Purpose: The purpose of this study was to identify the presence of intra-articular pathology
in patients undergoing shoulder arthroscopy immediately before modified Latarjet reconstruction
for recurrent anterior instability with bone deficiency. Methods: The records of 33 consecutive patients who underwent shoulder arthroscopy immediately
before the modified Latarjet reconstruction were analyzed. Arthroscopy was performed
just before the open procedure to identify and treat intra-articular pathology that
would otherwise have been missed or not well treated during the routine open anterior
approach to the shoulder. Results: In 24 of 33 cases (73%) associated pathologic lesions were identified and addressed
arthroscopically (lesions not likely to have been discovered and treated optimally
during the open deltopectoral approach). We identified and addressed 21 type 2 SLAP
lesions (64%) as well as 1 posterior Bankart lesion, 2 loose bodies, 2 rotator cuff
tears, and 2 localized areas of grade 4 chondromalacia. Conclusions: Arthroscopic examination before modified Latarjet reconstruction is recommended because
it allows the surgeon to identify and arthroscopically address associated pathologic
entities that are present in over two thirds of the cases. Level of Evidence: Level IV, therapeutic case series.
Key Words
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References
- Arthroscopic treatment of anterior-inferior glenohumeral instability: Two to five-year follow-up.J Bone Joint Surg Am. 2000; 82: 991-1003
- Arthroscopic findings after shoulder dislocation.Am J Sports Med. 1995; 23: 545-551
- Arthroscopic evaluation of acute initial anterior shoulder dislocations.Am J Sports Med. 1990; 18: 25-28
- Shoulder arthroscopy: Its role in evaluating shoulder disorders in the athlete.Am J Sports Med. 1990; 18: 480-483
- The arthroscopic treatment of glenoid labrum tears in the throwing athlete.Orthop Trans. 1984; 8: 44-52
- The inverted pear glenoid: An indicator of significant glenoid bone loss.Arthroscopy. 2004; 20: 169-174
- Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: Significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion.Arthroscopy. 2000; 16: 677-694
- Results of modified Latarjet reconstruction in patients with anteroinferior insignificance and significant bone loss.Arthroscopy. 2007; 23: 1033-1041
- Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder.J Bone Joint Surg Am. 1998; 80: 841-852
- Magnetic resonance imaging of the glenoid labrum in anterior shoulder instability.Am J Sports Med. 1994; 22: 493-498
- Magnetic resonance imaging of the glenoid labrum.Am J Sports Med. 1990; 18: 229-234
- Quantitative assessment of classic anteroinferior bony Bankart lesions by radiography and computed tomography.Am J Sports Med. 2003; 31: 112-118
- The disabled throwing shoulder: Spectrum of pathology. Part II: Evaluation and treatment of SLAP lesions in throwers.Arthroscopy. 2003; 19: 531-539
- SLAP lesions of the shoulder.Arthroscopy. 1990; 6: 274-279
- Surgical management of large rotator cuff tears combined with instability in elite rugby football players.Br J Sports Med. 2003; 37: 179-181
- The role of the long head of the biceps muscle and superior glenoid labrum in anterior stability of the shoulder.Am J Sports Med. 1994; 22: 121-130
- Superior labrum-biceps tendon complex lesions of the shoulder.Am J Sports Med. 1995; 23: 93-98
- Biceps tendon disorders in athletes.J Am Acad Orthop Surg. 1999; 7: 300-310
- Effect of a chondral-labral defect on glenoid concavity and glenohumeral stability.J Bone Joint Surg Am. 1996; 78: 94-102
- Glenoid rim morphology in recurrent anterior glenohumeral instability.J Bone Joint Surg Am. 2003; 85: 878-884
- Symptomatic shoulder instability due to lesions of the glenoid labrum.Am J Sports Med. 1983; 11: 279-288
Article info
Publication history
Published online: February 13, 2008
Footnotes
S.S.B. is a consultant for Arthrex, Naples, Florida.
Identification
Copyright
© 2008 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
