Arthroscopic Trillat technique for chronic anterior shoulder instability: outcomes at 2-year follow-up in 74 at-risk sports patients.

Background: Chronic anterior shoulder instability affects a young and athletic population, with a high demand for functional recovery and return to sport. The arthroscopic Trillat dynamic stabilization technique has shown great results at 2 years in terms of stabilization and functional outcomes on the general population. The hypothesis is that it could do so in at-risk for dislocation athletic population for stabilization and return to sport, with results comparable to the reference techniques.

Methods: This is a multicenter retrospective study of Walch-Duplay type 2, 3, and 4 at-risk sports patients treated by arthroscopic Trillat for chronic anterior shoulder instability between January 2012 and January 2021, at a 2-year follow-up. The primary endpoint was the occurrence of dislocation recurrence. Secondary endpoints were subluxation recurrence, functional outcomes, time and level of return to sport, functional scores, bony fusion, and complications.

Results: A total of 74 patients were analyzed, with a mean age of 24.4 years (15-50 years). Sports levels were moderate risk of dislocation Walch-Duplay type 2 for n = 34 (46%), medium-risk Walch-Duplay type 3 for n = 19 (26%), and high-risk Walch-Duplay type 4 for n = 21 (28%). Dislocation recurred in 3 patients (4.1%). All patients (100%) returned to sport, with an average delay of 4.6 months, with 56 (76%) returning to the same previous level. The mean Constant score was 94.5 (79-100), the Rowe score was 94.7 (70-100), the Walch-Duplay score was 90.2 (50-100), and the Shoulder Subjective Value score was 90.5 (65-100). Subgroup analysis of athletes at moderate risk of dislocation recurrence (Walch-Duplay type 2) vs. medium and high risk of dislocation recurrence (Walch-Duplay types 3 and 4) revealed no statistically significant difference. One patient presented with asymptomatic pseudarthrosis.

Conclusions: Arthroscopic Trillat offers highly satisfactory results in the treatment of chronic anterior shoulder instability for athletes regardless of the type of sport practiced and the type of risk according to Walch-Duplay. This simple and quick technique enables a rapid return to sport and at the previous level in the majority of cases. After showing its effectiveness in the general population at 2 years, arthroscopic Trillat offers a reliable alternative to the reference procedures in young athletic patients.