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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(01): 014-022
DOI: 10.1055/s-0041-1731357
Artigo de Atualização
Artroscopia e Traumatologia do Esporte

Arthroscopy Limits on Anterior Shoulder Instability

Article in several languages: português | English
Jair Simmer Filho 
1   Hospital Santa Rita, Vitória, ES, Brasil
,
Raul Meyer Kautsky 
1   Hospital Santa Rita, Vitória, ES, Brasil
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Abstract

Much is discussed about the limits of the treatment of anterior shoulder instability by arthroscopy. The advance in understanding the biomechanical repercussions of bipolar lesions on shoulder stability, as well as in the identification of factors related to the higher risk of recurrence have helped us to define, more accurately, the limits of arthroscopic repair.

We emphasize the importance of differentiation between glenoid bone loss due to erosion (GBLE) and glenoid edge fractures, because the prognosis of treatment differs between these forms of glenoid bone failure. In this context, we understand that there are three types of bone failure: a) bone Bankart (fracture); b) combined; and c) glenoid bone loss due to anterior erosion (GBLE), and we will address the suggested treatment options in each situation.

Until recently, the choice of surgical method was basically made by the degree of bone involvement. With the evolution of knowledge, the biomechanics of bipolar lesions and the concept of glenoid track, the cutoff point of critical injury, has been altered with a downward trend. In addition to bone failures or losses, other variables were added and made the decision more complex, but a little more objective.

The present update article aims to make a brief review of the anatomy with the main lesions found in instability; to address important details in arthroscopic surgical technique, especially in complex cases, and to bring current evidence on the issues of greatest divergence, seeking to guide the surgeon in decision making.

Keywords

shoulder joint - arthroscopy - glenoid cavity - rotator cuff injuries - shoulder injuries - shoulder dislocation


Publication History

Received: 07 December 2020

Accepted: 15 April 2021

Article published online:
25 October 2021

© 2021. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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