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J Shoulder Elbow Surg. 2016 Jun;25(6):898-906. doi: 10.1016/j.jse.2015.09.025. Epub 2015 Nov 21.

Arthroscopic Bankart repair and subscapularis augmentation: an alternative technique treating anterior shoulder instability with bone loss.

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Sports Traumatology Unit, San Giovanni-Addolorata Hospital, Rome, Italy. Electronic address:
Orthopaedic and Traumatology Unit, Pellegrini Hospital, Naples, Italy.
Arthroscopy Unit, Carlo Poma Hospital, Mantua, Italy.
BG Trauma Center Department of Traumatology, Eberhard Karls University, Tübingen, Germany.
Sports Traumatology Unit, San Giovanni-Addolorata Hospital, Rome, Italy.
Isokinetic Group, Rome, Italy.



This study presents the preliminary results of a new arthroscopic technique consisting of the association of 2 procedures, capsulolabral repair and subscapularis augmentation tenodesis, in the treatment of traumatic anterior shoulder instability with both glenoid bone loss and a Hill-Sachs lesion.


Eighty-nine patients engaged in sports were enrolled in this retrospective case-series study with 2 to 5 years' follow-up. All patients underwent a computed tomography scan to assess the percentage of glenoid bone loss by the Pico method. A prior stabilization procedure had failed in 20 patients, who were then segregated into a different group. Visual analog scale (VAS), Rowe, and American Shoulder and Elbow Surgeons (ASES) scores were used to assess the results.


Only 3 of 89 patients had a post-traumatic redislocation. The mean length of follow-up was 31.5 months (range, 25-60 months). The VAS, Rowe, and ASES scores showed significant improvements: The VAS score decreased from a mean of 3.1 to 0.5 (P = .0157), the Rowe score increased from 58.9 to 94.1 (P = .0215), and the ASES score increased from 68.5 to 95.5 (P = .0197). The mean deficit of external rotation was 6° with the arm at the side of the trunk, and the mean deficit was 3° with the arm in 90° of abduction.


The described procedure is a reproducible and effective technique used to restore joint stability in patients engaged in sports who have incurred anterior recurrent shoulder dislocation associated with glenoid bone loss (<25%) and a Hill-Sachs lesion.


Hill-Sachs lesion; Traumatic shoulder instability; arthroscopic subscapularis augmentation; glenoid defect

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