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The role of arthroscopy in the revision of failed Latarjet procedures

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Abstract

Glenohumeral instability is an intrinsic pathological condition of the shoulder, owing to its ample range of mobility that predisposes this joint to a somewhat limited degree of stability. Several techniques have been employed for the treatment of instability. Among these, one is the Latarjet procedure, recommended for cases of substantial bone deficit on the humeral head or on the anterior region of the glenoid. Such technique gives generally good, long-term results, considering the low incidence of recurrence. However, potential complications such as glenohumeral arthrosis, absorption of the bone block, breakage, malpositioning or mobilization of the screws, infections, neurological or vascular complications can be serious. Moreover, as a result of further severe trauma, the shoulder can become again globally unstable. In such cases, the question arises of which technique to employ in surgical revision, since the Latarjet procedure determines substantial subversion of glenohumeral anatomy. The aim of the study was the analysis of arthroscopical treatment after failure of a Latarjet procedure and to describe the related definitive results. During the period between January 2000 and June 2007, we treated 17 patients (18 shoulders) using arthroscopy, following failure of an open Latarjet surgical procedure. One patient was operated bilaterally. Clinical revision according to the Constant Score, ROWE, ASES, UCLA and the VAS scale for pain evaluation was carried out during follow-up examination after an average period of 5 years and 9 months (min. 2 years–max. 9 years) from latest surgery. The system of evaluation according to the Constant Score indicated an average score of 78.4/100 at follow-up examination; UCLA indicated 27.2/35; ASES 99.6/120; ROWE 75.2/100. With regard to pain, the VAS Scale indicated an average score of 2.9/10. As criteria for relapse, we considered classic cases of dislocation and subluxations, or sprains with subluxation, and subjectively experienced apprehension and pain to a degree that seriously inhibited the patient’s daily life. The incidence of relapse following the final surgical operation (taking into consideration both frank dislocations and subluxations) was 16.7%. At clinical revision, one patient showed dislocation due to relatively modest trauma ~1 year following the second surgery (5.6%). Episodes of subluxation or sprains continued in 2 shoulders (11.1% relapse). In 11 cases (61%), return to sports activities was achieved. Arthroscopy technique using anchors and sutures can, in selected cases, lead to satisfactory results, allowing, by means of minimal surgical invasion, identification and treatment also of intra-articular lesions, where associated.

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References

  1. Latarjet M (1954) A propos du traitement des luxations récidivantes de l’épaule. Lyon chir 49:994–1003

    CAS  PubMed  Google Scholar 

  2. Salvi AE, Paladini P, Campi F, Porcellini G (2005) The Bristow-Latarjet method in the treatment of shoulder instability that cannot be resolved by arthroscopy. A review of the literature and technical-surgical aspects. Chir Organi Mov 90(4):353–364

    CAS  PubMed  Google Scholar 

  3. Hill HA, Sachs MD (1940) The grooved defect of the humeral head. A frequently unrecognized complication of dislocations of the shoulder joint. Radiology 35:690–700

    Google Scholar 

  4. Levigne C (2000) Long term results of anterior coracoid abutment. A propos of 52 cases with homogenous 12 years follow-up. Rev Chir Orthop Reparatrice Apparat Mot 86(1):114–121

    Google Scholar 

  5. Walch G (1991) La luxation récidivante antérieure de l’épaule. Rev Chir Orthop 77(1):177–191

    Google Scholar 

  6. Bach BR Jr (1990) Arthroscopic removal of painful Bristow hardware. Arthroscopy 6(4):324–326

    PubMed  Google Scholar 

  7. Stromqvist B, Wingstrand H, Eqund N (1987) Recurrent shoulder dislocation and screw failure after the Bristow-Latarjet procedure. A case report. Arch Orthop Trauma Surg 106(4):260–262

    Article  CAS  PubMed  Google Scholar 

  8. Clavert P, Lutz JC, Wolfram-Gabel R, Kempf JF, Kahn JL (2009) Relationship of the musculocutaneous nerve and the coracobrachialis during coracoid abutement procedure (Latarjet procedure). Surg Radiol Anat 31(1):49–53

    Article  PubMed  Google Scholar 

  9. Allain J, Goutallier D, Glorion C (1998) Long term results of the Latarjet procedure for the treatment of anterior instability of the shoulder. J Bone Joint Surg Am 80:841–852

    Article  CAS  PubMed  Google Scholar 

  10. Molé D, Villanueva E, Caudane H, De Gasperi M (2000) Results of more 10 years experience of open procedures. Rev Chir Reparatrice Apparat Mot 86(suppl 1):111–114

    Google Scholar 

  11. Morrey BF, Janes JM (1976) Recurrent anterior dislocation of the shoulder: long term follow-up of Putti Platt and Bankart procedures. J.Bone Joint Surg 58A:252–256

    Google Scholar 

  12. O’Driscoll SW, Evans DC (1988) The Du Toit staple capsulorrhaphy for recurrent anterior dislocation of the shoulder: twenty years of experience in six Toronto Hospitals. Presented at the American Shoulder and Elbow Surgeons 4th open meeting. Atlanta

  13. Rovesta C, Marongiu MC, Fregni U, Minervini C, Celli A, Celli L (2003) Trattamento della instabilità di spalla postoperatoria. GIOT 29(2):70–76

    Google Scholar 

  14. Nicolosi M (2005) Oblique capsular shift in anterior and antero-inferior shoulder instability. Chir Organi Mov 90(2):137–143

    Google Scholar 

  15. Porcellini G, Castagna A, Campi F, Paladini P (2003) La spalla, patologia, tecnica chirurgica, riabilitazione. Verduci editore

  16. Matsen FA et al (1990) Glenohumeral instability in Rockwood C.A. “The shoulder”. W.B. Sounders, Philadelphia, p 585

  17. Rockwood CA, Gerber C (1985) Analysis of failed surgical procedures for anterior shoulder instability. Orthop Trans 9(1):48

    Google Scholar 

  18. Hovelius L et al (1983) Bristow-Latarjet procedure for recurrent anterior dislocation of the shoulder. Acta Orthop Scand 54:284–290

    CAS  PubMed  Google Scholar 

  19. Lane JG, Sachs RA, Riehl B (1993) Arthroscopic staple capsulorrhaphy. A long term follow-up. Arthroscopy 9:190–194

    Article  CAS  PubMed  Google Scholar 

  20. Kandziora F, Jager A, Bishof F et al (2000) Arthroscopic labrum refixation for post-traumatic anterior shoulder instability: suture anchor versus transglenoid fixation technique. Arthroscopy 16:359–366

    Article  CAS  PubMed  Google Scholar 

  21. Snyder SJ, Strafford BB (1993) Arthroscopic management of instability of the shoulder. Orthopaedics 16:993–1002

    CAS  Google Scholar 

  22. Tauro JC (2000) Arthroscopic inferior capsular split and advancement for anterior and inferior shoulder instability: technique and results at 2 to 5 year follow-up. Arthroscopy 16(5):451–456

    Article  CAS  PubMed  Google Scholar 

  23. Wolf EM (1993) Arthroscopic capsulolabral repair using suture anchors. Orthop Clin North Am 24:59–69

    CAS  PubMed  Google Scholar 

  24. Kim SH, Ha KI, Kim YM (2002) Bankart repair in traumatic anterior shoulder instability: open versus arthroscopic technique. Arthroscopy 18(7):755–763

    Article  PubMed  Google Scholar 

  25. Paladini P, Campi F, Paganelli M, Porcellini G (2005) Comparison between arthroscopic and arthrotomy in the treatment of shoulder instability. Chir Organi Mov 90(1):1–10

    CAS  PubMed  Google Scholar 

  26. Cole BJ, L’Insalata J, Irrgang J et al (2000) Comparison of arthroscopic and open anterior shoulder stabilization. J Bone Joint Surg Am 82:1108–1114

    Article  PubMed  Google Scholar 

  27. Randelli M, Maradei L, Markopoulos N, Castagna A (2008) Incidence of risk in shoulder surgery: medico-legal repercussions. Chir Organi Mov 91(2):125–131

    Article  PubMed  Google Scholar 

  28. Uhorchak JM, Arciero RA, Huggard D, Taylor DC (2000) Recurrent shoulder instability after open reconstruction in athletes involved in collision and contact sports. Am J Sports Med 28(6):794–799

    CAS  PubMed  Google Scholar 

  29. Rowe CR et al (1984) Recurrent anterior dislocation of the shoulder after surgical repair. Apparent causes of failure and treatment. J Bone Joint Surg 66A:159–168

    Google Scholar 

  30. Baudi P, Righi P, Bolognesi D, Rivetta S, Rossi Urtoler E, Guicciardi N, Carrara M (2005) How to identify and calculate glenoid bone deficit. Chir Organi Mov 90(2):145–152

    CAS  PubMed  Google Scholar 

  31. Hawkins RH, Hawkins RJ (1985) Failed anterior reconstruction for the shoulder instability. J Bone Joint Surg 67B(5):709–714

    Google Scholar 

  32. Odella S, Orestilli A, Odella F (2003) Instabilità di spalla: errori di strategia chirurgica. GIOT 29(suppl 2):63–69

    Google Scholar 

  33. Pichon H, Startun V, Barthelemy R, Saragaglia D (2008) Comparative study of the anatomic and clinical effect of Weaver or subtotal subscapularis tendon section in Latarjet procedure. Rev Chir Orthop Reparatrice Appar Mot 94(1):12–18

    Google Scholar 

  34. Arrigoni P, Huberty D, Brady PC, Weber IC, Burkhart SS (2008) The value of arthroscopy before an open modified latarjet reconstruction. Arthroscopy 24(5):514–519

    Article  PubMed  Google Scholar 

  35. 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 

  36. 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(2):156–160

    CAS  PubMed  Google Scholar 

  37. Balg F, Boileau P (2007) The instability severity index score. A simple pre-operative score to select patients for arthroscopic or open shoulder stabilization. J Bone Joint Surg Br 89(11):1470–1477

    Google Scholar 

  38. Grana WA et al (1993) Arthroscopic Bankart suture repair. Am J Sports Med 21(3):348–353

    Article  CAS  PubMed  Google Scholar 

  39. Boileau P, Villalba M, Héry JY, Balg F, Ahrens P, Neyton L (2006) Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg Am 88(8):1755–1763

    Article  PubMed  Google Scholar 

  40. Kim SH, Ha KI, Cho YB, Ryv BD, Oh I (2003) Arthroscopic anterior stabilization of the shoulder: two to six year follow-up. J Bone Joint Surg Am 85A(8):1511–1518

    Google Scholar 

  41. Russo R, Giudice G, Ciccarelli M, Vernaglia Lombardi L, Cautiero F (2005) Antero-inferior shoulder instability: treatment based on the Thal method. Chir Organi Mov 90(2):137–143

    CAS  PubMed  Google Scholar 

  42. Green MR, Christensen KP (1995) Arthroscopic Bankart procedure:2–5 year follow-up with clinical correlation to severity of glenoid labral lesion. Am J Sports Med 23:276–281

    Article  CAS  PubMed  Google Scholar 

  43. Pagnani MJ, Dome DC (2002) Surgical treatment of traumatic anterior shoulder instability in American football players. J Bone Joint Surg Am 84:711–715

    PubMed  Google Scholar 

  44. Castagna A, Garofalo R, Conti M, Randelli M (2005) Reverse Hagl: a possibile complication of a tight anterior gleno-humeral stabilization. Chir Organi Mov 90(2):201–207

    CAS  PubMed  Google Scholar 

  45. Schippinger G, Vasiu PS, Fankhauser F, Clement HG (2001) HAGL: lesion occurring after successful arthroscopic Bankart repair. Arthroscopy 17(2):206–208

    Article  CAS  PubMed  Google Scholar 

  46. Shaffer BS, Tibone JE (1999) Arthroscopic shoulder instability surgery complications. Clin Sports Med 18(4):737–767

    Article  CAS  PubMed  Google Scholar 

  47. Kim SH, Ha KI, Kim YM (2002) Arthroscopic revision Bankart repair: a prospective outcome study. Arthroscopy 18(5):469–482

    Article  PubMed  Google Scholar 

  48. Neri BR, Tuckman DV, Bravman JT, Yim D, Sahaipal DT, Rokito AS (2007) Arthroscopic revision of Bankart repair. J Shoulder Elbow Surg 16(4):419–424

    Article  PubMed  Google Scholar 

  49. Castagna A, Conti M, Borroni M, Massazza G, Vinci E, Franceschi G, Garofalo R (2008) Posterior shoulder pain and anterior instability: a preliminary clinical study. Chir Organi Mov 91(2):79–83

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Itlay

    Alessandro Castagna, Gianluca Melito & Nikolaos Markopoulos

  2. Ospedale Miulli, Acquaviva delle Fonti, Bari, Itlay

    Raffaele Garofalo

  3. Istituto di Clinica Ortopedica, Università di Bari, Bari, Itlay

    Silvana De Giorgi

  4. Via Padova 13 Santeramo in Colle-Ba, Bari, Itlay

    Raffaele Garofalo

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  1. Alessandro Castagna
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  2. Raffaele Garofalo
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  3. Gianluca Melito
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  4. Nikolaos Markopoulos
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  5. Silvana De Giorgi
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Correspondence to Raffaele Garofalo.

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Castagna, A., Garofalo, R., Melito, G. et al. The role of arthroscopy in the revision of failed Latarjet procedures. Musculoskelet Surg 94 (Suppl 1), 47–55 (2010). https://doi.org/10.1007/s12306-010-0060-0

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