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ASA, an Arthroscopic Technique for Recurrent Anterior Dislocations Using Partial Subscapularis Tenodesis in Association with Bankart Repair

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360° Around Shoulder Instability

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Abstract

There are different arthroscopic techniques described to treat anterior recurrent shoulder instability. We describe and report the results of a new surgical technique based on the combination of a Bankart repair and an arthroscopic subscapularis augmentation (ASA). The ASA in association with Bankart is a good indication to treat patients with hyperlaxity or deficiency of anterior capsule-labral structures with relative glenoid bone loss <10% in patients practising contact sports and <20% in others. We reported indications, technique, biomechanical ratio and our retrospective results. The results at short-time follow-up are encouraging, having less than 3% of failure. We did not observe secondary osteoarthritis or functional restriction of external rotation.

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References

  1. Voos JE, Livermore RW, Feeley BT, Altchek DW, Williams RJ, Warren RF, Cordasco FA, Allen AA, HSS Sports Medicine Service. Prospective evaluation of arthroscopic bankart repairs for anterior instability. Am J Sports Med. 2010;38:302–7. https://doi.org/10.1177/0363546509348049.

    Article  PubMed  Google Scholar 

  2. Fabbriciani C, Milano G, Demontis A, Fadda S, Ziranu F, Mulas PD. Arthroscopic versus open treatment of Bankart lesion of the shoulder: a prospective randomized study. Arthroscopy. 2004;20:456–62. https://doi.org/10.1016/j.arthro.2004.03.001.

    Article  PubMed  Google Scholar 

  3. Kim SJ, Kim SH, Park BK, Chun YM. Arthroscopic stabilization for recurrent shoulder instability with moderate glenoid bone defect in patients with moderate to low functional demand. Arthroscopy. 2014;30:921–7. https://doi.org/10.1016/j.arthro.2014.03.023.

    Article  PubMed  Google Scholar 

  4. Lenters TR, Franta AK, Wolf FM, Leopold SS, Matsen FA. Arthroscopic compared with open repairs for recurrent anterior shoulder instability. A systematic review and meta-analysis of the literature. J Bone Joint Surg Am. 2007;89:244–54. https://doi.org/10.2106/JBJS.E.01139.

    Article  PubMed  Google Scholar 

  5. Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy. 2000;16:677–94. https://doi.org/10.1053/jars.2000.17715.

    Article  CAS  PubMed  Google Scholar 

  6. Boileau P, Villalba M, Héry JY, Balg F, Ahrens P, Neyton L. Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg Am. 2006;88:1755–63. https://doi.org/10.2106/JBJS.E.00817.

    Article  PubMed  Google Scholar 

  7. Russo R, Cautiero F, Della Rotonda G. Risk factors for recurrent shoulder dislocation arthroscopically managed with absorbable knotless anchors. Adv Orthop Surg. 2014;2014:964358. https://doi.org/10.1155/2014/964358.

    Article  Google Scholar 

  8. Boileau P, O’Shea K, Vargas P, et al. Anatomical and functional results after arthroscopic Hill-Sachs remplissage. J Bone Joint Surg Am. 2012;94:618–26.

    Article  Google Scholar 

  9. 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 Shoulder Elbow Surg. 2014;23:814–20.

    Article  Google Scholar 

  10. Walch G, Boileau P. Latarjet-Bristow procedure for recurrent anterior instability. Tech Shoulder Elbow Surg. 2000;1:256–61.

    Article  Google Scholar 

  11. Lafosse L, Lejeune E, Bouchard A, et al. The arthroscopic Latarjet procedure for the treatment of anterior shoulder instability. Arthroscopy. 2007;23:1242–5.

    PubMed  Google Scholar 

  12. Lafosse L, Boyle S. Arthroscopic Latarjet procedure. J Shoulder Elbow Surg. 2010;19:2–12.

    Article  Google Scholar 

  13. Russo R, Togo F, Jannelli E. The surgical treatment of recurrent anterior dislocation of the shoulder. Ital J Orthop Traumatol. 1990;16(2):183–9.

    CAS  PubMed  Google Scholar 

  14. Taverna E, Golano P, Pascale V, et al. An arthroscopic bone graft procedure for treating anterior–inferior glenohumeral instability. Knee Surg Sports Traumatol Arthrosc. 2008;16:872–5.

    Article  CAS  Google Scholar 

  15. Mizuno N, Denard PJ, Raiss P, et al. Long term results of the Latarjet procedure for anterior instability of the shoulder. J Shoulder Elbow Surg. 2014;23(11):1691–9.

    Article  Google Scholar 

  16. Provencher MT, Ghodadra N, LeClere L, et al. Anatomic osteochondral glenoid reconstruction for recurrent glenohumeral instability with glenoid deficiency using a distal tibia allograft. Arthroscopy. 2009;25(4):446–52.

    Article  Google Scholar 

  17. Johnson LL. Arthroscopic surgery: principle and practice, Chap 15. St. Louis: Mosby; 1986. p. 1420–4.

    Google Scholar 

  18. Maiotti M, Massoni C. Arthroscopic augmentation with subscapularis tendon in anterior shoulder instability with capsulolabral deficiency. Arthrosc Tech. 2013;2(3):e303–10.

    Article  Google Scholar 

  19. Maiotti M, Russo R, Zanini A, et al. Arthroscopic Bankart repair and subscapularis augmentation: an alternative technique treating anterior shoulder instability with bone loss. J Shoulder Elbow Surg. 2016;25(6):898–906.

    Article  Google Scholar 

  20. Schröter S, Krämer M, Welke B, et al. The effect of the arthroscopic augmentation of the subscapularis tendon on shoulder instability and range of motion: A biomechanical study. Clin Biomech. 2016;38:75–83.

    Article  Google Scholar 

  21. Maiotti M, Massoni C, Russo R, et al. Arthroscopic subscapularis augmentation of Bankart repair in chronic anterior shoulder instability with bone loss less than 25% and capsular deficiency: clinical multicenter study. Arthroscopy. 2016;S0749–8063(16):30710–1.

    Google Scholar 

  22. Russo R, Della Rotonda G, Cautiero F, et al. Arthroscopic Bankart repair associated with subscapularis augmentation (ASA) versus open Latarjet to treat recurrent anterior shoulder instability with moderate glenoid bone loss: clinical comparison of two series. Musculoskelet Surg. 2017;101(1):75–83. https://doi.org/10.1007/s12306-016-0446-8.

    Article  CAS  PubMed  Google Scholar 

  23. Gordey EE, Wong IH. Using Bankart “plus” techniques to tackle anterior shoulder instability with bone loss: can newer arthroscopic adjuncts provide long-term stability? Arthroscopy. 2018;34(8):2294–7.

    Article  Google Scholar 

  24. Longo UG, Loppini M, Rizzello G, Ciuffreda M, Berton A, Maffulli N, et al. Remplissage, humeral osteochondral grafts, Weber osteotomy, and shoulder arthroplasty for the management of humeral bone defects in shoulder instability: systematic review and quantitative synthesis of the literature. Arthroscopy. 2014;30:1650–66.

    Article  Google Scholar 

  25. Meulen PD, Weening AA, Derek FP, Van Deurzen DF, Van den Bekerom MP. The relevance of the Latarjet procedure for the management of humeral bone defects in anterior shoulder instability. Arthroscopy. 2015;3:393–4.

    Article  Google Scholar 

  26. Taverna E, Golano P, Pascale V, Battistella F. Anarthroscopicbone graft procedure for treating anterior–inferior glenohumeral instability. Knee Surg Sports Traumatol Arthrosc. 2008;16:872–5.

    Article  CAS  Google Scholar 

  27. Griesser MJ, Harris JD, McCoy BW, Hussain WM, Jones MH, Bishop JY, et al. Complications and re-operations after Bristow- Latarjet shoulder stabilization: a systematic review. J Shoulder Elbow Surg. 2013;22:286–92.

    Article  Google Scholar 

  28. Shah AA, Butler RB, Romanowski J, Karadagli D, Warner JJ. Short-term complications of the Latarjet procedure. J Bone Joint Surg Am. 2012;94:495–501.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Shoulder-Knee Unit, Mediterranea Clinic, Napoli, Italy

    Marco Maiotti

  2. Orthopaedics and Traumatology Unit, Pineta Grande Hospital, Caserta, Italy

    Raffaele Russo & Giuseppe Della Rotonda

  3. Orthopaedics and Traumatology Unit, San Giovanni Evangelista Hospital, Rome, Italy

    Cecilia Rao

Authors
  1. Marco Maiotti
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  2. Raffaele Russo
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  3. Giuseppe Della Rotonda
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  4. Cecilia Rao
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Editor information

Editors and Affiliations

  1. Shoulder and Upper Limb Department, St. Luke's Hospital, Bielsko-Biała, Poland

    Roman Brzóska

  2. Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy

    Giuseppe Milano

  3. Istituto Ortopedico Gaetano Pini, Prima Clinica Ortopedica, Milan, Italy

    Pietro S. Randelli

  4. Department of Traumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Ladislav Kovačič

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Maiotti, M., Russo, R., Della Rotonda, G., Rao, C. (2020). ASA, an Arthroscopic Technique for Recurrent Anterior Dislocations Using Partial Subscapularis Tenodesis in Association with Bankart Repair. In: Brzóska, R., Milano, G., Randelli, P., Kovačič, L. (eds) 360° Around Shoulder Instability. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-61074-9_12

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  • DOI: https://doi.org/10.1007/978-3-662-61074-9_12

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-61073-2

  • Online ISBN: 978-3-662-61074-9

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