AI Article Synopsis
- - The study examines the effectiveness of arthroscopic Bankart repair for shoulder instability in patients with over 20% glenoid bone loss, comparing results between those who received bone graft augmentation and those who did not.
- - Results showed that patients who received bone graft augmentation (Group A) had significantly better outcomes, with a higher average Rowe score (95.0 vs 69.7) and a much lower recurrence rate (2.9% vs 48.5%) compared to those who did not receive augmentation (Group B).
- - Among contact/collision athletes, while 50% returned to their pre-injury sports level in both groups, many in Group B experienced residual instability, highlighting the potential advantages of bone
Article Abstract
Purpose: Glenoid bone loss contributes to recurrent instability after arthroscopic Bankart repair alone. With significant glenoid bone loss, better results have been reported after arthroscopic Bankart repair with glenoid arc reconstruction. However, no reports compare augmentation using bone graft with non-augmentation for glenoid bone loss. The purpose of this study was to assess clinical results of an arthroscopic Bankart repair with or without arthroscopic bone graft augmentation. It was hypothesized that such bone graft augmentation would restore shoulder stability, and lead to excellent outcomes.
Methods: Of 552 patients treated for anterior glenohumeral instability with arthroscopic Bankart repair, 68 met this study's inclusion criteria of glenoid bone loss over 20% and follow-up of at least 2 years. Patients were divided into 2 groups based on whether with bone graft augmentation for glenoid bone loss [Group A: n = 35, median age; 21 years (range 13-72 years)], or not (Group B: n = 33, median age; 21 years (range 13-50 years)]. For grafting, either autologous iliac bone or artificial bone made of hydroxyapatite was used. Rowe score, recurrence rate, and return to sport were used to assess the results.
Results: Mean Rowe score was 95.0 (SD 10.6) in Group A and 69.7 (SD 27.2) in Group B (p < 0.05). The recurrence rate was 2.9% (1/36) in Group A and 48.5% (16/33) in Group B (p < 0.05). Regarding contact/collision athletes, 24 were contained in Group A and 22 in Group B. Of the patients with recurrence in Group B, 13 (59.1%) were contact/collision athletes. Finally, 50% of the contact/collision sports athletes for both groups returned to their sports at the same as pre-injury level. Of the 11 patients who returned to the same level of contact/collision sports in Group B, seven returned with residual instability. Nine athletes in Group A and 3 in Group B quit their sports for personal or social reasons.
Conclusions: Bone graft augmentation was beneficial when used with Arthroscopic Bankart repair for recurrent anterior shoulder instability with glenoid bone loss. Especially, for recurrent anterior shoulder instability with glenoid bone loss in contact/collision sports athletes, bone graft augmentation should be strongly considered as beneficial.
Level Of Evidence: Level IV.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00167-019-05746-2 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
What is the clinical importance of radiographic changes around the humeral component in anatomic shoulder arthroplasty? A minimum 4-year follow-up study.
J Shoulder Elbow Surg
January 2025
Investigation Performed at the University of Washington, Department of Orthopaedic Surgery and Sports Medicine, Seattle, WA, USA. Electronic address:
Background: While stress shielding and adaptive bone changes around the humeral component are often observed after shoulder arthroplasty, the potential causative factors and clinical significance of these findings at mid-term follow-up have not been well elucidated. The purpose of this study was to investigate the frequency, patterns and clinical significance of radiographic findings around the humeral component of total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) at minimum 4-year follow-up.
Methods: The 6-week and minimum 4-year radiographs of patients who underwent HA and TSA were evaluated for filling ratios, changes in the humeral bone surrounding the component, and component shift or subsidence.
Deep learning algorithms enable MRI-based scapular morphology analysis with values comparable to CT-based assessments.
Sci Rep
January 2025
Department of Orthopaedic Surgery and Traumatology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland.
Scapular morphological attributes show promise as prognostic indicators of retear following rotator cuff repair. Current evaluation techniques using single-slice magnetic-resonance imaging (MRI) are, however, prone to error, while more accurate computed tomography (CT)-based three-dimensional techniques, are limited by cost and radiation exposure. In this study we propose deep learning-based methods that enable automatic scapular morphological analysis from diagnostic MRI despite the anisotropic resolution and reduced field of view, compared to CT.
View Article and Find Full Text PDFNovel 3D-Printed Reverse Shoulder Prosthesis for Reconstruction After Resection of the Scapular: A Report of 2 Cases.
JBJS Case Connect
January 2025
Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Case: The effective reconstruction and functional restoration of the shoulder joint after surgical treatment of shoulder girdle tumors, especially those involving resection of the glenoid, poses significant challenges. Reconstruction methods include allograft reconstruction and shoulder prosthesis. In this report, we present 2 cases of scapulectomy for tumors involving the glenoid, followed by shoulder reconstruction using custom-designed reverse shoulder prostheses that are partially fixed to the clavicle.
View Article and Find Full Text PDFBiomechanical Outcomes of Glenoid Bone Graft Fixation Techniques: A Systematic Review.
Am J Sports Med
January 2025
Mayo Clinic Arizona Department of Orthopedic Surgery, Phoenix, Arizona, USA.
Background: The Latarjet and other bony augmentation procedures are commonly used to treat anterior shoulder instability in the setting of significant glenoid bone loss. Although several fixation strategies have been reported, the biomechanical strength of these techniques remains poorly understood.
Purpose: To perform a systematic review of the biomechanical strength of glenoid bony augmentation procedures for anterior shoulder instability.
Debridement Technique for Single-Stage Revision Shoulder Arthroplasty.
JBJS Essent Surg Tech
January 2025
Shoulder and Elbow Service, Florida Orthopaedic Institute, Tampa, Florida.
Background: The incidence of revision shoulder arthroplasty continues to rise, and infection is a common indication for revision surgery. Treatment of periprosthetic joint infection (PJI) in the shoulder remains a controversial topic, with the literature reporting varying methodologies, including the use of debridement and implant retention, single-stage and 2-stage surgeries, antibiotic spacers, and resection arthroplasty. Single-stage revision has been shown to have a low rate of recurrent infection, making it more favorable because it precludes the morbidity of a 2-stage operation.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!