Arthroscopic Trillat procedure for chronic anterior shoulder instability: outcomes at a minimum 10-year follow-up

Chronic anterior glenohumeral instability can be treated by several stabilizing procedures. The arthroscopic Trillat procedure, a dynamic coracoid transfer creating an active sling effect, has shown effective stabilization at short and mid-term follow-up, but no series has reported outcomes beyond 10 years. We evaluated stabilization, function, range of motion, and return to sport at a minimum follow-up of 10 years.

This retrospective single-center study included patients treated with an arthroscopic Trillat procedure for chronic anterior glenohumeral instability between March 2012 and January 2016. Multidirectional or voluntary instability and glenoid bone loss greater than 20% were non-included. The primary endpoint was recurrent true dislocation. Secondary endpoints included recurrent subluxation, reoperation, patient-reported scores (Constant, Walch-Duplay, Rowe, Subjective Shoulder Value), external rotation versus the contralateral side, subscapularis testing, osteoarthritis, and return to sport.

Thirty-seven patients underwent surgery and 31 (83.8%) were assessed at a mean follow-up of 11.7 years (range 10 to 13). Recurrent true dislocation occurred in 1 patient (3.2%), following trauma, and recurrent anterior subluxation in 4 (12.9%), giving an overall recurrence rate of 16.1%. Reoperation for instability was 3.2%. Mean scores were Constant 96.1, Walch-Duplay 92.0, Rowe 91.1, and Subjective Shoulder Value 92.8%, with significant SSV improvement (median 80 to 98; p = 0.005). External rotation at the side was reduced (59.3 ° versus 69.3 °; p < 0.001) but preserved in abduction (79.5 ° versus 81.0 °; p = 0.08). Subscapularis testing was negative in about 91% of tested shoulders. Osteoarthritis was present in 5 of 26 patients (19.2%). Twenty-eight of 29 patients (96.6%) returned to sport, and 93% were satisfied.

At more than 10 years, the arthroscopic Trillat procedure provides low rates of recurrent dislocation and reoperation for instability, with high satisfaction and preserved subscapularis function. External rotation is reduced at the side but preserved in abduction. It is a reliable option for chronic anterior glenohumeral instability.

IV; retrospective case series.