Arthroscopic subscapularis bankart technique as a salvage procedure for failed anterior shoulder stabilization.
BACKGROUND
Shoulder instability is a relatively common problem. Even with contemporary surgical techniques, instability can recur following both open and arthroscopic fixation. Surgical management of capsular insufficiency in anterior shoulder stabilization represents a significant challenge, particularly in young, active patients. There are a limited number of surgical treatment options. The Laterjet technique can present with a number of intraoperative challenges and postoperative complication.


METHODS
We report an arthroscopic subscapularis tenodesis technique as a salvage procedure for challenging glenohumeral instability cases. Sutures are passed through the subscapularis tendon and capsule before they are tied as one in the subdeltoid psace. The rotator interval is closed with superior and medial advancement of anterior and inferior tissue. This technical note carefully describes this procedure with useful technical tips, illustrations, and diagrams.


METHODS
Two clinical cases are described involving patients with recurrent instability following failed surgery who were successfully managed with this procedure.


RESULTS
Both cases described resulted in improved shoulder stability, range of motion, and function following management with this surgical technique. This arthroscopic subscapularis tenodesis procedure is proposed as a useful alternative repair technique for cases of recurrent instability after failed surgery with isolated capsular insufficiency.


CONCLUSIONS
It is believed that this arthroscopic subscapularis tenodesis technique can potentially provide similar outcomes to open bone block stabilization procedures, while reducing the risks associated with those procedures.
Sports Medicine Department, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
Salma
S
Chaudhury
Sports Medicine Department, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
Demetris
D
Delos
Sports Medicine Department, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
Joshua S
JS
Dines
Sports Medicine Department, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
David W
DW
Altchek
Sports Medicine Department, Rothman Institute, Pennsylvania, USA.
Christopher C
CC
Dodson
Sports Medicine Department, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
Ashley M
AM
Newman
Sports Medicine Department, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
Stephen J
SJ
O'Brien
Bankart repair; anterior shoulder stabilization; arthroscopic; shoulder instability; subscapularis; tenodesis