Chapter 3 Instability

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CHAPTER 3 | Instability

FIGURE 3-131  Left shoulder, anterosuperolateral viewing portal. A: Arthroscopic Bankart repair. B: Arthroscopic remplissage. G, glenoid; H, humeral head.

Imaging: ■ X-rays are normal. ■ MRI scan showed a nondisplaced Bankart lesion and a type II SLAP lesion (Fig. 3-132). Arthroscopic Findings: ■ Bankart lesion was repaired by a knotless tech- nique with LabralTape and PushLock suture anchors (Arthrex, Inc., Naples, FL) (Fig. 3-133). ■ Type II SLAP lesion was repaired with LabralTape passed as a vertical mattress suture and fixed with a PushLock suture anchor (Fig. 3-134).

■ Torn superior glenohumeral ligament (SGHL) was also fixed with LabralTape and PushLock (Fig. 3-135).

Pearls, Pitfalls, and Decision-making: ■ Even though this is a first-time dislocation in a 37-year- old man, we elected arthroscopic repair because of his extremely demanding occupation (SWAT team officer). ■ For isolated SLAP lesions in patients over the age of 35, we usually perform biceps tenodesis rather than SLAP repair. However, when a SLAP lesion occurs in an anterior instability patient in association with a Bankart lesion, the SLAP is one of the components of

FIGURE 3-132  MRI. A: Coronal view shows a type II SLAP lesion. B: Axial view shows a Bankart lesion.