Editorial Commentary: Hyperlaxity Is a Common Factor in Failed Arthroscopic Bankart Repair
1
Issued Date
2023-04-01
Resource Type
ISSN
07498063
eISSN
15263231
Scopus ID
2-s2.0-85149209578
Pubmed ID
36872035
Journal Title
Arthroscopy - Journal of Arthroscopic and Related Surgery
Volume
39
Issue
4
Start Page
959
End Page
962
Rights Holder(s)
SCOPUS
Bibliographic Citation
Arthroscopy - Journal of Arthroscopic and Related Surgery Vol.39 No.4 (2023) , 959-962
Suggested Citation
Ganokroj P., Whalen R.J., Provencher C.x.M.T. Editorial Commentary: Hyperlaxity Is a Common Factor in Failed Arthroscopic Bankart Repair. Arthroscopy - Journal of Arthroscopic and Related Surgery Vol.39 No.4 (2023) , 959-962. 962. doi:10.1016/j.arthro.2022.12.018 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/82088
Title
Editorial Commentary: Hyperlaxity Is a Common Factor in Failed Arthroscopic Bankart Repair
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Hyperlaxity is a common factor in failed arthroscopic Bankart repair. The best treatment for patients with instability, hyperlaxity, and minimal bone loss is still controversial. Patients with hyperlaxity often have subluxations rather than frank dislocation, and concurrent traumatic structural lesions are infrequent. Conventional arthroscopic Bankart repair with or without capsular shift poses a risk of recurrence because of soft tissue insufficiency. The Latarjet is not a good procedure in patients with hyperlaxity and instability, especially an inferior component, and risks include a higher degree of postoperative osteolysis after Latarjet with an intact glenoid. The arthroscopic Trillat procedure may be used to treat this challenging patient group by repositioning the coracoid medially and downward by a partial wedge osteotomy. The coracohumeral distance and shoulder arch angle are decreased after performing the Trillat, which may reduce instability, and the Trillat procedure mimics the sling effect of the Latarjet. However, complications should be considered due to the procedure's nonanatomic nature, such as osteoarthritis, subcoracoid impingement, and loss of motion. Other options to improve inferior stability include robust rotator interval closure, coracohumeral ligament reconstruction, and posteroinferior/inferior/anteroinferior capsular shift. The addition of posteroinferior capsular shift and rotator interval closure in the medial lateral direction also benefits this vulnerable patient group.