ROLE OF 3D CT SCAN IN QUANTIFYING GLENOID BONE LOSS IN RECURRENT UNILATERAL SHOULDER DISLOCATION

Purpose: Patients with recurrent shoulder instability often present with osseous injury to the glenoid and humeral head. Glenoid bone loss can easily be quantied on a three-dimensional computed tomography scan by modeling the inferior portion of the glenoid contour as a true circle on an en face view. This study investigated the accuracy of CT in determining the presence and severity of glenoid bone loss in patients with unilateral recurrent shoulder dislocation. Methodology: This prospective cross-sectional study was done among patients with unilateral recurrent shoulder dislocation. Forty patients with anterior shoulder dislocation underwent shoulder CT examination before arthroscopy. Results: Glenoid bone loss was evident in 38 (95%) of the 40 patients at arthroscopy. Compared with arthroscopy, CT had sensitivity in detecting glenoid bone loss of 92.1%; specicity, 100%; positive predictive value, 100%; and negative predictive value, 40.0%. Three false-negative CT assessments had 5%, 5%, and 20% glenoid bone loss, respectively, at arthroscopy. There was a strong correlation between CT and arthroscopy with respect to the severity of glenoid bone loss (r = 0.73). Conclusion: CT has both a high sensitivity and a high specicity for detecting glenoid bone loss, and agreement with arthroscopy regarding the severity of glenoid bone loss is good. CT can be used to assess glenoid bone loss and the need for bone augmentation surgery.

Functional outcomes of modified Bristow procedure in recurrent shoulder dislocation

The glenohumeral joint is the most mobile in humans. Of all joints 50% dislocations involve the shoulder, mostly young males. When the first dislocation occurs under 20 years old the risk for recurrent instability increases to 90%. Many techniques are available to reduce and stabilize the glenohumeral joint in cases of anterior dislocations one of which is the famous Bristow’s procedure, originally described in 1954 by Laterjet. The purpose of this study was to determine the Functional Outcomes of Modified Bristow procedure. This retrospective review conducted at Aga Khan University Hospital Karachi from Jan 2000- Dec 2015, comprising patients who underwent modified Bristow procedure. 70 patients were recruited in the study who underwent modified Bristow procedure. Continuous...

Outcomes of arthroscopy in recurrent shoulder instability at Viet Duc University Hospital

Introduction: This study aims to assess the results of patients with recurrent shoulder dislocation treated with arthroscopic Bankart repair. Patients and Method: 31 patients (26 males and 5 females, with an average age of 28.7) were treated with arthroscopic Bankart repair from 2017 to 2018. Those with multidirectional instability, posterior shoulder instability and more-than-25% Hill-Sachs defects, along with those who had prior shoulder surgeries were excluded. Average follow-up time after surgery is 15.13 months. Frequency of pre-operative dislocation, post-operative dislocation, functional status and daily activity performance were evaluated. The results were assessed using CONSTANT score. Results: One patient had post-operative dislocation (3.23%). One patient had post-operative joint adhesion (3.23%). Assessment using CONSTANT score showed an excellent result in 67.4%, good in 12.9%, moderate in 12.9% and average in 6.46%. There was no case with poor result. One patient had post-operative dislocation due to a sport injury. Conclusions: Arthroscopic repair is a modern technology, and is being used widely in diagnosing and treating shoulder lesions. This study shows that arthroscopic repair for recurrent shoulder dislocation may bring good result for patients. Keywords: Shoulder instability, arthroscopy, Bankart.

Return to sport and patient satisfaction after arthroscopic Bankart repair: a single-institution experience

Introduction: Arthroscopic Bankart repair is a widely accepted procedure to treat recurrent shoulder dislocation. This study aims to describe our experience with arthroscopic Bankart repair and its functional outcome. Methods: 107 patients who underwent arthroscopic Bankart repair from 2008 to 2013 were followed up for a minimum of three years and reviewed by an independent observer. 80 consented to being interviewed using the Oxford Shoulder Instability Score (OSIS) and Simple Shoulder Test. Results: 82 shoulders (two bilateral) were studied. Mean age at first dislocation was 19.4 ± 3.4 (12.0–31.0) years. Mean follow-up was 4.4 ± 1.3 (3.0–9.0) years and 2.5 ± 3.0 (0.1–15.4) years elapsed from first dislocation to surgery. 41 (50.0%) patients played overhead or contact sports and 44 (53.7%) played competitive sports before injury; 8 (9.8%) patients reported recurrence of dislocation, which was significantly associated with playing competitive sports before injury (p < 0.039), 5 (6.1%) underwent revision surgery and 22 (26.8%) reported residual instability after surgery. 49 (59.8%) patients returned to playing sports, 75 (91.5%) were satisfied with their surgery and 79 (96.3%) were willing to undergo the surgery again. 74 (90.2%) patients had two-year good/excellent OSIS, which was significantly associated with playing competitive sports before injury (p = 0.039), self-reported stability after surgery (p = 0.017), satisfaction with surgery (p = 0.018) and willingness to undergo surgery again (p = 0.024). Conclusion: Arthroscopic Bankart repair yields good functional outcomes and is associated with high patient satisfaction, although not all patients return to sports.

Comparative study of arthroscopic Bankart repair versus open Latarjet procedure for recurrent shoulder dislocation

Objectives The primary aim of this study was to compare the clinical outcomes of patients undergoing arthroscopic Bankart repair and the open Latarjet procedure for recurrent dislocation of the shoulder. The secondary aims were to assess and compare the surgical cost, patient satisfaction, and complications, including recurrence and infection. Methods We retrospectively compared the clinical outcomes of all consecutive patients undergoing either arthroscopic Bankart repair or the open Latarjet procedure from May 2015 to May 2018 with a minimum 2-year follow-up. Forty-one patients (32 men, 9 women) in the Bankart group and 40 patients (34 men, 6 women) in the Latarjet group were available for the final follow-up. Results There were no statistically significant differences in the demographic parameters or clinical outcomes between the two groups. Functional satisfaction was higher with the Latarjet procedure. Bankart repair had a significantly higher operating cost than the Latarjet procedure. Three patients in the Bankart group and no patients in the Latarjet group developed recurrence. Conclusion Both procedures provided satisfactory clinical outcomes. However, the Latarjet group had a higher rate of functional satisfaction and lower operating cost, and there was a trend toward higher recurrence in the arthroscopic Bankart group.