Anterior shoulder instability: comparison between Latarjet open procedure and arthroscopic capsuloplasty.

BACKGROUND: Latarjet surgery and capsuloplasty are both valid alternatives for the treatment of anterior shoulder instability with limited glenoid bone loss, although in literature there is extensive discussion on it. The purpose of this study was to compare the outcomes of these procedures in patients with similar lesions. METHODS: Between January 2000 to October 2020, 59 nonconsecutive patients suffering from anterior shoulder instability were treated, 33 had arthroscopic capsuloplasty (Group 1) and 26 had open Latarjet procedure (Group 2). The Group 1 was composed by 12% of female and 88% of males with the mean age at surgery 25.6 +/- 9.07 (15-49 years). In the Group 2, the 100% of patients were males with mean age 32.42 +/- 10.74 (16-56). Rowe Score, UCLA score and WOSI score were used to test patients. RESULTS: Only UCLA (average was 22.18 ± 6.13 for the Capsuloplasty and 26.76 ± 6.57 in the Latarjet, p = 0.01) and ROWE scores (average was 70.15 ± 24.75 in Latarjet and 50.15 ± 24.70 in Capsuloplasty, p = 0.002) showed a statistically significant difference between the two procedures, while the WOSI (mean results of Latarjet 0.31 ± 0.16 against 0.24 ± 0.09 of the capsuloplasty, p = 0.069) there was no significant difference between the two groups in question. CONCLUSIONS: Apparently, the Latarjet surgery is better in terms of instability recurrence compared to capsuloplasty but has higher rate of shoulder joint osteoarthtritis. However, there are no significant differences that could decree which procedure is better. (www.actabiomedica.it).

The treatment of irreparable massive rotator cuff tears with inspace balloon: rational and medium-term results.

BACKGROUND AND AIM: The treatment of irreparable massive rotator cuff tears (MIRCTs) represents a challenge for the orthopedic surgeon both for the affected population and for the intrinsic characteristics of the injury. There are different types of treatment ranging from bursectomy to reverse shoulder prosthesis and subacromial spacers. The aim of the work is to establish the clinical and functional improvement of patients treated with subacromial spacer. METHODS: we conducted 2 studies: the first analyzing a sample of 24 patients (14 females and 10 male, mean age 65.7 years) operated between 2015 and 2017 whose last follow up dates back to October 2021 and a second one analyzing 55 patients (including patients of the first sample) (30 females and 25 males, mean age 64 years) over a period of time from 2015 to 2021. The mean follow up was 56 months. All patients were diagnosed with irreparable massive rotator cuff  tears and treated with subacromial spacer. RESULTS: the result in both studies was an increase of Constant score, tripled from the pre-operative values, in ROM, doubled, and a reduction of VAS. CONCLUSIONS: the clinical results are encouraging and the use of the subacromial spacer could be a valid surgical alternative for patients with MIRCTs.  However, we needed randomized trials with long-term follow-up.