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Arthroscopic anterior instability repair
Published in Andreas B. Imhoff, Jonathan B. Ticker, Augustus D. Mazzocca, Andreas Voss, Atlas of Advanced Shoulder Arthroscopy, 2017
Hardeep Singh, Andreas Voss, Robert A. Arciero
Arthroscopic Bankart repair was initially performed through a trans-glenoid technique. Boszotta et al. evaluated the long-term results following an arthroscopic trans-glenoid suture repair technique with two drill holes placed at the 3-o'clock and 5-o'clock positions. The technique yielded excellent outcomes with a low recurrence rate of 6.9%, and 85% of the patients were able to resume full sports activity.21 Arthroscopic versus open Bankart repair has been studied extensively to determine which is the optimal technique for acute dislocation. Arthroscopy has been debated to be the preferred method of repair for the initial traumatic instability as it is a minimally invasive approach, generates less scar tissues, provides the ability to address concomitant pathology, yields comparable stability, improved range of motion, and functional outcome, with an earlier return to sports and work.22
Dislocations around the shoulder
Published in Charles M Court-Brown, Margaret M McQueen, Marc F Swiontkowski, David Ring, Susan M Friedman, Andrew D Duckworth, Musculoskeletal Trauma in the Elderly, 2016
In a study of 11 patients over 40 years of age with a recurrent anterior shoulder dislocation, an anterior capsular and subscapularis tear from the lesser tuberosity was found.27 In all these patients the capsule and subscapularis tear were repaired and all were reported to have pain relief, shoulder function restoration and no recurrence after a mean followup of 5 years. Anterior capsular disruption and subscapularis tears from the lesser tuberosity have not been reported in subsequent studies. One study reported that a third of patients (n = 12) with a dislocation of the shoulder had a Bankart lesion and rotator cuff tear,28 with two of four of these patients having a recurrent dislocation. Satisfactory results were obtained following an isolated rotator cuff repair and no repair of the Bankart lesion. However, in the same study the authors did recommend Bankart repair when the shoulder remained unstable following cuff repair.
Shoulder girdle and proximal humerus
Published in Sebastian Dawson-Bowling, Pramod Achan, Timothy Briggs, Manoj Ramachandran, Stephen Key, Daud Chou, Orthopaedic Trauma, 2014
Prakash Jayakumar, Livio Di Mascio
Operative treatment is indicated in the following: irreducible or open dislocation; unstable reduction and recurrence; and associated bony, labral and cuff injuries. Immediate or expeditious surgical intervention (e.g. arthroscopic Bankart repair) may benefit patients <25 years old who are involved in high-demand sporting activities; recurrent symptoms of instability in this subgroup approach 100 per cent. Arthroscopic stabilization and labral repair have largely superseded open Bankart repair.
A quality assessment of YouTube content on shoulder instability
Published in The Physician and Sportsmedicine, 2022
Christine M Etzel, Steven L Bokshan, Timothy A Forster, Brett D Owens
Shoulder instability is a relatively common condition, especially in overhead throwing and high-level collision athletes, and can affect both men and women [12–14]. Glenohumeral joint instability commonly affects young, active patients, which is the same age group that frequently utilizes YouTube to gain further education [13,15,16]. Treatment and surgical approach for shoulder instability varies depending on the severity of glenoid and humeral bone loss [17]. Non-surgical management with physical therapy may be a viable treatment strategy in low-impact patients following first-time instability events [17]. However, recurrent dislocation events in high-risk active patients has been reported as high as 90% after non-operative treatment, often pointing to surgery as a treatment plan to reduce the risk subsequent instability events [17–19]. Currently, arthroscopic Bankart repair is the most utilized technique for surgical management of shoulder instability [12,13,17]. Bone block procedures such as Latarjet (coracoid transfer) or allograft reconstruction are options for bone loss defects that are >20% of the glenoid width [20].
Comparison of Two Posterior Soft-Tissue Repair Techniques to Prevent Dislocation after Total Hip Arthroplasty Using a Posterolateral Approach
Published in Journal of Investigative Surgery, 2021
Matthew Jian-Qiao Peng, Hong-Wen Xu
The following references in the Journal of Investigative Surgery describe experiments that involve repairing abdominal, shoulder and hip lesions, either by platelet plasma, heterotopic bone, soft tissue, or bioabsorbable rivet. For instance, Aliabadi-Wahle et al. [2] used synthetic materials (TMS-1 and TMS-2 vs. polytetrafluoroethylene and polypropylene etc.) to repair abdominal wall fascial defects covered by soft tissue and reaffirmed that fascial closure is preferable only when soft tissue coverage over the repair cannot be achieved. They also found that TMS-2 is well tolerated. In a study published in 2007, Collins et al. [3] conducted a biomechanical study of Bankart lesion fixation comparing biodegradable ArthroRivet tack vs. suture repair and suggested the suitability of the bioabsorbable rivet for use in Bankart repair. This indicated that bioabsorbable fixation is possible and practical in soft tissue procedures performed in the shoulder. In 2011, Klaassen and Pietrzak [4] conducted a retrospective investigation of platelet-rich plasma application and heterotopic bone formation following total hip arthroplasty. They discovered that 21.3% of the control patients developed heterotopic bone compared to 12.9% of the treatment patients after one year, and this difference was not significant. This did not influence the severity of heterotopic ossification, as autologous blood products play less of a role in total hip arthroplasty. However, none of these studies address the topical technique of TB or TT repair, so Wu et al.’s paper raises interesting possibilities.
Patient understanding, expectations, outcomes, and satisfaction regarding surgical management of shoulder instability
Published in The Physician and Sportsmedicine, 2019
Jeffrey D. Trojan, Steven F. DeFroda, Mary K. Mulcahey
Following treatment, PROs can be a useful tool to evaluate shoulder function. In a study evaluating patient satisfaction following arthroscopic Bankart repair, Oxford Instability Score, the American Shoulder and Elbow Surgeons questionnaire, and the Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire scores were all significantly improved 2 years postoperatively and correlated significantly with quality of life measures [27]. The authors did not provide individualized correlation coefficients for the specific PROs [27]. Furthermore, Kitayama et al. [28] reported significantly improved Western Ontario Shoulder Instability Index (WOSI) and Rowe scores 5–7 years postoperatively; however, they did not provide quality of life measures. These findings suggest that arthroscopic Bankart repair effectively improves PROs long-term.