Arthroscopic evaluation and management of anterior shoulder instability

Abstract

Shoulder instability is a common problem that is encountered in young population nowadays due to the increase in the number of road traffic injury cases causing shoulder dislocations. The most common amongst them is anterior shoulder instability which can be diagnosed clinically and radiologically. The aim of the paper is to evaluate the correlation of these clinical and radiological findings to arthroscopic findings and treat these injuries arthroscopically and compare their clinical outcome to open repair of anterior shoulder instability. Materials and Methods: To assess 20 cases of anterior shoulder instability clinically, radiologically and corelate it with arthroscopic evaluation of the instability and to compare open repair and arthroscopic repair of these injuries. Results: 20 patients who had anterior shoulder instability and underwent a diagnostic shoulder arthroscopy showed that all 20 of them had Bankart's lesion with 14 of them having an accompanying Hillsach's lesion. Amongst the 14 patients with Hillsach's lesion, 12 of them had a bone loss of less than 10% so were operated for arthroscopic Bankart's repair and the remaining 2 patients had a bone loss of 13% and 15 %. Both these patients underwent an additional Bristow Latarjet capsulolabral repair as the bone loss was less than 25% where using the Tasaki technique the coracoid process was transferred and fixed to the anterior glenoid. Conclusion: Overall, we have come to a conclusion that "Arthroscopic Evaluation and Management of Anterior Shoulder Instability" is a better method in evaluating the instability as it has a better sensitivity and specificity in identifying the pathology compared to an MRI, gives excellent results when repaired using suture anchors and gives excellent range of motion of the shoulder.