Revision arthroscopic soft-tissue stabilization for failed coracoid transfer yields low recurrence and high sports return rates.

BACKGROUND

The coracoid process transfer, such as the Bristow or Latarjet procedure, is standard procedure for cases of anterior shoulder instability with large bone defects. However, the revision surgery for failed coracoid transfer was challenging. The purpose of this study was to retrospectively assess the clinical outcomes after arthroscopic soft-tissue stabilization for failed coracoid transfer.

METHODS

This retrospective study assessed patients who underwent arthroscopic soft-tissue shoulder stabilization for failed coracoid transfer at our institute between January 2008 and December 2021 with at least 2 years of follow-up. Patients' demographics, radiographic findings, intraoperative findings, clinical outcomes (Rowe scores, Subjective Shoulder Value, and the visual analog scale for pain), and return to play sports were investigated.

RESULTS

This study included fifteen shoulders in fifteen patients (14 males and 1 female) with a mean age of 30 years (range, 18-51 years). Fourteen (93%) patients participated in sports activities. The average time between the initial and revision surgeries was 107 months (range, 24-360 months) with a follow-up of 46 months (range, 24-120 months). Preoperative computed tomographic showed graft nonunion in nine (60%) shoulders, graft malposition in five (33%) shoulders, and hardware complications in five (33%) shoulders. Intraoperative findings demonstrated an unrepaired Bankart lesion in 14 (93%) patients and a capsular tear in one (7%) patient. Rowe score, Subjective Shoulder Value, and pain visual analog scale significantly improved postoperatively ( < .001 for each). Twelve of 14 patients (86%) returned to sports activity at a complete or near-preinjury level. One (7%) patient experienced redislocation that required revision surgery and two (13%) experienced axial nerve palsy.

CONCLUSION

All shoulders with failed coracoid transfer had an unrepaired Bankart lesion except one shoulder with a capsular tear. Arthroscopic soft-tissue stabilization combined with selective augmentations yielded good clinical outcomes, demonstrated by a low recurrence rate, high return to play sports rate, and good shoulder function.