Boileau, Arthroscopy 2010 - Arthroscopic Bankart-Bristow-Latarjet Procedure: The Development and Early Results of a Safe and Reproducible Technique - Article Summary

Arthroscopic Bankart-Bristow-Latarjet Procedure: The Development and Early Results of a Safe and Reproducible Technique

Boileau, Old, et al.·Arthroscopy·2010·240 citations·Case series

Purpose

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.

Methods

47 consecutive patients with glenoid bone loss and capsular deficiency were treated with this all-arthroscopic technique; 6 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.

Results

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.

Conclusions

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.

Level of evidence: Level IV, therapeutic case series. Copyright remains with the authors and publisher.

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Arthroscopic Bankart-Bristow-Latarjet Procedure: The Development and Early Results of a Safe and Reproducible Technique

Boileau, Old, et al.·Arthroscopy·2010·240 citations·Case series

DOI·PubMed

Purpose

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.

Methods

47 consecutive patients with glenoid bone loss and capsular deficiency were treated with this all-arthroscopic technique; 6 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.

Results

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.

Conclusions

Level of evidence: Level IV, therapeutic case series. Copyright remains with the authors and publisher.

Purpose

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.

Methods

47 consecutive patients with glenoid bone loss and capsular deficiency were treated with this all-arthroscopic technique; 6 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.

Results

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.

Conclusions

Level of evidence: Level IV, therapeutic case series. Copyright remains with the authors and publisher.

Purpose

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.

Methods

47 consecutive patients with glenoid bone loss and capsular deficiency were treated with this all-arthroscopic technique; 6 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.

Results

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.

Conclusions

Level of evidence: Level IV, therapeutic case series. Copyright remains with the authors and publisher.