title: Revision anterior capsular shoulder stabilization using hamstring tendon autograft and tibialis tendon allograft reinforcement: minimum two-year follow-up.
abstract: Surgical treatment of anterior shoulder capsular deficiency has been a challenge for orthopaedic surgeons dealing with failed anterior shoulder stabilization procedures. We have used hamstring tendon autograft or tibialis tendon allograft to reinforce deficient anterior capsular tissue in patients with failed anterior shoulder stabilization. We performed a clinical follow-up of 15 patients at a minimum of 2 years after surgery, using the American Shoulder and Elbow Surgeons questionnaire, a physical examination, and radiographs. Thirteen patients were satisfied with their surgery. The mean American Shoulder and Elbow Surgeons score was 73, (range, 7-100). There were no postoperative dislocations. The operative shoulder had decreased range of motion compared with the contralateral shoulder. The operative arm lacked 10 degrees of forward flexion, 21 degrees of external rotation at the side, 24 degrees of external rotation with the arm in abduction, and 4 spinal levels of internal rotation. Two patients required total shoulder arthroplasty for painful glenohumeral arthritis. Clinical failure was related to glenohumeral arthritis or residual anterior shoulder apprehension. Our results support the use of hamstring autograft or tibialis anterior allograft for the reconstruction of the anterior capsule during revision shoulder stabilization surgery.
authors.affiliation: Ocean Orthopedic Associates, PA, Toms River, NJ, USA.
authors.forename: Jess G
authors.initials: JG
authors.lastname: Alcid
authors.forename: Scott E
authors.initials: SE
authors.lastname: Powell
authors.forename: James E
authors.initials: JE
authors.lastname: Tibone
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D017746:Joint Capsule / Q000601:surgery; D007593:Joint Instability / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000534:rehabilitation; D016059:Range of Motion, Articular / Q000502:physiology*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery*; D013710:Tendons / Q000637:transplantation*; D013718:Tensile Strength; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous