Recurrent Anterior Shoulder Dislocation Research Articles

Results of Arthroscopic Remplissage with Bankart Repair for the Management of Glenohumeral Instability with Hill-Sachs Bone Defect

Glenohumeral joint instability is one of the commonest disorders of the shoulder as it has a great range of motion on the expense of stability as refered to the bony configuration of the joint. Instability may be traumatic or atraumatic and uni-directional or multidirectional with wide range of patient complaints from mild pain in micro-instability to obvious dislocation. The most commonly used arthroscopic procedure include filling the humeral head defect by capsulo-tenodesis of the infraspinatus tendon and posterior capsule (Remplissage). The aim of this study was to present our results of Bankart repair and Reimplissage in management of recurrent shoulder instability with Hill-Sachs lesions. 20 young, middle age and fit patients with recurrent anterior shoulder dislocation with combined Bankart lesion and Hill-Sachs lesion. All Hill-Sachs lesions were large or engaging (Calandra grade 3 at time of arthroscopy) and all were managed by arthroscopic Bankart repair combined with Remplissage. When compared to pre-operative ROM, a statistically significant difference was found in the mean increase of anterior elevation by 2°, external rotation (ER) side by 4◦ and 5° for ER at 90° abduction at final follow-up (p value < 0.001). There were statistically significant difference in the mean decrease of 5° and 10° in ER side and ER at 90° abduction respectively at final follow-up compared to normal side ROM (p value < 0.001), also significant decrease in anterior elevation by 4° and IR at 90° abduction by 2° (p value < 0.001) which were not comparable to other studies but was clinically insignificant. The mean final Rowe and SST scores were 85 and 11.35 respectively indicating a statistically significant difference in mean increase of both the total Rowe and total SST percentage score when compared to pre-operative scores (p value < 0.001). All patients were followed prospectively for a minimum of 12 months. Conclusion: arthroscopic Bankart repair and remplissage is an effective means of managing shoulder instability in patients with large Hill-Sachs lesions and no significant glenoid bony defect.

LUtarjet-limit unique coracoid osteotomy Latarjet (With video).

BackgroundThe Latarjet procedure is an effective technique for the treatment of recurrent anterior shoulder dislocation with glenoid bone loss. However, the inevitable destruction of the coracoacromial arch may result in humeral head translation. The aim of the study is to introduce a modified Latarjet technique with coracoacromial arch preservation as well as its short term clinical outcomes.MethodsWe propose a novel individualized flexible arthroscopic suture button fixation Latarjet technique called `LUtarjet' with video. Precise measurements of the coracoid process, glenoid deficiency and osteotomy plane were made preoperatively. Only three arthroscopic portals were needed and limit unique coracoid osteotomy was performed with coracoacromial arch preservation. The mini window splitting of the subscapularis was performed from the posterior to the anterior direction and the split window was as small as 8–10 mm in length.ResultsA total of 27 patients (25.6 ± 5.4 years) were included in the study. The average surgical duration was 55.6 ± 6.3 min and the mean follow-up time was 8.1 ± 1.5 months. The functional score was significantly improved at the last follow-up. Radiologic evidence showed that the bone graft healing was placed in the desired position. No complications were found.ConclusionsWe present a fast, easy, accurate, safe arthroscopic ‘LUtarjet’ technique called FEAST that can simplify the arthroscopic Latarjet process and achieve a satisfactory bone graft position and satisfactory short-term clinical outcomes.Level of evidenceIV, case series.

Early outcomes of the arthroscopic Latarjet procedure in a series of 37 patients with shoulder instability

BackgroundAnterior shoulder dislocation remains a clinical challenge. This study aimed to assess the graft position and clinical outcomes of the arthroscopic Latarjet procedure and capsular repair for the treatment of recurrent anterior shoulder dislocation with significant glenoid bone loss in 37 patients.MethodsBetween 2017 and 2017, 37 patients underwent arthroscopic Latarjet plus capsular repair procedure for recurrent anterior shoulder dislocation combined with significant glenoid bone loss. In follow-up examinations, Walch-Duplay scores, subjective shoulder value (SSV) scores, Rowe scores, and active range of motion (AROM) were assessed. Three-dimensional computed tomography (CT) was used to evaluate coracoid graft position and bone resorption. A new method of evaluating the position of the coracoid bone block after Latarjet (H-Z method) was developed.ResultsThirty-seven patients were included in this study. Follow-up ranged from 6 to 36 months postoperatively (with an average of 13 months). No recurrent dislocation occurred at the final follow-up, and there was no significant effect on the AROM (all p > 0.05). Rowe (from 42.2 ± 5.6 to 91.1 ± 3.3), Walch-Duplay (from 31.5 ± 8.0 to 92.6 ± 3.7), and SSV (from 63.9 ± 6.1 to 79.3% ± 5.0%) scores were improved significantly after surgery (all p < 0.001). CT showed that the 29 patients had varying degrees of bone resorption, and 23 recovered to the preinjury level of motional function within 6–12 months after surgery.ConclusionsIn active patients with recurrent anterior shoulder dislocations and significant glenoid bone loss, the arthroscopic Latarjet procedure plus capsular repair could restore shoulder stability satisfactory.

Progress on the treatment of recurrent anterior dislocation of shoulder with bone defect

Recurrent anterior dislocation of shoulder with bone defect is one of the common diseases of shoulder joint. How to effectively repair glenoid bone defect and reduce recurrence rate of shoulder dislocation is a problem that clinicians focus on. Bone grafting could stimulate bone, promote bone regeneration and bone remodeling, and restore the normal anatomical structure of glenoid. Among them, Bristow-Latarjet procedure is a classic operation for recurrent shoulder dislocation. Latarjet procedure could repair larger glenoid bone defects, but with higher surgical skills for surgeons;autogenous iliac grafting is the first choice for revision once Latarjet procedure failed;osteochondral grafting (autogenous and allogenous) has certain advantages in reconstructing original articular surface and preventing joint degeneration, but autologous osteochondral grafting may cause secondary injury, while immune rejection is difficult to avoid for allogenous osteochondral grafting. With the improvement of composite materials, and the mechanism of bone regeneration and remodeling, as well as the advantages and disadvantages of bone grafting, tissue engineering technology may become an effective method for the treatment of glenoid bone defect in the future.

Outcomes of the Latarjet Procedure in Recurrent Anterior Shoulder Instability due to Tramadol-Induced Seizure

Background: This study was aimed to evaluate the final results of surgical treatment (Latarjet procedure) in the recurrent anterior shoulder instability following episodes of tramadol-induced seizure. Methods: From January 2005 to March 2013, 47 patients with recurrent anterior shoulder dislocation after suffering a seizure episode following tramadol use underwent surgical procedure. There were 53 shoulders in 47 male patients (six had bilateral recurrent dislocations). The mean age of the patients at the time of operation was 24.7 years (ranging from 20 to 44 years). The average number of episodes of anterior shoulder dislocation before surgery was 16. Results: External rotation with the elbow at the side improved from 45.8 ± 9.3° (30°-60°) pre-operatively to 61.5 ± 7.8° (45°-90°) postoperatively (P &lt; 0.001). Forward elevation also increased significantly post-operatively (P = 0.002). Mean pre-operative Rowe score was 28.41 ± 4.30 (30-85) which increased to 73.57 ± 8.40 post-operatively. The Western Ontario Shoulder Instability Index (WOSI) score decreased from 1352 ± 74 to 618 ± 46 (P &lt; 0.0001). Conclusion: Correcting glenoid bone loss by Latarjet procedure combined, if necessary, with humeral head defect reconstruction could be a proper treatment method in patients experiencing recurrent anterior shoulder dislocation after idiosyncratic seizure reaction of tramadol.

Functional Outcome of Open Latarjet Procedure in Non-Athletic Middle-Aged Patients.

Introduction:The movement and steadiness of the shoulder joint is due to both the dynamic and static stabilisers. Recurrent anterior shoulder instability is common due to the Bankart lesion or the Hill Sachs lesion. The bone loss and soft tissue failure due to these lesions causing instability is well compensated by Latarjet procedure which acts by triple blocking effect of the bone graft, the sling effect of the conjoint tendon of subscapularis and the ligament of the coracoacromial ligament stump.Materials and methods:Middle-aged patients with recurrent anterior shoulder dislocation and a mid-range instability on clinical assessment with an isolated glenoid bone loss of 20% or Bankart lesion with engaging Hill Sachs lesion were selected for the study. The surgical procedure included a subscapularis split to expose the glenoid. The coracoid graft harvested was prefixed with Kirschner wires and placed flush over the glenoid ensuring no medial or lateral overhang and fixed with 4.0mm cancellous screws with the washer. The functional outcome was measured with the ROWE score and ASES score and the movements were evaluated.Results:A total of 24 patients fulfilled the inclusion criteria. Post-operatively at final follow-up, the mean ROWE score was 97.08 ±8.45 and the mean ASES score was 94.4±9.10. One patient had screw breakage as a complication and another had restriction of movement which was managed with physiotherapy.Conclusion:Open Latarjet is an effective procedure for recurrent anterior shoulder instability in non-athletic middle-aged patients as a excellent functional outcome was achieved with this technique. We therefore recommend open Latarjet as an alternative to arthroscopic treatment in developing countries where patient affordability and the availability of the resources are the issues.

Modified latarjet procedure for recurrent shoulder instability: A series of 10 cases

Introduction: The Latarjet procedure employs rerouting of the osteotomised coracoid process with its attached conjoined tendon through a split in the substance of subscapularis and fixed to the antero inferior aspect of glenoid rim. Screwing of the coracoid process on to the anteroinferior side of the glenoid at the level of the anterior glenoid rim was described by Latarjet 2 in 1954. In his original technique, subscapularis was incised vertically along the whole of its length, then sutured with an over- lap. Latarjet procedure is an excellent surgical option for recurrent shoulder instability associated with glenoid bone deficiency with or without engaging hillsachs lesion. Aims: Our aim was to study the functional outcome of latarjet procedure in Indian population as many of these patients present with recurrent episodes of dislocation and most of these patients have glenoid bone loss with or without an assosciatedhillsachs lesion. Materials and Methods: Orthopaedics department between July 2019 to October 2020 with recurrent anterior shoulder dislocation were evaluated clinically and radiologically (ap view, trans-axillary lateral view, scapular y view, CT Scan and MRI Scan). A total of 10 patients (8 male and 2 female) with mean age at the time of surgery was 22.2 years (18-30 years) with recurrent episodes of anterior shoulder dislocation and glenoid bone loss (>25%) with or without an engaging hillsachs lesion were included in our study. Conclusion: In our study of 10 cases 9 patients had excellent to good results based on ROWE score and OSII score. Post operative range of motion of shoulder was almost fully achieved in all patients. Mean abduction was 170 deg (150-180 deg), mean external rotation loss was 20 deg (15-25 deg). None of our patients had recurrent episode of dislocation posteratively till the latest followup. Soft tissue Bankart repairs yield good results when used for capsulolabral avulsions and tears. With good clinical and radiological evaluation more complex lesions like bony bankarts and bankarts with associated hillsachsleison can be identified and successfully treated by latarjet procedure.

A prospective study of functional outcome of arthroscopic repair of recurrent anterior shoulder dislocation

Background: The causes of anterior dislocation of shoulder are usually trauma; a sports injury, road traffic accident, assault or fall. The arthroscopic Bankart repair offers minimally invasive procedure with less surgical trauma, less blood loss, with improvement in operative time, less perioperative morbidity, narcotic use, hospital stay, time loss from work, decrease in number of complications, cost of surgery and better cosmetic result.Aim: To assess the functional outcome of shoulder joint following arthroscopic repair of recurrent anterior shoulder dislocation.Materials and Methods: A hospital based prospective study was done with 30 patients to assess the functional outcome of arthroscopic repair of recurrent anterior shoulder dislocation from January 2019 to June 2020 done using the UCLA (University of California at Los Angeles), ASES (American Shoulder and Elbow Surgeons) shoulder score and the Rowe score.Results: Patients in the group operated with retro-grade femoral nailing showed similar functional outcome as compared to ante-grade femoral nailing. It was also noted that in patients with retro-grade femoral nailing early mobilization, smaller incision at entry point was possible and there was no need of a fracture table.Conclusion: Arthroscopic repair in cases of recurrent anterior shoulder instability is a reliable surgical procedure with respect to shoulder function and motion as it offers good clinical outcome, excellent post-operative shoulder range of motion with improved function. This surgical procedure has better patient compliance, and minimum surgical complications in properly selected patients.

Reliability of three dimensional CT measurement of glenoid track in patients with recurrent anterior dislocation of shoulder

To evaluate the reliability and repeatability of three-dimensional (3D)-CT measurement of glenoid track. Glenoid and Hill-Sachs bone defects in 60 patients with recurrent anterior dislocation of the unilateral shoulder were evaluated by 3D-CT and analyzed by three independent observers(shoulder orthopedists) according to the Di Giacomo method. These injuries were classified to formulate a surgical protocol. All the patients were repeatedly measured 1 week later. Intraclass correlation coefficient (ICC) and coefficient of variation (COV) were used for reliability analysis. Interobserver reliability was "very good" for both measurements of glenoid diameter and glenoid bone defects, and "good" for measurements of Hill-Sachs interval. Interobserver agreement was high on the assessment of the extent of the glenoid defect, and poor on track/off track assessment of the Hill-Sachs lesion. Intraobserver reliability for measurements of glenoid diameter, glenoid defect, and Hill-Sachs interval was "very good". The COV was 4.1% for glenoid diameter, 4.4% for glenoid defect, and 21.1% for Hill-Sachs interval. The reliability and reproducibility of 3D-CT measurements of glenoid bone defects are good, but the assessment of humeral head bone defects shows large variability with poor reliability.

Arthroscopic Bankart repair combined with Reimplissage for the treatment of recurrent anterior dislocation of shoulder in adults with Hill-Sachs defect

To investigate the method and clinical effects of the treatment of recurrent anterior dislocation of shoulder with Hill-Sachs injury by arthroscopic Bankart repair and Remplissage. From March 2016 to March 2019, 106 patients with recurrent anterior dislocation of shoulder with glenoid bone defect less than 20% underwent arthroscopic Bankart repair, including 76 males and 30 females, aged from 18 to 45 (27.3±8.6) years, 59 cases of left shoulder and 47 cases of right shoulder. Range of motion (ROM), American Shoulder and Elbow Surgeons(ASES) score, Constant-Murley score and Rowe score were used to evaluate shoulder functionand stability before and after operation. All patients were followed up, and the duration ranged from 21 to 60 months, with a mean of (41.5± 8.5) months. One patient developed infection after operation, and the infection was controlled after arthroscopic debridement again. The remaining patients did not have clinical complications such as infection, intra articular hematocele and redislocation. Shoulder flexion and lifting increased from (158.33±15.72) ° preoperatively to (169.43±10.04) ° at the latest follow up, and internal rotation changed from T7 (T4 to T10) preoperatively to T8 (T5 to T10) at the latest follow up;the average lateral external rotation and abduction 90 ° external rotation decreased from (58.46±15.51) ° preoperatively and (99.37±14.09) ° to (53.18±14.90) ° and (92.52±13.10) ° at the latest follow up, respectively. The ASES score, Constant -Murley score and Rowe score were significantly improved. The clinical effect of rehabilitation of Bankart repair combined with Remplissageunder arthroscopy in the treatment of recurrent dislocation of shoulder joint in adults with Hill-Sachs defect is satisfactory. Although the external rotation function is weaker than that before operation, it can effectively reconstruct the shoulder function and avoid the occurrence ofdislocation after operation.

Progress on arthroscopic surgery for recurrent anterior shoulder dislocation

The surgical treatment of recurrent anterior shoulder dislocation is a difficult problem in the field of sports injury medicine. The main reason focus on dynamic and osseous constraints of shoulder joint could not recover well. At present, arthroscopic surgery is used at home and abroad, and could receive statisfied postoperative effect, but the choice of specific surgical methods is still controversial. According to presence and size of glenoid and humeral skull defects, different treatments should be selected in clinic. The author recommends that no articular glenoid defect or glenoid defect <20%, choose Bankart surgery;articular glenoid defect <20% with Hill-Sachs bone defect <40%, choose Bankart surgery combined with remplissage surgery or ASA surgery;Glenoid defect 20% to 25%, choose "Sling";Glenoid defect 25% to 40%, choose Bristow-Latarjet; Glenoid or Hill-Sachs bone defect>40% or Bristow-Latarjet if the surgical repair fails, bone grafting is used. In addition, if (humeral avulsion of glenohumeral ligaments, HAGL) injury existed, HAGL injury repair should be used. In addition to considering the important factor of bone defects, it is necessary to combine patient's age, exercise level and surgeon's technique to comprehensively select the bestsurgical method.

Using Biceps Autograft in Reconstruction of Labral Defect in Recurrent Shoulder Dislocation

Recurrent anterior shoulder dislocation is a very common problem that face the orthopedic surgeon, which affect young people in their life, specially the professional workers or athletes and military persons. They may need either arthroscopic or open procedure to obtain a stable shoulder

Evaluation of Recurrence Rate and Risk Factors Affecting Recurrence of Recurrent Shoulder Dislocation in Kashani Hospital in 2017-2018

Background: In this article, the prevalence of recurrent anterior dislocation of the shoulder and the effect of factors such as age, occupation, primary cause and gender on it have been investigated. Objectives: This study aimed to investigate the factors related to the frequency of recurrent anterior shoulder dislocation in clients of the Orthopedic Ward of Kashani Hospital, Isfahan City, Iran, in 2017-2018. Methods: The present research is a cross-sectional study. The study population comprised all patients with traumatic and anterior shoulder dislocation referred to Kashani Hospital during 2017-2018. The sampling method in the present study was census. The patients were asked by phone or in person after their presence about the recurrences of dislocations between the beginning of 2017 and the end of 2018. The obtained data were analyzed in SPSS version 25. Results: Out of 256 patients, 22% had a recurrence of dislocation. The recurrence rate of dislocation in less than 20 years patients was 40%, and in 20 to 40 years was 63%. The highest recurrence rate of dislocation was reported in the age group of 20 to 40 years in the present study. Based on the present study results, the recurrence rate of dislocation in the age-group of 20-40 years was significantly higher than in other groups. There was no significant relationship between gender and recurrence of dislocation in the subjects (P&gt;0.05). Significance was observed in the primary cause and type of occupation in recurrence of dislocation (P&lt;0.05). Conclusion: The recurrence rate of dislocation in the patients who suffered from dislocations for the first time was 22%. Based on the results, the rate of recurrence of dislocation in the present study was lower than the rate of recurrence of dislocation in similar studies.

Outcome of Arthroscopic Bankart’s Repair Using Trans- Glenoid Suture Technique in Recurrent Post-Traumatic Anterior Shoulder Dislocation Without Bony Defect

Glenohumeral dislocation is a common entity and represents more than 50% of all joint dislocations with anterior dislocation being most common with overall incidence of 2%strategies

Radiographic study of effect of lateral placement of bone graft on shoulder joint degeneration after modified arthroscopic Latarjet surgery with elastic fixation

To investigate the mid-term effect of lateral placement of bone graft on shoulder joint degeneration after modified arthroscopic Latarjet surgery with elastic fixation for recurrent anterior shoulder dislocation with an anterior glenoid bone defect. According to the inclusion and exclusion criteria, 18 patients with recurrent anterior shoulder dislocation and anterior glenoid bone defect who received the modified arthroscopic Latarjet surgery with elastic fixation between January 2015 and November 2016 were enrolled in this study. There were 12 males and 6 females with an average age of 26.2 years (range, 19-37 years). The number of shoulder dislocation ranged from 4 to 30 times (mean, 8.8 times). The disease duration was 8-49 months (mean, 23.8 months). The mean anterior glenoid bone defect was 25.2% of the glenoid surface (range, 20%-29%). The mean preoperative Instability Severity Index Score (ISIS) was 7.6 (range, 7-10). According to Samilson-Prieto classification, the shoulder joint degeneration was rated as grade 0 in 13 cases, grade Ⅰ in 3 cases, and grade Ⅱ in 2 cases. Before and after operation, the visual analogue scale (VAS) score, American Society of Shoulder and Elbow Surgery (ASES) score, Walch-Duplay score, Rowe score, and shoulder mobility were used to evaluate the effectiveness. Imaging examination was performed to observe the shoulder joint degeneration, the position of the bone graft, and the postoperative shaping of the scapular glenoid. All patients were followed up 55-62 months, with an average of 59.6 months. There was no neurovascular injuries, infections, fixation-related and bone graft-related complications. No re-dislocation and revision occurred. All patients returned to normal life, 17 of whom returned to sport. The VAS score was significantly decreased and ASES, Walch-Duplay, and Rowe scores were significantly improved at last follow-up ( P<0.05). No significant difference was found in range of motion of forward flexion, abduction, lateral rotation at 90° abduction, internal rotation at 90° abduction, or lateral rotation at 0° between pre- and post-operation ( P>0.05). Three-dimensional CT showed that the centers of all bone grafts were between 3∶30 and 4∶30 (right shoulder) or between 7∶40 and 8∶20 (left shoulder) and no bone grafts were positioned superiorly or inferiorly in the glenoid En-face view. All bone grafts were positioned lateral to the scapular glenoid with an average distance of 3.5 mm (range, 2.3-4.6 mm) in cross-sectional imaging by CT. Compared with the preoperative Samilson-Prieto classification results, all cases showed no progression of shoulder joint degeneration at 36, 48 months and last follow-up. All bone grafts remodeled to a steady state within 24 months after operation. The bone graft and glenoid finally remodeled analogous to the shape of the intact glenoid in the En-face view and became flush with the glenoid rim, remodeling to a curved shape congruent to the humeral head in cross-sectional imaging by CT. The shape of the remodeled glenoid at last follow-up was not significantly different from that at 24 months after operation. The lateral placement of the bone graft during modified arthroscopic Latarjet surgery with elastic fixation do not accelerate the imaging changes of shoulder joint degeneration.

Eden-Hybinette Procedure for Revision Surgery in Recurrent Anterior Shoulder Instability in Epilepsy.

The purpose of this study was to analyze the clinical outcomes after Eden-Hybinette procedure for revision surgery in recurrent anterior shoulder instability in patients with epilepsy. We retrospectively evaluated eight such patients between 2015 and 2018. Four patients had failed Latarjet/Bristow procedure and two had failed arthroscopic Bankart procedure, while two had history of both the procedures. After medical control of epilepsy, Eden-Hybinette procedure was performed in all patients. WOSI score and Rowe shoulder score was recorded preoperatively and in subsequent post-operative follow-up. A paired t test was used to analyze and compare preoperative and postoperative outcomes and was considered significant if p value was < 0.05. The average follow-up was 30months (range 24-48months). There was no recurrence of shoulder instability. The mean WOSI score before surgery was 77.3 (range 70-83), which improved to 24.2 (range 19-30) at 24-month follow-up. The mean Rowe score before surgery was 11.3 (range 5-15), which improved to 81.8(range 65-90) at 24-month follow-up. The improvement in WOSI and Rowe score was found to be statistically significant [p value < 0.05]. We conclude that Eden-Hybinette is a useful revision procedure to manage recurrent anterior shoulder dislocation in patients with epilepsy. Optimum medical control of seizure is also an important factor in preventing recurrent shoulder instability.

LATARJET PROCEDURE FOR RECURRENT SHOULDER ANTERIOR INSTABILITY WITH LESS THAN 25% GLENOID BONE LOSS- ITS FUNCTIONAL OUTCOME: A PROSPECTIVE STUDY

Background: Latarjet procedure for a recurrent anterior shoulder dislocation with more than 25% of bone loss is a standard treatment with good functional outcome. In glenoid bone loss &lt; than25%, there is no concurrence in the surgery of choice between Bankart repair, Remplissage procedure and Latarjet procedure. This study is aimed to study the functional outcome following Latarjet procedure in recurrent shoulder instability in patients with &lt; than 25% glenoid bone loss and also to assess the instability symptoms and complications following this procedure. Methods: It is a Clinical, Prospective and Observational study on thirty patients with recurrent anterior dislocation of shoulder, with less than 25% glenoid bone loss treated with Open Latarjet Procedure, at Chettinad Hospital and Research Institute, Kelambakkam, done between Jan 2017 to Dec 2020, with a minimum follow-up of atleast 1year duration. Patients were post-operatively assessed functionally using Constant shoulder score, Rowe scoring system and the Walch- Duplay index score. Clinical instability was also assessed using the Anterior Apprehension and Anterior Drawer Test. Results: In our study with thirty patients, who underwent Latarjet procedure, Functional outcome of the patients were assessed using the Constant shoulder score, Rowe scoring system and the Walch- Duplay index score. The combined average percentage of Score of Scores of the three scoring systems were 74.46% had Excellent results, 14.42% had Good and 11.12% of patients had Average or Fair results. None of the patients had any instability symptoms post-operatively at the 1year post-op follow-up. Four patients had supercial Surgical Site Infections and 2 patients had developed mild to moderate shoulder stiffness. Conclusion: The Latarjet gives conrmationally Excellent to Good functional outcome and aid in the early return to activities of daily living and a fewer failure rate. In patients with Recurrent Anterior Shoulder Dislocation, with even less than 25% Glenoid bone loss, it may be pertinent to primarily consider the osseous option of a coracoid transfer (Latarjet) rather than opt for simpler Open Bankart, Arthroscopic Bankart or an Arthroscopic Remplissage procedure alone. Thus, as a yardstick the bone loss concept, either on the Glenoidal or on the Humeral aspect, alone, need to be the deciding factor. The fact remains that in the athletic or otherwise Recurrent Anterior Shoulder Dislocators, there is also a concomitant humeral component, apart from the apparent and demonstrable Glenoid defect with the “Circle concept”.

Arthroscopic remplissage: a valuable adjunct to arthroscopic Bankart’s repair in shoulder instability

&lt;p class="abstract"&gt;Current study present results of arthroscopic shoulder stabilisation surgery. 46 consecutive patients with recurrent anterior shoulder dislocations and less than 25% Glenoid bone loss were treated with arthroscopic surgery in 2017-2020. Arthroscopic repair of Bankart’s lesion with capsular shift was performed in each. In 8 patients, where the Hill sach’s lesion was “off track” or “engaging”, arthroscopic remplissage was performed along with arthroscopic Bankart’s repair. There was no recurrence of shoulder instability after a mean follow up of 1 year. This included the non-engaging Hill sach’s group (treated with Bankart’s repair) as well as the engaging or off track Hill sach’s group (treated with Bankart’s repair and remplissage). All patients went on to obtain full forward flexion, full abduction and internal rotation. The Bankart’s and remplissage group had a mean of 8 degrees restriction of external rotation. SST scores and oxford scores had improved considerably on follow up in both groups Arthroscopic shoulder surgery provides a safe and reliable option in the management of recurrent shoulder dislocations. Arthroscopic remplissage is a useful adjunct to Bankart’s repair when treating the difficult problem of a large engaging Hill Sachs lesion.&lt;/p&gt;&lt;p class="abstract"&gt; &lt;/p&gt;

The causes of Latarjet surgery failure and the revision surgeries

To review the causes of Latarjet surgery failure and various revision surgeries, in order to provide the reference for the revision of treatment options for Latarjet surgery failure. Literature on the causes of Latarjet surgery failure and revision surgeries was extensively reviewed and analyzed. Latarjet surgery is widely used in clinical practice for recurrent anterior dislocation of shoulder with glenoid defects, especially for the defects of more than 25%. The main reasons for its failure are ununion, bone resorption, graft dislocation, trauma, and graft fracture, etc. The revision surgeries are diverse, the standard treatment has not yet been formed. The revision surgeries include open iliac bone grafting, microscopic Eden-Hybinette surgery, soft tissue reconstruction, open or arthroscopic bone grafting, etc. The differences among the revisions are mainly reflected in grafts, complications, and their costs. Latarjet surgery is difficult to operate and requires high technical requirements for the surgeons. It is necessary to continuously improve the surgical technology to reduce the complications related to Latarjet surgery and its revision surgery.

Congruent Arc Latarjet with Subscapularis Split in Patients with Shoulder Instability and Hill Sachs Lesions: Functional Outcome at 2-Year Follow-Up

Introduction: Shoulder dislocations are the most frequent of all dislocations in the body. Recurrence of shoulder dislocations is common in the younger age group with associated Bankart or Hill Sach’s lesions. Over 200 procedures have been described in the literature for the treatment of recurrent anterior dislocation of shoulder.