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Acta Ortopédica Mexicana

ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología
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2009, Number 5

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Acta Ortop Mex 2009; 23 (5)

Clinical and functional course of patients after arthroscopic repair of a Bankart lesion

Barrios-Moyano A, Negrete-Corona J, Chávez-Hinojosa E
Full text How to cite this article

Language: Spanish
References: 11
Page: 281-285
PDF size: 89.07 Kb.


Key words:

instability, shoulder, arthroplasty.

ABSTRACT

Objective: Show the experience of the Orthopedics Service at Lic. Adolfo López Mateos Regional ISSSTE Hospital, in the management of anterior unidirectional shoulder instability with an arthroscopic technique consisting of reattaching the labrum in the glenoid with anchored sutures and capsular tightening with radiofrequency. Material and methods: Twenty-six patients with anterior unidirectional shoulder instability who were operated-on between August 2006 and November 2008 were included. Twelve patients underwent capsular re-tightening with radiofrequency and in 14 patients the latter was combined with sutured anchors. The patients selected had a history of relapsing glenohumeral dislocations and subluxations with anterior instability, with or without associated Bankart lesions, and all of them were young. Results: The results were assessed basically with the functional UCLA scale and considering the occurrence of any instability-related event during the postoperative follow-up; from this perspective, there were no cases of recurrent instability. Two cases reported severe postoperative pain, and one had irritation of the sutures; 6 patients had residual limitation of combined lateral rotation and abduction movements, with a mean of 10° compared with the sound contralateral limb. The most frequent incident was infiltration of solutions into the soft tissues due to the operative time. Conclusions: Capsular retightening with radiofrequency, whether combined or not with other repair techniques, has proven highly satisfactory from the perspective of the glenohumeral stabilization for anterior unidirectional instability. The arthroscopic approach offers the known advantages of being less aggressive to the soft tissues and a shorter time to resume work activities when rehabilitation therapy and exercises are followed.


REFERENCES

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  2. Hybbinette S: De la transposition d’un fragment osseux pour remédier aux luxations récidivantes de l’épaule. Acta Chir Scand 1932; 71: 411-45.

  3. Rowe C, Zarins B, Cuillo J: Recurrent anterior dislocation of the shoulder after surgical repair. J Bone Joint Surg Am 1984; 66: 159-68.

  4. Fleega BA: Arthroscopic reinforced capsular shift of anterior shoulder instability. Arthroscopy 2004; 20(5): 543-6.

  5. Rhee YG, Lee DH, Chun IH, Bae SC: Glenohumeral arthropathy after arthroscopic anterior shoulder stabilization. Arthroscopy 2004; 20(4): 402-6.

  6. Burkhart SS, De Beer JF: Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: Significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy 2000; 16(7): 677-94.

  7. Hewitt M, Getelman H, Zinder J: Arthroscopic management of shoulder Instability: pancapsular plication. Orthop Clinics North Am 2003; 34(4): 264-72.

  8. Stokes A, Savoie H, Field D, Ramsey R: Arthroscopic repair of anterior glenohumeral instability and rotator interval lesions. Orthop Clinics North Am 2003; 34(5): 318-26.

  9. Freedman KB, Smith AP, Romeo AA: Open Bankart repair versus arthroscopic repair with transglenoid sutures or bioabsorbable tacks for recurrent Anterior instability of the shoulder: a meta-analysis. Am J Sports Med 2004; 32(6): 1520-7.

  10. Latarjet M : A propos du traitementdes luxations récidivantes de l’épaule. Lyon Chir 1954; 49: 994-1003.

  11. Hill HA, Sachs MD: The grooved defect of the humeral head: A frequently unrecognized complication of dislocation of the shoulder joint. Radiology 1940; 35: 690-700.




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Acta Ortop Mex. 2009 Sep-Oct;23