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Arthroscopic Trillat procedure combined with capsuloplasty: an effective treatment modality for shoulder instability associated with hyperlaxity

  • SHOULDER
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study was to describe the results of an arthroscopic Trillat procedure utilized to treat patients with symptomatic antero-inferior shoulder instability associated with hyperlaxity.

Methods

A retrospective review was performed on 19 consecutive shoulders (17 patients, 2 bilateral) who underwent a Trillat procedure combined with anterio-inferior capsulolabral plasty from 2016 to 2019. Patients included in the study presented with shoulder instability combined with shoulder hyperlaxity and no glenoid or humeral bone loss. Clinical assessment included range of motion, apprehension, and instability tests. Outcome measures Constant–Murley score (CMS) scale, Walch-Duplay, ROWE, Subjective Shoulder Value (SSV), Visual Analogue Scale (VAS). Post-operatively, healing of the coracoid osteoclasy was evaluated by CT scan.

Results

The mean follow-up was 24.8 months (range, 12–51). Post-operatively, none of the patients experienced a recurrent dislocation or subluxation and the anterior apprehension test was negative in all shoulders. Post-operative motion deficits of 22.1° ± 15.8 [p < 0.05] and 12.4° ± 10.1 [p < 0.05] loss were documented for ER1 and ER2, respectively. All functional scores exhibited significant improvements. Post-operative CT scan was available in 16 shoulders and revealed coracoid union in 15/16 shoulders and an asymptomatic fibrous non-union without coracoid or implant migration in one patient.

Conclusion

The arthroscopic Trillat procedure combined with an antero-inferior capsulolabral plasty is effective in preventing recurrent instability and eliminating shoulder apprehension among patients suffering from anterior and or inferior hyperlaxity.

Level of evidence

Level IV.

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Authors and Affiliations

  1. Paris Shoulder Unit, Clinique Bizet, 22 Rue Georges Bizet, 75116, Paris, France

    Efi Kazum, Natalia Martinez-Catalan, Jean David Werthel & Philippe Valenti

  2. Beaujon Hospital APHP, 100 Boulevard General Leclerc, 92110, Clichy, France

    Rejeb Oussama

  3. Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Efi Kazum

  4. Hopital Ambroise Pare, 9 Avenue Charles de Gaulle, 92100, Boulogne-Billancourt, France

    Jean David Werthel

  5. Medical University of South Carolina, 96 Jonathan Lucas St, Charleston, SC, 29425, USA

    Josef Karl Eichinger

  6. Hospital Fundacion Jimenez Diaz, Avenida Reyes Catolicos 2, 28040, Madrid, Spain

    Natalia Martinez-Catalan

Authors
  1. Efi Kazum
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  2. Natalia Martinez-Catalan
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  3. Rejeb Oussama
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  4. Josef Karl Eichinger
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  5. Jean David Werthel
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  6. Philippe Valenti
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Contributions

EK—literature search, data analysis, data interpretation, and writing. NM-C—data collection, data analysis, and data interpretation. RO—data collection, data analysis, and data interpretation. JKE—literature search, study design, data analysis, data interpretation, and writing. JDW—literature search, study design, data analysis, data interpretation, and writing. PV—literature search, study design, data analysis, data interpretation, and writing.

Corresponding author

Correspondence to Efi Kazum.

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Conflicts of interest

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Ethical approval

This study was classified as observational (non-interventional) by our local ethics committee Statutory and ethical obligations of observational (non-interventional) studies in France: According to the past Huriet law on biomedical research, and to the current regulation that went into effect in August 2006 (law no. 2004-806), such studies do not require prior submission or approval to/from an IRB, and they do not require written consent. There is a current discrepancy on observational studies between the French legal requirements and the editors’ requirements. This observational research on data fulfills current French regulatory and ethical obligations.

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Kazum, E., Martinez-Catalan, N., Oussama, R. et al. Arthroscopic Trillat procedure combined with capsuloplasty: an effective treatment modality for shoulder instability associated with hyperlaxity. Knee Surg Sports Traumatol Arthrosc 30, 2067–2073 (2022). https://doi.org/10.1007/s00167-021-06752-z

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  • DOI: https://doi.org/10.1007/s00167-021-06752-z

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