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Current Trends and Innovations in Arthroscopic Shoulder Surgery
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Current Trends and Innovations in Arthroscopic Shoulder Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 30 January 2025 | Viewed by 4784

Special Issue Editors

Prof. Dr. Markus Scheibel

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Guest Editor
1. Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland
2. Department of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin Berlin, Berlin, Germany
Interests: shoulder joint; scapula; shoulder dislocation; acromioclavicular joint instability; arthroscopic rotator cuff repair; arthroscopy
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Sebastian Siebenlist

E-Mail Website
Guest Editor
Department of Sports Orthopeadics, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Straße 22, 81675 Munich, Germany
Interests: elbow joint; shoulder joint; orthopedic trauma; rotator cuff injury; arthroscopic surgery
Dr. Lucca Lacheta

E-Mail Website
Guest Editor
Department of Sports Orthopeadics, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Straße 22, 81675 Munich, Germany
Interests: shoulder joint; elbow joint; orthopedic surgery; arthroscopic surgery; traumatology

Special Issue Information

Dear Colleagues,

Over the past two decades, reconstructive procedures of the shoulder and adjacent joints have become increasingly popular worldwide and are currently predominantly carried out arthroscopically or via minimally invasive procedures. This was made possible in particular by the better understanding of pathomorphological changes in various shoulder diseases and the development of novel implants, instruments and surgical techniques.

The focus of rotator cuff surgery has primarily been on biomechanical and clinical studies that have examined the value of various reattachment techniques. Despite the establishment of highly stable constructs, clinical outcomes have not improved significantly. The level of primary stability has probably been reached or even exceeded here and the future will involve the biological enhancement of the reconstruction in order to further reduce the rate of re-tears. New approaches exist primarily in the joint-preserving treatment of irreparable or partially repairable ruptures. Different superior capsular reconstruction techniques and modern muscle transfer options to replace or augment the insufficient musculotendinous units of the rotator cuff are currently being tested in clinical research and are increasingly transitioning to clinical practice. Modern methods of capsular labrum reconstruction in the treatment of shoulder instability are now part of the standard arthroscopic repertoire and it is hoped that if the indication is correct, the recurrence rates can be further reduced in the long term. The quantification and consideration of significant bony defects in the shoulder joint make a decisive contribution to the success of the surgical treatment of shoulder instability.

Huge progress has also been made in traumatological shoulder surgery in recent years. While the treatment of glenoid and greater tuberosity fractures has long been carried out arthroscopically with very good clinical results, the range of indications for minimally invasive techniques has also been expanded to include more complex fracture situations of the scapula. The same applies to the the treatment of lateral clavicle fractures and acromioclavicular joint sprains. Arthroscopic or arthroscopic-assisted techniques avoid extensive soft tissue preparation with relevant access morbidity, and allow for the simultaneous treatment of accompanying glenohumeral pathologies. Obligatory second interventions can also be avoided.

The aim of this Special Issue is to give you an overview of established approaches and current innovations in reconstructive shoulder surgery.

With this in mind, we hope you enjoy reading through the following articles.

Prof. Dr. Markus Scheibel
Prof. Dr. Sebastian Siebenlist
Dr. Lucca Lacheta
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • shoulder and adjacent joints
  • arthroscopic surgery
  • rotator cuff surgery
  • reconstructive shoulder surgery
  • minimally invasive surgery

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Published Papers (4 papers)

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Research

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11 pages, 643 KiB  
Article
Concomitant Glenohumeral Pathologies in Patients with Acromioclavicular Joint Dislocations: How Do Acute and Chronic Instabilities Differ?
by Philipp Vetter, Manije Massih, Frederik Bellmann, Larissa Eckl, Philipp Moroder, Asimina Lazaridou and Markus Scheibel
J. Clin. Med. 2024, 13(6), 1723; https://doi.org/10.3390/jcm13061723 - 17 Mar 2024
Cited by 1 | Viewed by 935
Abstract
Background: Concomitant glenohumeral pathologies may be present in patients with acromioclavicular joint (ACJ) dislocations. This study aims to record and compare the prevalence and treatment of CGP in cases with acute and chronic ACJ dislocations. Methods: This retrospective cross-sectional binational, bicentric study included [...] Read more.
Background: Concomitant glenohumeral pathologies may be present in patients with acromioclavicular joint (ACJ) dislocations. This study aims to record and compare the prevalence and treatment of CGP in cases with acute and chronic ACJ dislocations. Methods: This retrospective cross-sectional binational, bicentric study included patients that underwent arthroscopically assisted stabilization for acute (group A) and chronic (group C) ACJ dislocations. Intraoperatively, CGPs and eventual treatments (debridement and reconstructive measures) were recorded. Results: The study included 540 patients (87% men; mean age 39.4 years), with 410 (75.9%) patients in group A and 130 (24.1%) in group C. Patients in group C were older (p < 0.001). The CGP prevalence was 30.7%, without a difference between groups A and C (p = 0.19). Supraspinatus tendon (SSP) and labral lesions were most common. Within group C, CGPs were more prevalent in surgery-naïve patients (p = 0.002). Among 49 patients with previous surgical treatment, CGPs tended to be more common in patients with prior open surgery than arthroscopically assisted surgery (p = 0.392). Increased CGP prevalence was associated with higher age (r = 0.97; p = 0.004) (up to 63% in the oldest age group, but also 17% for youngest age group) and higher in cases with Rockwood type-IIIB injuries compared to type-V injuries (p = 0.028), but type-IIIB injuries included more group C cases (p < 0.001). The most frequently found CGPs were treated by debridement rather than reconstructive interventions (SSP and labrum: p < 0.001, respectively). Conclusions: This study shows that one in three patients with ACJ instabilities has a CGP, especially elderly patients. Most of the CGPs were treated by debridement rather than constructive interventions. Full article
(This article belongs to the Special Issue Current Trends and Innovations in Arthroscopic Shoulder Surgery)
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11 pages, 3447 KiB  
Article
All-Suture Anchor vs. Knotless Suture Anchor for the Treatment of Anterior Shoulder Instability—A Prospective Cohort Study
by Marvin Minkus, Annette Aigner, Julia Wolke and Markus Scheibel
J. Clin. Med. 2024, 13(5), 1381; https://doi.org/10.3390/jcm13051381 - 28 Feb 2024
Viewed by 1248
Abstract
All-suture or soft-anchors (SA) represent a new generation of suture anchor technology with a completely suture-based system. This study’s objective was to assess Juggerknot® SA, for arthroscopic Bankart repair in recurrent shoulder instability (RSI), and to compare it to a commonly performed [...] Read more.
All-suture or soft-anchors (SA) represent a new generation of suture anchor technology with a completely suture-based system. This study’s objective was to assess Juggerknot® SA, for arthroscopic Bankart repair in recurrent shoulder instability (RSI), and to compare it to a commonly performed knotless anchor (KA) technique (Pushlock®). In a prospective cohort study, 30 consecutive patients scheduled for reconstruction of the capsulolabral complex without substantial glenoid bone loss were included and operated on using the SA technique. A historical control group was operated on using the KA technique for the same indication. Clinical examinations were performed preoperatively and 12 and 24 months postoperatively. RSI and WOSI at 24 months were the co-primary endpoints, evaluated with logistic and linear regression. A total of 5 out of 30 (16.7%) patients suffered from RSI in the SA group, one out of 31 (3.2%) in the KA group (adjusted odds ratio = 10.12, 95% CI: 0.89–115.35), and 13.3% in the SA group and 3.2% in the KAgroup had a revision. The median WOSI in the SA group was lower than in the KA group (81% vs. 95%) (adjusted regression coefficient = 10.12, 95% CI: 0.89–115.35). Arthroscopic capsulolabral repair for RSI using either the SA or KA technique led to satisfying clinical outcomes. However, there is a tendency for higher RSI and lower WOSI following the SA technique. Full article
(This article belongs to the Special Issue Current Trends and Innovations in Arthroscopic Shoulder Surgery)
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Review

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14 pages, 2304 KiB  
Review
Patch Augmentation in Arthroscopic Rotator Cuff Surgery—Review of Current Evidence and Newest Trends
by Maximilian Russo, Gert Karl Dirkx and Claudio Rosso
J. Clin. Med. 2024, 13(17), 5066; https://doi.org/10.3390/jcm13175066 - 27 Aug 2024
Cited by 1 | Viewed by 1326
Abstract
Background: Rotator cuff tears are a common and debilitating condition requiring surgical intervention. Arthroscopic rotator cuff repair is essential for restoring shoulder function and alleviating pain. Tear classification by size and tendon retraction, along with the grade for fatty infiltration, influence postoperative outcomes, [...] Read more.
Background: Rotator cuff tears are a common and debilitating condition requiring surgical intervention. Arthroscopic rotator cuff repair is essential for restoring shoulder function and alleviating pain. Tear classification by size and tendon retraction, along with the grade for fatty infiltration, influence postoperative outcomes, with large tears and higher fatty infiltration grades linked to higher retear rates. Managing complex tears is challenging, with failure rates ranging from 20 to 94%. Patch augmentation has emerged as a promising strategy, using biological or synthetic materials to reinforce tendon repairs, enhancing structural integrity and reducing retear risk. Methods: A review of the recent literature from January 2018 to March 2024 was conducted using PubMed/MEDLINE, Embase, and Web of Science. Keywords included “rotator cuff tear”, “rotator cuff augmentation”, “rotator cuff patch”, “tendon augmentation”, “massive rotator cuff tear”, “patch augmentation”, and “grafts”. Relevant articles were selected based on their abstracts for a comprehensive review. Results: Initial methods used autograft tissues, but advances in biomaterials have led to standardized, biocompatible synthetic patches. Studies show reduced retear rates with patch augmentation, ranging from 17 to 45%. Conclusions: Patch augmentation reduces the retear rates and improves tendon repair, but complications like immune responses and infections persist. Cost-effectiveness analyses indicate that while initial costs are higher, long-term savings from reduced rehabilitation, revision surgeries, and increased productivity can make patch augmentation economically beneficial. Full article
(This article belongs to the Special Issue Current Trends and Innovations in Arthroscopic Shoulder Surgery)
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Other

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17 pages, 1565 KiB  
Systematic Review
Is Revision Arthroscopic Bankart Repair a Viable Option? A Systematic Review of Recurrent Instability following Bankart Repair
by Alexander Baur, Jasraj Raghuwanshi and F. Winston Gwathmey
J. Clin. Med. 2024, 13(11), 3067; https://doi.org/10.3390/jcm13113067 - 23 May 2024
Cited by 1 | Viewed by 822
Abstract
Background/Objectives: Recurrent shoulder instability following Bankart lesion repair often necessitates surgical revision. This systematic review aims to understand the failure rates of arthroscopic revision Bankart repair. Methods: Following the PRISMA guidelines and registered on PROSPERO, this systematic review examined twenty-five articles [...] Read more.
Background/Objectives: Recurrent shoulder instability following Bankart lesion repair often necessitates surgical revision. This systematic review aims to understand the failure rates of arthroscopic revision Bankart repair. Methods: Following the PRISMA guidelines and registered on PROSPERO, this systematic review examined twenty-five articles written between 2000 and 2024. Two independent reviewers assessed eligibility across three databases, focusing on recurrent instability as the primary endpoint, while also noting functional measures, adverse events, revision operations, and return-to-sport rates when available. Results: The key surgical techniques for recurrent instability post-Bankart repair were identified, with revision arthroscopic Bankart being the most common (685/1032). A comparative analysis revealed a significantly lower recurrence for open coracoid transfer compared to arthroscopic revision Bankart repair (9.67% vs. 17.14%; p < 0.001), while no significant difference was observed between remplissage plus Bankart repair and Bankart repair alone (23.75% vs. 17.14%; p = 0.24). The majority of studies did not include supracritical glenoid bone loss or engaging Hill–Sachs lesions, and neither subcritical nor non-engaging lesions significantly influenced recurrence rates (p = 0.85 and p = 0.80, respectively). Conclusions: Revision arthroscopic Bankart repair remains a viable option in the absence of bipolar bone loss; however, open coracoid transfer appears to have lower recurrence rates than arthroscopic Bankart repair, consistent with prior evidence. Further studies should define cutoffs and investigate the roles of critical glenoid bone loss and off-track Hill–Sachs lesions. Preoperative measurements of GBL on three-dimensional computed tomography and characterizing lesions based on glenoid track will help surgeons to choose ideal candidates for arthroscopic revision Bankart repair. Full article
(This article belongs to the Special Issue Current Trends and Innovations in Arthroscopic Shoulder Surgery)
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