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CURRENT ISSUEMINERVA ORTOPEDICA E TRAUMATOLOGICA

A Journal on Orthopedics and Traumatology


Official Journal of the Piedmontese-Ligurian-Lombard Society of Orthopedics and Traumatology
Indexed/Abtracted in: EMBASE, Scopus, Emerging Sources Citation Index

 

Minerva Ortopedica e Traumatologica 2008 October;59(5):269-74

 ORIGINAL ARTICLES

Arthroscopic treatment of traumatic shoulder dislocation with TAG tissue anchor

Mariotti U. 1, Motta P. O. 1, Vassoney P. 1, Caranzano F. 2, Stroppiana F. 2

1 Unità Operativa di Chirurgia della Spalla Ospedale CTO, Torino, Italia
2 Dipartimento di Ortopedia, Clinica Ortopedica I Ospedale CTO, Torino, Italia

Aim.
The main evaluation limit of the results reported in the scientific
literature is the unhomogeneous selection of the patients. In fact, it
is the anatomopathological lesion that influences the prognosis, and
not the surgical approach. This study evaluated the clinical
effectiveness of arthroscopic gleno-humeral stabilization using TAG
tissue anchor.
Methods. Between 1998 and 2004 in our center we treated 231 patients
with arthroscopic stabilization of the gleno-humeral joint. Exclusion
criteria were multidirectional instability, engaged Hill Sachs lesion,
bony Bankart inverted pear, voluntary dislocators, HAGL lesion, SLAP
lesion, cuff tear, age > 30 years, incomplete documentation, follow
up < 2 years. Inclusion criteria was the use of TAG tissue anchor.
The average age at the time of operation was 26.2±5.3 years, the
average interval from operation to the final evaluation was 33.6 ±19.2
months. The ROWE, Constant, UCLA tests and the clinical test of
instability were recorded preoperatively and at the final evaluation.
Results. Ninety-nine patients corresponded to the inclusion criteria,
but we could re-examine only 61 of them. Preoperatively apprehension
and relocation tests were positive in 58 patients, sulcus sign in 24
and load and shift in 32. Two patients had postoperative instability
symptoms (1.2% P<0.01): 1 patient with dislocation, with
apprehension, relocation and load and shift sign, and 1 with
subluxation, with apprehension and relocation sign. The mean ROWE score
improved from 28.3 to 95.8 (P<0.01), the UCLA score from 23.6 to
33.4 (P<0.01), the Constant score from 71.2 to 90.7 (P<0.01). The
external rotation had an average limitation of 2% (P<0.01).
Conclusion. On the basis of our case series, in isolated Bankart lesion
the arthroscopic repair shows the same frequence of recurrences as the
open technique, but allows a better range of motion. When there are the
right indications, this technique should be preferred.

language: Italian


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