S1024 ARTHROSCOPIC SHOULDER STABILIZATION

Abstract

The goal for arthroscopic stabilization of anterior glenohumeral instability is to achieve an outcome equivalent to or better than open procedures. A number of arthroscopic procedures have been advocated to reestablish continuity of the inferior glenohumeral ligament complex (IGHLC) with the glenoid. Implantable suture anchors were developed to avoid the problems associated with arthroscopic staple capsulorrhaphy like iatrogenic injury of the glenoid or humeral surface, loosening and migration of the staple. The preferred techniques are easy implantable suture anchors made of titanium (Fastak). Our experience suggests, that if proper selection criteria are employed, normal patients and overhead-athletes may benefit from the advantages of an arthroscopic repair without accepting an increased risk for recurrence. From 4/96 to 10/00 we performed a prospective analysis of 242 shoulders, who underwent arthroscopic shoulder stabilization with FASTak-(n = 159) Panalok-(n = 26) and Sure-tac suture anchors (n = 57) in our clinic. The patients were re-examined with a follow-up of at least 12 months. The best results were in the FASTak-group. After 2 years 4.7% suffered a redislocation. 28.6% (2 patients) needed a revision, but none of the shoulders required a second open stabilization. The reason for redislocation or sub-luxation were traumatic injuries, participating in contact sports or in one case a generalized ligamentous laxity. The Rowe score was 83.1 ± 20.9 points. There was a high satisfaction of the patients with the operative result and 60.9% could go back to their pre-op sports level. At 24-months follow-up this study demonstrates good results of arthroscopic shoulder stabilisation with FASTak suture anchors. In combination with the LACS-Procedure or the Electro thermally assisted capsular shift (ETACS) not only the capsular detachment but also the capsular redundancy may be adressed and a lower failure rate can be expected.