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An Arthroscopic Technique for Anterior Stabilization of the Shoulder with a Bioabsorbable Tack*

SPEER, KEVIN P. M.D.†; WARREN, RUSSELL F. M.D.‡; PAGNANI, MICHAEL M.D.‡; WARNER, JON J. P. M.D.§, NEW YORK, N.Y.

Journal of Bone & Joint Surgery - American Volume: December 1996 - Volume 78 - Issue 12 - p 1801–7
Article

Arthroscopically assisted repair of the anterior aspect of the labrum with use of a bioabsorbable tack was performed in fifty-two consecutive patients who had chronic anterior instability of the shoulder. The average age of the patients was twenty-eight years (range, sixteen to fifty years). The etiology of the instability was a traumatic injury in forty-nine patients; twenty-six of those injuries were sustained during participation in a contact sport. Fifty shoulders had a Bankart lesion. The patients were evaluated at an average of forty-two months (range, twenty-four to sixty months) after the procedure. Forty-one (79 per cent) of the patients were asymptomatic and were able to participate in sports without restriction. The repair was considered to have failed in eleven (21 per cent) of the patients. In four of them, the failure resulted from a single traumatic reinjury during participation in a contact sport, and three of these reinjuries were treated nonoperatively. The remaining seven failures occurred atraumatically. Eight patients had an open glenoid-based capsulorrhaphy as a consequence of recurrent instability. At the reoperation, no evidence of the tack was found in any patient. In seven patients, the Bankart lesion had completely healed, and the anteroinferior aspect of the capsule was patulous. Anterior stabilization of the shoulder with a bioabsorbable tack may be indicated for patients who have anterior instability but do not need a capsulorrhaphy or capsular imbrication to reduce the joint volume.

†Sports Medicine and Shoulder Service, Division of Orthopaedic Surgery, Duke University Medical Center, Box 3371, Durham, North Carolina 27707.

‡Department of Sports Medicine, The Hospital for Special Surgery, 535 East 70th Street, New York, N.Y. 10021.

§Shoulder Service, Center for Sports Medicine, Department of Orthopaedic Surgery, University of Pittsburgh, 4601 Baum Boulevard, Pittsburgh, Pennsylvania 15213.

Copyright 1996 by The Journal of Bone and Joint Surgery, Incorporated
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