Dynamic anterior stabilization of the shoulder using buttons

Abstract

Background: Surgical procedures to treat anterior shoulder instability are essentially divided into those for significant bone loss and those without relevant bone loss. However, there is a gray area between these procedures that would not require bone grafting but would benefit from improved stabilization mechanisms. This study evaluates a technique based on the triple soft tissue block, the dynamic anterior stabilization of the shoulder, using an adjustable button. Methods: Twenty patients that underwent surgical procedure from September 2017 to March 2022 were prospectively evaluated. All were assessed with University of California-Los Angeles, American Shoulder and Elbow Surgeons scores, and measurement of external rotation of the shoulder before and 24 or more months after surgery, and the Rowe score at least 24 months postsurgery. The Rowe score was compared to the standard of 90, bone loss was also measured. Results: The mean University of California-Los Angeles score changed from 25.60 ± 2.83 before surgery to 34.60 ± 0.82 postsurgery P < .01; American Shoulder and Elbow Surgeons from 84.99 ± 8.94 before surgery to 97.34 ± 4.39 postsurgery P < .01; Rowe with an average of 98.00 ± 2.99 compared to the standard 90 of excellent results P < .01. The average loss of lateral rotation was 2.25° ± 2.55 (0°-5°), and the average bone loss in patients was 8% ± 2.48% (0%-20%). Conclusion: The proposed procedure demonstrated safety and effectiveness in treating recurrent anterior glenohumeral instability.

Keywords

• Anterior shoulder instability
• Dynamic anterior stabilization
• Glenoid bone loss
• Latarjet
• Bristow
• Button