Current concepts in chronic traumatic anterior shoulder instability.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Traumatology

Background:

• Chronic traumatic anterior shoulder instability involves recurrent dislocations due to capsuloligamentous/labral lesions, glenoid bone loss, and Hill-Sachs lesions.
• Patient factors (age, hyperlaxity, sports) and trauma factors (lesions, bone loss) influence recurrence and treatment decisions.
• Surgical interventions are generally indicated, but the optimal approach remains debated.

Purpose of the Study:

• To compare surgical treatment options for chronic traumatic anterior shoulder instability.
• To evaluate complications, return to sports, and short- and long-term outcomes, including osteoarthritis.
• To analyze risk factors affecting recurrence and treatment efficacy.

Main Methods:

• Discussion and comparison of surgical techniques: soft-tissue repair, free bone-block, and Latarjet procedures.
• Assessment of patient and trauma-related risk factors for recurrence.
• Evaluation of outcomes including complication rates, return to sport, and osteoarthritis development.

Main Results:

• Arthroscopic Bankart and open Latarjet procedures have a significant learning curve.
• Osteoarthritis is linked to dislocation frequency and surgical technique.
• Latarjet-type procedures demonstrate the lowest dislocation recurrence rates without apparent increased osteoarthritis risk when performed correctly.

Conclusions:

• The Latarjet procedure is effective in reducing recurrence for chronic traumatic anterior shoulder instability.
• Careful consideration of risk factors is crucial for selecting the appropriate surgical intervention.
• Properly executed Latarjet procedures offer favorable outcomes regarding stability and osteoarthritis.