Revision Treatment Options for Recurrent Instability Following Failed Anterior Arthroscopic Stabilization (AANA19)-Revision Treatment Options for Recurrent Instability Following Failed Anterior Arthroscopic Stabilizations_ _The Bone Block

Revision Treatment Options for Recurrent Instability Following Failed Anterior Arthroscopic Stabilizations_ _The Bone Block_-Dr. Michael Thomas Freehill, M.D.

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Video Summary

The speaker discusses challenges and evolving techniques in treating recurrent shoulder instability, particularly following failed Bankart repairs. High recurrence rates, especially in young collision-sport athletes, highlight limitations of traditional arthroscopic Bankart repairs. Glenoid bone loss over 20% typically necessitates a Latarjet procedure, but there remains a “gray zone” with less bone loss where options vary. Revision Bankart, open repairs, and Latarjet—arthroscopic or open—are considered alongside emerging bone block approaches using iliac crest or distal tibia grafts. The speaker emphasizes the complexity and risks of Latarjet, including nerve injury and graft complications. A novel arthroscopic bone block technique employing suture fixation rather than screws is presented, showing promising healing rates (~81-93%) and lower graft resorption. The graft is positioned via a minimally invasive rotator interval approach with suture anchors to secure it. Early results suggest this method offers a strong alternative with fewer complications, preserving options if it fails. Overall, the talk highlights innovation addressing recurrent anterior shoulder instability through tailored surgical solutions.

Asset Caption

Instructional Course Lecture: Revision Treatment Options for Recurrent Instability Following Failed Anterior Arthroscopic Stabilization

Keywords

recurrent shoulder instability

Bankart repair

Latarjet procedure

arthroscopic bone block

graft fixation techniques