ABSTRACT
Purpose
To compare the clinical outcomes of arthroscopic dynamic anterior stabilization (DAS)
between transferring the long head of the biceps (DAS-LHB) and the conjoined tendon
(DAS-CT) for anterior shoulder instability with <15% glenoid bone loss.
Methods
From January 2016 to May 2019, a total of 63 patients who underwent DAS for recurrent
anterior shoulder dislocation with < 15% glenoid bone loss were included, comprising
33 patients in DAS-LHB group and 30 patients in DAS-CT group. Clinical outcomes were
assessed preoperatively and at a minimum 3-year follow-up, including patient-reported
outcomes, range of motion, and return to sports (RTS). Postoperative recurrent instability
(including dislocation, subluxation, and subjective instability with a positive apprehension
test), revisions and complications were also recorded.
Results
No significant demographic characteristics difference was detected between the DAS-LHB
(26.3 ± 7.9 years) and DAS-CT groups (26.0 ± 6.7 years). At the latest follow-up,
there were no significant differences between two groups in functional scores: Oxford
Shoulder Instability Score (14.8±2.8 vs 15.2±3.6), Rowe score (95.9±6.5 vs 93.2±10.2),
visual analog scale for pain (0.8±1.2 vs 0.7±1.7), and American Shoulder and Elbow
Surgeons (95±8.8 vs 95.2±9.1) (all P > .218). No significant difference was detected
between groups in the rates of RTS (90.1% vs 86.7%, P = .700) and RTS at previous
level (78.7% vs 73.3%, P = .258), respectively. No recurrent dislocation occurred
in either group. One patient felt occasional subluxation in the DAS-LHB group, and
one was positive for the apprehension test in each group. One patient presented with
postoperative shoulder stiffness and underwent a secondary arthroscopic debridement
in the DAS-CT group.
Conclusion
Comparable rates of recurrence, complication, return to sports, and subjective shoulder
function were observed between DAS-LHB and DAS-CT groups.
Key words
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Reference
- Anterior Shoulder Instability Part II-Latarjet, Remplissage, and Glenoid Bone-Grafting-An International Consensus Statement.Arthroscopy. 2022; 38: 224-233
- Anterior Shoulder Instability Management: Indications, Techniques, and Outcomes.Arthroscopy. 2020; 36: 2791-2793
- The instability severity index score. A simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation.J Bone Joint Surg Br. 2007; 89: 1470-1477
- Risk factors for recurrence after Bankart repair a systematic review.Knee Surg Sports Traumatol Arthrosc. 2012; 20: 2129-2138
- The cost-effectiveness of the arthroscopic Bankart versus open Latarjet in the treatment of primary shoulder instability.Journal of Shoulder and Elbow Surgery. 2018; 27: S2-S9
- Contribution of osseous and muscular stabilizing effects with the Latarjet procedure for anterior instability without glenoid bone loss.Journal of shoulder and elbow surgery. 2013; 22: 1689-1694
- Does the dynamic sling effect of the Latarjet procedure improve shoulder stability? A biomechanical evaluation.Journal of shoulder and elbow surgery. 2013; 22: 821-827
- The stabilizing mechanism of the Latarjet procedure: a cadaveric study.J Bone Joint Surg Am. 2013; 95: 1390-1397
- Arthroscopic Bankart versus open Latarjet as a primary operative treatment for traumatic anteroinferior instability in young males: a randomised controlled trial with 2-year follow-up.Br J Sports Med. 2022; 56: 327-332
- Arthroscopic Bankart Repair Versus Open Latarjet for Recurrent Shoulder Instability in Athletes.Orthop J Sports Med. 2021; 923259671211023801
- The Effect of Subcritical Bone Loss and Exposure on Recurrent Instability After Arthroscopic Bankart Repair in Intercollegiate American Football.Am J Sports Med. 2017; 45: 1769-1775
- Evaluation and Management of Glenohumeral Instability With Associated Bone Loss: An Expert Consensus Statement Using the Modified Delphi Technique.Arthroscopy. 2021; 37: 1719-1728
- Complications and re-operations after Bristow-Latarjet shoulder stabilization: a systematic review.Journal of Shoulder and Elbow Surgery. 2013; 22: 286-292
- Early Outcomes and Perioperative Complications of the Arthroscopic Latarjet Procedure: Systematic Review and Meta-analysis.Am J Sports Med. 2019; 47: 2232-2241
- Complications Related to Latarjet Shoulder Stabilization: A Systematic Review.Am J Sports Med. 2021; 3635465211042314
- Arthroscopic stabilization for recurrent shoulder instability with moderate glenoid bone defect in patients with moderate to low functional demand.Arthroscopy. 2014; 30: 921-927
- Arthroscopic Autologous Scapular Spine Bone Graft Combined With Bankart Repair for Anterior Shoulder Instability With Subcritical (10%-15%) Glenoid Bone Loss.Arthroscopy. 2021; 37: 2065-2074
- Arthroscopic Bankart Repair With Remplissage in Comparison to Bone Block Augmentation for Anterior Shoulder Instability With Bipolar Bone Loss: A Systematic Review.Arthroscopy. 2021; 37: 706-717
- Dynamic Anterior Shoulder Stabilization With the Long Head of the Biceps Tendon: A Biomechanical Study.Am J Sports Med. 2019; 47: 1441-1450
- Long Head of Biceps Transfer to Augment Bankart Repair on Chronic Anterior Shoulder Instability with and Without Subcritical Bone Loss: A Biomechanical Study.Journal of shoulder and elbow surgery. 2022; 31: 1062-1072
- Anterior shoulder instability with Bristow procedure versus conjoined tendon transfer alone in a simple soft-tissue model.Arthroscopy. 2010; 26: 1189-1194
- Arthroscopic Transfer of the Long Head of the Biceps Brachii for Anterior Shoulder Instability.Arthrosc Tech. 2017; 6: e1911-e1917
- Dynamic Anterior Stabilization Using the Long Head of the Biceps for Anteroinferior Glenohumeral Instability.Arthrosc Tech. 2018; 7: e39-e44
- Arthroscopic Transfer of the Conjoined Tendon-Coracoid Tip Complex for Anterior Shoulder Instability.Arthrosc Tech. 2018; 7: e33-e38
- Two-year results of arthroscopic conjoint tendon transfer procedure for the management of failed anterior stabilization of the shoulder.JSES international. 2021; 5: 519-524
- Conjoined Tendon Transfer for Traumatic Anterior Glenohumeral Instability in Patients With Large Bony Defects and Anterior Capsulolabral Deficiency.Arthroscopy. 2018; 34: 12-20
- Arthroscopic Biceps Transfer to the Glenoid With Bankart Repair Grants Satisfactory 2-Year Results for Recurrent Anteroinferior Glenohumeral Instability in Subcritical Bone Loss.Arthroscopy. 2022; 38: 1766-1771
- Modified Latarjet Procedure Without Capsulolabral Repair for the Treatment of Failed Previous Operative Stabilizations in Athletes.Arthroscopy. 2018; 34: 1421-1427
- Glenohumeral arthrosis in anterior instability before and after surgical treatment: incidence and contributing factors.Am J Sports Med. 2004; 32: 1165-1172
- Glenoid rim morphology in recurrent anterior glenohumeral instability.J Bone Joint Surg Am. 2003; 85: 878-884
- A simple method for quantitative evaluation of the missing area of the anterior glenoid in anterior instability of the glenohumeral joint.Skeletal Radiol. 2008; 37: 731-736
- Evolving concept of bipolar bone loss and the Hill-Sachs lesion: from "engaging/non-engaging" lesion to "on-track/off-track" lesion.Arthroscopy. 2014; 30: 90-98
- Reliability, validity, and responsiveness of the American Shoulder and Elbow Surgeons subjective shoulder scale in patients with shoulder instability, rotator cuff disease, and glenohumeral arthritis.J Bone Joint Surg Am. 2005; 87: 2006-2011
- Reliability, agreement and validity of the 1988 version of the Rowe Score.Journal of Shoulder and Elbow Surgery. 2011; 20: 1041-1049
- The Oxford Shoulder Instability Score; validation in Dutch and first-time assessment of its smallest detectable change.Journal of Orthopaedic Surgery and Research. 2015; 10: 146
- Research Pearls: The Significance of Statistics and Perils of Pooling. Part 1: Clinical Versus Statistical Significance.Arthroscopy. 2017; 33: 1102-1112
- Return to Sport After Surgical Treatment for Anterior Shoulder Instability: A Systematic Review.Am J Sports Med. 2019; 47: 1507-1515
- Arthroscopic Latarjet: Suture-Button Fixation Is a Safe and Reliable Alternative to Screw Fixation.Arthroscopy. 2019; 35: 1050-1061
- Borderline Glenoid Bone Defect in Anterior Shoulder Instability: Latarjet Procedure Versus Bankart Repair.Am J Sports Med. 2018; 46: 2170-2176
- Arthroscopic stabilization of the shoulder: a prospective randomized study of absorbable versus nonabsorbable suture anchors.Arthroscopy. 2006; 22: 716-720
- Determining the Minimal Clinically Important Difference on the Oxford Shoulder Instability Score in Patients Undergoing Arthroscopic Bankart Repair for Shoulder Instability.Orthop J Sports Med. 2022; 1023259671211060023
- Biomechanical analysis of the modified Bristow procedure for anterior shoulder instability: is the bone block necessary?.Journal of shoulder and elbow surgery. 2014; 23: 1792-1799
- Long-Term Restoration of Anterior Shoulder Stability: A Retrospective Analysis of Arthroscopic Bankart Repair Versus Open Latarjet Procedure.J Bone Joint Surg Am. 2016; 98: 1954-1961
- A Multicenter Retrospective Study With a Minimum 5-Year Follow-up Comparing Arthroscopic Bankart Repair and the Latarjet Procedure.Orthop J Sports Med. 2020; 82325967120941366
- Is the Instability Severity Index Score a Valid Tool for Predicting Failure After Primary Arthroscopic Stabilization for Anterior Glenohumeral Instability?.Arthroscopy. 2019; 35: 361-366
- Biomechanical Comparison of the Long Head of the Biceps Tendon Versus Conjoint Tendon Transfer in a Bone Loss Shoulder Instability Model.Orthop J Sports Med. 2019; 72325967119883549
- Bankart repair with Transferred Long Head of the Biceps provides better biomechanical effect than Conjoined Tendon transfer in Anterior Shoulder Instability with 20% Glenoid Defect.Arthroscopy. 2022; 38: 2628-2635
- Inertia and muscle contraction parameters for musculoskeletal modelling of the shoulder mechanism.J Biomech. 1991; 24: 615-629
- Establishing a new index of muscle cross-sectional area and its relationship with isometric muscle strength.J Strength Cond Res. 2008; 22: 82-87
- Patient expectations before arthroscopic shoulder surgery: correlation with patients' reasons for seeking treatment.Journal of Shoulder and Elbow Surgery. 2013; 22: 1676-1681
- Return to Play After the Latarjet Procedure for Anterior Shoulder Instability: A Systematic Review.Am J Sports Med. 2019; 47: 3002-3008
- Arthroscopic Bankart Repair Versus Open Bristow-Latarjet for Shoulder Instability: A Matched-Pair Multicenter Study Focused on Return to Sport.Am J Sports Med. 2016; 44: 3198-3205
- Latarjet procedure for anterior shoulder instability: a 24-year follow-up study.Arch Orthop Trauma Surg. 2021; 141: 189-196
- Clinical Outcomes After Anterior Shoulder Stabilization in Overhead Athletes: An Analysis of the MOON Shoulder Instability Consortium.Am J Sports Med. 2019; 47: 1404-1410
- Arthroscopic Remplissage for Anterior Shoulder Instability: A Systematic Review of Clinical and Biomechanical Studies.Arthroscopy. 2019; 35: 617-628
- Remplissage Yields Similar 2-Year Outcomes, Fewer Complications, and Low Recurrence Compared to Latarjet Across a Wide Range of Preoperative Glenoid Bone Loss.Arthroscopy. 2022; 38: 2798-2805
- The arthroscopic Latarjet: a multisurgeon learning curve analysis.Journal of Shoulder and Elbow Surgery. 2020; 29: 681-688
- Long Head of Biceps Tenotomy Is Not Inferior to Suprapectoral Tenodesis in Arthroscopic Repair of Nontraumatic Rotator Cuff Tears: A Multicenter, Non-inferiority, Randomized, Controlled Clinical Trial.Arthroscopy. 2021; 37: 1767-1776
- Patients Have Strong Preferences and Perceptions for Biceps Tenotomy Versus Tenodesis.Arthroscopy. 2016; 32: 2444-2450
- Evaluation of the subscapularis split created with passive rotation during arthroscopic dynamic anterior stabilization (DAS): A cadaveric study.Orthop Traumatol Surg Res. 2021; 107102934
- The anatomy of the short head of biceps - not a tendon.Int J Shoulder Surg. 2009; 3: 75-79
- Superior biceps aponeurosis'-Morphological characteristics of the origin of the short head of the biceps brachii muscle.Ann Anat. 2019; 223: 85-89
- Pullout forces of sutures in muscle lacerations.Orthopedics. 2005; 28: 1187-1190
- Outcomes for Arthroscopic Repair of Combined Bankart/SLAP Lesions in the Treatment of Anterior Shoulder Instability: A Systematic Review and Meta-analysis.Orthop J Sports Med. 2019; 72325967119877804
- The Latarjet coracoid process transfer procedure: alterations in the neurovascular structures.Journal of Shoulder and Elbow Surgery. 2013; 22: 695-700
- Changes in the Neurovascular Anatomy of the Shoulder After an Open Latarjet Procedure: Defining a Surgical Safe Zone.Am J Sports Med. 2018; 46: 2185-2191
- Scapular dyskinesis after Latarjet procedure.Journal of Shoulder and Elbow Surgery. 2016; 25: 422-427
Article info
Publication history
Accepted:
December 30,
2022
Received in revised form:
December 29,
2022
Received:
June 22,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Ethics approval: The study was approved by the Ethics Committee of Shanghai Sixth People’s Hospital.
Funded by: National Natural Science Foundation of China [Grant No. 81772341]
Shanghai Shenkang Hospital Development Center [Grant No. 12017121]
Authors’ contributions:
Chenliang Wu: Conceptualization; Methodology; Data collection; Formal analysis; Investigation; Visualization; Writing-original draft
Junjie Xu: Conceptualization; Formal analysis; Review & editing
Zhaoyi Fang: Conceptualization; Data collection; Formal analysis; Review & editing
Jiebo Chen: Conceptualization; Data curation; Formal analysis; Investigation
Zipeng Ye: Conceptualization; Investigation; Data collection
Liren Wang: Data collection; Formal analysis; Investigation; Methodology
Yuhao Kang: Data collection; Formal analysis; Investigation; Methodology
Song Zhao: Conceptualization; Data statistics; Supervision; Methodology
Caiqi Xu: Conceptualization; Data processing; Formal analysis; Investigation; Review & editing
Jinzhong Zhao: Conceptualization; Funding acquisition; Formal analysis; Methodology; Supervision; Review & editing
All authors approved the final version of the manuscript and agreed their accountability in ensuring that any questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Level of Evidence: Ⅲ; retrospective comparative therapeutic trial.
Identification
Copyright
© 2023 Published by Elsevier on behalf of the Arthroscopy Association of North America
