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[Progress on arthroscopic surgery for recurrent anterior shoulder dislocation].

Ming-Tao Zhang1, Guang-Rui Zhang1, Jian-Ping Zhou1

  • 1Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China.

Zhongguo Gu Shang = China Journal of Orthopaedics and Traumatology
|May 25, 2021
PubMed
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Recurrent anterior shoulder dislocation treatment depends on bone defect size. Surgeons should tailor arthroscopic techniques like Bankart, remplissage, or Bristow-Latarjet based on glenoid and humeral defects for optimal outcomes.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomechanics

Background:

  • Recurrent anterior shoulder dislocation presents a significant challenge in sports injury management.
  • Restoring dynamic and osseous constraints of the shoulder joint post-injury remains difficult.
  • While arthroscopic surgery offers satisfactory results, optimal technique selection is debated.

Purpose of the Study:

  • To provide a decision-making framework for surgical treatment of recurrent anterior shoulder dislocation.
  • To correlate specific glenoid and humeral bone defect characteristics with recommended surgical interventions.
  • To emphasize a comprehensive approach considering patient factors alongside bone defects.

Main Methods:

  • Classification of surgical candidates based on the presence and size of glenoid and humeral bone defects.
Keywords:
ArthroscopesGlenohumeral jointJoint dislocationsReview

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  • Correlation of defect types with established surgical procedures (Bankart, remplissage, ASA, Sling, Bristow-Latarjet, bone grafting).
  • Inclusion of humeral avulsion of glenohumeral ligaments (HAGL) injury management.
  • Consideration of patient age, activity level, and surgeon expertise in treatment selection.

    • Main Results:

    • Specific defect size thresholds guide the choice between Bankart, Bankart with remplissage/ASA, Sling, and Bristow-Latarjet procedures.
    • Bone grafting is indicated for significant defects (>40%) or failed Bristow-Latarjet.
    • HAGL injuries require specific repair.
    • A multifactorial approach integrating bone defects with patient and surgeon factors is recommended.

    Conclusions:

    • Tailoring surgical treatment to the specific type and size of glenoid and humeral bone defects is crucial for managing recurrent anterior shoulder dislocation.
    • A stepwise algorithmic approach, considering bone loss and associated injuries like HAGL, optimizes surgical outcomes.
    • Patient-specific factors must be integrated with radiographic findings for personalized treatment planning.