Abstract
Introduction:
Management of glenohumeral instability focuses more on operative treatment, while non-operative management, especially in young, active patients, may cause recurrent instability in a high percentage.
Aim:
Management of anterior glenohumeral instability, their advantages and limitations, the operative techniques and results will be described and discussed.
Materials and Methods:
A total of 379 patients who were operated between 1985 and 1994 for recurrent shoulder instability were followed up; 110 patients were managed with open Bankart procedure, 165 patients with arthroscopic Bankart and 98 patients were treated with a bone-block procedure. Follow-up evaluation was performed 53 months on average postoperatively. According to Rowe the functional results were classified as excellent and good in 91% with the open Bankart procedure, 80.6% with the arthroscopic Bankart repair and the results using the bone-block were rated as excellent and good in 95.4%. Overall complication rate was 16.3% (arthroscopic), 6.4% (open Bankart) and 4.4% (bone-block group). In patients with long-time results, degenerative signs at the glenoid and/or the humeral head were evaluated on plane radiographs (according to Rosenberg). In 17 long-term results of the bone-block procedure, Stage I osteoarthritis was identified in 25.5%, but no severe osteoarthrosis (stage II or III), while in the open Bankart group an osteoarthrosis rate of 18.6% (stages II and III) was found.
Conclusion:
Different types and causes of glenohumeral instability recommend different techniques for operative treatment of anterior glenohumeral instability. The bone-block procedure provided the best results regarding stability and function; long-term radiological results indicate that bony repair prevents and does not cause osteoarthrosis.
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Wambacher, M., Smekal, V., Dallapozza, C. et al. Operative Management of Anterior Glenohumeral Instability. Eur J Trauma 32, 340–349 (2006). https://doi.org/10.1007/s00068-006-1000-4
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DOI: https://doi.org/10.1007/s00068-006-1000-4