Recurrent posterior shoulder instability after primary repair is uncommon, but presents a challenging clinical scenario. Most revisions in failed labral repair were associated with glenoid bone morphology related to critical bone loss, retroversion, or dysplasia. A variety of treatment options exist which include revision labral repair with or without capsular plication, glenoid osteotomy, humeral rotational osteotomy, or glenoid bone augmentation. No single technique has been shown to be superior and each technique has strengths and limitations. Therefore, thoughtful evaluation and planning is critical to address each patient's individual pathology to maximize success after revision surgery.
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http://dx.doi.org/10.1016/j.csm.2023.12.003 | DOI Listing |
Arthroscopy
January 2025
American Hip Institute Research Foundation, Chicago, IL 60018. Electronic address:
Purpose: To identify sex-based differences in pathology, outcomes, and complications after hip arthroscopy for femoroacetabular impingement (FAI), and to compare patient-reported outcomes (PRO) scores between males and females.
Methods: The PubMed and MEDLINE databases were searched in September 2024, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies had data stratified by sex, minimum 2-year patient reported outcome (PRO) scores for hip arthroscopy in the setting of FAI and labral pathology, and a 2014 or later publication date.
Am J Sports Med
January 2025
Duke University School of Medicine, Durham, North Carolina, USA.
Background: Superior labral tears are common shoulder injuries among athletes, and for athletes undergoing surgical intervention, one of the main priorities is to return to preinjury levels of activity in a timely manner. However, the literature surrounding return to play after superior labral repair presents inconsistent results, with limited studies evaluating the timing of return to play.
Purpose: To systematically review the rate and timing of return to play in athletes after arthroscopic superior labral repair.
Am J Sports Med
January 2025
Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Background: Anterior labroligamentous periosteal sleeve avulsion (ALPSA) lesions are associated with recurrent shoulder instability and higher rates of failure after capsulolabral repair compared with similarly treated Bankart lesions. Although these lesions can portend poor outcomes, there are limited data on the associated conditions and postoperative course in a young, active population.
Purpose: To evaluate the mid- to long-term clinical course and failure rates after ALPSA repairs and assess features associated with these outcomes.
Arthrosc Tech
November 2024
Ortopedika Hospital Hip Unit, Warsaw Poland.
Hip arthroscopy has been shown to be an effective surgical treatment with excellent outcomes and a low percentage of complications; however, there are published data regarding iatrogenic complications with hip distraction. Hip distraction is mandatory to gain access to the central compartment and to perform a reliable labral repair or labral reconstruction. Postless hip arthroscopy is very popular nowadays, and several techniques have been published.
View Article and Find Full Text PDFIn all aspects of orthopaedic surgery, restoring native patient anatomy has shown improved outcomes in comparison to nonanatomic reconstructions. Particular attention has been paid to the hip capsule, as the complex of the iliofemoral, pubofemoral, and ischiofemoral ligaments, as well as the zona orbicularis and iliocapsularis, all play an essential role in hip stability, mechanics, and maintenance of intra-articular pressures. An anatomic approach toward hip arthroscopy also includes labral repair or reconstruction with preservation of the chondrolabral junction and cam resection.
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