| Autor: |
Peebles LA; Steadman Philippon Research Institute, Vail, Colorado, U.S.A., Aman ZS; Steadman Philippon Research Institute, Vail, Colorado, U.S.A., Preuss FR; University of Virginia School of Medicine, Charlottesville, Virginia, U.S.A., Samuelsen BT; The Steadman Clinic, Vail, Colorado, U.S.A., Zajac TJ; The Steadman Clinic, Vail, Colorado, U.S.A., Kennedy MI; Steadman Philippon Research Institute, Vail, Colorado, U.S.A., Provencher MT; Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A. |
| Abstrakt: |
Recurrent multidirectional shoulder instability (MDI) is a challenging clinical problem, particularly in the setting of connective tissue diseases, and there is a distinct lack of literature discussing strategies for operative management of this unique patient group. These patients frequently present with significant glenoid bone loss, patulous and abnormal capsulolabral structures, and a history of multiple failed arthroscopic or open instability procedures. Although the precise treatment algorithm requires tailoring to the individual patient, we have shown successful outcomes in correcting recurrent MDI in the setting of underlying connective tissue disorders by means of a modified T-plasty capsular shift and rotator interval closure in conjunction with distal tibial allograft bony augmentation. The purpose of this Technical Note was to describe a technique that combines a fresh distal tibial allograft for glenoid bony augmentation with a modified T-plasty capsular shift and rotator interval closure for the management of recurrent shoulder MDI in patients presenting with Ehlers-Danlos syndrome or other connective tissue disorders after failed Latarjet stabilization. |
