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- Talk
- Canada
Bone Deficit and Shoulder Instability Surgery: Role of the Hill-Sachs in Arthroscopic Surgical Failures. Results of a Prospective Cohort Study
Description
In this presentation, Dr. Patrick Goetti discusses the Arthroscopic Anatomic Bankart repair, highlighting its effectiveness in reducing shoulder instability and improving patients' quality of life. The operation boasts an up to 80% success rate; however, it also faces significant challenges with failure rates that can be as high as 80%. Dr. Goetti emphasizes the importance of considering associated pathologies such as glenoid and humeral bone loss, which can greatly impact surgical outcomes.
He elaborates on recent insights regarding glenoid and humeral bone loss, noting how even minimal losses can affect recovery after surgery. The presentation also introduces the Glenoid track method for assessing Hill-Sachs lesions and mentions ongoing debates about the best predictive measurements for recurrent instability following arthroscopic repairs.
The data from a prospective multicenter cohort study, which included adolescents and adults with a history of shoulder dislocation, reveals substantial findings. Among the participants, most were young males with a high incidence of previous dislocations and a notable rate of Hill-Sachs lesions. The analysis shows that while the Latarjet procedure had a lower recurrence rate compared to the Bankart procedure, various factors, including angles of engagement during external rotation, were linked to recurrence. Interestingly, the study found that humeral bone loss plays a critical role in treatment failure, overshadowing the impact of glenoid bone loss. Dr. Goetti concludes that the orientation of Hill-Sachs lesions may be even more critical than their size in predicting outcomes, with recurrence significantly correlating to functional scores at follow-up.