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Glover MA, Waterman BR. Editorial Commentary: The Shoulder Instability-Return to Sports After Injury Scale Is More Than Just a Psychological Readiness Tool-It Is a Potential Predictive Model for Outcomes and Recurrence. Arthroscopy 2024:S0749-8063(24)00447-X. [PMID: 38901678 DOI: 10.1016/j.arthro.2024.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Accepted: 06/13/2024] [Indexed: 06/22/2024]
Abstract
The Shoulder Instability-Return to Sports After Injury (SIRSI) scale is a useful psychological readiness tool to determine whether athletes are prepared to return to sport. Although questions remain on the optimal timing of survey administration based on the type of procedure (i.e., arthroscopic Bankart repair vs Latarjet procedure) and external factors contributing to psychological readiness, its current use begs the question of what other applications may be appropriate. The SIRSI scale has recently been able to effectively predict patient-reported and clinical outcomes, such as postoperative instability recurrence. However, it also may have added value as a serial screening tool for determining a safe return to preinjury activity rather than just serving as a harbinger of further negative outcomes after shoulder stabilization. Increasingly, we must recognize the fundamental limitations in our current rehabilitation pathways and sometimes myopic, 1-dimensional return-to-play criteria (e.g., range of motion or isokinetic testing) in facilitating a safe return to competition. We must transition to a more regimented, criteria-based return-to-play battery that incorporates optimized psychological readiness. As such, the SIRSI scale, like its anterior cruciate ligament counterpart, could become the standard of care in determining confidence in returning to sport and ultimately serve as a benchmark of surgical success.
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Hurley ET, O'Grady J, Davey MS, Levin JM, Mojica ES, Gaafar M, Dickens JF, Delaney RA, Mullett H. Glenohumeral morphological predictors of recurrent shoulder instability following arthroscopic Bankart repair. Knee Surg Sports Traumatol Arthrosc 2024; 32:1571-1578. [PMID: 38572679 DOI: 10.1002/ksa.12169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/28/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE The purpose of this study was to evaluate glenohumeral morphological features on a magnetic resonance arthrogram (MRA) to determine risk factors for recurrence of anterior shoulder instability following arthroscopic Bankart repair (ABR). METHODS A retrospective review of patients who underwent ABR between 2012 and 2017 was performed to identify patients who had recurrence of instability following stabilisation (Group 1). These were pair-matched in a 2:1 ratio for age, gender and sport with a control (Group 2) who underwent ABR without recurrence. Preoperative MRAs were evaluated for risk factors for recurrence, with glenoid bone loss and Hill-Sachs lesions also measured. Multilinear and multilogistic regression models were used to evaluate factors affecting recurrence. RESULTS Overall, 72 patients were included in this study, including 48 patients without recurrence and 24 patients with recurrent instability. There was a significant difference between the two groups in mean glenoid bone loss (Group 1: 7.3% vs. Group 2: 5.7%, p < 0.0001) and the rate of off-track Hill-Sachs lesions (Group 1: 20.8% vs. Group 2: 0%, p = 0.0003). Of the variables analysed in logistic regression, increased glenoid anteversion (p = 0.02), acromioclavicular (AC) degeneration (p = 0.03) and increased Hill-Sachs width were associated with increased risk of failure. Increased chondral version (p = 0.01) and humeral head diameter in the anteriorposterior view were found to be protective and associated with a greater likelihood of success. CONCLUSION Glenoid anteversion was a risk factor for recurrent instability, whereas increased chondral version and humeral head diameter were associated with higher rates of success following ABR. Glenoid bone loss, presence of an off-track Hill-Sachs lesion, increased Hill-Sachs width and AC degeneration were also associated with failure. These findings should be used by surgeons to stratify risk for recurrence following ABR. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Eoghan T Hurley
- Department of Orthopaedic Surgery, Sports Surgery Clinic, Dublin, Ireland
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA
| | - Jack O'Grady
- Department of Orthopaedic Surgery, Sports Surgery Clinic, Dublin, Ireland
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA
| | - Martin S Davey
- Department of Orthopaedic Surgery, Sports Surgery Clinic, Dublin, Ireland
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA
| | - Jay M Levin
- Department of Orthopaedic Surgery, Sports Surgery Clinic, Dublin, Ireland
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA
| | - Edward S Mojica
- Department of Orthopaedic Surgery, Sports Surgery Clinic, Dublin, Ireland
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA
| | - Mohammed Gaafar
- Department of Orthopaedic Surgery, Sports Surgery Clinic, Dublin, Ireland
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA
| | - Jonathan F Dickens
- Department of Orthopaedic Surgery, Sports Surgery Clinic, Dublin, Ireland
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA
| | - Ruth A Delaney
- Department of Orthopaedic Surgery, Sports Surgery Clinic, Dublin, Ireland
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA
| | - Hannan Mullett
- Department of Orthopaedic Surgery, Sports Surgery Clinic, Dublin, Ireland
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA
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Hurley ET, Moore TK, Kilkenny C, Khan S, White-Gibson A, Dickens JF, Klifto CS, Mullett H. Young Collision Athletes Have High Rate of Return to Play and Good Clinical Outcomes Following Open Latarjet Procedure. Arthroscopy 2024; 40:1075-1080. [PMID: 37769824 DOI: 10.1016/j.arthro.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/25/2023] [Accepted: 09/07/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE To evaluate return to play (RTP), clinical outcomes, and recurrence rates in collision athletes 20 years of age and younger who underwent open Latarjet for anterior shoulder instability. METHODS A retrospective review of collision athletes 20 years of age and younger, who underwent an open Latarjet procedure by a single surgeon between the years of 2010-2020 was carried out. Inclusion criteria were 1) collision athlete, 2) underwent open Latarjet procedure, 3) 16-20 years old, and 4) minimum 24-month follow-up. Exclusion criteria were 1) other pathology of the ipsilateral shoulder and 2) noncollision athlete. Rate of RTP, time to RTP, rate of return to preinjury level, the Shoulder Instability Return to Sport after Injury score (SIRSI) score, Subjective Shoulder Value (SSV), visual analogue scale (VAS) scores, and recurrence events were recorded. Quantitative statistical analysis was carried out. RESULTS The study included 105 male collision athletes with a mean age of 18.6 ± 1.0 years (range: 17-20). The mean follow-up for patients was 36 ± 26.2 months. A total of 93 (88.6%) RTP at a mean time of 6.3 ± 2.2 months, with 73 (69.5%) returning to their preinjury level of participation. The mean SIRSI score was 69.2 ± 21.8, the mean VAS score was 2.3 ± 2.1, and the mean SSV score was 84.1 ± 16.8. Five patients (4.8%) redislocated their shoulder, with 4 of these requiring a further surgery (3.8%). Two patients (1.9%) reported incidents of subluxation. CONCLUSIONS The open Latarjet procedure in young collision athletes results in high rates of RTP, excellent functional outcomes and low recurrence rates at mid-term follow-up. Additionally, complication rates are low in this cohort. LEVEL OF EVIDENCE Level IV, case series.
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Affiliation(s)
- Eoghan T Hurley
- Sports Surgery Clinic, Dublin, Ireland; Duke University, Durham, North Carolina, U.S.A..
| | | | | | - Sami Khan
- Sports Surgery Clinic, Dublin, Ireland
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Teytelbaum D, Wegenka L, Wolk R, Ali A, Kaar CR, Karr S. Improvements in Sleep After Shoulder Arthroscopy Are Correlated With Improvements in Various Patient-Reported Outcomes: A Systematic Review. Arthrosc Sports Med Rehabil 2024; 6:100883. [PMID: 38362481 PMCID: PMC10867765 DOI: 10.1016/j.asmr.2024.100883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/28/2023] [Indexed: 02/17/2024] Open
Abstract
Purpose To determine the prevalence of sleep disturbances in patients before and after arthroscopic surgery of the shoulder and to evaluate the association between patient-reported outcomes and standardized sleep disturbance tools after shoulder arthroscopy. Methods A systematic review, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, was conducted by searching the PubMed, Embase, and Scopus databases using the terms "arthroscopic surgery" and "sleep." Two independent reviewers evaluated the studies based on the inclusion criteria focused on the effects of shoulder arthroscopy on sleep disturbance and the use of outcome measures related to sleep. Data on sleep quality and functional outcomes were collected and analyzed using various assessment tools, including the Pittsburgh Sleep Quality Index and American Shoulder and Elbow Surgeons score. The methodologic quality of included studies was assessed using the Methodological Index for Non-randomized Studies (MINORS) criteria. Results The review included 15 studies (9 Level IV, 5 Level III, and 1 Level II) comprising 1,818 arthroscopic patients (average age, 57.4 ± 8.86 years; follow-up range, 6 months to 75.7 months). The prevalence rates of sleep disturbances before and after shoulder arthroscopy ranged from 75.8% to 100% and from 19% to 62%, respectively. Every study included in this analysis reported an improvement in rates of sleep disturbances postoperatively compared with preoperatively. Improvements in standardized sleep disturbance scores were associated with functional outcomes. Conclusions Sleep disturbances are commonly observed before and after arthroscopic surgery of the shoulder. Arthroscopic surgery of the shoulder appears to improve sleep quality, and surgeons can expect functional outcomes, specifically the American Shoulder and Elbow Surgeons score, Simple Shoulder Test score, numeric rating scale or visual analog scale score, and Constant-Murley score, to improve in line with sleep quality. Level of Evidence Level IV, systematic review of Level II to IV studies.
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Affiliation(s)
- David Teytelbaum
- Department of Orthopaedic Surgery, Saint Louis University, St. Louis, Missouri, U.S.A
| | - Luke Wegenka
- Saint Louis University School of Medicine, St. Louis, Missouri, U.S.A
| | - Riley Wolk
- Saint Louis University School of Medicine, St. Louis, Missouri, U.S.A
| | - Ashley Ali
- Department of Orthopaedic Surgery, Saint Louis University, St. Louis, Missouri, U.S.A
| | - Courtney R.J. Kaar
- Sleep Medicine Section, Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Washington University, St. Louis, Missouri, U.S.A
| | - Scott Karr
- Department of Orthopaedic Surgery, Saint Louis University, St. Louis, Missouri, U.S.A
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Hurley ET, Danilkowicz RM, Paul AV, Myers H, Anakwenze OA, Klifto CS, Lau BC, Taylor DC, Dickens JF. Author Reply to "Can We Conclude That the Arthroscopic Bankart Repair and Open Latarjet Procedure Show Similar Rates of Return to Play and How Should This Conclusion Be Interpreted?". Arthroscopy 2024; 40:657-658. [PMID: 38206248 DOI: 10.1016/j.arthro.2023.07.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 07/27/2023] [Indexed: 01/12/2024]
Affiliation(s)
- Eoghan T Hurley
- Duke University, Department of Orthopaedic Surgery, Durham, North Carolina, U.S.A
| | | | - Alexandra V Paul
- Duke University, Department of Orthopaedic Surgery, Durham, North Carolina, U.S.A
| | - Heather Myers
- Duke University, Department of Orthopaedic Surgery, Durham, North Carolina, U.S.A
| | - Oke A Anakwenze
- Duke University, Department of Orthopaedic Surgery, Durham, North Carolina, U.S.A
| | - Christopher S Klifto
- Duke University, Department of Orthopaedic Surgery, Durham, North Carolina, U.S.A
| | - Brian C Lau
- Duke University, Department of Orthopaedic Surgery, Durham, North Carolina, U.S.A
| | - Dean C Taylor
- Duke University, Department of Orthopaedic Surgery, Durham, North Carolina, U.S.A
| | - Jonathan F Dickens
- Duke University, Department of Orthopaedic Surgery, Durham, North Carolina, U.S.A
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Hurley ET, Lunn K, Bethell M, Levin J, Pasqualini I, Frangiamore S, Anakwenze O, Klifto CS. Return to play following operative management of anterior shoulder instability in overhead athletes-A systematic review. Shoulder Elbow 2024; 16:15-23. [PMID: 38435042 PMCID: PMC10902415 DOI: 10.1177/17585732231205175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/15/2023] [Accepted: 09/16/2023] [Indexed: 03/05/2024]
Abstract
Background The purpose of this study was to systematically review the rate and timing of return to play in overhead athletes following operative management of anterior shoulder instability. Methods A systematic literature search based on PRISMA guidelines, utilizing the EMBASE, MEDLINE, and The Cochrane Library Databases. Eligible for inclusion were clinical studies reporting on return to play among overhead athletes following arthroscopic Bankart repair, open Latarjet procedure or Remplissage procedure. Results There are 23 studies included with 961 patients. Among those undergoing arthroscopic Bankart repair, the rate of return to play was 86.2%, with 70.6% returning to the same level of play and the mean time to return to play was 7.1 months. Among those undergoing an open Latarjet procedure, the rate of return to play was 80.9%, with 77.7% returning to the same level of play and the mean time to return to play was 5.1 months. Among those undergoing a Remplissage procedure, the rate of return to play was 70.6%, with 70.0% returning to the same level of play or mean time to return to play. Discussion Overall, there were high rates of return to play following operative management of anterior shoulder instability in overhead athletes.
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Affiliation(s)
- Eoghan T Hurley
- Department of Orthopaedic Surgery, Duke University, Durham, NC, USA
| | - Kiera Lunn
- School of Medicine, Duke University, Durham, NC, USA
| | | | - Jay Levin
- Department of Orthopaedic Surgery, Duke University, Durham, NC, USA
| | | | | | - Oke Anakwenze
- Department of Orthopaedic Surgery, Duke University, Durham, NC, USA
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Hurley ET, Danilkowicz RM, Paul AV, Myers H, Anakwenze OA, Klifto CS, Lau BC, Taylor DC, Dickens JF. Majority of Studies Show Similar Rates of Return to Play After Arthroscopic Bankart Repair or Latarjet Procedure: A Systematic Review. Arthroscopy 2024; 40:515-522. [PMID: 37146663 DOI: 10.1016/j.arthro.2023.04.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/07/2023]
Abstract
PURPOSE To systematically review the current evidence in the literature to compare return to play following arthroscopic Bankart repair versus open Latarjet procedure for the treatment of anterior shoulder instability. METHODS A literature search was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Comparative studies reporting return to play following arthroscopic Bankart repair versus open Latarjet procedure were included. Return to play was compared, with all statistical analysis performed using Review Manager, Version 5.3. RESULTS Nine studies with 1,242 patients (mean age: 15-30 years) were included. The rate of return to play was 61% to 94.1% among those undergoing arthroscopic Bankart repair and 72% to 96.8% in those undergoing an open Latarjet procedure. Two studies (Bessiere et al. and Zimmerman et al.) found a significant difference in favor of the Latarjet procedure (P < .05 for both, I2 = 37%). The rate of return to play at preinjury level was 9% to 83.8% among those undergoing arthroscopic Bankart repair and 19.4% to 80.6% in those undergoing an open Latarjet procedure, with no study finding a significant difference (P > .05 for all, I2 = 0%). The mean time of return to play was 5.4 to 7.3 months among those undergoing arthroscopic Bankart repair and 5.5 to 6.2 months in those undergoing an open Latarjet procedure, with no study finding a significant difference (P > .05 for all, I2 = 39%). CONCLUSIONS Overall, the majority of studies showed no significant difference in rates of return to play or timing following arthroscopic Bankart repair or open Latarjet procedure. Furthermore, no study has found a significant difference in rate of return to play at pre-injury level, or rate of return to play among collision athletes. LEVEL OF EVIDENCE Level III, systematic review of Level I-III studies.
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Affiliation(s)
- Eoghan T Hurley
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, U.S.A..
| | | | - Alexandra V Paul
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, U.S.A
| | - Heather Myers
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, U.S.A
| | - Oke A Anakwenze
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, U.S.A
| | - Christopher S Klifto
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, U.S.A
| | - Brian C Lau
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, U.S.A
| | - Dean C Taylor
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, U.S.A
| | - Jonathan F Dickens
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, U.S.A.; Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
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Akhtar M, Wen J, Razick D, Shehabat M, Saeed A, Baig O, Asim M, Tokhi I, Aamer S, Akhtar MB. Mid- to Long-Term Outcomes of Arthroscopic Shoulder Stabilization in Athletes: A Systematic Review. J Clin Med 2023; 12:5730. [PMID: 37685797 PMCID: PMC10488802 DOI: 10.3390/jcm12175730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
There exists a considerable amount of evidence regarding short-term outcomes of shoulder arthroscopy in athletes; however, mid- to long-term data are limited. Therefore, the purpose of this review is to evaluate studies assessing mid- to long-term outcomes and rates of return to sport in athletes undergoing primary shoulder arthroscopy. A search for the systematic review was performed in PubMed, Scopus, and Embase on 14 March 2023. Study parameters, as well as their respective outcomes, were described in detail and compiled into diagrams. Five studies were included, which contained data on a total of 307 shoulders in patients with mean ages ranging from 20.3 to 26.9 years and mean follow-up times ranging from 6.3 to 14 years. The arthroscopic Bankart repair was the primary surgical intervention performed in all five studies. The overall rate of return to sport was 84% (range, 70-100%) across the studies. The rate of return to sport at pre-injury level was 65.2% (range, 40-82.6%) across four studies. The overall rate of recurrent instability was 17.3%, with redislocation specifically occurring in 13.7% of patients across all studies. The overall rate of revision surgery was 11.1%. Athletes who underwent primary shoulder arthroscopy demonstrated favorable outcomes and a high rate of RTS at a minimum follow-up of 5 years. However, rates of recurrent instability, redislocation, and revision surgery occurred at less than favorable numbers, which emphasizes the importance of proper patient selection when considering candidates for arthroscopic versus open repairs.
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Affiliation(s)
- Muzammil Akhtar
- College of Medicine, California Northstate University, Elk Grove, CA 95757, USA; (J.W.); (D.R.); (M.S.); (M.A.); (I.T.)
| | - Jimmy Wen
- College of Medicine, California Northstate University, Elk Grove, CA 95757, USA; (J.W.); (D.R.); (M.S.); (M.A.); (I.T.)
| | - Daniel Razick
- College of Medicine, California Northstate University, Elk Grove, CA 95757, USA; (J.W.); (D.R.); (M.S.); (M.A.); (I.T.)
| | - Mouhamad Shehabat
- College of Medicine, California Northstate University, Elk Grove, CA 95757, USA; (J.W.); (D.R.); (M.S.); (M.A.); (I.T.)
| | - Ali Saeed
- College of Osteopathic Medicine, William Carey University, Hattiesburg, MS 39401, USA;
| | - Osamah Baig
- Lake Erie College of Osteopathic Medicine, Erie, PA 16509, USA;
| | - Maaz Asim
- College of Medicine, California Northstate University, Elk Grove, CA 95757, USA; (J.W.); (D.R.); (M.S.); (M.A.); (I.T.)
| | - Ilham Tokhi
- College of Medicine, California Northstate University, Elk Grove, CA 95757, USA; (J.W.); (D.R.); (M.S.); (M.A.); (I.T.)
| | - Sonia Aamer
- Southern California Orthopedic Institute, Bakersfield, CA 93309, USA;
| | - Muhammad Bilal Akhtar
- Department of Occupational Therapy, University of St. Augustine for Health Sciences, San Marcos, CA 92069, USA;
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Itoigawa Y, Uehara H, Koga A, Morikawa D, Kawasaki T, Shiota Y, Maruyama Y, Ishijima M. Arthroscopic Bankart repair with additional footprint fixation using the double-row technique at the 4 o'clock position anatomically restored the capsulolabral complex and showed good clinical results. Knee Surg Sports Traumatol Arthrosc 2022; 30:3827-3834. [PMID: 35428941 DOI: 10.1007/s00167-022-06974-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 03/29/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE To investigate the clinical outcome and magnetic resonance imaging (MRI) findings after arthroscopic Bankart repair with additional double anchor footprint fixation (DAFF) at the 4 o'clock position, where the native footprint is widest anatomically, for recurrent anterior shoulder instability. METHODS Forty-two patients (mean age 27.0 years) with recurrent anterior shoulder instability and without severe glenoid bone defects underwent arthroscopic Bankart repair with additional DAFF at the 4 o'clock position. Using three standard portals, single-row repair was performed at the 2, 3, and 5 o'clock positions, and DAFF with the suture bridging technique was conducted at the 4 o'clock position. MRI was performed preoperatively and at 6 months postoperatively. Patients with follow-up periods of ≥1 year were included in the present study and clinically evaluated at the final follow-up. The morphology at the 2 and 4 o'clock positions on radial MRI slices was compared between the preoperative and 6-month postoperative scans, and the footprint of the repaired capsulolabral complex at 6 months postoperatively was compared between the 2 and 4 o'clock positions. RESULTS The average follow-up period was 19.5 ± 6.2 months. The rates of dislocation recurrence and positive apprehension test results were 2.4 and 4.8%, respectively. External rotation was restricted by 3.5°. The University of California at Los Angeles and Rowe scores at the final follow-up were 34.5 ± 1.0 points and 97.2 ± 5.7 points, respectively, representing significant improvements over the preoperative scores (p < 0.01). Although the capsulolabral complex at 6 months postoperatively was firmly repaired at both the 2 and 4 o'clock positions compared to its preoperative state, the footprint of the restored capsulolabral complex was wider at the 4 o'clock position than at the 2 o'clock position (p < 0.01). CONCLUSIONS Additional DAFF at the 4 o'clock position improved the glenohumeral stability and function of the shoulder joint. This study suggests that this technique is a reliable and useful treatment for shoulder instability. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Yoshiaki Itoigawa
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan.
| | - Hirohisa Uehara
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Akihisa Koga
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Daichi Morikawa
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Takayuki Kawasaki
- Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Yuki Shiota
- Department of Orthopaedic Surgery, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Yuichiro Maruyama
- Department of Orthopaedic Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba, 279-0021, Japan
| | - Muneaki Ishijima
- Department of Orthopaedic Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan
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Dai F, Yang J, Zhang Q, Li Y, Xiang M. Arthroscopic Autologous Scapular Spine Bone Graft for Recurrent Anterior Shoulder Dislocation With Subcritical (10%-15%) Glenoid Bone Loss. Arthrosc Tech 2022; 11:e1871-e1878. [PMID: 36457382 PMCID: PMC9705272 DOI: 10.1016/j.eats.2022.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 06/27/2022] [Indexed: 11/06/2022] Open
Abstract
For anterior shoulder instability with subcritical glenoid bone loss (10%-15%), there is no consensus on the optimal treatment. Now, we describe the technique of using autogenous scapular spine bone graft for recurrent anterior shoulder dislocation. This procedure can effectively increase the anterior bone barrier and strengthen the effect of Bankart repair. In addition, this procedure not only avoids coracoid or iliac crest transfer, but also adopts nonrigid fixation, which makes it safer and more convenient. We believe that this technique will provide a promising alternative to the surgical treatment of recurrent anterior shoulder dislocation in subcritical glenoid bone loss (10%-15%).
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Affiliation(s)
| | | | | | | | - Ming Xiang
- Address correspondence to Ming Xiang, Ph.D., Department of Upper Limb, Sichuan Provincial Orthopaedic Hospital, Chengdu, 610041, China.
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Krespi R, Maman E, Factor S, Benshabat D, Dolkart O, Ashkenazi I, Beyth S, Chechik O. Combined Bankart and SLAP repair: patient-reported outcome measurements after a minimum 5-year follow-up. Arch Orthop Trauma Surg 2022; 143:2621-2626. [PMID: 36018369 DOI: 10.1007/s00402-022-04599-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 08/20/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Anterior shoulder instability is typically characterized by detachment of the anteroinferior labrum (Bankart lesion). Some patients also sustain a superior labrum anterior-to-posterior (SLAP) injury. The purpose of this study was to compare the medium-term clinical results of isolated anterior Bankart repairs (ABR) with those of combined Bankart and SLAP repair (ABR + SLAP). METHODS Data on all patients treated surgically for recurrent anterior shoulder instability between 2006 and 2011 were retrospectively collected from medical charts. The minimum follow-up was 5 years. Patients were interviewed to assess patient-reported outcome measurements (PROM) as determined by the American Shoulder and Elbow Surgeons Score (ASES), the Subjective Shoulder Score (SSV), and the Disabilities of the Arm, Shoulder, and Hand Score (DASH), as well as their quality of life (QOL: SF12 questionnaire). Information on complications, re-operations, and recurrent instability was recorded and evaluated as well. RESULTS A total of 150 patients (88% males) with a mean age 23.7 years (range 15-40) were included. Forty-two patients following ABR + SLAP repair were compared to 108 patients following ABR alone, with a mean follow-up of 7.8 years (range 5-10.7). The rate of re-dislocation was similar in both groups (26% for ABR + SLAP vs 20% for ABR, p = .44). There were no significant differences in functional outcome between the ABR + SLAP and the ABR alone groups (SSV 86.7 vs 86.5, p = .93, ASES 89.6 vs 86.5, p = .11, and DASH 4.9 vs 7, p = .17), or in QOL outcome (SF12 physical 95.6 vs 93.3, p = .27, SF12 mental 84.4 vs 85.7, p = .63). CONCLUSION Surgical repair for anterior shoulder instability and a coexisting SLAP lesion yields clinical results as good as those of isolated ABR, as evidenced by similar PROM and re-dislocation rates after medium-term follow-up. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Raphael Krespi
- Orthopedic Division, Department of Orthopedic Surgery, Affiliated with the Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv University, 6 Weitzman St., 6423906, Tel Aviv, Israel
| | - Eran Maman
- Orthopedic Division, Department of Orthopedic Surgery, Affiliated with the Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv University, 6 Weitzman St., 6423906, Tel Aviv, Israel
| | - Shai Factor
- Orthopedic Division, Department of Orthopedic Surgery, Affiliated with the Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv University, 6 Weitzman St., 6423906, Tel Aviv, Israel.
| | - Dvir Benshabat
- Orthopedic Division, Department of Orthopedic Surgery, Affiliated with the Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv University, 6 Weitzman St., 6423906, Tel Aviv, Israel
| | - Oleg Dolkart
- Orthopedic Division, Department of Orthopedic Surgery, Affiliated with the Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv University, 6 Weitzman St., 6423906, Tel Aviv, Israel
| | - Itay Ashkenazi
- Orthopedic Division, Department of Orthopedic Surgery, Affiliated with the Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv University, 6 Weitzman St., 6423906, Tel Aviv, Israel
| | - Shaul Beyth
- Department of Orthopedic Surgery, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ofir Chechik
- Orthopedic Division, Department of Orthopedic Surgery, Affiliated with the Sackler Faculty of Medicine, Tel Aviv Medical Center, Tel Aviv University, 6 Weitzman St., 6423906, Tel Aviv, Israel
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Gupta S, Cole WW, Miskimin C, Stamm M, Mulcahey MK. Patients Report A Positive Experience on Social Media After Bankart Repair. Arthrosc Sports Med Rehabil 2022; 4:e1277-e1281. [PMID: 36033168 PMCID: PMC9402415 DOI: 10.1016/j.asmr.2022.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose The purpose of this cross-sectional study was to analyze publicly available posts on Instagram and Twitter to gain an understanding of patients’ perspectives regarding Bankart injuries and repair. Methods Public posts on Instagram and Twitter were queried from June 1, 2019, to June 1, 2020, with the following hashtags: #Bankart #Bankartrepair #Bankartlesion #labrumrepair #labralrepair #shoulderdislocation. Posts that did not contain those hashtags were excluded. In addition, posts that included that hashtag but displayed content unrelated to Bankart repair were excluded. A binary categorical system was used for media format (picture or video), perspective (patient, family or friend, physician, hospital or physical therapy group, professional organization, news media, or industry), timing (preoperative, postoperative, nonoperative), tone (positive, negative, or neutral), content (surgical site, hospital or surgeon, imaging, rehabilitation, activities of daily living [ADLs], return to work, surgical instruments, or education), post popularity (number of likes), and geographic location. Results 1,154 Instagram posts were identified. 722/1,154 posts (62.6%) were made by patients. 600 (52.0%) of the post tones were positive, 407 (35.3%) were neutral, and 667 (57.8%) were postoperative. The most common content included in Instagram posts were ADLs (577; 50.0%), education (233; 20.2%), and rehabilitation (226; 19.6%). Overall, posts had an average of 117 likes and had geotags from 49 different countries. 155 tweets were identified, 92 of which (59.4%) were made by physicians, 113 (72.9%) were neutral, 127 (81.9%) were nonoperative, and the most common type of content posted was education (130; 83.9%). Overall, posts on Twitter had an average of 3.2 likes and had geotags from 4 different countries. Conclusions Instagram posts were made mostly by patients postoperatively and focused on ADLs. The tone of the Instagram posts indicates that a majority of patients have a positive experience with Bankart repair. The majority of tweets were made by physicians and provided educational information with a neutral tone. Clinical Relevance Exploring patient's experiences with Bankart repair on social media provides insight into their overall experience with the surgery. The majority of patients reported a positive experience.
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Affiliation(s)
- Sanchita Gupta
- Tulane University School of Medicine, New Orleans, Louisiana, U.S.A
| | - Wendell W. Cole
- Tulane University School of Medicine, Department of Orthopaedic Surgery, New Orleans, Louisiana, U.S.A
| | - Cadence Miskimin
- Tulane University School of Medicine, Department of Orthopaedic Surgery, New Orleans, Louisiana, U.S.A
| | - Michaela Stamm
- Tulane University School of Medicine, Department of Orthopaedic Surgery, New Orleans, Louisiana, U.S.A
| | - Mary K. Mulcahey
- Tulane University School of Medicine, Department of Orthopaedic Surgery, New Orleans, Louisiana, U.S.A
- Address correspondence to Mary K. Mulcahey, M.D., 1430 Tulane Avenue, #8632, New Orleans, LA 70112, U.S.A.
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