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Two-year results of arthroscopic conjoint tendon transfer procedure for the management of failed anterior stabilization of the shoulder

BACKGROUND: Management of failed anterior stabilization is difficult. There are two main options for revision either a revision labral repair which has published high failure rates because of poor quality capsulolabral tissues or a bone block/Latarjet procedure with associated morbidity and complica...

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Autores principales: Patel, Vishal, Pearse, Eyiyemi, Arnander, Magnus, Tennent, Duncan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8178602/
https://www.ncbi.nlm.nih.gov/pubmed/34136864
http://dx.doi.org/10.1016/j.jseint.2020.12.009
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author Patel, Vishal
Pearse, Eyiyemi
Arnander, Magnus
Tennent, Duncan
author_facet Patel, Vishal
Pearse, Eyiyemi
Arnander, Magnus
Tennent, Duncan
author_sort Patel, Vishal
collection PubMed
description BACKGROUND: Management of failed anterior stabilization is difficult. There are two main options for revision either a revision labral repair which has published high failure rates because of poor quality capsulolabral tissues or a bone block/Latarjet procedure with associated morbidity and complication rates. On this background, the senior author (D.T.) has developed a new procedure to treat this difficult to manage clinical scenario. AIM: The aim of this study was to evaluate the 2-year results of an arthroscopic conjoint tendon transfer procedure. The procedure has previously been developed to provide a potential solution for active patients with a failed labral repair, subcritical glenoid bone loss, and an on-track Hill-Sachs lesion. METHODS: Consecutive patients who fulfilled the inclusion criteria were prospectively recruited. Inclusion criteria were active patients with recurrent shoulder instability owing to failed labral repair, less than 10% anterior glenoid bone loss, and an on-track Hill Sachs lesion. Patients were fully consented and offered a choice of revision with an arthroscopic labral repair, a Latarjet procedure or the arthroscopic conjoint tendon transfer procedure. Preoperative and postoperative Western Ontario Shoulder Instability Index and Oxford Instability Score were collected. RESULTS: Eight patients met the inclusion criteria and opted for the conjoint tendon transfer procedure. Mean age was 35 with a male:female ratio of 7:1. No patients had hyperlaxity clinically. At median follow-up of 31 months (range 24-41), there was a significant improvement in both the median Western Ontario Shoulder Instability Index (53.7 to 13.4, P = .0003) and Oxford Instability Score (27 to 44.5, P = .0017) scores. No patient had a further dislocation, and all were able to resume contact and noncontact sports. CONCLUSION: Our results at a minimum of 2-year follow-up demonstrate that the arthroscopic transfer of the conjoint tendon confers clinical stability in patients with a failed primary labral repair who have minimal bone loss.
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spelling pubmed-81786022021-06-15 Two-year results of arthroscopic conjoint tendon transfer procedure for the management of failed anterior stabilization of the shoulder Patel, Vishal Pearse, Eyiyemi Arnander, Magnus Tennent, Duncan JSES Int Shoulder BACKGROUND: Management of failed anterior stabilization is difficult. There are two main options for revision either a revision labral repair which has published high failure rates because of poor quality capsulolabral tissues or a bone block/Latarjet procedure with associated morbidity and complication rates. On this background, the senior author (D.T.) has developed a new procedure to treat this difficult to manage clinical scenario. AIM: The aim of this study was to evaluate the 2-year results of an arthroscopic conjoint tendon transfer procedure. The procedure has previously been developed to provide a potential solution for active patients with a failed labral repair, subcritical glenoid bone loss, and an on-track Hill-Sachs lesion. METHODS: Consecutive patients who fulfilled the inclusion criteria were prospectively recruited. Inclusion criteria were active patients with recurrent shoulder instability owing to failed labral repair, less than 10% anterior glenoid bone loss, and an on-track Hill Sachs lesion. Patients were fully consented and offered a choice of revision with an arthroscopic labral repair, a Latarjet procedure or the arthroscopic conjoint tendon transfer procedure. Preoperative and postoperative Western Ontario Shoulder Instability Index and Oxford Instability Score were collected. RESULTS: Eight patients met the inclusion criteria and opted for the conjoint tendon transfer procedure. Mean age was 35 with a male:female ratio of 7:1. No patients had hyperlaxity clinically. At median follow-up of 31 months (range 24-41), there was a significant improvement in both the median Western Ontario Shoulder Instability Index (53.7 to 13.4, P = .0003) and Oxford Instability Score (27 to 44.5, P = .0017) scores. No patient had a further dislocation, and all were able to resume contact and noncontact sports. CONCLUSION: Our results at a minimum of 2-year follow-up demonstrate that the arthroscopic transfer of the conjoint tendon confers clinical stability in patients with a failed primary labral repair who have minimal bone loss. Elsevier 2021-02-24 /pmc/articles/PMC8178602/ /pubmed/34136864 http://dx.doi.org/10.1016/j.jseint.2020.12.009 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Shoulder
Patel, Vishal
Pearse, Eyiyemi
Arnander, Magnus
Tennent, Duncan
Two-year results of arthroscopic conjoint tendon transfer procedure for the management of failed anterior stabilization of the shoulder
title Two-year results of arthroscopic conjoint tendon transfer procedure for the management of failed anterior stabilization of the shoulder
title_full Two-year results of arthroscopic conjoint tendon transfer procedure for the management of failed anterior stabilization of the shoulder
title_fullStr Two-year results of arthroscopic conjoint tendon transfer procedure for the management of failed anterior stabilization of the shoulder
title_full_unstemmed Two-year results of arthroscopic conjoint tendon transfer procedure for the management of failed anterior stabilization of the shoulder
title_short Two-year results of arthroscopic conjoint tendon transfer procedure for the management of failed anterior stabilization of the shoulder
title_sort two-year results of arthroscopic conjoint tendon transfer procedure for the management of failed anterior stabilization of the shoulder
topic Shoulder
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8178602/
https://www.ncbi.nlm.nih.gov/pubmed/34136864
http://dx.doi.org/10.1016/j.jseint.2020.12.009
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