title: Arthroscopic Bankart repair and subscapularis augmentation: an alternative technique treating anterior shoulder instability with bone loss.
abstract: BACKGROUND
  This study presents the preliminary results of a new arthroscopic technique consisting of the association of 2 procedures, capsulolabral repair and subscapularis augmentation tenodesis, in the treatment of traumatic anterior shoulder instability with both glenoid bone loss and a Hill-Sachs lesion.
  
  
  METHODS
  Eighty-nine patients engaged in sports were enrolled in this retrospective case-series study with 2 to 5 years' follow-up. All patients underwent a computed tomography scan to assess the percentage of glenoid bone loss by the Pico method. A prior stabilization procedure had failed in 20 patients, who were then segregated into a different group. Visual analog scale (VAS), Rowe, and American Shoulder and Elbow Surgeons (ASES) scores were used to assess the results.
  
  
  RESULTS
  Only 3 of 89 patients had a post-traumatic redislocation. The mean length of follow-up was 31.5 months (range, 25-60 months). The VAS, Rowe, and ASES scores showed significant improvements: The VAS score decreased from a mean of 3.1 to 0.5 (P = .0157), the Rowe score increased from 58.9 to 94.1 (P = .0215), and the ASES score increased from 68.5 to 95.5 (P = .0197). The mean deficit of external rotation was 6° with the arm at the side of the trunk, and the mean deficit was 3° with the arm in 90° of abduction.
  
  
  CONCLUSIONS
  The described procedure is a reproducible and effective technique used to restore joint stability in patients engaged in sports who have incurred anterior recurrent shoulder dislocation associated with glenoid bone loss (<25%) and a Hill-Sachs lesion.
authors.affiliation: Sports Traumatology Unit, San Giovanni-Addolorata Hospital, Rome, Italy. Electronic address: m.maiotti@libero.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Maiotti
authors.affiliation: Orthopaedic and Traumatology Unit, Pellegrini Hospital, Naples, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Russo
authors.affiliation: Arthroscopy Unit, Carlo Poma Hospital, Mantua, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Zanini
authors.affiliation: BG Trauma Center Department of Traumatology, Eberhard Karls University, Tübingen, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Schröter
authors.affiliation: Sports Traumatology Unit, San Giovanni-Addolorata Hospital, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Massoni
authors.affiliation: Isokinetic Group, Rome, Italy.
authors.forename: Diana
authors.initials: D
authors.lastname: Bianchedi
mesh_terms: D000293:Adolescent; D000328:Adult; D001178:Arthroplasty / Q000379:methods*; D001182:Arthroscopy; D001265:Athletic Injuries / Q000601:surgery; D001862:Bone Resorption / Q000601:surgery*; D005260:Female; D051445:Fibrocartilage / Q000601:surgery; D006801:Humans; D017746:Joint Capsule / Q000601:surgery; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D012540:Scapula / Q000601:surgery; D012783:Shoulder Dislocation / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D053656:Tenodesis / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
keywords: Hill-Sachs lesion; Traumatic shoulder instability; arthroscopic subscapularis augmentation; glenoid defect