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      A Reproducible Technique for Creation of the Subscapularis Split During Dynamic Anterior Stabilization for Shoulder Instability

      brief-report
      Author(s): , M.D. a , , M.D. b , , M.D. c , , M.D. d , , M.D. e , , M.D. f , g , h , ∗
      Publication date (Electronic):
      Journal: Arthroscopy Techniques
      Publisher: Elsevier

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          Abstract

          The subscapularis split is a required difficult step of several instability procedures. We propose creating a subscapularis split using the shuttled long head of the biceps by simple passive external rotation of the arm during dynamic anterior stabilization. This technique simplifies one of the technically demanding steps of dynamic anterior stabilization, making the split quicker and more reproducible.

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          The arthroscopic Latarjet procedure for the treatment of anterior shoulder instability.

          Laurent Lafosse, Etienne Lejeune, Antoine Bouchard … (2007)
          Anterior instability is a difficult clinical problem that is treated by a variety of open and arthroscopic methods with good results. Bankart repair remains a popular option. However, in those situations involving irreparable ligamentous damage or bony deficiency, this technique may be insufficient to stabilize the shoulder. One of the principal methods of open treatment for this problem is the Latarjet procedure, as described in his article in 1954. It has proven to be a durable and reliable method of treatment for anteroinferior instability of the glenohumeral joint. Several authors have reported on the long-term outcomes of this procedure with satisfactory results. There has been no previous description of the Latarjet procedure being performed arthroscopically. We present the first report of a new surgical technique, the arthroscopic Latarjet procedure. This procedure is fully arthroscopic and combines the advantages of the open procedure with those of arthroscopic stabilization. This is a significant step forward in the development of arthroscopic shoulder reconstruction and enables shoulder surgeons to treat all cases of instability arthroscopically.
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            Short-term Complications of the Arthroscopic Latarjet Procedure: A North American Experience.

            Robert J. Meislin, George S. Athwal, Paul J Favorito … (2016)
            To report on the intraoperative and early postoperative (<3 months) problems and complications encountered with the arthroscopic Latarjet procedure in patients with complex anterior shoulder instability.
            Article 0 comments Cited 38 times – based on 0 reviews     Review now
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              Arthroscopic Bankart-Bristow-Latarjet procedure: the development and early results of a safe and reproducible technique.

              Pascal Boileau, Yannick Roussanne, Numa Mercier … (2010)
              To evaluate the reproducibility and safety of a novel arthroscopic technique combining a Bristow-Latarjet procedure with a Bankart repair and to report the early clinical and radiologic results. Forty-seven consecutive patients with glenoid bone loss and capsular deficiency were treated with this all-arthroscopic technique; six patients had a failed arthroscopic capsulolabral repair. The coracoid fragment was osteotomized, passed with the conjoined tendon through the subscapularis muscle, and fixed in the standing position with a cannulated screw on the abraded glenoid neck. The capsule and labrum were then reattached on the glenoid rim, leaving the coracoid bone block in an extra-articular position. Potential intraoperative and postoperative complications were recorded. All patients were reviewed and had postoperative radiographs; 35 had computed tomography scans. The procedure was performed entirely arthroscopically in 41 of 47 patients (88%); a conversion to open surgery was needed in 6 patients (12%). The axillary nerve was identified in all cases, and no neurologic injuries were observed. No patient had any recurrence of instability at the most recent follow-up (mean, 16 months). The mean Rowe score was 88 ± 16.7, and the mean Walch-Duplay score was 87.6 ± 12.9. The Subjective Shoulder Value was 87.5% ± 12.7%. The bone block was subequatorial in 98% of the cases (46 of 47) and flush to the glenoid surface in 92% (43 of 47); it was too lateral in 1 (2%) and too medial (>5 mm) in 3 (6%). There was 1 bone block fracture and 7 migrations. The arthroscopic Bristow-Latarjet-Bankart procedure is reproducible and safe. This procedure allows restoration of shoulder stability in patients with glenoid bone loss and capsular deficiency, as well as in the case of failed capsulolabral repair. Arthroscopy offers the advantage of providing adequate visualization of both the glenohumeral joint and the anterior neck of the scapula, allowing accurate placement of the bone block and screw. Surgeons should be aware that the procedure is technically difficult and potentially dangerous because of the proximity of the brachial plexus and axillary vessels. Training on cadaveric specimens and transition from open to mini-open and, finally, to all arthroscopic is recommended. Level IV, therapeutic case series. Copyright © 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                Alexandre Lädermann
                Journal
                Journal ID (nlm-ta): Arthrosc Tech
                Title: Arthroscopy Techniques
                Publisher: Elsevier
                ISSN (Electronic): 2212-6287
                Publication date PMC-release: 02 September 2020
                Publication date Collection: September 2020
                Publication date (Electronic): 02 September 2020
                Volume: 9
                Issue: 9
                Pages: e1433-e1438
                Affiliations
                [a ]Department of Orthopaedics and Trauma Surgery, Faculty of Medicine, Fayoum University, Fayoum, Egypt
                [b ]Department of Shoulder Surgery, Sanatorio Allende, Córdoba, Argentina
                [c ]Department of Orthopaedic & Rehabilitation, Oregon Health & Science University, Portland, OR, USA
                [d ]La Clinica Ortopedica, ASST PINI-CTO, Università degli Studi di Milano, Milan, Italy
                [e ]Centre Hospitalier Privé Saint-Grégoire (Vivalto Santé), Saint- Grégoire, France
                [f ]Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin
                [g ]Faculty of Medicine, University of Geneva, Switzerland
                [h ]Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
                Author notes
                [∗ ]Address correspondence to Alexandre Lädermann, P.D.-M.D., Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Av. J.-D. Maillard 3, CH-1217 Meyrin, Switzerland. alexandre.laedermann@ 123456gmail.com
                Article
                Publisher Item ID: S2212-6287(20)30151-1
                DOI: 10.1016/j.eats.2020.06.007
                PMC ID: 7528756
                PubMed ID: 33024688
                SO-VID: 9403a90c-8364-497d-b998-7c6c7b445c6b
                Copyright © © 2020 by the Arthroscopy Association of North America. Published by Elsevier.
                License:

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 20 March 2020
                Date accepted : 5 June 2020
                Categories
                Subject: Technical Note

                Data availability:

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