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The Arthroscopic Trillat Procedure is a Valuable Treatment Option for Recurrent Anterior Instability in Young Athletes with Shoulder Hyperlaxity

Published:November 08, 2022DOI:https://doi.org/10.1016/j.arthro.2022.10.046

      Abstract:

      Purpose

      The purpose of this study is to report the outcomes of the all-arthroscopic Trillat procedure, combined with capsular plication, for the treatment of recurrent anterior instability in young athletes with shoulder hyperlaxity (ER> 90°).

      Methods

      We performed a retrospective evaluation of patients with recurrent anterior instability and shoulder hyperlaxity who underwent an arthroscopic Trillat between 2009 and 2019. Patients with concomitant rotator cuff lesions, voluntary or multidirectional instability were excluded. The osteotomized coracoid was fixed above the subscapularis with a cannulated screw or a suture button; a capsular plication was systematically associated. We followed patients with X-rays, CT-scans, Subjective Shoulder Value, VAS, Walch, Constant, and Rowe scores. Mean follow-up was 56 months (24-145).

      Results

      Twenty-eight consecutive patients, 30 shoulders (mean age 25 years) were identified and all met criteria. The main finding under arthroscopy was a “loose shoulder” with anteroinferior capsular redundancy and no or few (10%) labrum tears, glenoid erosion (13%) or Hill-Sachs lesions (10%). At last follow-up, 90% of the shoulders (27/30) were stable, and 79% (19/24) of the patients practicing sports returned to their preinjury activity level. The Walch-Duplay and Rowe scores improved from 54 (38-68) to 81 (4-100) and 55 (30-71) to 84 (45-100) respectively, p<0.001.

      Conclusion

      The arthroscopic Trillat is an effective procedure for the treatment of recurrent anterior instability in young athletes with shoulder hyperlaxity, but no substantial humeral or glenoid bone loss, allowing return to overhead/contact sports.

      Level of evidence

      Level IV, retrospective study.

      Key words

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