Summary

Augmenting the glenoid rim with additional bone widens the glenoid arc and increases healing response of the anterior capsulolabral repair.

Abstract

Twenty patients with recurrent traumatic anterior dislocations were repaired with an arthroscopic Bankart combined with secured clavicle autograft. Indications for the augmentation include chronic glenoid rim loss 15-25%, collision athletics, revision of failed surgery, engaged Hill Sachs lesion, and recurrent seizures. Enlarged Hill Sachs defect combined with off track lesions had remplissage added to this procedure.

Successful stabilization occurred in 18 of the 20 shoulders. A second surgery was required in one patient with graft displacement and a second patient with a traumatic redislocation. External rotation loss averaged 5 degrees. Post operative imaging included radiographs and CT scans (12) prior to returning to sport.

The arthroscope continues to be a preferred surgical approach to visualize and correct an unstable shoulder. There are a number of patients at risk of recurrence due to anatomic changes and bone loss, and others due to type of sport or seizure occurrence. The Latarjet procedure has gained popularity to improve stabilization rates in high risk patients. Unfortunately, the complication rates and types of complications have raised concern in athletic patients. Traversing the subscapularis with a non anatomic repair can produce greater loss of external rotation and potentiate the evolution of degenerative arthritis. Use of the clavicle autograft in an inexpensive option to repair the articular structures and reduce risk of recurrence in the active, demanding population.