ARTHROSCOPIC SHOULDER INSTABILITY SURGERY : Complications - 08/09/11

Doi : 10.1016/S0278-5919(05)70183-6

Benjamin S. Shaffer, MD ^a, James E. Tibone, MD ^b

^a Department of Orthopaedics, Georgetown University School of Medicine; and the Division of Sports Medicine, Georgetown University Medical Center, Washington, DC (BSS)

^b Department of Orthopaedic Surgery, University of Southern California School of Medicine, Los Angeles; and the Kerlan-Jobe Orthopaedic Clinic, Los Angeles, California (JET)

Resumen

“Those diseases which medicines do not cure, iron [scalpel] cures; those which iron cannot cure, fire [thermal devices] cures; and those which fire cannot cure, are to be reckoned wholly incurable.”

— HIPPOCRATES 400 BCE^{1 Hippocrates: Aphorisms by Hippocrates The Genuine Works of Hippocrates [Written 400 BCE; translated from the Greek by Francis Adams] New York: W. Wood and Co (1886).

Haga clic aquí para ir a la sección de Referencias}

In the nearly 2 decades since Johnson's^{37 Detrisac D.A., Johnson L.L. Arthroscopic shoulder capsulorrhaphy using metal staples Orthop Clin North Am 1993 ; 24 : 71-88

Haga clic aquí para ir a la sección de Referencias, 77 Johnson L: Arthroscopic management for shoulder instability: Stapling. Presented at the Arthroscopic Association of North America Specialty Day. Atlanta, February 1988

Haga clic aquí para ir a la sección de Referencias} pioneering efforts to arthroscopically correct shoulder instability, arthroscopic stabilization has received considerable attention. But despite the potential advantages of cosmesis, preservation of motion, and improved function, outcomes following arthroscopic stabilization have lagged behind expectations, with recurrence rates consistently higher than the 2% to 5% failure rate reported following open repairs.^{53 Geiger D.F., Hurley J.A., Torey J.A. , y al. Results of arthroscopic versus open Bankart suture repair Clin Orthop Rel Res 1997 ; 337 : 111-117 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 56 Gill T.J., Micheli L.J., Gebhard F. , y al. Bankart repair for anterior instability of the shoulder: Long-term outcome J Bone Joint Surg Am 1997 ; 6 : 850-857

Haga clic aquí para ir a la sección de Referencias, 103 Montgomery W.H., Jobe F.W. Functional outcomes in athletes after modified anterior capsulolabral reconstruction Am J Sports Med 1994 ; 22 : 352-358 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 134 Rowe C.R., Patel D., Southmayd W.W. The Bankart procedure: A long-term end-result study J Bone Joint Surg Am 1978 ; 60 : 1-16

Haga clic aquí para ir a la sección de Referencias, 172 Weber SA: A prospective evaluation comparing open and arthroscopic treatment of recurrent anterior glenohumeral dislocation. Presented at the 16th Annual Meeting of the American Orthopaedic Society for Sports Medicine. New Orleans, February 1990

Haga clic aquí para ir a la sección de Referencias} Other complications, including nerve injury, articular damage, stiffness, loose and migrating hardware, and foreign body reactions, are much less common and do not usually result in permanent disability. Complications are frequently technique-specific and can be prevented by familiarity with the common pitfalls inherent in each arthroscopic repair procedure. Complications can be further minimized through familiarity with normal, variational, and pathologic shoulder anatomy. This article reviews the documented complications of arthroscopic shoulder stabilization and emphasizes their causes and the strategies by which they may be minimized or avoided. Because most clinical experience and literature reviews involve the treatment of patients with anterior and anterior-inferior shoulder instability, the focus of this discussion is on errors and complications of these instability patterns.

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Esquema

Address reprint requests to Benjamin Shaffer, MD, Department of Orthopaedics, Georgetown University Medical Center, 3800 Reservoir Road NW, Washington, DC 20007