Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
권호 표지
DOI QR코드

DOI QR Code

Revision after Instability Surgery

수술 후 재발한 견관절 불안정증의 치료

  • Kim, Paul Shinil (Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine) ;
  • Jo, Chris Hyunchul (Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine)
  • 김신일 (서울대학교 의과대학 서울대학교병원운영 서울특별시보라매병원 정형외과학교실) ;
  • 조현철 (서울대학교 의과대학 서울대학교병원운영 서울특별시보라매병원 정형외과학교실)
  • Received : 2017.07.31
  • Accepted : 2018.02.07
  • Published : 2020.10.30
⟨ Previous Next ⟩

Abstract

Recurrence is the most common complication after shoulder instability surgery, and the main causes of the postoperative recurrence of instability are trauma, misdiagnosis, and technical errors. The risk factors of recurrence may be classified as patient related, anatomical or technical. Causes of failure should be thoroughly evaluated by meticulous history taking, physical examination, and imaging studies, and followed by proper treatment of pathologic lesions. Nonoperative treatment should be considered initially in cases of recurred instability after shoulder instability surgery, but if this fails, repeated recurrence is prevented by performing appropriate anatomical reconstruction of ruptured Bankart lesions, capsular laxities, glenoid deficiencies and humeral head bone defects.

견관절 불안정증 수술의 가장 흔한 합병증은 불안정성의 재발이다. 견관절 불안정증 수술 후 불안정증 재발의 원인은 주로 외상, 부정확한 진단 및 술기상의 문제 등이 있으며 재발률을 높이는 위험인자로는 환자 요인과 해부학적 원인, 기술적 요인이 있다. 수술 실패의 원인을 세심한 병력 청취와 이학적 검사, 영상학적 검사 등으로 파악하여 원인 병변에 적절한 치료를 시행해야 한다. 수술 후 재발한 불안정증은 우선적으로 비수술적 치료를 고려해야 한다. 하지만 비수술적 치료가 실패한 경우 Bankart 병변의 파열, 관절막의 이완, 관절와 및 상완골 두의 결손에 따른 올바른 적응증을 가지고 적절한 치료 방법을 선택하여 가능한 해부학적 복원을 시행하여야 재발이 반복되는 것을 방지할 수 있을 것이다.

Keywords

References

  1. Cole BJ, L'insalata J, Irrgang J, Warner JJ. Comparison of arthroscopic and open anterior shoulder stabilization. J Bone Joint Surg Am. 2000;82:1108-14. https://doi.org/10.2106/00004623-200008000-00007
  2. Petrera M, Patella V, Patella S, Theodoropoulos J. A meta-analysis of open versus arthroscopic Bankart repair using suture anchors. Knee Surg Sports Traumatol Arthrosc. 2010;18:1742-7. https://doi.org/10.1007/s00167-010-1093-5
  3. Archetti Netto N, Tamaoki MJ, Lenza M, et al. Treatment of Bankart lesions in traumatic anterior instability of the shoulder: a randomized controlled trial comparing arthroscopy and open techniques. Arthroscopy. 2012;28:900-8. https://doi.org/10.1016/j.arthro.2011.11.032
  4. Fabbriciani C, Milano G, Demontis A, Fadda S, Ziranu F, Mulas PD. Arthroscopic versus open treatment of Bankart lesion of the shoulder: a prospective randomized study. Arthroscopy. 2004;20:456-62. https://doi.org/10.1016/j.arthro.2004.03.001
  5. Sperber A, Hamberg P, Karlsson J, Sward L, Wredmark T. Comparison of an arthroscopic and an open procedure for posttraumatic instability of the shoulder: a prospective, randomized multicenter study. J Shoulder Elbow Surg. 2001;10:105-8. https://doi.org/10.1067/mse.2001.112019
  6. Bottoni CR, Smith EL, Berkowitz MJ, Towle RB, Moore JH. Arthroscopic versus open shoulder stabilization for recurrent anterior instability: a prospective randomized clinical trial. Am J Sports Med. 2006;34:1730-7. https://doi.org/10.1177/0363546506288239
  7. Boileau P, Villalba M, Hery JY, Balg F, Ahrens P, Neyton L. Risk factors for recurrence of shoulder instability after arthroscopic Bankart repair. J Bone Joint Surg Am. 2006;88:1755-63. https://doi.org/10.2106/00004623-200608000-00010
  8. Kim SH, Ha KI, Cho YB, Ryu BD, Oh I. Arthroscopic anterior stabilization of the shoulder: two to six-year follow-up. J Bone Joint Surg. 2003;85:1511-8. https://doi.org/10.2106/00004623-200308000-00012
  9. Cho NS, Yi JW, Lee BG, Rhee YG. Revision open Bankart surgery after arthroscopic repair for traumatic anterior shoulder instability. Am J Sports Med. 2009;37:2158-64. https://doi.org/10.1177/0363546509339015
  10. Abouali JA, Hatzantoni K, Holtby R, Veillette C, Theodoropoulos J. Revision arthroscopic Bankart repair. Arthroscopy. 2013;29:1572-8. https://doi.org/10.1016/j.arthro.2013.04.017
  11. Levine WN, Arroyo JS, Pollock RG, Flatow EL, Bigliani LU. Open revision stabilization surgery for recurrent anterior glenohumeral instability. Am J Sports Med. 2000;28:156-60. https://doi.org/10.1177/03635465000280020401
  12. Zabinski SJ, Simonian P, Warner J, et al. Recurrent instability: surgical failures. In: Warren R, Craig E, Altchek D, ed. The unstable shoulder. Philadelphia: Lippincott-Raven; 1998. 429-46.
  13. Hawkins RH, Hawkins RJ. Failed anterior reconstruction for shoulder instability. J Bone Joint Surg Br. 1985;67:709-14. https://doi.org/10.1302/0301-620X.67B5.4055865
  14. Shah AS, Karadsheh MS, Sekiya JK. Failure of operative treatment for glenohumeral instability: etiology and management. Arthroscopy. 2011;27:681-94. https://doi.org/10.1016/j.arthro.2010.11.057
  15. Burkhart SS, De Beer JF. Traumatic glenohumeral bone defects and their relationship to failure of arthroscopic Bankart repairs: significance of the inverted-pear glenoid and the humeral engaging Hill-Sachs lesion. Arthroscopy. 2000;16:677-94. https://doi.org/10.1053/jars.2000.17715
  16. Kim SH, Ha KI, Kim YM. Arthroscopic revision Bankart repair: a prospective outcome study. Arthroscopy. 2002;18:469-82. https://doi.org/10.1053/jars.2002.32230
  17. Neviaser AS, Benke MT, Neviaser RJ. Open Bankart repair for revision of failed prior stabilization: outcome analysis at a mean of more than 10 years. J Shoulder Elbow Surg. 2015;24:897-901. https://doi.org/10.1016/j.jse.2014.11.036
  18. Sisto DJ. Revision of failed arthroscopic Bankart repairs. Am J Sports Med. 2007;35:537-41. https://doi.org/10.1177/0363546506296520
  19. Boileau P, Gendre P, Baba M, et al. A guided surgical approach and novel fixation method for arthroscopic Latarjet. J Shoulder Elbow Surg. 2016;25:78-89. https://doi.org/10.1016/j.jse.2015.06.001
  20. Kaar TK, Schenck RC Jr, Wirth MA, Rockwood CA Jr. Complications of metallic suture anchors in shoulder surgery: a report of 8 cases. Arthroscopy. 2001;17:31-7. https://doi.org/10.1053/jars.2001.18246
  21. Porcellini G, Campi F, Pegreffi F, Castagna A, Paladini P. Predisposing factors for recurrent shoulder dislocation after arthroscopic treatment. J Bone Joint Surg Am. 2009;91:2537-42. https://doi.org/10.2106/JBJS.H.01126
  22. Cho NS, Hwang JC, Rhee YG. Arthroscopic stabilization in anterior shoulder instability: collision athletes versus noncollision athletes. Arthroscopy. 2006;22:947-53. https://doi.org/10.1016/j.arthro.2006.05.015
  23. Voos JE, Livermore RW, Feeley BT, et al. Prospective evaluation of arthroscopic Bankart repairs for anterior instability. Am J Sports Med. 2010;38:302-7. https://doi.org/10.1177/0363546509348049
  24. Arce G, Arcuri F, Ferro D, Pereira E. Is selective arthroscopic revision beneficial for treating recurrent anterior shoulder instability? Clin Orthop Relat Res. 2012;470:965-71. https://doi.org/10.1007/s11999-011-2001-0
  25. Boone JL, Arciero RA. Management of failed instability surgery: how to get it right the next time. Orthop Clin North Am. 2010;41:367-79. https://doi.org/10.1016/j.ocl.2010.02.009
  26. Randelli P, Ragone V, Carminati S, Cabitza P. Risk factors for recurrence after Bankart repair a systematic review. Knee Surg Sports Traumatol Arthrosc. 2012;20:2129-38. https://doi.org/10.1007/s00167-012-2140-1
  27. Provencher MT, Bhatia S, Ghodadra NS, et al. Recurrent shoulder instability: current concepts for evaluation and management of glenoid bone loss. J Bone Joint Surg Am. 2010;92 Suppl 2:133-51. https://doi.org/10.2106/JBJS.J.00906
  28. Skendzel JG, Sekiya JK. Arthroscopic glenoid osteochondral allograft reconstruction without subscapularis takedown: technique and literature review. Arthroscopy. 2011;27:129-35. https://doi.org/10.1016/j.arthro.2010.09.012
  29. Tauber M, Resch H, Forstner R, Raffl M, Schauer J. Reasons for failure after surgical repair of anterior shoulder instability. J Shoulder Elbow Surg. 2004;13:279-85. https://doi.org/10.1016/j.jse.2004.01.008
  30. Locher J, Wilken F, Beitzel K, et al. Hill-Sachs off-track lesions as risk factor for recurrence of instability after arthroscopic Bankart repair. Arthroscopy. 2016;32:1993-9. https://doi.org/10.1016/j.arthro.2016.03.005
  31. Sachs RA, Williams B, Stone ML, Paxton L, Kuney M. Open Bankart repair correlation of results with postoperative subscapularis function. Am J Sports Med. 2005;33:1458-62. https://doi.org/10.1177/0363546505275350
  32. Scheibel M, Nikulka C, Dick A, Schroeder RJ, Popp AG, Haas NP. Structural integrity and clinical function of the subscapularis musculotendinous unit after arthroscopic and open shoulder stabilization. Am J Sports Med. 2007;35:1153-61. https://doi.org/10.1177/0363546507299446
  33. Hansen BP, Beck CL, Beck EP, Townsley RW. Postarthroscopic glenohumeral chondrolysis. Am J Sports Med. 2007;35:1628-34. https://doi.org/10.1177/0363546507304136
  34. McNickle AG, L'Heureux DR, Provencher MT, Romeo AA, Cole BJ. Postsurgical glenohumeral arthritis in young adults. Am J Sports Med. 2009;37:1784-91. https://doi.org/10.1177/0363546509333481
  35. Petty DH, Jazrawi LM, Estrada LS, Andrews JR. Glenohumeral chondrolysis after shoulder arthroscopy: case reports and review of the literature. Am J Sports Med. 2004;32:509-15. https://doi.org/10.1177/0363546503262176
  36. Kralinger F, Aigner F, Longato S, Rieger M, Wambacher M. Is the bare spot a consistent landmark for shoulder arthroscopy? A study of 20 embalmed glenoids with 3-dimensional computed tomographic reconstruction. Arthroscopy. 2006;22:428-32. https://doi.org/10.1016/j.arthro.2005.12.006
  37. Balg F, Boileau P. The instability severity index score. A simple pre-operative score to select patients for arthroscopic or open shoulder stabilisation. J Bone Joint Surg Br. 2007;89:1470-7. https://doi.org/10.1302/0301-620X.89B11.18962
  38. Millett PJ, Clavert P, Warner JJ. Arthroscopic management of anterior, posterior, and multidirectional shoulder instability: pearls and pitfalls. Arthroscopy. 2003;19 Suppl 1:86-93. https://doi.org/10.1016/j.arthro.2003.09.031
  39. Robinson CM, Aderinto J. Recurrent posterior shoulder instability. J Bone Joint Surg Am. 2005;87:883-92. https://doi.org/10.2106/00004623-200504000-00029
  40. Arrigoni P, Huberty D, Brady PC, Weber IC, Burkhart SS. The value of arthroscopy before an open modified Latarjet reconstruction. Arthroscopy. 2008;24:514-9. https://doi.org/10.1016/j.arthro.2007.11.021
  41. Yiannakopoulos CK, Mataragas E, Antonogiannakis E. A comparison of the spectrum of intra-articular lesions in acute and chronic anterior shoulder instability. Arthroscopy. 2007;23:985-90. https://doi.org/10.1016/j.arthro.2007.05.009
  42. Neri BR, Tuckman DV, Bravman JT, Yim D, Sahajpal DT, Rokito AS. Arthroscopic revision of Bankart repair. J Shoulder Elbow Surg. 2007;16:419-24. https://doi.org/10.1016/j.jse.2006.05.016
  43. Barnes CJ, Getelman MH, Snyder SJ. Results of arthroscopic revision anterior shoulder reconstruction. Am J Sports Med. 2009;37:715-9. https://doi.org/10.1177/0363546508328411
  44. Boileau P, Richou J, Lisai A, Chuinard C, Bicknell RT. The role of arthroscopy in revision of failed open anterior stabilization of the shoulder. Arthroscopy. 2009;25:1075-84. https://doi.org/10.1016/j.arthro.2009.04.073
  45. Sekiya JK. Arthroscopic labral repair and capsular shift of the glenohumeral joint: technical pearls for a multiple pleated plication through a single working portal. Arthroscopy. 2005;21:766.
  46. Hovelius L, Vikerfors O, Olofsson A, Svensson O, Rahme H. Bristow-Latarjet and Bankart: a comparative study of shoulder stabilization in 185 shoulders during a seventeen-year follow-up. J Shoulder Elbow Surg. 2011;20:1095-101. https://doi.org/10.1016/j.jse.2011.02.005
  47. Burkhart SS, De Beer JF, Barth JR, Cresswell T, Roberts C, Richards DP. Results of modified Latarjet reconstruction in patients with anteroinferior instability and significant bone loss. Arthroscopy. 2007;23:1033-41. https://doi.org/10.1016/j.arthro.2007.08.009
  48. Giannakos A, Vezeridis PS, Schwartz DG, Jany R, Lafosse L. All-arthroscopic revision Eden-Hybinette procedure for failed instability surgery: technique and preliminary results. Arthroscopy. 2017;33:39-48. https://doi.org/10.1016/j.arthro.2016.05.021
  49. Schmid SL, Farshad M, Catanzaro S, Gerber C. The Latarjet procedure for the treatment of recurrence of anterior instability of the shoulder after operative repair: a retrospective case series of forty-nine consecutive patients. J Bone Joint Surg Am. 2012;94:e75. https://doi.org/10.2106/JBJS.K.00380
  50. Hantes ME, Venouziou A, Bargiotas KA, Metafratzi Z, Karantanas A, Malizos KN. Repair of an anteroinferior glenoid defect by the Latarjet procedure: quantitative assessment of the repair by computed tomography. Arthroscopy. 2010;26:1021-6. https://doi.org/10.1016/j.arthro.2010.05.016
  51. Longo UG, Loppini M, Rizzello G, Ciuffreda M, Maffulli N, Denaro V. Latarjet, Bristow, and Eden-Hybinette procedures for anterior shoulder dislocation: systematic review and quantitative synthesis of the literature. Arthroscopy. 2014;30:1184-211. https://doi.org/10.1016/j.arthro.2014.04.005
  52. Bhatia S, Van Thiel GS, Gupta D, et al. Comparison of glenohumeral contact pressures and contact areas after glenoid reconstruction with Latarjet or distal tibial osteochondral allografts. Am J Sports Med. 2013;41:1900-8. https://doi.org/10.1177/0363546513490646
  53. Tjoumakaris FP, Sekiya JK. Combined glenoid and humeral head allograft reconstruction for recurrent anterior glenohumeral instability. Orthopedics. 2008;31:497.
  54. McCabe MP, Weinberg D, Field LD, O'Brien MJ, Hobgood ER, Savoie FH 3rd. Primary versus revision arthroscopic reconstruction with remplissage for shoulder instability with moderate bone loss. Arthroscopy. 2014;30:444-50. https://doi.org/10.1016/j.arthro.2013.12.015
  55. Purchase RJ, Wolf EM, Hobgood ER, Pollock ME, Smalley CC. Hill-Sachs "remplissage": an arthroscopic solution for the engaging Hill-Sachs lesion. Arthroscopy. 2008;24:723-6. https://doi.org/10.1016/j.arthro.2008.03.015
  56. Miniaci A, Gish MW. Management of anterior glenohumeral instability associated with large Hill-Sachs defects. Tech Shoulder Elb Surg. 2004;5:170-75. https://doi.org/10.1097/01.bte.0000137216.70574.ba