Bankart Repair With Subscapularis Augmentation in Athletes With Shoulder Hyperlaxity

Maiotti, Marco; Russo, Roberto; Zanini, Antonio Carlos; Castricini, Roberto; Castellarin, Gianluca; Schröter, Steffen; Rossi, Carlo Maria; Savoie, Felix H.

doi:10.1016/j.arthro.2021.01.062

Cited by 13 publications

(14 citation statements)

References 64 publications

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“…In a multicenter study it was reported that there was only external rotation limitation of mean 15° when the arms were by the sides of the body and mean 10° when in 90° abduction. [ 19 ] In the current study, external rotation limitation was found to be similar at mean 10° compared to preoperatively. Other than this, no difference was found in the joint range of movement, which was consistent with the literature.…”

Section: Discussionsupporting

confidence: 53%

“…This technique was evaluated again with more patients in a multicenter study and again good results were reported, with re-dislocation in 16 of 397 patients. [ 19 ] Similarly in the current study, the preoperative and postoperative Constant Murley, ASES, Rowe and UCLA scores were compared and there was seen to be a significant improvement after the surgery. Of the 83 patients included in the study, re-dislocation occurred in only 2.…”

Section: Discussionmentioning

confidence: 62%

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Bankart repair with subscapularis augmentation: A case control study

Karakuş

Öztermeli

2023

Medicine

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To examine the effect on functional shoulder scores of Bankart repair with arthroscopic subscapularis tendon augmentation applied to cases of anterior shoulder instability with < 25% glenoid defect and ligament-labral failure. A total of 83 patients underwent Bankart repair with subscapularis tendon augmentation between 2015 and 2021. The range of movement of the patients was measured by 2 doctors using a goniometer. The Constant Murley score, American Shoulder and Elbow Surgeons score, Rowe score, and the University of California at Los Angeles scores were recorded preoperatively and postoperatively. Statistically significant increases were determined in the postoperative functional scores compared to the preoperative values as mean 41.4 ± 2.08 unit increase in the Constant Murley score, mean 41.4 ± 1.8 unit increase in the American Shoulder and Elbow Surgeons score, mean 13.8 ± 1.45 unit increase in the University of California at Los Angeles and mean 49.3 ± 7.45 unit increase in the Rowe score (P = .001; P < .01). Compared with the preoperative evaluation, there was found to be a postoperative statistically significant unit decrease of 10.2 ± 1.47 in the external rotation measurement (P = .001; P < .01). The number of dislocations was determined to have a negative correlation with the internal rotation measurements (r = −0.305; P = .005; P < .01), and a weak negative statistically significant relationship with external rotation measurements (r = −0.329; P = .002; P < .01). Unlike other techniques, as this repair technique includes both the tendon and the capsule as a single piece, it was seen to be a sufficient and reliable technique that is easy-to apply.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 62%

Bankart repair with subscapularis augmentation: A case control study

Karakuş

Öztermeli

2023

Medicine

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“…Historical surgery, such as the Putty–Platt and Magnuson–Stack procedures, involves entire tendon shortening, thus interfering with external rotation. In contrast, our method only involved the stretched portion of the subscapularis tendon upper border, thus leaving the middle and inferior subscapularis in the normal, anatomic position[ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Arthroscopy with subscapularis upper one-third tenodesis for treatment of recurrent anterior shoulder instability independent of glenoid bone loss

An¹,

Wang²,

Wang³

et al. 2022

WJCC

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BACKGROUND Recurrent anterior shoulder instability is a common traumatic injury, the main clinical manifestation of which is recurrent anteroinferior dislocation of the humeral head. The current follow-up study showed that the effect of arthroscopic Bankart repair is unreliable. AIM To evaluate the clinical efficacy of arthroscopy with subscapularis upper one-third tenodesis for treatment of anterior shoulder instability, and to develop a method to further improve anterior stability and reduce the recurrence rate. METHODS Between January 2015 and December 2018, male patients with recurrent anterior shoulder instability were selected. One hundred and twenty patients had a glenoid defect < 20% and 80 patients had a glenoid defect > 20%. The average age was 25 years (range, 18–45 years). Patients with a glenoid defect < 20% underwent arthroscopic Bankart repair with a subscapularis upper one-third tenodesis. The patients with a glenoid defect > 20% underwent an arthroscopic iliac crest bone autograft with a subscapularis upper one-third tenodesis. All patients were assessed with Rowe and Constant scores. RESULTS The average shoulder forward flexion angle was 163.6° ± 8.3° and 171.8° ± 3.6° preoperatively and at the last follow-up evaluation, respectively. The average external rotation angle when abduction was 90° was 68.4° ± 13.6° and 88.5° ± 6.2° preoperatively and at the last follow-up evaluation, respectively. The mean Rowe scores preoperatively and at the last follow-up evaluation were 32.6 ± 3.2 and 95.2 ± 2.2, respectively ( P < 0.05). The mean Constant scores preoperatively and at the last follow-up evaluation were 75.4 ± 3.5 and 95.8 ± 3.3, respectively ( P < 0.05). No postoperative dislocations were recorded by the end of the follow-up period. CONCLUSION Arthroscopy with subscapularis upper one-third tenodesis was effective for treatment of recurrent anterior shoulder instability independent of the size of the glenoid bone defect, enhanced anterior stability of the shoulder, and did not affect postoperative range of motion of the affected limb.

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“…In this frame, the paper "Bankart Repair With Subscapularis Augmentation in Athletes With Shoulder Hyperlaxity" by Maiotti, Russo, Zanini, Castricini, Castellarin, Schröter, Massoni, and Savoie, all recognized and expert surgeons, is a perfect example of personalized medicine applied to shoulder surgery. 11 The study includes a group of 397 patients treated with arthroscopic Bankart plus the arthroscopic subscapularis augmentation (ASA) technique 12 with evidence of shoulder hyperlaxity (positive sulcus sign in the external rotation [ER]1 position and CoudaneeWalch test >85 ) performing non-overhead collision and contact sports activities, recurrent anterior instability, and glenoid bone loss <15%. They excluded athletes suffering voluntary instability, multidirectional instability, or with pre-existing osteoarthritis and throwing athletes.…”

Section: Università Degli Studi DI Milanomentioning

confidence: 99%

Editorial Commentary: Personalized Medicine for Shoulder Instability May Result in Best Outcomes With the Lowest Complication Rates

Randelli

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Personalization is a type of medical care in which the treatment is customized for an individual patient. When treating shoulder instability, we need to consider not only soft-tissue damage but also the bony lesion and patient characteristics. Of particular importance is the consideration of whether there is anterior glenoid bone loss, together with the presence of a HilleSachs lesion, on or off-track, as well as whether the patient is hyperlax and/or is an athlete, in which case in what type of sport. In hyperlax, nonoverhead sport athletes with recurrent anterior instability and glenoid bone loss <15%, Bankart repair with subscapularis augmentation is an effective procedure with a lower risk of complications and arthritis than a bony procedure. This is a perfect example of personalized medicine indicating a particular treatment to the benefit of patients.

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Bankart Repair With Subscapularis Augmentation in Athletes With Shoulder Hyperlaxity

Cited by 13 publications

References 64 publications

Bankart repair with subscapularis augmentation: A case control study

Bankart repair with subscapularis augmentation: A case control study

Arthroscopy with subscapularis upper one-third tenodesis for treatment of recurrent anterior shoulder instability independent of glenoid bone loss

Editorial Commentary: Personalized Medicine for Shoulder Instability May Result in Best Outcomes With the Lowest Complication Rates

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