Post-traumatic anterior glenohumeral microinstability in nonathletic patients satisfactory short-term outcomes of a case-control study of concurrent intra-articular soft arthroscopic Latarjet technique and suture-anchor capsular plication

Abstract

Introduction/Objectives

Arthroscopic management of post-traumatic anterior glenohumeral micro-instability, in the non-athletes, has not yet been thoroughly investigated. The current study compared the outcomes of antero-inferior capsulo-labral repair for the management of anterior glenohumeral microinstability (following a single-event trauma in the nonathletes) versus those of Bankart repair for the management of recurrent anterior gleno-humeral dislocation/macro-instability.

Methods

Conducted between March 2018 and February 2024, this case–control study included 62 patients allocated according to the managed pathology into 2 groups. Group A included 21 nonathletes with anterior glenohumeral microinstability (following single-event trauma) managed with suture-anchor antero-inferior capsulo-labral repair coupled with the intra-articular soft arthroscopic Latarjet technique (in-SALT), including soft-tissue biceps tenodesis to the upper subscapularis. Whereas group B, on the other hand, included 41 nonathletes with recurrent anterior glenohumeral dislocation/macroinstability (i.e. type-V superior labrum anterior to posterior [SLAP] lesion) managed with suture-anchor Bankart repair coupled with in-SALT. Outcome measurements included the 2-year postoperative visual analog scale (VAS) score; range of forward flexion (FF) and external rotation (ER) at 90°-abduction; and the American Shoulder and Elbow Surgeons (ASES) and Rowe scores.

Results

There were no intergroup statistically significant differences in baseline patient characteristics. The mean age of the patients was 26.8 ± 7.0 in group A and 26.6 ± 6.8 in group B. Other than 1 female patient in each group, all included patients were male. Except for range of motion in group A, patients in both groups had significant postoperative improvement in all outcome measurements (P < 0.05 for all). Both groups showed comparable postoperative outcomes in terms of the VAS score (1.0 ± 0.8 vs 1.1 ± 0.9; P = 0.607), FF (173.8° ± 7.4° vs 172.2° ± 5.2°; P = 0.324), ER at 90°-abduction (83.3° ± 7.3° vs 80.7° ± 6.1°; P = 0.142), ASES score (91.5 ± 4.4 vs 92.1 ± 3.0; P = 0.582); Rowe score (89.8 ± 4.0 vs 88.2 ± 5.8; P = 0.264), and instability persistence/recurrence (4.8% vs 2.4%; P = 0.624), respectively.

Conclusion

Anterior glenohumeral micro-instability following a single-event trauma in nonathletes could be successfully managed (in a way similar to that of type-V SLAP lesion of the recurrent anterior glenohumeral dislocation/macroinstability) via in-SALT-augmented suture-anchor antero-inferior capsulo-labral repair with comparable outcomes.

Trial Registration

The study was approved by the Institutional Committee of Scientific Research and Ethics (IRB: 2/2023 ORTH 30-3).

Level of evidence

III.