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Complications after arthroscopic labral repair for shoulder instability

  • Shoulder Surgery: Complications (X Li, Section Editor)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Arthroscopic labral repair is a widely performed and safe technique for anterior or posterior shoulder instability; however, complications have been reported in the literature. Postoperative injection of local anesthetic via an intra-articular pain pump should be avoided to prevent chondrolysis of the glenohumeral joint. Postoperative stiffness of the shoulder can be treated with physiotherapy, and a surgical treatment is indicated in shoulders that failed a conservative treatment. Although nerve injury is relatively rare, the axillary nerve should be given careful attention. Recurrent shoulder instability is the most common complication after labral repair, but most reported rates of recurrent instability after arthroscopic Bankart repair are less than 10 %. Augmentations, such as rotator interval closure and Hill-Sachs remplissage, have a potential to reduce the rate of recurrence. A better understanding of these possible complications, including their pathology and treatment, is essential for optimization of outcomes after arthroscopic labral repair.

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References

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  1. 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 

  2. Randelli P, Ragone V, Carminati S, Cabitza P. Risk factors for recurrence after Bankart repair—a systematic review. Knee Surg Sports Traumatol Arthrosc. 2012;20:2129–38.

    Article  CAS  PubMed  Google Scholar 

  3. 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 

  4. 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 

  5. Ahmed I, Ashton F, Robinson CM. Arthroscopic Bankart repair and capsular shift for recurrent anterior shoulder instability—functional outcomes and identification of risk factors for recurrence. J Bone Joint Surg. 2012;94-A:1308–15.

    Article  Google Scholar 

  6. Brilakis E, Mataragas E, Deligeorgis A, Maniatis V, Antonogiannakis E. Midterm outcomes of arthroscopic remplissage for the management of recurrent anterior shoulder instability. Knee Surg Sports Traumatol Arthrosc. 2014 [Epub ahead of print]

  7. 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 

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

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

    CAS  PubMed  Google Scholar 

  10. 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 

  11. Lim TK, Koh KH, Lee SH, Shon MS, Bae TS, Park WH, et al. Inferior anchor cortical perforation with arthroscopic Bankart repair: cadaveric study. Arthroscopy. 2013;29:31–6.

    Article  PubMed  Google Scholar 

  12. Frank RM, Mall NA, Gupta D, Shewman E, Wang VM, Romeo AA, 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 

  13. 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 

  14. 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 

  15. Sanders TG, Zlatkin MB, Paruchuri NB, Higgins RW. Chondrolysis of the glenohumeral joint after arthroscopy: findings on radiography and low-field-strength MRI. AJR Am J Roentgenol. 2007;188:1094–8.

    Article  PubMed  Google Scholar 

  16. Anderson SL, Buchko JZ, Taillon MR, Ernst MA. Chondrolysis of the glenohumeral joint after infusion of bupivacaine through and intra-articular pain pump catheter: a report of 18 cases. Arthroscopy. 2010;26:451–61.

    Article  PubMed  Google Scholar 

  17. 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 

  18. 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 

  19. 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 

  20. 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 

  21. 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 Shoulder Elbow Surg. 2010;19:944–9.

    Article  PubMed  Google Scholar 

  22. Bailie DS, Ellenbecker TS. Severe chondrolysis after shoulder arthroscopy: a case series. J Shoulder Elbow Surg. 2009;18:742–7.

    Article  PubMed  Google Scholar 

  23. 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. This article analyzed all published cases of glenohumeral chondrolysis and provides the evidence that chondrolysis was associated with the intra-articular infusion of local anesthetic via a pain pump.

    Article  Google Scholar 

  24. Hovelius L, Saeboe M. Neer Award 2008: Arthropathy after primary anterior shoulder dislocation—223 shoulders prospectively followed up for twenty-five years. J Shoulder Elbow Surg. 2009;18:339–47.

    Article  PubMed  Google Scholar 

  25. Kavaja L, Pajarinen J, Sinisaari I, Savolainen V, Björkenheim JM, Haapamäki V, et al. Arthrosis of glenohumeral joint after arthroscopic Bankart repair: a long-term follow-up of 13 years. J Shoulder Elbow Surg. 2012;21:350–5.

    Article  PubMed  Google Scholar 

  26. 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 

  27. Harris JD, Gupta AK, Mall NA, Abrams GD, McCormick FM, Cole BJ, et al. Long-term outcomes after Bankart shoulder stabilization. Arthroscopy. 2013;29:920–33.

    Article  PubMed  Google Scholar 

  28. Elmulund AO, Kartus J, Rostgård-Christensen L, Sernert N, Magnusson L, Ejerhed L. A 7-year prospective, randomized, clinical, and radiographic study after arthroscopic Bankart reconstruction using 2 different types of absorbable tack. Am J Sports Med. 2009;37:1930–7.

    Article  Google Scholar 

  29. 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. This article proposes a novel arthroscopic solution for a selective loss of external rotation after surgical stabilization of anterior instability.

    Article  PubMed  Google Scholar 

  30. 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 

  31. 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 

  32. Chechik O, Maman E, Dolkart O, Khashan M, Shabtai L, Mozes G. Arthroscopic rotator interval closure in shoulder instability repair: a retrospective study. J Shoulder Elbow Surg. 2010;19:1056–62.

    Article  PubMed  Google Scholar 

  33. Connolly J. Humeral head defects associated with shoulder dislocations. AAOS Instr Course Lect. 1972;1972:42–54.

    Google Scholar 

  34. 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 

  35. Purchase RJ, Wolf EM, Hobgood ER, Pollack ME, Smalley CC. Hill-Sachs “remplissage”: an arthroscopic solution for the engaging Hill-Sachs lesion. Arthroscopy. 2008;24:723–6.

    Article  PubMed  Google Scholar 

  36. 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 

  37. 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. This article reports mid- to long-term outcomes of Hill-Sachs remplissage and gives us evidence that the remplissage technique is effective for prevention of recurrent instability.

    Article  PubMed  Google Scholar 

  38. Zhu YM, Zhang J, Shen JW, Jiang CY. Arthroscopic Bankart repair combined with remplissage technique for the treatment of anterior shoulder instability with engaging Hill-Sachs lesion: a report of 49 cases with a minimum 2-year follow-up. Am J Sports Med. 2011;39:1640–7.

    Article  PubMed  Google Scholar 

  39. Leroux T, Bhatti A, Khoshbin A, Wasserstein D, Henry P, Marks P, et al. Combined arthroscopic Bankart repair and remplissage for recurrent shoulder instability. Arthroscopy. 2013;29:1693–701.

    Article  PubMed  Google Scholar 

  40. 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 

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Conflict of Interest

Keisuke Matsuki and Hiroyuki Sugaya declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by the authors.

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Authors and Affiliations

  1. Shoulder and Elbow Center, Funabashi Orthopaedic Hospital, 1-833 Hazama, Funabashi, Chiba, 2740822, Japan

    Keisuke Matsuki & Hiroyuki Sugaya

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  1. Keisuke Matsuki
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  2. Hiroyuki Sugaya
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Correspondence to Keisuke Matsuki.

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This article is part of the Topical Collection on Shoulder Surgery: Complications

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Matsuki, K., Sugaya, H. Complications after arthroscopic labral repair for shoulder instability. Curr Rev Musculoskelet Med 8, 53–58 (2015). https://doi.org/10.1007/s12178-014-9248-5

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