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The University of Western Australia, Perth, Australia
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Clinique Victor Hugo, 5 Bis rue du Dôme 75016 Paris, France
American Hospital of Paris, 55 Boulevard du Château, 92200 Neuilly-sur-Seine, France
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Shoulder, Elbow Unit, Sportsclinicnumber1, Papiermuehlestrasse 73, 3014 Bern, Switzerland
Shoulder, Elbow and Orthopaedic Sports Medicine, Department of Orthopaedic Surgery and Traumatology, Inselspital, Bern University Hospital, Bern, Switzerland
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Royal Perth Hospital, Perth, Australia
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Chronic traumatic anterior shoulder instability can be defined as recurrent trauma-associated shoulder instability requiring the assessment of three anatomic lesions: a capsuloligamentous and/or labral lesion; anterior glenoid bone loss and a Hill–Sachs lesion.
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Surgical treatment is generally indicated. It remains controversial how risk factors should be evaluated to decide between a soft-tissue, free bone-block or Latarjet-type procedure.
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Patient risk factors for recurrence are age; hyperlaxity; competitive, contact and overhead sports. Trauma-related factors are soft tissue lesions and most importantly bone loss with implications for treatment.
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Different treatment options are discussed and compared for complications, return to sports parameters, short- and long-term outcomes and osteoarthritis.
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Arthroscopic Bankart and open Latarjet procedures have a serious learning curve. Osteoarthritis is associated with the number of previous dislocations as well as surgical techniques.
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Latarjet-type procedures have the lowest rate of dislocation recurrence and if performed correctly, do not seem to increase the risk of osteoarthritis.
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revision rates in the meta-analysis by Zumstein et al were 24% and 10%, respectively. 14 The impact of the learning curve on complication rates is unclear. 19 , 20 Groh et al reported an overall complication rate of 7%, and failed to show an
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, as concluded by the authors, the congruent-arc modification is potentially less tolerant of screw-positioning error, which is a relevant finding given that the Latarjet procedure has been proven to have a long learning curve. Ekhtiari et al, 34
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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during July 2003 and March 2007. They noticed a fall in percentage of complications from 19% to 10%, mainly because of a lower rate of infection and instability. 21 The complication-related learning curve diminishes with an increase in the surgeon
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( 39 , 40 ). Various factors must be taken into account, such as learning curves, surgeon adaptation to the system, and time required for setting up additional devices in the operating room ( 41 ). Further research is required to determine whether
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Trauma and Orthopedics Department, Centre of Posgraduate Medical Education, Otwock, Poland
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. Choi S Bae JH Kwon YS & Kang H . Clinical outcomes and complications of cementless reverse total shoulder arthroplasty during the early learning curve period . Journal of Orthopaedic Surgery and Research 2019 14 53 . ( https://doi.org/10
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with a steep learning curve, and other authors found difficulty in achieving the satisfactory results reported by these authors. The remplissage procedure described by Purchase et al 20 in 2008 converts an intra-articular HSD into an extra
Faculty of Medicine, University of Geneva, Switzerland
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Affidea Centre de Diagnostic Radiologique de Carouge CDRC, Geneva, Switzerland
Department of Surgical Sciences, Uppsala University, Sweden
Department of Neuroradiology, University Hospital Freiburg, Germany
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Medical Research Department, Artanim Foundation, Geneva, Switzerland
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Benchouk S Kherad O Lädermann A . Comparison of arthroscopic and open Latarjet with a learning curve analysis . Knee Surg Sports Traumatol Arthrosc 2016 ; 24 ( 2 ): 540 - 545 . 47. Chen L Xu Z Peng J
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Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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. Kautzner J Zeman P Stančák A Havlas V . Hip arthroscopy learning curve: a prospective single-surgeon study . Int Orthop 2018 ; 42 : 777 – 782 . 64. Galatz LM . Editorial commentary: open versus
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Procedure: My Learning Curve In: Shoulder Concepts: Arthroscopy, Arthroplasty & Fractures. Ed. P Boileau. Sauramps Medical 6 2014 . 34036113 7. Gilat R Lavoie-Gagne O Haunschild ED Knapik DM Parvaresh KC Fu MC Forsythe B Verma N Cole
