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Clinical outcomes following revision anterior shoulder arthroscopic capsulolabral stabilization

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Traditionally surgeons have treated failed shoulder instability with open capsulolabral repair. Despite improved instrumentation, technique and familiarity in shoulder arthroscopy, few studies have reported the outcomes of arthroscopic revision shoulder instability repair. The purpose of this study was to assess clinical outcomes in patients following revision shoulder arthroscopic anterior capsulolabral stabilization.

Materials and methods

Sixty-two patients (63 shoulders) with failure of primary instability repairs were treated with revision arthroscopic anterior shoulder stabilization at a mean follow-up of 46.9 ± 16.8 months (range 18–78). Clinical outcomes were evaluated using validated patient-reported outcome questionnaires including the American Shoulder and Elbow Surgeons score, Simple Shoulder Test, visual analog pain scale and Western Ontario Shoulder Instability Index. In addition, patients were queried for recurrent instability events (subluxation or dislocation) or revision surgery.

Results

At final follow-up, the mean postoperative Western Ontario Shoulder Instability normalized score was 80.1 ± 18.7 (range 15.0–100). There were clinically significant improvements in American Shoulder and Elbow Surgeons scores, Simple Shoulder Test scores and ten-point visual analog scale for pain (P < 0.001). Recurrent instability occurred in 12 shoulders (19.0 %), with number of prior surgeries and hyperlaxity found to be significant risk factor for failure (P < 0.001 and P = 0.04, respectively).

Conclusion

Revision arthroscopic anterior stabilization of the shoulder can result in satisfactory outcomes in appropriately selected patients who have failed previous capsulolabral repair. An increased number of prior surgeries and hyperlaxity are predictive of poor outcome.

Study design

Case series, LOE IV.

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References

  1. Abouali JA, Hatzantoni K, Holtby R, Veillette C, Theodoropoulos J (2013) Revision arthroscopic Bankart repair. Arthroscopy 29:1572–1578

    Article  PubMed  Google Scholar 

  2. Arce G, Arcuri F, Ferro D, Pereira E (2012) Is selective arthroscopic revision beneficial for treating recurrent anterior shoulder instability? Clin Orthop Relat Res 470:965–971

    Article  PubMed Central  PubMed  Google Scholar 

  3. Barnes CJ, Getelman MH, Snyder SJ (2009) Results of arthroscopic revision anterior shoulder reconstruction. Am J Sports Med 37:715–719

    Article  PubMed  Google Scholar 

  4. Bartl C, Schumann K, Paul J, Vogt S, Imhoff AB (2011) Arthroscopic capsulolabral revision repair for recurrent anterior shoulder instability. Am J Sports Med 39:511–518

    Article  PubMed  Google Scholar 

  5. Bedi A, Ryu RK (2010) Revision arthroscopic Bankart repair. Sports Med Arthrosc 18:130–139

    Article  PubMed  Google Scholar 

  6. Boileau P, Richou J, Lisai A, Chuinard C, Bicknell RT (2009) The role of arthroscopy in revision of failed open anterior stabilization of the shoulder. Arthroscopy 25:1075–1084

    Article  PubMed  Google Scholar 

  7. Bottoni CR, Smith EL, Berkowitz MJ, Towle RB, Moore JH (2006) Arthroscopic versus open shoulder stabilization for recurrent anterior instability: a prospective randomized clinical trial. Am J Sports Med 34:1730–1737

    Article  PubMed  Google Scholar 

  8. Castagna A, Garofalo R, Melito G, Markopoulos N, De Giorgi S (2010) The role of arthroscopy in the revision of failed Latarjet procedures. Musculoskelet Surg 94(Suppl 1):S47–S55

    Article  PubMed  Google Scholar 

  9. Cho NS, Yi JW, Lee BG, Rhee YG (2009) Revision open Bankart surgery after arthroscopic repair for traumatic anterior shoulder instability. Am J Sports Med 37:2158–2164

    Article  PubMed  Google Scholar 

  10. Creighton RA, Romeo AA, Brown FM Jr, Hayden JK, Verma NN (2007) Revision arthroscopic shoulder instability repair. Arthroscopy 23:703–709

    Article  PubMed  Google Scholar 

  11. Fabbriciani C, Milano G, Demontis A, Fadda S, Ziranu F, Mulas PD (2004) Arthroscopic versus open treatment of Bankart lesion of the shoulder: a prospective randomized study. Arthroscopy 20:456–462

    Article  PubMed  Google Scholar 

  12. Franceschi F, Longo UG, Ruzzini L, Rizzello G, Maffulli N, Denaro V (2008) Arthroscopic salvage of failed arthroscopic Bankart repair: a prospective study with a minimum follow-up of 4 years. Am J Sports Med 36:1330–1336

    Article  PubMed  Google Scholar 

  13. Gartsman GM, Roddey TS, Hammerman SM (2000) Arthroscopic treatment of anterior–inferior glenohumeral instability. Two to five-year follow-up. J Bone Joint Surg Am 82-A:991–1003

  14. Gerber C, Nyffeler RW (2002) Classification of glenohumeral joint instability. Clin Orthop Relat Res 400:65–76

    Article  PubMed  Google Scholar 

  15. Gerometta A, Rosso C, Klouche S, Hardy P (2014) Arthroscopic Bankart shoulder stabilization in athletes: return to sports and functional outcomes. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-2984-7

    Google Scholar 

  16. Kim SH, Ha KI, Cho YB, Ryu BD, Oh I (2003) Arthroscopic anterior stabilization of the shoulder: two to six-year follow-up. J Bone Joint Surg Am 85-A:1511–1518

  17. Kropf EJ, Tjoumakaris FP, Sekiya JK (2007) Arthroscopic shoulder stabilization: is there ever a need to open? Arthroscopy 23:779–784

    Article  PubMed  Google Scholar 

  18. Krueger D, Kraus N, Pauly S, Chen J, Scheibel M (2011) Subjective and objective outcome after revision arthroscopic stabilization for recurrent anterior instability versus initial shoulder stabilization. Am J Sports Med 39:71–77

    Article  PubMed  Google Scholar 

  19. Krueger D, Kraus N, Pauly S, Chen J, Scheibel M (2011) Subjective and objective outcome after revision arthroscopic stabilization for recurrent anterior instability versus initial shoulder stabilization. Am J Sports Med 39:71–77

    Article  PubMed  Google Scholar 

  20. Lehmann M, HaberMeyer P, Lichtenberg S, Werner A (1996) Arthroscopic revision surgery in shoulder instability. J Shoulder Elbow Surg 5:S67

    Article  Google Scholar 

  21. Levine WN, Arroyo JS, Pollock RG, Flatow EL, Bigliani LU (2000) Open revision stabilization surgery for recurrent anterior glenohumeral instability. Am J Sports Med 28:156–160

    CAS  PubMed  Google Scholar 

  22. Lo IK, Parten PM, Burkhart SS (2004) The inverted pear glenoid: an indicator of significant glenoid bone loss. Arthroscopy 20:169–174

    Article  PubMed  Google Scholar 

  23. Manta JP, Organ S, Nirschl RP, Pettrone FA (1997) Arthroscopic transglenoid suture capsulolabral repair. Five-year followup. Am J Sports Med 25:614–618

    Article  CAS  PubMed  Google Scholar 

  24. Meehan RE, Petersen SA (2005) Results and factors affecting outcome of revision surgery for shoulder instability. J Shoulder Elbow Surg 14:31–37

    Article  PubMed  Google Scholar 

  25. Millar NL, Murrell GA (2008) The effectiveness of arthroscopic stabilisation for failed open shoulder instability surgery. J Bone Joint Surg Br 90:745–750

    Article  CAS  PubMed  Google Scholar 

  26. Neri BR, Tuckman DV, Bravman JT, Yim D, Sahajpal DT, Rokito AS (2007) Arthroscopic revision of Bankart repair. J Shoulder Elbow Surg 16:419–424

    Article  PubMed  Google Scholar 

  27. Patel RV, Apostle K, Leith JM, Regan WD (2008) Revision arthroscopic capsulolabral reconstruction for recurrent instability of the shoulder. J Bone Joint Surg Br 90:1462–1467

    Article  CAS  PubMed  Google Scholar 

  28. Provencher MT, Ghodadra N, Romeo AA (2010) Arthroscopic management of anterior instability: pearls, pitfalls, and lessons learned. Orthop Clin North Am 41:325–337

    Article  PubMed  Google Scholar 

  29. Rouleau DM, Faber K, MacDermid JC (2010) Systematic review of patient-administered shoulder functional scores on instability. J Shoulder Elbow Surg 19:1121–1128

    Article  PubMed  Google Scholar 

  30. Rowe CR, Zarins B, Ciullo JV (1984) Recurrent anterior dislocation of the shoulder after surgical repair. Apparent causes of failure and treatment. J Bone Joint Surg Am 66:159–168

    CAS  PubMed  Google Scholar 

  31. Schmid SL, Farshad M, Catanzaro S, Gerber C (2012) The Latarjet procedure for the treatment of recurrence of anterior instability of the shoulder after operative repair: a retrospective case series of forty-nine consecutive patients. J Bone Joint Surg Am 94:e75

    Article  PubMed  Google Scholar 

  32. Sisto DJ (2007) Revision of failed arthroscopic Bankart repairs. Am J Sports Med 35:537–541

    Article  PubMed  Google Scholar 

  33. Zabinski SJ, Callaway GH, Cohen S, Warren RF (1999) Revision shoulder stabilization: 2- to 10-year results. J Shoulder Elbow Surg 8:58–65

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, University of Saskatchewan, Saskatoon, SK, Canada

    Jason J. Shin

  2. Department of Orthopedic Surgery, University of Texas Health Science Center at Houston, Houston, TX, USA

    Randy Mascarenhas

  3. Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Anish V. Patel, Adam B. Yanke, Gregory P. Nicholson, Brian J. Cole, Anthony A. Romeo & Nikhil N. Verma

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  1. Jason J. Shin
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  2. Randy Mascarenhas
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  3. Anish V. Patel
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  4. Adam B. Yanke
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  8. Nikhil N. Verma
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Corresponding author

Correspondence to Jason J. Shin.

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Conflict of interest

NN Verma is a consultant for Smith and Nephew, BJ Cole is a consultant for Arthrex, AA Romeo is a consultant for Arthrex, GP Nicholson is consultant for Tornier, and other authors have no potential conflicts of interest in relation to this article.

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Shin, J.J., Mascarenhas, R., Patel, A.V. et al. Clinical outcomes following revision anterior shoulder arthroscopic capsulolabral stabilization. Arch Orthop Trauma Surg 135, 1553–1559 (2015). https://doi.org/10.1007/s00402-015-2294-7

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  • DOI: https://doi.org/10.1007/s00402-015-2294-7

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