Superior capsular reconstruction for recurrent anterior shoulder dislocation with irreparable rotator cuff tear: a case report

• DOI: 10.1016/j.xrrt.2022.03.005
• Publication Date: 2022-04-22T16:07:03Z
• Authors: Keizumi Matsugasaki; Atsushi Urita; Yukinori Tsukuda; Hiroshi Taneichi; Norimasa Iwasaki
• Keywords: Bankart lesion; Rotator cuff injury; Bankart repair; Cuff; Joint stability

Traumatic or recurrent dislocation of the shoulder due to disruption anterior band inferior glenohumeral ligament (AIGHL) complex occurs in young and active populations.1Blasier R.B. Guldberg R.E. Rothman E.D. Anterior stability: Contributions rotator cuff forces capsular ligaments a cadaver model.J Shoulder Elbow Surg. 1992; 1: 140-150Abstract Full Text PDF PubMed Scopus (129) Google Scholar However, concomitance tears associated with traumatic increases advancing age.24Simank H.G. Dauer G. Schneider S. Loew M. Incidence dislocations results therapy older patients.Arch Orthop Trauma 2006; 126: 235-240https://doi.org/10.1007/s00402-005-0034-0Crossref (47) These different injury patterns are thought represent secondary changes tissue properties that occur aging.9Hawkins R.J. Bell R.H. Hawkins Koppert G.J. patient.Clin Relat Res. 1986; 206: 192-195Crossref (97) Treatment instability patients has been focused on Bankart lesion osseous lesions glenoid humeral head. A large defect, Hill-Sachs lesion, poses risk postoperative redislocation after repair.2Boileau P. Villalba Héry J.Y. Balg F. Ahrens Neyton L. Risk factors for recurrence arthroscopic repair.J Bone Joint Surg Am. 88: 1755-1763https://doi.org/10.2106/jbjs.e.00817Crossref (0) Scholar,3Burkhart S.S. Debeer J.F. Tehrany A.M. Parten P.M. Quantifying bone loss arthroscopically instability.Arthroscopy. 2002; 18: 488-491https://doi.org/10.1053/jars.2002.32212Abstract (309) On other hand, among patients, main focus because functional outcomes including pain weakness muscles become problematic dislocation.25Sonnabend D.H. primary than 40 years age. Conservative versus operative.Clin 1994; 304: 74-77Crossref Scholar,28Toolanen Hildingsson C. Hedlund T. Knibestöl Oberg Early complications over years: An ultrasonographic electromyographic study.Acta Scand. 1993; 64: 549-552Crossref (89) an irreparable tear is difficult condition treat middle-aged patients. Superior reconstruction (SCR) widely performed tear.4Burkhart Hartzler R.U. reverses profound pseudoparalysis minimal no arthritis.Arthroscopy. 2019; 35: 22-28https://doi.org/10.1016/j.arthro.2018.07.023Abstract (91) Scholar,14Mihata Lee T.Q. Hasegawa A. Kawakami Fukunishi K. Fujisawa Y. et al.Arthroscopic superior capsule can eliminate tears.Am J Sports Med. 2018; 46: 2707-2716https://doi.org/10.1177/0363546518786489Crossref (92) few reports have described tear. This report describes repair SCR treatment case would provide not only improvement by reconstructing but also stability filling graft material. 54-year-old man complained restricted function right shoulder. The first had occurred at 52 age he fell his hand. He then experienced shoulder, 20 events 2 years. Physical findings showed clearly range motion 100° flexion, 90° abduction, 30° external rotation, internal rotation level L4. patient could elevate concerns anxiety regarding dislocation. Positive were obtained apprehension test sulcus sign. University California, Los Angeles, score was 10 (maximum, 34), Japanese Orthopaedic Association 35 100). Radiographs slight degenerative joint without head (Fig. 1). Computed tomography defect comprised 20% whole 2, A). larger track considered off-track as Yamamoto al B).30Yamamoto N. Itoi E. Abe H. Minagawa Seki Shimada al.Contact between horizontal extension: new concept track.J 2007; 16: 649-656https://doi.org/10.1016/j.jse.2006.12.012Abstract (415) Magnetic resonance imaging (MRI) anteroinferior labral 2- 5-o’clock position massive supraspinatus infraspinatus tendons 3, A-C). According Goutallier classification, fatty infiltration stage 1 3 oblique sagittal view D). Based these findings, we diagnosed tear.Figure 2Three-dimensional computed tomography. (A) Glenoid. (B) Humeral head.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Figure 3Preoperative magnetic imaging. Axial view. Oblique coronal (C) (D) medial muscle cuffs.View (PPT) options discussed considering patient, tear, lesion. tendon based severe infiltration. Reverse arthroplasty (RSA) one options, this middle-aged, did show osteoarthritic changes. We therefore believed soft-tissue such desirable In addition, bony necessary thus required additional treatment. remplissage procedure involves prevent engagement missing so unavailable remplissage, enables material addition capsule. finally decided perform combined SCR. arthroscopy beach chair under general anesthesia. arthroscope used visualization. standard diagnostic evaluate intra-articular structures tendon. observed from 4, Furthermore, existed posterolateral portion B), engaging during abduction rotation. detached repaired using 4 suture anchors (FiberTak anchor; Arthrex Inc., Naples, FL, USA) 5, Tear sizes mm anteroposterior diameter 50 mediolateral diameter. Fascia lata (size 140 × mm) harvested lateral aspect contralateral thigh, distal greater trochanter. (length, mm; width, thickness, 8 fashioned folding fascia twice B). Two (Corkscrew FT 4.5 inserted into glenoid. (Biocomposite Corkscrew FT, Double Loaded 4.75 side tuberosity. Of these, posterior anchor fill After threads passed through graft, subacromial space. fixed mattress sutures, bridging technique which (SwiveLock C, Closed Eyelet Finally, side-to-side sutures No. FiberWire added teres minor pillow weeks postoperatively. Passive exercises started operation. Active forward elevation sitting allowed Heavy work sports 6 months postoperatively.Figure 5(A) Arthroscopic folding.View At latest follow-up, 24 postoperatively, occurred. improved 165° 45° Th10. Angeles 33, 95. progression change joint. MRI healing grafts tuberosity 6, prevalence following Previous shown individuals typically display spectrum pathologies younger dislocation.6Curl L.A. Warren R.F. Glenohumeral stability. Selective cutting studies static restraints.Clin 1996; 330: 54-65Crossref (79) Scholar,20Pevny Hunter Freeman J.R. Primary older.Arthroscopy. 1998; 14: 289-294Abstract (77) rate higher individuals. Deitch reached 75% adolescents.7Deitch J. Mehlman C.T. Foad S.L. Obbehat Mallory adolescents.Am 2003; 31: 758-763https://doi.org/10.1177/03635465030310052001Crossref (109) Wheeler reported 92% who received nonoperative further dislocation.29Wheeler J.H. Ryan J.B. Arciero R.A. Molinari R.N. acute athletes.Arthroscopy. 1989; 5: 213-217Abstract (258) Pevny 4% group years.20Pevny central joint, structure likely fail pre-existing elderly patients.5Craig E.V. mechanism dislocations.Clin 1984; 190: 212-216Crossref (44) restraint provided may cause instability. Rodosky noted 50% decrease activity resulted increase occurrence dislocations.22Rodosky M.W. Harner C.D. Fu F.H. role long biceps labrum shoulder.Am 22: 121-130Crossref (418) importance muscles, dynamic stabilizer cadaveric model.10Itoi Newman S.R. Kuechle D.K. Morrey B.F. K.N. Dynamic stabilisers arm abduction.J Br. 76: 834-836Crossref For reasons, treatments when exist.9Hawkins Scholar,24Simank Rotator should be experience Not AIGHL rim glenoid.8Di Giacomo de Gasperis Scarso Bipolar dislocation.Knee Traumatol Arthrosc. 2016; 24: 479-488https://doi.org/10.1007/s00167-015-3927-7Crossref (28) 3-dimensional studies.19Omori Koishi Futai Goto Sugamoto al.Measurement vivo investigated analysis open MRI.Am 2014; 42: 1290-1295https://doi.org/10.1177/0363546514527406Crossref (74) Scholar,30Yamamoto Several contributing factor instability.12Locher Wilken Beitzel Buchmann Longo U.G. Denaro V. al.Hill-Sachs repair.Arthroscopy. 32: 1993-1999https://doi.org/10.1016/j.arthro.2016.03.005Abstract (76) Scholar,17Mook W.R. Petri Greenspoon J.A. Horan M.P. Dornan Millett P.J. Clinical anatomic predictors Latarjet defects.Am 44: 1407-1416https://doi.org/10.1177/0363546516634089Crossref (48) Scholar,23Shaha J.S. Cook Rowles D.J. Bottoni C.R. Shaha S.H. Tokish J.M. validation instability.J 98: 1918-1923https://doi.org/10.2106/jbjs.15.01099Crossref demonstrated repair, whereas on-track 8% rate.23Shaha our case, Surgical needs address Various surgical available tears, débridement, decompression, RSA, SCR.11Kang Sin A.T. Cheung tears: cost-effectiveness analysis.Orthopedics. 2017; 40: e65-e76https://doi.org/10.3928/01477447-20160926-06Crossref (22) Scholar,15Mihata Watanabe Ohue Tsujimura al.Clinical tears.Arthroscopy. 2013; 29: 459-470https://doi.org/10.1016/j.arthro.2012.10.022Abstract (460) Scholar,18Mulieri Dunning Klein Pupello D. Frankle arthritis.J 2010; 92: 2544-2556https://doi.org/10.2106/jbjs.i.00912Crossref Elderly lower demands relief concern suitable candidates débridement decompression if response conservative inadequate.11Kang unable RSA expanded indications various conditions patients.18Mulieri provides tears. reconstructions preferable absence good clinical tears.4Burkhart Mihata (ASCR) centralization lata, thereby increasing offering outcomes.15Mihata theoretically balances acting restores function. suturing residual stability.16Mihata McGarry M.H. Kahn Goldberg I. Neo Biomechanical continuity tendon.Am 1423-1430https://doi.org/10.1177/0363546516631751Crossref (152) biomechanical advantage force coupling improving subscapularis intact repaired.13Mihata comparison tear.Am 2020; 48: 3429-3438https://doi.org/10.1177/0363546520965993Crossref (18) leads SCR, lead imbalance couple.13Mihata Scholar,27Takayama Yamada Kobori temporal Hamada presence pseudoparalysis, status tendon.J 2021; 30: e659-e675https://doi.org/10.1016/j.jse.2021.04.019Abstract (5) couple Only ASCR Tajika tear.26Tajika Nishinaka Uehara Tsutsui tear: report.JBJS Case Connect. 8: e101https://doi.org/10.2106/jbjs.cc.17.00224Crossref effect grafted Remplissage capsule-tenodesis, glenoid.21Riff AJ, Frank RM, Sumner S, Friel N, Bach BR Jr, Verma NN, al. Trends stabilization techniques United States private-payer database. Med 2017;5:1-7. https://doi.org/10.1177/2325967117745511Google torn similar preventing rim. believe combination led although remains autograft appears useful stabilize improve help