Arthroscopic Revision of Failed Open Anterior Stabilization of the Shoulder (SS-06)

Abstract

The purpose of this study is to report the results of arthroscopic Bankart repair following failed open stabilization. We reviewed 22 patients with recurrent anterior instability after open surgical stabilization. There were 17 men and five women with an average age of 31 years (range, 15-65). The previous interventions consisted of 16 osseous transfers, three open Bankart repairs and three capsular shifts. The causes of failure were additional trauma in 12 patients and bone-block complications in 13. All patients had distension of the antero-inferior capsule. Labral re-attachment and capsulo-ligamentous re-tensioning with suture anchors was performed in all cases with an additional rotator interval closure in four patients and an inferior capsular plication in 12 patients. The bone block screws were removed in eight patients. Nineteen patients were evaluated at an average follow-up of 43 months (range, 24-72). One patient had recurrent subluxations, and two had persistent apprehension. Eight patients (42%) were still painful. Anterior elevation was unchanged and loss of external rotation was 6°. Nine patients returned to sport at the same level, and all patients returned to their previous occupation. Eighty-nine percent were satisfied or very satisfied. The mean subjective shoulder value (SSV), Walch-Duplay, Rowe and UCLA scores were 83% ± 23%, 85 ± 21, 81 ± 23 and 30 ± 7 points, respectively. Arthroscopic revision of open anterior shoulder stabilization gives satisfactory results. The shoulders are both stable and functional. However, our enthusiasm is tempered by some cases of persistent pain.