Purpose
The purpose of this study was to evaluate the results of revision arthroscopic stabilization
after failed open anterior shoulder stabilization.
Methods
We studied a retrospective series of 22 consecutive patients with recurrent anterior
shoulder instability after open surgical stabilization (12 Latarjet procedures, 4
Eden-Hybinette procedures, 3 open Bankart repairs, and 3 capsular shifts). Failure
was associated with a traumatic episode in 12 patients, capsular laxity with persistent
Bankart lesions in all patients, and a bone block complication in 13 patients. Labral
reattachment and capsuloligamentous retensioning with suture anchors were performed
in all cases. An additional rotator interval closure was performed in 4 cases and
an inferior capsular application in 12. Bone block screws were removed during arthroscopy
in 8 patients because of malpositioning or mobility. Nineteen patients were evaluated
at a mean follow-up of 43 months.
Results
All patients returned to their previous occupations, including 6 cases of work-related
injury. Of the patients, 1 (5%) had recurrent subluxation and 2 (11%) had persistent
apprehension. The subjective shoulder value was 83% ± 23%. A good or excellent result
was found in 85% of patients according to the Walch-Duplay score and 13 patients (67%)
according to the Rowe score. Shoulder pain was found in 6 patients (32%) (4 with light
pain and 2 with moderate pain). Of the 5 patients with osteoarthritis before surgery,
3 progressed by 1 stage.
Conclusions
Arthroscopic revision of failed open anterior shoulder stabilization provides satisfactory
results in a selected patient population. Some persistent pain and osteoarthritis
progression remain concerns. The main advantages of the arthroscopic approach are
the avoidance of anterior dissection in front of the subscapularis, which places the
axillary nerve at risk, and the ability to address the various soft-tissue pathologies
encountered.
Level of Evidence
Level IV, therapeutic case series.
Key Words
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Article info
Publication history
Published online: September 07, 2009
Accepted:
April 17,
2009
Received:
October 24,
2008
Footnotes
The authors report no conflict of interest.
Identification
Copyright
© 2009 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
