Yousef Khair*, Ayman Mustafa, Saab Mestarihi, Malek Ghnaimat, Gaith Abu Nwar, Sana’a Haddadin, Silvana De Giorgi
Received:May 5, 2021 Published:May 14, 2021
Corresponding author: Yousef Khair, Department of Orthopedics, Royal Medical Services, Zahran street, Zahran Post office mail code 11183, Amman, Jordan
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Background: Recurrent anterior shoulder dislocation is a very common problem that face the orthopedic surgeon, which affects young people in their life, especially the professional workers or athletes and military persons. They may need either arthroscopic or open procedure to obtain a stable shoulder. Arthroscopic Bankart repair is the most popular technique used, but there is a high recurrence rate in patients either with labral tear or glenoid bone loss more than 25%. Bankart repair depends on the presence of a capsule stretching and /or attenuation which is reported in patients with a chronic recurrent shoulder dislocation. The purpose of this study is to explain the technique that we used to reconstruct the labral defect in recurrent shoulder dislocation by using Biceps Brachii tendon as auto graft.
Methods: Four patients with history of recurrent shoulder dislocation underwent shoulder arthroscopy using the long head of Biceps as autograft in our department with average follow up 21 months (range,18 - 26 months) after the operation. All the patients had history of recurrent shoulder dislocation. We evaluated them according to clinical examinations and radiological investigations including X-ray and MRI. In this paper we explain our arthroscopic technique using long head of Biceps Brachii as a graft to cover anterior glenoid in cases of unreconstructedly labrum.
Results: The patients who underwent arthroscopic surgery using this technique had a significant improvement, pain free range of motion were normal forward flexion 170˚ - 180˚, abduction 90˚, external rotation with abduction 90˚, with normal flexion of elbow, normal supination and pronation. Apprehension test post-operative was negative, and improvement DASH score 14.5 to 16.5. The patients return to do their daily activities normally.
Conclusion: Using Biceps tendon as autograft to cover the labral defect will do the same work of the labrum to form a bumper by deepening the socket so the ball will be in its place, for this reason we repair the capsule and the Biceps tendon to restore shoulder instability with less side effects when comparing with conjoined tendon transfer and it is a simple procedure.
Keywords: Recurrent Shoulder Instability; Bankart Repair; Biceps Brachii Autograft; Latarjet Procedure
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