Arthroscopic Subscapularis Bankart Technique as a Salvage Procedure for Failed Anterior Shoulder Stabilization

HSS Journal: Volume 10, Issue 1

Salma Chaudhury, MD

Sports Medicine Department, Hospital for Special Surgery

Demetris Delos, MD

Sports Medicine Department, Hospital for Special Surgery


Joshua S. Dines, MD

Joshua S. Dines, MD

Assistant Attending Sports Medicine and Shoulder Service, Hospital for Special Surgery
Clinical Assistant Professor of Orthopaedic Surgery, Weill Cornell Medical College

David W. Altchek, MD

David W. Altchek, MD

Attending Orthopaedic Surgeon, Hospital for Special Surgery
Co-Chief, Sports Medicine & Shoulder Service, Hospital for Special Surgery
Professor of Clinical Orthopaedic Surgery, Weill Cornell Medical College

Christopher C. Dodson, MD

Sports Medicine Department, Rothman Institute

Ashley M. Newman, BA

Sports Medicine Department, Hospital for Special Surgery

Stephen J. O'Brien, MD, MBA

Attending Orthopaedic Surgeon, Hospital for Special Surgery
Associate Attending Orthopaedic Surgeon, NewYork-Presbyterian Hosipital
Professor of Clinical Orthopaedic Surgery, Weill Cornell Medical College
Vice Chairman of the Sports Medicine Department, Hospital for Special Surgery
Executive Sports Committee, Hospital for Special Surgery

Abstract

Background

Shoulder instability is a relatively common problem. Even with contemporary surgical techniques, instability can recur following both open and arthroscopic fixation. Surgical management of capsular insufficiency in anterior shoulder stabilization represents a significant challenge, particularly in young, active patients. There are a limited number of surgical treatment options. The Laterjet technique can present with a number of intraoperative challenges and postoperative complication.

Description of Technique

We report an arthroscopic subscapularis tenodesis technique as a salvage procedure for challenging glenohumeral instability cases. Sutures are passed through the subscapularis tendon and capsule before they are tied as one in the subdeltoid psace. The rotator interval is closed with superior and medial advancement of anterior and inferior tissue. This technical note carefully describes this procedure with useful technical tips, illustrations, and diagrams.

Patients and Methods

Two clinical cases are described involving patients with recurrent instability following failed surgery who were successfully managed with this procedure.

Results

Both cases described resulted in improved shoulder stability, range of motion, and function following management with this surgical technique. This arthroscopic subscapularis tenodesis procedure is proposed as a useful alternative repair technique for cases of recurrent instability after failed surgery with isolated capsular insufficiency.

Conclusion

It is believed that this arthroscopic subscapularis tenodesis technique can potentially provide similar outcomes to open bone block stabilization procedures, while reducing the risks associated with those procedures.

This article appears in HSS Journal: Volume 10, Issue 1.
View the full article at springerlink.com.

About the HSS Journal

HSS Journal, an academic peer-reviewed journal published three times a year, February, July and October. The Journal accepts and publishes peer reviewed articles from around the world that contribute to the advancement of the knowledge of musculoskeletal diseases and disorders.

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