77.80; group 2, 75.88; P = .33). Retears (Sugaya classification IV and V) were determined by MRI at 12 months and observed in a total of 7 patients (8.8%): 3 from group 1 (7.5%) and 4 from group 2 (10%). No retears were observed on MRI in the remaining 73 patients (91.2%): 37 patients from group 1 and 36 patients from group 2. There was no statistically significant difference in rate of retears between groups ( P = .69). Conclusion: Intra-articular injection of corticosteroids after rotator cuff repair does not increase the risk of retears and is thus an effective and safe treatment method for increasing ROM (forward flexion, external rotation) and improving clinical score (ASES) during the early postoperative period of patients undergoing rotator cuff repair.

scholarly journals Influence of positioning of L4–5 disc prostheses on functional outcomes and sagittal balance: 2-year follow-up of a cohort of 38 patients

2020 ◽  
Vol 32 (6) ◽  
pp. 842-849
Author(s):  
Jean Meyblum ◽  
Baptiste Boukebous ◽  
Pierre Diviné ◽  
Philippe Cottin ◽  
Charles-Henri Flouzat Lachaniette ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Sagittal Balance ◽  
Functional Outcomes ◽  
Pelvic Incidence ◽  
Total Disc Replacement ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

OBJECTIVEThe main objective of this study was to evaluate the influence of L4–5 total disc replacement (TDR) positioning on functional outcome at the 2-year follow-up. The secondary objective was to assess its influence on sagittal balance.METHODSProspective data were compiled for 38 single-level L4–5 ProDisc-O TDRs. Anteroposterior placement (APP) was the distance between the center of the implant and the center of the L5 endplate divided by the total length of the L5 endplate. This ratio was expressed as a percentage (APP 0%–49%, anterior off-centering; 50%, perfect centering; and 51%–100%, posterior off-centering). The patients were divided into 3 groups depending on the APP and using quartile values: group 1, anterior placement (APP 0%–46%); group 2, central placement (APP 46.1%–52%, the 2 central quartiles); and group 3, posterior placement (APP 52.1%–100%). The sagittal balance parameters assessed were overall lordosis, segmental lordosis, and pelvic incidence. Adequate lordosis was defined for each patient according to their pelvic incidence. The Oswestry Disability Index and visual analog scale (VAS) scores for back and leg pain were assessed.RESULTSThe average APP was 48% (range 40%–64%). There were 10 patients in group 1, 18 in group 2, and 10 in group 3. There was a significant difference in functional outcomes among the 3 groups. APP influenced the VAS back (p = 0.04) and VAS leg (p = 0.05) scores. Group 1 consistently showed the highest performance scores. No significant association between APP and the sagittal balance parameters was found. Patients who had preoperative sagittal imbalance or those who significantly modified their balance after the surgery had the poorest outcomes.CONCLUSIONSDisc prostheses at L4–5 seem to provide better functional outcome when they are positioned anteriorly to the center of the vertebral body.

scholarly journals Effects of posterior tibial slope on the mid-term results of medial unicompartmental knee arthroplasty

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Zhijie Chen ◽  
Kaizhe Chen ◽  
Yufei Yan ◽  
Jianmin Feng ◽  
Yi Wang ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Tibial Slope ◽  
Posterior Tibial ◽  
Significant Difference ◽  
Medial Unicompartmental Knee Arthroplasty ◽  
Group 3 ◽  
Group 2 ◽  
Postoperative Knee ◽  
Group 1

Abstract Objective To evaluate the effect of medial posterior tibial slope (PTS) on mid-term postoperative range of motion (ROM) and functional improvement of the knee after medial unicompartmental knee arthroplasty (UKA). Methods Medical records of 113 patients who had undergone 124 medial UKAs between April 2009 through April 2014 were reviewed retrospectively. The mean follow-up lasted 7.6 years (range, 6.2–11.2 years). Collected were demographic data, including gender, age, height, weight of the patients. Anteroposterior (AP) and lateral knee radiographs of the operated knees were available in all patients. The knee function was evaluated during office follow-up or hospital stay. Meanwhile, postoperative PTS, ROM, maximal knee flexion and Hospital for Special Surgery (HSS) knee score (pre−/postoperative) of the operated side were measured and assessed. According to the size of the PTS, patients were divided into 3 groups: group 1 (<4°), group 2 (4° ~ 7°) and group 3 (>7°). The association between PTS and the knee function was investigated. Results In our cohort, the average PTS was 2.7° ± 0.6° in group 1, 5.6° ± 0.9° in group 2 and 8.7° ± 1.2° in group 3. Pairwise comparisons showed significant differences among them (p < 0.01). The average maximal flexion range of postoperative knees in each group was 112.4° ± 5.6°, 116.4° ± 7.2°, and 117.5° ± 6.1°, respectively, with significant difference found between group 1 and group 2 (p < 0.05), and between group 1 and group 3 (p < 0.05). However, the gender, age, and body mass index (BMI) did not differ between three groups and there was no significant difference between groups in terms of pre−/postoperative HSS scores or postoperative knee ROM. Conclusion A mid-term follow-up showed that an appropriate PTS (4° ~ 7°) can help improve the postoperative flexion of knee. On the other hand, too small a PTS could lead to limited postoperative knee flexion. Therefore, the PTS less than 4° should be avoided during medial UKA.

The Relationship between Serum Ferritin Levels and 5-Year All-Cause Mortality in Hemodialysis Patients

2021 ◽  
pp. 1-7
Author(s):  
Emre Erdem ◽  
Ahmet Karatas ◽  
Tevfik Ecder
Keyword(s):  
Serum Ferritin ◽  
Hemodialysis Patients ◽  
Rank Test ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Group 3 ◽  
Group 2 ◽  
The Relationship ◽  
Group 1

<b><i>Introduction:</i></b> The effect of high serum ferritin levels on long-term mortality in hemodialysis patients is unknown. The relationship between serum ferritin levels and 5-year all-cause mortality in hemodialysis patients was investigated in this study. <b><i>Methods:</i></b> A total of 173 prevalent hemodialysis patients were included in this study. The patients were followed for up to 5 years and divided into 3 groups according to time-averaged serum ferritin levels (group 1: serum ferritin &#x3c;800 ng/mL, group 2: serum ferritin 800–1,500 ng/mL, and group 3: serum ferritin &#x3e;1,500 ng/mL). Along with the serum ferritin levels, other clinical and laboratory variables that may affect mortality were also included in the Cox proportional-hazards regression analysis. <b><i>Results:</i></b> Eighty-one (47%) patients died during the 5-year follow-up period. The median follow-up time was 38 (17.5–60) months. The 5-year survival rates of groups 1, 2, and 3 were 44, 64, and 27%, respectively. In group 3, the survival was lower than in groups 1 and 2 (log-rank test, <i>p</i> = 0.002). In group 1, the mortality was significantly lower than in group 3 (HR [95% CI]: 0.16 [0.05–0.49]; <i>p</i> = 0.001). In group 2, the mortality was also lower than in group 3 (HR [95% CI]: 0.32 [0.12–0.88]; <i>p</i> = 0.026). No significant difference in mortality between groups 1 and 2 was found (HR [95% CI]: 0.49 [0.23–1.04]; <i>p</i> = 0.063). <b><i>Conclusion:</i></b> Time-averaged serum ferritin levels &#x3e;1,500 ng/mL in hemodialysis patients are associated with an increased 5-year all-cause mortality risk.

Recurrence and Revision Rates With Arthroscopic Bankart Repair Compared With the Latarjet Procedure in Competitive Rugby Players With Glenohumeral Instability and a Glenoid Bone Loss <20%

2021 ◽  
Vol 49 (4) ◽  
pp. 866-872
Author(s):  
Luciano A. Rossi ◽  
Ignacio Tanoira ◽  
Tomás Gorodischer ◽  
Ignacio Pasqualini ◽  
Maximiliano Ranalletta
Keyword(s):  
Bone Loss ◽  
Functional Outcomes ◽  
Return To Sport ◽  
Glenoid Bone Loss ◽  
Bankart Repair ◽  
Latarjet Procedure ◽  
Glenohumeral Instability ◽  
Arthroscopic Bankart Repair ◽  
Significant Difference ◽  
Rugby Players

Background: There is a lack of evidence in the literature comparing outcomes between the arthroscopic Bankart repair and the Latarjet procedure in competitive rugby players with glenohumeral instability and a glenoid bone loss <20%. Purpose: To compare return to sport, functional outcomes, and complications between the arthroscopic Bankart repair and the Latarjet procedure in competitive rugby players with glenohumeral instability and a glenoid bone loss <20%. Study Design: Cohort study; Level of evidence, 3. Methods: Between June 2010 and February 2018, 130 competitive rugby players with anterior shoulder instability were operated on in our institution. The first 80 patients were operated on with the arthroscopic Bankart procedure and the other 50 with the open Latarjet procedure. Return to sport, range of motion (ROM), the Rowe score, and the Athletic Shoulder Outcome Scoring System (ASOSS) were used to assess functional outcomes. Recurrences, reoperations, and complications were also evaluated. Results: In the total population, the mean follow-up was 40 months (range, 24-90 months) and the mean age was 24.2 years (range, 16-33 years). Ninety-two percent of patients were able to return to rugby, 88% at their preinjury level of play. Eighty-nine percent of patients in the Bankart group and 87% in the Latarjet group returned to compete at the same level ( P = .788). No significant difference in shoulder ROM was found between preoperative and postoperative results. The Rowe and ASOSS scores showed statistical improvement after operation ( P < .01). No significant difference in functional scores was found between the groups The Rowe score in the Bankart group increased from a preoperative mean (± SD) of 41 ± 13 points to 89.7 points postoperatively, and in the Latarjet group, from a preoperative mean of 42.5 ± 14 points to 88.4 points postoperatively ( P = .95). The ASOSS score in the Bankart group increased from a preoperative mean of 53.3 ± 3 points to 93.3 ± 6 points postoperatively, and in the Latarjet group, from a preoperative mean of 53.1 ± 3 points to 93.7 ± 4 points postoperatively ( P = .95). There were 18 recurrences (14%). The rate of recurrence was 20% in the Bankart group and 4% in the Latarjet group ( P = .01). There were 15 reoperations (12%). The rate of reoperation was 16% in the Bankart group and 4% in the Latarjet group ( P = .03). There were 6 complications (5%). The rate of complications was 4% in the Bankart group and 6% in the Latarjet group ( P = .55). The proportion of postoperative osteoarthritis was 10% in the Bankart group (8/80 patients) and 12% (6/50 patients) in the Latarjet group ( P = .55). Conclusion: In competitive rugby players with glenohumeral instability and a glenoid bone loss <20%, both the arthroscopic Bankart repair and the Latarjet procedure produced excellent functional outcomes, with most athletes returning to sport at the same level they had before the injury. However, the Bankart procedure was associated with a significantly higher rate of recurrence (20% vs 4%) and reoperation (16% vs 4%) than the Latarjet procedure.

scholarly journals Impact of percutaneous embolization versus subinguinal microsurgical ligation on semen parameters in primary varicocele patients: comparative study

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Haytham M. Nasser ◽  
Ahmed Hussein ◽  
Gad M. Behairy ◽  
Mostafa Abdo
Keyword(s):  
Sperm Count ◽  
Semen Analysis ◽  
Statistical Significance ◽  
Semen Parameters ◽  
Male Factor ◽  
Percutaneous Embolization ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Background Varicocele is an abnormally dilated pampiniform plexus of the veins within the spermatic cord and is considered the most common correctable cause of male factor infertility. Many approaches are described for treatment either surgical (tradition inguinal, subinguinal, and laparoscopic) or non-surgical percutaneous embolization. During the period from August 2017 to December 2018, we prospectively analyzed the preoperative and post-operative alteration of semen parameters (at 3 and 9 months) of the data collected from 63 patients with clinically evident varicocele referred to our tertiary hospital. Patients were divided into two groups: group 1, thirty-three patients who underwent subinguinal microsurgical ligation, and group 2, thirty patients who underwent percutaneous embolization. Results Sixty-three patients enrolled in this study were divided in two groups: group 1, patients who underwent surgery, and group 2, patients who underwent embolization; the mean age is 24.6 ± 1.27 years in group 1 and 23.7 ± 2 years in group 2; there was no statistically significant difference between the two groups as regards BMI, diabetes, hypertension, and smoking. Bilaterality was present in 15.2% of group 1 patients and 10% in group 2 patients (P value 0.06). Most of the patients were classified as grades 2 and 3 with no statistical significance regarding severity of the disease. Preoperative semen parameters for patients including sperm count, motility, and abnormal forms showed no statistically significant difference between the two groups. Post-intervention semen analysis was done twice during follow-up after 3 months and 9 months from the date of intervention. After 3 months, the semen parameters were improved in both groups in spite of the higher sperm count in group 2 but with no statistical significance. After 9 months follow-up, semen analysis showed persistent increase in sperm mobility in group 1 patients in comparison to group 2 patients. Both groups had better improvement in count of normal form with no statistical significant change. Conclusion Improvement of semen parameters while treating primary varicocele by either subinguinal microsurgery approach or percutaneous embolization shows equivalent outcomes.

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