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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.

Author information

1
Sports Traumatology Unit, San Giovanni-Addolorata Hospital, Rome, Italy. Electronic address: m.maiotti@libero.it.
2
Orthopaedic and Traumatology Unit, Pellegrini Hospital, Naples, Italy.
3
Arthroscopy Unit, Carlo Poma Hospital, Mantua, Italy.
4
BG Trauma Center Department of Traumatology, Eberhard Karls University, Tübingen, Germany.
5
Sports Traumatology Unit, San Giovanni-Addolorata Hospital, Rome, Italy.
6
Isokinetic Group, Rome, Italy.

Abstract

BACKGROUND:

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.

METHODS:

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.

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.

CONCLUSIONS:

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.

KEYWORDS:

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

PMID:
26613984
DOI:
10.1016/j.jse.2015.09.025
[Indexed for MEDLINE]

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