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 (external rotation >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 or 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, computed tomography scans, and Subjective Shoulder
Value, visual analog scale, Walch, Constant, and Rowe scores. Mean follow-up was 56
months (24-145).
Results
Twenty-eight consecutive patients (30 shoulders) with a mean age of 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 < .001.
Conclusions
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.
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Article info
Publication history
Published online: November 08, 2022
Accepted:
October 26,
2022
Received:
December 15,
2021
Footnotes
See commentary on page 959
The authors report the following potential conflicts of interest or sources of funding: P.B. received support from Smith & Nephew to develop specific instruments and implants used to perform the arthroscopic Trillat procedure described here. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 Published by Elsevier on behalf of the Arthroscopy Association of North America
