Issue link: https://viewer.e-digitaledition.com/i/1347209
Arthroscopic Shoulder Instability Repair: An Orthopedist Details Technical Factors for Success BY THOMAS CROCKER SUCCESSFUL ARTHROSCOPIC SHOULDER INSTABILIT Y REPAIR REQUIRES A CAREFULLY DE VISED SURGICAL PL AN FOCUSED ON SE VER AL TECHNICAL A SPECTS OF THE PROCEDURE, ACCORDING TO ONE E XPERT. "MANAGEMENT OF GLENOHUMER AL instability is one of the most challenging pathologies that shoulder surgeons encounter." That is the assessment of Walter B. McClelland, Jr., MD, FA AOS, an orthopedic surgeon specializing in hand, shoulder and elbow surgery at Atlanta's Peachtree Orthopedics, writing for American Academy of Orthopaedic Surgeons (A AOS) news magazine AAOS Now. Dr. McClelland serves as the current chair of the A AOS Shoulder & Elbow Evaluations Committee and is president-elect of the Georgia Shoulder & Elbow Society. In a recent article for the magazine, Dr. McClelland points to the variability in patient anatomy and overall health as testing factors for surgeons when treating shoulder instability. This condition is characterized by complete or partial dislocation of the joint, often due to trauma or overuse. If conservative treatment proves ineffective or is not indicated, surgeons may choose to perform open or arthroscopic repair. The latter is challenging and once had higher rates of recurrent instability, according to Dr. McClelland, but it has now achieved parity with open repair. In a 2017 study published in The Open Orthopaedics Journal, researchers in Portugal note that "[i]n a recent systematic review, the rate of recurrent instability after arthroscopic procedures was not statistically different from the recurrence rate after open procedures." For patients, the stakes of surgery, regardless of approach, are high — 5% to 30% of primary open or arthroscopic procedures for shoulder instability are unsuccessful, according to the Portuguese study. SPECIAL CLINICAL SECTION: ORTHOPEDICS 2 2