APEX Optimizing Surgical Outcomes for Knee & Shoulder Arthroscopy-Optimizing Instability Labral Repair: Bankart, SLAP

Video Transcription

Video Summary

Dr. John D. Kelly IV discusses optimizing treatment of shoulder instability, focusing on arthroscopic repair of anterior labral tears and SLAP (superior labrum anterior-posterior) injuries. He advocates for less invasive, anatomy-preserving arthroscopic methods over open surgery to restore the native labrum and capsular stability, emphasizing labral height and a strong "bumper" effect to prevent humeral dislocation. Dr. Kelly highlights the importance of capsular shifting, including the inferior and posterior bands of the inferior glenohumeral ligament complex, to restore shoulder stability. For SLAP injuries, he stresses differentiating normal anatomic variants from clinically significant labral tears, particularly those involving the "rip-stop" area near the biceps anchor, which impact mechanical stability. He warns against overtightening or "hog-tying" the biceps tendon during repair, which can impair function, especially in throwers. Rehab and kinetic chain correction are vital. Overall, precise diagnosis and surgical technique can achieve low recurrence rates and excellent outcomes.

Asset Caption

Faculty: John D. Kelly, IV, M.D., FAANA

Keywords

shoulder instability

arthroscopic repair

anterior labral tears

SLAP injuries

capsular shifting

biceps tendon repair