Long-term outcomes after repair of recurrent post-traumatic anterior shoulder instability: comparison of arthroscopic transglenoid suture and open Bankart reconstruction

Zaffagnini, Stefano; Muccioli, Giulio Maria Marcheggiani; Giordano, Giovanni; Bonanzinga, Tommaso; Alberto, Grassi; Nitri, Marco; Bruni, Danilo; Ravazzolo, Giovanni; Marcacci, Maurilio

doi:10.1007/s00167-011-1674-y

Cited by 57 publications

(45 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Functional follow-up scores confirmed the good long-term results already reported in the literature after the same procedure [3-6,26,27,34]. Although patients with subscapularis muscle histopathologic anomalies had more recurrence in this study, their functional scores at follow-up were not significantly different when compared to patients with normal muscle histology.…”

Section: Discussionsupporting

confidence: 87%

“…The Constant-Murley shoulder score is not validated for patients undergoing surgery for shoulder instability [20]. We used this score at follow-up because it was already obtained preoperatively and it is reported in other long-term follow-up studies on open anterior shoulder stabilization, thus allowing for comparison [3,26,27]. The Rowe shoulder score, the ASES shoulder assessment and the SANE rating have been validated for the evaluation of patients after shoulder stabilization [25,28,29].…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Primary open anterior shoulder stabilization: a long-term, retrospective cohort study on the impact of subscapularis muscle alterations on recurrence

Gamulin

Dayer

Lübbeke

et al. 2014

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundPost-traumatic anterior shoulder instability patients may present histopathologic lesions within the subscapularis muscle compatible with a scarring process associated with disuse atrophy. We hypothesized that such lesions identified on intraoperative biopsy at the time of primary anterior shoulder stabilization would predict a higher risk of postoperative instability recurrence.MethodsOf 52 eligible patients (52 shoulders) who had undergone subscapularis muscle biopsy during primary anterior open labral repair and capsulorrhaphy, 35 (mean age at surgery, 27.2 years; male sex, 71.4%) were retrospectively evaluated (mean follow-up, 12.9 years; range, 10.9-14.5 years). Primary outcome was shoulder instability recurrence. Secondary outcomes included shoulder range of motion, functional scores, and radiological analysis of glenohumeral joint degenerative changes.ResultsOverall five patients (14.3%) presented shoulder instability recurrence. Twelve patients with histopathologic lesions had significantly more instability recurrence than 23 without histopathologic changes (33.3% vs. 4.3%; risk difference, 29% [95% CI 1; 57]; p = 0.038). Patients without histopathologic changes had significantly reduced external rotation with arm at side (ER1; -11.9°; p = 0.001) and with shoulder abducted to 90° (ER2; -14.9°; p = 0.001) on the operated side when compared to the contralateral side. Patients with histopathologic lesions had only ER2 significantly reduced (-8.9°; p = 0.031). There was no substantial difference regarding functional and quantitative radiological scores between both patients’ groups.ConclusionsHistopathologic changes within the subscapularis muscle at the time of primary open labral repair and capsulorrhaphy were associated with an increased risk of shoulder instability recurrence. Further investigations are needed to assess the impact of dedicated postoperative rehabilitation programs for patients presenting these lesions. Their recognition on preoperative magnetic resonance imaging should also be investigated; non-anatomical repairs could be an option in these cases.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Methodsmentioning

confidence: 99%

Primary open anterior shoulder stabilization: a long-term, retrospective cohort study on the impact of subscapularis muscle alterations on recurrence

Gamulin

Dayer

Lübbeke

et al. 2014

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…A prospective study reported up to 90% recurrence rate in young athletes under 24-year-old following a first time shoulder dislocation [47] . Specifically, participation in contact sports was a significant patient factor in developing recurrent instability [48,49] . It is important to identify the chronicity of the shoulder problem, the functional restriction and quantification of the glenoid and humeral bone loss prior to treatment.…”

Section: Managementmentioning

confidence: 99%

Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss

Ramhamadany

Modi

2016

WJO

View full text Add to dashboard Cite

The management of recurrent anterior gleno-humeral joint instability is challenging in the presence of bone loss. It is often seen in young athletic patients and dislocations related to epileptic seizures and may involve glenoid bone deficiency, humeral bone deficiency or combined bipolar lesions. It is critical to accurately identify and assess the amount and position of bone loss in order to select the most appropriate treatment and reduce the risk of recurrent instability after surgery. The current literature suggests that coracoid and iliac crest bone block transfers are reliable for treating glenoid defects. The treatment of humeral defects is more controversial, however, although good early results have been reported after arthroscopic Remplissage for small defects. Larger humeral defects may require complex reconstruction or partial resurfacing. There is currently very limited evidence to support treatment strategies when dealing with bipolar lesions. The aim of this review is to summarise the current evidence regarding the best imaging modalities and treatment strategies in managing this complex problem relating particularly to contact athletes and dislocations related to epileptic seizures.

show abstract

“…The longer the follow-up is, the higher redislocation rates are; this was stated by Zaffagnini et al ,44 who found, in a retrospective series with a follow-up from 10 to 17 years, a redislocation rate of 12.5% in 49 shoulders, and Plath et al ,45 who presented a case series with a 10-year follow-up, with a 21% redislocation rate in 100 shoulders. We could not stratify the recurrence risk for follow-up duration; however, a graphic representation of recurrence ratios plotted for average follow-up duration (figures 3–6) seems to confirm this statement.…”

Section: Discussionmentioning

confidence: 88%

Hill-Sachs lesion is not a significant prognostic factor for recurrence of shoulder redislocation after arthroscopic Bankart repair

Randelli

Cucchi

Martini³

et al. 2016

Journal of ISAKOS

View full text Add to dashboard Cite

Long-term outcomes after repair of recurrent post-traumatic anterior shoulder instability: comparison of arthroscopic transglenoid suture and open Bankart reconstruction

Abstract: Therapeutic Study-Retrospective Comparative Study, Level III.

Cited by 57 publications

References 33 publications

Primary open anterior shoulder stabilization: a long-term, retrospective cohort study on the impact of subscapularis muscle alterations on recurrence

Primary open anterior shoulder stabilization: a long-term, retrospective cohort study on the impact of subscapularis muscle alterations on recurrence

Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss

Hill-Sachs lesion is not a significant prognostic factor for recurrence of shoulder redislocation after arthroscopic Bankart repair

Contact Info

Product

Resources

About