Abstract
Purpose
To evaluate the clinical, functional, and radiological midterm outcomes of the all-arthroscopic
modified Eden-Hybinette procedure in patients with recurrent anterior shoulder instability.
Methods
A retrospective, single-center case series with prospectively collected data was conducted.
The inclusion criterion was traumatic recurrent anterior shoulder instability with
significant glenoid bone loss; patients with atraumatic or multidirectional instability
were excluded. An all-arthroscopic modified Eden-Hybinette procedure using iliac crest
autograft and double-pair button fixation was carried out. All patients were postoperatively
assessed for recurrence and apprehension. Shoulder range of motion values and functional
scores, including American Shoulder and Elbow Surgeons Score, Oxford instability,
Rowe instability, and Walch-Dupplay, were recorded. Graft positions, healing, and
absorption were evaluated with computed tomography. Comparisons of values were performed
with paired
t tests for normally distributed differences and with nonparametric Wilcoxon’s signed
rank test otherwise.
Results
The final study cohort included 28 patients, mean age 36 ± 10 years, and mean follow-up
period 43 ± 6 months (range 36 to 53). Median glenoid bone loss was 12.4% (range 8%
to 33%). No recurrence occurred, no subjective shoulder instability was reported,
and no major complications were documented through the last follow-up. Postoperative
shoulder range of motion had no significant differences compared with the healthy
side. All final postoperative functional scores significantly increased to show excellent
results compared with preoperative values. All grafts were positioned and healed optimally,
and none was completely reabsorbed.
Conclusions
The all-arthroscopic modified Eden-Hybinette procedure is safe, leading to excellent
clinical and radiological midterm outcomes in patients with recurrent anterior shoulder
instability. This technique restores glenoid bone defects and preserves the normal
shoulder anatomy.
Level of Evidence
IV, therapeutic, retrospective case series
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Article Info
Publication History
Published online: October 27, 2020
Accepted:
October 17,
2020
Received:
June 20,
2020
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2020 by the Arthroscopy Association of North America
