Arthroscopy-assisted Trillat procedure for anterior shoulder instability: Surgical technique and preliminary clinical results

Abstract

The Trillat procedure performed as open surgery to treat anterior shoulder instability has been proven effective in preventing recurrences and restoring range of motion. An arthroscopically assisted variant of the Trillat procedure is described here, together with the preliminary clinical results in 18 patients treated between 2011 and 2014. After a mean follow-up of 24.7±9.8 months, the clinical outcomes were very satisfactory, with a Walch-Duplay score of 81.5±18.0, a Rowe score of 83.6±16.0, and 94% of satisfied or very satisfied patients. Mean operative time was 55±13min. No recurrences were recorded. As an easily performed procedure that provides good clinical outcomes, the arthroscopically assisted Trillat procedure is a simple and reproducible alternative to arthroscopic Latarjet procedure, which is still reserved for highly experienced surgical teams.

Arthroscopic Trillat Procedure: A Guided Technique

“…Walch et al 2 reported 96% patient satisfaction with more than 10 years of follow up in patients with anterior instability with massive irreparable cuff tears. Ongoing instability has been reported as 16% by Walch et al 2 , by Gerber et al 5 as 4% recurrent dislocation but 18% recurrent apprehension, and recently by Labattut et al 8 as 5.5% in a short-term follow-up of arthroscopically assisted open Trillat procedures. In both articles by Walch et al 2 and Gerber et al, 5 they reported glenohumeral osteoarthritis at final follow-up of 64.3% and 62%, respectively.…”

“…Our arthroscopic Trillat technique is simpler and less technically demanding than arthroscopic Latarjet procedures, making it a good initial procedure for surgeons wanting to transition to extra-articular arthroscopic stabilization procedures (Table 3). An important advantage of this technique, compared with other open or arthroscopic Trillat techniques, 8,9 is the lack of release of the pectoralis minor tendon from the coracoid process. This negates the need for dissection medial to the coracoid process and thus reduces the risk of serious intraoperative bleeding and damage to the musculocutaneous and axillary nerves.…”

Arthroscopic Trillat Coracoid Transfer Procedure Using a Cortical Button for Chronic Anterior Shoulder Instability

“…Recently, Labattut et al 10 . reported a 5.5% recurrence rate and satisfactory functional results at short-term follow-up after arthroscopically assisted Trillat procedure for chronic anterior instability.…”

Open Trillat Procedure for Recurrent Anterior Instability of the Shoulder in Elderly Patients

“…Labattut et al. 20 described an arthroscopy-assisted Trillat procedure for anterior shoulder instability in 18 patients as a simple and reproductive alternative to arthroscopic Latarjet procedure. They found at a median follow-up of 24.7 months very satisfactory clinical outcomes with 94% of satisfied or very satisfied patients and no recurrences recorded.…”

“…It allows the assessment of the subscapularis at the end of the procedure to prevent any infra-coracoid impingement (which may lead to a loss of external rotation) as the treatment of associated lesions. 19 Labattut et al 20 described an arthroscopy-assisted Trillat procedure for anterior shoulder instability in 18 patients as a simple and reproductive alternative to arthroscopic Latarjet procedure. They found at a median follow-up of 24.7 months very satisfactory clinical outcomes with 94% of satisfied or very satisfied patients and no recurrences recorded.…”