Purpose
To evaluate the short-term outcomes of the arthroscopic dynamic anterior stabilization
(DAS), which is a transfer of the intra-articular portion of the long head biceps
through the subscapularis split and fixation on the anterior glenoid, combined with
a Bankart repair.
Methods
A retrospective evaluation was performed of DAS and a minimum of 2-year follow-up.
Inclusion criteria were the presence of anteroinferior instability, a positive apprehension
test at 90° of abduction and external rotation, and subcritical glenoid bone loss
(less than 20%). Exclusion criteria were severe (≥20%) glenoid bone loss, presence
of biceps lesions or rupture (spontaneous or biceps tenotomy), pre-existing glenohumeral
osteoarthritis, multidirectional or voluntary instability, previous arthroscopic stabilization
procedure, and epilepsy. Outcomes included the Rowe score, range of motion (ROM),
and recurrence.
Results
Twenty-three patients were treated with DAS and arthroscopic Bankart repair during
the study period. One person was lost to follow-up, leaving 22 patients available
at last follow-up. Those 22 patients had an average age of 31.9 ± 12.3 years (range,
18-68) and were evaluated at an average follow-up of 3.2 ± 0.7 years (range, 1.2-4.2).
The Rowe score increased from 36.1 ± 16.2 (range, 10-70) preoperatively to 89.8 ±
20.1 (range, 30-100) postoperatively (P < .001) with almost all patients (90.9%) improving their score beyond the minimal
clinically important difference of 9.7 points. Postoperatively, ROM was maintained.
Three patients (13.6%) analyzed at final follow-up demonstrated recurrence, one was
successfully treated conservatively, but two revised with a Latarjet. No postoperative
Popeye deformity, biceps cramping, or other complication were reported.
Conclusions
The DAS procedure may be an option for augmentation of a Bankart repair in patients
with anterior shoulder instability and subcritical bone loss. ROM is maintained without
evidence of postoperative Popeye deformity or biceps cramping.
Level of Evidence
Level IV, retrospective study.
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Article info
Publication history
Published online: December 06, 2021
Accepted:
November 22,
2021
Received:
April 18,
2021
See commentary on page 1772Footnotes
The authors report the following potential conflicts of interest or sources of funding: P.C. reports paid consultant for Wright and Arthrex and receives royalties from Wright. P.J.D. reports grants and personal fees from Arthrex, outside the submitted work. A.L. reports paid consultant for Arthrex, Wright, and Medacta and receives royalties from Wright. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
This study has been funded by a grant of FORE (Foundation for research and teaching in the field of orthopaedic surgery, trauma, sports medicine and imaging of the musculoskeletal system): grant number FORE 2021-11.
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© 2021 by the Arthroscopy Association of North America
