Arthroscopic Trillat technique for chronic anterior shoulder instability: outcomes at 2 years follow-up in 74 at risk sport-patient.

Abstract

Background: Chronic anterior shoulder instability affects a young and athletic population, with a high demand for functional recovery and return to sport. Arthroscopic Trillat dynamic stabilization technique has shown great results at 2 years in terms of stabilization and functional outcomes on general population. The hypothesis is that it could do so in at-risk for dislocation athletic population for stabilization and return to sport, with results comparable to the reference techniques.

Methods: Multicenter retrospective study of Walch-Duplay type 2, 3 and 4 at risk sports patients treated by arthroscopic Trillat for chronic anterior shoulder instability between January 2012 and January 2021, at a two years follow-up.

Primary endpoint: occurrence of dislocation recurrence. Secondary endpoints: subluxation recurrence, functional outcomes, time and level of return to sport, functional scores, bony fusion and complications.

Results: 74 patients were analyzed, with a mean age of 24.4 years (15-50). Sports level was, moderate risk of dislocation Walch-Duplay type 2 for n=34 (46%), medium risk Walch- Duplay type 3 for n=19 (26%) and high-risk Walch-Duplay type 4 for n=21 (28%). Recurrence of dislocation occurred in 3 patients (4.1%). 100% of patients returned to sport, with an average delay of 4.6 months, with n=56 (76%) returning to the same previous level. The mean Constant score was 94.5 (79-100), the Rowe score 94.7 (70-100), the Walch-Duplay score 90.2 (50-100) and the SSV score 90.5 (65-100). Subgroup analysis of athletes at moderate risk of dislocation recurrence (Walch-Duplay type 2) vs. medium and high risk of dislocation recurrence (Walch-Duplay type 3 and 4) revealed no statistically significant difference. One patient presented with asymptomatic pseudarthrosis.

Conclusion: Arthroscopic Trillat offers highly satisfactory results in the treatment of chronic anterior shoulder instability for athletes regardless of the type of sport practised and type of risk according to Walch-Duplay. This simple and quick technique enables a rapid return to sport and at the previous level in the majority of cases. After showing its effectiveness in the general population at two years, arthroscopic Trillat offers a reliable alternative to the reference procedures in young athletic patients.