Paper 243: Arthroscopic Repair of Combined SLAP and Bankart Lesions

ABSTRACTS Paper 242: Arthroscopic Repair of Isolated Partial Subscapularis Tendon Tears MARTIN MIKEK, MD, SLOVENIA, PRESENTING AUTHOR MOHSEN HUSSEIN, MD, SLOVENIA ABSTRACT Rotator cuff tears involving complete subscapularis tendon tears are relatively uncommon. In contrast to that, partial intraarticular tears in the upper third of subscapularis tendon insertion appear to be much more frequent. According to different theories, these tears could be related either to degenerative tendon weakening or subcoracoid impingement. We describe an arthroscopic intraarticular approach for repair of partial intraarticular subscapularis tendon lesions and present short-term results of this technique. We prospectively followed 38 patients diagnosed with partial isolated subscapularis tendon tear and treated by arthroscopic intraarticular tendon repair. In all patients a coracoplasty through rotator interval was performed and tendon was repaired with one or two absorbable suture anchors. There were 23 men and 15 women with a mean age of 52 years in our study group. Functional results were assessed by Constant and UCLA score, pain was evaluated by VAS. All measurements were performed preoperatively and at the time of final examination by an independent observer. Statistical significance was calculated using T-test for paired variables. Average time of follow-up was 18 months. Average preoperative Constant score was 43(⫾9) and improved afterwards to 84 (⫾7). Average preoperative UCLA score was 11(⫾4) and improved to 31 (⫾2) at the final examination. Average preoperative VAS score was 8 (⫾1) and postoperatively 2 (⫾1). The measured improvements in shoulder function and pain were all statistically significant. Arthroscopic intraarticular repair of partial articularsided subscapularis tendon tears is an effective procedure that preserves the residual intact attachment of the subscapularis tendon and according to our short-term results helps to significantly improve shoulder function. Paper 243: Arthroscopic Repair of Combined SLAP and Bankart Lesions GUILLERMO R. ARCE, MD, ARGENTINA, PRESENTING AUTHOR ANTÓNIO CARTUCHO, M.D., PORTUGAL BENNO EJNISMAN, MD, BRAZIL ENRIQUE ESTEBAN PEREIRA, MD, ARGENTINA ABSTRACT Overview: Superior labral anterior posterior (SLAP) lesions arise from different injury mechanisms. Their as-

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sociation with an anteroinferior labrum detachment is a challenging situation for athletes. Arthroscopic techniques over the open procedures are suitable for an accurate reconstruction of the involved structures. Purpose: The aim of this study was to retrospectively evaluate patients who underwent arthroscopic treatment for SLAP lesions combined with anteroinferior labral reconstruction (Maffet SLAP V). Type of Study: Case Series. Level IV. Methods: Out of 123 arthroscopic shoulder stabilization procedures performed in ours institutions, 21(17%) patients presented a superior labrum detachment which deserved suture anchor fixation. Eighteen patients (15 males and 3 females) with a mean age of 27 years (range 17 to 43 years) were available for a mean follow up of 35.5 months (range 24 to 56 months). In all the patients the symptoms started after trauma. The main preoperative complain was instability with dislocations and subluxations in 15 shoulders. Three patients suffered pain alone without important signs of instability. Only in 5 cases the preoperative MRI demonstrated the superior labrum injury. As a first step of the procedure the anterior-inferior labrum was fixed with moderate capsular placation. The SLAP lesion was stabilized later through a posterolateral portal. An average of 4.3 anchors were used to fix the anteroinferior labrum and one of these devices was used to stabilize the superior labrum posterior to the LHB insertion area. The included cases were fully preoperatively and postoperatively evaluated with extensive physical exam, UCLA, Constant & Murley and Rowe Scores. Results: At the follow up evaluations two patients were considered clinical failures (11%). One due to dislocations and one for pain and disability without instability symptoms. Functional results were excellent-good in 16 patients (89%). The mean UCLA Score increased from 17,1 preoperatively to a 28.8 postoperatively (P ⫽ 0,00002) with a corresponding increase in the mean Rowe Score from 34,1 to 85 points (P ⫽ 0,00003). The Constant and Murley Score improve from 63,7 preoperatively to 84,4 postoperatively (P ⫽ 0,0002). Conclusions: The combined injury of the superior and anterior-inferior labrum is not infrequently seen. Arthroscopic fixation of the avulsed labrum seems to be the mainstay of treatment of these complex injuries. Key Words: Shoulder - SLAP - Instability – Bankart Paper 244: Arthroscopic Posterior Stabilization for Recurrent Posterior Glenohumeral Instability: A Report of 18 Cases JEAN FRANCOIS KEMPF, MD, FRANCE, PRESENTING AUTHOR LE CONIAT YVAN, MD, FRANCE PHILIPPE CLAVERT, FRANCE