Arthroscopic Bankart Repair Using a Lasso-Loop Stitch

Anterior inferior shoulder dislocation is a common injury. After primary traumatic shoulder dislocation and conservative treatment, the risk of re-dislocation is very high in patients younger than 35 years. With age, the risk of re-dislocation after traumatic shoulder dislocation and conservative treatment decreases. Surgical treatment via either open or arthroscopic stabilization minimizes the risk of re-dislocation. Today, anterior shoulder stabilization by arthroscopic refixation of the labroligamentous complex with suture anchors is a standard procedure, if there is no severe chronic bony defect at the glenoid site. Lafosse et al. described the so-called „Lasso-loop stitch“. This technique allows for positioning of the knot away from the joint and at the same time it establishes a labral bump that stabilizes the humeral head against (sub)luxation. The surgical principle and aim consist of refixation of the anterior labrum-capsule-ligament complex to the glenoid with positioning of the knot at distance to the joint as well as bulging up the labrum. This stabilizes the shoulder joint and therefore avoids further dislocations and associated pathologies. The aim of this work is to give an illustrated instruction of the surgical technique of arthroscopic Bankart repair using the lasso-loop stitch.

Cine-mr imaging of the shoulder

Purpose: Shoulder lesions are usually examined with the joint in only one or two positions. We examined the shoulder with the joint in a variety of positions. We also assessed the application of cine-MR to the detection of instability and impingement Material and Methods: the cine-MR examinations were performed in 30 patients and 15 healthy volunteers. We used an open 0.2 T system and a closed 1.0 T system. Spoiled gradient echo 2D T1-weighted images and turbo spin-echo T1- and T2-weighted images were obtained with a field of view of 180 mm. the examinations were videotaped and evaluated later Results: Normal variations of the glenohumeral joint were easy to recognize. Subluxations and luxations of the humeral head as well as rupture of the labrum were identified. It was also possible to identify the labrum with a signal change after arthroscopic refixation. and we were able to objectively assess distances between the osseous structures during dynamic movement Conclusion: Unlike static MR, cine-MR would appear to be useful in visualizing the capsular ligament complex of the gleno-humeral joint in impingement and instability. It also provides information on dynamic changes and may thus prove to be an important tool for shoulder diagnostics. the method may provide an early diagnosis in the sub-acromial impingement syndrome