TY - JOUR
T1 - Long-term outcomes after repair of recurrent post-traumatic anterior shoulder instability
T2 - Comparison of arthroscopic transglenoid suture and open Bankart reconstruction
AU - Zaffagnini, Stefano
AU - Muccioli, Giulio Maria Marcheggiani
AU - Giordano, Giovanni
AU - Bonanzinga, Tommaso
AU - Grassi, Alberto
AU - Nitri, Marco
AU - Bruni, Danilo
AU - Ravazzolo, Giovanni
AU - Marcacci, Maurilio
PY - 2012/5
Y1 - 2012/5
N2 - Purpose: The purpose of this study is to report long-term outcomes of the arthroscopic modified Caspari technique compared to an open capsular shift surgery to treat post-traumatic anterior shoulder recurrent instability. The hypothesis was that the open surgery group would show higher degenerative changes than to the modified Caspari technique group after a follow-up from 10 to 17 years. Methods: One hundred and ten nonrandomized consecutive patients who underwent a surgical repair of recurrent unilateral anterior shoulder instability between 1990 and 1999 were retrospectively analyzed. Eighty-two patients were available for long-term follow-up. In particular, 49 patients (59.8%) (group A) were treated with arthroscopic transglenoid modified Caspari suturing technique (mean follow-up 13.7 ± 2.2 years), whereas 33 patients (40.2%) (group B) were treated with combined open capsular shift and Bankart repair (mean follow-up 15.7 ± 2.2 years). Patients were evaluated according to the failure rate (re-dislocation), Rowe, UCLA, and Constant scores. Radiological osteoarthritis changes were ranked according to Samilson score. Results: There were no statistically significant differences between the two groups concerning the failure rate (n.s.), Rowe (n.s.), UCLA (n.s.), and Constant (n.s.) scores. Group A: re-dislocation rate 12.5% (6 re-dislocations), Rowe 85.0 ± 22.6, UCLA 26.4 ± 4.8, and Constant 86.3 ± 16.7. Group B: re-dislocation rate 9% (3 re-dislocations), Rowe 83.2 ± 24.4, UCLA 26.9 ± 4.2, and Constant 87.4 ± 14.1. Radiographic findings of osteoarthritis: 2 severe (4%), 4 moderate (8%), and 12 mild (25%) in group A; 2 severe (6%), 4 moderate (12%), and 9 mild (27%) in group B; differences between groups were not statistically significant (n.s). Conclusions: The results after both techniques were good in majority of patients, with no significant differences in terms of re-dislocation and osteoarthritis development. Compared to the current literature, the recurrence rate was high in both groups. The modified Caspari technique could be an arthroscopic alternative for older, non-athletic shoulders. Level of evidence: Therapeutic Study-Retrospective Comparative Study, Level III.
AB - Purpose: The purpose of this study is to report long-term outcomes of the arthroscopic modified Caspari technique compared to an open capsular shift surgery to treat post-traumatic anterior shoulder recurrent instability. The hypothesis was that the open surgery group would show higher degenerative changes than to the modified Caspari technique group after a follow-up from 10 to 17 years. Methods: One hundred and ten nonrandomized consecutive patients who underwent a surgical repair of recurrent unilateral anterior shoulder instability between 1990 and 1999 were retrospectively analyzed. Eighty-two patients were available for long-term follow-up. In particular, 49 patients (59.8%) (group A) were treated with arthroscopic transglenoid modified Caspari suturing technique (mean follow-up 13.7 ± 2.2 years), whereas 33 patients (40.2%) (group B) were treated with combined open capsular shift and Bankart repair (mean follow-up 15.7 ± 2.2 years). Patients were evaluated according to the failure rate (re-dislocation), Rowe, UCLA, and Constant scores. Radiological osteoarthritis changes were ranked according to Samilson score. Results: There were no statistically significant differences between the two groups concerning the failure rate (n.s.), Rowe (n.s.), UCLA (n.s.), and Constant (n.s.) scores. Group A: re-dislocation rate 12.5% (6 re-dislocations), Rowe 85.0 ± 22.6, UCLA 26.4 ± 4.8, and Constant 86.3 ± 16.7. Group B: re-dislocation rate 9% (3 re-dislocations), Rowe 83.2 ± 24.4, UCLA 26.9 ± 4.2, and Constant 87.4 ± 14.1. Radiographic findings of osteoarthritis: 2 severe (4%), 4 moderate (8%), and 12 mild (25%) in group A; 2 severe (6%), 4 moderate (12%), and 9 mild (27%) in group B; differences between groups were not statistically significant (n.s). Conclusions: The results after both techniques were good in majority of patients, with no significant differences in terms of re-dislocation and osteoarthritis development. Compared to the current literature, the recurrence rate was high in both groups. The modified Caspari technique could be an arthroscopic alternative for older, non-athletic shoulders. Level of evidence: Therapeutic Study-Retrospective Comparative Study, Level III.
KW - Anterior shoulder instability
KW - Arthroscopic translgenoid suture
KW - Combined open capsular shift and Bankart repair
KW - Modified Caspari technique
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U2 - 10.1007/s00167-011-1674-y
DO - 10.1007/s00167-011-1674-y
M3 - Article
C2 - 21932077
AN - SCOPUS:84860157974
VL - 20
SP - 816
EP - 821
JO - Knee Surgery, Sports Traumatology, Arthroscopy
JF - Knee Surgery, Sports Traumatology, Arthroscopy
SN - 0942-2056
IS - 5
ER -