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- Title
Arthroscopic reduction and subscapularis remplissage (ARR) of chronic posterior locked shoulder dislocation leads to optimized outcomes and low rate of complications.
- Authors
Romano, Alfonso M.; Edwards, T. Bradley; Nastrucci, Guglielmo; Casillo, Pasquale; Di Giunta, Angelo; Zappia, Marcello; Susanna, Massimiliano; Ascione, Francesco
- Abstract
Purpose: Unrecognized posterior shoulder dislocation with a concomitant humeral head fracture affects joint function and no consensus exists regarding treatment. The present study analyses clinical and radiographic outcomes of a novel arthroscopic technique for reducing chronic locked posterior shoulder dislocation associated with subscapularis remplissage. Methods: The study comprises a retrospective analysis of consecutive chronic posterior locked shoulders (CPLS) with minimum 2-years follow-up of patients who had undergone McLaughlin technique arthroscopic modification for the treatment of CPLS with a reverse Hill–Sachs lesion. Active range of motion (ROM), Western Ontario (WOSI) and Constant Score (CS), were evaluated pre- and postoperatively. Plain radiographs and magnetic resonance imaging (MRI) scans were collected pre- and post-operatively, recording bone defect, osteoarthritis, cuff integrity/fatty infiltration, and the grade of filling of the reverse Hill-Sachs. Results: Twelve male patients with a mean follow-up of 37.3 months ± 10.5 (range, 24–58) were included. Mean WOSI and CS scores improved from 41 to 92 and 28 to 94 points, respectively. ROM measurements all had significantly increased at final follow-up, with no significant differences in arm rotation. No defects were left unfilled at final MRI examination. Conclusion: The results of this uncontrolled study with a limited number of patients confirm that arthroscopic reduction and subscapularis remplissage is a highly effective and satisfactory treatment method resulting in no shoulder rotation deficits. Level of evidence: Level IV.
- Subjects
SHOULDER dislocations treatment; SHOULDER surgery; ORTHOPEDIC surgery complications; HUMERUS injuries; SHOULDER joint range of motion; ARTHROSCOPY
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2021, Vol 29, Issue 7, p2348
- ISSN
0942-2056
- Publication type
Article
- DOI
10.1007/s00167-020-06317-6