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Anterior Traumatic Instability Without Glenoid Bone Loss

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Arthroscopy

Abstract

The glenohumeral joint is the most commonly dislocated joint in the body which can be attributed to its highly mobile articulation. Although glenohumeral instability can occur in any direction, anterior instability is by far the most common, which ranges from subtle increased laxity to recurrent dislocation. Traumatic injury is the most common cause of shoulder instability, accounting for approximately 95 % of anterior shoulder dislocations [1]. In the successful management of traumatic anterior shoulder instability, the importance of patient history and thorough clinical examination supplemented with the radiological workup cannot be overemphasized. As these issues are effectively elaborated in the previous chapters, in this chapter, we will discuss about the indications, techniques, complications, and results of surgical management of anterior shoulder instability without glenoid bone loss.

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References

  1. Hovelius L. Anterior shoulder dislocation of the shoulder in teen-agers and young adults: five-year prognosis. J Bone Joint Surg Am. 1987;69A:393–9.

    Google Scholar 

  2. Robinson CM, Dobson RJ. Anterior instability of the shoulder after trauma. J Bone Joint Surg (Br). 2004;86-B:469–79.

    Article  Google Scholar 

  3. Gumina S, Postacchini F. Anterior dislocation of the shoulder in elderly patients. J Bone Joint Surg (Br). 1997;79(4):540–3.

    Article  CAS  Google Scholar 

  4. Handoll HH, Almaiyah MA, Rangan A. Surgical versus non-surgical treatment for acute anterior shoulder dislocation. Cochrane Database Syst Rev. 2004;1:CD 004325. doi:10.1002/14651858.

    Google Scholar 

  5. Boone JL, Arciero RA. First-time anterior shoulder dislocations: has the standard changed? Br J Sports Med. 2010;44:355–60.

    Article  PubMed  Google Scholar 

  6. Porcellini G MD, Campi F MD, Pegreffi F MD, Castagna A MD, Paladini P MD. Predisposing factors for recurrent shoulder dislocation after arthroscopic treatment. J Bone Joint Surg Am. 2009;91:2537–42.

    Article  PubMed  Google Scholar 

  7. Rokito AS, Namkoong S, Zuckerman JD, Gallagher MA. Open surgical treatment of anterior glenohumeral instability: an historical perspective and review of the literature. Am J Orthop. 1998;27:723–5.

    CAS  PubMed  Google Scholar 

  8. Millett PJ M.D., M.Sc., Clavert P M.D., Warner JJP M.D. Arthroscopic management of anterior, posterior, and multidirectional shoulder instability: pearls and pitfalls. Arthrosc J Arthrosc Relat Surg. 2003;19 Suppl 1:86–93. No 10, December.

    Article  Google Scholar 

  9. Matthews LS, Zarins B, Michael RH, Helfet DL. Anterior portal selection for shoulder arthroscopy. Arthroscopy. 1985;1:33–9.

    Article  CAS  PubMed  Google Scholar 

  10. Romeo AA M.D., Cohen BS M.D., Carreira DS M.D. Traumatic anterior shoulder instability. Orthop Clin N Am. 2001;32(3):399–409.

    Article  CAS  Google Scholar 

  11. Provencher MT M.D., Ghodadra N M.D., Romeo AA M.D. Arthroscopic management of anterior instability: pearls, pitfalls, and lessons learned. Orthop Clin N Am. 2010;41:325–37.

    Article  Google Scholar 

  12. Snyder SJ, Strafford BB. Arthroscopic management of instability of the shoulder. Orthopedics. 1993;16(9):993–1002.

    CAS  PubMed  Google Scholar 

  13. Hill HA, Sachs MD. The grooved defect of the humeral head. Radiology. 1940;35:690–700.

    Article  Google Scholar 

  14. Antonio GE, Griffith JF, Yu AB, Yung PS, Chan KM, Ahuja AT. First time shoulder dislocation: high prevalence of labral injury and age related differences revealed by MR arthrography. J Magn Reson Imaging. 2007;26:983–91.

    Article  PubMed  Google Scholar 

  15. Taylor DC, Arciero RA. Pathologic changes associated with shoulder dislocations: arthroscopic and physical examination findings in first time, traumatic anterior dislocations. Am J Sports Med. 1997;25:306–11.

    Article  CAS  PubMed  Google Scholar 

  16. Boileau P, O’Shea K, Vargas P, Pinedo M, Old J, Zumstein M. Anatomical functional results after arthroscopic Hill-Sachs remplissage. J Bone Joint Surg Am. 2012;94:618–26.

    Article  PubMed  Google Scholar 

  17. Wolf EM, Arianjam A. Hill-Sachs remplissage, an arthroscopic solution for the engaging Hill-Sachs lesion: 2- to 10-year follow-up and incidence of recurrence. J Should Elb Surg. 2014;23(6):814–20.

    Article  Google Scholar 

  18. Calandra JJ, Baker CL, Uribe J. The incidence of Hill-Sachs lesions in initial anterior shoulder dislocations. Arthroscopy. 1989;5:254–7.

    Article  CAS  PubMed  Google Scholar 

  19. Giovanni Merolla MD, Paolo Paladini MD, Giuseppe Di Napoli MD, Fabrizio Campi MD, Giuseppe Porcellini MD. Outcomes of arthroscopic Hill-Sachs remplissage and anterior bankart repair a retrospective controlled study including ultrasound evaluation of posterior capsulotenodesis and infraspinatus strength assessment. Am J Sports Med. 2015;43:407. doi:10.1177/0363546514559706.

    Article  PubMed  Google Scholar 

  20. Koo SS, Burkhart SS, Ochoa E. Arthroscopic double-pulley remplissage technique for engaging Hill-Sachs lesions in anterior shoulder instability repairs. Arthroscopy. 2009;25:1343–8.

    Article  PubMed  Google Scholar 

  21. Elkinson I, Giles JW, Boons HW, et al. The shoulder remplissage procedure for Hill-Sachs defects: does technique matter? J Should Elb Surg. 2013;22(6):835–41.

    Article  Google Scholar 

  22. Sonnabend DH. Treatment of primary anterior shoulder dislocation in patients older than 40 years of age. Conservative versus operative. Clin Orthop. 1994;304:74–7.

    PubMed  Google Scholar 

  23. Neviaser RJ, Neviaser TJ. Recurrent instability of the shoulder after age 40. J Should Elb Surg. 1995;4:416–8.

    Article  CAS  Google Scholar 

  24. Wirth MA, Rockwood Jr CA. Operative treatment of irreparable rupture of the subscapularis. J Bone Joint Surg Am. 1997;79:722–31.

    CAS  PubMed  Google Scholar 

  25. Kim TK, Rauh PB, McFarland EG. Partial tears of the subscapularis tendon found during arthroscopic procedures on the shoulder: a statistical analysis of sixty cases. Am J Sports Med. 2003;31:744–50.

    PubMed  Google Scholar 

  26. Porcellini G M.D., Paladini P M.D., Campi F M.D., Paganelli M M.D. Shoulder instability and related rotator cuff tears: arthroscopic findings and treatment in patients aged 40 to 60 years. Arthrosc J Arthrosc Relat Surg. 2006;22(3):270–6.

    Article  Google Scholar 

  27. Detrisac DA, Johnson LL. Arthroscopic shoulder capsulorrhaphy using metal staples. Orthop Clin N Am. 1993;24:71–88.

    CAS  Google Scholar 

  28. Morgan CD, Bodenstab AB. Arthroscopic Bankart suture repair: technique and early results. Arthroscopy. 1987;3:111–22.

    Article  CAS  PubMed  Google Scholar 

  29. Wredmark T, Tornkvist H, Johansson C, Brobert B. Long-term functional results of the modified Bristow procedure for recurrent dislocations of the shoulder. Am J Sports Med. 1992;20:157–61.

    Article  CAS  PubMed  Google Scholar 

  30. Matsuki K, Sugaya H. Complications after arthroscopic labral repair for shoulder instability. Curr Rev Musculoskelet Med. 2015;8(1):53–8.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Owens BD, Harrast JJ, Hurwitz SR, Thompson TL, Wolf JM. Surgical trends in Bankart repair—an analysis of data from the American Board of Orthopaedic Surgery certification examination. Am J Sports Med. 2011;39:1865–9.

    Article  PubMed  Google Scholar 

  32. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol. 1999;20:250–78.

    Article  CAS  PubMed  Google Scholar 

  33. Price MR, Tillett ED, Acland RD, Nettleton GS. Determining the relationship of the axillary nerve to the shoulder joint capsule from an arthroscopic perspective. J Bone Joint Surg. 2004;86-A:2135–42.

    PubMed  Google Scholar 

  34. Eakin CL, Dvirnak P, Miller CM, Howkins RJ. The relationship of the axillary nerve to arthroscopically placed capsulolabral sutures— an anatomic study. Am J Sports Med. 1998;26:505–9.

    CAS  PubMed  Google Scholar 

  35. Ando A, Sugaya H, Takahashi N, Kawai N, Hagiwara Y, Itoi E. Arthroscopic management of selective loss of external rotation after surgical stabilization of traumatic anterior glenohumeral instability: arthroscopic restoration of transverse sliding procedure. Arthroscopy. 2012;28:749–53.

    Article  PubMed  Google Scholar 

  36. Levine WN, Clark AM, D’Alessandro DF, Yamaguchi K. Chondrolysis following arthroscopic thermal capsulorrhaphy to treat shoulder instability—a report of two cases. J Bone Joint Surg. 2005;87-A:616–21.

    Article  Google Scholar 

  37. Jerosch J, Aldawoudy AM. Chondrolysis of the glenohumeral joint following arthroscopic capsular release for adhesive capsulitis: a case report. Knee Surg Sports Traumatol Arthrosc. 2007;15:292–4.

    Article  PubMed  Google Scholar 

  38. Petty DH, Jazrawi LM, Estrada LS, Andrews JR. Glenohumeral chondrolysis after shoulder arthroscopy: case reports and review of the literature. Am J Sports Med. 2004;32:509–15.

    Article  PubMed  Google Scholar 

  39. Good CR, Shindle MK, Kelly BT, Wanich T, Warren RF. Glenohumeral chondrolysis after shoulder arthroscopy with thermal capsulorrhaphy. Arthroscopy. 2007;23:797.e1–5.

    Google Scholar 

  40. Scheffel PT, Clinton J, Lynch JR, Warme WJ, Bertelsen AL, Matsen III FA. Glenohumeral chondrolysis: a systematic review of 100 cases from the english language literature. J Should Elb Surg. 2010;19:944–9.

    Article  Google Scholar 

  41. Bailie DS, Ellenbecker TS. Severe chondrolysis after shoulder arthroscopy: a case series. J Should Elb Surg. 2009;18:742–7.

    Article  Google Scholar 

  42. Matsen FA, Papadonikolakis A. Published evidence demonstrating the causation of glenohumeral chondrolysis by postoperative infusion of local anesthetic via a pain pump. J Bone Joint Surg. 2013;95-A:1126–34.

    Article  Google Scholar 

  43. Kavaja L, Pajarinen J, Sinisaari I, et al. Arthrosis of glenohumeral joint after arthroscopic Bankart repair: a long-term follow-up of 13 years. J Should Elb Surg. 2012;21:350–5.

    Article  Google Scholar 

  44. Franceschi F, Papalia R, Del Buono A, Vasta S, Maffulli N, Denaro V. Glenohumeral osteoarthritis after arthroscopic Bankart repair for anterior instability. Am J Sports Med. 2011;39:1653–9.

    Article  PubMed  Google Scholar 

  45. Jeong JH, Shin SJ. Arthroscopic removal of proud metallic suture anchors after Bankart repair. Arch Orthop Trauma Surg. 2009;129(8):1109–15.

    Article  PubMed  Google Scholar 

  46. Privitera DM, Bisson LJ, Marzo JM. Minimum 10-year follow-up of arthroscopic intra-articular Bankart repair using bioabsorbable tacks. Am J Sports Med. 2012;40:100–7.

    Article  PubMed  Google Scholar 

  47. Lim TK, Koh KH, Lee SH, et al. Inferior anchor cortical perforation with arthroscopic Bankart repair: cadaveric study. Arthroscopy. 2013;29:31–6.

    Article  PubMed  Google Scholar 

  48. Frank RM, Mall NA, Gupta D, et al. Inferior suture anchor placement during arthroscopic Bankart repair: influence of portal placement and curved drill guide. Am J Sports Med. 2014;42:1182–9.

    Article  PubMed  Google Scholar 

  49. McCarty III LP, Buss DD, Datta MW, Freehill MQ, Giveans MR. Complications observed following labral or rotator cuff repair with use of poly-L-lactic acid implants. J Bone Joint Surg. 2013;95-A:507–11.

    Article  Google Scholar 

  50. Haneveld H, Hug K, Diederichs G, Scheibel M, Gerhardt C. Arthroscopic double-row repair of the rotator cuff: a comparison of bio-absorbable and non-resorbable anchors regarding osseous reaction. Knee Surg Sports Traumatol Arthrosc. 2013;21:1647–54.

    Article  PubMed  Google Scholar 

  51. Silver MD, Daigneault JP. Symptomatic interarticular migration of glenoid suture anchors. Arthroscopy. 2000;16:102–5.

    Article  CAS  PubMed  Google Scholar 

  52. Kaar TK, Schenck Jr RC, Wirth MA, Rockwood Jr CA. Complications of metallic suture anchors in shoulder surgery: a report of 8 cases. Arthroscopy. 2001;17:31–7.

    Article  CAS  PubMed  Google Scholar 

  53. Zuckerman JD, Matsen III FA. Complications about the glenohumeral joint related to the use of screws and staples. J Bone Joint Surg Am. 1984;66:175–80.

    CAS  PubMed  Google Scholar 

  54. Landsiedl F. Arthroscopic therapy of recurrent anterior luxation of the shoulder by capsular repair. Arthroscopy. 1992;8:296–304.

    Article  CAS  PubMed  Google Scholar 

  55. Green MR, Christensen KP. Arthroscopic versus open Bankart procedures: a comparison of early morbidity and complications. Arthroscopy. 1993;9:371–4.

    Article  CAS  PubMed  Google Scholar 

  56. Petrera M, Patella V, Patella S, Theodoropoulos J. A meta-analysis of open versus arthroscopic Bankart repair using suture anchors. Knee Surg Sports Traumatol Arthrosc. 2010;18:1742–7.

    Article  CAS  PubMed  Google Scholar 

  57. Petrera M, Dwyer T, Tsuji MRS, Theodoropoulos JS. Outcomes of arthroscopic Bankart repair in collision versus noncollision athletes. Orthopedics. 2013;36:e621–6.

    Article  PubMed  Google Scholar 

  58. Wolf EM, Pollack ME. Hill-Sachs “remplissage”: an arthroscopic solution for the engaging Hill-Sachs lesion. Arthroscopy. 2004;20 Suppl 1:e14–5.

    Article  Google Scholar 

  59. Boileau P, O’Shea K, Vargas P, Pinedo M, Old J, Zumstein M. Anatomical and functional results after arthroscopic Hill-Sachs remplissage. J Bone Joint Surg. 2012;94-A:618–26.

    Google Scholar 

  60. Leroux T, Bhatti A, Khoshbin A, et al. Combined arthroscopic Bankart repair and remplissage for recurrent shoulder instability. Arthroscopy. 2013;29:1693–701.

    Article  PubMed  Google Scholar 

  61. Buza III JA, Iyengar JJ, Anakwenze OA, Ahmad CS, Levine WN. Arthroscopic Hill-Sachs remplissage. J Bone Joint Surg. 2014;96- A:549–55.

    Article  Google Scholar 

  62. Owens BD, DeBerardino TM, Nelson BJ, et al. Long-term follow-up of acute arthroscopic Bankart repair for initial anterior shoulder dislocations in young athletes. Am J Sports Med. 2009;37:669–73.

    Article  PubMed  Google Scholar 

  63. Scott Paxton E M.D., Dodson CC MD, Lazarus MD M.D. Shoulder instability in older patients. Orthop Clin N Am. 2014;45:377–85.

    Article  Google Scholar 

  64. Neviaser RJ, Neviaser TJ, Neviaser JS. Concurrent rupture of the rotator cuff and anterior dislocation of the shoulder in the older patient. J Bone Joint Surg Am. 1988;70(9):1308–11.

    CAS  PubMed  Google Scholar 

  65. Gill TJ, Warren RF, Rockwood Jr CA, et al. Complications of shoulder surgery. Instr Course Lect. 1999;48:359–74.

    CAS  PubMed  Google Scholar 

  66. Maracci M, Zaffagnini S, Petitto A, et al. Arthroscopic management of recurrent anterior dislocation of the shoulder: analysis of technical modifications on the Caspari procedure. Arthroscopy. 1996;12:144–9.

    Article  Google Scholar 

  67. Mologne TS, McBride MT, Lapoint JM. Assessment of failed arthroscopic anterior labral repairs: findings at open surgery. Am J Sports Med. 1997;25:813–7.

    Article  CAS  PubMed  Google Scholar 

  68. Bach BR, Warren RF, Fronek J. Disruption of the lateral capsule of the shoulder: a cause of recurrent dislocation. J Bone Joint Surg (Br). 1988;70-B:274–6.

    Google Scholar 

  69. Bokor DJ, Conboy VB, Olson C. Anterior instability of the glenohumeral joint with humeral avulsion of the glenohumeral ligament: a review of 41 cases. J Bone Joint Surg (Br). 1999;81-B:93–6.

    Article  Google Scholar 

  70. Grana WA, Buckley PD, Yates CK. Arthroscopic Bankart suture repair. Am J Sports Med. 1993;21:348–53.

    Article  CAS  PubMed  Google Scholar 

  71. Walch G, Boileau P, Levigne C, et al. Arthroscopic stabilization for recurrent anterior shoulder dislocation: results of 59 cases. Arthroscopy. 1995;11:173–9.

    Article  CAS  PubMed  Google Scholar 

  72. Rowe CR, Zarins B. Recurrent transient subluxation of the shoulder. J Bone Joint Surg Am. 1981;63-A:863–71.

    Google Scholar 

  73. Zarins B, Rowe CR, Stone JW. Shoulder instability: management of failed reconstructions. Instr Course Lect. 1989;38:217–30.

    CAS  PubMed  Google Scholar 

  74. Savoie 3rd FH, Miller CD, Field LD. Arthroscopic reconstruction of traumatic anterior instability of the shoulder: the Caspari technique. Arthroscopy. 1997;13:201–9.

    Article  PubMed  Google Scholar 

  75. Green MR, Christensen KP. Arthroscopic Bankart procedure: two- to five-year follow-up with clinical correlation to severity of glenoid labral lesion. Am J Sports Med. 1995;23:276–81.

    Article  CAS  PubMed  Google Scholar 

  76. Goldberg BJ, Nirschl RP, McConnell JP, Pettrone FA. Arthroscopic transglenoid suture capsulolabral repairs: preliminary results. Am J Sports Med. 1993;21:656–64.

    Article  CAS  PubMed  Google Scholar 

  77. Manta JP, Organ S, Nirschle RP, Pettrone FA. Arthroscopic transglenoid suture capsulolabral repair: five-year followup. Am J Sports Med. 1997;25:614–8.

    Article  CAS  PubMed  Google Scholar 

  78. Pap G, Machner A, Heitmann D, Merk H, Neumann HW. Recurrent luxation after arthroscopic refixation of the labrum using suture anchors in traumatic ventral shoulder luxation. Zentralbl Chir. 2001;126:199–204.

    Article  CAS  PubMed  Google Scholar 

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Morey, V.M., Porcellini, G., Campi, F., Paladini, P., Merolla, G. (2016). Anterior Traumatic Instability Without Glenoid Bone Loss. In: Randelli, P., Dejour, D., van Dijk, C., Denti, M., Seil, R. (eds) Arthroscopy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49376-2_35

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