32 - Anterior instability—open surgery: Primary and revision with outcomes

Abstract

Anterior glenohumeral instability presents a unique challenge to the orthopedic surgeon in terms of treatment decision making. Assessments of patient demographics, patient demands, prior treatment, and imaging are all included among the important factors considered in treatment decision making. Over the past 15 to 20 years, the arthroscopic Bankart procedure has become the surgical procedure of choice for treatment of anterior glenohumeral instability without significant bone defects for most surgeons. However, despite the enthusiasm for bone augmentation procedures, such as the Latarjet, the open Bankart procedure remains a reliable procedure for anterior instability, both as an initial surgical procedure and in the revision setting. Certain patient factors, including surgery in the revision setting, patients who are young contact sport athletes, and patients with glenoid deficiencies of 10% to 20%, and those patients with bipolar lesions, may be good candidates for open rather than arthroscopic Bankart surgery.