AJSM Webinar Series: Management of Anterior Shoulder Instability: A Highlight of the Top 4 Articles in AJSM (2024 to 2025)

Video Transcription

Video Summary

The webinar, hosted by AJSM and AOSSM, reviewed four key 2024-2025 studies on anterior shoulder instability, featuring expert surgeons discussing advanced surgical techniques and outcomes. Dr. Provencher presented a biomechanical study introducing the subtalar joint as a novel allograft for glenoid reconstruction, showing comparable effectiveness to the distal tibial allograft and improved congruency versus the traditional Latarjet procedure. Dr. McDonnell discussed the remplissage procedure combined with arthroscopic Bankart repair for patients with less than 15% glenoid bone loss, demonstrating reduced recurrence rates and improved mid-term outcomes compared to Bankart alone, highlighting the procedure's ease and effectiveness. Dr. Boileau reviewed long-term results (10+ years) of arthroscopic Latarjet surgery using cortical button fixation, showing low recurrence, high patient satisfaction, good bone block healing, and minimal osteoarthritis. Dr. Barth shared a 9+ year matched cohort study comparing isolated arthroscopic Bankart repair to open Latarjet in patients without bone loss, revealing significantly higher recurrence rates (20%) with Bankart, emphasizing the Latarjet as the gold standard for durable stability. The panel discussed critical bone loss thresholds, graft options, surgical learning curves, and the expanding role of remplissage. Key consensus included the superiority of bone augmentation procedures in significant bone loss, the safety and effectiveness of remplissage in suitable cases, and the importance of surgical volume and technique mastery to minimize complications and optimize outcomes.

Keywords

anterior shoulder instability

subtalar joint allograft

glenoid reconstruction

remplissage procedure

arthroscopic Bankart repair

Latarjet surgery

bone augmentation

surgical outcomes

shoulder surgery techniques