Arthroscopic treatment of traumatic shoulder dislocation with TAG tissue anchor

Aim The main evaluation limit of the results reported in the scientific literature is the unhomogeneous selection of the patients. In fact, it is the anatomopathological lesion that influences the prognosis, and not the surgical approach. This study evaluated the clinical effectiveness of arthroscopic gleno-humeral stabilization using TAG tissue anchor. Methods. Between 1998 and 2004 in our center we treated 231 patients with arthroscopic stabilization of the gleno-humeral joint. Exclusion criteria were multidirectional instability, engaged Hill Sachs lesion, bony Bankart inverted pear, voluntary dislocators, HAGL lesion, SLAP lesion, cuff tear, age > 30 years, incomplete documentation, follow up < 2 years. Inclusion criteria was the use of TAG tissue anchor. The average age at the time of operation was 26.2 +/- 5.3 years, the average interval from operation to the final evaluation was 33.6 +/- 19.2 months. The ROWE, Constant, UCLA tests and the clinical test of instability were recorded preoperatively and at the final evaluation. Results. Ninety-nine patients corresponded to the inclusion criteria, but we could re-examine only 61 of them. Preoperatively apprehension and relocation tests were positive in 58 patients, sulcus; sign in 24 and load and shift in 32. Two patients had postoperative instability symptoms (1.2% P<0.01): 1 patient with dislocation, with apprehension, relocation and load and shift sign, and 1 with subluxation, with apprehension and relocation sign. The mean ROWE score improved from 28.3 to 95.8 (P<0.01), the UCLA score from 23.6 to 33.4 (P<0.01), the Constant score from 71.2 to 90.7 (P<0.01). The external rotation had an average limitation of 2% (P<0.01). Conclusion. On the basis of our case series, in isolated Bankart lesion the arthroscopic repair shows the same frequence of recurrences as the open technique, but allows a better range of motion. When there are the right indications, this technique should be preferred.