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Arthroscopic Dynamic Anterior Stabilization Using Either Long Head of the Biceps or Conjoined Tendon Transfer for Anterior Shoulder Instability Results in a Similarly Low Recurrence Rate

  • Author Footnotes
    ∗ The three authors contribute equal to the work.
    Chenliang Wu
    Footnotes
    ∗ The three authors contribute equal to the work.
    Affiliations
    Department of Sports Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China
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  • Author Footnotes
    ∗ The three authors contribute equal to the work.
    Junjie Xu
    Correspondence
    Corresponding Authors: Jinzhong Zhao, MD, Postal address: Department of Sports Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China. Tel: +86-021-64369181-58091
    Footnotes
    ∗ The three authors contribute equal to the work.
    Affiliations
    Department of Sports Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China
    Search for articles by this author
  • Author Footnotes
    ∗ The three authors contribute equal to the work.
    Zhaoyi Fang
    Footnotes
    ∗ The three authors contribute equal to the work.
    Affiliations
    Department of Sports Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China
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  • Jiebo Chen
    Affiliations
    Department of Sports Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China
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  • Zipeng Ye
    Affiliations
    Department of Sports Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China
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  • Liren Wang
    Affiliations
    Department of Sports Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China
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  • Yuhao Kang
    Affiliations
    Department of Sports Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China
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  • Song Zhao
    Affiliations
    Department of Sports Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China
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  • Caiqi Xu
    Correspondence
    Corresponding Authors: Caiqi Xu, MD, Postal address: Department of Sports Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China. , Tel: +86-021-64369181-58091
    Affiliations
    Department of Sports Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China
    Search for articles by this author
  • Jinzhong Zhao
    Correspondence
    Corresponding Authors: Junjie Xu, MD, Postal address: Department of Sports Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 600 Yishan Road, Shanghai, 200233, China. , Tel: +86-021-64369181-58091
    Affiliations
    Department of Sports Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, China
    Search for articles by this author
  • Author Footnotes
    ∗ The three authors contribute equal to the work.
Published:January 24, 2023DOI:https://doi.org/10.1016/j.arthro.2022.12.040

      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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