Abstract
Purpose: Revision surgery after failed open stabilisation can be difficult and challenging. Arthroscopy has been utilised for assessment and preoperative planning, but there are few reports of arthroscopic stabilisation as the definitive revision procedure.
Methods: We reviewed our experience of 12 cases requiring revision, including one originally stabilised at our own institution. There were 9 males and 3 females, with an average age of 27 years assessed at an average of 18 months (range 6–46 months) following arthroscopic revision. Patients were scored using the SF-12, simple shoulder test, and Walch-Duplay outcome measures.
Results: The cases were revised arthroscopically from 6 months to 11 years after the open procedure, which included Bankart repairs (with and without suture anchors), capsular shifts and Putti-Platt procedures. Eight cases were successfully revised for symptomatic recurrent anterior instability, and in all capsulolabral reconstruction was carried out using a knotless anchor technique. In two cases secondary posterior instability was managed either by posterior labral repair or by balancing anterior release. In two cases disabling postsurgical stiffness was managed by arthroscopic anterior release with improvement in functional range of motion.
Summary: Open surgical stabilisation can be complicated by recurrent instability or stiffness, or may be followed by further trauma in this active athletic population. Arthroscopy enables detailed and more thorough diagnosis of the reason for failure. These early results demonstrate that arthroscopic revision is safe and feasible, facilitates a range of intra-articular surgical options and provides outcomes that may be comparable with open revision.
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