• Frank Hoffmann.
• Klinik für Orthopädie und Sportorthopädie, Pettenkoferstrasse 10, D-83022 Rosenheim. Orthopaedie@kliro.de
• Oper Orthop Traumatol. 2006 Jun 1; 18 (2): 101-19.

ObjectiveArthroscopic refixation of the labrum-ligament complex at the glenoid.IndicationsPosttraumatic anterior or anterior-inferior shoulder instability with Bankart or ALPSA lesion (anterior labral periosteal sleeve avulsion).ContraindicationsAtraumatic shoulder instability. Instabilities due to blunted or frayed degeneration of the labrum-ligament complex. HAGL lesion (humeral avulsion of the glenohumeral ligaments) with humeral detachment of the glenohumeral ligaments. Larger bony glenoid defects.Surgical TechniqueMobilization of the labrum-ligament complex from the neck of the glenoid, superior tightening and refixation at the glenoid rim with the aid of absorbable suture anchors.Postoperative ManagementImmobilization of the affected arm for 4 weeks in an immobilization bandage with abduction pillows. Daily pendulum exercises. Active flexion up to 70 degrees and abduction up to 40 degrees, all in neutral or internal rotation. Avoidance of external rotation for a total of 6 weeks.ResultsFrom January 1999 to December 2001, 58 patients with a Bankart or ALPSA lesion were treated with arthroscopic shoulder stabilization using absorbable suture anchors and slowly absorbable braided sutures. 56 patients underwent a follow-up clinical examination after, on average, 31 months (24-48 months). None of these patients had suffered more than five shoulder dislocations before the operation (average 2.8). Of the intraoperative lesions, a plain Bankart lesion was present in twelve patients (21.4%), 44 patients had an ALPSA lesion (78.6%), of which one in two were combined with an SLAP 2 or SLAP 3 lesion (superior labrum from anterior to posterior). In the evaluation using the Rowe Score, there was an excellent result for 40 patients (71.4%), and a good result for twelve (21.4%). Four patients suffered a repeat dislocation and were therefore classified as poor results (7.2%).

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