Recurrent Shoulder Dislocations
Conditions
Keywords
ABD, ABDuction, ABR, Arthroscopic Bankart Repair, ACJ, AcromioClavicular Joint, AD, Anterior Drawer, ARIC, Arthroscopic Rotator Interval Closure, BL, Bankart Lesion, CHL, CoracoHumeral Ligament, ER, External Rotation, FF, Forward Flexion, GHJ, GlenoHumeral Joint, HSL, HillSacs Lesion, IR, Internal Rotation, ISP, InfraSPinatus, PD, Posterior Drawer, RI, Rotator Interval, ROM, Range Of Motion, SGHL, Superior GlenoHumeral Ligament, SSC, SubSCapularis, SSP, SupraSPinatus
Brief summary
Study Title: Arthroscopic rotator interval closure in shoulder instability repair - a prospective study Objective: To evaluate the effect of arthroscopic rotator interval closure (ARIC) on patients with recurrent shoulder dislocations undergoing arthroscopic bankart repair (ABR) in terms of recurrence, rehabilitation and function. Hypothesis: 1. Although Hyperlax patients undergoing ABR have higher incidence of recurrent shoulder dislocations than those without hyperlaxity, adding ARIC will lower the recurrent dislocation rate. 2. Patients with arthroscopic bankart repair (ABR) and ARIC are slower in gaining the range of motion (ROM) but within 6 months are equal to those with ABR only.
Interventions
PROCEDUREArthroscopic Bankart repair
Seated in a beach chair position, arm fixed with a skin traction device (Spider shoulder Immobilizer or 3kg traction), arthroscopy through a posterior portal, anterior portal used for inspection and instrumentation, labral lesion released using a suture liberator, full radius and VAPER. Preparation of the glenoid with rasp up and down. Insertion of anchors as necessary into the glenoid and ligation of labral lesion with the sutures. Wound closure with ethilon 4/0 suture, striped dressing, velpeau arm sling.
PROCEDUREABR+ARIC
Seated in a beach chair position, arm fixed with a skin traction device (Spider shoulder Immobilizer or 3kg traction), arthroscopy through a posterior portal, anterior portal used for inspection and instrumentation, labral lesion released using a suture liberator, full radius and VAPER. Preparation of the glenoid with rasp up and down. Insertion of anchors as necessary into the glenoid and ligation of labral lesion with the sutures. Through additional anterior superior portal a suture is passed inferior and adjacent to the SSP and through the superior portion of the Sub Scapularis tendon while the arm in 30 degree of external rotation. Tightening the suture on top of the capsule underneath the deltoid. Wound closure with ethilon 4/0 suture, striped dressing, velpeau arm sling.
Sponsors
Tel-Aviv Sourasky Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
16 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Age 16-40 years old * Anterior Shoulder instability * Hyperlaxity (general and shoulder laxity)
Exclusion criteria
* Previous humerus/glenoid fracture * large bony Bankart * Previous shoulder operation * Adhesive capsulitis-Habitual dislocations
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Recurrent shoulder dislocation or instability symptoms | Patients will be followed in hospital shoulder clinic 6, 12, 26, 52 weeks post op and then in 1 year intervals until final follow up. |
Secondary
| Measure | Time frame |
|---|---|
| Post operative range of motion (ROM) | Patients will be followed in hospital shoulder clinic 6, 12, 26, 52 weeks post op and then in 1 year intervals until final follow up. |
| Activity level | Patients will be followed in hospital shoulder clinic 6, 12, 26, 52 weeks post op and then in 1 year intervals until final follow up. |
| Need for recurrent surgery | Patients will be followed in hospital shoulder clinic 6, 12, 26, 52 weeks post op and then in 1 year intervals until final follow up. |
| Pain | Patients will be followed in hospital shoulder clinic 6, 12, 26, 52 weeks post op and then in 1 year intervals until final follow up. |
Countries
Israel
Outcome results
None listed