Arthroscopic Posterior Labral Repair and Capsular Shift With a Lateralized Posterior Portal

Ciccone, II William J.

doi:10.1016/j.eats.2013.05.005

Cited by 5 publications

(7 citation statements)

References 14 publications

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“…Rather, in many cases, significant abrasions and degenerations can be observed in the posteroinferior labral area. 8,10,16,29 Based on the postoperative results in the literature, arthroscopic posterior labral refixation delivers good results in terms of both recurrence (2.4%-8%) and returnto-sport rate. 1,2,5,15,16,24,29 It is worth noting, however, that the rate of return to sport at the preinjury level is lower for throwing athletes.…”

Section: Discussionmentioning

confidence: 99%

“…There are 2 solutions for this: one is to create a complementary posterolateral portal, placed distally and laterally from the standard posterior portal, and the other solution is to place a standard posterior portal 1 cm distally and 1 to 2 cm laterally from its original position. 8 , 16 , 24 , 25 We usually create the standard portal more distally and laterally; depending on the position and size of the labral injury, we decide whether to create a complementary posterior portal during the operation. Anatomic studies indicate that the complementary posterior portal is located very close to the axillary nerve, which runs closest to the glenoid rim at the 6-o’clock position.…”

Section: Discussionmentioning

confidence: 99%

“…Rather, in many cases, significant abrasions and degenerations can be observed in the posteroinferior labral area. 8 , 10 , 16 , 29 …”

Section: Discussionmentioning

confidence: 99%

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Return to Sport After Arthroscopic Treatment of Posterior Shoulder Instability

Pavlik¹,

Tátrai²,

Papp³

2020

Orthopaedic Journal of Sports Medicine

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Background: Arthroscopic treatment of posterior shoulder instability has become more popular and effective in recent years, but few data are available concerning the rate of return to sport. Purpose: To present our experiences with arthroscopic posterior labral reconstruction in athletes and review our results, with a particular focus on the rate of return to sport. Study Design: Case series; Level of evidence, 4. Methods: Included in the study were 40 arthroscopic stabilizations performed because of posterior shoulder instability in 37 athletes at a single institution. During follow-up, the athletes’ rate of return to sport was calculated. Shoulder function was evaluated based on a pre- versus postoperative comparison of the Rowe instability score and the American Shoulder and Elbow Surgeons score. Additionally, the return-to-sport rate was compared among different subgroups: traumatic versus atraumatic origin of injury, competitive versus recreational athletes, high-risk versus low-risk sport, and posterior-only versus anterior and posterior stabilization. Data were statistically analyzed using paired-samples t test and nonparametric Fisher exact test. Results: The average follow-up period was 54.4 months (range, 24-112 months). Three shoulders (7.5%) continued to have posterior subluxations postoperatively. There were 34 excellent, 3 good, and 3 fair results based on the Rowe score (average postoperative score, 92.9), and patients achieved an average postoperative American Shoulder and Elbow Surgeons score of 92.7. The pre- to postoperative improvement was statistically significant in both scoring systems ( P < .001). Of the 37 patients, 36 (98.2%) were able to return to sport activity: 27 of them (72.9%) to their original sport and 19 (51.4%) at their preinjury level. A significantly higher rate of return to the same sport occurred in athletes who had traumatic injury compared with a subgroup of athletes without a traumatic event ( P < .02). Conclusion: More than half of the athletes were able to return to their preinjury level of sport after arthroscopic posterior labral reconstruction. In addition, low recurrence rates and good functional outcomes were seen in >90% of the patients, and 98% returned to sport activity. The athletes had a significantly higher rate of return to sport if their posterior shoulder instability had a clear traumatic origin.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Return to Sport After Arthroscopic Treatment of Posterior Shoulder Instability

Pavlik¹,

Tátrai²,

Papp³

2020

Orthopaedic Journal of Sports Medicine

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“…Other investigators have suggested alternative portals for access to the posterior and inferior labrum. Ciccone 12 reported on his use of a lateralized posterior portal without use of accessory portals for fixation of posterior labral tears, and the posterolateral accessory portal, as well as a low posterolateral portal, has been described—all used with the purpose of gaining a proper angle for anchor placement. 6 Any of these described portals can be used at the surgeon's discretion, as long as the entire labrum is visualized, with the correct trajectory achieved for anchor placement circumferentially.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Repair of a Circumferential 360° Labral Tear

Rao

Cvetanovich

Zuke

et al. 2017

Arthroscopy Techniques

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Injuries to the glenoid labrum can result in shoulder instability and pain. These lesions may occur anywhere around the glenoid labrum, and thus, the arthroscopist must be prepared to approach all aspects of the glenoid from multiple angles. The pan-labral or circumferential (360°) tear of the glenoid labrum presents a unique challenge to even the experienced arthroscopist. The extent of the lesion requires the use of accessory portals and percutaneous techniques to establish adequate visualization and to facilitate the proper trajectory for anchor placement. The pan-labral tear also demands intraoperative planning throughout the repair to ensure proper tensioning and alignment of the labrum and capsular tissue. The purposes of this article are to report a technique for repairing a pan-labral lesion and to emphasize the use of accessory portals and percutaneous techniques for complete access to the glenoid.

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“…Several techniques have been identified to facilitate posterior glenoid anchor placement and repair of the posterior labrum. 5,6,[11][12][13][14] Adequate tissue preparation, including liberation and mobilization of the capsulolabral complex and debridement of the glenoid rim, is also believed to be critical to achieving a successful repair and optimized outcomes. Commonly, this is performed from 1 of 2 established anterior portals or directly from the posterior portal.…”

mentioning

confidence: 99%

The “Sublabral Window” in Arthroscopic Posterior Shoulder Instability Surgery: Description of a Technique for Safe Posterior Glenoid Preparation

Patel

Bravman

McCarty

2016

Arthroscopy Techniques

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Arthroscopic posterior labral repairs for posterior shoulder instability can be challenging. Preparation of the capsulolabral tissue and glenoid bony surface is critical. Iatrogenic injury to the articular cartilage and unwarranted truncation of the capsulolabral tissue are concerns during preparation. As a result, several techniques have been described to potentially avoid these complications. We describe an additional technique for improving access and preparing the capsulolabral tissue and glenoid surface through a "sublabral window." This technique approaches the posterior labrum and glenoid through an already established posterior portal and mitigates iatrogenic injury to the labrum and articular cartilage. The technique is rather simple and easily adaptable.

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Arthroscopic Posterior Labral Repair and Capsular Shift With a Lateralized Posterior Portal

Cited by 5 publications

References 14 publications

Return to Sport After Arthroscopic Treatment of Posterior Shoulder Instability

Return to Sport After Arthroscopic Treatment of Posterior Shoulder Instability

Arthroscopic Repair of a Circumferential 360° Labral Tear

The “Sublabral Window” in Arthroscopic Posterior Shoulder Instability Surgery: Description of a Technique for Safe Posterior Glenoid Preparation

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